[Takaki Kanehiro and the diet experiments of beriberi in navy in modern Japan].

Beriberi is a disease caused by insufficiency vitamin B1 in the body which, if untreated, can cause death. It was the disease with the highest incidence in the Japanese army during the Meiji and Taisho Periods. It was treated with a variety of therapeutic treatments by the Navy and the Army respectively, based on the different therapy systems of Britain and Germany at the time, with an argument about these treatments lasting more than half a century. Eventually, the Navy experimented with dietary modification for beriberi, according to Takagi Kanehiro, successfully reducing beriberi incidence to zero. This rewrote the epidemic history of beriberi in the Japanese Navy.

VOJNA LJECILISTA NA KVARNERU U AUSTRO-UGARSKOJ MONARHIJI I BRIGA ZA UNAPREDENJE CASNICKOG ZDRAVLJA / [Military Health Resorts in Kvarner in the Austro-Hungarian Monarchy and Care for Improving Officer Health]

The health of officers (as well as the entire army) is exposed to additional risks due to the performance of various life-threatening tasks for the needs of the state. Therefore, it is not unusual for the state to take care of the health of its officers (as well as the army) through a system of Vojvodina medical care or specialised society through the construction of military or officer health resorts [Militärkurhaus / Offizierskurhaus] with the provision of medical/ health services. The subject of this paper is the relationship between architecture and the provision of military-medical services of officer/military health resorts built by the Society of the White Cross [Gesellschaft vom Weißen Kreuze] in Kvarner at the end of the 19th and the beginning of the 20th century. The research is based on data collected from Austrian architectural, medical and tourist magazines and yearbooks of Austrian Society of the White Cross. The results of the research contribute to a better understanding of the improvement of the health of officers, the development of the architecture of health buildings [Kurhaus] and the entire history of medicine and health tourism in the Croatian Adriatic.

Confederates in the Attic: Posttraumatic Stress Disorder, Cardiovascular Disease, and the Return of Soldier's Heart.

Da Costa originally described Soldier's Heart in the 19th Century as a syndrome that occurred on the battlefield in soldiers of the American Civil War. Soldier's Heart involved symptoms similar to modern day posttraumatic stress disorder (PTSD) as well as exaggerated cardiovascular reactivity felt to be related to an abnormality of the heart. Interventions were appropriately focused on the cardiovascular system. With the advent of modern psychoanalysis, psychiatric symptoms became divorced from the body and were relegated to the unconscious. Later, the physiology of PTSD and other psychiatric disorders was conceived as solely residing in the brain. More recently, advances in psychosomatic medicine led to the recognition of mind-body relationships and the involvement of multiple physiological systems in the etiology of disorders, including stress, depression PTSD, and cardiovascular disease, has moved to the fore, and has renewed interest in the validity of the original model of the Soldier's Heart syndrome.

Adult body height as a mediator between early-life conditions and socio-economic status: the case of the Dutch Potato Famine, 1846-1847.

Adult body height appears to be a relatively accurate summary variable of early-life exposures' influence on health, and may be a useful indicator of health in populations where more traditional health-related indicators are lacking. In particular, previous studies have shown a strong, positive relationship between environmental conditions in early life (particularly nutritional availability and the disease environment) and adult height. Research has also demonstrated positive associations between height and socioeconomic status. We therefore hypothesize that height mediates the relationship between early-life conditions and later-life socio-economic outcomes. We also hypothesize that the period of exposure in early life matters, and that conditions during pregnancy or the first years of life and/or the years during puberty have the largest effects on height and socio-economic status. To test these relationships, we use a sample of 1817 Dutch military conscripts who were exposed during early life to the Dutch Potato Famine (1846-1847). We conduct mediation analyses using structural equation modelling, and test seven different time periods in early-life. We use potato prices and real wages to proxy early-life environmental conditions, and occupational status (using the HISCAM scale) to proxy socioeconomic status. We find no evidence of mediation, partial or full, in any models. However, there are significant relationships between potato prices in adolescence, height and socio-economic status. To determine causality in these relationships, further research is needed.

Writers as Shell Shock Witnesses during World War I.

