Surgery in antiquity: the origin of the Trendelenburg position revisited.

INTRODUCTION: The Raised Pelvic Position, also known as Trendelenburg position, consists of the elevation of the pelvis above the horizontal plane in the supine position with the head lowered. The position is named after Friedrich Trendelenburg, a German surgeon, who flourished in Berlin at the end of the nineteenth century. Although modern studies trace the position's principle back to the first century BC, we herein present even earlier descriptions, dating back to the fifth century BC. MATERIAL AND METHODS: The whole ancient Greek literature was digitally searched. All relevant references were analyzed from the original sources. RESULTS: We found at least nine references to the Raised Pelvic Position in the ancient Greek literature from the following physicians: Hippocrates (fifth century BC), Soranus of Ephesus (first century AD), Aetius of Amida (fifth century AD) and Paulus Aegineta (seventh century AD). DISCUSSION AND CONCLUSION: All references presented, describe clearly the Raised Pelvic Position, as part of a strategy to repair uterine pathologies, mainly prolapsed uterus, but also instability, bleeding, tumors and infertility. We conclude that ancient Greek writers were aware of the usefulness of the head-down position, as reflected from the numerous existing descriptions dating back to the fifth century BC.

DOCTORS AND ARCHITECTS - DO THESE PROFESSIONS HAVE ANYTHING IN COMMON?

Both architecture and medicine have accompanied man for centuries. Both architects and doctors make every effort to ensure that the objects of their interest (buildings and the human body) comply with the Vitruvian principles of ideal construction. Doctors take steps to restore these principles in the event of a disease, and like architects, they try to keep the subject of their activities as long as possible. It can be said that this two professions have a common ancestor: the first physician known by name in general history - Imhotep - was not only an outstanding doctor, but also an architect. He designed and built the funerary complex in Saqqara on the basis of a combination of different types of burials from lower and upper Egypt. He also was the author of the prototype of the Edwin Smith Papyrus, discovered in Luxor, a document containing the rational and scientific approach of ancient physicians to diseases for which science dominates over magic. Historians are debating whether it is Imhotep, and not Hippocrates, who should be called the father of medicine. The 21st century forces both doctors and architects to take up newer and newer challenges and change standards. Both of these professions today are based on the service provider-recipient relationship. According to modern technologies, they both work in accordance with the guidelines displayed on the computer screen. Doctors take responsibility for human health and life, while architects - for interpersonal relationships created in the buildings they have designed.

Merit Ptah, "The First Woman Physician": Crafting of a Feminist History with an Ancient Egyptian Setting.

Merit Ptah is widely described as "the first woman physician and scientist" on the Internet and in popular history books. This essay explores the origins of this figure, showing that Merit Ptah came into being in the 1930s when Kate Campbell Hurd-Mead misinterpreted a report about an authentic ancient Egyptian healer. Merit Ptah gradually became a prominent figure in popular historical accounts during second-wave of feminism, and, in the twenty-first century she appeared in Wikipedia and subsequently spread throughout the Internet as a female (sometimes black African) founding figure. The history of Merit Ptah reveals powerful mechanisms of knowledge creation in the network of amateur historians, independently from the scholarly community. The case of Merit Ptah also pinpoints factors enabling the spread of erroneous historical accounts: the absence of professional audience, the development of echo chambers due to an obscured chain of knowledge transmission, the wide reach of the Internet, the coherence with existing preconceptions, the emotional charge of heritage, and even - in the case of ancient Egypt - the tendency to perceive certain pasts through a legendary lens. At the same time, the story of Merit Ptah reveals how important role models have been for women entering science and medicine.

History of thyroid surgery.

The authors present an outline of the development of thyroid surgery from the ancient times to the beginning of the 20th century, when the defini-tive surgical technique have been developed and the physiologic and pathopfysiologic consequences of thyroid resections have been described. The key representatives, as well as the contribution of the most influential czech surgeons are mentioned.

Achilles and Patroclus: Lesser known Physicians of Homer's Iliad.

During the Trojan War, aside from the renowned Greek physicians, Machaon and Podalirius, sons of Asclepius, another two heroes, Achilles and Patroclus, are reported to have been capable of providing medical care to the wounded in the Greek camp.

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 history of women in dermatology.

In the past and present, the status of men is often superior to women in most developing countries and it has a negative effect on the social development of these countries. If women are educated as men in a society, then this society can advance rapidly since the effect of educated women influence the quality of life and health in a positive way and not only for those women, but younger generations who follow them as well. This article reviews the history of some remarkable women in dermatology.

A commentary of in Plaute Cappadox in his Curculio by Dr. J. A. Vander Linden.

In 1656, some Selecta medica of Dr Johannes A. Vander Linden (1609-1664) were published in Leiden. Among these miscellaneous, it was quite unexpected to come on a medical commentary on a fictional character from Plautus' theatre : Cappadox hepaticus, or the Bilious. Today unknown, full of erudite quotations, this scholarly doctor's commentary is both philological and medical, on twenty densely printed pages in Latin. Every term used by Plautus is analized, weighed up, and confronted with texts or contemporary situations, thereby drawing knowlegde for his everyday work, how to define a bilious, hydropical affection.

