Tricks of a painful trade

Museum: The Center for Urologic History reopens today with its displays of painstakingly preserved medical instruments and quack ads.

January 22, 2004|By Rona Kobell | Rona Kobell,SUN STAFF

The permanent collection is enough to make anyone's knees buckle -- 19th-century speculums that used candlelight to examine the urinary tract, scopes shaped like pistols, a pointy probe called the "prostate punch."

But that never stopped people from touring the American Urological Association's odd museum of medical instruments and ephemera in its old, cramped home on Charles Street in Baltimore before it packed up the collection last July.

Today, when the William P. Didusch Center for Urologic History reopens in Hock Business Park near Baltimore-Washington International Airport, visitors will notice there's less to see. Curator Dr. Rainer Engel decided to showcase fewer items in better light, so the collection has a chronology that doesn't overwhelm.

"I've learned that I am not a Sears house. I don't have to show 1,500 different jogging suits. I show a select number," Engel said. "When you just show the highlights, everyone has time to look at [them and] say, `Oh, wow.'"

Or, more likely, "Ooh, ouch."

Over the centuries, urologists haven't exactly used the most comfortable tools to probe the urinary tract and the bladder. Though the goal was humane -- to remove a tumor or other obstruction and get the plumbing working again -- the means could be brutal. A case along one wall of the museum, for example, shows the evolution of the cystoscope, which is used to examine the bladder.

In the 19th century, urologists initially used a candle for light when they conducted exams. Conditions improved slightly after the light bulb was invented, but the bulbs would often burn out during surgery, forcing surgeons to stop mid-incision and replace them. Now, the scopes use fiber-optic lighting, and doctors can steer them to the bladder.

Another wall highlights the progression of the prostatic incisor, which is used to remove prostate tissue blocking the mouth of the bladder.

Then there is the punch, a primitive tool used to remove suspect masses. But the punch had no eyepiece, so the surgeon was basically operating by feel. Fortunately, the pistol-shaped resectoscope came along, allowing doctors to look before cutting.

Visitors sometimes recoil at the sights, and Engel doesn't blame them. A century ago, the mortality rate for urology operations was 25 percent. Fifty years ago, it had dropped to less than 1 percent. Even the techniques Engel learned during his urology training at Johns Hopkins Hospital in the early 1970s are now largely outdated.

"In terms of patient comfort, there is no comparison between then and now," Engel said. "I love these instruments, I grew up with them. But these new flexible ones, they're just wonderful."

Engel, 71, performed urological surgery until 2000 -- he said he wanted to quit while he was still "doing very good surgery" -- and now runs the museum. He also teaches urology at John Hopkins Hospital two days a week.

Engel says that today's urologists perform far less surgery than he did even 20 years ago, thanks to prescription drugs and other remedies offering non-invasive relief.

But not all cures are created equally -- which brings Engel to the "quackery" exhibit, one of the museum's newest additions.

Before the Food and Drug Administration came along, unscrupulous salesmen hawked miracle cures such as McLean's Liver and Kidney Balm and an alcohol-opium cocktail marketed as Mrs. Winslow's Soothing Syrup. Many products depicted American Indians in headdresses on their bottles, hoping to convince customers that the concoction was an age-old natural remedy.

The sham often worked, and people died from drinking what sometimes amounted to poison.

Engel has added an exhibit on male impotence and hopes to include a gallery of medical illustrations next year. And he's planning an exhibit on Civil War general medicine, surgery and urology next year.

The museum's tight budget leaves Engel only a few thousand dollars each year to spend on acquisitions. Though some of the cytoscopes came from e-Bay, the doctor relies on museum patrons to donate their collections.

Recently, Ben Z. Swanson Jr., former executive director for the National Museum of Dentistry in Baltimore, donated several fliers advertising balms to Engel's quackery exhibit from his collection of more than 25,000 dental and 15,000 medical items.

"The quackery exhibit is the most fun for me. That stuff is still with us. It's very current," Swanson said. "It's as big as it ever was."

Engel expects the new location to bring in even more of its core audience: Conference-going urologists tend to spend a lot of time in airports. He also will change exhibits regularly -- he has 2,000 instruments in storage.

But Swanson said the dentistry and urology museums always faced the same challenges attracting visitors, and that the move to Hock Business Park might make Engel's job harder.

"If the collection is just for the urology professionals, they'll come through anyway," Swanson said. "Whether they want to bus schoolchildren out there, that's another story."

And an unlikely one, considering that some adults can barely handle seeing devices like the "cat claw" and the "tuna needle."

"Schoolchildren? That's not really our thing," said American Urological Association communications specialist Wendy Isett. "When people are thinking of museums where they can take children, they don't think urology."

William P. Didusch Center for Urologic History is in the Hock Business Park, 1000 Corporate Blvd.,Linthicum. It is open 9 a.m. to 5 p.m. weekdays. Admission and parking are free. Phone: 410-689-3700.

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