[Physicians of Gladiators in the Ancient Rome]. / Gladiatorenärzte im antiken Rom.

Gladiators in ancient Rome were an integral part of the Roman world and were a unique phenomenon. Their bloody fight presumably originated from the cult of the dead. Later it was a feature of the self-portrayal of many Roman noblemen, especially during the election campaigns. Eventually it became an imperial privilege. Legally, gladiators were slaves. They were trained in specially equipped schools (ludus, plural: ludi). Also, special schools existed that trained fighters to compete in the arena against wild animals. Doctors at the ludi took care of the fighters: They prepared them for the fight or treated injuries. The gladiator cemeteries of Ephesus and York clearly demonstrate typical injury patterns. The most prominent and best-known gladiator physician is - due to his eminent self-portrayal - Galenus. Even though he looked after the gladiators of his hometown Pergamon only for a brief time. From ancient inscriptions we know the names of several other physicians who took care of gladiators. Especially these largely forgotten doctors are referenced in this article.

[Was cannibalism practiced in ancient Gaul? Critognatus, the leader of the Celts, in the focus of Caesar's propaganda]. / Kannibalismus im alten Gallien? Der Keltenfürst Critognatus im Brennpunkt der Propaganda Caesars.

Critognatus, the leader of the Celts, is mentioned only once in the extant ancient literature, namely in Caesar's description of the siege of Alesia in BG VII 77.2-78.2. Here he is portrayed as a determined patriot who wants to encounter the Roman invader bravely and at the risk of all available means. Nevertheless, crafty Caesar succeeds in stamping him by propagandistic pinches to an evil monster and cannibal. On the one hand Caesar falls back on current Roman prejudices towards the Gauls. On the other hand, the endocannibalism practised among Celts to a certain extent as a cult action seems to have played a rôle. Caesar's propagandistic methods are transparent and at the same time so effective that the label of an ogre sticks to Critognatus until the present day. Caesar's portrayal aims above all at the justification of his Gallic War which he wages against uncivilized and inhuman opponents who are a menace to Rome and even to the culture itself.

[Therapy or torture: a treatment of gout misunderstood by Gregory of Tours]. / Therapie oder Tortur--Eine missverstandene Behandlung der Gicht bei Gregor von Tours.

Historiarum libri decem, a work written by St. Gregory, the bishop of Tours, is an important contemporary source for the study of the Merovingian times. In Book V 42 Gregory reports the story of Maurilio, the bishop of Cahors in the Southern Gaul, who was strongly suffering from gout. Maurilio treated the illness himself applying a hot iron to his foot and shank. This therapy is already mentioned in the Corpus Hippocraticum. It seems, however, that cauterization was not known to St. Gregory of Tours as a medical treatment of this particular illness. He simply saw in it a sanctifying practice in the sense of penitential mortification. Indeed, for Gregory this interpretation is an important part of his literary aim, as Maurilio is for him a brilliant example of a minister of the Church. Although Maurilio is well-known for his piety, knowledge, and uprightness in diocesan dealings, he voluntarily, as Gregory thinks, submits to ascetic self-castigation.

[The struggle of early Christians against Isis medica: breaks and continuity in traditions in the context of health and healing]. / Zum Kampf der frühen Christenheit gegen die Isis Medica--Bruch und Kontinuität von Traditionen im Ubergangsfeld von Heil und Heilung.

The study of health and healing gods may offer significant examples of how certain ideas survive, with hardly any substantial loss, across periods of great change. It is no surprise that, following centuries of struggle by early Christians against the worship of pagan gods, some originally heathen ideas and elements of thinking should have been in due course, if with prudence, adapted to Christian needs and sensibilities. A most remarkable instance of such practice is to be found, somewhat surprisingly, in the life of the bishop St. Cyril of Alexandria. He opposed rigorously the cult of Isis, above all in Egypt, but nevertheless adapted features of Isis to his conception of the Blessed Virgin Mary as 'Theotokos'. In this manner Isis, the goddess-mother, with her child Horus became--in a certain measure--a type of the Blessed Virgin Mother of God, accompanied by the Infant Jesus. The legendary arson perpetrated at the start of the 6th century A.D. against a temple in Cologne wherein a healing deity was worshipped should, it is argued here for the first time, be understood in the context of conflict between early Christianity and the cult of Isis. There is good reason to believe that the aforementioned temple set on fire by Gallus, later Bishop of Clermont, was in fact the shrine of Isis in Cologne.

