FO013KIDNEY DISEASES DESCRIBED BY ANTONIO BENIVIENI (1543-1592), THE FOUNDER OF PATHOLOGICAL ANATOMY

Abstract

Introduction and Aims:In1507 the printing house of Filippo Giunti published post humously a landmark book of the Florentine physician Antonio Benivieni entitled The hidden causes of diseases (de abditis nonnullis ac mirandis morborum et sanationum causis). The book edited by Girolamo, his poet brother, and by the physicians Giovanni Rosati was structured on 111 brief chapters referring to some 200 clinical cases. For nearly 20 of them autopsy findings were available and were used to explain signs of dis-eases observed in life. Method(s): The Hidden Causes was praisedby Antonio Maria Valsalva, Giovanni Battista Morgagni, and by Albert von Haller. Result(s): Benivieni described kidney disease in children and adults. In children he reported on: 1. A 11 year-old boy with anuria of 7 days duration; 2. A child with severe dropsy, 3. A boy with hypospadias, 4. A case of female epispadias and vesical extrophy. Adult cases included 1. A dropsical farmer healed by long-lasting water abstention;2. A lady with severe ascites healed after crushing the abdomen against a stone which allowed draining of the abdomen;3.a soldier with post-obstructive anuria due to a scar caused by the section of the bladder neck in the battle; 4. A lady with difficult urine emission due to synechiae of the labia minora caused by syphilis; 5. A male with bladder stone cutting the bladder; 6. A case of pleurisy with cough, bloody sputum and fever healed after passing purulent urine; 7. A case of autonomic hyperreflexia with bladder disten-tion due to cord injury following the fall from a fig tree; 8. A case of excessive sweating treated with success; 9. the successful treatment of a father and his son struck by lightning causing an apoplexy-like state. Both were dumb and lacked sensitivity which caused 7 day deprivation of foods and water; 10. A very educational mortal case of heat shock (Chapter XVI); 11. Antonio Benivieni's clinical skills are evident in the treatment of a nun with anuria of 12 days duration. "A stone had obstructed her urethra. I introduced a hook so the stone could not go back into the bladder. Then I introduced a tool rounded off at its extremity and by beating the stone I was able to fragment it. After retracting the hook and the rounded tool urine and stone fragments came out and the patient healed immediately"; 12.Two stones were found in the bladder during the autopsy of a 80 year old relative of Benivieni. 13. hair longer than the palm of the hand were found in the urine of a 30 year old man; 14. A case of adult shut phimosis to due tight frenulum caused difficult urination. Incision of the prepuce and skin retraction below the frenulum healed him. Conclusion(s): The results indicate that Benivieni was capable to identify the hidden causes of diseases and offer a key tools to geti an insight into the state of medicine and surgery of that times.