The issue of First World War shell shock has been documented mainly from a medical perspective. Many medical texts dealing with war psychoneuroses and their aggressive treatments, such as electrotherapy, were published during the war. Accounts from shell-shocked soldiers are rare. Nevertheless, shell shock was described from a non-medical point of view by a few writers who had undergone or witnessed this pathology. Their texts deal mainly with the psychiatric forms, the most striking ones, but also with the more common concepts of commotion, emotion and pathological fear. The French philosopher Émile Chartier (1868-1951), alias Alain, described the commotional syndrome from which he suffered. The German writer Ernst Jünger (1895-1998), a brave officer and an example for his men, reported his emotional shock. Some psychiatric forms of shell shock are present in the work of the pacifist writer Jean Giono (1895-1970), the naturalist Maurice Genevoix (1890-1980), who suffered himself from a section of the left median and ulnar nerves, or the British poet Siegfried Sassoon (1886-1967). War hysteria and pathological fear have been described, on several occasions, by Blaise Cendrars (1887-1961) or the German writer Erich Maria Remarque (1898-1970). Electrotherapy has been scarcely reported except by Louis-Ferdinand Céline (1894-1961).

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.

El cuidado de la salud del Ejército de los Andes del general San Martín / The health care of the Army of Andes of General San Martín

A través de la revisión de documentos históricos y otras fuentes bibliográficas, y desde la perspectiva de la enfermería, se describen los recursos y prácticas sanitarias con que contaba el equipo de salud que acompañó al cuerpo del Ejército de los Andes al mando del general José de San Martín desde el inicio del cruce de los Andes el 19 de enero en las Provincias Unidas del Río de la Plata, hasta finalizada la batalla de Chacabuco, en la Capitanía General de Chile, el 12 de febrero de 1817. Este trabajo nos permite conocer el trabajo de los primeros sanitarios militares que asistieron en el cuidado de los soldados de los ejércitos patrios y contribuir así a difundir la historia de la Medicina Argentina. (AU)

Through the review of historical documents and other bibliographic sources, and from the perspective of nursing, we describe the health resources and practices held by the health team that accompanied the Army of Los Andes under the command of General José de San Martín, from the start of crossing Los Andes on January 19th in the Provincias Unidas del Río de la Plata, to finish in the battle of Chacabuco, in the General Captaincy of Chile on February 12th, 1817. This work allows us to know the work of the first military health professionals who assisted in the care of the soldiers of the patriotic armies and contribute to spread the history of the Argentine Medicine. (AU)

[Analysis on the stationed system for detached medical officer in the Song Dynasty].

The stationed system for detached medical officer, designated by the Royal Hanlin Department, was an important management system in the Song Dynasty for medical aid and epidemic prevention. The selection of the officers was based on the test results of the candidates. The dispatch of such medical officers was considered comprehensively on the local conditions, with priority given to those provinces and counties in shortage of such officers, and sent them in order based on the duration of their working time.The primary responsibility of the stationed medical officers was to provide medical services to locally stationed troops, at the same time also involved in treating and saving people as epidemics occurred in local places. The term of their service was two years. The system is a kind of relatively mature medical management practices, which could improve the level of local army medical services and control the occurrence and spread of epidemics effectively.

The U.S. Army Occupational and Environmental Medicine Residency at Aberdeen Proving Ground, Maryland: 1960-1996.

