Descriptions of bladder stones have been found in ancient Egyptian, Hindu, and Greek texts (Ellis 248). These painful stones are caused when a mass of minerals in urine crystallizes together. Sometimes the stones are small enough to pass naturally, while larger stones may require surgical intervention in order to be removed. Although surgery to remove these stones was largely unsuccessful due to shock, blood loss and death in a high percentage of unfortunate patients, this particular surgical endeavor helped to progress the surgical field to the benefit of all of humanity. Take a deep breath for this one.
Surgical Intervention:
The Lithotomy was described as far back as the 1st century A.D. by Greek physicians (Ton-That). The procedure only required three main tools, the knife, a hook, and a pair of forceps. Old medical illustrations show that patients were laid out on their backs and their legs were bent in the air and held in place by assistants. The stone would be maneuvered until it could be easily felt and then the skin would be cut at the perineum between the anus and genitals (Ton-That). Once the incision was made, a hook would be inserted and forceps were used to crush the stone and pull out the mass (Ton-That). Cutting the perineum was not as popular an option once the patient was over the age of 14 because the presence of the prostate tended to make the procedure rather difficult to pull off (Ellis 248). Other methods included opening the bladder above the pubis and inserting instruments into the urethra to break down the stone. All of this was done without any anesthesia.
A Man on a Mission:
There are a plethora of reasons why someone would have been afraid to visit a doctor for a bladder stone, pain and death being main ones. In 1782 a Frenchman named, Colonel Claude Martin, was suffering from a bladder stone and decided to take matters into his own hands. He fashioned a file from a slim knitting needle and inserted it into his urethra multiple times a day to break the stone into smaller pieces (Atwood). After making this uncomfortable procedure part of his daily routine, the stones were eventually passed. Today, doctors insert small cameras into the urethra and break large stones up with the help of a laser or other instruments. Luckily due to medical advancements, dying from bladder stones in developed countries is almost entirely unheard of.
If that doesn’t make you thankful for modern medicine I don’t know what will!
Until Next Time
N.F.
Sources:
- Atwood, Sophie. “History: He performed the first ever lithotripsy-on himself…with a knitting needle.” AudDoc. 13 March, 2019. Accessed 4 November, 2021.ausdoc.com.au/news/history-he-performed-first-ever-lithotripsy-himself-knitting-needle.
- Ellis, Harold. “A History of Bladder Stone.” Journal of Royal Society of Medicine Volume 72, April 1979. Accessed 4 November, 2021. https://journals.sagepub.com/doi/pdf/10.1177/014107687907200403.
- Ton-That, Matthew. “Lithotomy: Cutting for Stone.” Urologic History. Issue 3-Fall 2020. Accessed 4 November, 2021. urologichistory.museum/collections/the-scope-of-urology-newsletter/issue-3-fall-2020/lithotomy-cutting-for-stone.
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