The Medical Historical Cultural Foundations of Western Nasal Surgery from Ancient Greece to the Middle Ages.

The manuscript aims to clarify the origins of Western rhinosurgery through the ancient texts of the greatest physicians of the past, up to the Byzantine Era, focusing on the "exchange of knowledge" between peoples. This excursus is carried out by quoting the texts of the greatest doctors of the past, such as Hippocrates, Galen and Celsus and by analysing the works of Byzantine authors such as Oribasius, Aetius, Antillus, which, more than others, represent the moment of fusion and interpenetration of Ancient Medical knowledge, paving the way for the Medieval Scholae Medicae in the West. The aim, therefore, is to fill that sort of "great gap" (from the foundation of Constantinople in the 4th century AD to the early Arab culture in the 11th century AD) due to the fact that figures such as Branca, Vianeo and, finally, Tagliacozzi, are considered direct actors of a recovery of the "ancient knowledge" of classic authors. This literature tends to less evaluate, instead, that important and huge cultural exchange -literally osmotic- in medical and surgical knowledge between peoples and civilizations, that find a trait d'union in the application of medical knowledge and surgical practical techniques matured in the Byzantine, Arab and Early Medieval period. In final analysis, through the History of Rhinosurgery, this paper aims to highlight how Western medical knowledge is made up of the ensemble of cultures which are apparently distant and different from each other, which merge themselves in a truly universal and transcultural knowledge: the Medical knowledge. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

THE ORIGINS OF THE BLOOD TRANSFUSION: EUROPEAN LITERATURE AND ITALIAN DEBATE ON NEW INNOVATIONS (1667-1668)

This paper deals with the literary debate on the first experiments regarding blood transfusion on human beings between 1667 and 1668 in Europe, with particular attention to the less-known experimental research, carried out in Italy. The authors examine the details of the experimental developments, focusing on the techniques and instruments used by physicians involved in this new surgical approach, with special attention to the Italian debate and experimentations. The article suggests that transfusion was considered a part of what we could call "emergency surgery". In this framework, Italian transfusional pioneers played a central role in the improvement and transmission of a discipline that was still in its dawning throughout Europe. Moreover, the manuscript highlights the contribution of the "chirurgia infusoria" as an innovative therapeutic system for an immediate and rapid recovery. From this perspective, blood transfusion represents a surgical practice for reanimation and resuscitation. The objective of this work was to analyze the importance of foreign literature and the English and French disputes presented by Davia in Italy, which made them known. Despite foreign prohibition in Italy, experiments with animal-to-human transfusions continued after 1648. A papal bull excommunicating scientists for conducting such research has never been found.

G. B. Morgagni Among Human Pathology, Forensic Medicine and Mummiology. The Beatification of Gregorio Barbarigo of Padua

The article is the first step of a research project aimed at investigating new perspectives and aspects of Morgagni's role and work. His activities as a medical examiner and forensic doctor are yet to be truly discovered. Manuscripts, written by Morgagni when he was a forensic expert for the Health Magistrate of Venice, currently preserved at the City Library in Forli (Italy), shed light on a new aspect of his cultural background. As a forensic doctor, he also helped push an increase in "social medicine" in Italy, when physicians began to collaborate with the administrative and political institutions in order to plan environmental and urban regulations to control air quality. While reading his reports, his contribution to the primordial medical Hygiene and Public Health emerges. Among his reports, the authors focused on the one concerning the Beatification of Gregorio Barbarigo, which clearly highlights his pathological approach, as well as his knowledge and application of embalming systems and mummiology. Moreover, this report could be considered as an issue in the history of paleopathology.

Public hygiene and funeral rituals during the Risorgimento: mummies and ashes.

Starting in 1865, regulations pursuant to public hygiene issued by the Unitary Government provided for administrative and political control of the funerary practice. Specifically, they regulated the management of cemeteries and the burials, increasingly drawing the funeral rituals from the control of the Church and of Catholicism, therefore secularising death for the construction of a new political religion. Hygiene became fundamental in order to promulgate cremation as a system of preserving the integrity of the bodies, preserving the ashes as a tangible and indestructible product of body matter and as a measure to protect public health by eliminating the risk of miasmatic pollution of the air caused by the cadaveric fumes. In the early 1870s, the practice of cremation began to spread, especially in the territories of Lombardy-Veneto and Savoy, as an expression of the progressive policies of the new Italian state, antagonistic to the old Catholic religious traditions. This paper intends to highlight the key aspects of the political significance that the cremation took on during the Risorgimento period, while also illustrating the methods adopted by important authors from that time period regarding incineration techniques and cremation methods.

Feet and fertility in the healing temples: a symbolic communication system between gods and men?

Anatomical ex-votos of feet have always been interpreted as representing the unhealthy part of the body for which patients were asking healing. However, according to the archaeological data and literary sources, another interpretation is also possible: the purpose of this article is to focus on the strong relationship between feet and fertility in the ancient world by cross-referencing the available archaeological evidence with the scientific data relating to this topic. That shed light on an important aspect of the Healing Temples in Greek and Roman medicine.

