Pediatric vesicolithotomy from ancient India to Greece, Arabia and the western world

  • John G. RaffenspergerEmail author
  • V. Raveenthiran
Original Article


Surgeons removed bladder stones by perineal lithotomy in ancient times. The first surgeon who dared to invade a body cavity knew human anatomy and was skilled in the use of surgical instruments. The operation probably originated in India since the Sushruta Samhita, a surgical text, antedates Hippocrates by several hundred years. Sushruta’s knowledge of bladder of stones, surgical complications and instrumentation identifies him as originator of vesicolithotomy. Why did Hippocrates advise his students to leave operations for bladder stones to practitioners who were skilled in the art? Who were these practitioners and how did knowledge of vesicolithotomy reach Greece from India? Our research suggests that the operation came to Greece from India over ancient trade routes and with surgeons who accompanied Alexander the Great’s army. The Sushruta Samhita was translated in Arabic and may have reached Europe during the dark ages by way of Arabian surgeons such as Albucasis. Chelseldon, an eighteenth century English surgeon, brought Sushruta’s vesicolithotomy to a peak of perfection.


Sushruta (900-600 BC) Hippocrates (460-370 BC) Alexander the Great (357-323 BC) Ammonius Lithotomus (circa 200 BC) Celsus (25 BC-50 AD) Albucasis (936-1013 AD) William Cheseldon (1688-1752 AD) Vesicolithotomy History of Medicine 


Author contributions

JGR conceived the project and wrote the first draft. VR critically revised the manuscript and added references. Both authors approved the final manuscript.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts or commercial interest


  1. 1.
    Tefekli A, Cezayirli F (2013) The history of urinary stones: in parallel with civilization. Sci World J 2013:423964. Google Scholar
  2. 2.
    Ellis H (2011) The early days of surgery for stones in the bladder. J Perioper Pract 21:179–180CrossRefGoogle Scholar
  3. 3.
    Hippocrates on Airs Waters and Places; in Adams, F. [Tr] The Genuine works of Hippocrates [Vol 1] London Sydenham Society, 1829, 201Google Scholar
  4. 4.
    Nittis S (1939) Hippocratic Oath in reference to lithotomy. New interpretation with historical notes on castration. Bull Hist Med 7:719–728Google Scholar
  5. 5.
    Herr HW (2008) ‘I will not cut… ‘: the oath that defined urology. Br J Urol Int 102:769–771CrossRefGoogle Scholar
  6. 6.
    Jouanna J, Allies N (2012) Greek medicine from Hippocrates to Galen: selected papers (Ed by Eijk P). Leiden; BostonGoogle Scholar
  7. 7.
    Serageldin I (2013) Ancient Alexandria and the dawn of medical science. Glob Cardiol Sci Pract 47:395–404Google Scholar
  8. 8.
    Fraser PM (2001) Ptolemaic Alexandria, vol 3. Clarendon Press, OxfordGoogle Scholar
  9. 9.
    Tsoucalas G, Sgantzos M (2017) Ammonius Lithotomos (3rd Century BC), the Alexandrian innovative surgeon who introduced lithoclastic cystotomy. Surg Innov 24:183–185CrossRefGoogle Scholar
  10. 10.
    Celsus CA (1938) De Medicina, vol 7, translated by SpencerWG. Harvard University Press, Cambridge, MA, pp 26–28Google Scholar
  11. 11.
  12. 12.
    Singh V (2017) Sushruta: the father of surgery. Natl J Maxillofac Surg 8:1–3CrossRefGoogle Scholar
  13. 13.
    Bhishagratna KK (1907) Introduction. In: Bhishagratna KK (ed) An English translation of the Sushruta Samhita based on original Sanskrit text, vol 1. Self Publications, Calcutta, pp 1–67Google Scholar
  14. 14.
    Raffensperger JG (2012) Children’s surgery, a world wide history. McFarland & Company, London, pp 48–55Google Scholar
  15. 15.
    Sushruta S (1911) Chikista Sthana chapter 7—The medical treatment of Asmari (urinary calculus). In: Bhishagratna KK (ed) An English translation of the Sushruta Samhita based on original Sanskrit text, vol 2. Self publications, Calcutta, pp 329–337Google Scholar
  16. 16.
    Mukhopadhyaya G (1914) The surgical instruments of the Hindus, vol 2. Calcutta University Press, Calcutta, pp 79–80Google Scholar
  17. 17.
    Sushruta S, NIdana S (1911) Chapter 3—Urinary calculus. In: Bhishagratna KK (ed) An English translation of the Sushruta Samhita based on original Sanskrit text, vol 2. Self publishing, Calcutta, pp 25–30Google Scholar
  18. 18.
    Rawlinson HG (1916) Intercourse between ancient India and the western world, from the earliest time to the fall of Rome. Cambridge University Press, Cambridge, p 24Google Scholar
  19. 19.
    Adamson PB (1982) The military surgeon: his place in history. J R Army Med Corps 128:43–50CrossRefGoogle Scholar
  20. 20.
    Machowiak Phillip A (2007) Postmortem solving histories great medical mysteries. College of Physicians, Philadelphia, p 60Google Scholar
  21. 21.
  22. 22.
    op.cit. Raffensperger, pp 48–56Google Scholar
  23. 23.
    Raju VK (2003) Sushruta of ancient India. Indian J Ophthalmol 51(2):119–122Google Scholar
  24. 24.
    Hoernle AFR (1897) The Bower manuscript, (English Tr.). Archeological Survey of India, CalcuttaGoogle Scholar
  25. 25.
    Changizi Ashtiyani S, Cyrus A (2010) Rhazes, a genius physician in diagnosis and treatment of kidney calculi in medical history. Iran J Kidney Dis 4:106–110Google Scholar
  26. 26.
    Madineh SM (2009) Avicenna’s Canon of medicine and modern urology: part-2: bladder calculi. Urol J 6:63–68Google Scholar
  27. 27.
    Abdel-Halim RE, Altwaijiri AS, Elfaqih SR, Mitwalli AH (2003) Extraction of urinary bladder stone as described by Abul-Qasim Khalaf Ibn Abbas Alzahrawi (Albucasis) (325–404 H, 930–1013 AD), A translation of original text and a commentary. Saudi Med J 24:1283–1291Google Scholar
  28. 28.
    Morgagni JB (1960) The seats and causes of disease (book-3). (Translated by Alexander B), New York Academy of Medicine, New York, NY, pp 476, 496–497Google Scholar
  29. 29.
    Cope Z (1953) William Cheseldon. E. and S. Livingston, LondonGoogle Scholar
  30. 30.
    Cheseldon W (1943) A Treatise on the high operation for a stone. In: Leonardo RA (ed) History of surgery. Froben, New York, pp 207–208Google Scholar
  31. 31.
    Raffensperger JG (1969) A review of the first textbook of pediatric surgery in the English language. J Pediatric Surg 4(4):403–405CrossRefGoogle Scholar
  32. 32.
    Lebowitz RL, Vargas B (1987) Stones in the urinary bladder in children and young adults. Am J Radiol 148:491–495Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Children’s Memorial HospitalChicagoUSA
  2. 2.Northwestern UniversityEvanstonUSA
  3. 3.SRM Medical CollegeChennaiIndia

Personalised recommendations