History of Urology Forum
Presentation Authors: Mário Pereira Lourenço, Duarte Vieira-Brito, Ricardo Godinho, Pedro Peralta, Amilcar Sismeiro, Coimbra, Portugal, Joao Lemos Almeida*, Lisbon, Portugal
Introduction: Studying the diseases of royal families allows for a better understanding of the evolution of Urologic knowledge and treatments performed through history.
The aim of this paper is to analyse the evolution of Urologic knowledge since the middle ages, using medical descriptions of the Portuguese royal family.
Methods: Consultation of specialized bibliography.
Results: The first king with records of urological/andrological disease was king Sancho II (1209-1248), "accused" of impotence. Some authors maintain that King Afonso V (1432-1481) suffered from hirsutism, probably caused by excess of testosterone. King Joao II (1455-1495) died of chronic renal disease secondary to renal tuberculosis. King Sebastiao (1554-1578) suffered from urethritis since the age of 9, being treated with bloodletting, purges, plasters, water with cinnamon and hot food. King Antonio "Prior do Crato" (1531-1595) suffered from renal lithiasis and haematuria and died of kidney disease. King Filipe IV (1605-1655) suffered from lithiasis and was treated with donkey's milk and broths. King Joao IV (1604-1656) had a “superior origin urinary retention" secondary to uric lithiasis and was submitted to bloodletting, oil baths in the renal region, pills consisting of steel, coral and ivory. However, he died 2 years later due to chronic kidney disease. King Afonso VI (1643-1683) was impotent (a hydrocele served as justification for his erectile dysfunction). King Pedro II (1648-1706), King Joao V (1689-1750) and King Jose (1711-1777) suffered from syphilis, with records associating the disease with the greater sexual activity of the kings. King Joao V used amber essence (ambarum griseum) secretly coming from Paris as a "fortifier" for sexual activity. King Pedro IV (1798-1834) suffered from impotence, gonococcal urethritis and lithiasis, which was treated with Vichy water and muriate of iron. His autopsy revealed white and soft kidneys, with a calculus in the left kidney. King Miguel (1802-1866) suffered from "hands convulsions", which was attributed to excessive masturbation. King Manuel II (1889-1932) had a macrophallus, which caused dyspareunia in his wife.
Conclusions: Medical records in the middle ages are scarce and some diagnoses are the result of the subjective evaluation of historians who carried out their studies centuries later. The medical descriptions, the knowledge of urological diseases and the treatments performed have undergone a substancial advance since the Renaissance. The evaluation of kings' records allows for an assessment of the standard care available at the time.
Source of Funding: None