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Clinical Insight
P R O B E
• V o l . L I I I • N o . 3 • A p r – J u n 2 0 1 4
History of Medicine
The History of Urinary Stones: In Parallel
With Civilization
Tefekli A, Cezayirli F
Sci World J
. 2013;2013:423964.
The roots of modern science and history of urinary stone
disease go back to the ancient era of Egyptians and
Mesopotamians. Hippocrates defined the symptoms of
bladder stones. The first recorded details of “perineal
lithotomy” were those of Cornelius Celsus. Ancient arabic
medicine was based mainly on classical Greco-Roman
works. Interestingly, the Fourth Lateran Council in 1215
forbade physicians from performing surgical procedures,
as contact with blood or body fluids was viewed as
contaminating to men. With Renaissance, new procedures
could be tried on criminals. The first recorded suprapubic
lithotomy was carried out by Pierre Franco in 1561. In
1874, Bigelow developed a lithotrite, which was introduced
into the bladder under anesthesia (called as “litholopaxy”).
Young was the first to report ureteroscopy (1929). With
advances in intracorporeal lithotripsy techniques,
ureteroscopy became the treatment of choice for ureteric
stones. In 1976, Fernstrom and Johannson established
percutaneous access to remove a renal stone. However,
with the introduction of the first extracorporeal shock wave
machine in 1980, a dramatic change in stone management
was observed. Civilization in parallel with scientific
developments has brought us to a point where we try not
to “cut” our patients for stone disease, as Hippocrates
admonishes, but rather manage them with minimal
invasive alternatives.
Rhazes, a Genius Physician in Diagnosis and
Treatment of Kidney Calculi in Medical History
Changizi Ashtiyani S, Cyrus A
Iran J Kidney Dis
. 2010;4(2):106–110.
Abu Bakr Mohammad Ibn Zakariya Razi, known
in the West as Rhazes (865 to 925 AD), was born in
the ancient city of Rayy, near Tehran, Iran. He was a
renowned physician in medical history and not only
followed Hippocrates and Galen, but also greatly extended
the analytical approach of his predecessors. Based on
the existing documents, he was known as the most
distinguished character in the world of medicine up to the
17th century. A great number of innovations and pioneering
works in medical science have been recorded in the name
of Rhazes. His fundamental works in urology as part of his
research in the realm of medicine have remained unknown.
Pathophysiology of the urinary tract, venereal diseases, and
kidney and bladder calculi are among his main interests
in this field. He also proposed and developed methods for
diagnosis and treatment of kidney calculi for the first time
in medical history. He presented a very exact and precise
description of neuropathic bladder followed by vertebral
fracture. He advanced urine analysis and studied function
and diseases of the kidneys. Rhazes recommendations for
the prevention of calculi are quite scientific and practical
and in accordance with current recommendations to avoid
hypercalciuria and increased saturation of urine. Rhazes
was not only one of the most important Persian physician–
philosophers of his era, but for centuries, his writings
became fundamental teaching texts in European
medical schools.
