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Congenital megacolon observation by Frederick Ruysch—1691
Journal of Pediatric
Surgery VOL. 5, NO. 1
FEBRUARY,1970
Congenital Megacolon Observation by Frederick Ruysch-1691 By ERIC LEENDERS AND WILLIAM K. SIEBER DESCRIPTION of congenital megacolon was reported by Hirschsprung in 1886 at the “Gesellshaft fur Kinderheilkunde-Berlin”’ and appears in the literature of 1887. Several cases had been observed before this time. The earliest ones were thought to be those of Parry in 1825 and Billard in 1829.” F. Jayle in 1909” called attention to a report by F. Ruysch dated 1691, and now generally accepted as the first recorded instance of this disorder. This was the case of a child who died at the age of five years and who was autopsied by Frederick Ruysch. The observation was reported in his work. Observationurn Anatomici-chirurgicarum Centuria, t published in Amsterdam in 1691. The English translation from the original Latin text (Fig. 1) is as follows: “Observation 92: Enormous dilatation of the colon. A five year old girl had been complaining for a long while of abdominal cramps. Whatever remedies have the ability to ease pain, dispel flatus, or kill worms were tried several times and found useless; for the pains continued and finally she died. When the small body was opened, I could see (to my amazement) hardly any abdominal viscus except that part of the colon where the rectum begins. The other viscera were hidden under an enormous extension of that part.” F. Ruysch,” a Dutch physician, was born on 23 March 1638 at ‘s Gravenhaage (Netherlands). At first a pharmacist, he received his medical doctor’s degree with a thesis, “De Pleuritide” in 1664. A year thereafter he described the lymphatic system, “Dislucidatio Valvularum in Vasis Lymphaticis.” This work established his reputation as an anatomist. Ruysch was a man with varied interests. He became the official city teacher of obstetrics. Subsequently he was nominated to “Praelector Chirurgiae et Anatomiae” and later became Professor of Botany. His fame grew all over Europe. In 1720 he was nominated to the Royal Society of London, and in I72 1 he replaced Isaac Newton at the Royal Society of Paris. One wonders why Ruysch did not describe the distal narrow segment. In his typical concise autopsy reports, Ruysch presents only positive findings and
T
HE CLASSICAL
From the Sargical Services of the Children’s Hospital of Pittsburgh and the School of Medicine, University of Pittsburgh, Pittsburgh, Pa. ERIC LEENDERS,M.D.: Teaching Fellow in Pediatric Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pa. WILLIAM K. SIEBER,M.D.: Clinical Assistant Professor of Surgery, School of Medicine, University of Pittsburgh, Pitt,sburgh, Pa. JOURNAL.OF PEDIATRICSURGERY,VOL. 5, No. 1 (FEBRUARY). 1970
1
LEENDERS
AND SIEBER
autopsy report of congenital megacolon (Observationum Fig. l.- A.-Original Anatomico-Chirurgicarum Centuria). B.-Front page of F. Ruysch’s original book published in 169 I. C.-Portrait of F. Ruysch. (B and C courtesy of the Welch Medical Library, The Johns Hopkins University School of Medicine.) disregards what he considers to be normal. This may be why there is no mention of the distal segment-an oversight, the significance of which has become apparent only in recent years. SUMMARY
Although the Hirschsprung in to F. Ruysch, a “Observationurn
classical description of congenital megacolon is reported by 1886, the first recorded instance of this disorder is attributed Dutch anatomist. This first case report appears in his work, Anatomici-Chirurgicarum Centuria,” in 169 1.
CONGENITAL
MEGACOLON
OBSERVATION
3
ACKNOWLEDGMENT The authors acknowledge the help of Donald W. Peterson, M.D., Fellow, History of Medicine, Johns Hopkins Hospital, Baltimore, Md.
Institute of the
REFERENCES 1. Hirschsprung: Stuhltragheit neugeborener in folge von dilatation und hypertophie des colons. larb. kinderh, 27:1, 1887. 2. Finney, J. M. T.: Congenital idiopathic dilatation of the colon. Surg. Gynec. Obstet. 61624, 1908. 3. Jayle. F.: La dilatation congenitale
idiopathique du colon. Presse Medicale. 17: 803, 1909. 4. Ruysch, F.: Observationum anatomiaechirurgicarum centuria. Amsterdam. 169 I. 5. Scheltema, P.: Het leven van F. Academisch proefschrift-SliedRuysch. recht. Gebroeders Luyt, 1886.
