Using city gates as a means of estimating ancient traffic flows.

Despite the recent flurry of interest in various aspects of ancient urbanism, we still know little about how much traffic flowed in and out of ancient cities, in part because of problems with using commodities as proxies for trade. This article investigates another approach, which is to estimate these flows from the built environment, concentrating on transport infrastructure such as city gates. To do this, I begin by discussing a new model for how we would expect this kind of infrastructure to expand with population, before investigating the relationship between the populations of sites and the total numbers and widths of city gates, focusing on the Greek and Roman world. The results suggest that there is indeed a systematic relationship between the estimated populations of cities and transport infrastructure, which is entirely consistent with broader theoretical and empirical expectations. This gives us a new way of exploring the connectivity and integration of ancient cities, contributing to a growing body of general theory about how settlements operate across space and time.

The Influence of Gondeshapur Medicine during the Sassanid Dynasty and the Early Islamic Period.

The development of the most active period of Persian medicine occurred in the ancient city of Gondeshapur, between the third and seventh centuries. Rebuilt between 256 and 260 by Shapur I, the second Sassanid monarch, Gondeshapur is said to have welcomed the first hospital and the consequent study of medicine, mainly based on the Greek system. It has also been mentioned that these teachings would be expanded by his successor, Shapur II. However, both statements need solid confirmation. Nestorian priests-professors and other academics expelled from the Byzantine Empire gave fundamental encouragement to cultural and medical development in Gondeshapur. With Khosrow I, Gondeshapur became a cosmopolitan city with studies of medicine, philosophy, eloquence, and music. The medical studies were conducted in an academic setting, and practiced in a hospital, with the documentary support of a library which would be provided with the main texts, mainly of Greek, Syrian, and Indian origin. The Byzantine-inspired hospital system of Gondeshapur with its own management, organic system, and differentiated personnel, was later reproduced in several cities of the Middle East and medieval Europe under Islamic rule. The academic prestige and functionality of Gondeshapur, which peaked in the seventh century, began to decline in the following centuries apparently due to the creation of similar intellectual and hospital centres in Baghdad, by the Caliph al-Mansur, and the subsequent transfer of doctors, technicians, professors and other personnel from Gondeshapur, to ensure there the operation of hospitals and also medical studies. This cultural policy was continued and expanded by al-Mansur successors, in particular by the Caliph al-Ma'mun, until the tenth century.

Plagues and artistic votive expressions (ex voto) of popular piety.

In past centuries, epidemics, the scourge of humankind, caused pain, anger, uncertainty of the future, social as well as economic disorder and a significant impact on their victims, involving also their spiritual sphere. The latter effect led to undoubted effects on participation in the religious and social life of communities. The custom of preparing artistic votive expressions has been lost in the mists of time and evidence of ex voto gifts, offered by believers to pagan gods, has been found in prehistoric archaeological sites. Furthermore, several finds from the Ancient Greek and Roman worlds may be observed in our museums. These remains are generally ceramic and metal artifacts, reproducing limbs and other body parts which had been healed. These elements, according to the belief of those making the offerings, had benefited from the miraculous intervention of a thaumaturgical deity. With the advent of Christianity, some pre-existing religious practices were endorsed by the new religion. Believers continued to demonstrate their gratitude in different ways either to miracle-working saints or to the Virgin Mary, because they thought that, thanks to an act of faith, their own health or that of a family member would benefit from the direct intervention of the divine entities to whom they had prayed. In the Ancient Greek world, it was believed that the god Asclepius could directly influence human events, as testified by the popularity of shrines and temples to the god, especially at Epidaurus. In the Christian world as well, particular places have been detected, often solitary and secluded in the countryside or in the mountains, where, according to tradition, direct contact was established between the faithful and Saints or the Virgin Mary Herself. Manifestations occurred by means of miracles and apparitions, thereby creating a direct link between the supernatural world and believers. Religious communities, in these extraordinary places, responded to the call through the building of shrines and promotion of the cult. Over time, the faithful reached these places of mystery, performing pilgrimages with the aim of strengthening their religious faith, but also with the purpose of seeking intercession and grace. In this case, the request for clemency assumed spiritual characteristics and also became a profession of faith. Accordingly, the shrines in the Christian world are places where supernatural events may occur. In these environments the believer resorted to faith, when medicine showed its limits in a tangible way. For the above reasons, while epidemics were occurring, the requests for clemency were numerous and such petitions were both individual and collective. In particular, by means of votive offerings (ex voto) the believers, both individually and collectively, gave the evidence of the received grace to the thaumaturgical Saint. Through the votive act, a perpetual link between the believer and the Saints or Holy Virgin was forged and a strong request for communion was transmitted. The aim of the present study is to describe the role played by votive tablets (ex voto) in the last 500-600 years, as visible evidence of human suffering. From this perspective, these votive expressions may assume the role of markers because, in accordance with the expressions of popular faith, they allow us to follow the most important outbreaks that have caused distress to Christian communities.