BACKGROUND: Reorganization of the Army and critical assessment of Army Graduate Medical Education programs prompted the Occupational and Environmental Medicine (OEM) Consultant to the Army Surgeon General to initiate a review of current Army OEM residency training. Available information indicated the Army OEM residency at Aberdeen Proving Ground, MD, was the first and longest operating Army OEM residency. Describing this residency was identified as the first step in the review, with the objectives of determining why the residency was started and sustained and its relevance to the needs of the Army. METHODS: Records possibly related to the residency were reviewed, starting with 1954 since certification of physicians as Occupation Medicine specialists began in 1955. Interviews were conducted with selected physicians who had strong affiliations with the Army residency and the practice of Army OEM. FINDINGS: The Army OEM residency began in 1960 and closed in 1996 with the transfer of Army OEM residency training to the Uniformed Services University of the Health Sciences, Bethesda, MD. Over 36 years, 47 uniformed residency graduates were identified; 44 were from the Army. Forty graduated between 1982 and 1996. The OEM residency was part of a dynamic cycle. Uniformed OEM leaders identified the knowledge and skills required of military OEM physicians and where these people should be stationed in the global Army. Rotations at military sites to acquire the needed knowledge and skills were integrated into the residency. Residency graduates were assigned to positions where they were needed. Having uniformed residents and preceptors facilitated the development of trust with military leaders and access to areas where OEM physician skills and knowledge could have a positive impact. Early reports indicated the residency was important in recruiting and retaining OEM physicians, with emphasis placed on supporting the Army industrial base. The late 1970s into the 1990s was a more dynamic period. There was heightened interest in environmental protection and restoration of military installations, and in the threats posed by nuclear, biological and chemical weapons. Additionally, President Reagan initiated a military buildup that brought new health risks to soldiers who would use and maintain modern equipment. Army OEM physicians were required to possess competencies in many areas, to include depots in the Army industrial base, occupational health for the soldier for exposures like carbon monoxide in armored vehicles, military unique exposures like those from chemical threat agents, and environmental medicine to assess health risks on contaminated U.S. military sites and from exposures of deployed forces. These offered interesting OEM training opportunities that challenged residents in the program and helped recruit new residents. DISCUSSION: The strength of the first Army OEM residency was that it was part of a dynamic cycle that consisted of identifying and defining Army OEM needs, training physicians to meet those needs and assigning residency graduates to positions where they would have a positive impact. This paradigm can be used as the basis for contemporary assessments of the Army's need for uniformed OEM physicians and a uniformed OEM residency program.

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.

The Colour Treatment: A Convergence of Art and Medicine at the Red Cross Russell Lea Nerve Home.

When the Red Cross opened its new convalescent home at Russell Lea in Sydney in 1919, it contained a coloured room designed for treating 'nerve cases'. This room was painted by Roy de Maistre, a young artist, and was modelled on the Kemp Prossor colour scheme trialled at the McCaul Convalescent Hospital in London for the treatment of shell shock. Dubbed the 'colour cure' by the popular press, this unconventional treatment was ignored by the Australian medical profession. The story of de Maistre's colour experiment is not widely known outside the specialist field of Australian art history. Focusing on the colour room as a point of convergence between art and medicine in the context of the First World War, this article investigates Red Cross activities and the care of soldiers suffering from nervous conditions.

Roman Military Medicine and Croatian Archaeological Perspectives.

This article offers a general examination of the sources responsible for understanding Roman military medicine, starting with literal and epigraphical sources all the way to archaeological remains consisting of hospitals, the infrastructure of military garrisons and small medical tools. Given that not one of the literary sources does not directly mention the medical personnel within the various military units, epigraphical discoveries widely represent the main source of our knowledge on the subject. On the other hand, the archaeological exploration of military garrisons offers proof of the medical care of Roman soldiers. If at first it appears that Roman military medicine is perfectly obvious and clear, actually this is not the case as many questions remain to be answered and debated. In all this, Croatia has its own archaeological perspective, where notably, one site stands out, which could hold a key role according to the layout of buildings within the garrison including its hospital.

[The disease and treatment of the frontline soldiers in Han dynasty].

