THE HISTORY OF UROLOGY ON POSTAGE STAMPS AND CANCELLATIONS

Vol. 158, 1335-1339. October 1997 Printed i n U.S.A.

Historical Article THE HISTORY OF UROLOGY ON POSTAGE STAMPS AND CANCELLATIONS ERWIN W. RUGENDORFF

AND

TOM WILSON

From Frankfurt a m Main, Germany and Ashford, England

ABSTRACT

Purpose: Many important phases and personalities in the history of urology have been depicted on postage stamps, stationery and cancellations. Materials and Methods: The article gives a short recounting of several notable events that contributed to the development of urology as chronicled by philatelic material. Results: Beginning with the Egyptian papyri and ending with a recently acknowledged urologist, the historical survey covers uroscopy, lithotomy, lithotrity, anatomy, pathology, instruments, surgical techniques in urology, imaging techniques of the urinary tract, dialysis and renal transplantation. Personalities whose accomplishments have made a deep imprint in the history of urology, if honored on philatelic items, are described in this article. Conclusions: Although the resulting picture does not necessarily present a continuity, it does emphasize certain peaks and high points in the evolution of this specialty. KEYWORDS:history, philately

Uroscopy, a practice that has been described in the medical on a German stamp (fig. 1, 0. Ephraim McDowell (1771 to literature as far back as antiquity, is depicted on postage 1830) performed lithotomy 22 times in succession without stamps (fig. 1, A), and on special cancellations.'-7 During the losing a case (fig. 1, LQ.5 Guillaume Dupuytren (1778 to 1835) period of 2600 to 1200 BC medical knowledge was already contrived bilateral lithotomy using a double lithotome with recorded by Egyptians on medical papyri. The Ebers Papy- concealed blades.5. l2 rus, written about 1500 BC, clearly refers to hematuria sugBy tying both ureters with ligature in animals, Claudius gesting that it is caused by parasites.",7 One of the authors of Galen of Pergamon (129 to 199) demonstrated that urine these writings could have been Imhotep, a physician at the passes into the bladder through the ureters coming exclucourt of Pharaoh Djosar, about 2780 BC.6.R sively from the kidneys. He recommended a curved or Hippocrates (460 to 377 BC) mentions the catheter as S-shaped metal catheter for use in both men and women. being among his surgical tools. It seems, however, that he did It is suggested that Arabians were the first to develop a not use it to diagnose bladder stones. The commitment "I will flexible catheter obtained from stiffened animal skins and not cut persons laboring under the stone, but will leave this that Avicenna (930 to 10373, in his Canon of Medicine, was to be done by men who are practitioners of this work" in the the first to describe it (fig. 2, A). Rhazes (865 to 925) has been Oath attributed to Hippocrates reflects his attitude toward credited with the use of side openings in a catheter.*:',14 lithotomy.5-7 Aristotle (384 to 322 BC), who had not observed Abulcasis (936 to 1013) favored a silver catheter that he used blood clots in the internal cavity of the kidney of those ani- mainly for urinary retention secondary to bladder stone and mals he dissected, concluded that the b!ood did not reach it. for imgation. He performed urethrotomy, using a triangular He taught that stones were formed primarily in the bladder pointed blade of tempered iron fixed on a wooden handle, as as a result of humors passing down from the kidneys.2.5.6 well as lithotomy, making a transverse incision between the Dioscorides Pedanius (first century AD) believed in talis- anus and the scrotum. mans and recommended the use of the Jew-stone found Ambroise Pare (1510 to 1590) introduced new concepts in .~ of the treatment of hydrocele and urethral strictures (fig. 2, B ) . in Judaea for dissolving urinary c a l c ~ l i . ~Aretaeus Cappadocia (81to 138), who gave the first accurate account of He designed special leaden sounds for excoriating the "cardiabetes, practiced urethrotomy for urethral calculi that nosities" and performed antegrade internal urethrotomy could not be dislodged.4.5 (most likely through a perineal incision) with sharp metal The date of introduction of lithotomy into Europe is un- catheters. Of interest are the unusual illustrations in his certain. The technique of lithotomy described by Aulus Opera omnia showing ingenious tools to be used in cutting for Cornelius Celsus (first century AD) was practiced with only the stone and the earliest recorded impotence device.ls minor modifications until the sixteenth c e n t ~ r y . For ~ . ~cenLorenz Heister (1683 to 1758) wrote at lengths about cathturies, itinerant lithotomists and barber-surgeons, as well eterization and puncture of the bladder. He used a suprapuas physicians who specialized in cutting for the stone, as bic trocar and usually left it in place for some days or even Johannes Andreas Eisenbarth (1663 to 1727) were regarded permanently in old men suffering from prostatism. Auguste as mysterious, adventurous and even shady (fig. 1, B).l.3.7.9.10Nelaton (1807 to 1873) designed the rubber catheter that A lithotome, as part of a set of ancient surgical instruments spared the patient the distress of the classic "tour de maitre" from the collection of the Karl-Sudhoff-Institute is depicted with rigid catheters and sounds. He also devised an aspirator for evacuation of stone fragments after lithotrity. The credit Accepted for publication February 28, 1997. 1335

