"I have had an exceedingly beautiful life" The Jewish gynecopathologist Robert Meyer (1864-1947) and his extraordinary response to Nazi repression.

The Jewish scientist Robert Meyer received worldwide professional recognition as a pioneer gynecopathologist. Before his death, he wrote a memoir in which he gave an entirely positive assessment of his life. The latter, however, is at odds with the fact that he was disenfranchised by the National Socialists and driven into emigration. But even before Hitler's seizure of power, he had to cope with several strokes in private as well as in professional life. This article takes these apparent inconsistencies as an occasion for a fundamental analysis of Robert Meyer's life and work. Special attention is paid to his scientific achievements, but also to repressive experiences in the Third Reich, the background of his emigration and his specific handling of these adversities. Various archival documents, Meyer's memoirs, and other contemporary writings by and about Robert Meyer and about the development of the field of gynecopathology serve as central sources. The study concludes that Meyer made fundamental contributions to the embryology of the vagina, ovarian tumors, cancer diagnosis, endometriosis, and genital and fetal abnormalities. Despite his scientific merits, he was never granted a regular professorship - mainly, because he was professionally caught between two stools (gynecology and pathology), but also due to low career ambition. Nevertheless, thanks to influential supporters, he was able to hold out in Germany until 1939, when he emigrated to the United States. Meyer considered his life "beautiful" despite many misfortunes because he defined happiness in life primarily in terms of fulfilling personal relationships and was willing to accept life as it comes. In addition, he found distraction and fulfillment in his scientific work.

"En buena medicina". las fuentes médicas del discurso de Céspedes ante la Inquisición / "En buena mediçina". Cespedes' medical sources during their deposition before the Inquisition trial

Uno de los hermafroditas más afamados del siglo XVI español fue Céspedes, un cirujano que trató de persuadir a la Inquisición de que la doble mutación corporal que sufrió era un proceso natural. Céspedes afirmó que la transformación de Elena comenzó cuando dio a luz y fue completada mediante cirugía, pero Eleno volvió a su forma femenina de nuevo en la cárcel, porque un cáncer le forzó a cortarse el pene. En este trabajo estudio el testimonio de Céspedes conocido por la historiografía como el 'discurso de su vida', analizo los argumentos que utilizó para convencer al tribunal de sus transmutaciones consecutivas de acuerdo a su biblioteca e identifico los tres textos médicos en romance en los que se basó

One of the most famous hermaphrodite in Spain’s sixteenth Century was Céspedes, a surgeon who tried to persuade the Inquisition court that the double corporal mutations (s)he suffered were a natural process. Céspedes state that the Elena's transformation started when she gave birth and was completed by surgery, but Eleno became into a female shape again in prison, because a cancer forced him to cut himself the penis. In this paper, I study Céspedes' deposition, known by historiography as the "discourse of her life", I analyze the arguments (s)he used in order to convince the court their consecutive transmutations according their medical library, and I identify the tree vernacular medical texts (s)he based on

Development and history of morcellators.

PURPOSE OF REVIEW: Controversy exists surrounding extraction of tissue in gynecologic surgery using morcellators following cases of disseminated uterine cancers discovered after the use of electromechanical morcellators. This chapter traces the history of tissue extraction in gynecology and reviews the evolving scientific data and opinions regarding the future of morcellation. RECENT FINDINGS: Since the initial Food and Drug Administration warning about morcellation in 2014, subsequent studies do not support the Food and Drug Administration's high incidence of occult uterine cancer. Current research continues, focusing on methods of contained tissue morcellation, both laparoscopically and vaginally. SUMMARY: Minimally invasive surgical techniques have revolutionized gynecology, drastically reducing the need for open procedures. To maximize patient safety while preserving the rapid recovery and low morbidity of laparoscopic and vaginal approaches, optimal methods of tissue extraction need to be developed and promulgated.

Morcellation equipment: past, present, and future.