This paper purports to identify and analyze the medical information of the frontline soldiers in the Northwest borderland provinces of Han Dynasty, especially Juyan and Dunhuang region, through an heuristic reading of the Juyan Bamboo Slips and the Dunhuang Bamboo Slips of the Han Dynasty. My findings are as follows. The most frequent disease found in the bamboo slips was the external injury. The injury of the frontline soldiers mainly occurred from the quarrels among armed soldiers using weapons. The bamboo slips also demonstrate that the quarrels usually arose due to the fierce tension caused by the frontier line service such as heavy guard activity and labour duty. Undernourishment and chronic stress the soldiers suffered might be another reasons. The second most common disease harassing the soldiers was exogenous febrile disease. In most cases reviewed in this paper, the exogenous febrile disease was usually concurrent with complex symptoms such as chills, fever, headache, etc. The bamboo slips show that the exogenous febrile disease was related to the harsh climate of the Northwest provinces, featuring extremely dry weather and the large magnitude of diurnal temperature fluctuations. In addition, the annual temperature range in the Northwest province was huge, fluctuating between very cold and dry winter and very hot and dry summer. The third most common disease this study identified was the disorder of the digestive system and respiratory system. However, these two types of disease were virtually indistinguishable in the bamboo slips, because the ancient Chinese chroniclers did not distinguish them, usually dubbing both diseases simply 'abdominal pain.' It should be mentioned that a few slips mention contagious disease such as dysentery and dermatolosis, and sudden death, as well. Overall, the bamboo slips demonstrate extremely poor status of the soldiers' heath condition and poor medical environment surrounding the soldiers stationing in the Northwest borderland military camps. The records also show that acupuncture, applying a plaster, drugs were the most common medical treatment. Drugs among them was the most frequently used. Whereas Acupuncture, applying a plaster were very rarely used. Medication has been used in three ways: powdered medicine, medicinal decoction and pill. Medicinal decoction was the most commonly used way.

Use of Rorschach tests at the Nuremberg war crimes trial: A forgotten chapter in history of medicine.

Seventy years ago, psychiatrists and psychologists had unusual access to the Nazi leaders awaiting trial by the International Military Tribunal in Nuremberg. Early leaders in the field of psychosomatic medicine were instrumental in facilitating these interviews as well as arranging for the administration of psychological testing with the Rorschach inkblot test. These observations were kept under wraps for decades and there remains controversy even now about what these Rorschachs revealed-demonic psychopaths or just morally corrupt individuals.

A bioarchaeological approach to the reconstruction of changes in military organization among Iron Age Samnites (Vestini) From Abruzzo, Central Italy.

The Samnites were an Iron Age population that shifted from warlike mountain dwellers to the largest sociopolitical unit of central Italy, able to dispute with Rome the domination over the peninsula. Archaeological and historical evidence suggests that this major shift in the scale of conflict may have involved a reorganization of the military system, which changed from an elite militia to a conscript or standing army from the Orientalizing-Archaic (800-500 BC) to Hellenistic times (400-27 BC). We propose a bioarchaeological framework jointly analyzing skeletal properties and funerary treatment in male Samnites to investigate on this shift in military organization. We anticipated that, when Samnites had an elite militia, the warring force was constituted by the wealthier segments of the society. Conversely, we expected the warring force of the standing/conscript army to be mainly drawn from the lower social strata. We considered high asymmetry in J, a measure of humeral torsional rigidity (calculated via cross-sectional geometry, CSG) as a proxy for pre- and peri-adolescent-onset weapon training. The social standing of the individual was approximated via funerary treatment analysis (Status Index). Results show that in the Orientalizing-Archaic period, humeral asymmetry and Status Index are positively correlated, and the high-status subsample shows significantly higher asymmetry than the low-status subsample. Among Hellenistic Samnites, no correlation between Status Index and humeral asymmetry is present, and the low-status subsample is the most lateralized. Results support the use of CSG in a strong theoretical framework to investigate past changes in military organization and their correlates in terms of sociopolitical development, alterations of power relationships, and warfare.

