ABSTRACT
Hildegard of Bingen (1098-1179AD) is one of the most relevant figures of the Middle Ages. She wrote two medical books, Physica (Natural history) and Causae et curae (Causes and remedies). Our aim was to provide a comprehensive account of Hildegard of Bingen's conception of epilepsy, of the remedies proposed to treat it, and of the medical and physiological theories behind their use. We searched Hildegard of Bingen's entire body of writings to identify any possible reference to epilepsy or epileptic seizures. We reported the identified passages referring to epilepsy and discussed their content in light of medieval medical and physiological theories. Most references to epilepsy were found in Physica and Causae et curae. The suggested remedies against epilepsy range from herbal preparations to animal remedies and jewel therapy. Hildegard's conception of epilepsy gives the impression of an original revisitation of the traditional theory of humors, and carries strong moral connotations. Hildegard of Bingen's conception of epilepsy appears strongly rooted in medieval thinking and less in physiological theories. However, it differs in many respects to the traditional medieval beliefs and is a further proof of her unique personality. As living testimony of the past, Hildegard's writings enable us to shed a fascinating light on the beliefs concerning epilepsy in the middle ages.
Subject(s)
Epilepsy/history , Epilepsy/therapy , History, Medieval , Manuscripts, Medical as Topic/history , Therapeutics/history , Animals , Data Collection , Female , Germany , Humans , Mental Processes , Personality , Thinking , WritingABSTRACT
OBJECTIVE: The purpose of this study was to investigate the effects on exercise tolerance and quality of life of an outpatient rehabilitation program implemented at home without a physiotherapist's direct supervision in patients with chronic obstructive lung disease. DESIGN: Patients with moderate chronic obstructive pulmonary disease were studied. The rehabilitation program included lower limb exercise on a stationary bicycle and upper limb exercise and stretching, together with education, and it lasted for 12 wks. Every 2 wks, a physiotherapist contacted patients by phone to evaluate their compliance with the rehabilitation program and any adverse effects. The main measures of outcome were the Health Status Index, cycle ergometer test, forced expiratory volume in 1 sec, and forced vital capacity. Patients were evaluated at the baseline and at 12 wks. RESULTS: A total of 32 patients were recruited and 28 (mean age, 70.4 yrs) completed the trial. After pulmonary rehabilitation, a significant improvement was found in seven of the nine Health Status Index quality-of-life subscales. Exercise tolerance also improved significantly, whereas no variation was observed in pulmonary function tests. There was no correlation between the improvement in quality of life and the improvement in exercise tolerance. The improvements in the Health Status Index physical function and general health subscales correlated negatively with forced expiratory volume in 1 sec (percentage of predicted value) and positively with residual volume/total lung capacity ratio. The improvement in exercise tolerance (expressed in watts or as maximum oxygen uptake), but not in quality-of-life indexes, was associated negatively with age and positively with weight, cognitive function, and forced expiratory volume in 1 sec/forced vital capacity ratio. CONCLUSIONS: We conclude that an inexpensive home rehabilitation program can improve quality of life and exercise tolerance in patients with moderate chronic obstructive pulmonary disease. Furthermore, our results indicate that exercise tolerance evaluated by cycloergometry and quality of life evaluated by the mean of the Health Status Index questionnaire are independent outcome measures of pulmonary rehabilitation.
Subject(s)
Exercise Therapy , Exercise Tolerance/physiology , Health Status , Pulmonary Disease, Chronic Obstructive/rehabilitation , Aged , Female , Forced Expiratory Volume , Health Status Indicators , Humans , Male , Outcome Assessment, Health Care , Pulmonary Disease, Chronic Obstructive/physiopathology , Quality of LifeABSTRACT
Los autores hicieron el estudio con aleacion al azar, doble-ciego, y con control placebo con el objeto de demostrar la eficacia de los tratamientos homeopaticos en la migranas. Sesenta pacientes, de ambos sexos, entre 12 a 70 anos, a los que se les administro dosis solas a la 30c potencia en cuatro ocasiones, con intervalos de dos semanas, administrando uno de los ocho seguientes medicamentos, con la opcion de asociar dos de ellos: Belladona, Ignatia, Lachesis, Silicea, Gelsemium, Cyclamen, Natrum muriaticum, Sulphur. Veinte pacientes fueron tratados con 2 diferentes medicamentos escogidos de este grupo antes del inicio del ensayo. La eleccion del medicamento se baso en las caracteristicas personales de reactividad y en las diferentes modalidades encontradas en cada paciente. Los controles clinicos fueron llevados durante dos y cuatro meses despues del inicio del tratamiento. La elaboracion estadistica de los resultados demostraron homogenidad completa entre el grupo control (placebo), y el grupo con tratamiento homeopatico. Un analisis de los pacientes tratados homeopaticamente mostro una reduccion significativa en la periodicidad, frecuencia, y duracion de los ataques de migrana. Este estudio muestra la real eficacia de la homeopatia en comparacion a los modelos de estudio experimentales clasicos. los cuales pueden ser adaptados a las caracteristicas especificas de la homeopatia