The historical origins of interstitial cystitis.
OBJECTIVE
We identify early descriptions of interstitial cystitis and trace its evolution as a clinical entity during the 19th century.


METHODS
Primary and secondary source documents relating to interstitial cystitis, bladder inflammation and bladder stones were reviewed.


RESULTS
What is believed to be the earliest published record of interstitial cystitis appeared in an 1836 textbook by the Philadelphia surgeon Joseph Parrish, who documented a syndrome of chronic frequency, urgency, dysuria and pelvic pain he called "tic doloureux of the bladder." Tic doloureux was a contemporaneous diagnosis used to describe painful, idiopathic disorders of nerves. Parrish attributed this term to his mentor, Dr. Phillip Syng Physick, who applied it to patients with severe lower urinary tract symptoms with no discernible etiology, with the most common etiology during the 19th century being bladder stones. A review of archival material from the Philadelphia College of Physicians indicates that by 1808 Physick had developed a concept of bladder inflammation, a "bladder ulcer," that produced lower urinary tract symptoms in the absence of bladder stone.


CONCLUSIONS
By 1808 Philip Syng Physick had described an inflammatory condition of the bladder producing the same lower urinary tract symptoms as a bladder stone. By 1836 he had expanded this concept to include a chronic frequency, urgency and pain syndrome occurring in the absence of demonstrable etiology. We propose that these are the earliest known descriptions of bladder inflammation and interstitial cystitis.
Parsons
J Kellogg
JK
Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA. parsonsk@jhmi.edu
Parsons
C Lowell
CL
D018856:Cystitis, Interstitial / Q000266:history*; D049671:History, 18th Century; D049672:History, 19th Century; D015143:Philadelphia