Magyar László szerk.: Orvostörténeti Közlemények 174-177. (Budapest, 2001)

KÖZLEMÉNYEK — COMMUNICATIONS - Kapronczay Károly: A short history of the urology in Hungaiy. — (A magyarországi urológia rövid története.)

operations was performed in the 18th century by Cheselden whose method was adopted in the 19th century by the German Langenbach and for female patients by the French Lisfranc. Because of the absence of the relief of pain, the increased risk of wound infection and the frequent mortality, lithotomy was performed just occasionally and physicians performing it were admonished to the greatest circumspection. They preferred lithotripsy though it was performed just very rarely too because of the pain. In 1106 Abul-Kasim designed an instrument by means of which bladder stones could be carefully pulled out of bladder through urethra with the help of a thin yarn, after which bladder was irrigated with the aid of a catheter. In the 15th century Alessandro Benetti designed a lithotrite by means of which bladder stones could be broken in bladder already after which rubble was removed by the irrigation of the bladder. The eminent surgeons of the 16th and the 17th century, Paré, Franco and Hildanus, designed so-called "duckbilled", screwed and mechanical lithotrites one after the other in various sizes and on various levels of fineness considering anatomical points of view. Later tool-makers assembled special sets of such instruments and "mass-produced" them. According to the records of that time, lithotripsy was performed not only by experts. Some descriptions left to us are fantastic. For example at the beginning of the 19th century an English colonial officer, called Mercet reduced his bladder stones with a fine file stuck up into his bladder. According to another description a monk called Hoin shattered his bladder stones with a hammer, blowing a fine tube stuck up into his bladder. Even if these stories are true, such processes must have caused a terrible pain. The first urological description of the Hungarian medical history dates back to 1572. It can be found in the book entitled Ars Medico, written by György Lencsés describing 26 surgical interventions. He recommended to carry urine off through catheter in the case of wandering bladder stones, described the shape of metal catheters and recommended curved ones to men and straight ones to women. Some signs show that even he was ill suffering from nephrolithiasis and that is why he knew this sickness so thoroughly. He described also the way of lithotomy but preferred lithotripsy and catheterisation. Also another Hungarian surgeon of that age, István Borbély from Kassa, in his book on surgery recommended a method of appliance of catheter for the removal of bladder stones and proposed powder of tooth of pike mixed in wild honey against dysuria and testicular pains. One can find many methods for the treatment of urological diseases in the surgical Schoolbook of Sámuel Rácz entitled A ' borbélyt tanításoknak első darabja (The First Piece of the Instructions for Barbers) published in 1794, those were applied partly in the case of nephrolithiasis and urethral disturbances like fistulas, obstructions etc. In its surgical part Sámuel Rácz wrote rather fully of lithotripsy, catheterisation, lithotomy considered to be dangerous, catarrhal and inflammatory disturbances of urethra and the treatment of ulcers those were presumably scars originating in venereal diseases. The medical tariff of the Council of the Governor-General of Hungary published in 1829 points to the round of urological interventions stating the physicians' and the surgeons' fees. According to this tariff a catheterisation cost 1 forint (gulden) for a man and 30 krajcárs (pennies) for a woman. A lithotripsy was 3 forints and 30 krajcárs, a lithotomy 8 forints and 30 krajcárs. These fees were accounted very high considering the value of the Hungarian forint of that time.