Histories of Medieval Plague in Renaissance Italy.

During the sixteenth century, Italian scholars revised their conception of the field of history so that its purposes went beyond providing political and morally edifying narratives. These scholars contended that history must also account for culture and nature in an encyclopedic fashion. In the same years, numerous newly available texts from antiquity, the Byzantine empire, and the Middle Ages provided insight into the character of earlier outbreaks of plague. Italian physicians, embracing new visions of the field of history, the culture of humanism, and an inductivist epistemology, used these texts to argue that there were continuities among ancient, medieval, and Renaissance epidemics. They catalogued plague and formed historical categories based on severity and perceived origins, leading to the rejection of the conclusions of fourteenth-century western Europeans who viewed the plague of 1347-1353 as unprecedented. These erudite physicians saw medieval plague to be one example of the extreme epidemics that have regularly occurred throughout history.

Ancient trash mounds unravel urban collapse a century before the end of Byzantine hegemony in the southern Levant.

The historic event of the Late Antique Little Ice Age (LALIA) was recently identified in dozens of natural and geological climate proxies of the northern hemisphere. Although this climatic downturn was proposed as a major cause for pandemic and extensive societal upheavals in the sixth-seventh centuries CE, archaeological evidence for the magnitude of societal response to this event is sparse. This study uses ancient trash mounds as a type of proxy for identifying societal crisis in the urban domain, and employs multidisciplinary investigations to establish the terminal date of organized trash collection and high-level municipal functioning on a city-wide scale. Survey, excavation, sediment analysis, and geographic information system assessment of mound volume were conducted on a series of mounds surrounding the Byzantine urban settlement of Elusa in the Negev Desert. These reveal the massive collection and dumping of domestic and construction waste over time on the city edges. Carbon dating of charred seeds and charcoal fragments combined with ceramic analysis establish the end date of orchestrated trash removal near the mid-sixth century, coinciding closely with the beginning of the LALIA event and outbreak of the Justinian Plague in the year 541. This evidence for societal decline during the sixth century ties with other arguments for urban dysfunction across the Byzantine Levant at this time. We demonstrate the utility of trash mounds as sensitive proxies of social response and unravel the time-space dynamics of urban collapse, suggesting diminished resilience to rapid climate change in the frontier Negev region of the empire.

The Justinianic Plague: An inconsequential pandemic?

Existing mortality estimates assert that the Justinianic Plague (circa 541 to 750 CE) caused tens of millions of deaths throughout the Mediterranean world and Europe, helping to end antiquity and start the Middle Ages. In this article, we argue that this paradigm does not fit the evidence. We examine a series of independent quantitative and qualitative datasets that are directly or indirectly linked to demographic and economic trends during this two-century period: Written sources, legislation, coinage, papyri, inscriptions, pollen, ancient DNA, and mortuary archaeology. Individually or together, they fail to support the maximalist paradigm: None has a clear independent link to plague outbreaks and none supports maximalist reconstructions of late antique plague. Instead of large-scale, disruptive mortality, when contextualized and examined together, the datasets suggest continuity across the plague period. Although demographic, economic, and political changes continued between the 6th and 8th centuries, the evidence does not support the now commonplace claim that the Justinianic Plague was a primary causal factor of them.

From poison to drug: new recipes discovered containing colchicine as a remedy for Podagra in Rome and Byzantium.