[Jean Dominique Larrey and a paradoxical charity postage stamp]. / Jean Dominique Larrey und eine paradoxe Wohlfahrtsmarke.

A few years ago, the author had the lucky opportunity to acquire a charity stamp in an upright format showing the great French army surgeon Jean Dominique Larrey. This remarkable stamp, issued in 1964 for the benefit of the French Red Cross, is in itself a historical paradox which perhaps has not yet been noticed. In fact, it should have never been issued, since Larrey, to put it briefly, would have made the foundation of the Red Cross almost unnecessary: if Larrey's requirements concerning a prompt and extensive care of all wounded soldiers and persons involved in a battle had been put into practice only in Europe, there would have been no reason for an organization like the Red Cross. Henri Dunant, walking through the battlefield of Solferino in 1859, would have seen many corpses and all kinds of broken army material lying around. Seeing all that would probably have saddened him, but he would have hardly undertaken any humanitarian activity. The misery and chaos on the battlefield that moved the Swiss observer so much and prompted him to found the Red Cross would have simply not existed. Nevertheless, Jean Dominique Larrey would certainly feel greatly flattered if he could see his portrait applied to supporting the charity organization which carries out many of the ideas--once vigorously advanced by himself--up to the present day.

[Aspects of senile dementia in ancient Rome: literary fiction and factual reality]. / Aspekte der Altersdemenz im antiken Rom: Literarische Fiktion und faktische Lebenswirklichkeit.

Old people and their pecularities have been the object of writers since the beginning of Western literature. The aim of this study is to verify the social and juridical significance of senile dementia in ancient Rome. Among the few relevant sources the 10th satire of Juvenal attracts attention. It describes a demented patient who revises his succession in favour of a lady with bad reputation. Logically, we wonder whether such dispositions were possible and after all legally binding. Or did Juvenal exaggerate? A look at the Roman legislation shows: Since the Twelve Tablet Law there were instruments to control or to help demented people. This meant care in the sense of the today's curatorship or guardianship. These measures were supposed to prevent extravagancy or doing business and legal acts like marriages or last wills in the state of diminished responsibility. Nevertheless, it must be assumed that there was a considerable discrepancy between juridical theory and daily practice, because the position of the "pater familias" was virtually untouchable, the individual freedom of the full citizen was firmly underlined and the Roman civil law allowed only little executive interferences. Juvenal's bizarre example should not only be taken as good literary fiction. It might reflect the sad, but nevertheless probable reality of the people directly concerned. Apart from that it has to be said that senile dementia played only a minor role in Roman legislation. Mainly because there were considerably less very old people--and in particular people with senile dementia--than today.

[Euripides and Heraclitus on the attitude towards the corpse--an unrecognized fragment of Heraclitus in Electra, v. 289]. / Euripides und Heraklit uber den Umgang mit den Körpern Verstorbener--Ein unerkanntes Heraklitfragment in der Elektra, V. 289.

Among the fragments of Heraclitus preserved to our times there is one saying that corpses ought to be disposed of more urgently than excrements Diels/Kranz 22 B 96. This sentence of an aphoristic nature, as frequently in the case of Heraclitus' scripts, allows many different interpretations. Even in antiquity these words led to vitriolic reactions and perplexed other writers. It is why they have been frequently quoted. Nevertheless, it has been overlooked until now that Euripides, the youngest of the three great Attic tragedians, had inserted them into one of his dramas. In his Electra it is the title figure who uses them while reporting the slaughter of Agamemnon. The quotation bears witness to Euripides' erudition as of one of the earliest men known to have possessed a private library. He must, therefore, have had access to many treatises on various subjects, among them to the work by Heraclitus. The Electra is a kind of homage to the obscure thinker from Ephesus. From this fact, and from the plot of this particular play, we may gain some insight into an ambivalent attitude of the ancient Greeks towards the corpse that certainly influenced ideas about human anatomy in particular and medical knowledge in general. A characteristic feature of the malefactors, namely Aigisthos and Clytaimestra, is the deliberate dishonouring of their victims corpse. By contrast, the noble characters Orestes and Electra never violate the corpse of their arch-enemy Aigisthos, but see to it that he is properly buried. Burial was, particularly in Athens, so essential that in the well-known Arginusai trial the failure to bury the fallen soldiers resulted in capital punishment for the accused. Nevertheless, it is likely that Euripides, following Heraclitus, did not reject the anatomical examination of corpses for scientific purposes, as he was not only in this regard a supporter of science and progress. Perhaps Plato's notion of the human body as the tomb of the soul is foreshadowed here. This notion may have helped demythologize the corpse. Anyway, it is striking to observe the beginnings of the so-called Hippocratic medicine on the coast of Asia Minor and the near islands. It is exactly this part of the world where the pre-Socratics had made their first attempts at reasoning about the nature of being and made the transition from mythos to logos a few generations earlier. That intellectual climate was certainly good for nourishing scientific ideas of paramount importance. Heraclitus was without doubt one of the deepest-thinking pre-Socratics. The acceptance of his results by many critical thinkers of the time, such as Euripides, helped them attain their due recognition.

