Laboring Under the Stone: A Literary Legacy of Lithiasis

Abstract

Introduction and Objectives

The history of mankind’s suffering greatly from calculus disease has been one of excruciating longevity. Since the first historical records, humans have formed stones and endured the wrath of this concretion’s passage via the delicate mechanisms of the urinary tract. This study involved detailed investigations of historical writings of famous stone sufferers to better appreciate the circumstances of our patients.

Methods

Collected histories both of textbooks and articles were scrutinized for the accounts of famous stone sufferers. Once identified, primary resources were sought with English translations given preference. Cross-referencing all informational sources was attempted. The accounts were then classified as lower urinary tract (BS), upper urinary tract (KS), by century of the individual, and whether these were ancient (before 100 years ago) or recent (from the twentieth century onwards).

Results

Many of these great men and women suffered in relative silence. Not much is available on descriptions of their colic. However, there are others such as Michel Montaigne, Erasmus of Rotterdam, Benjamin Franklin, Thomas Sydenham, Sir William Osler, and Richard Selzer who are able to transform their suffering into ethereal expressions of pure pain and suffering. The ancient descriptions are twofold fascinating, as the victims of stone disease face quackery and profound ignorance from the medical profession and no effective remedy for the pain. Here again, there are two typical responses: the enlightened cerebral concerns of Montaigne, Sydenham, and Franklin versus the punitive, religious overtones from Erasmus and Pepys. Lower and upper tract stones produce equal horrors to those once thought to incur punishment from the gods or turning to stonelike “living statues.”

Conclusions

No amount of literary expression can capture the true essence of renal colic. Medical texts from their earliest times place stone passage near the top of the pantheon of medical suffering. Each of these prolific and erudite stone sufferers provides us, the next generation, a unique window into the perception of colic. “The colic was followed by an ulcer, or more accurately, by a hard swelling which first extended all along the lower right groin. Then it centered on the pit of my stomach, almost like a dragon with its teeth biting my navel while the rest of its body was writhing and its tail stretching towards my loins…it cause constant, sometimes, unbearable pain.” [Erasmus]