1336

HISTORY OF UROLOGY ON POSTAGE STAMPS

FIG.1. A, uroscopy-miniature from Avicenna’s Canon of Medicine (Austria, 1982).B , Doctor Eisenbarth (F. R. Germany, 1977).C, lithotome and hernia instrument (D. R. Germany, 1981).D, Ephraim McDowell (U.S.A., 1959).

for bringing lithotrity to the peak of its development belongs to Henry Bigelow (1818 to 1890). He attempted to crush and remove bladder stones of any size and degree of hardness at a single sitting (litholapaxy, 1878). Of prime importance to the success of his method was his evacuating apparatus, more powerful than previous aspirators. C. G. Heynemann’s cancellation (cystoscope makers) reminds us of Max Nitze (1848 to 1906) who, in 1877, constructed the forerunner of the modem cystoscope. Paracelsus (1493 to 1541) stated that urine was a n index of the function of the whole body and that it was a guide to the state of health (fig. 2, C ) .To detect the cause of a disease, the urine was weighed and distilled, and the position of the resulting vapor in the alembic indicated the site of the disease. Andreas Vesalius (1514 to 1564) defied tradition and gave a correct description of the structure of the kidney. In his De Humani Corporis Fabrica, he contradicted Galen and ridiculed the description of the famous “filter kidney” consisting of 2 chambers separated by a filter membrane.15 William Harvey (1578 to 1657) described a method of treating cancer of the testicle by ligation of the spermatic cord for which he was probably better known in his own days than for the discovery of the blood circulation. Bartolomeo E. Eustachi (around 1510 to 1574) discovered the suprarenal glands and described the uriniferous tubules. Caspar Bauhin (1560 to 1624) reported a left ectopic kidney situated in the pelvis. Nicolaus Peterson Tulp (1593 to 1674) described the condition later known by the title of fibrous cavernositis (Peyronie’s disease) as ”coles incurvatus.” Marcello Malpighi (1628 to 1694) discovered the glomeruli by injecting ink into the renal artery (fig. 2, D).Franqois de La Peyronie (1678 to 1747) founder of the Academy of Surgery, in 1743, described the condition known today under his epon-

ymous name. The credit for demonstrating the significance of prostatic hyperplasia goes to Giovanni Battista Morgagni (1682 to 1771). In 1761, he first described the pedunculated testicular and epididymal appendages. Albrecht von Haller (1708 to 1777) reported on anomalies of the bladder (double bladder). Karl Freiherr von Rokitansky (1804 to 1878), in 1846, described the hydronephrotic dilatation of the kidney under the title of “hydrops renalis.” Joseph Hyrtl (1810 to 18941, in 1882, established the existence of a relatively avascular plane posterior to the midline of the kidney (“bloodless line”) used in the incision for nephrolithotomy). Rudolf Virchow (1821 to 1902), in 1863, described 2 types of tissue in hyperplastic prostates as “adenoma” and “myoma” but remained in doubt whether they were true neoplasia. Nikolay Pirogoff (1810 to 1881), founder of the War Field Urology, recommended bypassing the urine following urethral trauma and stipulated that no instrument should be introduced into the urethra immediately after it had been injured (fig. 3, A). Theodor Billroth (1829 to 1894) is credited with performing the first planned perineal prostatectomy for carcinoma in 1867. In 1874, he published a case describing the suprapubic approach and removal of a large bladder tumor from a child, at a time when other surgeons still used the perineal approach for bladder surgery. Alfred Fournier (1832 to 1914), in 1907, first practiced side-to-side anastomosis on a patient with a severed ureter end (fig. 3, B ) . Fournier’s gangrene has been used to describe the necrotizing fasciitis of the genital and perineal tissues due to mixed infections with aerobic and anaerobic organisms. Ernst von Bergmann (1836 to 1907), in 1874, added a short transverse limb t o Simon’s incision for renal surgery. Theodor E. Kocher (1841 to 1917) performed an anterior transperitoneal nephrectomy through a midline incision as early as 1876.

HISTORY OF UROLOGY ON POSTAGE STAMPS

FIG. 2.

1337

A,Avicenna (Algeria, 1980).B , Ambroise Pare (France, 1943).C,Paracelsus (Switzerland, 1993).D,Marcello Malpighi (Transkei,

1985).

