Dimitrios Mavrokordatos Disproving the Hemostatic Myth of Aqua Binelli.

"Aqua Binelli" or "Aqua Balsamica Arterialis" was a hemostatic compound invented by the Italian Fedele Binelli in 1797. Its hemostatic properties were viewed as the solution to treating hemorrhage in cases of wounds and surgical operations. Those who opposed the compound were persuaded of its total lack of effectiveness, supporting the view that hemostasis could be achieved by exerting pressure on, stitching, and ligating a vessel. The publications of Karl Ferdinand von Gräfe, Professor at the University of Berlin and fervent advocate of Aqua Binelli, helped spread the use of the compound in Europe. In 1832, however, one of his students, a young Greek named Dimitrios Mavrokordatos, who became the first Professor of Anatomy and Physiology in the newly established University of Athens in 1837, published in Würzburg his dissertation titled Observations on the Potency of Aqua Binelli (Weitere Nachrichten über das Binellische Wasser), where a completely different picture emerged relating to those applications of the compound that von Gräfe considered successful. The case of Mavrokordatos' dissertation was a typical 19th-century scientific controversy between a young student and his teacher who enjoyed the support of his associates. Eventually, the myth of the hemostatic activity of Aqua Binelli was debunked.

Insights in the history of pancreas: Restoring the true meaning of "kallikreas".

BACKGROUND/PURPOSE: This paper investigates the history of pancreas in classical and late antiquity with the intent to correlate it to the modern medical knowledge. Furthermore, an attempt is made to understand the true meaning of the term "kallikreas". METHODS: Only primary textual sources are used in the transcription of ancient references of "pancreas" and/or "kallikreas". All of the references are analyzed and interpreted under a modern prism for better understanding the ancient anatomy proposed. RESULTS: The ancient references describe the actual organ, its position and the blood vessels related to it. An attempt if made to correlate the ancient physiology of the organ to the modern one. Finally, the problematic issue of the ancient terminology is studied. CONCLUSIONS: Textual proofs are offered that the knowledge that exists and that travelled through the ages concerning the identification of pancreas with "kallikreas", from which the hormone kallikrein took its name, is erroneous and that the term refers instead to the mesentery.

The ancient history of dementia.

OBJECTIVE: This paper presents dementia, as studied in the ancient Greek and Byzantine bibliography, aiming at clarifying whether there was an early differentiation between dementia and senile dementia. METHODS: Numerous references of the terms morosis, delirium (παραλήρηµα) or "leros" (λήρος), and anoia were found in the writings of authors from the seventh century BC up to the fourteenth century AD. The references were studied and those referring to everyday use of the words were eliminated from the corpus, which is, thus, formed solely by the terms with medical connotations. RESULTS: The ancient history of dementia may be separated in two periods: before and after Posidonius, who differentiated two medical ontologies relating to dementia: dementia appearing due to old age called λήρος and dementia appearing due to other reasons called morosis. During the first period, we mainly have authors referring to dementia due to old age or due to cold black bile, defined as a deterioration of memory and reasoning. In all cases, the etiology and the clinical manifestations are presented while we make an attempt to correlate the ancient descriptions to modern medical entities. CONCLUSIONS: The study of the ancient texts proves that dementia was distinguished from senile dementia early in history. This differentiation was manifested even with a shift in the use of specific terminology. Finally, the attempt to correlate modern medical entities with dementia-related issues results in interesting hypotheses.

Evidence of the Earliest Thyroid Cancer Operation Performed Successfully.

Thyroid surgery appears early in history, even though the anatomic description and the function of the thyroid gland was not understood [...].

The ancient surgical bloodletting method of arteriotomy.

Methods of bloodletting were widely known in antiquity and were used for the cure of numerous illnesses and symptoms, caused mainly by the supposed excess of blood in the body. This article presents and discusses arteriotomy, a surgical method of bloodletting, appearing after the 1st century AD in the texts of Celsus, Galen, Antyllus, and Severus. The texts were studied either in their primary language or in a translation. Secondary references were only used for comparing the ancient technique to modern surgical methods.

