Rabie
E. Abdel-Halim*
Saudi
Medical Journal 1990; 11 (2): 87-88
In the
Graeco-Roman era and in the Middle Ages in Europe, S-shaped bronze catheters
with one terminal eye were in common use. In the East, the evolution of
urethral catheters started with the firm establishment of Moslem supremacy, and
by 1013, straight or one-curve catheters made of gold, silver, copper, lead or
salve of white lead with a rounded end and many side holes and a stylet were
the standard instruments. Then in Europe in 1853 a prototype of the Foley
catheter was designed. The next important evolutionary step was the rubber
catheter of Nelaton in 1873.
Due to the
frequent need to relieve an overfull bladder, the use of urethral catheters can
be traced back to antiquity. A bronze
S-shaped catheter with one terminal eye and size proportionate to age and sex1
was in common use since the Hippocratic period in Greece, or the days of
Charaka and Susruta in India2 and up to the seventh century AD.
3
From the ninth to the fourteenth century in Europe the development
of Graeco-Roman medicine came to an end and no progress was made in medical
science. 2-6 Meanwhile, in the East with the firm establishment of
Moslem supremacy, medicine along with other branches of knowledge were revived
and acquired a scientific nature. 4,7,8 Under this influence, in the
ninth century new catheters made of gold, silver and copper with only one curve
to follow the normal curvature of the male urethra and a smooth rounded
terminal end with many lateral holes were in use. 9 It had the
advantages of resisting encrustation by urine10 and far fewer
incidences of blockage. 9 Furthermore, a stylet in the lumen of the
catheter was first thought of and used by Al Razi (841-926 AD) to save the
patients the previous agonies of repeated catheterization due to blockage.
9
Then more malleable and subsequently safer catheters were made
first from lead by AI Razi, 9 afterwards from the salve of white
lead treated with ram blood to make it firmer so that it could be shaped, by
Ibn Sina (980-1037 AD). 11 Also the tanned skin of some marine or
wild animals was tried and the edges were joined by cheese or fish glue.
17 Meanwhile, the notion of a straight metal catheter was introduced and
designed by AI-Zahrawi (Albucasis) (930-1013 AD). 12 According to AI
Baghdady (1219 AD), 13 straight or curved metal catheters made of
gold, silver, copper or salve of white lead were more popular than the leather
ones as they were far smoother .
As the contributions of these scholars influenced the European
mediaeval schools of medicine well into the eighteenth century, 2,4,12
the metal catheters mentioned above, whether straight or curved, remained as
the standard instruments. 14,15 Then, as the nineteenth century in
Europe opened a period of ingenuity on the part of surgeons and surgical
instrument makers, 2,16 a prototype of the Foley catheter was
designed. 17 This was followed by many modifications, the most
important of which was the rubber catheter of Nelaton.18
References
1- Celsus
AC, De medicina (Spencer WG, trans). London: William Heinmann; Cambridge and
Massachusetts: Harvard University Press, 1938; 3: 425.
2- Desnos
EC. The history of urology up to the latter half of the nineteenth century .In:
Murphy LJT, ed. The history of urology. Springfield, Illinois: Charles C.
Thomas, 1972: 30,69, 152-155.
3- Paulus
Aegineta, The seven books of Paulus Aegineta. (Adams F, trans.) London: The
Syndenham Society, 1846; 2: 351.
4- Cumston
CG. An introduction to the history of medicine from the time of Pharaohs to the
end of the XVII century .In: Islamic medicine. London: Dawsons of Pall Mall,
1968: 187-200.
5- Bickers
W. Adventures in Arabian medicine. J R CoIl Surg Ireland 1969; 5: 5-14.
6- Margotta
R. The dark ages, the decline of Rome. In Lewis P, ed. An illustrated history
of medicine. Feltham, Middlesex: Paul Hamlyn, 1968: 100-105.
7- Dickinson
EH. The medicine of the Ancients. Liverpool: Adam Holden, 1875: 37-39.
8- Kirkup
JR. The history and evolution of surgical instruments. I. Introduction. Ann Roy
CoIl Surg Engl1981 ; 63: 279-285.
9- Al-Razi,
Abu Bakr Muhammad Ibn Zakariyya. Kitabul Hawi Fi-T Tibb (Rhazes Liber
continens), Ist edn. The Bureau, Osmania Oriental Publications Hyderabad:
Osmania University. 1961: 10; 164-166.
IO-
Wangesteen OH, Wangesteen Sarah D. The rise of surgery from empiric craft to
scientific discipline. Minneapolis: University of Minnesota Press, 1978: 91.
11- 1bn
Sina, Abu Ali Al-Husain Ibn Abdullah. Kitab al-Qanun fit-tibb. (Avicenna Canon
of Medicine) Beirut. Dar Sadir reprint of Bulaq edition. Cairo, 1877; 2:
522-523.
12-
Albucasis, (Abu'I-Qasim Khalaf Ibn Abbas Al Zahrawy). Albucasis on surgery and
instruments. A definitive edition of the Arabic text with English translation
and commentary by Spink MS, Lewis JL, eds. London: Publications on the history
of medicine. London: The Wellcome Institute, 1973: 403-405.
13-
AI-Baghdady, Abu AI-Hassan Ali Ibn Ahmad Ibn Ali Ibn Hubal. Kitab AL-Mukhtarat
Fil Tibb. The Bureau, Osmania Oriental Publications Hyderabad: Osmania
University, 1943; 3: 435-436.
14- Parey,
Ambrose. The works of that famous chirurgion Ambrose Paery, Translated out of
Latine and compared with the French by Tho. Johnson. London: Printed by Richard
Cotes and Willi Du-gard, 1649: 420.
15- Diderot
D, d' Alembert, J Le R. Encyclopedie ou dictionnaire raisonne des sciences.
Paris, 1751-1772, Anatomie Chirurgie. Faksimile-Oruck nach dem Originalen, bei
Antiqua-Verlag, Lindau i.B. 1978: 2 & Fig. 1-6, plate X (Chirurgie).
16- Ellis
HC. A history of bladder stone. Oxford: Blackwell Scientific Publications,
1969: 39.
17- Reybard
JF. Traite pratique des retrecissements du canal de l'uretre. Paris: Labe,
1853: 397-399, 600, Fig. 13, Pl.2.
18- Nelaton
A. In Desnos EC. The history of urology to the latter half of the nineteenth
century (Murphy T, trans. & ed.) Springfield, Illinois: Charles C Thomas,
1972: 155.
* King Abdul-Aziz University Hospital, PO Box 6615, Jeddah 21452, Saudi Arabia
Rabie El-Said Abdel-Halim, FRCS Ed, Professor of Urology