OBJECTIVES: In Antiquity, colchicine was used as a poison and as a remedy for Podagra. Research so far has revealed that the physician Alexander of Tralles was the first who used it in the 6th century AD. Alexander recommended a plant he called "Hermodaktylon", which takes off the pain in the feet immediately. "Hermodaktylon" is identified with Colchicum autumnale L., which contains colchicine in his bulbs and seeds. We will present new data that varieties of Colchicum were used for medical treatment of Podagra far earlier than hitherto known by research. METHODS: We performed a systematic full text search in Greek and Latin original sources of Antiquity for "Hermodaktylon"/"Hermodactylus" and for the synonyms "Ephemeron"/"Ephemerum", "Kolchikon"/"Colchicum", and "Bolbos (agrios)"/"bulbus (agrestis)". We analysed our findings with philological and historico-critical methods. RESULTS: There are 48 text passages in original sources. Lucian of Samosata (2nd century AD) was the first who mentioned a plant he called "bolbos" as a remedy for Podagra. The Byzantine physician Jacobus Psychrestes (5th century AD) developed two recipes. Aëtius of Amida (6th century AD) transmitted two recipes. One case with an overdose of colchicine was discovered which resulted in the death of a patient in Byzantine times. CONCLUSIONS: New specific recipes containing Colchicum were discovered. Jacobus Psychrestes and Aëtius used Colchicum systematically for the therapy of Podagra earlier than the 6th century AD. However, the therapeutic use of Colchicum was already known in the 2nd century AD.

The death of the Byzantine Emperor John II Komnenos (1087-1143).

INTRODUCTION: The purpose of this study is to give a brief account of the life of John II Komnenos, his reign and to clarify the events and causes surrounding his death. METHODS: A thorough search of the literature was undertaken in PubMed and Google Scholar as well as in history books through the internet and in History and Medical University libraries. RESULTS: The death of the king cannot be attributed to poisoning from an injured hand by arrow poison. The long period of time before the presentation of symptoms should be attributed to their being caused by an infection. The failure of both conservative anti-inflammatory treatment and surgical drainage point towards an anaerobic infection or a septic inflammation. CONCLUSION: The death of the emperor John Komnenos was caused by a severe infection of the hand of unknown agent leading to septicaemia. This conclusion is based on the fact that death came a week or more after the injury of the hand and it was not caused by the poison of the arrow which would have been fatal within several hours.

Women Physicians in Byzantium.

Women were allowed to practice the medical profession during the Byzantine Empire. The presence of female physicians was not an innovation of the Byzantine era but actually originated from ancient Greece and Rome. The studies and the training of women doctors were apparently equivalent to those of their male colleagues. The principal medical specialties of the female doctors were gynecology and midwifery. Byzantine legislation treated relatively equally both female and male doctors. For this reason, it can be assumed that the presence of female doctors was correlated with the position of women in Byzantine society. However, there is not sufficient information in the literature to clarify whether female and male doctors used to earn equal payment for the same service.

The Birth of Hospital, Asclepius cult and Early Christianity.

History of hospital is one of main fields of researches in medical history. Besides writing a history of an individual hospital, considerable efforts have been made to trace the origin of hospital. Those who quest for the origin of hospital are faced with an inevitable problem of defining hospital. As the different definition can lead to a different outcome, it is important to make a clear definition. In this article, the hospital was defined as an institution in which patients are housed and given medical treatments. According to the definition, the Great Basilius is regarded to have created the first hospital in 369 CE. The creation of hospital is considered to be closely related with Christian philantrophy. However, the question is raised against this explanation. As the religious philantrophy does not exclusively belong to the Christianity alone, more comprehensive and persuasive theory should be proposed to explain why the first hospital was created in the Christian World, not in the Buddhistic or other religious world. Furthermore, in spite of sharing the same Christian background, why the first hospital appeared in Byzantine Empire, not in Western Roman Empire, also should be explained. My argument is that Asclepius cult and the favorable attitude toward medicine in Greek world are responsible to the appearance of the first hospital in Byzantine Empire. The evangelic work of Jesus was heavily depended on healing activities. The healing activities of Jesus and his disciples were rivalled by Asclepius cult which had been widely spread and practiced in the Hellenistic world. The temples of Asclepius served as a model for hospital, for the temples were the institution exclusively reserved for the patients. The exclusive housing of patients alone in the temples of Asclepius is clearly contrasted with the other early forms of hospitals in which not only patients but also the poor, foreigners and pilgrims were housed altogether. Toward the healing god Asclepius, the Latin Church fathers and Greek Church fathers showed significant difference of attitudes. The Latin fathers were generally very critical on Asclepius while the Greek fathers were more favorable to the same healing god. This difference is also considered to be an important factor that can explain why the first hospital appeared in the Byzantine Empire.