Edoardo Bassini (1844 to 1924), in 1882, introduced the fixation of the floating kidney by capsular sutures. William S. Halsted (1852 to 1922), in 1904, assisted Hugh Hampton Young in carrying out radical perineal prostatectomy for carcinoma of the prostate. Thoma Ionescu (1860 t o 1926), in 1897, removed the capsule from the lateral border of the kidney and transfixed the floating kidney with nonresorbable sutures. Anton von Eiselsberg (1860 to 1930), in 1904, successfully excised a diverticulum of the bladder by an extravesical technique. August Bier ( 1861 to 1949), promoter of intraspinal anesthesia with cocaine, suggested in 1893 that atrophy of the enlarged prostate might follow ligation of its arterial supply. He performed 11 such operations with 3 deaths, and in 7 patients the results were considered good. Felix Guyon (1831 to 1920), known as the father of modem urology, founded the International Society of Urology and was elected president of its First International Congress held in Paris in 1908 (fig. 3, C ) . Georges Marion (1869 to 1943) devised various urological techniques. He was the first to describe the asymmetrical obstruction of the upper urinary tract that can be seen occasionally on the excretory urogram In prostate cancer. Robert C. Coffey (1869 to 1933), in 1910, reported his experimental studies on ureterointestinal anastomosis in dogs using a submucosal tunnel in the bowel wall for implantation of the ureter. Charles Mayo (1865 to 1939) was the first surgeon to use Coffey’s technique clinically, and in 1912 he reported successful results in 3 patients suffering from

exstrophy (“Coffey-Mayo operation”). The ileum was first used clinically to replace a portion of the ureter by Schoemaker in 1909. It was not until 1932 that Rudolf Nissen (1896 to 1981) performed the second such operation replacing the extensively strictured half of the ureter by a length of isolated ileum. Enrique Finochietto ( 1881 to 1948) designed several surgical instruments. His bladder retractor is very useful when performing suprapubic prostatectomy. In 1889, Charles Edouard Brown-Sequard (1817 to 1894) announced that he had devised a rejuvenating therapy for the body and mind by injecting himself with a liquid extract derived from the testicles of dogs and guinea pigs.’G For his insight Brown-Sequard is considered a founder of early organotherapy and modem endocrinology. Johann Chr. Doppler (1803 to 1853). in 1842, first described the effect that bears his name. Since the first medical application of Doppler ultrasound in 1959 (Satomura) improved technology and signal displays have increased the number of areas in which this technique is clinically appropriate, including the genitourinary system. On November 8, 1895, Wilhelm Conrad Roentgen (1845 to 1923) discovered x-rays in his Wurzburg laboratory. For his discovery Roentgen was awarded the first Nobel Prize in physics. Urologists seized upon this new way of visualizing the kidneys and the urinary tract without resorting to invasive procedures. Antoine Beclere (1856 to 1939) studied the applications of x-rays in medicine and acquired a n increasing interest in radiotherapy. In 1916, by application of”paquets de radium,” he treated successfully a young man with an abdominal

HISTORY OF UROLOGY ON POSTAGE STAMPS

1338

FIG.3. A, Nikolay Pirogoff (U.S.S.R.,1960). B , Alfred Fournier (France, 1946). C, Felix Guyon (France, 1979). D,Alexis Carrel (Sweden, 1972).

FIG.4. A, Joseph

E.Murray (Dominica, 1995). B , kidney transplantation and dialysis (Austria, 1990)

metastasis after orchiectomy for seminoma. This early observation led to the systemic use of radiotherapy. Nikola Tesla (1856 to 1943) was one of the first to produce x-ray photographs. He conceived the idea of the rotatory magnetic field, which found application in nuclear magnetic resonance. The portrait of Arthur L. Shawlow, co-inventor of laser (1958), is shown on a stamp issued by Malagasy in 1990. Modern imaging techniques of the urinary tract-ultrasonography, computerized tomography, and magnetic resonance imaging-are depicted on a 1994 series of stamps from Great Britain.

At the University of Chicago, Alexis Carrel (1873 to 1944) and Charles Guthrie developed a new technique of direct suture for anastomosis of blood vessels that revolutionized vascular surgery and enabled them, in 1905, to successfully transplant the kidney from 1 animal to another (fig. 3, D). In 1943, Willem J. Kolff saved the life of a patient with renal failure using the first rotating artificial kidney machine. Although technical advances greatly improved the artificial kidney, the treatment continued to be expensive and distressing to the patient. The alternative was transplantation.

