Wine and treatment of genitourinary disease: from antiquity to modern times.

OBJECTIVE: Wine is one of the oldest documented medicinal remedies, dating back thousands of years. We explore the medicinal uses of wine, with a focus on the treatment of genitourinary disease, beginning in ancient Egypt, India, and Israel, and then moving forward to include Greek, Roman, and Arabic medicine. Our review continues into the Middle Ages and renaissance, and finally evaluates the medicinal properties of wine as we understand them in our current scientific paradigm and its specific application to urology. METHODS: A review of the literature was completed, reviewing the medical theories and medicinal uses of wine from ancient civilization to the present. RESULTS: Wine has been used in the treatment of genitourinary disease for thousands of years. This agent has been employed by physicians in nearly all cultures and in all eras of medical history. Medical uses include, but are not limited to, appetite stimulant, anesthetic, tonic, antiseptic, vasodilator, diuretic, antibacterial agent, and diaphoretic. The physiologic properties and value of this ancient medicine continue to be studied today. CONCLUSIONS: The medicinal use of wine has common applications over thousands of years and multiple civilizations. The pharmacologic and physiologic properties of this agent continue to be studied and applied in the modern era and continue to be relevant in the field of urology.

Female urinary incontinence and the construction of nineteenth-century stigmatized womanhood.

Before the 20th century, female urinary incontinence was a problematic disease because it presented a medical challenge (it was difficult to treat before the advent of surgical techniques) and prevented women from fulfilling their roles as spouses and caretakers. The latter was particularly troublesome during the 19th century when Western women (ie, white, middle/upper class, Protestant women) were expected to follow rigid, socially constructed gender roles, especially within the private microcosm of the family unit. Incontinent women of childbearing age had no place in the hierarchy of Euro-American society and were thus constructed as impure, polluted, and sexually undesirable. This stigmatization of the incontinent body not only marginalized the medical needs of the suffering woman but also characterized her as an unfeminine, contaminated, and repulsive object to be ostracized and excluded from the social rituals that defined selfhood.

Conocimiento de las enfermedades urogenitales en la obra de Gaspar Casal, «Historia natural y médica del Principado de Asturias» (1762) / Knowledge of the urogenital diseases in the work of Gaspar Casal, «natural and medical history of the Principality of Asturias» (1782)

OBJETIVO: Gaspar Casal (Gerona 1680, Madrid 1759) realiza la mayor parte de su obra médica en Oviedo, donde vive treinta y cuatro años, antes de volver a Madrid como médico de la Real Cámara. Fruto de su trabajo en Asturias es el libro póstumo «Historia natural y médica del Principado de Asturias» (Madrid, 1762), considerado el mejor exponente de la medicina española del siglo XVIII, y donde se describe por primera vez el «mal de la rosa», más tarde llamada pelagra o avitaminosis B. MÉTODOS: Estudio de la vida de Gaspar Casal y análisis de su única obra «Historia natural y médica del Principado de Asturias», especulando sobre el conocimiento de las enfermedades nefro-urológicas y genitales que se deduce de este texto. RESULTADOS: Casal conoce y trata la litiasis renal, que relaciona en unas ocasiones con las dolencias articulares y la gota, y en otras con la abundancia de comida y la vida sedentaria. Otras enfermedades acompañadas de poliuria y edemas que describe, son compatibles con el diagnóstico actual de nefritis infecciosa o degenerativa. Utiliza en pocas ocasiones el sondaje vesical en los casos de estranguria y anuria, incluye posiblemente en el término de «iscuria renal o supresión alta» a algunos enfermos con anuria y a otros con retención de orina, aunque también usa el término «iscuria vesical» para estos últimos. Los síntomas disuria-estranguria y hematuria, los trata sólo con terapia empírica, y se intuye en su texto que para los cirujanos locales no era habitual el alivio de estos síntomas mediante el sondaje uretral. Atiende una epidemia de paperas, con orquitis en los varones, que trata mediante sangrías, aunque se mostró contrario al abuso de las mismas. Sólo ocasionalmente hace tratar quirúrgicamente ciertas enfermedades testiculares. CONCLUSIONES: «Historia natural y médica del Principado de Asturias» refleja el espectro de las enfermedades que en la primera mitad del siglo XVIII ocupaban el trabajo de un médico, a saber, las derivadas de las carencias alimentarias, infecciosas, parasitarias y las degenerativas y vásculo-cerebrales en personas añosas. Desde el punto de vista nefro-urológico, es muy interesante comprobar el conocimiento en esa época de la enfermedad litiásica y de los síntomas del tramo urinario inferior, tratados al modo recomendado por los clásicos, con tratamiento físico y preparados empíricos, pocas veces con sondaje; y, en menor medida, los resultados del tratamiento médico de las orquitis y el tratamiento quirúrgico de algunas lesiones testiculares (AU)