[Wishes for recovery on bronze--comments on a coin in honour of L. Aelius Caesar]. / Ein eherner Genesungswunsch--Anmerkungen zu einer Münze des L. Aelius Caesar.

L. Aelius Caesar is a little known co-regent of Hadrian who, having already been taken ill, was elected Princeps as Hadrian's successor and died soon afterwards. The city of Mytilene in Lesbos dedicated a bronze coin for him while he was still alive. The reverse of the coin shows the arrival of Asclepios in the shape of a snake. It is certainly a reference to the mythic translation of the cult of Asclepios to Rome in the third century B. C. which introduced the worship of the healing god on the Tiber Island. The community of Mytilene that struck the coin wanted to wish the ruler, whose illness was generally known, a good recovery or even to encourage him to convalesce at the famous ancient spa of Mytilene. At the same time they wanted to make a request on their own behalf. They wanted to gain the favour of the putative successor to the ruling Princeps in order to keep or regain certain liberties for their city which have been reduced by Vespasian in his centralization of the Roman Empire.

The catheter and its use from Hippocrates to Galen.

PURPOSE: We comprehensively reviewed the history and use of the bladder catheter in Western medicine from 500 BC to 200 AD. MATERIALS AND METHODS: Greek and Latin texts were key word searched to identify descriptions of contemporary instruments and their uses. RESULTS: The catheter and its use were mentioned by about 10 ancient authors in more than a total of 20 texts dating to the end of the second century AD. The authors include Hippocrates, Celsus, Soranus, Rufus, Aretaeus and Galen. They described the use of the instrument in reference to contemporary anatomy and physiology, and indications and contraindications in regard to certain conditions, such as urinary retention, bladder stones and intravesical blood clots. Technical details and particularities of use were also reviewed, as were pharmacological considerations and underlying physical principles. CONCLUSIONS: Knowledge of the urinary catheter, and its usefulness and risks in ancient medicine can be dated from the 5th century BC. Our study of European texts documents its broad use. Because catheterization was perceived as a practical measure, it generated little scientific controversy.

The catheter and its use in late antiquity and the early middle ages.

PURPOSE: Based on Greek and Latin sources the use of the urinary catheter in Western medicine between 200 and 1000 CE was reviewed. MATERIALS AND METHODS: Computerized databank searches permitted the identification and analysis of ancient and early medieval texts that include material on the catheter. RESULTS: Ten medical authors mentioned the catheter and its use. In the Byzantine world they include the encyclopedists Oribasius, Aetius and Paul of Aegina. The best known Latin author is Caelius Aurelianus. These writers often put together summaries of earlier works. Innovation or independent research was not easily found at a time during which neither anatomical autopsy nor experimentation was widely practiced. CONCLUSIONS: Old texts contain numerous instructions on how to skillfully use the catheter. As a technical achievement, it was independent of philosophical trends. Its primary indications, namely urinary retention, bladder stones and the administration of cures, changed little with time. As one of the oldest and most important instruments at the disposal of physicians, the history of the catheter should be known to every urologist.

[A lead seal of the "Germanos' Health Service" as an early forerunner of the health insurance card in ancient Byzantium]. / Ein Bleisiegel der "Diakonie des Germanos" als früher Vorläufer eines Krankenversicherungsausweises im alten Byzanz".

