A Mysterious Disappearance

Disease go away. We know that. Sometimes it’s because of heroic efforts to eradicate them. Or perhaps we just create new categories, expectations and descriptions that replace the old entity. And sometimes it’s just what the heck?

For example, bladder stones. Two hundred years ago it seemed like everyone in Europe had them, especially the men. In fact, contrary to what you might expect, it was a disease of young men, and in some areas it was so prevalent as to be considered endemic.

Nowadays if you google “bladder stone” first up you’ll get a mix of articles on kidney stones in people and bladder stones in dogs. It’s just not a thing anymore. What happened?

Now, it’s definitely not a bad thing that bladder stones seem to have gone away. Imagine something up to the size of a hen’s egg with rough edges situated in your bladder. It would constantly rub up against the walls causing excruciating pain and blood in the urine. On top of that, the blockage of flow would create a stagnant pool of urine that frequently and then chronically became infected. In those pre-antibiotic days the infections could spread and kill you, or you might get so blocked up that you would destroy your kidneys and die of renal failure.

How bad was the pain? There was an operation for removing stones. This operation had a 20-40% mortality rate, and consisted, usually, of someone cutting through the perineal area into the bladder and yanking out the stone(s) without any anesthesia. And practitioners had no problem lining up business!

Or you could take matters into your own hands. The fascinating “General” Claud Martin did. Martin’s Wikipedia page is pretty bland, but other have more to say

 ...the French adventurer Claud Martin. The notorious Martin kept four wives and was, among other things, the only man ever known to have successfully performed a surgical operation on himself. Lord Valentia wrote in an account after Martin's death: 'a more infamous or despicable character ... never existed. He had not a single virtue, though he laboured to assume the appearance of several' (quoted in Philip Davies, Splendours of the Raj, London 1985, pp.93-4).

http://www.tate.org.uk/art/artworks/zoffany-colonel-mordaunts-cock-match...

Martin had bladder stones. He devised an instrument made from a knitting needle set in a whalebone handle and after catherizing himself with a cannula he would work this into his bladder and saw away at the stone…twice a day for nine months. Apparently it worked, but was so uncomfortable that he just went ahead and died from them when they came back.

https://books.google.com/books?id=yrg9AAAAIAAJ&pg=PA147&lpg=PA147&dq=cla...

So where did bladder stones go? Why don’t people have them anymore? Some say it may be related to industrialization or improved standards of living. It’s said, although documentation is lacking, that they are still a problem for the young men and boys in less developed areas. But why would growing up in a remote rural area cause bladder stones? And why the gender differential if it’s something environmental? Nobody really knows.