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FRII-09 JOHANN PETER FRANK AND THE DAWNING OF THE MODERN HEALTHCARE SYSTEM: LET THERE BE LIGHT!
THE JOURNAL OF UROLOGYâ
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METHODS: Medical journals and news publications were reviewed regarding the work of Dr. Brunschwig. RESULTS: Alexander Brunschwig was born in El Paso, Texas on Sept. 11th, 1901. He attended Rush Medical School followed by training at Boston City Hospital, the University of Chicago and the University of Strasbourg, France. He was on staff at the University of Chicago from 1931 to 1947 when he performed the first one-stage radical pancreatoduodenectomy in 1937 which disproved the prevailing thought that an intact pancreas was required. He subsequently published “The Surgery of Pancreatic Tumors” in 1942, a milestone work in the developing field of hepatobiliary surgery. In 1947, Brunschwig became Chief of Gynecology at Memorial Hospital for Cancer in New York where he remained for the duration of his career. While Bricker performed the first pelvic exenteration in 1940 for rectal cancer, Brunschwig was operating largely on advanced gynecologic cancers and published the first case series of 22 patients in 1948 in the first volume of the journal ‘Cancer.’ Brunschwig’s initial cases had ‘wet colostomies’ with implantation of the ureters into segments of colon. His work was the subject of criticism from some contemporaries who considered him a “butcher,” but largely favorable recognition culminating with the publication of ‘L’Exenteration pelvienne’ in 1964 that reported 5 year survival in 116 of 562 patients. Dr. Brunschwig’s commitment to surgical therapy is exemplified in his aggressive approach, while his feelings about alternatives are reflected by his belief that “more people make a living giving chemotherapy than are cured by it.” CONCLUSIONS: On August 7th, 1969, Dr. Brunschwig collapsed in the operating room during his final surgical procedure. He died the same night at the age of 67 due to a cardiac event. His early contributions to the surgical management of advanced pelvic malignancy, and multitude of other fields, deserve a place in the History of Urology. Source of Funding: None
FRII-09 JOHANN PETER FRANK AND THE DAWNING OF THE MODERN HEALTHCARE SYSTEM: LET THERE BE LIGHT! € Stefan Uckert*, Hannover, Germany; Alois Dauenhauer, Rodalben, Germany; Knut Albrecht, Hannover, Germany; Andreas Bannowsky, €ck, Germany; Markus Kuczyk, Hannover, Hermann van Ahlen, Osnabru Germany INTRODUCTION AND OBJECTIVES: In modern westernized countries, urology - as we know it - is an integrated part of an efficient healthcare system committed to high common standards of education and quality of surgical and non-surgical treatment, supervised by government authorities. Nevertheless, Johann Peter Frank (born 1745 - died 1821), the man who greatly contributed by his innovative ideas and work to the creation of this system, is only randomly known. METHODS: A search of primary and secondary sources (books, journals, internet) was conducted in order to reproduce the life and work of Johann Peter Frank. RESULTS: Johann Peter Frank received his degree as a medical doctor from Heidelberg University in 1766. At that time, medicine in central Europe was not dominated by professional physicians but the activities of barbers, dressers, bladder stone surgeons, and midwifes. Due to the lack of knowledge, the life of thousands of patients were put at risk. In 1779, during his occupation € rstbischof of Speyer, Count of as the private physician of the Fu Limburg-Styrum, Frank conceived his vision of a modern and beneficial health care system, “Die Medicinische Polizey”. He presented the ideas of a standardized academic education of physicians, bedsite teaching, safe hygienic regulations and government funding in
Vol. 191, No. 4S, Supplement, Monday, May 19, 2014
order to create an infrastructure of hospitals and an administrative institution supervising the entire health care system. In 1784, as professor of the University of Pavia, under the hospices of his great mentor, Joseph II, Emperor of Austria, Frank set out to accomplish what he had outlined in “Die Medicinische Polizey”: improving the medical infrastructure, supporting and standardizing academic education of doctors, fighting against quackery by a system of supervision and control, and setting up a network of physician’s offices in rural regions. CONCLUSIONS: The achievements of Johann Peter Frank undoubtedly led European medicine and surgery into a new era. The significant role he played in the progress of modern medicine is most certainly due to his dedication and fervent conviction by which he made healthcare issues a matter of political discussion. Source of Funding: none