Dental Caries and Tooth Wear in a Byzantine Paediatric Population (7th to 10th Centuries AD) from Yenikapi-Constantinople, Istanbul.

Dental caries and wear are important conditions to record in archaeological collections. The aim of the present paper is to determine the frequency and distribution of dental caries and dental wear in a mediaeval Byzantine paediatric population in Yenikapi, Constantinople, Istanbul. The present research was carried out on the skeletal remains of 1 infant and 28 children with a total of 180 teeth (113 primary and 67 permanent teeth). The frequency of ante-mortem tooth loss in the sample was 1%. The total frequency of carious lesions in the sample was 2.2%. The frequency of dental wear was rather low (3.3%) exhibiting presence of dentin clusters mostly. The present study evaluated an archaeological collection with low dental wear and low dental caries prevalence indicating a fishing community.

A war psychiatry approach to warfare in the Middle Byzantine period.

Combat stress cases were traced in historical texts and military manuals on warfare from the Middle Byzantine period; they were mainly labelled as cowardice. Soldiers suffered from nostalgia or exhaustion; officers looked stunned, or could not speak during the battle. Cruel punishments were often enforced. Suicide and alcohol abuse were rarely mentioned. The Byzantines' evacuation system for battle casualties was well organized. Psychological operations were conducted and prisoners-of-war were usually part of them. The Byzantine army had 'parakletores', officers assigned to encourage soldiers before combat. The leaders dealt with combat stress by using their rhetoric skills and emphasizing religious faith in eternal life. The treatment of the 'cowards' was rather similar to modern war psychiatry principles of treatment. No description of PTSD was found.

History of colorectal surgery: A comprehensive historical review from the ancient Egyptians to the surgical robot.

BACKGROUND: Colorectal surgery has its roots in the early civilisations and its development followed a complex pathway never disjoined from the social and cultural environment where it took place. METHOD: The most relevant historical sources have been evaluated. RESULTS: A comprehensive review of the history of colorectal surgery is presented, from the ancient Egyptian culture to the modern achievements. The development of surgery of colon, rectum and anus is reported with particular reference to the social environment and history; as the development of colorectal surgery parallels the occurrence of human historical events, the study of the former cannot be disjoined from the latter. CONCLUSION: Study and knowledge of the history of medicine--and, in particular, of colorectal surgery for those interested in this particular subject--is a privileged way to understand who we are nowadays and where we come from.

Uterine cancer in the writings of Byzantine physicians.

Byzantine physicians recognized uterine cancer as a distinct disease and tried to suggest a therapeutic approach. The work of Oribasius, Aetius of Amida, Paul of Aegina, Cleopatra Metrodora and Theophanes Nonnus reflects the Hippocratic-Galenic scientific ideas as well as their own concept on this malignancy. According to their writings uterine cancer was considered an incurable disease and its treatment was based mainly on palliative herbal drugs.

Kynanthropy: canine madness in Byzantine late antiquity.

Those afflicted bark like dogs, scramble on all fours and loiter around graveyards - canine madness, referred to as kynanthropy, was an illness concept in its own right in the medicine of late antiquity. At roughly the same time as the medical description produced by Aëtius of Amida, the Syrian chronicler John of Ephesus, also from Amida, reported an epidemic of dog-like madness sweeping his home town in ad 560. The symptoms are identical and both authors are from Amida - what is the connection between the two depictions? In addition to the history of the medical concept, the example of the canine madness of Amida and its cultural embedding allows us to contextualize and interpret the significance of dog-like behaviour for the people of the sixth century AD.

