[Polybos and the heritage of Hippocrates]. / Polibo e l'eredita' di Ippocrate.

The rise of medicine as science is first expressed in the Corpus Hippocraticum, collection of writings of many authors and different schools. To Hippocrates is attributed the principal books, mainly by Galen, because the dogmatic authoritatian great ancient physician was of support to his own glory as new Hippocrates. In ancient Greece physicians were itinerant, travelling from city to city: when Hippocrates went out of Cos, the chairmanship of the School of Medicine was given to Polybos, son-in-law of Hippocrates and quoted by Aristotle as author of De Natura Hominis, a work which introduces physiopathology in medicine. Polybos joined the Hippocratic method (study the patient and not only the disease) with the naturalism derived from the School of Crotona and followed by Aristotle: thus Polybos seems to be not only the principal pupil of Hippocrates, but also the author of a synthesis of the medical thought of different schools, so that Hippocratism as summa of the medical thought of that time was propagated to our centuries.

Traces of medical activity in Ephesus.

Ephesus was an important city of Asia Minor, existing as an exchange point between Egypt and the Greek-Roman world. As it was the birthplace of famous physicians and situated between Kos-Knidos and Pergamon, it is surprising that no medical buildings have been clearly identified in this area. In the upper old Hellenistic city, two pillars include, on the southern face, a youth with a goat and Hermes, respectively. On the internal faces, reliefs of tripods, an omphalos, a mortar and a twined snake may refer to mantic and/or pharmacy and medicine. Near the pillars, a temple for sacrifices dedicated to Hera and a statue of Apollo manteion in the Prytaneoion have been found. Because both the Apollo and Hermes myths are closely related to medicine, the pillars may be a sign of medical activity in that part of the city. This activity may be related to both mantic in the direction of the temple and practice in the direction of a building which has not yet been identified. This interpretation is confirmed by an inscription on the Museion-Church of Virgin Mary: a physician from the Mouseion is referred to as a practitioner near the supreme priest (hieros): thus, the pillars may be an indication of both sacred and medical activities in that part of the city.

[Lancisi, Baglivi and the medical academies in Rome]. / Il Ruolo del Lancisi e del Baglivi all'interno delle Accademie Mediche Romane.

Many medical academies were active in Rome during the 17th century; they were promoted by noble patrons, ecclesiastics or eminent physicians, and equipped with libraries. Their role was important in the spreading of the new biomedical thought, founded on the comparison between ideas and experimental data. As an epistemological heritage of Marcello Malpighi and as a connection to the new scientific European ideas, Baglivi directed his efforts towards a leading role of the experimental observations, whereas his predecessor Lancisi was bound to the theorical "ipse dixit" role of the masters of medicine. The analysis of the statutes of the Roman Academies bring to light the new experimentalism, due to the "virtuosi" (vituous men) and "curiosoni" (inquisitive/odd persons) of the Academies: Baglivi, in his De praxi medica, invites the princes to establish in every Metropolitan Hospital an Academy - Medicorum Collegium, in which discussion on clinical aspects should be performed: extraordinary importance is devoted to the epistemological difference between "experientia" (guided in the profession by a membrum - litteratum, thought the direct comparison on the texts) and "experimentum" (following the clinical observation, guided by a membrum historicum-practicum).

Medical profession changes between religion, science, skill, ethics, law and economics.

How has the medical profession changed during the centuries? How has the evolution of the profession been influenced by the balance of different issues, e.g. magic, religion, philosophy, science, technology, ethics, law and/or economics? One needs to examine many historical changes leading from the hierarchized medicine of Ancient Egypt to the Asklepiadic and Hippocratic medicine at the time of Plato, from the newly organized medicine of the Renaissance to the emerging social medicine of the XIX century, from the nosological medicine centered on the evaluation of the symptoms to the medicine which explores the human body through technologies. Furthermore, an overview from the past to the future should analyze the new doctor-patient relationship in a health system of managed care, between market and solidarity, between the efficientistic guidelines of the providers (hospitals, physicians, etc.) and an anthropocentric view of the rights of the citizen-customers. These problems are presented and discussed by many Authors in three issues of Medicina nei Secoli (II/III.1997-I, 1998) as an aid to understanding what it means to be a physician today, from the past to the future.

[The dream in the medicine of Asklepieia]. / Il sogno nella medicine degli Asklepieia.