PURPOSE OF REVIEW: This review was written in an effort to describe the evolution of power morcellation equipment from their creation to their current state. In addition, this review addresses the continuously evolving equipment involved with power morcellation and looks to describe where the field is headed in the future. In addition, recent professional and federal recommendations have changed the way power morcellation is being approached and has led to the development of contained morcellation systems, which, although in their infancy, are also being proven to be well tolerated options. RECENT FINDINGS: This article will review the most current research on electronic power morcellation and the multiple attempts to prove superiority from the many different types of equipment, and also the many different approaches to morcellation. In addition, with the adaptation to contained morcellation, this review will cover research focused on optimizing a containment system and the techniques involved. SUMMARY: In summary, this review is aimed at describing many of the currently available power morcellation products and contained morcellation systems in an effort to allow physicians to understand the different options available, and to discuss well tolerated, effective, and clinically proven techniques that can lead to improved surgical outcomes in the future.

Infancia, género y medicina. Un análisis histórico de los discursos endocrinológicos sobre el síndrome adiposo genital en Buenos Aires y Argentina / Childhood, gender and medicine. A historical analysis of endocrinological discourses on genital adipose syndrome in Buenos Aires and Barcelona

Este trabajo pretende contribuir a la problematización de las lecturas sobre la obesidad y la sexualidad infantil a través de un análisis histórico de los discursos de la endocrinología en Buenos Aires y Barcelona, en las décadas de 1920 y 1930. Focalizaremos en dos escenarios de una controversia en torno de la obesidad de los varones que articuló saberes de la endocrinología con supuestos morales sobre las familias y representaciones de género. Nuestro objetivo es identificar cómo se resignificaron los saberes sobre hormonas sexuadas disponibles en el campo científico internacional, en el marco de las experiencias clínicas locales. Consideramos que los endocrinólogos se valieron de estereotipos de género para leer los cuerpos de sus pacientes, pero sus interpretaciones también estuvieron mediadas por los intereses y las lógicas de las instituciones de las que formaron parte. La relevancia del psicoanálisis en Buenos Aires y la importancia de la tradición experimental en Barcelona serán aspectos centrales para identificar las particularidades de cada caso. Nuestro corpus documental está constituido por publicaciones científicas especializadas (AU)

This paper aims to contribute to the problematization of the interpretation on obesity and childhood sexuality through a historical analysis of the speeches of endocrinology in Buenos Aires and Barcelona in the 1920s and 1930. We will focus on two stages of a controversy around obesity of boy who articulated knowledge of endocrinology with moral assumptions about families and gender representations. Our goal is to identify how knowledge about sexed hormones available in the international scientific field, in the context of local clinical experiences resignified. Endocrinologists believe that availed themselves of gender stereotypes to read the bodies of their patients, but their performances were also mediated by the interests and the logic of the institutions of which they were part. The relevance of psychoanalysis in Buenos Aires and the importance of the experimental tradition in Barcelona will be central aspects to identify the particularities of each case. Our documentary corpus consists of specialized scientific publications (AU)

Female cancer. A perspective from the Latin south

Esse tema emergiu no campo da "história de doenças 'graças ao trabalho de um grupo heterogêneo de historiadores médicos e sociais, sociólogos, antropólogos e profissionais de saúde baseada principalmente em países da Europa e anglo-saxões. Tal abordagem multidisciplinar parte de perspectivas onde o câncer e sua história parecem abrigar alguns insights significativos para muitos sem resposta. Tais pesquisas estão contribuindo para expandir a análise do histórico de doenças pelo desenho da atenção às doenças crônicas e não transmissíveis, cuja relevância ter sido um pouco negligenciada em comparação com a atenção dada às doenças contagiosas e infecciosas. Uma boa parte dos estudos tem se concentrado particularmente na história dos cânceres femininos, mais especificamente, ginecológicos (mama, colo do útero, ovário e útero) começando a delinear a trajetória contemporânea sobre o câncer na saúde da mulher e o impacto do câncer nas sociedades. Há, no entanto, alguma razão crescente para a literatura examinar os cânceres femininos: no início no século XX, o câncer ginecológico é mencionado muitas vezes quando a doença é abordada. Nas décadas seguintes cresceram em grande extensão as observações acerca da identificação, diagnóstico, tratamento e prognóstico sustentado e noções gerais sobre o câncer como uma doença, de forma mais ampla. Exames históricos sobre câncer têm sido cautelosos em retratar os componentes de gênero da doença, permeando toda as iniciativas em "luta contra o câncer."Recentemente, os historiadores de câncer na América Latina estão contribuindo bastante para os relatos históricos da doença, documentando algumas de suas características distintas em uma região. Neste sentido, a América Latina oferece um lócus fecundo para explorar questões de espacialidade em conhecimentos médicos que vão além de uma mera recontagem da comunalidade e as diferenças observadas ao controle da doença em relação a Europa e à América.

