Disease of the kidney and of the urinary tract in De Medicina Methodica (Padua, 1611) of Prospero Alpini (1563-1616).

AIM: The study was devised to understand the contribution to nephrology ofDe Medicina Methodicaof Prospero Alpini published in 1511, at a time when the fame of the professor reached the azimuth. METHOD: We have analyzed the contents of chapters devoted to nephrology in that book of Prospero Alpini and the novelties of his message. RESULTS: Prospero Alpini (1563-1616) taught at the University of Padua (1594-1616), at the same time of Galileo Galilei, Santorio Santorio, and Girolamo Fabrizi dAcquapendente, when measurements (pulse, temperature, perspiration) were introduced into medicine. He was a travelling physician to whom we owe fundamental contributions to the use of urine to prognosticate life and death (De Praesagienda vita et morte aegrotantium libri septem, Venetiis, apud Haeredes Melchioris Sessae,1601). As prefect of the Botanical Garden - the first ever and a model in the world - he could turn the study of simples into cures(De Medicina Methodica Libri Tredecim. Patavi, apud Franciscum Bolzettam, 1611. Ex typographia Laurentij Pasquali, is anin foliovolume of XLVII + 424 pages, 54 lines per page), wherein Alpini aimed to rejuvenate antique medical Methodism. It is a testimony of the interest of medicine philosophers of the modern era for the corpuscular and atomic ideas (Nancy Siraisi). Methodists (2ndCentury BC) refused anatomy and physiology as unique guidelines to the interpretations of diseases and gave importance to the development of a pharmacological science and alternative medicine. The book begins with a 3 page letter to Francis Maria della Rovere Duke of Montefeltro, and a 2 page letter to the readers. We discuss the novelties of the chapters on renal colic (de dolorerenum), hematuria (de sanguinis profluvium), pyuria, anuria (de urina suppressa) and its cure, polyuria (de urina profluvio), renal abscesses, hydrops and its treatment by skin incisions. We also analyze the chapter on kidney and bladder stones (Book X, Chapter XVIII, pp. 354-356) - a masterpiece of scholarly teaching - encompassing localization of stones, their formation and shape, renal colic and its irradiation according to the site and gender, the best antalgic position to pass stones, the use of laxatives, cathartics, warm baths, the plants to be used, their preparation and quality, the waters to be drank and their quantity (up to 15 pounds a day), the removal of bladder stones without surgery (methods learned in Cairo and described in Aegyptyan Medicine), and lithotomy and its feasibility even in old people. CONCLUSION: De Medicina Methodicawas a modern monograph devoted to clinical medicine including urinary disease. The book reflected the polyhedral personality of the author, his experience as physician of the Republic of Venice at Cairo, and his capabilities as a director of the Botanical Garden of the University of Padua, a unique research centre in those times.