Medical management of urolithiasis in the Middle Ages: Thesaurus Pauperum of Pope John XXI.

BACKGROUND/OBJECTIVE: This paper will present a brief description of medicine in the Middle Ages, and more comprehensive analysis of the medical management of urolithiasis in Thesaurus Pauperum, the main text of Pedro Hispano. METHOD: An in-depth reading of the Italian translation of Thesaurus Pauperum, and a review of the literature of the life of Pedro Rebuli Guiliani, known as Pedro Hispano, was performed. RESULT: Pedro Hispano was born in Portugal around 1205. He studied philosophy, theology and medicine in Paris. He was named professor of medicine at the University of Siena in 1247 and was elected Pope, as John XXI, in 1276. His primary medical book was Thesaurus Pauperum ('Treasure of the Poor'), a prescription handbook for common diseases, directed not only to physicians but also to ordinary people. We focused on the description of medical management of urolithiasis in Thesaurus Pauperum. CONCLUSION: This text is interesting not so much on account of the pharmacopoeia used, but instead, because it is, probably, one of the first medical text reporting therapeutics close to the modern evidence-based medicine.

Pierre Franco (1505-1578): An Innovative Surgeon of the 16th Century in the Treatment of Hernia and Lithotomy.

Pierre Franco (1505-1578) was a brilliant surgeon of the Renaissance, a contemporary of Ambroise Paré. He made an impact on the history of surgery with his innovative approaches in the treatment of hernia, lithotomy, and the use of the suprapubic incision. The purpose of this study is to present a detailed account of his work, innovations, and achievements as well as the impact he made on the surgery of the Renaissance.

[Urinary lithiasis, a disease followed through its historical footprints.] / La litiasis, una enfermedad seguida a través de sus huellas históricas.

OBJETIVE: Through two historic episodes we find that they are closely related with urinary lithiasis. METHODS: The cases are described and documented in the same historical account. RESULTS: The lithiasic disease of two historical known characters. Both in a different cultural environment looked for a miraculous healing. CONCLUSIONS: Cure was not achieved in the first case but in the second. Both happened in the Middle Age within a period of 100 years and more than 5,000 kilometers away from each other.

La litiasis, una enfermedad seguida a través de sus huellas históricas / Urinary lithiasis, a disease followed through its historical footprints

OBJETIVO: A través de dos episodios, encontramos que están íntimamente relacionados con la litiasis. MÉTODOS: En el mismo relato histórico se describen documentalmente los casos. RESULTADOS: La enfermedad litiásica de dos personajes históricamente conocidos. Ambos, en su diferente ambiente cultural, buscan la curación milagrosa. CONCLUSIONES: No se logró en el primer caso y sí en el segundo. Ambos, se sucedieron en plena Edad Media, en un espacio de cien años y a más de cinco mil km. de distancia

OBJECTIVE: Through two historic episodes we find that they are closely related with urinary lithiasis. METHODS: The cases are described and documented in the same historical account. RESULTS: The lithiasic disease of two historical known characters. Both in a different cultural environment looked for a miraculous healing. CONCLUSIONS: Cure was not achieved in the first case but in the second. Both happened in the Middle Age within a period of 100 years and more than 5,000 kilometers away from each other

[A brief history of recognition on urolithiasis before medieval period].

Urinary stone was first found by human as early as 4900 BC when the Egyptian monks applied emesis, catharsis, diuresis, and diaphoresis for its treatment which, as they claimed, can expel the stones out of the body occasionally. In 2700 BC, definite records on urinary stone were seen in Egytian papyrus which attempted to cure this disorder by sucking method. In the 4(th) century BC, the Greek physician Alexandria mentioned that such stones can be expelled after being smashed. By then, the Greeks recognized the existence of renal stone by describing its manifestations. Sushruta, an ancient Indian royal physician mentioned in 6(th) century BC, the picking up of stones by splints through the urethra and the complications of such disorder in his Sushrutasamhita. He also recommended the removal of stones through the perineal part. Unfortunately, many patients died of such operation. Ancient Roman physicians described such operation circumstantially and the herbs for its treatment in the 1(st) century BC. During the 10(th) century, the Arabian physician Abukasis was the first to advocate the method of smashing stones in the urethra with an instrument he devised. In the period before medieval age, the removal of urinary stones through the perineal incision had been the main method which was so limited an approach due to the lack of anatomical knowledge and antiseptic conception.