OBJECTIVES: Gaspar Casal (Gerona, 1680, Madrid, 1759) made most of his medical work in Oviedo (Asturias, Spain), where he lived for thirty-four years, before his return to Madrid as a doctor for the Royal House. Fruits of this work is the book «Natural and medical history of the Principality of Asturias» (Madrid, 1762), considered the best exponent of the Spanish medicine of the 18th century, and where the «disease of the rose», known later as pellagra or hypovitaminosis B, was first described in. METHODS: Study of the life of Gaspar Casal and analysis of «Natural and medical history of the Principality of Asturias», speculating on the knowledge about nephro-urologic and external genitalia diseases that can be deduced from the text. RESULTS: Casal knows and treats kidney lithiasis, relating it either to joint diseases and gout, or to dietetic excess and sedentary life in some of his patients. Other diseases coursing with poliuria and oedemas, are compatible with the nowadays diagnosis of infectious or degenerative nephritis. He rarely uses a bladder catheter for cases of stranguria and anuria, probably including some patients with anuria and others with urinary retention in the term «renal ischuria or high suppression», although he also uses the term «vesical ischuria» for the last ones. He treats the symptoms disuria-stranguria and haematuria, with empiric therapy, and, as it may be deduced from the text, some local surgeons didn't use or know to alleviate those symptoms with urethral catheterisation. He attends an epidemics of mumps, with orchitis in male patients, that were treated with bloodletting, although he stood against the misuse of phlebotomy in several diseases. Only occasionally he orders surgical treatment for several testis diseases. CONCLUSIONS: «Natural and medical history of the Principality of Asturias» reflects the spectrum of diseases that conforms the day-to-day working schedule of a Spanish family doctor in the beginning of the 18th century, that is to say: diseases resulting from dietary shortage, infective, parasite, degenerative and vascular-cerebral diseases in older patients. From the nephro-urologic point of view, it is very interesting to read about the knowledge on stone diseases and lower urinary tract symptoms, that were treated as recommendedby the classic authors, with physical therapy and empiric formulas, rarely with bladder catheterization. To a lesser degree, the results of the medical treatment of orchitis and the surgical treatment of some testis diseases are also depicted (AU)

Inicio de la docencia urológica en la universidad española. Dr. Alberto Suárez de Mendoza / The start of urological teaching in the Spanish University. Dr. Alberto Suárez de Mendoza

OBJETIVO: Presentamos la semblanza del Dr. Suárez de Mendoza, uno de los primeros urólogos formado en Urología en el Hospital Necker, de París, junto al Dr. Guyon, que abrió el campo a la creación de la especialidad en España y el primer profesor oficial de la asignatura en la Facultad de Medicina de Madrid. MÉTODO: Hemos revisado su expediente académico en el Archivo Histórico Nacional y buscado datos en la Facultad de Medicina y en el Colegio de Médicos madrileño sobre su presencia en España. Extraído de los Reales Decretos información sobre la escuela libre de Medicina y la creación de las especialidades médicas en los planes de estudios universitarios y, por último, analizamos su obra escrita. RESULTADO/CONCLUSIÓN: Consideramos al Dr. Suárez de Mendoza una de las personalidades que dieron entidad a la Urología en nuestro país, por su formación, por su amplitud de saberes y por su vasta experiencia, como profesor de la asignatura en la Universidad española, como autor de un gran número de trabajos publicados y como inventor por sus aportaciones al desarrollo de la anestesia y de la Urología. Su tratado, el primero en español que recoge con detalle las primeras innovaciones en los medios de exploración urológicos, nos permite conocer y valorar el progresivo avance y evolución del conocimiento que presenta la Urología

