Flagstaff Hill Maritime Museum and Village
Equipment - Catheter, 20th century
... After World War II, Sir Ludwig Guttman introduced the concept of sterile intermittent catheterization in patients with spinal cord injury. For many years, sterile technique was used for catheterization. ...After World War II, Sir Ludwig Guttman introduced the concept of sterile intermittent catheterization in patients with spinal cord injury. For many years, sterile technique was used for catheterization. ...
The word “catheter” comes from Greek, meaning “to let or send down.” Catheters were used as early as 3,000 B.C. to relieve painful urinary retention. In those times, many materials were used to form a hollow catheter shape, including straw, rolled up palm leaves, hollow tops of onions, as well as, gold, silver, copper, brass, and lead.
Malleable catheters were developed in the 11th century. In time, silver was used as the basis of catheters as it could be bent to any desired shape and was felt to have an antiseptic function.
Benjamin Franklin, the inventor and colonial statesman, fashioned silver catheters for use by his older brother John. John suffered from kidney stones and needed to undergo a daily ritual of placing a bulky metal catheter into his bladder. To make these daily requirements on his brother less painful, Franklin worked with his local silversmith on his design for a flexible catheter. "It is as flexible as would be expected in a thing of the kind, and I imagine will readily comply with the turns of the passage," he wrote to John. Holes were bored into the sides of the catheter to allow for drainage.
Coudé tip catheters were developed in the 18th and 19th centuries to facilitate male catheterization and continue to be used for this purpose in current medical practice. Catheters made from rubber were developed in the 18th century but were weak at body temperature, leaving debris in the bladder. The advent of rubber vulcanization, by Goodyear in 1844, improved the firmness and durability of the catheter, and allowed for mass production. Latex rubber became available in the 1930s. Dr. Frederic E.B. Foley (a St. Paul urologist) introduced the latex balloon catheter at a urologic meeting in 1935. Though he lost a legal battle with Davol for the patent, this catheter has since been known as the “Foley.” The earliest self-retaining catheters had wing tips (called Malecot) or flexible shoulders (called Pezzer), and were tied to the male penis or sutured to the female labia.
Charriere’s French scale was used to describe the external diameter of a catheter. Thus the term “French (Fr)” size was coined. Joseph-Frederic-Benoit Charriere was a 19th century Parisian maker of surgical instruments. A 12 French catheter is approximately 4 mm in external diameter (0.33 mm = 1 French [Fr]). In French-speaking countries, these catheters may be referred to as the Charriere or abbreviated Ch. Catheterization of the bladder was felt to be fairly safe because of the antiseptic principles of Lister (1867). But many physicians continued to be concerned about catheter-related infections as patients were still developing “catheter fever” (systemic infection) despite antiseptic principles.
After World War II, Sir Ludwig Guttman introduced the concept of sterile intermittent catheterization in patients with spinal cord injury. For many years, sterile technique was used for catheterization. In 1971, Dr. Jack Lapides of the University of Michigan at Ann Arbor introduced the clean intermittent catheterization (CIC) technique. Dr. Lapides’ theory was that bacteria weren’t the only cause of infection. He believed that chronic stagnant urine residuals and overstretching of the bladder were also responsible. But the fact that CIC was not performed in totally sterile conditions, Dr. Lapides still felt it was superior to indwelling catheters. Initially, Lapides was scorned in the urology world. Three decades after this debate, clean intermittent catheterization remains the preferred method to treat chronic urine retention and neurogenic bladder. Recent regulatory changes have recommended against the reuse of catheters for CIC in an attempt to further reduce the risk of catheter-associated urinary tract infections.
https://www.urotoday.com/urinary-catheters-home/history-of-urinary-catheters.html
This catheter was donated to Flagstaff Hill Maritime Village by the family of Doctor William Roy Angus, Surgeon and Oculist. It is part of the “W.R. Angus Collection” that includes historical medical equipment, surgical instruments and material once belonging to Dr Edward Ryan and Dr Thomas Francis Ryan, (both of Nhill, Victoria) as well as Dr Angus’ own belongings. The Collection’s history spans the medical practices of the two Doctors Ryan, from 1885-1926 plus that of Dr Angus, up until 1969.
