Abstract
The origin of endoscopy goes dack to Greek time. Hippocrates (BC 460-375) had written about the usage of a speculum for the diagnosis and treatment of hemorrhoids. The real speculum of Greek-Roman period are seen among the remains of Pompeij (AD 79). They have two to four lieves which are opened by gripes or a scew and applied for the observation of the rectum, vagina or uterus (fig.-1). The speculum was supposed to be used rather widely in that period. It was introduced into Europe and used without remarkable development until 17th centry(fig.-2). In 1807 P.B. Bozzini (1773-1809), a doctor of Frankfurt am Main, had published a booklet of 25 pages entitled by “Lichtleiter or a report on a simple device for the observation of the cavity or space of living animals and its application”. Bozzini had intended to use his instrument mainly for the clarification of the general rule of movement in 'Animalisation'. In his age, philosophic discussion about an animate things such as 'Animismus'or 'Vitalismus' was widespreding. His instrument (fig.-3, 4) doesn't like to be used virtually, and it was named by authorities as a magic lantern for the observation of hidden inside of the human body. His further investigation was forbidden. Bozzini's booklet is the first work on endoscopy but gave little influence to its following development. In early 19th century urology began to separate from surgery as a special department. In 1826, PS. Segalas (1792-1875), an urologist in Paris had demonstrated his method for the observation of interior of the urethra and urinary bladder. He used two candles and a concave mirror for illumination (fig.-6). His technique is a simple but practical one and he had succeeded in its clinical application. In 1856. A.J. Désormeaux (1815-1882), an urologist of Necker Hospital, had demonstrated a sophisticated instrument utilizing a gasogen lamp, lens and mirror (fig.-7, 8, 9). His instrument was given a fovorable reception, and in 1865 he published a book of 180 pages entitled as “Endoscope and its application for the diagnosis and treatment of urethral and bladder diseases” He is the first one who used the word ‘endoscope’. A. Kussmaul (1822-1903), a professor of medicine in Freiburg, was famous in that period by his treatment of pyloric stenosis by means of gastric lavage with alkaline solution. Of course his treatment was effective in limited cases and he was trying to make more exact diagnosis. His disciple was sent to Paris to learn Desormeux's endoscope. In 1968 he asked a sword-swallower to swallow a metal tube and succeeded to observe a part of his gastric mucosa with a Désormeaux's endoscope. An exact copy of the metal tube (47×1.3cm.) is preserved today in Kyushu university (fig.-15). This was approved as the first gastroscopy. No need to say that his gastroscope was unable to be used for practice and his interest had also moved to the other field. However his success is an important milestone in the history of gastroscopy as a testimony of the possibility of straight rigid tube insertion into the stomach. In 1970's, endoscopy was carried out for the observation and treatment of the nasal cavity, larynx and urethra. Endoscopy of the rectum wasn't performend widely because the traditional speculum was considered enough for clinical purpose. About esophagoscopy, several odd instruments were seen in literatures, but their clinical application must be impossible. In conclusion, endoscopy had originated in Greek. A remarkable development was made in 19th century and much interest was focused on it as a new technique for the observation of the human cavity. However development in the other fields such as electricity or optics was necessary before its wide clinical application. Furthermore little attention was payed on the position of patients, which is importand for endoscopy.