OBJECTIVES: We present a biographical sketch of Dr. Suarez de Mendoza, one of the first urologists trained as so in the Necker Hospital in Paris with Dr. Guyon, who opened the field to the creation of this speciality in Spain, and first official professor of the subject of in the Faculty of Medicine of Madrid. METHODS: We reviewed his academic expedient in the National Historical Archive and search for data about his presence in Spain in the Faculty of Medicine and Medical College of Madrid. From the Royal Decrees we obtained information about the Free School of Medicine, and the creation of medical specialities in the University study plans; finally, we analyzed his written works. RESULTS /CONCLUSIONS: We consider Dr. Suarez de Mendoza one of the personalities giving entity to Urology in our country, for his education, for the amplitudeof his knowledge, and for his wide experience, as professor of the subject in the Spanish University, as author of a great number of published works, and as inventor of his contributions to the development of anesthesia and urology. His treaty, the first in Spanish coveringin detail the innovations in urological examination methods, enables us to know and value the progressive advance and evolution of knowledge in urology

Hojas urológicas del Dr. Narciso Serrallach Mauri, escritas hace casi 100 años / No disponible

Se expone un resumen de los trabajos y comentarios más interesantes del Dr. Narciso Serrallach Mauri, presentados en Hojas Urológicas, revista que bajo su propia dirección editó de forma continuada desde 1913 hasta 1935, anual o semestralmente. En ella pueden encontrarse los temas urológicos que en aquel entonces eran de mayor actualidad y despertaban el mayor interés así como las publicaciones y actividades de las sociedades médicas donde desarrolló su actividad profesional urológica. Se hace hincapié también en la valoración de su actividad en relación al estado de la ciencia y de la sociedad en el periodo estudiado (AU)

We present a summary of the most interesting works and commentaries by Dr. Narciso Serrallach Mauri, presented in Urological Records, a journal edited under his direction continuously from 1913 to 1935, annually or every six months. The state-of-the-art urological topics of the time rising the highest interest can be found in the journal, as well as in the publications and activities of the medical societies where he carried out his professional urological activity. We also emphasize the evaluation of his activity in relation to the estate of science and society at his time (AU)

Diagnóstico y tratamiento de la uretritis crónica en la sanidad militar con el cambio de siglo (XIX-XX) / Diagnosis and treatment of chronic urethritis in the Military health-care system with the change of the Century (XIX-XX)

OBJETIVO: Podemos afirmar que en los Hospitales Militares, instituciones pioneras dentro de la organización sanitaria del país, aproximadamente un 25% de la patología durante la segunda mitad del siglo XIX, correspondería a las Enfermedades Venéreas, existiendo salas dedicadas a este tipo de afecciones que inicialmente se asociaban a las Enfermedades del Aparato Genito-urinario. La "Gota Militar" o Uretritis Blenorrágica fue un padecimiento venéreo con gran incidencia y prevalencia en la era pre-antibiótica. En el presente trabajo revisaremos los métodos diagnósticos y terapéuticos realizados por los Médicos Militares Españoles durante el periodo indicado. MÉTODOS: Se realiza una introducción, interrelacionando los conocimientos de la época con el medio en que los Médicos Militares desarrollaban su actividad profesional. Se hace referencia a las Revistas de Sanidad Militar, vehículo de las inquietudes y demostración del nivel de conocimiento teórico y práctico que les distinguía. En base a sus Hojas de Servicio y a sus publicaciones, hacemos mención de los Urólogos originarios de la Sanidad Militar que más interés demostraron en el campo de la patología de la uretra, comentando la metodología que utilizaban en el diagnóstico y tratamiento de la Uretritis Blenorrágica. RESULTADOS Y CONCLUSIONES: La Sanidad Militar de finales del siglo XVIII y principios del XIX reunió a un grupo de profesionales que demostraron ingenio y perseverancia en el tratamiento de la "Gota Militar". Conocer los conceptos en el diagnóstico y manejo de las uretritis, mejora nuestra perspectiva en el conocimiento de estas patologías y nos confirma en la valoración de los avances de que hoy disponemos, gracias a la suma de esfuerzos de nuestros predecesores

