# A note on the history of Hirschsprung’s disease, and an over 120 years apology

## TL;DR

This paper discusses the history of Hirschsprung’s disease and suggests reconsidering its naming to credit overlooked contributions.

## Contribution

The paper highlights K. Tittel’s overlooked role in identifying key features of Hirschsprung’s disease.

## Key findings

- Hirschsprung’s disease was previously described in medical literature over a century before Hirschsprung’s work.
- K. Tittel identified the narrow rectum and absence of ganglion cells in 1901 but was not credited for the disease’s cause.

## Abstract

In 1886, Harald Hirschsprung presented what he believed to be a new and rare condition at the Berlin Congress for Children’s Diseases. In 1888, still unaware of earlier reports, he published a paper titled “Constipation in Newborns as a Consequence of Dilation and Hypertrophy of the Colon,” suggesting that the enlargement of the colon was congenital. Although he noted a narrowing of the rectum in his initial case, Hirschsprung attributed this condition to a dilated intestine rather than a narrowed rectum. In fact, F. Ruysch had described a case of over-enlarged colon as early as 1691, and in 1800, D. Battini published another case of severe constipation posthumously. Between 1825 and 1888, around 20 similar cases had been documented in medical literature. K. Tittel was the first person to draw attention to the narrow rectum and the absence or scarcity of ganglion cells in this region in 1901. However, he did not identify this as the exact cause of the disease, This was evident not only in his own article but also in references to his work in other publications. Despite this fact in the literature, the disease is known as “Hirschsprung Disease”. Given the historical and scientific context, it may be time to reconsider the attribution of K. Tittel’s discovery and to recognize the significant contributions of him in understanding of this disease.