Who discovered intravenous urography? Swick, von Lichtenberg, Lichtwitz and the chemists

Positions

1. Swick: the urographic use

   Moses Swick, a young American working in Germany, observed that the iodinated pyridines made by Binz and Räth were excreted rapidly by the kidney and, with an N-acetylated derivative later named Uroselectan, obtained images of the kidneys, ureters and bladder after intravenous injection. His single-author paper appeared in Klinische Wochenschrift in 1929, beside a joint clinical paper with von Lichtenberg. The New York Academy of Medicine gave him its Valentine Medal in 1966.

   Sources

   1. Swick 1929, Darstellung der Niere und Harnwege im Röntgenbild durch intravenöse Einbringung eines neuen Kontraststoffes, des Uroselectans, Klin Wochenschr 8:2087-2089 Primary
   2. von Lichtenberg and Swick 1929, Klinische Prüfung des Uroselectans, Klin Wochenschr 8:2089-2091 Primary
   3. Wikipedia (de): Moses Swick Secondary
   4. Hierholzer and Hierholzer 2002, The discovery of renal contrast media in Berlin, Am J Nephrol (PubMed) Secondary

2. Von Lichtenberg: the clinic and the platform

   Alexander von Lichtenberg, already co-author of retrograde pyelography (1906), headed the Berlin clinic where Swick completed the work, co-signed the clinical paper, and presented the method at meetings in Munich (1929) and at the AUA (1930). For decades the method was associated with him, and Swick received little credit.

   Sources

   1. Wikipedia (de): Alexander von Lichtenberg Secondary
   2. Wikipedia (de): Moses Swick Secondary
   3. von Lichtenberg and Swick 1929, Klinische Prüfung des Uroselectans, Klin Wochenschr 8:2089-2091 Primary

3. The chemists: Binz and Räth

   Arthur Binz and Curt Räth of the Agricultural Academy in Berlin made the iodinated pyridine compounds (Selectan) as anti-infectives. Binz published his own history of Uroselectan in 1937.

   Sources

   1. Hierholzer and Hierholzer 2002, The discovery of renal contrast media in Berlin, Am J Nephrol (PubMed) Secondary
   2. Wikipedia (de): Arthur Binz Secondary

Evidence

The sequence is documented: compounds from Binz and Räth; testing by Swick first in Leopold Lichtwitz's clinic at Altona, Hamburg, and then in von Lichtenberg's St Hedwig clinic in Berlin; two adjacent papers in Klinische Wochenschrift in 1929; presentations by von Lichtenberg in 1929 and 1930. Swick's own account followed in JAMA in 1930 and in a retrospective of 1966. No kit source records a claim to credit by Lichtwitz. The political aftermath defeats any simple moral: von Lichtenberg was dismissed from all posts in 1936 for his Jewish ancestry and died in exile in Mexico in 1949; Lichtwitz was forced out in 1933; Binz, as general secretary of the German Chemical Society from 1932 to 1937, was instrumental in dismissing its Jewish employees.

Current standing

Modern accounts credit the chemists with the compound, Swick with discovering its use for urography, and von Lichtenberg's clinic with the first clinical series and its publicity. Swick's recognition came late: the Valentine Medal in 1966, then honours in Berlin and New York. The film gives the discovery to Swick and the presentation to his professor, and records the professor's own dismissal.

All sources