Sun Tzu and The Art of War: Implications for the Healthcare Professional.

Nearly 2500 years ago, Sun Tzu wrote The Art of War, a book that provided emperors and military leaders with methods to achieve success on the battlefield. Those same strategies and tactics will also work on the battlefield of the healthcare war that is going to take place in the very near future. Perhaps we can go back in time and learn the valuable lessons that were used so successfully and apply them to modern healthcare to help us through the quagmire of the healthcare crisis. This article was inspired by the book Sun Tzu and the Art of Business, by Mark McNeilly (Oxford University Press, 2011).

[A new look at the tomb of the physician, Morlongo Venice]. / Un nouveau regard sur la "tomba del medico" (Morlungo, Vénétie).

The development of the inventory and synthetic study of collyrium stamps, commonly known as "oculist's stamps", includes the physico-chemical analysis of rare stamped collyrium's remains. The fragments of collyrium which were discovered in a tomb of Morlungo (Veneto) are all the more remarkable as the remedy's name stamped on two of them remains enigmatic at the moment and because of the association in a funerary context with an-other thirty-five finds. More specifically, they were discovered near surgical bronze instruments, a large amount of amber, a portable sundial and a seal box. Recent archaeological, textual and technological data thus make the study of the remains of collyriums of Morlungo particularly interesting for the history of medicine.

The dawn of medicine: ancient egypt and Athotis, the king-physician.

The earliest physician recorded in history is Athotis (Aha), one of the first rulers of ancient Egypt. While it is debatable whether the story of a king-physician is a fact or just a legend, it is clear that ancient Egyptian medicine developed around the time of his reign. The fortunate combination of earlier medical observations, the development of script, and favorable social conditions made the dawn of ancient Egypt also the dawn of medicine.

The earliest mention of a black bag.

A black bag, needed especially for home visits, has been used since the time of Hippocrates who, in his treatise "On good manners", gave the first detailed description of a medical bag with guidelines for the required equipment and structure. Ancient Egyptian and Palestinian references also date back at least two millenniums.

Information about Macedonian medicine in ancient Greece.

Ancient Greek Macedonians were highly interested in the improvement of their physical and psychological health. At first, they worshiped the mythical god Asclepius and his daughter Hygieia. In at least 24 places in northern Greece, in Halkidiki, Thessaloniki, Kozani, Kavala, Thassos, Serres and other places, archaelogical findings were related to Asclepius. Macedonian kings were also interested in the development of medicine, for the sake of their fellow citizens and their soldiers. Characteristic examples are the close relations of Hippocrates with king Perdikas (5(th) century B.C.) and of Nicomachus (Aristotle's father being a physician) with king Amintas. Alexander the Great had as his personal physician, the famous physician Philippos of Acarnania. An incident between Alexander and Philippos of Acarnania shows the respect of Macedonian kings to their doctors: Alexander became ill after a bath in the frozen river Cydnus (near ancient Tarsus). At this time he received a letter from his general Parmenion for not to trust his physician. Alexander gave this letter to Philippos to read it and while Philippos was reading it and was rather frightened, he saw Alexander drinking the medicine he had given him. We may note that Alexander the Great as a student of Aristotle had a general education about medicine. Archaeological findings revealed two funerary monuments of physicians: a doctor from Thasos, who practiced in Pella as a public physician during the 3rd quarter of the 4(th) century B.C. and a physician named Alexander, who lived in the 1rst half of the 5(th) century A.D. The tomb of a third physician, probably a surgeon, excavated in Pydna, near mount Olympus (3(rd) century BC)also indicates the importance of physicians in Macedonia. Archaeological findings, like surgical knives, from the Hellinistic and Roman periods, found in the city of Veria, also showed the respect of Ancient Greeks to medicine and to their physicians. An example is the skeleton of a young woman with an anterior cranial hole found in Veria. This trauma was attributed to a delicate surgical operation, perhaps performed to alleviate endocranial pressure.

'I am in blood Stepp'd in so far...': ethical dilemmas and the sports team doctor.

There are many ethical dilemmas that are unique to sports medicine because of the unusual clinical environment of caring for players within the context of a team whose primary objective is to win. Many of these ethical issues arise because the traditional relationship between doctor and patient is distorted or absent. The emergence of a doctor-patient-team triad has created a scenario in which the team's priority can conflict with or even replace the doctor's primary obligation to player well-being. As a result, the customary ethical norms that provide guidelines for most forms of clinical practice, such as patient autonomy and confidentiality, are not easily translated in the field of sports medicine. Sports doctors are frequently under intense pressure, whether implicit or explicit, from management, coaches, trainers and agents, to improve performance of the athlete in the short term rather than considering the long-term sequelae of such decisions. A myriad of ethical dilemmas are encountered, and for many of these dilemmas there are no right answers. In this article, a number of ethical principles and how they relate to sports medicine are discussed. To conclude, a list of guidelines has been drawn up to offer some support to doctors facing an ethical quandary, the most important of which is 'do not abdicate your responsibility to the individual player.''I am in blood Stepp'd in so far that, should I wade no more, Returning would be as tedious as to go o'er' -Macbeth: Act III, Scene IV, William Shakespeare.