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This historical analysis examines an anonymous 18th-century German autopsy report to determine if it describes endometriosis. Two pathologists with historical expertise transcribed and assessed the manuscript, identifying that the patient, likely Countess von Reitzenstein, died from a malignant gynecological tumor but exhibited ovarian pathology consistent with an endometriotic cyst. The authors note that while such descriptions are rare in 18th-century literature, this case provides strong macroscopic evidence for the diagnosis, correlating pathological findings with clinical symptoms similar to earlier works by Morgagni. This paper is centrally about endometriosis — specifically, it presents a historical retrospective confirming an 18th-century autopsy record as a valid early description of the condition.
Abstract
Descriptions of endometriosis in 18th century monographs and manuscripts are rare and the recorded macroscopic features of endometriosis seldom support this attribution to the described cases. Recently, we became aware of an anonymous German autopsy report from the 18th century. After transcription, the manuscript was assessed by pathologists with historical expertise. This revealed that the patient died because of a malignant tumor, most probably of a gynecological origin. Furthermore, the described ovarian pathologic findings strongly support the diagnosis endometriotic ovarian cyst. Like Giovanni Battista Morgagni (1668-1772) in his landmark publication De Sedibus et Causis Morborum per Anatomen Indagatis (1761), the author correlated the pathological findings at autopsy with the symptoms of the patient. The identity of the patient could, with high probability, be established as being the Countess of Reitzenstein, the wife of a Prussian general major in the army of Friedrich the Great: Karl Erdmann von Reitzenstein (1722-1789).
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Summary
Descriptions of endometriosis in 18th century monographs and manuscripts are rare and the recorded macroscopic features of endometriosis seldom support this attribution to the described cases. Recently, we became aware of an anonymous German autopsy report from the 18th century. After transcription, the manuscript was assessed by pathologists with historical expertise. This revealed that the patient died because of a malignant tumor, most probably of a gynecological origin. Furthermore, the described ovarian pathologic findings strongly support the diagnosis endometriotic ovarian cyst. Like Giovanni Battista Morgagni (1668–1772) in his landmark publication De Sedibus et Causis Morborum per Anatomen Indagatis (1761), the author correlated the pathological findings at autopsy with the symptoms of the patient. The identity of the patient could, with high probability, be established as being the Countess of Reitzenstein, the wife of a Prussian general major in the army of Friedrich the Great: Karl Erdmann von Reitzenstein (1722–1789).
Zusammenfassung
Beschreibungen einer Endometriose sind in Monografien und Manuskripten des 18. Jahrhunderts selten, wobei die makroskopischen Aufzeichnungen derartiger Fälle die Merkmale einer solchen kaum unterstützen. Kürzlich wurden die Autoren des vorliegenden Artikels auf einen anonymen Autopsiebericht des 18. Jahrhunderts aufmerksam. Nach der schriftlichen Transkription dessen haben 2 historisch versierte Pathologen den Bericht beurteilt. Das Ergebnis zeigte, dass die Patientin an einem malignen Tumor, am ehesten gynäkologischer Natur, starb. Ferner konnten in der Beschreibung pathologische Veränderungen des Ovars erkannt werden, die die Diagnose einer Endometriosezyste sehr wahrscheinlich erscheinen lassen. Wie Giovanni Battista Morgagni (1682–1772) in seiner Meilenstein-Publikation De Sedibus et Causis Morborum per Anatomen Indagatis (1761) korrelierte der Autor die pathologischen Veränderungen der Autopsie mit den Symptomen der Patientin. Zudem konnte mit hoher Sicherheit die Verstorbene als Gräfin von Reitzenstein identifiziert werden – die Gattin des preußischen Generalmajors der Armee von Friedrich dem Großen: Karl Erdmann von Reitzenstein (1722–1789).
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R.M.F. van der Weiden, D. Haberland, R. Sedivy, and J.G. van den Tweel declare that they have no competing interests.
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van der Weiden, R.M.F., Haberland, D., Sedivy, R. et al. An 18th century description of endometriosis. Wien Med Wochenschr 170, 71–75 (2020). https://doi.org/10.1007/s10354-019-0693-z
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DOI: https://doi.org/10.1007/s10354-019-0693-z
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