Trepanations in the ancient Greek colony of Akanthos: Skull surgery in the light of Hippocratic medicine.

OBJECTIVE: The study presents seven new cases of trepanations on four individuals from the ancient Greek colony of Akanthos (5th - 1st c. BC) and juxtaposes the paleopathological observations with the Hippocratic treatises. MATERIALS: A meta-analysis of 42 published trepanations on 27 individuals from Greece. METHODS: Trepanations from Akanthos were observed macroscopically, stereoscopically and by computer tomography. The meta-analysis considers the demographic, geographical and temporal distribution, the techniques, associated pathology, and survival rate. RESULTS: Trepanations were observed on four females in Akanthos. Three trepanations were performed with scraping and four with drilling. Two individuals exhibited significant signs of healing, and two survived shortly after the operation. In two cases, trepanation was practiced for treating cranial injuries. In Greek antiquity trepanation was performed predominantly in males, principally as a surgical treatment of cranial injuries. The survival rate was 62.9 %. Scraping was the oldest, most frequent and successful technique. CONCLUSIONS: Trepanation performed systematically in Greece since the Bronze Age (ca. 2,000 BC). Hippocrates who rationally conceived medicine, codified the pre-existing empirical knowledge. The trepanations from Akanthos show technical similarities but also discrepancies from the Hippocratic recommendations, confirming the mental and technical readiness of the ancient surgeon. SIGNIFICANCE: The synchronous to Hippocrates trepanations from Akanthos, provide the opportunity to compare physical evidence with the written sources. LIMITATIONS: The frequency of trepanations is affected by the representativeness and the state of the skeletal preservation. SUGGESTIONS FOR FUTURE RESEARCH: Trepanations published in previous decades, need to be reassessed with new imaging modalities. A standard recording methodology is fundamental for data comparison.

Votive Reliefs of Lower Extremities Disorders: A Brief Review.

The purpose of this paper is to present a series of votive reliefs from Graeco-Roman antiquity related to disorders of the lower extremities, in order to comprehend the importance of anatomical offerings as gifts of gratitude to healing gods such as Asclepius. The selected offerings cover disorders such as varicose vein disease and deformities of the lower limbs and provide significant information on medical treatments in ancient Greece, as well as the importance of religious practices in the healing process.

The manifestation of "gangrene" in the Hippocratic corpus.

We trace the early historical references concerning "gangrene," specifically in the treatises of the Hippocratic corpus. The term "gangrene" today refers to the necrosis, or death, of tissues resulting from prolonged ischemia, bacterial invasion, and subsequent putrefaction. Apart from the name "gangrene," another term, "sphacelus," exists in the corpus, referring to similar decay. An effort is made to correlate cases of "gangrene" and "sphacelus" described in the Hippocratic texts and related bibliography. In this study we retained only references to "sphacelus" that have the same end points as "gangrene." References to necrosis of the skull, the brain, the teeth, the jaw, the extremities, the ribs, and some resulting from "ulcers" were isolated. Their clinical manifestations, prognosis, and treatment are presented, together with general comments on the disease's etiology.

Management of obesity in the writings of Soranus of Ephesus and Caelius Aurelianus.

Caelius Aurelianus (5th century AD) is famous for translating the writings of Soranus of Ephesus (2nd century AD) into Latin. In his book On acute and chronic diseases, Caelius gives an almost complete edition of the works of Soranus, while adding some of his own and other writers' material. Obesity was even at that time considered to be a disease and the authors treat the subject extensively. The nature, etiology, the clinical manifestations of obesity are described, although treatment covers the greatest part of the material. Infliction of perspiration, very low caloric intake diet, exercise, and diuresis are proposed, and one cannot overlook the strong similarities of some of the treatments with those used nowadays as secondary aids for weight loss.