Lethal Lullabies: A History of Opium Use in Infants.

Poppy extract accompanied the human infant for more than 3 millenia. Motives for its use included excessive crying, suspected pain, and diarrhea. In antiquity, infantile sleeplessness was regarded as a disease. When treatment with opium was recommended by Galen, Rhazes, and Avicenna, baby sedation made its way into early medical treatises and pediatric instructions. Dabbing maternal nipples with bitter substances and drugging the infant with opium were used to hasten weaning. A freerider of gum lancing, opiates joined the treatment of difficult teething in the 17th century. Foundling hospitals and wet-nurses used them extensively. With industrialization, private use was rampant among the working class. In German-speaking countries, poppy extracts were administered in soups and pacifiers. In English-speaking countries, proprietary drugs containing opium were marketed under names such as soothers, nostrums, anodynes, cordials, preservatives, and specifics and sold at the doorstep or in grocery stores. Opium's toxicity for infants was common knowledge; thousands of cases of lethal intoxication had been reported from antiquity. What is remarkable is that the willingness to use it in infants persisted and that physicians continued to prescribe it for babies. Unregulated trade, and even that protected by governments, led to greatly increased private use of opiates during the 19th century. Intoxication became a significant factor in infant mortality. As late as 1912, the International Hague Convention forced governments to implement legislation that effectively curtailed access to opium and broke the dangerous habit of sedating infants.

[Montaigne, his illness and his doctors]. / Montaigne, hans sygdom og lægerne.

Michel de Montaigne (1533-1592), the great French humanist and inventor of the Essays, a central work in the world-literature, suffered from a severe hereditary kidney disease with stones, gravel and frequent colic. The illness is well and carefully described in the essays with valuable and detailed contributions from his experience as a patient, trying to humanize and accept the suffering. He experimented with quite a number of cures (hydrotherapies) during a long journey on horseback to Rome and back to Perigord. Fundamentally, he was in favour of leaving the treatment to the nature, and he had an aversion to the medical art, doctors and drugs. He was preoccupied with the death and in particular the so-called rational suicide, a revival from the antiquity. He died from his renal disease. Montaigne's inspiration for the following centuries and his literary importance today is briefly outlined, including his extraordinary experience as a patient. It is strongly recommended to read Montaigne and to learn from his wisdom.

A Renaissance Pope with arthritis following frostbite.

Pius II, a 15th century Pope, developed chronic foot pain following frostbite at age 30. Later in life he was progressively disabled by arthritis elsewhere and by colic, which may have been due to kidney stones. The differential diagnosis of his rheumatic disease and its effect on his career are discussed.

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."

Lessons in medical humanism: the case of Montaigne.

Michel de Montaigne, the great French humanist and inventor of the personal essay, suffered from frequent and severe renal colic. He wrote about his illness in his travel journal and in his last and greatest essay, "Of Experience." In his illness narratives, Montaigne integrated disease and suffering into his life and art. He humanized rather than conquered his disease. A mature humanism replaced his youthful Stoic philosophy of detachment and disengagement and provides a worthy model for our own medical humanism.

Exploratory celiotomy in 1474 AD: brief case report.

In 1474 ad a prisoner in Paris underwent an exploratory celiotomy to ascertain the cause of abdominal "colic." The patient recovered.

[The death of Fernando Pessoa. The differential diagnosis of liver colic]. / A propósito da morte de Fernando Pessoa. O diagnóstico diferencial da cólica hepática.

A clinical review of the most probable cause of death of the poet Fernando Pessoa is made. The many times cited final diagnosis of "hepatic colic" and the limited clinical information available are considered. The spectrum of chronic alcoholism and its risks are questioned by recent advances on pathology knowledge.

Of colic and rumbling in the guts.

Infant colic is a common disorder of doubtful aetiology. The known facts have been interpreted in a historical and geographical context. The apparent increase in incidence of the condition in the Westernized world during the twentieth century may reflect the technological advances and social changes that have occurred in recent years.

[Julián Gutiérrez de Toledo and his book "Cure of the stone and pain in the loin and/or renal colic" in 1498]. / Julián Gutiérrez de Toledo y su libro "Cura de la piedra y dolor de yjada o/y colica renal" en 1498.

The physician Julián Gutiérrez de Toledo, born in the Imperial Town halfway through the Fifteenth Century and deceased around 1520, has a great relevance in the History of Urology for being the first writer of a treatise on urological topics in the Castilian language with his work "Cure of the stone and loin pain or/and renal colic" (Editor Melchor Gorricio, Printer Pedro de Hagembach, Toledo 1498). His work marks the transit from The Middle Ages to the Modern Times in what refers to awareness of the urinary tract diseases. The book "Cure of the stone..." has 85 pages written in two columns of 40 lines each with gothic characters. On the cover there is an engraving of the saint physicians Cosme and Damian, and on the last page is the printer's coat-of-arms. The book consists of five parts as all books from late Middle Ages: Of the Causes, Signs and Prognosis, Preservation, Of the Cure, Misgivings. The value of the treaty is that it compiles all that was known at the time on urinary lithiasis showing a marked Avicenna-like Galenism to which the author adds his own observations that show the Renaissance man. An exceptional witness of the reign of the Catholic King and Queen, this incunabular should be known by the Spanish speaking urologist as illustrious predecessor.