A subject with abnormally short stature from Imperial Rome.

In spite of the rich iconographic and literary documentation from ancient sources, the skeletal evidence concerning individuals of abnormally short stature in the Greco-Roman world is scarce. The necropolis of Viale della Serenissima/Via Basiliano in Rome, mostly referable to the II century AD, recently yielded the skeleton of an individual characterized by proportionate short stature, gracile features suggesting female gender, and delayed epiphysial closure, associated with full maturation of the permanent dentition. These characteristics could be compatible with the phenotype associated with female gonadal dysgenesis. The skeletal individual described here, although poorly preserved, represents the first evidence of a paleopathologic condition affecting skeletal growth documented for the population of ancient Rome.

For a history of andrology.

Two issues of this Journal are devoted to the history of andrology and male sexuality, from Hippocratic medicine to contemporary ethical problems due to the increasing role of technology in human reproduction. Studies have been devoted to: the Hippocratic Corpus, to authors of the Roman Empire, to Byzantine medicine; the transmission of ancient texts through Arabic and other languages of the Middle East; the influence of Constantinus Africanus' translations from Arabic to Latin; early modern theories about semen, male sexuality, impotence. Recent developments of biochemistry and epistemology are analyzed to show how these and other topics have influenced sexual ideas and behaviours until the discovery - around 1840 - of the chemical nature of male sexual hormones. In more recent years, technologies and cellular and molecular biology have opened new perspectives in the fields of fertilization and male sexuality, giving way at the same to new ethical, social and legal problems.

[Lancisi, Baglivi and the medical academies in Rome]. / Il Ruolo del Lancisi e del Baglivi all'interno delle Accademie Mediche Romane.

Many medical academies were active in Rome during the 17th century; they were promoted by noble patrons, ecclesiastics or eminent physicians, and equipped with libraries. Their role was important in the spreading of the new biomedical thought, founded on the comparison between ideas and experimental data. As an epistemological heritage of Marcello Malpighi and as a connection to the new scientific European ideas, Baglivi directed his efforts towards a leading role of the experimental observations, whereas his predecessor Lancisi was bound to the theorical "ipse dixit" role of the masters of medicine. The analysis of the statutes of the Roman Academies bring to light the new experimentalism, due to the "virtuosi" (vituous men) and "curiosoni" (inquisitive/odd persons) of the Academies: Baglivi, in his De praxi medica, invites the princes to establish in every Metropolitan Hospital an Academy - Medicorum Collegium, in which discussion on clinical aspects should be performed: extraordinary importance is devoted to the epistemological difference between "experientia" (guided in the profession by a membrum - litteratum, thought the direct comparison on the texts) and "experimentum" (following the clinical observation, guided by a membrum historicum-practicum).

Theophilus' Auctoritas: the role of De urinis in the medical curriculum of the 12th-13th centuries.

The three principles to know, to know how and to know how to be are already condensed in the works of Theophilos (7th-9th centuries). Theophilus' De urinis was included in Latin translation in the Articella, probably because of its intermediate position between the texts of high doctrinal value by Hippocrates and Galen (lacking, however, a unifying 'theory of urine') and the epitomes, short manuals without any theoretical background. It thus forms an excellent synthesis of a cultural approach reconciling iatrosophia and techne and offers to the reader a text reconciling the theory and the practice, useful to health workers in hospitals, novice beginners and medical scholars. Thanks to his strong attention to the correlation between symptoms and pathology and to his search for assessment scales, Theophilus became the author on whom the birth of medical medieval studies was founded.

[Philosophical and historical values of medicine]. / I valori filosofici e storici della medicina.

History of Medicine has pointed its higher attention on both great physicians and relevant medical schools. The hieratic person of the physician has been pre-eminent and conditioning the relationship between patients and doctor, the latter in a paternalistic dominant position. Changes occurred in medicine during the last century, mainly related to the technological advancements and a new ethiopatogenetic view. Better social conditions, improvement of diagnostic procedures and the discovery of effective therapeutic drugs (e.g. antibiotics, etc.) has produced advancements in general life conditions (measured by parameters such as aging, reduction of newborn mortality etc.), but also an increase in the cost of the social medical system. So, the new frontier of History of Medicine is the analysis of changes occurred in medicine (new epistemological rules, pressure of new technologies, more sophisticated citizens-patients) to deepen the values of medicine in an anthropological view of managed care.

The Perì ouron treatise of Stephanus of Athens: Byzantine uroscopy of the 6th-7th centuries AD.

In the 6th-7th centuries AD, treatises on uroscopy were written by Theophilus, Magnus and the author of work transmitted through the ms. Parisinus gr. 2260, Stephanus of Athens. These works are the first to deal comprehensively with the problem of urines, uroscopy and their clinical role, so that a philological and content analysis and examination of their reciprocal relationships may clarify an important period in the birth and development of Byzantine uroscopy, which represents a significant epistemological passage in the medieval history of medicine (e.g. the positing of relationships between physical signs and systemic diseases).