FRII-10 A HISTORICAL PERSPECTIVE ON PEYRONIE’S DISEASE AND ITS FOUNDING FATHER Amanda Saltzman*, Stephen Carriere, Jarratt Pytell, Harold Fuselier, New Orleans, LA INTRODUCTION AND OBJECTIVES: Peyronie’s Disease (PD) is a connective tissue disorder where a plaque forms in the tunica albuginea of the corpora cavernosa, resulting in a penile abnormality. Men between 40 and 60 years of age are most commonly affected, with an incidence of about 0.3% to 8.9%. PD was first described in 1743 by Francois Gigot de La Peyronie as a rosary bead of scar tissue along a patient’s penis creating the classic upward curvature. Due to the interesting history of both PD and La Peyronie, we aim to discuss La Peyronie himself and early theories of the pathogenesis and treatment of the disease he described. METHODS: We performed a PubMed literature search using the terms “Francois de la Peyronie” and “history of Peyronie’s disease”. 145 articles returned, 3 of which met inclusion criteria with a primary topic dedicated to the namesake of the disease or historical perspectives other than natural history of the disease. These articles were reviewed to compile a thorough report on Francois de La Peyronie and historical theories of the disease. RESULTS: Born in Montpellier, France, in 1678, La Peyronie was integral in describing PD. He was a barber-surgeon and became the chief surgeon at St. Eloi hospital where he treated numerous kings. He published only case reports and his most significant contribution to surgery was likely the management of gangrenous bowel. He founded the Royal Society of Sciences of Montpellier, an academic center that united physicians and surgeons for the first time in France, allowing surgeons to become doctors and share control over medical academic titles. Throughout the long history of PD, many factors have been theorized and proposed as potential causes of this disease. These include incest, sexually transmitted disease, genetics, the use of penile venous access, gout, diabetes, violations of “Nature’s Laws”, and as a response to a partner’s menopause. Interestingly, the current accept mechanism includes trauma, which is perhaps suggested in the historical reports of “annoying resistance” during intercourse with a “bored acquiescence”. Treatment suggested for PD include spa treatments with special mineral water, oral and topical minerals, and blood acidification. CONCLUSIONS: The rich historical reports of PD and its namesake offer a rare insight into the historical perspectives of PD as we enter the 21st century. It undoubtedly allows us to appreciate how far we’ve come and allow us to consider how far we still have to go. Source of Funding: none
e630
METHODS: Medical journals and news publications were reviewed regarding the work of Dr. Brunschwig. RESULTS: Alexander Brunschwig was born in El Paso, Texas on Sept. 11th, 1901. He attended Rush Medical School followed by training at Boston City Hospital, the University of Chicago and the University of Strasbourg, France. He was on staff at the University of Chicago from 1931 to 1947 when he performed the first one-stage radical pancreatoduodenectomy in 1937 which disproved the prevailing thought that an intact pancreas was required. He subsequently published “The Surgery of Pancreatic Tumors” in 1942, a milestone work in the developing field of hepatobiliary surgery. In 1947, Brunschwig became Chief of Gynecology at Memorial Hospital for Cancer in New York where he remained for the duration of his career. While Bricker performed the first pelvic exenteration in 1940 for rectal cancer, Brunschwig was operating largely on advanced gynecologic cancers and published the first case series of 22 patients in 1948 in the first volume of the journal ‘Cancer.’ Brunschwig’s initial cases had ‘wet colostomies’ with implantation of the ureters into segments of colon. His work was the subject of criticism from some contemporaries who considered him a “butcher,” but largely favorable recognition culminating with the publication of ‘L’Exenteration pelvienne’ in 1964 that reported 5 year survival in 116 of 562 patients. Dr. Brunschwig’s commitment to surgical therapy is exemplified in his aggressive approach, while his feelings about alternatives are reflected by his belief that “more people make a living giving chemotherapy than are cured by it.” CONCLUSIONS: On August 7th, 1969, Dr. Brunschwig collapsed in the operating room during his final surgical procedure. He died the same night at the age of 67 due to a cardiac event. His early contributions to the surgical management of advanced pelvic malignancy, and multitude of other fields, deserve a place in the History of Urology. Source of Funding: None
