Between history, art and medicine: the Dresden-Friedrichstadt hospital, its Neptune fountain and connections to Vienna.

The Dresden-Friedrichstadt hospital originated from Marcolini's summer palace. It was founded in 1845 and opened in 1849. It is a place where history and art of European importance mixes with technical and medical innovations. We reflect on the meetings of Napoleon Bonaparte and Metternich in 1812, the creation of the famous Neptune fountain by Longuelune and Matielli and two outstanding physicians of the 19th century, the surgeon Eduard Zeis, who coined the medical term "plastic surgery", and Maximilian Nitze, inventor of the first "modern" cystoscope and the father of urology.

[Memory in disciplinary cultures and "sites" of memory in medicine : Maximilian Nitze (1848-1906) and the establishment of urology]. / Fachkulturelles Gedächtnis und Erinnerungsorte in den medizinischen Wissenschaften : Maximilian Nitze (1848-1906) und die Etablierung der Urologie.

The canon of material and immaterial references of the urological heritage must always be recognized as a part of a continous process of negotiation. Within German Urology the culture of remembrance on Maximilian Nitze reveals one of such processes.

[The clinic Heilanstalt Weidenplan in Halle (Saale), origin of the German urology. Otto Kneise's founding of the first independent urology department in Germany]. / Die Klinik "Heilanstalt Weidenplan" in Halle (Saale), eine Pionierstätte der Deutschen Urologie. Otto Kneises Weg zur ersten selbständigen Urologie in Deutschland.

The routine use of cystoscope initiated the development of the modern urology. Otto Kneise (1875-1953) extended the targets of cystoscopy by including examinations of the male bladder and prostate. He achieved the goal that "cystoscopy is part of general work in urology and not a pure gynecological act". He, thus, founded the specialty gynecological urology in the field urology, which prevented it from becoming an independent field. Under the leadership of Otto Kneise, the first independent urology department in Germany was created in the hospital Heilanstalt Weidenplan.

Where next for the endoscope?

The concept of examining the body's interior and its organs dates back to ancient times. The roots of modern endoscopy lie in early nineteenth century Europe, and the intervening centuries have seen a steady evolution of devices and techniques. Nowadays, a wide variety of urinary tract disorders are successfully managed in a minimally invasive manner thanks to the endoscope and related technologies. Distal-sensor, 'digital', endoscopes have the potential to revolutionize the field, and change the way in which we use and think about endoscopy. Virtual endoscopy, capsule endoscopy, and a range of other techniques derived from physics and molecular biology all promise great improvements in visualization of the urinary tract and other urologic structures. Ultimately, the continued improvement of these minimally invasive technologies will enhance the quality of care that we can offer our patients.

Two centuries of cystoscopy: the development of imaging, instrumentation and synergistic technologies.

The cystoscope used today is the product of centuries of development. The desire to view the cavities of the body was first described several centuries ago. The earliest true prototype was Bozinni's 1805 urethral viewing tube, on which many others were based. These primitive instruments were challenging to use for the operator, uncomfortable for the patient, and dangerous for both. Patient positioning was based on the method of bladder distension and the goal of the operation, rather than comfort. Images visualized by early models were inverted and backwards, and required the operator to be skilled in correcting this image. Reflected candlelight was used for illumination, and objects appeared small and distant. With the advent of lenses, prisms and the incandescent light, cystoscopy advanced to Nitze's prototype, a forerunner of the current cystoscope. Once the image quality was improved, instrumentation through the cystoscope was introduced, broadening the scope of urology, from the management of venereal disease to a premier surgical speciality. Finally, the invention of fibre optics and digital imaging provided the cystoscope used by urologists worldwide, giving unparalleled image quality, allowing for educational opportunities and a quality of patient care unimaginable to the early pioneers. An understanding of this past brings not only an appreciation of the technology currently available, but also a glimpse into what the cystoscope has the potential to become. From this past, it is clear that today's cystoscope is merely a forerunner of that which the future will bring.

[The biography of Maximilian Nitze (1848-1906) and his contribution to the urology]. / La biografía de Maximilian Nitze (1848-1906) y su contribución a la Urología.