ABOUT THE “W.R.ANGUS COLLECTION”
Doctor William Roy Angus M.B., B.S., Adel., 1923, F.R.C.S. Edin.,1928 (also known as Dr Roy Angus) was born in Murrumbeena, Victoria in 1901 and lived until 1970. He qualified as a doctor in 1923 at University of Adelaide, was Resident Medical Officer at the Royal Adelaide Hospital in 1924 and for a period was house surgeon to Sir (then Mr.) Henry Simpson Newland. Dr Angus was briefly an Assistant to Dr Riddell of Kapunda, then commenced private practice at Curramulka, Yorke Peninsula, SA, where he was physician, surgeon and chemist.
In 1926, he was appointed as new Medical Assistant to Dr Thomas Francis Ryan (T.F. Ryan, or Tom), in Nhill, Victoria, where his experiences included radiology and pharmacy. In 1927 he was Acting House Surgeon in Dr Tom Ryan’s absence.
Dr Angus had become engaged to Gladys Forsyth and they decided he further his studies overseas in the UK in 1927. He studied at London University College Hospital and at Edinburgh Royal Infirmary and in 1928, was awarded FRCS (Fellow from the Royal College of Surgeons), Edinburgh. He worked his passage back to Australia as a Ship’s Surgeon on the on the Australian Commonwealth Line’s T.S.S. Largs Bay.
Dr Angus married Gladys in 1929, in Ballarat. (They went on to have one son (Graham 1932, born in SA) and two daughters (Helen (died 12/07/1996) and Berenice (Berry), both born at Mira, Nhill According to Berry, her mother Gladys made a lot of their clothes. She was very talented and did some lovely embroidery including lingerie for her trousseau and beautifully handmade baby clothes.
Dr Angus was a ‘flying doctor’ for the A.I.M. (Australian Inland Ministry) Aerial Medical Service in 1928. Its first station was in the remote town of Oodnadatta, where Dr Angus was stationed. He was locum tenens there on North-South Railway at 21 Mile Camp. He took up this ‘flying doctor’ position in response to a call from Dr John Flynn; the organisation was later known as the Flying Doctor Service, then the Royal Flying Doctor Service. A lot of his work during this time involved dental surgery also. Between 1928-1932 he was surgeon at the Curramulka Hospital, Yorke Peninsula, South Australia.
In 1933 Dr Angus returned to Nhill and purchased a share of the Nelson Street practice and Mira hospital (a 2 bed ward at the Nelson Street Practice) from Dr Les Middleton one of the Middleton Brothers, the current owners of what previously once Dr Tom Ryan’s practice.
Dr Tom and his brother had worked as surgeons included eye surgery. Dr Tom Ryan performed many of his operations in the Mira private hospital on his premises. He had been House Surgeon at the Nhill Hospital 1902-1926. Dr Tom Ryan had one of the only two pieces of radiology equipment in Victoria during his practicing years – The Royal Melbourne Hospital had the other one. Over the years Dr Tom Ryan had gradually set up what was effectively a training school for country general-practitioner-surgeons. Each patient was carefully examined, including using the X-ray machine, and any surgery was discussed and planned with Dr Ryan’s assistants several days in advance. Dr Angus gained experience in using the X-ray machine there during his time as assistant to Dr Ryan.
When Dr Angus bought into the Nelson Street premises in Nhill he was also appointed as the Nhill Hospital’s Honorary House Surgeon 1933-1938. His practitioner’s plate from his Nhill surgery is now mounted on the doorway to the Port Medical Office at Flagstaff Hill Maritime Village, Warrnambool.
When Dr Angus took up practice in the Dr Edward and Dr Tom Ryan’s old premises he obtained their extensive collection of historical medical equipment and materials spanning 1884-1926. A large part of this collection is now on display at the Port Medical Office at Flagstaff Hill Maritime Village in Warrnambool.