The passage between theurgical to secular rational medicine in the ancient Greece is due to the naturalistic philosophers of the Ionia and the Hippocratic school, between 5th-4th century. However, we have a testimony that both theurgical and rational medicine coexisted in the temples of healing deified gods of medicine, i.e. Asklepion, Amphiaraos, etc. In fact, inscriptions, lat. sanationes, found in few Asklepíeia, i.e. Epidaurus, Lebena, Rome Tiberina Island, show clinical cases solved by the god. The dream is the bridge between the sick persons and the healer god, who acts during the incubation (incubatio) of semisleeping patients in a forbidden room (the [Greek]), near the temple. On the other hand, the dream in the Hippocratic medicine is useful for diagnostic purpose, other than for therapy. An extraordinary case of therapy for psychoneurotic diseases, such as melancholy or hypochondria, was the example of Aelius Aristides, who described his twelve-year experience of dreams related to Asklepiós in the Asklepieion of Pergamon.

De octimestri partu and pathology of the last trimester of pregnancy.

The Hippocratic treatise De Octimestri Partu has been transmitted in two separate parts, regarding deliveries at the seventh month and eighth month, respectively. The thesis is that fetuses delivered after the seven month of pregnancy survive, whereas after eighth month not. The explanation given that during the eighth month a sickness of the mother damages the fetus, so that he cannot survive suffering of delivery. The analysis of the text evidences that two different terms, e.g. [Greek] and [Greek], have been used, the first one associated to pathological events, the second to sufferings for delivery. The unfavourable prognosis for the disease of the eighth month is due to a sickness of the mother during the 6th quarantine: terms used put forth the opinion that the disease is due to hemodynamic changes. Epidemiological research on the current pathology of the last trimester of pregnancy shows a performance of cesarean section ranging between 18% (national average) and 90% (eclampsia in main hospitals). The only deadly condition which occurs during the eighth month seems to be gravidic hypertension or mild preeclampsia, conditions which do not allow the fetus to reach the ninth month when cesarean section was not available. Thus, the disease of the eighth month described in the Hippocratic treatise seems to be mild preeclampsia, i.e. gravidic hypertension.

Final finality in livings from ancient philosophy and medicine to contemporary biomedicine.

In recent years biotechnology has introduced into medicine new possibilities for the manipulation of forms of life, including in vitro fertilization, production of transgenic animals and use of human fetal tissues for therapeutic procedures. This has given rise to a debate on final finality of the beginning human life, which has involved scientific, philosophical, religious as well as legal issues. A report by an English governmental Commission (Warnock Committee, 1984) stated a practical term, e.g. 14 days, during which the so-called preembryo may be useful for research or therapeutics. The time has been chosen on embryological bases (i.e. appearance of nerve-type cells in the primitive streak), whereas a law is claimed to avoid discussions about the time of appearance of sensitivity of embryos. On the other side is the opinion of the Court for Blount County of Tennessee expressed in the rule Davis vs. Davis (1989). While the term preembryo is considered a false distinction between stages of differentiation of human embryos, human life is considered beginning at conception and human embryos not as property. A comparative analysis of medical and philosophical thought before the influence of Christianity shows that, for Hippocrates as well as for Aristotle, final finality of the early embryo leads to consider the human being as a person just when life is blooding. This phase occurs after the milk one or vegetative stage, which is characterized by the property of doubling life when cells are separated, the same stage considered in the rule Davis vs. Davis.

Transmission of classical medical texts through languages of the Middle-East.

Classical texts, i.e. Greek treatises on medicine, reached Western Europe during the Middle-Ages by few ways, mainly either directly from the Hellenistic world, or indirectly through versions in the languages of the Middle-East, especially [Syriac]-Arabic. The comparison between Greek manuscripts and translations may be useful for both correction and interpretation of texts. An extraordinary case may arise when the original Greek treatise is lost and only the Arabic version is available. This is the case of a Commentarium of Galen on the Hippocratic De aere aquis et locis: the treatise has recently been found in a manuscript (Tal'at, tibb 550) at the National Library, Cairo, and is the work of translators of the school of Hunayn ibn Ishâq (9th century), the Nestorian physician who had a skilled philological method of reconstruction of original Greek texts. Other relevant ways of transmission (Byzantine area-Spain mainly at the time of the Emperor Constantine VII Porphyrogenete, Arabian Africa-Salernum with Constantine the African) played an important role in the recovery of Classical Medicine in the Western World, through both Arabic-Muslim and Arabic-Hebrew physicians.

Views of classical medicine. Theurgical and secular rational medicine in the healing-temples of ancient Greece.

