Thursday, December 15, 2016
Urinary Stones in the Middle Ages
In the middle ages, surgeons called “lithotomists” traveled around Europe with their special tables called “lithotomy tables” on which they placed patients to cut out stones. The term “lithotomy position” is still used in the OR today to refer to placing a patient in a position similar to a woman in childbirth. The patients, these lithotomists treated were typically men with bladder stones from enlarged prostates rather than actual kidney stones. The bladder stones led to recurrent infections, caused pain, and made it difficult for men to urinate.
Surgery in the middle ages occurred well before the invention of anesthesia or antibiotics and many men chose instead to not undergo treatment for their stones. The number of patients who died from their lithotomy surgery was frighteningly high and lithotomists were known to leave town quickly if things went bad.
The surgeries were so fraught with danger and pain that Jan de Doot, a Dutch blacksmith, was said to have performed a surgery on himself to remove a bladder stone. A painting from 1655 by Carel de Savoyen depicts Doot, holding his knife and bladder stone.
His approach was to make an incision below the scrotum directly into the bladder, find the stone, and extract it. He had his brother help him in the surgery by holding the scrotum aside. Jan de Doot apparently had already experienced two of these surgeries by lithotomists before performing his third “diy” surgery. It is from them that he likely learned the technique.
Painting by Carel de Savoyen