Examining the osteological paradox: Skeletal stress in mass graves versus civilians at the Greek colony of Himera (Sicily).

OBJECTIVES: Bioarchaeologists interpret skeletal stress as evidence of resilience or frailty, where absence of lesions might result from lack of exposure to pathogens (i.e., good health) or extreme vulnerability (i.e., selection). We examine physiological stress in two skeletal series from Greek Himera: (1) nine mass graves from the battles of Himera (480 and 409 BCE) and (2) Himeran civilians (648-409 BCE). Civilians are assumed to have died from multiple causes, including ill health leading to their deaths. Individuals from the battles presumably died while in relatively good health, in battle. More skeletal stress among civilians than battle casualties would support the idea that skeletal stress is a sign of frailty at Himera. We compare variation in skeletal stress between and among civilians and battle casualties. MATERIALS AND METHODS: Cribra orbitalia, porotic hyperostosis, linear enamel hypoplasia (LEH), and sub-periosteal new bone formation, were examined in 474 individuals (mass graves n = 64; civilians n = 410). RESULTS: Chi-square tests showed significantly higher prevalence of LEH (p = 0.04) and sub-periosteal new bone formation (p = 0.05) among young and mid-aged adult male civilians than mass grave casualties. Skeletal stress was also lower in the earlier battle, and varied among civilians with burial style. DISCUSSION: Our findings generally support the hypothesis that skeletal stress is evidence of frailty (i.e., leading to greater risk of mortality). However, the relationship between stress and frailty is complicated by social factors, when considering historical context. In particular, a possible "soldier-class" may have experienced less stress than the overall civilian population.

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.

Pharmacology and psychiatry at the origins of Greek medicine: The myth of Melampus and the madness of the Proetides.

Melampus is a seer-healer of Greek myth attributed with having healed the young princesses of Argos of madness. Analysis of this legend and its sources sheds light on the early stages of the "medicalizing" shift in the history of ancient Greek medicine. Retrospective psychological diagnosis suggests that the descriptions of the youths' madness rose from actual observation of behavioral and mental disorders. Melampus is credited with having healed them by administering hellebore. Pharmacological analysis of botanical specimens proves that Helleborus niger features actual neurological properties effective in the treatment of mental disorders. The discussion aims at examining the rational aspects of the treatment of mental conditions in Greco-Roman antiquity.

Trauma management in Homer's Iliad.

Homer's Iliad is one of the highest intellectual products of the early ancient Greek civilisation. A plethora of medical information lies within Iliad's 24 rhapsodies, and a total of 147 injuries are described. The present study records and evaluates all cases of trauma management included in this epic poem. Not only Iliad's original text but also all myths related to Iliad from the five-volume Greek Mythology by Ioannis Kakridis were meticulously studied to locate the injured person, the type of trauma, the care provider and the type of given care as well as the outcome of each case. A total of 21 cases were found and evaluated with a 5% mortality rate. The majority of these injuries were caused by an arrow (43%) and were located to the upper extremity (43%). Injuries of the head, neck and trunk were not treated as all of them were lethal. Many of the recorded trauma management techniques can be correlated to modern medicine. Furthermore, the role and skills of military doctors and paramedics, mentioned by Homer, is discussed.