History of hysterectomy: a significant problem for colonoscopists that is not present in patients who have had sigmoid colectomy.

PURPOSE: During colonoscopy, it is often difficult to traverse the sigmoid colon in patients who have had a hysterectomy, presumably due to postsurgical pelvic adhesions. We performed this study to document this difficulty and to determine whether sigmoid colectomy prevents it. METHODS: Data were acquired from a single endoscopist's prospective database. Colonoscopies performed in women were grouped according to history of hysterectomy and/or sigmoid colectomy. Groups were compared for colonoscopy completion rate, medication used, and time of examination. Participation of fellows and rate of complications were recorded. Patients with a history of abdominal-perineal resection of the rectum were excluded. RESULTS: From 1989 to 2006, a total of 4116 colonoscopies were performed in women: 993 had undergone hysterectomy (24.1%), of whom 108 (10.9%) had also undergone sigmoid colectomy. There were 3123 exams in woman who had their uterus (75.9%); 320 (10.2%) had undergone sigmoid colectomy. Patients who still had a sigmoid colon but had a history of hysterectomy had significantly lower colonoscopy completion rates (89.2%) and significantly longer mean examination time (28.9 +/- 12.3 minutes), and more of them required sedation with benzodiazepines (88.7%) than the other groups (P < .05). Fellow participation increased time of colonoscopy and complications were more frequent in patients with hysterectomy. CONCLUSION: Posthysterectomy adhesions to the sigmoid colon make colonoscopy more difficult and more painful. These adverse effects are not present in hysterectomized women who have undergone sigmoid resection.

Testosterone therapy in women with gynecological and sexual disorders: a triumph of clinical endocrinology from 1938 to 2008.

INTRODUCTION: Although the term "medicalization" has been used by some to describe contemporary testosterone use in women with sexual disorders and testosterone deficiency syndrome, testosterone therapy for women with various gynecological and sexual disorders has been practiced since the late 1930s. AIM: The study aimed to perform a historical review of testosterone use in women with sexual and gynecological disorders. This review is necessary to bridge important knowledge gaps in the clinical use of testosterone in women with sexual health concerns and to provoke new thoughts and understanding of the multidisciplinary role of testosterone in women's overall health. METHODS: Review of medical literature on androgen therapy in women was carried out from 1938 through 2008. RESULTS: Approximately 70 years ago, clinicians from various disciplines relied on personal experience and clinical observations for outcome assessment of testosterone therapy in women. These early reports on testosterone use in women with sexual medical problems served as a foundation for the development of contemporary approaches and subsequent testosterone treatment regimens. Testosterone use was reported for sexual dysfunction, abnormal uterine bleeding, dysmenorrhea, menopausal symptoms, chronic mastitis and lactation, and benign and malignant tumors of the breast, uterus, and ovaries. CONCLUSIONS: Health-care professionals engaged in the management of women's health issues have observed the benefits of androgen therapy throughout much of the 20th century. Despite this clinical use of testosterone in women for more than seven decades, contemporary testosterone therapy in women is hotly debated, misunderstood, and often misrepresented in the medical community.

La intervención del Dr. Francisco Díaz en el proceso inquisitorial contra Elena/ o Céspedes, una cirujana transexual condenada por la inquisición de Toledo en 1587 / The intervention of Dr. Francisco Díaz in the inquisitorial process against Elena /o de Cespedes, a transsexual surgeon found guilty by the Inquisition in Toledo in 1587

