Remarks on the development of neuro-urology

Department of Urology, Cologne Medical Center at Holweide Hospital, Cologne, Germany

During the middle of the nineteenth century, operative medicine saw a change from the philosophical deductive methods of the so-called Romantic Era to inductive and scientifically orientated ways of working. The previously limited scope of operative medicine abruptly altered then. Simultaneously, organ-related thinking gained acceptance. The development of urology as an independent subject area paralleled the rise of gynecologic and abdominal surgery as well as traumatology. As classic surgery remained within an anatomical theory up to the thirties of the 20th century, raising urology developed a physiological way of thinking. Here, bladder function was in the focus of investigation. The establishment of experimental physiology during the nineteenth century was of vital importance to the development of scientific medicine in the twentieth. Based on the experiments of Charles Bell (muscle contractions) at the beginning of the 19th century ,1858 Rudolf Haidenhain (1834-1897) of Breslau, Silesia and August Colberg (1829-1868) made studies on the tonus of bladder muscle in 1858. These experiments were completed by Eugen Rehfisch, a disciple of famous Leopold Casper (1859-1959) of Berlin, who was the first to measure the phenomena of bladder pressure and flow simultaneously within a living person. This was the basis in the development of modern urodynamics. If analyzing difficulties micturition of several neurological disorders are analyzed, tabes dorsalis proofed to be the most important neurologic disorder. After Word War I. urologists focused their interests on the rehabilitation of spinal cord injuries and the paralyzed bladder. There is no doubt that there were US urologists like famous H. H. Young (1870-1945) of Baltimore or Frank Hinman ( 1870-1961) of San Francisco founding neuro-urologic research extensively. Establishing clean intermittent self-catheterization in the 50th by Sir Ludwig Guttmann (1899-1980) of Edinburgh, a former native of Germany and expellee due to nazi racism was a milestone in the development of a distinguished subspecialty. At last investigations on neurotransmitters enabled urologists to develop sophisticated therapy modalities.

Session VIII -- Poster Session 2
Saturday, 16 June 2001, 9:00 - 9:30 am

Sixth Annual Meeting of the International Society for the History of the Neurosciences (ISHN) and
Eighth Meeting of the European Club for the History of Neurology (ECHN)

Cologne, Germany