Hydrocephalus according to Byzantine writers.

OBJECTIVE: To describe hydrocephalus, the techniques applied for its treatment by Byzantine physicians, and their later influence. METHODS: A study and analysis of the original texts of the Byzantine medical writers, written in Greek, was undertaken. A comparison with current concepts also was made. RESULTS: Three eminent Byzantine physicians: Oribasius (4th century AD), Aetius (6th century AD), and Paul of Aegina (7th century AD) gave the first detailed information regarding hydrocephalus and its conservative and surgical treatment. These physicians, who were trained in Alexandria, quote the concepts of the now-lost works of the celebrated surgeons of the Pneumatic School of Alexandria Leonides and Heliodorus (1st century AD) and its follower Antyllus (2nd century AD). In the types of hydrocephalus they described, we identify the conditions currently known as cephalhematoma and subgaleal hematoma, for which conservative and surgical treatments were provided, and epidural hematoma, which was thought to be incurable. CONCLUSION: The term hydrocephalus was coined during the Hellenistic period. The clinical picture of the disease, however, as described by later Byzantine physicians, does not correspond to current concepts. The ideas of the Byzantine physicians were based on the ancient Hippocratic, Hellenistic, and Roman traditions, which influenced Arab medicine and then Western European medicine, thus constituting significant roots of modern neurosurgery.

Professor Nicolas Taptas (1871-1955): a pioneer of post-laryngectomy voice rehabilitation.

OBJECTIVE: To report on the career of Professor Nicolas Taptas of Constantinople (1871-1955) and his contribution to the development of an artificial larynx. STUDY DESIGN: Historical review. METHODS: The unpublished documents of Taptas's family archives and one of his papers, describing his own original technique for voice rehabilitation after total laryngectomies, were studied. RESULTS: In his texts, Taptas described the application of external laryngeal prostheses in one of his patients who underwent total laryngectomy. Taptas meticulously recorded his own first successful attempt in a woman with cancer of the larynx. He was one of the first scientists who, at the end of the 19th century, devised an external laryngeal prosthesis, which had the advantage of rehabilitating a sufficiently strong whispering voice; by using a prototype valve, he avoided problems of aspiration of liquids and food to the bronchi. CONCLUSION: Nicolas Taptas's contribution to the development of the artificial larynx was vital because he devised and applied one of the first external laryngeal artificial prostheses with satisfactory functional results.

From the roots of rhinology: the reconstruction of nasal injuries by Hippocrates.

The goal of this report is to describe the therapeutic methods and surgical techniques used by Hippocrates (5th century BC) in the treatment of nasal injuries. We studied the original Greek texts of the (generally considered genuine) Hippocratic book Mochlicon and, especially, the analytical On Joints. We identified the treatments and techniques applied to the restoration of injured noses. We found that Hippocrates classified nasal injuries, from simple contusions of soft tissues to complicated fractures. Hippocrates provided detailed instructions for each case, from poultice application and bandaging to reconstruction and reshaping of the nasal bones in cases of fractures and deviation. Hippocrates' texts reflect the interest of the classical period in nasal injuries, a common enough accident in athletics. Hippocratic conservative and surgical management for each form of injury was adopted by later physicians and influenced European medicine.

Surgery for inguinal hernia in Byzantine times (A.D. 324-1453): first scientific descriptions.

The aim of this article is to present the techniques applied by Byzantine physicians for inguinal hernia repair and to note their influence on the development of surgery after that time. A study and analysis of the original texts of the Byzantine medical writers, written in Greek, and containing the now mostly lost knowledge of the ancient Hellenistic and Roman periods, was undertaken. Two Byzantine physicians, Aetius of Amida (6th century A.D.) and Paul of Aegina (7th century A.D.), described two techniques for confrontation of inguinal hernia, namely the surgical removal of the prolapsed peritoneum and the cauterization of the groin. These methods were probably derived from the texts of earlier Greek surgeons to which they added their own keen observations. The study of Byzantine medical and literary texts proves that the surgical techniques for inguinal hernia were practiced in Byzantine times and influenced later Arabian and European surgery, thus constituting significant roots of surgery.