Pathfinders in oncology from ancient times to the end of the Middle Ages.

This commentary highlights the onset and progression of the diagnosis and treatment of cancer from ancient times to the 15th century. During the preparation of this synoptic review of the lives and contributions to oncology of 7 ancient physicians, it became clear that despite separation by centuries, ethnicity, and religion, they had many things in common. For example, with the exception of Chauliac, all were born into wealthy families, had an excellent education in the liberal arts and sciences, and were mentored by outstanding teachers. After they became physicians, they traveled extensively, were polyglots, were sponsored by influential individuals, had inquisitive minds, searched for the true nature of diseases, and were proud to share the results of their observations with others. Except for Galen, all of them were kind and well-mannered individuals. They cared with sincere dedication for the poor and those who had untreatable disease, including cancer. Although their understanding of cancer was limited, they were deeply concerned about the neglect and hopelessness of cancer patients. They were aware of their shortcomings in offering effective treatment beyond the surgical excision of early cancers. For advanced cancers, they had nothing to give beyond palliative care with herbals and minerals. All physicians who care for cancer patients owe these pioneer physicians, whatever their shortcomings, an inexpressible debt for their attempts to cure cancer. Cancer 2016;122:1638-46. © 2016 American Cancer Society.

What the ancient Greeks and Romans knew (and did not know) about seasickness.

OBJECTIVE: To find and analyze descriptions in ancient Greek and Roman literature that reveal what was known at the time about seasickness. METHODS: A systematic search was made in the original literature beginning in the Greek period with Homer in ca 800 bc and extending up to Aetios Amidenos in the late Roman period in ca 600 ad. RESULTS: Rough seas and unpleasant odors were recognized as the major triggers; susceptibility was greater in persons not adapted to sea travel, of a labile mental state, or with anxiety; nausea, emesis, vertigo, anorexia, faintness, apathy, headache, and impending doom were frequently reported symptoms. Preventive and therapeutic measures included habituation to sea travel, looking at stationary contrasts on the coast, fasting or certain diets, inhaling pleasant fragrances, medicinal plants, and ingesting a mixture of wine and wormwood. CONCLUSION: The triggers, symptoms, and preventive measures of seasickness were well-known in antiquity. The implications for transport of troops and military actions were repeatedly described, e.g., by Livius and Caesar. At that time, the pathophysiologic mechanism was explained by the humoral theory of Empedokles and Aristoteles. Seneca Minor localized the bodily symptoms in various organs such as stomach, gullet, and esophagus, and also attributed them to an imbalance of bile. Recommended medication included ingestion of the plant white hellebore, a violent gastrointestinal poison. This remedy contains various alkaloids but not scopolamine, which today is the most effective anti-motion-sickness drug.

Glaucoma and the Origins of Its Name.

PURPOSE: To identify the origins of the name of the disease Glaucoma. METHODS: Ancient Greek medical literature, Homeric poems, and ancient Greek religion and art were examined. RESULTS: The roots of the name Glaucoma could be traced back to Homeric times. Ancient Greek physicians following the Hippocratic tradition preferred the use of the terms Hypochysis or Hypochyma for the same disease. This fact indicates that the older term Glaucoma did not fulfill strict medical criteria, but had a long history connected to superstition, which the rational ancient Greek physician tried to overcome using terms derived from their fundamental principal of humoral pathology. CONCLUSIONS: In ancient Greek medical literature, Glaucoma had a significant place among ocular diseases. The origin of its name could be traced back to Homeric times and could be connected to the ancient belief of a primitive folk about the apotropaic role of animals against diseases, which in this case is represented by the superstitious role of the owl.

