ABSTRACT
Archaeological explorations have unearthed findings confirming that ancient man suffered from urinary lithiasis: in one expedition, a renal calculus dating to approximately 4200 BC was found among the bones of a young egyptian.(1) Ancient records similarly confirm that stone disease was present among the Greek and Roman civilizations. As a disease dating back at least to antiquity, physicians and scientists of the time offered differing theories on the origin urinary calculi. Hippocrates presented one of the earliest hypotheses on the etiology of urinary lithiasis, when he observed that many patients with calculi had sandy sediment in their urine, and suggested that stone formation was a consequence of the consumption of water rich in lime or silt.(2) Galen, the Roman physician, postulated that gout and rheumatism were related to calculi, and suggested that the pathophysiology of these processes was intertwined. Ancient Indian physicians presented an alternative theory on stone pathogenesis, describing four unique types of calculi, variously formed by phlegm, vapour, bile, and semen.(3) The type of stone could be divined by the physician following examination of its morphology. In later centuries, medieval physicians hypothesized that urinary calculi arose as a consequence of excessive dietary salt, exposure to excessive heat, or the presence of obstructing matter in the urinary tract.