BJECTIVES: We can say that in military hospitals, pioneer institutions in health-care in our country, approximately 25% of the pathology over the second half of the 19th century would correspond to sexually transmitted diseases (STD), with hospital wards dedicated to these diseases, initially associated with genitourinary diseases. The «military drip» or blennorrhagic urethritis was a venereal disease with great incidence and prevalence in the pre-antibiotic era. This article reviews the diagnostic and therapeutic methods employed by Spanish military doctors during such period. METHODS: In the introduction we state the relationship between the knowledge of the time and the environment in which military doctors developed their professional activity. We make reference to military health-care journals, vehicle for their worries and demonstration of the level of theoretical and practical knowledge they were distinguished for. Based on their service records and publications we refer the urologists from the military health-care system that showed a greater interest in the field of urethral diseases, talking about the methodology they used for diagnosis and treatment of blennorrhagic urethritis. RESULTS AND CONCLUSIONS: Military health-care at the end of 18th century and the beginning of the 19th century joined a group of professionals who demonstrated talent and perseverance in the treatment of "military drip". To know the concepts for the diagnosis and treatment of urethritis improves our perspective in the knowledge of these pathologies, and confirms us in the evaluation of the advances available for us today, thanks to the addition of efforts of our predecessors (AU)

Urogenital surgery of the 15th century in Anatolia.

PURPOSE: We examined the urological procedures of the 15th century covered in the surgery textbook, Cerrahiyyetu'l Haniyye. MATERIALS AND METHODS: Three copies of the surgery textbook, Cerrahiyyetu'l Haniyye (Sultan's Surgery), by Serefeddin Sabuncuoglu, who lived in Turkey between 1385 and 1470, were evaluated. The colorfully miniaturized and illustrated textbook, written 536 years ago, covers a number of surgical disciplines, including urology. We evaluated urological sections with regard to the type of procedures, definitions and approaches for certain diseases and surgical tools used for urological operations. RESULTS: The textbook reviews the surgical treatment of urological conditions such as varicocele, hydrocele, hermaphroditism, imperforated urinary meatus, meatal stenosis, hypospadias, penile and scrotal lesions, and circumcision techniques. It includes definitions of diseases, etiologies and surgical therapies, and describes surgical instruments. The author also illustrated surgical approaches and instruments. CONCLUSIONS: A treasure trove of surgical knowledge, Cerrahiyyetu'l Haniyye has enlightened urologists from the 15th century to the present day.

[Urology and Psychosomatics. A historical summary]. / Urologie und Psychosomatik. Ein geschichtlicher Abriss.

The investigation and description of psychosomatic interrelationships has a long tradition in the field of urology. At the beginning of last century, psychosomatic theories and therapies involving urologic questions were developed, some of which are still part of current therapeutic strategies. Numerous studies accentuated the need for a psychosomatic diagnostics and therapy of urologic diseases. The appreciation of psychosomatic urology is growing, a fact which is reflected in current urological teaching curricula.

[Urological pathology in the memoires and critiques of the Literary Meetings of the San Carlos Royal College in Madrid (1788-1834)]. / Patología urológica en las memorias y censuras de las Juntas Literarias del Real Colegio de San Carlos de Madrid (1788-1834).

OBJECTIVE: The urologic cases presented for discussion to the Board of the San Carlos Royal College of Surgery (Madrid), created in 1787 by royal decree of King Carlos III for the education and training of surgeons attending the general population, are reviewed. Their contents and the stage of the art of urology in that period are analyzed. METHODS: 303 records in the archives of the Faculty of Medicine of the Complutensis University of Madrid, presented to the Board of the San Carlos Royal College of Surgery for discussion at their regular meetings on Thursday, during the period spanning 1788-1834, were reviewed. A complete list of urologic cases and a transcription of the description of a bladder procedure are presented. RESULTS: 69 urologic cases were found. Lithiasis was the most common, followed by voiding disorders that encompass all urethrovesical conditions. Complications, such as fistula and abscess, account for a large part of the cases reported, followed by testicular and scrotal pathology (basically hydrolece), veneral disease and their complications of stricture and infection. The surgical techniques mainly comprised lithotomy (with analysis of the different perineal approaches), bladder punction for retention, urethrotomy, circumcision and surgical treatment of hydrocele by castration or punction. CONCLUSIONS: The urologic cases reviewed by the Board of the San Carlos Royal College of Surgery were basically those of the most common conditions of that period, mainly lithiasis and voiding disorders arising from urethrovesical conditions and their complications, as well as diseases of the male genitalia. The surgical techniques focussed mainly on the description of stone removal by the perineal approach and castration or punction for hydrocele. The reports and reviews followed the principles of galenic and hippocratic medicine. The impact of European advancements were only observed in the latter stages. Undoubtedly, these records and reviews have made an outstanding contribution to the 18th and early 19th century Spanish medical literature.