The "Canone Inverso": when tobacco was not so bad. A Look Back at the Primordial Debate on the tobacco effects in the Occupational Medicine.

AIM: The article provides an overview on the beginning and evolutions of medical observations on tobacco induced diseases between Eighteenth and Nineteenth century. METHODS: By searching for historical medical literature, first studies on tobacco-induced diseases focused on production risks rather than on adverse effects that the use of tobacco has for the human health. RESULTS: The approach induced first eighteenth-century authors to define this substance as a non-pathogenic and, consequently, not to consider tobacco factories dangerous for health workers. In those years, tobacco was employed in therapy as a stimulant treatment and it was considered harmless and even healthy and preventive of several acute diseases. CONCLUSIONS: Authors will show that studies on pathogenic effects of smoking will only start around late nineteenth century, when the idea of the healthiness of tobacco industry was already supported.

The Earliest Blood Transfusions in 17th-Century in Italy (1667-1668).

Historical accounts of the earliest experiments in blood transfusion celebrate work done in France and England in 1667 to 1668. Less attention has been given to pioneering experiments conducted at the same period in Italy. We review records of the first blood transfusion experiments conducted in 17th century Italy. Using original source documents, we provide details of early experiments focusing on the identity of early researchers, their instruments, and techniques. Accounts of the period describe animal-to-animal, animal-to-human, and human-to-human transfusions. We highlight how transfusion was considered a new form of emergency surgery, carried out in order to save patients who could not be cured with traditional therapy of the time.

Electrotherapy in the treatment of patients affected by rabies: experiments conducted at the "Maggiore" hospital of Milan in 1865.

During the nineteenth century, the scientific context of rabies treatment was weak due to the lack of the literature on specific nosology of the rabies disease, and unspecific and ineffective therapy approaches. Electrotherapy already represented an important therapeutic approach for nervous system diseases, although not specifically for rabies. In the present paper, the authors discuss the use of electrotherapy in the treatment of humans affected by rabies in an experimental study conducted at the Maggiore Hospital of Milan, with the aim of establishing the discovery of a possible specific therapy. By analyzing the printed scientific sources available in the Braidense Library of Milan, the authors describe four experiments conducted on patients of different ages. Symptoms and effects both during and after the electrotherapy are also highlighted. The experiments demonstrated that electricity is not an effective therapy in the treatment of rabies, being rather able to cause serious functional and organic alterations in all the patients. Analyzing the Milanese experiments, the authors reported specific Italian history of a scientific and medical approach to rabies at the end of the 18th century, which led to the promotion of health education, reinforced prevention strategies and opened the way to the vaccination era.

[Baccio Baldini (1517-1589), protomedicus on the medical court between humanism and experimentalism]. / Baccio Baldini (1517-1589), protomedico alla Corte Medicea tra umanesimo e sperimentalismo.

The article aims to shed light on some particular aspects of the activity and the scientific thought of Baccio Baldini, Director of the Laurentian Library and Court physician of the Medici family in Florence. The analysis of his work as a humanist and the recovery of some unpublished documents enable to define the figure of Baldini as a paradigmatic example of the court physicians of modern age in Italy, highlighting the complementarity between humanism and experimentalism in the Renaissance medicine.

[ANATOMY AND BODIES: DEAD BODIES IN MUSEUMS FROM VAN RUYSCHA VON HAGENS]. / ANATOMIE E CORPI: IL CADAVERE AL MUSEO DA VAN RUYSCH A VON HAGENS.

The aim of the conference of which we are here publishing the proceedings, held in Rome at Sapienza-University in 2013, was to valorise the specific museological heritage of Italian Universities, in relation to analogous European and non-European Museums of Anatomy and Pathological Anatomy. A particular attention has been devoted to highlight the history of the origins and evolution of specific museological collections in order to focus reasons and circumstances of their foundation through the analysis of the signifcances, finctions and uses of anatomical parts or artifacts in different cultural contexts.

[TO CURE THE APPARENTLY DEAD. NOSOLOGY AND MEDICAL RESUSCITATION IN ITALY(XVIII CENT.)]. / CURARE LA MORTE APPARENTE. NOSOLOGIA E TECNICHE DI RIANIMAZIONE NELL' ITALIA DEL SETTECENTO.

The first specific techniques and triages for medical resuscitation developed in the XVIII century, specifically to rescue the drowned persons. The topic of resuscitation in strictly connected to the theme of the apparent death, to the dread of the "buried alive", to the progress of forensic medicine and to the administrative and legislative policies. The contribute aims to focus on the contribution of the medical and pathologic nosology about the conception of the apparent death, read as asphyxia.

[DAUGHTERS OF SUN. MANIA, MELANCHOLY AND LOVE SICKNESS IN ANCIENT MYTH AND SCIENTIFIC SOURCES]. / LA MALATTIA DELLE FIGLIE DEL SOLE MANIA, MALINCONIA E MAL D'AMORE DAL MITO ALLE FONTI SCIENTIFICHE.