[Greek science in the centre of the Dialogue between Orient and Occident ].

Most pre-Socratic Greek philosophers originated from Ionia, in Minor Asia, where Achaeans had been installed since the 11th century B. C. During the Age of Pericles, Empedocles of Agrigento, in Sicily, Leucippus and Democritus from Abdera, Anaxagoras of Clazomenae, active in Athens, and Socrates in Athens also took over philosophy and science in Continental Greece. Plato, Socrates' disciple and founder of Academia, and his own disciple Aristotle, founder of the Lyceum, and his pupils, such as Theophrastus of Eresos, followed them. In the area of medicine and pharmacy, Hippocrates of Cos and his disciples and followers redacted between 450 and 300 B. C., what is known as Hippocratic corpus. Then came Galen from Pergamum who completed the theory of Humours, during the second century. Nestorian Christians, considered as heretical in the Byzantine Empire, were accepted in Sassanid Persia and carried Greek culture with them. After Arabic conquest and Baghdad City creation, in 762, they translated Hippocratic corpus in Arabic language so that Hippocratico-Galenic theory could pass in Arabic-Muslim world. It was then developed by Al-Kindi in Baghdad, Ibn Al-Jazzar in Kairouan, Razes or Avicenna, both Persians. The 11th and the 12th centuries were characterised by Latin translations, by Constantine the African in Monte-Cassino, Gerard of Cremona or Mark of Toledo. The School of Salerno created then the conditions for the fusion of Greek, Arabic and Jewish medicines. The creation of modern science from Greek philosophy was a consequence of a permanent dialogue between Orient and Occident.

Colchis - Iberian Medicine or Cura Mediana

This paper reviews the ancient traditions about Colchis. It considers the legends of the Argonauts and the Golden Fleece, of Medea and the plant lore which is well established in Georgia. Many remedies and poisons are native to the area. Hippocrates is said to have visited Colchis to study local healing traditions, describing the country, with its rich flora and fauna as well as its diseases. Thus, Medea can be considered a pioneer of cosmetics, haematology, surgery and toxicology leading the way for the development of modern medicine.

Alexandria, An emporium in the Silk Road, and the Traffic of Unusual Medicines.

In Ancient times, an active trade of exotic and peculiar drugs tool place along the Silk Road. Coming through China, India, Central Asia, Armenia, including Colchis, Arabia, Nubia as far as Greece and Rome, it was centered during Ptolemaic and Roman times in Alexandria, the world Emporium, remarkably advanced in scientific medicine. Physicians required a variety of active ingredients for their pharmacotherapy, following various related branches of medicine. These included: 1) herbal remedies: including toxic plants 2) polypharmacy: missing together all kind of drugs 3) dreckapotheke or copropharmacy, employing unclean materials 4) organic therapy, using exotic or domestic animal products 5) aromatherapy, lined to essential oils and perfumes 6) 'medical astrology and botany', regarding the laws of sympathy in the natural world 7) alchemy and magic medicine: with occult knowledge

[The research on medicine in Greco-Roman Egypt in the Centre de Documentation de Papyrologie Littéraire (CEDOPAL) of the University of Liège]. / Les recherches sur la médecine dans l'Égypte gréco-romaine au Centre de Documentation de Papyrologie Littéraire (Cedopal) de l'Université de Liège.

The paper presents the research on medicine in Greco-Roman Egypt conducted in the last forty years at the Centre de Documentation de Papyrologie Littéraire (CEDOPAL) at the University of Liège. It describes the main results obtained by deciphering, editing, translating and commenting Greek and Latin medical papyri, be they literary, documentary or magical.

[Anonymous Londinensis and the Greek documentary papyrus of medicine at the CEDOPAL]. / L'Anonyme de Londres et les papyrus documentaires grecs de médecine au Cedopal.

