The Hippocratic Method of Surgical Cauterization for the Tumescence Spleen in the Rare "Spetses Syndrome".

Spleen in antiquity was considered by the Hippocratic medicine as a viscerous organ of spongy character, which could clear human body of the black bile. According to the Hippocratic doctrine of the 4 humors, black bile could cause a series of diseases. Both the anatomical position and shape of the spleen were also recognized. In the case of a splenic hardening, with simultaneous augmentation of its dimensions and dermal ulceration and/or splenic abscess, some interventions were proposed. Thus, herbal medicine, phlebotomy, and minimal surgery with local cauterization were applied for treatment, to confront a disease that was considered serious but not fatal. The Hippocratic physicians encountered various spleen diseases and among them they most probably confronted a rare splenic pathological entity, named centuries later as "Spetses syndrome," a rare type of thalassemia of the Spetses island of Saronikos Gulf. Although the approach seems in modern terms rather primitive, the ancient Greek medico-philosophers most likely understood the significance of the spleen.

The evolution of intramedullary spinal cord tumor surgery.

OBJECTIVE: Resections of intramedullary spinal cord tumors were attempted as early as 1890. More than a century after these primitive efforts, profound advancements in imaging, instrumentation, and operative techniques have greatly improved the modern surgeon's ability to treat such lesions successfully, often with curative results. METHODS: We review the history of intramedullary spinal cord tumor surgery, as well as the evolution and advancement of technologies and surgical techniques that have defined the procedure over the past 100 years. RESULTS: Surgery to remove intramedullary spinal cord tumors has evolved to include sophisticated imaging equipment to pinpoint tumor location, laser scalpel systems to provide precise incisions with minimal damage to surrounding tissue, and physiological monitoring to detect and prevent intraoperative motor deficits. CONCLUSION: Modern surgical devices and techniques have developed dramatically with the availability of new technologies. As a result, continual advancements have been achieved in intramedullary spinal cord tumor surgery, thus increasing the safety and effectiveness of tumor resection, and progressively improving the overall outcomes in patients undergoing such procedures.

[The process of the acceptance of modern medical techniques in Japan at the beginning of the Meiji Era: with a focus on the surgical instruments, "écraseur" and "galvanic cautery"].

In this paper, I focus on the historical analysis of the process of the introduction and acceptance of modem medical techniques in Japan from the standpoints of medical assessments by Japanese doctors at that time. The "écraseur" and "galvanic cautery" are surgical instruments which were introduced into Japan from Prussia in 1873-74. These two surgical instruments have almost the same utility, such as the removal of tumors, polypi, and other growths without the effusion of the blood. At the beginning of the Meiji era, many social facilities, for example, European style hospitals and medical schools, academic journals, industrial expositions and catalog sales of medical devices, were introduced in Japan. These social facilities were related to the transfer of the medical practices in which these surgical instruments were used. Although this transfer was achieved in a short time, it involved technology assessments by Japanese doctors from many practical standpoints, including economic viewpoints. In particular, the "galvanic cautery" served as a medical device that had significant mutual effects in the surrounding areas.

The first Anatolian contribution to treatment of sciatica by Serefeddin Sabuncuoglu in the 15th century.

Serefeddin Sabuncuoglu was an early 15th century surgeon in Anatolia. His masterpiece entitled Cerrahiyetül Haniye (Imperial Surgery) is the first illustrated surgical textbook in the Turkish Islamic literature of the Ottoman era Anatolia. It is the first written medical-surgical work in Anatolian history and it covers the treatment of more than 40 illnesses, which range from hydrocephalus to sciatica. This study aims to investigate the contribution of Anatolia to neurosurgery through Sabuncuoglu's treatment of sciatica, a problematic and common illness.

Dental chapters of Serefeddin Sabuncuoglu's (1385-1468?) illustrated surgical book Cerrahiyyetu'l Haniyye.

From the 7th to the 11th centuries Arabic authors translated ancient Greek and Roman medical textbooks into their own languages. In the 11th and 12th centuries, noted authors used these early translations when writing other classical texts. One of these was that of the Andalusian surgeon, Albulcasis (936-1013), whose famous work is entitled, at-Tasrif (4,6). It has been used as a reference book for centuries and was translated into Latin in the 15th century and into Turkish by me when I discovered a manuscript of it in the Manisa Library in Turkey (14). The best interpreter of it, however, was Serefeddin Sabuncuoglu (1365-1468). He used the classification of at-Tasrif, but improved on it by adding original observations and three original chapters. His book is entitled, Cerrahiyyetu'l Haniyye which means The Imperial Surgery (15).

Al-Zahrawi and Arabian neurosurgery, 936-1013 AD.

The authors highlight the neurosurgical contributions of an Arabic surgeon by the name of Abul-Qasim Al-Zahrawi, known in Western literature as Abulcasis. This man lived during the Middle Ages from 936 to 1013 AD and wrote a 30-volume treatise on medicine. A significant part of his work on surgery consists of early descriptions of neurosurgical diagnosis and treatment, including the surgical treatment of head injuries and skull fractures, spinal injuries and dislocations, hydrocephalus and subdural effusions, headache, and many other medical afflictions. He described neurosurgical instruments such as cranial drills that avoided puncture of the dura mater. Abulcasis is known for his concepts of pain as a symptom and his emphasis on anatomy of the skull and brain in relation to the neurosurgical operations of that period. Because his works were translated from Arabic to Latin, Hebrew, and Turkish with only recent or limited translation into the modern occidental languages, the historic role played by this man has been largely unknown by neurosurgeons who are not fluent in these languages.

What's new in electrosurgical instrumentation?

A 1976 report of the use of radiofrequency current to devitalize carcinomas in man stimulated this review of the historical background, the presently used techniques, and the problems associated with electrosurgery. Difficulties in electrosurgical techniques requiring further research are identified--i.e., the high heating and variable performance of dry dispersive electrodes, the hazards of tissue stimulation, high-frequency interference, and the potential impact of government regulation.