Margaret Dix, Charles Hallpike and the 'Lagerungs' Manoeuvre.

The main objective of this manuscript is to describe some personal and professional aspects of two outstanding researchers and pioneers in neuro-otology. Among other achievements, Margaret Ruth Dix, and Charles Skinner Hallpike, designed the most-used provocative test for positional nystagmus for the diagnosis of lithiasis in the vestibular posterior semicircular canal.

Margaret Dix, Charles Hallpike and the 'Lagerungs' Manoeuvre / Margaret Dix, Charles Hallpike e a Manobra 'Lagerungs'

ABSTRACT The main objective of this manuscript is to describe some personal and professional aspects of two outstanding researchers and pioneers in neuro-otology. Among other achievements, Margaret Ruth Dix, and Charles Skinner Hallpike, designed the most-used provocative test for positional nystagmus for the diagnosis of lithiasis in the vestibular posterior semicircular canal.

RESUMO O principal objetivo desse manuscrito diz respeito a alguns aspectos pessoais e profissionais de dois excelentes pesquisadores e pioneiros da neuro-otologia. Entre outras descrições, Margaret Ruth Dix e Charles Skinner Hallpike descreveram o teste provocativo mais utilizado de nistagmo posicional para o diagnóstico de litíase no canal semicircular posterior do sistema vestibular.

[The diseases of Bossuet]. / Pathographie de Bossuet (1627-1704).

Jacques Bénigne Bossuet--nicknamed 'the Bright Eagle from Meaux' by Voltaire--died at 77, in his Parisian place of residence, on April 12th 1704. Which disease so took this robust prelate of Burgundian origin, bishop since he was 53 and whose active life had been filled with important duties and honours. If bibliography about his life is copious we owe before any trusting the testimony of his private secretary, priest François Le Dieu, whose diary describes everyday life in detail. Thus we know his fevers, skin rashes in 1699, and his bronchial and digestive problems and we can follow the evolution of his vesical lithiasis complicated with purulent, necrosing cystisis which led to the lethal evolution in spite of the efforts of renowned praticians.

Enterolithiasis.

Enterolithiasis or formation of gastrointestinal concretions is an uncommon medical condition that develops in the setting of intestinal stasis in the presence of the intestinal diverticula, surgical enteroanastomoses, blind pouches, afferent loops, incarcerated hernias, small intestinal tumors, intestinal kinking from intra-abdominal adhesions, and stenosing or stricturing Crohn's disease and intestinal tuberculosis. Enterolithiasis is classified into primary and secondary types. Its prevalence ranges from 0.3% to 10% in selected populations. Proximal primary enteroliths are composed of choleic acid salts and distal enteroliths are calcified. Clinical presentation includes abdominal pains, distention, nausea, and vomiting of occasionally sudden but often fluctuating subacute nature which occurs as a result of the enterolith tumbling through the bowel lumen. Thorough history and physical exam coupled with radiologic imaging helps establish a diagnosis in a patient at risk. Complications include bowel obstruction, direct pressure injury to the intestinal mucosa, intestinal gangrene, intussusceptions, afferent loop syndrome, diverticulitis, iron deficiency anemia, gastrointestinal hemorrhage, and perforation. Mortality of primary enterolithiasis may reach 3% and secondary enterolithiasis 8%. Risk factors include poorly conditioned patients with significant obstruction and delay in diagnosis. Treatment relies on timely recognition of the disease and endoscopic or surgical intervention. With advents in new technology, improved outcome is expected for patients with enterolithiasis.

Seventeenth-century 'treasure' found in Royal Society archives: the Ludus helmontii and the stone disease.

Our archival researches at the Royal Society reveal that a small envelope attached to a 1675 letter from an Antwerp apothecary, A. Boutens, contained a sample of the 'Ludus' prepared as a remedy for the 'stone disease' then sweeping through Europe, which was first announced in J. B. van Helmont's De lithiasi (1644). After examining the fascination with the medical use of the Ludus (which required the 'alkahest' for its preparation) and the tenacious efforts to procure it, we trace the fortunae of two other ludi in England, brought to and offered by Francis Mercurius van Helmont during his English sojourn. Both eventually found their way to the geologist John Woodward, one of them through Sir Isaac Newton. Finally we show how the allure of the Ludus helmontii vanished, with transformations in mineral analysis and reclassifications from Woodward to John Hill.

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)

XXV Aniversario del Grupo de Trabajo de Endoscopia-Litiasis-Laparoscopia (LEL) / XXV anniversary of the endoscopy-lithiasis-laparoscopy (LEL) working group

Introducción: El objetivo de este artículo es relatar los avatares estructurales y cambios de contenido, vividos por nuestro Grupo de Trabajo, LEL durante veinticinco años. Material y métodos: El material recopilado proviene de tres fuentes: las vivencias y experiencias del autor, la iconografía proporcionada por los coordinadores y, los datos obtenidos de programas, cartas, etc. Este material ha sido cribado y ordenado en seis etapas y se ha procedido a señalar en cada una de ellas los datos específicos de cada jornada, los datos claves estructurales y los hechos más relevantes durante el periodo. Resultados: Como consecuencia de la actividad del Grupo se han conseguido varios propósitos: protocolizarlas técnicas endoscópicas del Aparato Urinario Inferior y prolongarlas al Aparato Urinario Superior: URS y cirugía percutánea, el tratamiento integral de la Litiasis, la defensa de técnicas propias (como la RTU frente alternativas)así como peritar las nuevas tecnologías (láser en Urología) y sustituir técnicas de cirugía abierta por otras pertenecientes al Grupo: NLP y Laparoscopia. Conclusiones: Durante 25 años el Grupo de Trabajo LEL, se ha mantenido cohesionado y activo, participando en cambios internos estructurales y externos, motivados por la aparición durante este periodo, de espectaculares novedades: acceso endoscópico al Aparato Urinario Superior, tratamiento Integral de la Litiasis y alternativas a cirugías clásicas (Cirugía Percutánea, Cirugía Laparoscópica) (AU)