The present paper proposes an account of my research on human and veterinary medicine in Graeco-Roman and Byzantine Egypt, undertaken since 2008 at the CEDOPAL at the University of Liège. This research focuses on literary papyri, particularly on the Anonymus Londiniensis (Hermopolis?, 2d half of the 1st).

Reduction of temporomandibular joint dislocation: an ancient technique that has stood the test of time.

The first known recorded evidence for the reduction of a mandibular joint dislocation is documented in a papyrus dated to c. 1500 BC that originated from ancient Egypt. This same technique was later discussed by Hippocrates in Greece and the Hippocratic corpus is referred to in early Islamic writings. It is detailed in medieval European texts and eventually was incorporated into modern dental and medical practice. Today, mandibular joint dislocation is probably not that common but to be included in an important ancient Egyptian treatise, predominately concerned with trauma to the head and neck, could suggest it was a more frequent occurrence in antiquity. This could relate to the heavy tooth wear, frequent antemortem tooth loss and the related sequelae of severe malocclusion and overclosure evident in many surviving ancient Egyptian skulls.

Whistleblowing in medicine and in Homer's Iliad.

'Thinking with Homer', or drawing creatively on themes and scenes from Homer's Iliad and Odyssey, can help us to better understand medical culture and practice. One current, pressing, issue is the role of the whistleblower, who recognises and exposes perceived poor practice or ethical transgressions that compromise patient care and safety. Once, whistleblowers were ostracised where medical culture closed ranks. However, in a new era of public accountability, medicine looks to formally embrace whistleblowing to the point that not reporting transgressions can now constitute a transgression of professionalism. Where medical students identify with the history and traditions of medical culture, they inevitably find themselves in situations of conflicting loyalties if they encounter senior clinicians behaving unprofessionally. What are the implications of facing these dilemmas for students in terms of role modelling and shaping of character as a doctor, and how might a study of Homer help with such dilemmas? We suggest that a close reading of an opening scene in Homer's the Iliad can help us to better appreciate such ethical dilemmas. We link this with the early Greek tradition of parrhesia or 'truth telling', where frankly speaking out against perceived injustice is encouraged as resistance to power and inappropriate use of authority. We encourage medical educators to openly discuss perceived ethical dilemmas with medical students, and medicine as a culture to examine its conscience in a transition from an authoritarian to an 'open' society, where whistleblowing becomes as acceptable and necessary as good hygiene on the wards.

URINARY INCONTINENCE (SALASAL BAWL) IN GRECO-ARABIC MEDICINE: A REVIEW.

INTRODUCTION: Greco-Arabic Medicine imparts vast knowledge regarding diseases afflicting different systems. Urinary incontinence (UI) is involuntary leakage of urine. It is an undiagnosed, under-reported, and frequently untreated medical condition that greatlyaffects the quality of life of women in any age. Therefore, a literary search in classical literature of Greco-Arabic medicine for UI was explored to implement in current era. Material and METHODS: Meticulous literature search was carried out to comprehend the concept of urinary incontinence described in ancient Unani literature. The classical Greco-Arabic medicine texts were searched. Further, browsing of PubMed/Google Scholar and other websites was carried by searching complementary and alternative treatment for urinary incontinence and herbal remedies useful in urinary incontinence. RESULTS: The causes of urinary incontinence described in Greco-Arabic texts are abnormal temperament of body or bladder, dislocation of vertebrae, pregnancy, diuretic, laxity of musculature of bladder, diseases of surrounding structure such as uterine inflammation, omphalitis, constipation, etc. The principle treatment is treating the cause viz., the temperament is corrected by diet and herbs in abnormal temperament, and elimination of morbid humour is required in dominance of humour. Further, web search showed that herbs are useful in Urinary diseases. However, evidences are weak. CONCLUSION: The classical Greco-Arabic texts are enriched with important information. Thus documentation and preservation of the traditional knowledge is required so that it can still be conserved for future research in pharmaceuticals and drug discovery.