Management of penile tumours during the Byzantine period.

While conventional treatment of penile cancer consists of total penile amputation and bilateral lymphadenectomy, recently a more conservative strategy comprising penile-preserving surgery and selective lymphadenectomy has been applied in order to preserve the penis and to minimize unnecessary inguinal lymphadenectomy. A thorough literature survey was performed to see what was already known of the surgical treatment of penile tumours in ancient times. In the Byzantine period, surgery appeared to have been highly developed, as one may conclude from the surgical material included mainly in the works of Oribasius of Pergamus and Paul of Aegina. Being aware of cancer, they described in their medical encyclopaedias malignant and benign tumours of the prepuce and glans penis, as well as their surgical and non-surgical management. After local excision of malignant tumours, they strongly recommended burning to prevent relapse, whereas they discouraged simultaneous removal of external and internal preputial lesions, because of the risk of perforation of the prepuce. These surprisingly detailed descriptions prove that Byzantine surgery had reached a higher level than commonly supposed. Penile-preserving treatment, which has recently become the therapeutic strategy of choice, was already accomplished in ancient times by using adjuvant thermal or chemical burning after local tumour excision.

[A development of Byzantine Christian charities during the 4(th)-7(th) centuries and the birth of the hospital].

This study aims to examine the beginning and the development of Christian Charities during the 4(th)-6(th) centuries which would eventually result in the birth of the hospital in modern sense in the first half of the 7(th) century. For this purpose, I looked carefully into various primary sources concerning the early Christian institutions for the poor and the sick. Above all, it's proper to note that the first xenodocheion where hospitality was combined with a systematic caring, is concerned with the Trinitarian debate of the 4(th) century. In 356, Eustathios, one of the leaders of homoiousios group, established xenodocheion to care for the sick and the lepers in Sebaste of Armenia, whereas his opponent Aetios, doctor and leader of the heteroousios party, was reckoned to have combined the medical treatment with his clerical activities. Then, Basil of Caesarea, disciple of Eustathios of Sebaste, also founded in 372 a magnificent benevolent complex named 'Basileias' after its founder. I scrupulously analysed several contemporary materials mentioning the charitable institution of Caesarea which was called alternatively katagogia, ptochotropheion, xenodocheion. John Chrysostome also founded several nosokomeia in Constantinople at the end of the 4(th) century and the beginning of the 5(th) century. Apparently, the contemporary sources mention that doctors existed for these Charities, but there is no sufficient proof that these 'Christian Hospitals,' Basileias or nosokomeia of Constantinople were hospitals in modern sense. Imperial constitutions began to mention ptochotropheion, xenodocheion and orphanotropheion since the second half of the 5(th) century and then some Justinian laws evoked nosokomium, brephotrophia, gerontocomia. These laws reveal that 'Christian Hospitals' were well clarified and deeply rooted in Byzantine society already in these periods. And then, new benevolent institutions emerged in the 6(th) century: nosokomeia for a specific class and lochokomeia for maternity. In addition, one of the important functions of Sampson Xenon was, according to Novel 59, to hold a funeral service for the people of Constantinople. Nevertheless, there is no sufficient literary material that could demonstrate the existence of a hospital in modern sense. The first hospital where outpatient service, hospitalization and surgery were confirmed was Sampson Xenon in the first half of the 7th century, figured in the tale of Stephanos of the The Miracles of St. Artemios. Why was the early Byzantine literary so reticent as to write the medical activities in the Christian Charities? It's because Christian innovation didn't rest on the medical treatment but caring for the poor and the sick, depending on the word of Mt. 25.35-36. In this meaning, I'd like to say that the Early Byzantine history of Christian Charities or 'Christian Hospitals' consists of only a footnote of the verse.

Holy fools: a religious phenomenon of extreme behaviour.

