“I will not cut, even for the stone”: origins of urology in the hippocratic collection

Poulakou‐Rebelakou, Effie; Rempelakos, A.; Tsiamis, Costas; Dimopoulos, C.

doi:10.1590/s1677-5538.ibju.2015.01.05

Cited by 4 publications

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References 3 publications

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“…Hence a saying proposed many years before by Hippocrates, 'Thou shalt not cut for stone, ' was brought into law. [2] Stone disease is still one of the most common conditions seen in medical practice. It is associated with considerable mortality, chronic kidney disease (CKD) and occasionally even end-stage kidney disease (ESKD).…”

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Nephrolithiasis (part 1): Epidemiology, causes and pathogenesis of recurrent nephrolithiasis

Meyers

Naicker²

2021

S Afr Med J

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Kidney stone disease is commonly seen in general practice in both children and adults. This review addresses the epidemiology, causes, pathogenesis, diagnosis and management of recurrent nephrolithiasis, and the data reviewed in this article are taken from experience gained from running a kidney stone clinic for 40 years, which culminated in the publication of an MD thesis entitled 'The pivotal role of a kidney stone clinic in the management and prevention of recurrent calcium oxalate nephrolithiasis' . [1] The thesis is considerably more detailed than the review, and is available to those who wish to further their reading on the subject. EpidemiologyRenal calculous disease was known in the days of Hippocrates (400 BCE). The era of the alchemists started in about 1200 BCE, and the barber surgeons from about 1400 -1700 BCE. The alchemists diagnosed the causes of kidney disorders as well as kidney stones based on the colour, composition, odour and taste of multiple urine samples to which chemicals had been added. They were then able to 'treat' their patients. The victims of the barber surgeons seldom survived after attempts to remove renal, ureteric and bladder calculi. Hence a saying proposed many years before by Hippocrates, 'Thou shalt not cut for stone, ' was brought into law. [2] Stone disease is still one of the most common conditions seen in medical practice. It is associated with considerable mortality, chronic kidney disease (CKD) and occasionally even end-stage kidney disease (ESKD). [3][4][5] In 2001, nephrolithiasis was estimated to occur in about 12% of males and 5% of females. Multiple recurrences were seen in ~50% of these individuals. [6,7] Calcium oxalate (CaOx) calculi have been found to be the cause of stones in >80% of stone patients, and are frequently recurrent. Renal CaOx calculi occur in 85% of cases, and in the other 15%, calcium phosphate (CaP) comprises the chemical make-up. These CaP calculi occasionally cause ESKD.CaOx calculi are rare in the South African (SA) black population and in African Americans. The introduction of Westernised diets in recent years is expected to increase stone formation, but by a small margin only. As has been shown in African Americans, genetic factors occur that significantly inhibit the precipitation of CaOx in the urine.Although not yet studied in the black SA population, similar genetic findings remain a distinct possibility. [8][9][10] Moreover, as the years progress, so does stone incidence increase -especially in children. This is well illustrated in Fig. 1, and the epidemiological causes are for further reading, as discussed in the references. [11][12][13][14] Note: • There has been an increase in incidence in all age groups -mostly in those aged 10 -19 years (23%). • The mean incidence in African Americans is 15% (stone type not specified). • There are no data in black South Africans. CaOx calculi are still rare (~1%). [11] Causes of nephrolithiasis Major risk factors related to stone formation are shown in Fig. 2. These can include medullary sponge k...

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confidence: 99%

Nephrolithiasis (part 1): Epidemiology, causes and pathogenesis of recurrent nephrolithiasis

Meyers

Naicker²

2021

S Afr Med J

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The Hippocratic Tradition and the Development of Medical Knowledge and Practice

Marcum

2024

Handbook of the Philosophy of Medicine

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Updates in the Metabolic Management of Calcium Stones

Penniston

Nakada

2018

Curr Urol Rep

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Many patients with stones desire prevention to avoid repeated surgical interventions. Yet, recent practice pattern assessments and health care utilization data show that many patients are rarely referred for metabolic evaluation or management. Innovations in metabolic management over the past decade have improved its effectiveness in reducing risk and preventing calcium stones. Although no new pharmacologic agents for calcium stone prevention have recently become available, there is relatively new thinking about some diet-based approaches. This review will synthesize current evidence to support individualized metabolic management of calcium stones.

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“I will not cut, even for the stone”: origins of urology in the hippocratic collection

Cited by 4 publications

References 3 publications

Nephrolithiasis (part 1): Epidemiology, causes and pathogenesis of recurrent nephrolithiasis

Nephrolithiasis (part 1): Epidemiology, causes and pathogenesis of recurrent nephrolithiasis

The Hippocratic Tradition and the Development of Medical Knowledge and Practice

Updates in the Metabolic Management of Calcium Stones

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