indigo-carmine and Kidney-Calculi

Sir William Osler published his textbook, The Principles and Practice of Medicine, in 1892. It became the definitive treatise on a wide variety of diseases. The section on nephrolithiasis clearly presents the etiology, pathology, symptoms, diagnosis, and treatments. What remains a mystery is the mention, under rare forms of human stones, of a type called "indigo.". A search of Index Medicus starting from 1909 backward to its inception in 1879 was performed for key words "indigo," "calculus," "renal" or "bladder stones" and "indicanuria." Twelve textbooks of urology published before 1940 were scrutinized for references to indigo calculi.. Only two references to indigo were found, both related to its use for treating constipation (1887 and 1891). Of the 12 textbooks, only 4 make passing reference to "indigo stones." They all mention that such calculi are very rare, but direct references to cases are lacking. One textbook references a study of blue stones from Egyptian mummies.. It is unlikely that Osler's reference to an indigo calculus was taken lightly during his writing of The Principles and Practice of Medicine. The case of the indigo calculus is fascinating and perhaps enlightening if only for the source of Osler's intrigue.

Topics: History, 19th Century; History, 20th Century; Humans; Indican; Indigo Carmine; Indoles; Kidney Calculi; Pigments, Biological; Urinary Bladder Calculi

Twenty patients with hypoplastic kidney (12 men and 8 women, left kidney in 13 cases, right kidney in 7 cases) were observed between 1961 and 1971. The age of the patients ranged from 14 to 60 years. The anomaly predominated (65% of the patients) in the third and fourth decades of life; in this age the diagnosis of the true nature of the condition was often due to complications requiring examination. Carefully taken history and complete radiological survey are essential for the recognition. The value and characteristic features yielded by particular investigation are discussed. In 8 patients clincial diganosis was confirmed at operation. Most common complications of hypoplastic kidney included hypertension, lithiasis, hydronephrosis, pyelonephritis and periodic hematuria. In 9 pateints (4 women and 5 men) renal hypoplasia was associated with other anomalies of the genitourinary tract.

Topics: Adolescent; Adult; Angiography; Female; Hematuria; Humans; Hydronephrosis; Hypertension, Renal; Indigo Carmine; Kidney; Kidney Calculi; Male; Middle Aged; Pyelonephritis; Urography