Surgery VOL. 5, NO. 1
FEBRUARY,1970
Congenital Megacolon Observation by Frederick Ruysch-1691 By ERIC LEENDERS AND WILLIAM K. SIEBER DESCRIPTION of congenital megacolon was reported by Hirschsprung in 1886 at the “Gesellshaft fur Kinderheilkunde-Berlin”’ and appears in the literature of 1887. Several cases had been observed before this time. The earliest ones were thought to be those of Parry in 1825 and Billard in 1829.” F. Jayle in 1909” called attention to a report by F. Ruysch dated 1691, and now generally accepted as the first recorded instance of this disorder. This was the case of a child who died at the age of five years and who was autopsied by Frederick Ruysch. The observation was reported in his work. Observationurn Anatomici-chirurgicarum Centuria, t published in Amsterdam in 1691. The English translation from the original Latin text (Fig. 1) is as follows: “Observation 92: Enormous dilatation of the colon. A five year old girl had been complaining for a long while of abdominal cramps. Whatever remedies have the ability to ease pain, dispel flatus, or kill worms were tried several times and found useless; for the pains continued and finally she died. When the small body was opened, I could see (to my amazement) hardly any abdominal viscus except that part of the colon where the rectum begins. The other viscera were hidden under an enormous extension of that part.” F. Ruysch,” a Dutch physician, was born on 23 March 1638 at ‘s Gravenhaage (Netherlands). At first a pharmacist, he received his medical doctor’s degree with a thesis, “De Pleuritide” in 1664. A year thereafter he described the lymphatic system, “Dislucidatio Valvularum in Vasis Lymphaticis.” This work established his reputation as an anatomist. Ruysch was a man with varied interests. He became the official city teacher of obstetrics. Subsequently he was nominated to “Praelector Chirurgiae et Anatomiae” and later became Professor of Botany. His fame grew all over Europe. In 1720 he was nominated to the Royal Society of London, and in I72 1 he replaced Isaac Newton at the Royal Society of Paris. One wonders why Ruysch did not describe the distal narrow segment. In his typical concise autopsy reports, Ruysch presents only positive findings and
T
HE CLASSICAL
From the Sargical Services of the Children’s Hospital of Pittsburgh and the School of Medicine, University of Pittsburgh, Pittsburgh, Pa. ERIC LEENDERS,M.D.: Teaching Fellow in Pediatric Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pa. WILLIAM K. SIEBER,M.D.: Clinical Assistant Professor of Surgery, School of Medicine, University of Pittsburgh, Pitt,sburgh, Pa. JOURNAL.OF PEDIATRICSURGERY,VOL. 5, No. 1 (FEBRUARY). 1970
1
LEENDERS
AND SIEBER
autopsy report of congenital megacolon (Observationum Fig. l.- A.-Original Anatomico-Chirurgicarum Centuria). B.-Front page of F. Ruysch’s original book published in 169 I. C.-Portrait of F. Ruysch. (B and C courtesy of the Welch Medical Library, The Johns Hopkins University School of Medicine.) disregards what he considers to be normal. This may be why there is no mention of the distal segment-an oversight, the significance of which has become apparent only in recent years. SUMMARY
Although the Hirschsprung in to F. Ruysch, a “Observationurn
classical description of congenital megacolon is reported by 1886, the first recorded instance of this disorder is attributed Dutch anatomist. This first case report appears in his work, Anatomici-Chirurgicarum Centuria,” in 169 1.
CONGENITAL
MEGACOLON
OBSERVATION
3
ACKNOWLEDGMENT The authors acknowledge the help of Donald W. Peterson, M.D., Fellow, History of Medicine, Johns Hopkins Hospital, Baltimore, Md.
Institute of the
REFERENCES 1. Hirschsprung: Stuhltragheit neugeborener in folge von dilatation und hypertophie des colons. larb. kinderh, 27:1, 1887. 2. Finney, J. M. T.: Congenital idiopathic dilatation of the colon. Surg. Gynec. Obstet. 61624, 1908. 3. Jayle. F.: La dilatation congenitale
idiopathique du colon. Presse Medicale. 17: 803, 1909. 4. Ruysch, F.: Observationum anatomiaechirurgicarum centuria. Amsterdam. 169 I. 5. Scheltema, P.: Het leven van F. Academisch proefschrift-SliedRuysch. recht. Gebroeders Luyt, 1886.