Monks in Byzantine times (330-1453 AD) often expressed their faith with extreme manifestations of behaviour, such as living on a high column (stylites), on a tree (dendrites) or in crowded urban centres of the empire pretending to be fools for Christ's sake. These Holy Fools exposed themselves to the ridicule and the mistreatment of the citizens, being protected, however, by their state of insanity to mock and violate moral codes and social conventions. The official Church barely tolerated these religious attitudes as promoting deviations from standard orthodoxy, and the Quinisext Ecumenical Council (592 AD) judged them as dangerous and formally denounced the phenomenon. The two most famous of them in Byzantium were Symeon of Emesa and Andrew of Constantinople, whose lives constitute unique testimonies to insanity and the simulation thereof. The survival and transplantation of the Holy Fools in Russia, called "yurodivye", where they met widespread acceptance, confirm their appeal in specific geographic areas and their endurance over time. We attempt to approach the symbolism of holy lunacy and to analyse the personality trends of these "eccentric" saints.

Thinking about Chemistry in Byzantium and the Islamic World.

This article investigates several discussions of "chemistry," understood as an analysts' category referring to theories and practices dealing with the structure and transformation of matter. By reading these texts (a treatise defending kimiya' by al-Farabi, the famous passage from Ibn Sina's Shifa' on transmutation, Ibn Taymiyyah's fatwa against kimiya', Michael Psellos's treatise On Making Gold, and the same author's Accusation against a sitting Patriarch of Constantinople), the article aims to lay the groundwork for integrating the historiography of Byzantine and Arabic alchemy into a wider western Eurasian intellectual history.

Isotopic reconstruction of human diet and animal husbandry practices during the Classical-Hellenistic, imperial, and Byzantine periods at Sagalassos, Turkey.

An isotopic reconstruction of human dietary patterns and livestock management practices (herding, grazing, foddering, etc.) is presented here from the sites of Düzen Tepe and Sagalassos in southwestern Turkey. Carbon and nitrogen stable isotope ratios were determined from bone collagen extracted from humans (n = 49) and animals (n = 454) from five distinct time periods: Classical-Hellenistic (400-200 BC), Early to Middle Imperial (25 BC-300 AD), Late Imperial (300-450 AD), Early Byzantine (450-600 AD), and Middle Byzantine (800-1200 AD). The humans had protein sources that were based on C(3) plants and terrestrial animals. During the Classical-Hellenistic period, all of the domestic animals had δ(13) C and δ(15) N signatures that clustered together; evidence that the animals were herded in the same area or kept in enclosures and fed on similar foods. The diachronic analysis of the isotopic trends in the dogs, cattle, pigs, sheep, and goats highlighted subtle but distinct variations in these animals. The δ(13) C values of the dogs and cattle increased (reflecting C(4) plant consumption) during the Imperial and Byzantine periods, but the pigs and the goats displayed little change and a constant C(3) plant-based diet. The sheep had a variable δ(13) C pattern reflecting periods of greater and lesser consumption of C(4) plants in the diet. In addition, the δ(15) N values of the dogs, pigs, cattle, and sheep increase substantially from the Classical-Hellenistic to the Imperial periods reflecting a possible increase in protein consumption, but the goats showed a decrease. Finally, these isotopic results are discussed in the context of zooarcheological, archeobotanical, and trace element evidence.

Breastfeeding in Byzantine icon art.

INTRODUCTION: The Mary Galaktotrophousa is a representation of the Virgin breastfeeding the infant Jesus. MATERIALS: The origin of this theme goes back to Antiquity when images of gods feeding humans were considered as an example that should be imitated by human. In the early days of Christianity, the Fathers of the Church recognized on the feature of Mary the ideal exemplary of maternity. CONCLUSION: The image of the Virgin breastfeeding the Holy Child, except the theological interpretation of the gesture, underline the fact that breastfeeding represents one of the most substantial gestures in the woman nature.