The medicine described in Homer's epic is essentially a war medicine. The therapies, such as healing herbs, are a gift of the gods, the healing Apollo and Centaur Chiron. According to Hesiod, the author of Opera et dies (Works and days), in the eighth century medicine was a combination of religious and magical elements along with hygienic rules, dietetics and healing herbs. Health and diseases were attributed to the gods and Daímones and Theoí intermediate, as far as human events are concerned, between the Pantheon and men. In ancient times medicine was associated with the gods, especially Apollo, son of Zeus, and only in the 6th-5th century B.C. Asklepius (Asklepiós), the Thessalian king of the Iliad, was deified. Thus, theurgical medicine was practised by the priests of Asklepius and Asklepíeia (Asklepius' temples) were built as places for all kinds of medical treatment. In the 5th century, scientific observation became a common method of medical practice due to the physician working as a craftsman, arising from naturalistic philosophy, knowledge of anatomy, etiopatogenetic view of medicine and consideration of chronic diseases. Therapy was usually ineffective and the best doctors were those especially good at prognosis. Health and diseases were thus seen as a balance of the whole person, holistic view of man. As classical medicine was usually ineffective, in buildings devoted to health (i.e. tà Asklepíeia) the custom was to combine medicine (téchne) with the practice of dreams (incubatio) and theurgical aspects: the sacred spring, an odeîon or theatre, an ábaton for incubation and dreams, a temple devoted to the gods of healing (Apollo, Asklepius, Amphiaraos, etc.) were present together with those health buildings where physicians practised medicine.

From theurgical to secular medicine in ancient Greece: pínakes and sanationes.

Although rational secular medicine, i.e. medicine founded on clinical observation and on the exploration of the natural causes of diseases, prevailed in Greece as late as the IV century B.C., testimonies of theurgical medicine survive in temples dedicated to the gods of medicine, e.g. Maleatas, Amphiaros and Asklepios. Votive inscriptions (Latin sanationes) show clinical cases, solved with the aid of the physician-god, who acts during the dream, which is an essential component in classical medicine and art of the medical treatment. It is worth noting that sanationes have been found in temples of many healing cities, e.g. Epidauros and Lebena and in Tiberine Island in Rome, but not in Kos and Pergamon, where Hippocrates and Galen were active, respectively. Is it just fortuitousness or testimony of the prevailing "scientific" meaning due to the work of the two most representative physicians of the classical world?

The origin of the Corpus Hippocraticum from ancestors to Codices Antiqi: the Codex Vaticanus Graecus 276.

The Corpus Hippocraticum (C.H.) was originated by the collection of writings of late Greek medicine, mainly of Hippocratic school. The original works have been transmitted through rolls of papyrus or parchments as single treatise or small group of treatises until the IX-X century A.D., when in Byzantium were active scriptoria devoted to collect classical works of both religious and profane argument. Under the auspices of Emperor Constantine Porphyrogenete (tenth century), the tendency to encyclopedism of that period induces large collections of thematic works, i.e. about classical philosophy, astronomy, mathematics or medicine, as may be argued by the content of the Encyclopedia [2 Greek words] (X century). Vetusti codices, such as Vindobonensis med. IV, Parisinus 2253 (A), Laurentianus 74.7 (B), Marcianus Venentus gr. 269 (M) and Vaticanus gr. 276 (V) represent witnessing of the formation of the C.H.: codicological analysis suggests that these manuscripts have been handwritten in scriptoria of Byzantium's area, then carried in Western Europe. Since the first testimony of V is at the Royal Court in Palermo, the Norman Kings played a relevant role in tracing codices from Byzantium to Sicily, as well as Cardinal Bessarion to Rome and Venice.

[Philosophical and historical values of medicine]. / I valori filosofici e storici della medicina.

History of Medicine has pointed its higher attention on both great physicians and relevant medical schools. The hieratic person of the physician has been pre-eminent and conditioning the relationship between patients and doctor, the latter in a paternalistic dominant position. Changes occurred in medicine during the last century, mainly related to the technological advancements and a new ethiopatogenetic view. Better social conditions, improvement of diagnostic procedures and the discovery of effective therapeutic drugs (e.g. antibiotics, etc.) has produced advancements in general life conditions (measured by parameters such as aging, reduction of newborn mortality etc.), but also an increase in the cost of the social medical system. So, the new frontier of History of Medicine is the analysis of changes occurred in medicine (new epistemological rules, pressure of new technologies, more sophisticated citizens-patients) to deepen the values of medicine in an anthropological view of managed care.

For a history of andrology.

Two issues of this Journal are devoted to the history of andrology and male sexuality, from Hippocratic medicine to contemporary ethical problems due to the increasing role of technology in human reproduction. Studies have been devoted to: the Hippocratic Corpus, to authors of the Roman Empire, to Byzantine medicine; the transmission of ancient texts through Arabic and other languages of the Middle East; the influence of Constantinus Africanus' translations from Arabic to Latin; early modern theories about semen, male sexuality, impotence. Recent developments of biochemistry and epistemology are analyzed to show how these and other topics have influenced sexual ideas and behaviours until the discovery - around 1840 - of the chemical nature of male sexual hormones. In more recent years, technologies and cellular and molecular biology have opened new perspectives in the fields of fertilization and male sexuality, giving way at the same to new ethical, social and legal problems.