OBJETIVO: Dar a conocer, de un modo exhaustivo, un episodio casi inédito en la vida del Doctor Francisco Díaz (1527-1590), cirujano del rey Felipe II, y autor del Primer Tratado de Urología en la historia de la Medicina. Que sepamos hasta la fecha existían pocas noticias de la actuación que, como experto, tuvo que realizar Díaz en el proceso inquisitorial contra Elena/o de Céspedes, un presunto hermafrodita acusado por el Santo Oficio que siendo mujer y haciéndose pasar por hombre, se había casado con otra. El juicio tuvo lugar en Toledo en 1587 y alcanzó gran resonancia en su época, ya que la encausada, vestida con indumentaria masculina y usurpando las prerrogativas del varón, había conseguido fraudulentamente títulos y prebendas vedadas a la mujer, entre ellos la titulación de cirujana. Salvo las referencias de Folch Jou y Burshatin, ambas escuetas e incompletas, ningún autor ni biógrafo del celebre cirujano, había hecho cita de este pasaje de su vida que a nuestro juicio debió suponer para el urólogo un gran quebranto de su reputación. MÉTODOS: Se han revisado los trabajos de los dos autores antes citados, todas las obras y biografías del Dr. Francisco Díaz a nuestro alcance y microfilmado y transcrito en su totalidad el legajo 234, expediente 24, de la Sección Inquisición del Archivo Histórico Nacional de Madrid, correspondiente a Elena de Céspedes (alias Eleno de) (> de 500 folios) para extraer el mayor número de datos acerca de la acusada y sobre la actuación en el proceso del Dr. Francisco Díaz. RESULTADO Y CONCLUSIONES: La exploración como especialista en órganos génito-urinarios había sido solicitada a Francisco Díaz por el Vicario de Madrid para conceder o no una licencia de matrimonio a dicha mujer que afirmaba ser varón. En su informe de 1586 el urólogo declaró, sorprendentemente, que el peticionario era hombre. Como se demostraría durante el juicio la encausada, que en su defensa alegaba ser hermafrodita, había logrado engañar al experto con sus «malas artes» alterando su morfología genital. Gracias a sus conocimientos en cirugía se había automutilado obturando quirúrgicamente su vagina y colocado un «artificio» para simular que era varón. Al final, tras la opinión de los contraexpertos del Santo Oficio, Francisco Díaz tendría que retractarse, confirmar que era mujer y acusar a la reo de hechicería para salvar su responsabilidad. En el trabajo, sin embargo, concluimos que la acusada era un transexual masculino lo que, en parte, disculparía el error del urólogo 400 años después (AU)

OBJECTIVES: To make known, comprehensively, an almost unknown episode in the life of Dr. Francisco Diaz (1527-1590), surgeon of the king Philip II, and author of the first urology treaty in the history of medicine. To our knowledge, to date there were few references about the participation that, as an expert, Francisco Diaz had to have in the inquisitorial process against Elena de Cespedes, a presumed hermaphrodite accused by the Inquisition because being a woman married another one pretending to be a man. The trial was carried out in Toledo in 1587 and had great impact in that time, because the accused, dressing with male clothes and usurping the prerogatives of a man, had gotten by fraud titles and favours which were forbidden for women, the title of surgeon among them. Except for the reference by Folch Jou and Burshatin, both short and incomplete, no other author or biographer of the famous surgeon had cited this episode of his life, which to our judgment could mean a great damage to his reputation. METHODS: We reviewed the works by the two a fore mentioned authors, all the works and biographies about Dr. Francisco Diaz that we could found, and microfilmed and transcript the whole bundle 234, expedient 24, from the section Inquisition at the National Historical Archive in Madrid, corresponding to Elena de Cespedes (alias Eleno) (> 500 pages) to obtain the greatest amount of data about the accused and the performance of Dr. Francisco Diaz. RESULTS AND CONCLUSIONS: Francisco Diaz was requested, as an expert, by the Vicar of Madrid to perform the examination of the genitourinary organs to give or not marriage license to that woman saying she was a man. In his report in the year 1586, surprisingly the urologist declared that the petitioner was a man. As it would be demonstrated during the trial, the accused, who alleged being hermaphrodite in her defense, had been able to deceive the expert with her tricks alteringher genital morphology. Thanks to her surgical knowledge she had mutilated herself surgically closing her vagina and placed a device to simulate she was a male. At the end, after the opinion of the counter experts of the Inquisition Francisco Diaz had to retract, confirmed that the accused was a female, and accused her of witchcraft to save his responsibility. Nevertheless, in the work we conclude that the accused was a male transsexual, which, in part, would excuse the urologist's error 400 years later (AU)