Medical profession changes between religion, science, skill, ethics, law and economics.

How has the medical profession changed during the centuries? How has the evolution of the profession been influenced by the balance of different issues, e.g. magic, religion, philosophy, science, technology, ethics, law and/or economics? One needs to examine many historical changes leading from the hierarchized medicine of Ancient Egypt to the Asklepiadic and Hippocratic medicine at the time of Plato, from the newly organized medicine of the Renaissance to the emerging social medicine of the XIX century, from the nosological medicine centered on the evaluation of the symptoms to the medicine which explores the human body through technologies. Furthermore, an overview from the past to the future should analyze the new doctor-patient relationship in a health system of managed care, between market and solidarity, between the efficientistic guidelines of the providers (hospitals, physicians, etc.) and an anthropocentric view of the rights of the citizen-customers. These problems are presented and discussed by many Authors in three issues of Medicina nei Secoli (II/III.1997-I, 1998) as an aid to understanding what it means to be a physician today, from the past to the future.

[Environment and political institutions between antiquity and contemporary medicine]. / Ambiente ed istituzioni politiche nella medicina antica ed in quella contemporanea.

In both myth and Genesis (by God) the creation of the world begins with the separation of water, sky/air and ground; later appear the life and the man and from Olympic divinities (or God) derive health and disease and remedies. When Milesian philosophers distinguished between nature (to be observed) and speculation, a parallel revision has been made in the medicine, from theurgical to rational one. Thus, Hippocratic medicine pointed attention on air waters and places as natural environmental elements, to be observed, as method to understand the probable diseases of a city, also with a role of political institutions, says the Hippocratic treatise De aëre. Centuries later, only in the 19th century has been rediscovered the importance of environment in the health's policy, a concept full developed in the last time (i.e. health and pollution, health and quality of life).

[Measure in Arabic and Middle Age medicine]. / La mesure médicale dans le monde Arabe reflétée dans la médecine occidentale du XIVe siècle.

During the XIVth century to the qualitative knowledge is superimposed the concept of the importance of a quantitative evaluation of natural phenomena. The Arabic works on science, first translated in Latin by Adelard of Bath, and the recovery of classical culture into Western Europe are discussed by Grosseteste, R. Bacon and Ockham with a separation of religious truth from the scientific findings; Jean Buridan (Paris) applied this meaning to physics and Simone di Castello (Bologna) considered the necessity of the measure of elements, qualities and humours to explain and correct health and disease. So, the logica nova was acquired also by medicine, as demonstrated by the works of Anthony Ricart and by the direct quantitation made by Santorio Santorio (early XVIIth c.), who constructed appropriate instruments for measurement of medical parameters.

Critical and historical approach to Theophilus' De Urinis. Urine as blood's percolation made by the kidney and uroscopy in the middle ages.

In classical Greek medicine, neither Hippocrates nor Galen considered the condition of the urine to be an important sign of systemic diseases, and they did not relate its characteristics to definite illnesses, except in obvious cases of urinary tract disease. In their teaching, urine was used together with other physical signs as a prognostic indicator. With Theophilus, however, uroscopy gained an important role, and the appearance of the urine became pathognomic of specific diseases. De Urinis owed its popularity to this new approach and to its didactic character, as it was written as a practical handbook. After the 12th century, De Urinis occupied an assured position among the few ancient medical treatises that in Latin translation formed a worldwide teaching canon for medieval and Renaissance medical schools.

History of medicine and prehistoric orthopedics.

Increasing efforts have been recently made to apply medical technologies to history of medicine of ancient time. Despite the use of molecular biology techniques, the most reliable results have been obtained by the paleopathological study on disease which may be recognized by the observation of stigmata of bones: the datation of skeletal lesions and the findings of cranial and orthopedic lesions indicate that the attempts of cure of bones are typical of early medical activity, dating from the prehistoric antiquity.

[Medical institutions in Rome in V-IX centuries: Byzantine influences]. / Influenze Bizantine nelle strutture sanitarie dei secoli V-IX in Roma.

Medical and welfare centers (xenodochia, diaconiae), were built in Rome in the early Middle Age under the Byzantine influence. The Byzantine influence played a very important role in organizing these welfare institutions as well as in promoting cultural, ethical and religious patterns in order to provide treatments and aids for the poor and sick people.

Healing rituals and sacred serpents.

Votive tablets found during the excavation of shrines of the Graeco-Roman god of medicine (Asklepios or Aesculapius) associate the healing of superficial lesions with contact with the oral cavity of non-poisonous serpents. We suggest that this may have been the empirical exploitation of the healing properties of salivary growth factors. By immunohistochemistry and immunoblotting we demonstrate the expression of the epidermal growth factor and its receptor in the oral, upper digestive, and salivary epithelia of Elaphe quatuorlineata, a species probably used in healing rituals.