Note 335 — THIRD SECTION. Relation of the Physician to Diseases consequent upon the Use or Misuse of the Genital Organs.

Galen, De loc. affect. bk. I. ch. 1. (VIII. p. 12.), οὕτω δὲ εἰ καὶ σάρκα τινὰ δι᾽ ἕλκωσιν ἐπιτραφεῖσαν ἡγούμεθα τὸν τράχηλον τῆς κύστεως ἐμφράττειν, ἔκ τε τῶν προηγησαμένων τοῦ ἕλκους σημείων ἔκ τε τοῦ κενωθῆναι τὸ οὖρον ἐπὶ τῷ καθετηρι συλλογιούμεθα· καί ποτε καὶ γενόμενον οἶδα τοιοῦτόν τι πάθημα· διαβαλλομένου γοῦν τοῦ καθετῆρος, ἤλγησεν κατ’ἐκεῖνο τοῦ πόρου τὸ μέρος, ἔνθα καὶ πρότερον ἐτεκμηράμεθα τὴν ἕλκωσιν εἶναι· θλασθείσης δὲ τῆς σαρκὸς ὑπὸ τοῦ καθετῆρος, ἠκολούθησε μὲν μετὰ τὴν τῶν οὔρων ἔκκρισιν αἵματός τέ τι καὶ θρύμματα τῆς σαρκός· ... τὸ δ’εἴτε πάθος εἶναι λεκτέον τοῦ πόρου τὸ γεγονός, εἶτε αἴτιον ἰσχουρίας ἐν τῷ πόρῳ περιέχεσθαι, τῶν ἀχρήστων εἰς τὴν τέχνην ἐστίν. (Accordingly if we suspect some accretion of tissue, the result of ulceration, to be blocking the neck of the bladder, our diagnosis will depend both on the foregoing signs of the existence of an ulcer and also on the fact of the urine being voided on the introduction of a catheter. Sometimes moreover I have noted the following case to occur; on turning the catheter about pain was experienced at the part of the canal where we had previously conjectured the ulceration to be situated, and the tissue being broken down by the catheter, there followed after the evacuation of the urine some blood and particles of tissue.... Whether in this case we ought to describe the mischief as something affecting the urethral canal, or say that the cause is something lying in the same canal, is scientifically unimportant). For the catheter must always have the shape of the passage leading to the bladder (Method. med. bk. IV. ch. 7. X. p. 301.); accordingly it must be bent into the shape of the letter “S” (Introduct. ch. 19. Vol. XIV. p. 788). The inventor of it was Erasistratus (ibid. p. 751.). The employment of the catheter is well described by Paulus Aegineta bk. VI. ch. 59., who adds that different catheters must be used according to age and sex.