Urolithiasis pp 269-283 | Cite as

Fictitious Stones and Sir William Osler

  • Michael E. Moran
Chapter

Abstract

Introduction and Objective

Stone disease has for some reason that is not quite clear attracted both the prankster as well as the malingerer. The people who suffer from acute stone colic present with those who seek nothing more than narcotics. The term Munchausen’s disease was coined to describe the patient’s who seek surgery for some psychopathologic gain. William Osler who is considered by many to be the greatest physician of the twentieth century wrote the standard book of medicine for almost 30 years, The Principles and Practice of Medicine, which discussed stone disease.

Methods

Osler’s textbook and references to his life and times were used to formulate his thought processes on urolithiasis. In addition he passed his first stone while still the chief at Johns Hopkins and attempted to pass off a stone from his walkway on his former resident and young staff physicians, Dr. Thomas B. Futcher, who subsequently wrote the case up, perhaps the first documented case of a fictitious stone, but assuredly not the last.

Results

This is a review of Osler’s views on urolithiasis, his own sufferings and thoughts on this malady. His use of narcotics, treatment of narcotic addicts, which he had firsthand knowledge from treating his colleague, William Stewart Halstead. In addition, various forms of hypochondriacs and the psychological ramifications of chronic illness affected an increasingly broad group of people including Charles Darwin and Florence Nightingale. How the relationship of chronic suffering affects the relationship in stone disease is historically relevant.

Conclusions

The development and impact of fictitious or psychologically significant fictitious stone disease affects the management of patients and is reviewed with incidence, cost to society, and the medical ramifications. Finally, one peculiar group of stone formers is presented, those with foreign bodies that serve as a nidus for further stone growth and result in significant potential harm and even death.

Keywords:

Urolithiasis history fictitious stones Robert Burton Friedrich Sertürner Colic Opioids Sir William Osler Munchausen’s Disease Hypochondria Charles Darwin Florence Nightingale Jack London Wirt Bradley Dakin Egerton Yorrick Davis 

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Michael E. Moran
    • 1
  1. 1.American Urological AssociationWilliam P. Didusch Center for Urologic HistoryLinthicumUSA

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