Ancient medical and philosophical sources do not discuss the etiology of lovesickness, simply cataloguing its symptoms. The 'informal' connection between black bile and lovesickness turns, in later texts, into a disease in whick black bile overheats, changing its nature (in CH it is a cold and dry element), burning and producing smoke. The article analyze this 'ontological' changement; the Pseudoaristotelian Problema XXX can help in reconstructing the sense of the mythological stories of Pasiphae, Medea, Ariadne and Phaedra, women bound by a close family relationship.

From Nuremberg to bioethics: an educational project for students of dentistry and dental prosthesis.

In the lessons of medical-scientific methodologies of the medical faculty at the Sapienza University of Rome, basic notions on the ethical and deontologic aspects characterizing the history of the medical profession are provided, including the formulation and application of bioethical principles to clinics and biomedical research. Within such framework, an educational project has been initiated on the historical origin of the current normative and juridic dispositions in the regulation of experimental biomedical research and the relationship between health operators and patients, with particular attention to the procedure, the meaning the value either professional or deontologic, of ethics and the legality of the informed consensus. Emphasis is put on medical and experimental abuses that occurred in Germany during the nazi regime.

[Bodies, mummies and texts for an history of embalming in Italy]. / Corpi, mummie e testi per una storia dell'imbalsamazione funebre in Italia.

In the early 80's, a systematic investigation was started of the series of mummies from Central and Southern Italy, in particular from important Renaissance depositions. Radiological exams were carried out on each individual, not only to determine the age at death of those subjects lacking any indication of age, but also to detect possible pathological findings. Furthermore, X-rays allow greater understanding of the techniques and the substances used for embalming, including the type of craniotomy, the partial or complete evisceration, and the identification of the embalming substances used to fill the body cavities. The great number of artificial mummies, examined by G. Fornaciari and his equipe, allowed the study of human embalming techniques, related to methods and procedures described by medical and non-medical authors in Early Modern age. The history of the art of mummification has been here reconstructed, from the 'clyster' techniques to the partial or total evisceration of the corpses, to the introvascular injection of drying and preserving liquors.

[Neo-'hippocratism' in Bernardino Ramazzini]. / L'ippocratismo di Bernardino Ramazzini. per la costruzione di una medicina sociale.

Neo-hippocratism is a rational and mechanic method to explain pathological phenomena and discover the causes of diseases. Bernardino Ramazzini uses Hippocratic empirical observation to investigate the relations between the alterations of the air - due to mephitic vapours, of organic and inorganic origin - and the development of pathological processes. His notion of corruption of the atmosphere as the origin of epidemics and specific diseases, and that of prevention as the main strategy of modern medicine, is developed in medical literature and in the public medicine projects of the end of the Seventeenth century.

The use of mercury against pediculosis in the Renaissance: the case of Ferdinand II of Aragon, King of Naples, 1467-96.

The hair samples of Ferdinand II of Aragon (1467-1496), King of Naples, whose mummy is preserved in the Basilica of San Domenico Maggiore in Naples, showed a high content of mercury, with a value of 827ppm. Furthermore, examination using a stereomicroscope and a scanning electron microscope (SEM) of head and pubic hairs of Ferdinand II, revealed a lice infestation. The reasons for the massive presence of the mercury in the king's hair are discussed and contemporary literature regarding the use of this metal in medical therapies and in cosmetic practices is analysed. As a result, the high value of mercury in the hair of Ferdinand II can be attributed to antipediculosis therapy, applied as a topic medicament. This case represents an important finding for the history of medicine, because demonstrates that in the Renaissance mercury was applied locally not only to treat syphilis, as well attested by direct and indirect sources, but also to prevent or eliminate lice infestation.

Gene-environment interactions in the pre-Industrial Era: the cancer of King Ferrante I of Aragon (1431-1494).

King Ferrante I of Aragon, leading figure of the Italian Renaissance, died in 1494. The autopsy of his mummy revealed a tumor infiltrating the small pelvis. We examined the histologic and molecular features of this ancient tumor to investigate its primary origin. Hematoxylin-eosin, Van Gieson, and Alcian Blue staining showed neoplastic cells infiltrating muscular fibers and forming pseudo-glandular lumina disseminated in fibrous stroma with scarce mucus. A strong immunoreactivity of the neoplastic cells was shown for pancytokeratins and proliferating cell nuclear antigen. Molecular fingerprints were investigated by examining K-ras, BRAF, and microsatellite instability in ancient tumor DNA. Sequencing analysis showed G-to-A transition in codon 12 of K-ras. BRAF mutations and microsatellite instability were not observed. Because the presence of K-ras codon 12 mutation could be associated with exposure to chemical carcinogens, possibly present in some food items, paleodietary reconstruction of the King Ferrante I was carried out by carbon (δ(13)C ) and nitrogen (δ(15)N) stable isotopes analysis. δ(13)C and δ(15)N values found in bone collagen of the King were consistent with a massive intake of animal proteins. Overall, our data show that the tumor of Ferrante I was a mucinous adenocarcinoma with molecular fingerprints characteristic of colorectal carcinogenesis linked to K-ras pathway. Paleodietary reconstruction and historical chronicles indicate a strong consumption of meat by the King. The possible abundance of dietary carcinogens, related to meat consumption, could explain the K-ras mutation causing the colorectal tumor that killed Ferrante I more than 5 centuries ago.