Maximilian Carl Friedrich Nitze was born on the 18 of September of 1848 in Berlin the capital of Prussia. 1869 while still being a Student of the Heidelberg University the first nephrectomy of the world performed by Gustav Simon (1824-1876) woke his interest in urology. 1874 by the age of 26 he passed his state examination and obtained a doctor degree in medicine. On the 2 October of 1877 he presented the first cystoscope to the members of the Real Medical School in Dresden. Nitzes doubtless valuable contribution to urology was making real the endoscopical exploration of the genitourinary system and initializing the era of surgical treatments under direct vision. By the beginning of the XX century urology reached the status of an independent specialty by separating from surgery, dermatology/venerology, internal medicine and pathology.

Max Nitze, the cystoscope and urology.

PURPOSE: Maximilian Carl-Friedrich Nitze (1848 to 1906) designed the modern cystoscope, providing a foundation for urology. MATERIALS AND METHODS: The historical literature, including the original writings of Nitze, was reviewed. RESULTS: The invention of the cystoscope by Nitze revolutionized endoscopy but his true genius lay in his lifelong pursuit of better methods to diagnose and treat patients with urological diseases and in teaching others the practical use and value of cystoscopy. He also designed the first operating cystoscope, took the first endoscopic photographs and published the first textbook in urology. CONCLUSIONS: The legacy of discovery of Max Nitze established the specialty of urology and a legitimate claim as the father of urology.

[Maximilian Nitze (1848-1906): Obstetrician to urology]. / Maximilian Nitze (1848-1906): Geburtshelfer der Urologie.

Maximilian Carl Friedrich Nitze was born on the 18th of September 1848 in Berlin. In 1874 he passed his state examination in Leipzig for a doctorate in medicine. Nitze demonstrated the first urethroscope and cystoscope, which he had built with great effort and under considerable hardship, at the Dresden-Friedrichstadt Institute using a cadaver--this was the hour of birth of modern urology. Nitze's invention of the cystoscope and his achievements as a urologist have made urology into an independent specialist branch of medicine. This led, after his early death, to the establishment of the German Society for Urology and the Zeitschrift für Urologie in 1906, as well as the organization of the first urological congress in Vienna in 1907.

Legacy of Edwin Beer: fulguration of papillary bladder tumors.

PURPOSE: Edwin Beer introduced the first endoscopic treatment of papillary bladder tumors in 1910. This historical review describes how his landmark discovery paved the way for office cystodiathermy to treat recurrent papillary tumors. MATERIALS AND METHODS: The medical writings of Edwin Beer and all studies pertaining to the treatment of papillary bladder tumors from 1879 to the present were reviewed. RESULTS: Edwin Beer discovered that papillary bladder tumors could be destroyed through the ordinary cystoscope with high frequency current by electro-coagulation. This therapy revolutionized the treatment of bladder tumors. CONCLUSIONS: The legacy of Edwin Beer is that office fulguration of recurrent papillary bladder tumors has now become a practical reality due to recent changes in the histological classification of papillary tumors, better definition of their biological behavior and improved endoscopic equipment.

[A look inside the bladder--the human behind it]. / Ein Blick in die Blase-der Mensch dahinter.

To study the inside of humans is an old wish of mankind. Cystoscopy and its development are known to-initiates. In the following we do not stress this examination, but focus on those people behind it who shared in paving the way for improvement with their fantasy and energy without neglecting to report on the human and very human aspects.

The discovery of renal contrast media in Berlin.

After X-rays were detected and cystoscopes had become available, progress in nephrology depended on the development of contrast media which would permit imaging of the kidneys and the urinary system. We describe how A. Binz and C. Räth, two chemists at the Agricultural Academy in Berlin, synthesized iodinated derivatives which were potent chemotherapeutics. Moses Swick tested the substances in the clinics of L. Lichtwitz (Hamburg) and A. von Lichtenberg (Berlin) and discovered a rapid renal excretion. He also observed that an iodinated N-acetylated derivative, later named Uro-Selectan, amplified X-ray contrast after intravenous application. With this substance and other derivatives which were produced by Schering-Kahlbaum AG, the door was open for excretion urography.