Hippocratic concepts of acute and urgent respiratory diseases still relevant to contemporary medical thinking and practice: a scoping review.

BACKGROUND: The collected works of Hippocrates were searched for concepts on the diagnosis, prognosis, and treatment of acute and urgent respiratory diseases, with the objective to trace their origins in the Hippocratic Collection. METHODS: A scoping review was performed to map out key concepts of acute and severe respiratory diseases in the entire Hippocratic Collection. The digital library Thesaurus Lingua Graeca (TLG) was researched for references in the entire Hippocratic Collection regarding the epidemiology, pathophysiology, prognosis, diagnosis and treatment of acute respiratory diseases; then, the relevant texts were studied in their English translation by the Loeb Classical Library. RESULTS: Hippocratic physicians followed principles of treatment for pneumonia and pleurisy, still relevant, such as hydration, expectoration, analgesia and prompt mobilisation. Other approaches, including the inhalation of "vapours through tubes" in angina, can be considered as forerunners of modern medical practice. Thoracic empyema was diagnosed by shaking the patient and direct chest auscultation after "applying your ear to his sides". In case of an emergency from upper airway obstruction, urgent insertion of primitive airway equipment, such as a small pharyngeal tube, was applied. CONCLUSIONS: The main Hippocratic concepts on four still common acute and urgent respiratory diseases -pneumonia, pleurisy, thoracic empyema and upper airway obstruction- were identified and most of them were found to be in agreement with contemporary medical thinking and practice.

The embalming, the scientific method and the paleopathology: the case of Gaetano Arrighi (1836).

Since the most ancient times the problem of the artificial preservation of dead bodies has been an important object of study. In ancient and classic times the reasons leading to this practice were essentially of a religious and esoteric type, but in the modern age, following the development of medical and biological studies, embalming has assumed a more practical trend which is both medicine and scientific. The discovery of blood circulation has marked the scientific method which, in its various forms, has circulated all over Europe bringing fame to eminent anatomists such as Federico Ruysch (1638-1731), William (1718-1783) and John Hunter (1728-1793), Jean Nicolas Gannal (1791-1852), Giuseppe Tranchina, Laskowky and Brosch, who affirmed the embalming by endoarterial injection of conservation fluids making evisceration useless and obsolete. The advent of formalin and the introduction of new surgical and autoptic methods have made this practice gradually fall into disuse. For this reason, the mummy found in Leghorn (Tuscany, Central Italy) is of particular importance since was obtained applying the intravascular injection following the method, described by the Italian medical Giuseppe Tranchina in 1835. The mummified body belongs to Gaetano Arrighi, a prisoner in the Leghorn fortress. He was born in Arezzo in 1789 and died on March 1836 at the age of 47 in the Civil Hospital of Leghorn following pleurisy, as results in an annexed document. The day after his death Dr. Raimondo Barsanti from Pisa and Superintendent at the Leghorn hospital made up the Tranchina's method, which consisted in the injection of an arsencial -mercury solution inside of the blood vessels, giving rigidity and dark red color to the dead body. The excellent outcome of the intervention has made it possible, more than 160 years later, to study not only the method by which Arrighi's body was embalmed but also to perform a careful paleopathological imaging study by traditional X-rays and by Computer Axial Tomography (CAT). The high percentage of mercury present in the conservation fluid conferred radiopacity, making it possible to evidence the diffusion of the liquid into the entire artery tree and in particular into the aorta as well as in all the right and left artery systems. The radiopacity showed an unusual thoracic picture suggesting a pathological situation. The CAT study enriched and ameliorated the results obtained by X-rays making it possible to reconstruct the embalming procedure and to confirm the diagnosis of wet pleurisy probably cause by a tubercular infection.

[Edvard Grieg's health and his physicians]. / Edvard Griegs helse og legene.

The Norwegian composer Edvard Grieg (1843-1907) suffered from pleurisy at the age of 17 years. The tuberculosis infection later also involved his lungs and columna. Throughout his whole life, his health was impaired by a destroyed left lung and considerable deformity of his thoracic columna. As complications to these sequelae, he suffered from numerous respiratory infections. Later he developed combined lung and heart failure. Grieg was admitted, many times to different spas and sanatoria both in Norway and abroad. In addition he was treated by many different doctors, and several of them became his personal friends. In this article, the author presents some of these physicians, and briefly describes Edvard Grieg's health problems.