Introduction: The purpose of this article is to describe the structural vicissitudes and content changes experienced by our Work Group, LEL over the last twenty-five years. Materials and methods: The compiled material comes from three sources: the author’s experiences; the iconography provided by the coordinators; and the data obtained from programmes, letters, etc. This material has been analyzed and organized into six stages and the following has been highlighted in each of these: specific data from each day; key structural data; and the most relevant facts during the period. Results: Various proposals have been made as a result of the Group’s activity: to formally record the endoscopy techniques for the lower urinary tract and extend them to the upper urinary tract: URS and percutaneous surgery, the comprehensive treatment of lithiasis, the defence of our own techniques (such as UTR versus alternatives),as well as to provide an expert opinion on new technologies (laser in urology), and to replace open surgery techniques with others belonging to the Group: PNL and laparoscopy. Conclusions: For 25 years, the LEL Work Group has stayed active and closely united. It has participated in both internal and external structural changes prompted by the appearance of spectacular new developments that have emerged over this period of time: endoscopic access to the upper urinary tract; comprehensive treatment of lithiasis; and alternatives to traditional surgeries (percutaneous surgery, laparoscopic surgery) (AU)

La patología urológica en la obra de abulcasis / Urological diseases in the works of Abulcasis

OBJETIVO: Realizar un estudio de la obra quirúrgica de Abulcasis en el campo de la Urología, conocer el instrumental y las diferentes técnicas empleadas así como las innovaciones introducidas para solucionar algunos aspectos de la patología urológica. MÉTODOS: Se ha revisado y traducido del latín la parte urológica del libro XXX del Tasrif utilizando la edición editada en Estrasburgo en 1532. RESULTADOS: El autor apenas se refiere a los aspectos clínicos de las diferentes patologías del aparato genitourinario centrándose en el tratamiento quirúrgico de las mismas. Utiliza con asiduidad el cauterio sobre todo para controlar la hemorragia en las diferentes intervenciones. Se puede comprobar que algunos pasos quirúrgicos se continúan practicando en la actualidad. CONCLUSIONES: Abulcasis es el primer médico nacido en España que estudia el tratamiento quirúrgico de la patología urológica y que hace un estudio gráfico del instrumental utilizado. Aporta innovaciones técnicas en diversas intervenciones y describe por primera vez la talla vesical en la mujer, la litotricia vesical y uretral

OBJECTIVES: To perform a study on the surgical work of Abulcasis in the field of urology, to know the surgical tools and different techniques used, as well as the innovations applied to solve some features of urological diseases. METHODS: The part on urology from the book XXX by Tasrif, the edition from Strasbourg in 1532 was reviewed and translated from Latin. RESULTS: The author does not refer much to the clinical features of the various pathologies of the genitourinary apparatus; he focuses instead on the surgical treatment of them. The author usually used the «cautery» mainly to control hemorrhage in various operations. Some of these surgical practices are being used nowadays. CONCLUSIONS : Abulcasis was the first doctor born in Spain that studied the surgical treatment of urological diseases and performed a graphic study on the tools used. He introduced technical innovations on different operations and described for the first time the vesical lithotomy on women, and vesical and urethral lithotripsy (AU)

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 y desarrollo de la ureterorrenoscopia / Birth and development of ureterorenoscopy

Se describe en este trabajo la historia del desarrollo de la ureterrenoscopia rígida que comenzó en 1979 y hoy en día es una realidad en la mayoría de los servicios urológicos del mundo. Desde el primer Ureterorrenoscopio con un calibre extraordinariamente amplio y sin ningún sistema de dilatación, ni tampoco ningún sistema operativo, fue desarrollándose la actual técnica en donde desde la bomba de hidratación hidráulica hasta la fragmentación con láser ha permitido convertir a la ureterorrenoscopia en un procedimiento habitual para la resolución de litiasis, extracción de cuerpos extraños intraureterales ó renales, resolución de estenosis, diagnóstico de hematurias unilateralesy tratamiento endourológica de tumores uroteliales muy seleccionados

In this paper we describe the history of the development of rigid ureterorenoscopy. It started in 1979 and today is a reality in most urological departments of the world. From the first ureterorenoscope with a extraordinarily large caliber and no dilation or operative systems, the current technique have developed, so that from hydraulic water pump to laser fragmentation have enabled to make ureterorenoscopy a common procedure for the resolution of urinary stones, extraction of foreign bodies in the ureter or kidney, treatment of stenosis, diagnosis of unilateral hematuria and endourological treatment of selected urothelial tumors

Historia de la litotricia por ondas de coche en España / The history of extracorporeal shockwave lithotripsy in Spain

Se aporta bosquejo histórico acerca de la urolitiasis con especial hincapié en las alternativas históricas a la cirugía de la litiasis.Se introducen los antecedentes que llevan al nacimiento de la litotricia extracorpórea por ondas de choque y a la implantación de la misma en nuestro país

We give a historical outline of urinary lithiasis with emphasis in the alternative therapeutic optionsto surgery.We expose the previous steps that led to the birth of extracorporeal shockwave lithotripsy and its implementationin our country