Susruta, the pioneer urologist of antiquity.

PURPOSE: Susruta, a pioneer surgeon of antiquity, practiced around 1000 BC in India. We review his many contributions with special reference to the management of urological ailments. MATERIALS AND METHODS: Information gleaned from the available English translation of 3 volumes of Susruta's treatise in surgery is analyzed with commentaries and historical perspectives chronicled by Oriental and Occidental historians. RESULTS: Susruta belonged to the period between 600 and 1000 BC. His conceptions of anatomy, physiopathology and therapeutic strategies were of unparalleled brilliance, considering the early age in the history of mankind with no supportive knowledge base preceding his era. His discussions of many aspects of urological diseases are often reaffirmed in the principles of urology today. CONCLUSIONS: Through his rational understanding, elaborate teachings and practice of the art of surgery, and many urological ailments in particular Susruta has earned the glory of being the pioneer urologist of antiquity.

Genitourinary imaging: the past 40 years.

During the past 40 years, there has been a dramatic evolution in genitourinary imaging. This evolution has resulted in fundamental changes in the subspecialty. Uroradiology initially focused on radiographic imaging of the urinary tract and was practiced primarily by urologists. After the development of safe intravenous contrast materials, radiologists who focused on the urinary tract and worked closely with urologists forged major advances in urinary tract imaging and intervention. More recently, imaging of the extraurinary genital organs has been added to the subspecialty. Cross-sectional imaging techniques have supplanted radiographic imaging for both urinary and genital imaging. The emergence of the cross-sectional techniques, however, has blurred the traditional organ system-based distinction between gastrointestinal radiology and genitourinary radiology, as both organ systems are imaged simultaneously, and has resulted in a new amalgamation, abdominal radiology, with roots in both specialties. The challenge for the new generation of abdominal radiologists, trained predominantly in cross-sectional techniques, will be to maintain the close interaction with our clinical colleagues that the traditional organ system orientation fostered.

Patent medicines for the treatment of genitourinary diseases.

The present article addresses the nineteenth-century advertising of patent medicines in America, sold to "cure" diseases of the kidney and bladder, the "loss of manhood", and "debilitating conditions of the generative system." Most of the proprietary remedies made extravagant claims of effectiveness concerning a wide variety of ailments, and some claimed to cure every disease. Examples of promotional excesses demonstrate how the public was persuaded to buy a kaleidoscope of largely useless and occasionally harmful patent nostrums. The ephemera considered became a part of the history of medicine related to urology.

The future of the realm: medicine and divination in ancient Syro-Mesopotamia.

The contributions of Syro-Mesopotamian cultures to the understanding of illnesses and organ functions have been sought in examination of medical and therapeutic texts. These provide a wealth of knowledge on prevalent diseases and nascent empirical therapeutics. There are, however, other sources of information relevant to this topic that have not been as thoroughly explored. Examination of representative arts, for example, provides documentations of the breadth of anatomical knowledge in these cultures. Study of the omen literature is useful in illustrating beliefs in disease etiology as well as documentation of prevalent diseases and observations on anatomical variations. In the present article we explore the various sources for information relevant to the kidney and related diseases.

Medicinal plants for the treatment of urogenital tract pathologies according to Dioscorides' De Materia Medica.

The De Materia Medica of the Greek Dioscorides reports about 200 plants used for the treatment of pathologies of the urogenital tract during the 1st century AD. On the basis of explicit and implicit affirmations by Dioscorides, a theoretical system concerning the specific properties of these plants has been attempted. Comparison of the species reported by Dioscorides and Pliny the Elder for renal affections does not support the thesis of a close relationship between De Materia Medica and the Naturalis Historia.