The aim of this study is to present a Byzantine lead seal from the 6th century A. D. in the light of other comparable finds and to explain its function. According to the Greek inscription it was issued by the so-called "Germanos' Health Service". Its beneficiaries carried it probably around the neck or wrist. This charitable institution, settled in Constantinople, supported people in need. Feeding of the poor and free access to the baths certainly belonged to the standard services of the "Germanos' Health Service". Several reasons favour the assumption that medical help was also included in the range of benefits offered to people to whom it would have otherwise been out of reach. Contrary to the modern Health Insurance there was no legal claim to the medical care. It was rather a voluntary charitable supply that is to be seen in the context of Christian love and of personal striving for the salvation of the soul through good deeds. Therefore, the seal of the "Germanos' Health Service" belongs at least indirectly among the forerunners of the modern Health Insurance Card which ought to give access to participation in the blessing of good health.

[Defense of Ovid: annotations on Metamorphoses IV 119-123)]. / Eine lanze für Ovid - Anmerkungen zu 'Metamorphosen' IV 119-124.

The description of Pyramus' suicide in the Metamorphoses has been commented on by many scholars. There has been particular criticism of the comparison between the unfortunate lover's wound, squirting out blood, and a burst water-main. This has been supposed to show yet again how Ovid, in spite of his undoubtedly great talent, is capable of ruining a story by exaggeration. Nevertheless, a medical look at his wording leads to quite a different judgement. In his simile of the burst water-main Ovid obviously had in mind the haemorrhage from a damaged femoral artery, which can shoot blood to a considerable distance, sometimes over several yards. Only in this way can the fruits of the mulberry tree, hanging high over the wounded Pyramus, be moistened with blood and painted dark. This is, after all, the metamorphosis which justifies the inclusion of the story in the whole corpus. As it is possible for a person fatally wounded in this way to survive for some hours, the poet has to guarantee that Pyramus dies within minutes of turning his sword against himself. Only so can Thisbe, returning quickly, confess her love for Pyramus in such a heartfelt way and follow him at once. The haemorrhage from a femoral artery my indeed kill a person within a few minutes. Therefore Ovid's description is neither gruesome nor tasteless but simply natural and dramatically conclusive. The comparison with the water-main is one which would easily have occurred to the poet. From Ovid' point of view and that of his contemporaries, who had no knowledge of the circulation of the blood, no better comparison can be imagined than that between the blood vessels of the human body and urban water-pipes, a technical achievement of which the Romans were particularly proud.

Roman emperors suffering from apoplexy: the medical and historical significance of classical literary sources.

According to various Greek and Latin texts, several Roman emperors died of "apoplexy". This paper presents a systematic collection and evaluation of these sources. The contents of the texts are compared with contemporary knowledge as well as present-day perspectives. In retrospect, few of the "royal cases" can be classified as cerebrovascular disorders.

[A drill-bow in Horace, Odes 3.6.7]. / Ein Bogenbohrer bei Horaz, Carmina 3, 26, 7.

With the short poem Odes 3.26 Horaces says--ostensibly--farewell to the subject of love. A symbol of his retreat is the order given to his followers: they ought to lay in the Temple of Venus the three objects which he has used in his night escapades struggling for the girls' love: lucida funalia (torches), vectis (jemmies), and arcus. The last words has been puzzling the scholars for centuries. Many took offence at the transmitted text and offered conjectures of their own. Some, however, defended arcus using different arguemtns, for instance that arcus refers to bows and arrows as weapons of the lascivious night-reveller. Also the author of this article retains arcus in the text. The context and grammatical construction let assume that also this noun denotes a tool of a burglar, preferably a drill driven by a fiddle-bow. Such instruments were use by carpenters, joiners, and surgeons. Apart from this, gigantic drill-bows were known among military machines. These were frequently applied in sieges. Horace might have seen descriptions and drawings of them in military handbooks which he presumably read in order to prepare himself for his short and rather inglorious career as an officer in the army of Caesar's murderers. For Romans without military experience who suddenly obtained a high rank at war this was a typical way of making good their shortcomings. The parallel between the siege of a town and the attack upon the beloved girl's house must be regarded as a poetic exaggeration; the reader should be amused by an impracticable idea. Furthermore, a possible connection between Horace's poem and the Heracles of Euripides is pointed out here for the first time. In Heracles 942-6 the hero, driven insane by Lyssa's work, asks for his bow, his arrows and siege instruments to take Mycenae, the fortress of his tormentor Eurystheus. In fact he brakes into his own bedroom and kills his spouse and his son.