HISTORY OF UROLOGY ON POSTAGE STAMPS

1339

REFERENCES The first long-term success with human allografting occurred in Boston in 1954 when Joseph E. Murray (fig. 4, A), 1. Dietrich, H. H.: Kleine Geschichte der Urologie-Eine philatelisJ. P. Merrill and J. H. Harrison transplanted a kidney from tische Betrachtung. Akt. Urol., 1 6 215, 1985. 1 twin to the other who had end stage renal disease.17 2. Eknoyan, G., DeSanto, N. G., Capasso. G. and Massry, S . G.: Unless the replacement kidney could be obtained from an History of Nephrology. Basel: Karger, 1994. 3. Herman, J. R.: Urology, A View through the Retrospectroscope. identical twin, the problem of organ rejection by the receivHagerstown, Maryland: Harper and Row, 1973. er’s immune system had to be solved. In 1960, MacFarlane Burnet (1899to 1985) and Peter B. Medawar (1915 to 1987) 4. Mauermayer. W. and Schultze-Seemann, F.: Deutsche GesellschaR fur Urologie 1907-1978. Erofiungsreden der P r k i were awarded the Nobel Prize for their discovery of acquired denten 1.-30. Kongress. New York: Springer-Verlag. 1979. immunological tolerance, such that transplant grafts would 5. Murphy, L. J. T.: Development of Modem Urology. The History no longer be rejected. Hemodialysis and kidney transplantaof Urology. Springfield, Illinois: Charles C. Thomas, part 11, tion are depicted on several stamps (fig. 4, B ) and cancellachapt. 8, pp. 191-494, 1972. tions. A patient undergoing hemodialysis with an artificial 6 . Schott, H.: Die Chronik der Medizin. Dortmund: Chronik Verlag, kidney is depicted on the 60 cent stamp of a set of 4 issued by 1993. Bermuda in 1994. Despite authorized organ sharing systems 7. Wershub, L. P.: Urology: From Antiquity to the 20th Century. St. and grants for organ procurement in many countries around Louis, Missouri: Warren H. Green, 1970. 8. Furukawa, A.: Medical History Through Postage Stamps. St. the world, there are still increasing numbers of patients on Louis, Illinois,; Ishiyaku EuroAmerica, 1994. the waiting list for kidney grafts. 9. Wallossek, R.: Arztliches Raritatenkabinett-Ale &zte dieser A small number of modern urologists have been honored on Welt. Odenthal: Wallossek, 1991-1995. stamps, philatelic stationery or portrait cancellations: Ali Bey Ibrahim (1880 to 1947)-professor of surgery a t the 10. Wilson, T. and Rugendofl, E. W.: Steinschnitt, Urologie und Philatelie. Urologe, 34: 289, 1994. University of Cairo and minister of health; Nicolae 11. Garrison, F. H.: An Introduction to the History of Medicine with Hortolomei (1885 to 196ltprofessor of surgery a t the UniMedical Chronology, Suggestions for Study and Bibliographiversity of Bucharest, promoter of the Rumanian school of cal Data, 3rd ed. Philadelphia: W. B. Saunders Company, 1924. urology; Jose Mendoza y Logotipo (1887 to 1951)-founder of 12. Hirsch, A.: Biographisches Lexikon der hervorragenden Arzte the Urological Society of San Salvador; Juscelino Kubitschek aller Zeiten und Volker. Berlin: Urban & Schwarzenberg, de Oliveira (1902 t o 1976belected President of Brazil, pio1962. neering the construction of the new capital Brasilia; Werner 13. Bloom, D. A., McGuire, E. J. and Lapides, J.: A brief history of urethral catheterization. J. Urol., 151: 317, 1994. Forssmann (1904 to 1979bco-winner of the 1956 Nobel Prize in medicine for “discoveries concerning heart catheter- 14. Mattelaer, J. J., Ed.: De Historia Urologiae Europaeae, Vol. 3. Historical Committee European Association of Urology, 1996. ization and pathological changes in the circulatory system;” Theodor Burghele (1905 to 1977)-founder of modern Ruma- 15. Norman, J. M.: Morton’s Medical Bibliography: An Annotated Checklist of Texts Illustrating the History of Medicine. Hants, nian urology; Mandel Tabakow Hidal (1915 to 1979k-assoEngland: Scolar Press, 1991. ciate professor and chief of urology at SBo Paulo Medical 16. Hoberman, J. M., Yesalis. C. E.: The history of synthetic testosSchool in Brazil and Antonio Roig Soler (1889 to 1970)terone. Sci. Amer., February: 60, 1995. practiced urology in Barcelona, built a strong reputation as a 17. Terasaki, Pl.: History of Transplantation. Thirty-Five Recollecphilatelist, and eventually gave up his medical practice opentions. Los Angeles, California: UCLA Tissue Typing Laboratory, 1991. ing a successful stamp store.