La cirugía española renacentista y la técnica del "punto de oro" / No disponible

No disponible

[The stone disease]. / El mal de la piedra.

OBJECTIVES: In this paper we describe the history of lithiasis and the development of its treatment. We discuss the steps that led to the birth of endoscopic surgery and extracorporeal shockwave lithotripsy. METHODS: We reviewed books and writings of History of Urology and Endourology. RESULTS/CONCLUSIONS: To know a little of the history and treatment of lithiasis, the contributions of Spanish urologists, as well as the instruments that made it possible.

El mal de la piedra / The stone disease

OBJETIVO: En este trabajo se realiza una descripción histórica de los descubrimientos sobre la litiasis y la evolución de su tratamiento. Se exponen los antecedentes que llevan al nacimiento de la endourología y de la litotricia por ondas de choque.MÉTODOS: Hemos revisado los libros y las publicaciones de la historia de la urología y de la endourología.RESULTADOS/CONCLUSIONES: Conocer la historia y el tratamiento de la litiasis, las aportaciones de los urólogos españoles así como el desarrollo de los materiales que han contribuido a conseguirlo(AU)

OBJECTIVES: In this paper we describe the history of lithiasis and the development of its treatment. We discuss the steps that led to the birth of endoscopic surgery and extracorporeal shockwave lithotripsy.METHODS: We reviewed books and writings of History of Urology and Endourology.RESULTS/CONCLUSIONS: To know a little of the history and treatment of lithiasis, the contributions of Spanish urologists, as well as the instruments that made it possible(AU)

William Osler, urolithiasis, and God's own medicine.

OBJECTIVES: To identify the contributions of Sir William Osler, who is regarded as the pre-eminent physician of his time, to urology, both objective and subjective. METHODS: A search of Osler's bibliography of over sixteen hundred publications, as well as his observations, some hitherto unpublished, on the episodes of renal colic that he personally experienced, was conducted. Osler was treated with morphine, which he characterized as "God's own medicine," and the origin of this description is explored. RESULTS: Osler published over 50 articles devoted to urologic topics, including 2 on vaginismus and Peyronie's disease; the former, by his fun loving alter ego, Egerton Yorrick Davis, was a hoax. Osler discusses urolithiasis and renal colic in his magnum opus, The Principles and Practice of Medicine, citing Montaigne's self description of his suffering as "unexcelled." Osler later personally experienced 2 episodes of renal colic, which he graphically and eloquently describes in his Lumleian Lectures of 1910. His descriptions of renal colic before and after his own experience are compared in the light of Plato's comment that a physician should experience the disease that he treats. CONCLUSIONS: William Osler was one of those giants who, in the early days of specialization, took all of medicine for their own. His contributions to urology were significant and include his descriptions of his own episodes of renal colic and the use of morphine-"God's own medicine."

A tribute to the life and accomplishments of Birdwell Finlayson.

PURPOSE: Birdwell Finlayson was a talented researcher and clinician whose pioneering work in the field of urolithiasis led him to worldwide prominence in urology. We researched his life and accomplishments to provide a historical account of his career. MATERIALS AND METHODS: The archives of the Department of Urology and the University of Florida Health Science Center Library were searched for publications, photographs and other records relating to Doctor Finlayson. Additionally, we interviewed many of his friends and colleagues for more information. RESULTS: Birdwell Finlayson was born in Pocatello Bannock, Idaho. He completed a urology residency and obtained a Ph.D. in biophysics at the University of Chicago. In 1967 he joined the faculty at the University of Florida. His interest in understanding the fundamentals of stone formation led to the discovery that crystal retention at a site of nephron injury was essential for stone formation. This fixed particle hypothesis continues to serve to as the foundation for urolithiasis research today. His computer model EQUIL is the gold standard for calculating urinary supersaturation with respect to kidney stone formation. Finlayson was 1 of the 6 original coinvestigators for shock wave lithotripsy in the United States. He is also remembered for his wit and his love of aeronautics, as he was a flight instructor and stunt pilot. Finlayson died unexpectedly of idiopathic hypertrophic cardiomyopathy on July 22, 1988. CONCLUSIONS: Birdwell Finlayson was an internationally renowned surgeon and stone disease expert whose research continues to serve as the basis of urolithiasis research at the University of Florida and worldwide.