[Environment and political institutions between antiquity and contemporary medicine]. / Ambiente ed istituzioni politiche nella medicina antica ed in quella contemporanea.

In both myth and Genesis (by God) the creation of the world begins with the separation of water, sky/air and ground; later appear the life and the man and from Olympic divinities (or God) derive health and disease and remedies. When Milesian philosophers distinguished between nature (to be observed) and speculation, a parallel revision has been made in the medicine, from theurgical to rational one. Thus, Hippocratic medicine pointed attention on air waters and places as natural environmental elements, to be observed, as method to understand the probable diseases of a city, also with a role of political institutions, says the Hippocratic treatise De aëre. Centuries later, only in the 19th century has been rediscovered the importance of environment in the health's policy, a concept full developed in the last time (i.e. health and pollution, health and quality of life).

[Measure in Arabic and Middle Age medicine]. / La mesure médicale dans le monde Arabe reflétée dans la médecine occidentale du XIVe siècle.

During the XIVth century to the qualitative knowledge is superimposed the concept of the importance of a quantitative evaluation of natural phenomena. The Arabic works on science, first translated in Latin by Adelard of Bath, and the recovery of classical culture into Western Europe are discussed by Grosseteste, R. Bacon and Ockham with a separation of religious truth from the scientific findings; Jean Buridan (Paris) applied this meaning to physics and Simone di Castello (Bologna) considered the necessity of the measure of elements, qualities and humours to explain and correct health and disease. So, the logica nova was acquired also by medicine, as demonstrated by the works of Anthony Ricart and by the direct quantitation made by Santorio Santorio (early XVIIth c.), who constructed appropriate instruments for measurement of medical parameters.

The irresistible fascination of medical theories about opposites.

Theurgical medicine was a part of the eternal fight between good and evil and health was reconciliation with the gods. This duality characterized ancient medicine, i.e. Greek medicine after the Homeric age or Chinese traditional medicine. In the passage to medicine of observation due to the School of Cos duel between good and evil becomes substrate of new medicine and the balances between*opposites represented by elements and qualities were the fundaments of the humoralism. Fascination of opposites continues for centuries up to now, both in western and far eastern medicine: yin/yang, antibody/antigen, cAMP/cGMP, oncogene/antioncogene are examples of this attractive theory. Although fundaments of biological and medical observations are the basis of theories of opposites, the trend is to overcome reality and today represents, following idealism in the 19th century, an inconscious ancestral reminiscence of theurgical philosophy and medicine.

The Perì ouron treatise of Stephanus of Athens: Byzantine uroscopy of the 6th-7th centuries AD.

In the 6th-7th centuries AD, treatises on uroscopy were written by Theophilus, Magnus and the author of work transmitted through the ms. Parisinus gr. 2260, Stephanus of Athens. These works are the first to deal comprehensively with the problem of urines, uroscopy and their clinical role, so that a philological and content analysis and examination of their reciprocal relationships may clarify an important period in the birth and development of Byzantine uroscopy, which represents a significant epistemological passage in the medieval history of medicine (e.g. the positing of relationships between physical signs and systemic diseases).

History of medicine and prehistoric orthopedics.

Increasing efforts have been recently made to apply medical technologies to history of medicine of ancient time. Despite the use of molecular biology techniques, the most reliable results have been obtained by the paleopathological study on disease which may be recognized by the observation of stigmata of bones: the datation of skeletal lesions and the findings of cranial and orthopedic lesions indicate that the attempts of cure of bones are typical of early medical activity, dating from the prehistoric antiquity.

Critical and historical approach to Theophilus' De Urinis. Urine as blood's percolation made by the kidney and uroscopy in the middle ages.

In classical Greek medicine, neither Hippocrates nor Galen considered the condition of the urine to be an important sign of systemic diseases, and they did not relate its characteristics to definite illnesses, except in obvious cases of urinary tract disease. In their teaching, urine was used together with other physical signs as a prognostic indicator. With Theophilus, however, uroscopy gained an important role, and the appearance of the urine became pathognomic of specific diseases. De Urinis owed its popularity to this new approach and to its didactic character, as it was written as a practical handbook. After the 12th century, De Urinis occupied an assured position among the few ancient medical treatises that in Latin translation formed a worldwide teaching canon for medieval and Renaissance medical schools.