The Disease and Treatment of the Frontline Soldiers in Han Dynasty / 의사학

This paper purports to identify and analyze the medical information of the frontline soldiers in the Northwest borderland provinces of Han Dynasty, especially Juyan and Dunhuang region, through an heuristic reading of the Juyan Bamboo Slips and the Dunhuang Bamboo Slips of the Han Dynasty. My findings are as follows. The most frequent disease found in the bamboo slips was the external injury. The injury of the frontline soldiers mainly occurred from the quarrels among armed soldiers using weapons. The bamboo slips also demonstrate that the quarrels usually arose due to the fierce tension caused by the frontier line service such as heavy guard activity and labour duty. Undernourishment and chronic stress the soldiers suffered might be another reasons. The second most common disease harassing the soldiers was exogenous febrile disease. In most cases reviewed in this paper, the exogenous febrile disease was usually concurrent with complex symptoms such as chills, fever, headache, etc. The bamboo slips show that the exogenous febrile disease was related to the harsh climate of the Northwest provinces, featuring extremely dry weather and the large magnitude of diurnal temperature fluctuations. In addition, the annual temperature range in the Northwest province was huge, fluctuating between very cold and dry winter and very hot and dry summer. The third most common disease this study identified was the disorder of the digestive system and respiratory system. However, these two types of disease were virtually indistinguishable in the bamboo slips, because the ancient Chinese chroniclers did not distinguish them, usually dubbing both diseases simply 'abdominal pain.' It should be mentioned that a few slips mention contagious disease such as dysentery and dermatolosis, and sudden death, as well. Overall, the bamboo slips demonstrate extremely poor status of the soldiers' heath condition and poor medical environment surrounding the soldiers stationing in the Northwest borderland military camps. The records also show that acupuncture, applying a plaster, drugs were the most common medical treatment. Drugs among them was the most frequently used. Whereas Acupuncture, applying a plaster were very rarely used. Medication has been used in three ways: powdered medicine, medicinal decoction and pill. Medicinal decoction was the most commonly used way.

Los caballos y las Órdenes de Caballería: una visión a través de Las Siete Partidas de Alfonso X 'El Sabio', y de otros documentos / The horses and the Orders of Chivalry: a vision through 'The Seven-Part Code' of Alfonso XI 'The Wise' and other documents

El código de honor que regía la vida del caballero medieval fue una conquista relativamente tardía -durante el S. XII, aproximadamente-, lograda principalmente por la Iglesia para controlar los desmanes de los primitivos guerreros. Los cambios sociales y culturales acentuaron la evolución. Para este estudio, se han utilizado documentos del S. XIII donde se observa la importancia de los Caballos Hispanos de la época, especialmente por su uso bélico contra los musulmanes. Además, se ha extraído la información más interesante dentro de Las Siete Partidas de Alfonso X 'El Sabio', donde se muestra la visión que se tenía de los caballeros y sus armas (siendo el caballo el arma ideal) durante la Baja Edad Media. Todos estos documentos son esenciales para comprender este periodo histórico y la evolución posterior, con la unión de las coronas peninsulares y la formación de un ejército único para toda España, con la caballería como eje

The honor code followed by the medieval knight was a relatively late achievement -during the 12th century, approximately-, mainly thanks to the Church in order to control the abuses of primitive warriors. Social and cultural changes increased evolution. For this work, some documents from the 13th century have been used, which show the importance of Hispanic Horses of that time, in special for their military services against muslims. Besides, the most interesting information from The Seven-Part Code of Alfonso X 'The Wise', has been extracted and it shows how the knights and their weapons (the ideal weapon the horse) were considerated during the Middle Ages. All these documents are essential to understanding this historical epoch and the next period, with the union of peninsular crowns and the consolidation of a unique army for Spain, with the cavalry as a central axis

Paula Lind Ayers: "song-physician" for troops with shell shock during World War I.

BACKGROUND: Little is known about the therapeutic uses of music during the First World War. This historical study provides a biography of Paula Lind Ayers (1891-1974), a vocalist, actress, and YMCA Entertainer who became known as "the girl who could sing away shell shock." OBJECTIVE: The purpose of this study is to describe Paula Lind Ayers' respite services during World War I and provide a contextual biography of her life. METHODS: The author conducted an exhaustive search regarding Paula Lind Ayers' life and her activities during World War I. Numerous databases were used to locate print sources. Libraries, archives, and organizations were consulted to obtain unpublished primary sources. The author evaluated materials via a recursive process that included corroborating evidence, assessing source reliability, and contextualizing information. Data were synthesized and analyzed for emergent themes. RESULTS: Findings suggest that Paula Lind Ayers developed a systematic approach using familiar, live singing that was effective in alleviating symptoms of shell shock. Her method was replicated by others overseas during World War I. After the war, she returned to a successful performance career until the Great Depression. No information was found about Ayers' life from the year 1929 until her death in 1974. CONCLUSIONS: Understanding Paula Lind Ayers' contribution to music therapy provides a deeper awareness of past therapeutic uses of music with soldiers who experienced shell shock. Such understanding helps shape the way we view the present conception of music therapy with veterans and how we might answer questions that will affect the future of the field.