[A report of St. Bonaventura in the mirror of the history of neurology]. / Ein bericht des heiligen Bonaventura im spiegel der neurologiegeschichte.

Ancient and medieval literature contain few case reports of specific syndromes. But there is no lack of such accounts in theological literature, with its long tradition of gathering and documenting individual case studies involving miracle cures--a practice which stretches from the ancient sanctuaries of Asclepius to today's places of pilgrimage. Among the many miracles attributed to St. Francis, complied around 1260 by his biographer, St. Bonaventura, is the case of a young monk afflicted by a sudden hemiplegia accompanied by aphasia and mental confusion. According to legend, he was miraculously and completely healed by the appearance of St. Francis. The report can be interpreted from a number of different approaches: medical, theological, literary or even autobiographical. Neurologists may treat this "case history" as an early description of a "prolonged ischaemic neurological deficit" (PRIND).

Between horror and hope: gladiator's blood as a cure for epileptics in ancient medicine.

Between the first and the sixth century a single theological and several medical authors reported on the consumption of gladiator's blood or liver to cure epileptics. The origins of the sacred or apoplectic properties of blood of a slain gladiator, likely lie in Etruscan funeral rites. Although the influence of this religious background faded during the Roman Republic, the magical use of gladiators' blood continued for centuries. After the prohibition of gladiatorial combat in about 400 AD, an executed individual (particularly had he been beheaded) became the "legitimate" successor to the gladiator. Occasional indications in early modern textbooks on medicine as well as reports in the popular literature of the 19th and early 20th century document the existence of this ancient magical practice until modern times. Spontaneous recovery of some forms of epilepsy may be responsible for the illusion of therapeutic effectiveness and for the confirming statements by physicians who have commented on this cure.

St. Francis came at dawn--the miraculous recovery of a hemiplegic monk in the Middle Ages.

We present the English translation of a remarkable case report from the 13th century. A collection of miracles ascribed to St. Francis contains the story of a young monk suddenly afflicted by a neurological disorder characterized by hemiplegia, speech problems and confusion. St. Francis' appearance led to complete recovery. From a theological and literary point of view, the text includes many allusions to the miracles performed by Jesus and to pagan traditions from Asclepius to Ovid. Retrospective neurological diagnoses range from a prolonged ischemic neurological deficit (PRIND) to psychogenesis. This case history is a rare example of faith healing in its contemporary context.

[On the simile of the courageous general in Herophilos]. / Zum gleichnis vom tapferen feldherrn bei Herophilos.

Herophilos of Chalcedon is certainly an outstanding representative of ancient medicine. He rightly counts the Father of anatomy. He was, nevertheless, interested in all branches of medicine and should have written on numerous special subjects. Unfortunately only scarce fragments of his writings have survived till now. A nowadays rather neglected fragment deriving from Herophilos' scripts on drugs has survived in Plin. nat XXV 57 f. It reports on the effects of helleborus albus (probably White Hellebore, i.e. Veratrum album L.) which evokes strong vomits. In a pregnant simile the remedy is compared to a courageous general who having stimulated his soldiers goes into battle in front of them. Editors and commentators do not say much about this passage, perhaps bewildered by the appropriate, but in the technical prose certainly striking simile. A surprising parallel occurs in the Gospel according to St. John 10:1-6 - the core of Jesus' self-description as the Good Shepherd. Comparing both passages leads to the conclusion that this select metaphor must have been a well-known motif in the literature of the Hellenistic and imperial periods. Moreover, a look at the ancient historiography and military writings shows that we have to do with a commonplace: both the talent to deliver a vigorous speech encouraging the soldiers to go into battle and the personal bravery in the fight are virtues necessary to an eminent military commander. Furthermore, we get insight into a general understanding of Herophilos as a writer. It was stressed frequently that Herophilos' epoch-making results in the field of medicine had found their way into the belles-lettres and poetry. Now we see that the inspiration was mutual. When Herophilos wished to give prominence to an important statement, he also did not hesitate to borrow effects of style from the poets and writers of the Kunstprosa. In his care for a literary form he exceeds what we unusually observe in the writers of 'technical' prose.