Fri-13 the Uroscopy Wheel: A Tool for Streamlined Diagnosis

Abstract

If the history and physical examinations are perceived as augmentations of the physicians senses-sight, sound, smell, taste, and touch then the major augmentation to sight has been the magnification of microscopes.METHODS: A review of the literature of microscopes and their well documented history can put this instrument into the clinical realm and urology in particular.RESULTS: A review of the literature of microscopes and their well documented history can put this instrument into the clinical realm and urology in particular.RESULTS: The very first known references to magnified imaging comes from the Ancient Greeks and Pythagoras, followed by Pliny the Elder and Ahhazen c. 1038 and Roger Bacon. Salvino d'Amarto degli Armati in Florence invented eye glasses in the 14th century. The revolution of glass production in the Lowlands allowed for investigators to study the optical magnification properties of lenses and one, Galileo heard of these advances and began his own investigation leading to Sidereus Nuncius of 1610. Microscopes directly followed both in Italy and elsewhere, including England.CONCLUSIONS: Literally the stage was now set for Marie François Xavier Bichat (1771-1802) to introduce the pathologic study of disease using microscopes in his 1799 Treatise on Membranes. Johannes Peter M€ uller (1801-1858) developed both the notions of pathology of tissues but taught most of the next generation of microscopists who would profoundly influence all of pathology. The use of the microscope in urinalysis also quickly was adopted. In 1854 Lionel Beale of King's College London published his The Microscope and its Application in Clinical Medicine where he spends no small amount upon the examination of urinary sediments. Golding Bird followed this with a book entirely on urinary microscopic evaluation of sediments and crystals, Urinary Deposits: Their Diagnosis, Pathology and Therapeutical Indications in 1844. Though spermatozoa had been identified by Leeuwenhoek in 1677 and there arose the infamous controversy regarding the homunculus-Russian nesting dolls within the head of the sperm. In November 1677's letter to Lord Brounker, secretary to the Royal Society he states, "I had observed enough material coming from a sick person.but also from a healthy one, immediately after ejaculation. I had seen such a multitude of live animalcules more than a million, having the size of a grain of sand and moving in a space.those animalcules were smaller than the red blood cells. They had a round body, foam in the front, terminated in a point at the back; they were equipped with a tail with five to six times the body length. The progressed in a snake-like motion helped by their tail." Despite this outstanding head-start the clinical application of Leeuwenhoek's observations would take more centuries to advance. The first real utilization of a detailed spermatozoa count was only reported by Macomber and Sander in the New England Journal of Medicine in 1929 and the first statistical survey of male infertility awaited John MacLoed's w...