An atlas on urinary sediment written by a surgeon and a chemist still of interest today

Austria 19th century

Giovanni B. Fogazzi

Divisione di Nefrologia e Dialisi, Ospedale Maggiore, IRCCS, Milano, Italy

Correspondence and offprint requests to: GB Fogazzi, Divisione di Nefrologia e Dialisi, Ospedale Maggiore, IRCCS, Via Commenda 15, I-20122 Milano, Italy.

In 1871 the Austrian Robert Ultzmann (1842–1889), a surgeon who was one of the founders of urology [1], and Karl Berthold Hofmann (1842–1922), a professor of medical chemistry [2] (Figure 1Go), published an Atlas on `physiologic and pathologic urinary sediment' [3].



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Fig. 1. Robert Ultzmann (left) and Karl Berthold Hofmann (courtesy of Institut für Geschichte der Medizin der Universität Wien. Published with permission).

 
The Atlas was in two parts. The first described the elements which can be found in normal and pathologic urine (e.g. many types of crystals, cells, casts, microorganisms). The second part described the urinary profiles which can be observed in several morbid conditions (e.g. renal and bladder bleeding, `desquamative nephritis', `acute and chronic Bright's disease', amyloidosis, `acute and chronic pyelitis', `calculous pyelitis', bladder carcinoma). All these were shown in thirty-four beautiful colour plates, two of which are reproduced here (Figure 2Go).



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Fig. 2. Left, plate VII. Top. Native uric acid. Rosettes made up of crystals with the shape of stones sharpened at their extremity; close to them isolated crystals with the shape of a thin stone, showing indentations on their obtuse angles; on the left, a large crystal composed of small sharp stones lying one upon the other like tiles. From the urine of the morning. Bottom. Native uric acid. Well structured crystals which are made up of large sharpened stones whose surface is partly characterized by steps lying one upon the other. Right, plate XXXV. Top. Sediment of desquamative nephritis (catarrh of urinary tubes). Blood corpuscles in discrete quantity; isolated cells; epithelial cells adhering to tubes; epithelial casts. Bottom. Sediment of diffuse acute nephritis (Bright's disease, acute parenchymatous nephritis). Many blood corpuscles, cells, epithelium detached from urinary tubes, coarse and more or less pigmented, epithelial and hyaline casts (from reference 3, using Ultzmann and Hofmann words. From author's collection).

 
The Atlas of Ultzmann and Hofmann, even though a minor work, is interesting today because it shows:

Acknowledgments

The author is grateful to Mrs Alida Ambrosiani, Ospedale Maggiore, IRCCS, Milano for translating from German the Atlas of Ultzmann and Hofmann.

References

  1. Fischer I. Biographisches Lexikon der hervorragenden Ärtzte der letzten fünfzig Jahre. Zweiter Band. Urban & Schwarzenberg, Berlin, 1935; 1597
  2. Santifaller L, Obermayer-Marnach E. Österreichisches biographisches Lexikon 1815–1950. II. Band. Böhlaus Nachf., Graz, 1959; 382–383
  3. Ultzmann R, Hofmann KR. Atlas der physiologischen und pathologischen Harnsedimente. Braumüller, Wien, 1871
  4. Altschule MD. Vienna the Great Medical Center: 1848–1918. In: Essays on the rise and decline of bedside medicine. Lea & Febiger, Philadelphia, 1989; 249–263
  5. Beale LS. Kidney diseases, urinary deposits, and calcolus disorders; their nature and treatment (3rd edn), Churchill, London, 1869
  6. Delefosse E. Procédés pratiques pour l'analyse des urines des dépôts et des calculs urinaires. Savy, Paris, 1877
  7. Rieder H. Atlas der klinischen Mikroskopie des Harnes. Vogel, Leipzig, 1898