FRII-09 JOHANN PETER FRANK AND THE DAWNING OF THE MODERN HEALTHCARE SYSTEM: LET THERE BE LIGHT! € Stefan Uckert*, Hannover, Germany; Alois Dauenhauer, Rodalben, Germany; Knut Albrecht, Hannover, Germany; Andreas Bannowsky, €ck, Germany; Markus Kuczyk, Hannover, Hermann van Ahlen, Osnabru Germany INTRODUCTION AND OBJECTIVES: In modern westernized countries, urology - as we know it - is an integrated part of an efficient healthcare system committed to high common standards of education and quality of surgical and non-surgical treatment, supervised by government authorities. Nevertheless, Johann Peter Frank (born 1745 - died 1821), the man who greatly contributed by his innovative ideas and work to the creation of this system, is only randomly known. METHODS: A search of primary and secondary sources (books, journals, internet) was conducted in order to reproduce the life and work of Johann Peter Frank. RESULTS: Johann Peter Frank received his degree as a medical doctor from Heidelberg University in 1766. At that time, medicine in central Europe was not dominated by professional physicians but the activities of barbers, dressers, bladder stone surgeons, and midwifes. Due to the lack of knowledge, the life of thousands of patients were put at risk. In 1779, during his occupation € rstbischof of Speyer, Count of as the private physician of the Fu Limburg-Styrum, Frank conceived his vision of a modern and beneficial health care system, “Die Medicinische Polizey”. He presented the ideas of a standardized academic education of physicians, bedsite teaching, safe hygienic regulations and government funding in
Vol. 191, No. 4S, Supplement, Monday, May 19, 2014
order to create an infrastructure of hospitals and an administrative institution supervising the entire health care system. In 1784, as professor of the University of Pavia, under the hospices of his great mentor, Joseph II, Emperor of Austria, Frank set out to accomplish what he had outlined in “Die Medicinische Polizey”: improving the medical infrastructure, supporting and standardizing academic education of doctors, fighting against quackery by a system of supervision and control, and setting up a network of physician’s offices in rural regions. CONCLUSIONS: The achievements of Johann Peter Frank undoubtedly led European medicine and surgery into a new era. The significant role he played in the progress of modern medicine is most certainly due to his dedication and fervent conviction by which he made healthcare issues a matter of political discussion. Source of Funding: none
FRII-10 A HISTORICAL PERSPECTIVE ON PEYRONIE’S DISEASE AND ITS FOUNDING FATHER Amanda Saltzman*, Stephen Carriere, Jarratt Pytell, Harold Fuselier, New Orleans, LA INTRODUCTION AND OBJECTIVES: Peyronie’s Disease (PD) is a connective tissue disorder where a plaque forms in the tunica albuginea of the corpora cavernosa, resulting in a penile abnormality. Men between 40 and 60 years of age are most commonly affected, with an incidence of about 0.3% to 8.9%. PD was first described in 1743 by Francois Gigot de La Peyronie as a rosary bead of scar tissue along a patient’s penis creating the classic upward curvature. Due to the interesting history of both PD and La Peyronie, we aim to discuss La Peyronie himself and early theories of the pathogenesis and treatment of the disease he described. METHODS: We performed a PubMed literature search using the terms “Francois de la Peyronie” and “history of Peyronie’s disease”. 145 articles returned, 3 of which met inclusion criteria with a primary topic dedicated to the namesake of the disease or historical perspectives other than natural history of the disease. These articles were reviewed to compile a thorough report on Francois de La Peyronie and historical theories of the disease. RESULTS: Born in Montpellier, France, in 1678, La Peyronie was integral in describing PD. He was a barber-surgeon and became the chief surgeon at St. Eloi hospital where he treated numerous kings. He published only case reports and his most significant contribution to surgery was likely the management of gangrenous bowel. He founded the Royal Society of Sciences of Montpellier, an academic center that united physicians and surgeons for the first time in France, allowing surgeons to become doctors and share control over medical academic titles. Throughout the long history of PD, many factors have been theorized and proposed as potential causes of this disease. These include incest, sexually transmitted disease, genetics, the use of penile venous access, gout, diabetes, violations of “Nature’s Laws”, and as a response to a partner’s menopause. Interestingly, the current accept mechanism includes trauma, which is perhaps suggested in the historical reports of “annoying resistance” during intercourse with a “bored acquiescence”. Treatment suggested for PD include spa treatments with special mineral water, oral and topical minerals, and blood acidification. CONCLUSIONS: The rich historical reports of PD and its namesake offer a rare insight into the historical perspectives of PD as we enter the 21st century. It undoubtedly allows us to appreciate how far we’ve come and allow us to consider how far we still have to go. Source of Funding: none