Periscyphismus and Section of the Temporal Vessels: Two Byzantine Surgical Remedies for Headache Relief.

Headache is a prevalent clinical symptom and condition, whose management has been challenging from the antiquity to the 21st century. Physicians in the Greek, Roman and Byzantine antiquity employed surgical techniques to treat headache in patients presenting with persistent symptoms that were not alleviated with conservative means. A survey in the medical literature of the period reveals that two surgical procedures, periscyphismus and section of the temporal vessels, were developed for this purpose. The present study describes the techniques presented in the sources of the period and elaborates on their evolution and influence across different historical periods and contexts.

Gynaecomastia and scrotal rhacosis: two aesthetic surgical operations for men in Byzantine times.

BACKGROUND: Nowadays, as in the past, much attention is paid to aesthetic operations in women, while only infrequently have such operations been referred to in males. Generally, male aesthetic surgery was introduced to surgical practise during the 19th century. In this study, we analysed the practise of such operations in Byzantine times and in other ancient cultures with surgical knowledge, i.e. ancient India and China METHODS: The sixth book of Paul of Aegina's "Epitome of Medicine" was studied for description of aesthetic operations in males in the Byzantine period, since this book is completely devoted to surgery and is generally considered to be the most important reference for surgery in Byzantine times. The original text and its excellent translation by Francis Adams were used. References concerning aesthetic operations for males were identified. Accordingly, historical work and reviews on plastic surgery in ancient India and China were studied. RESULTS: Mainly, two aesthetic surgical procedures for males in the Byzantine period were identified. These two procedures comprise gynaecomastia and rhacosis (scrotal relaxation). Two different techniques were reported for the surgical management of gynaecomastia, through sub-mammary or supra-mammary access. Two procedures were noted for rhacosis, for which Paul of Aegina reproduced the respective chapters from Leonides' and Antyllus' works. Evidence supporting male aesthetic surgery in ancient India and China or elsewhere was not found. CONCLUSIONS: Despite the dubious aesthetic result, the existence of different aesthetic surgical techniques in males substantiate the advanced level of surgery achieved by physicians in the Byzantine period.