In 1939 Dr Angus and his family moved to Warrnambool where he purchased “Birchwood,” the 1852 home and medical practice of Dr John Hunter Henderson, at 214 Koroit Street. (This property was sold in1965 to the State Government and is now the site of the Warrnambool Police Station and an ALDI sore is on the land that was once their tennis court).
The Angus family was able to afford gardeners, cooks and maids; their home was a popular place for visiting dignitaries to stay whilst visiting Warrnambool. Dr Angus had his own silk worm farm at home in a Mulberry tree. His young daughter used his centrifuge for spinning the silk.
Dr Angus was appointed on a part-time basis as Port Medical Officer (Health Officer) in Warrnambool and held this position until the 1940’s when the government no longer required the service of a Port Medical Officer in Warrnambool; he was thus Warrnambool’s last serving Port Medical Officer. (Masters of immigrant ships arriving in port reported incidents of diseases, illness and death and the Port Medical Officer made a decision on whether the ship required Quarantine and for how long, in this way preventing contagious illness from spreading from new immigrants to the residents already in the colony.)
Dr Angus was a member of the Australian Medical Association, for 35 years and surgeon at the Warrnambool Base Hospital 1939-1942,
He served with the Australian Department of Defence as a Surgeon Captain during WWII 1942-45, in Ballarat, Victoria, and in Bonegilla, N.S.W., completing his service just before the end of the war due to suffering from a heart attack. During his convalescence he carved an intricate and ‘most artistic’ chess set from the material that dentures were made from.
He then studied ophthalmology at the Royal Melbourne Eye and Ear Hospital and created cosmetically superior artificial eyes by pioneering using the intrascleral cartilage. Angus received accolades from the Ophthalmological Society of Australasia for this work. He returned to Warrnambool to commence practice as an ophthalmologist, pioneering in artificial eye improvements. He was Honorary Consultant Ophthalmologist to Warrnambool Base Hospital for 31 years. He made monthly visits to Portland as a visiting surgeon, to perform eye surgery.
He represented the Victorian South-West subdivision of the Australian Medical Association as its secretary between 1949 and 1956 and as chairman from 1956 to 1958. In 1968 Dr Angus was elected member of Spain’s Barraquer Institute of Barcelona after his research work in Intrasclearal cartilage grafting, becoming one of the few Australian ophthalmologists to receive this honour, and in the following year presented his final paper on Living Intrasclearal Cartilage Implants at the Inaugural Meeting of the Australian College of Ophthalmologists in Melbourne
In his personal life Dr Angus was a Presbyterian and treated Sunday as a Sabbath, a day of rest. He would visit 3 or 4 country patients on a Sunday, taking his children along ‘for the ride’ and to visit with him. Sunday evenings he would play the pianola and sing Scottish songs to his family.
One of Dr Angus’ patients was Margaret MacKenzie, author of a book on local shipwrecks that she’d seen as an eye witness from the late 1880’s in Peterborough, Victoria. In the early 1950’s Dr Angus, painted a picture of a shipwreck for the cover jacket of Margaret’s book, Shipwrecks and More Shipwrecks. She was blind in later life and her daughter wrote the actual book for her.
Dr Angus and his wife Gladys were very involved in Warrnambool’s society with a strong interest in civic affairs. He had an interest in people and the community. They were both involved in the creation of Flagstaff Hill, including the layout of the gardens.
After his death (28th March 1970) his family requested his practitioner’s plate, medical instruments and some personal belongings be displayed in the Port Medical Office surgery at Flagstaff Hill Maritime Village, and be called the “W. R. Angus Collection”.
The W.R. Angus Collection is significant for still being located at the site it is connected with, Doctor Angus being the last Port Medical Officer in Warrnambool.
The collection of medical instruments and other equipment is culturally significant, being an historical example of medicine, administration, household equipment and clothing from late 19th to mid-20th century. Dr Angus assisted Dr Tom Ryan, a pioneer in the use of X-rays and in ocular surgery.
Stainless steel catheter with hollow tip from W.R. Angus Collection. Top and end of this instrument screw together.
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Flagstaff Hill Maritime Museum and Village