Hippocrates (ca 460 BC to ca 370 BC).

The chapter begins with a review of some of the background thinking during Hippocrates time. The brain was considered to be the location of the soul which was the essence of subjective experience. However, this was not a brain function as such but rather a location where the pneuma reacted with the soul. Hippocrates' monograph on cranial trauma begins with a description of the bones and sutures. He then systematized the classification of cranial injury. He sensibly advised accurate diagnosis into one of the types of injury he described and supported extension of any skin opening to facilitate diagnosis of the bone, the injury of which was his primary concern. His description of operative technique has rarely been surpassed, placing emphasis on care and methods for the avoidance of further injury. He also emphasized the importance of probing during trepanation to avoid damaging the dura and underlying brain. In addition, he insisted on using water to cool the trepan. All of this was positive. However, the respect in which he was held in subsequent generations meant that two albeit understandable errors were perpetuated. The first error was the use of prophylactic trepanation to permit the drainage of the pus which he believed would inevitably develop under a fissure. The second was to avoid trepanning at sutures, the reasons for which proscription are not clearly stated. In conclusion, it may be noted that what limited reporting of results is available demonstrates that Hippocrates trepanations were largely not successful.

Revisiting the evolution of the Hippocratic Oath in obstetrics and gynecology.

Hippocrates, an influential figure in ancient Greek medicine, is best known for his lasting contribution, the Hippocratic Oath, which includes a significant message about obstetrics and gynecology. Given the Oath's status as a widely regarded ethical code for medical practice, it requires critical evaluation. The message of the Oath, as it related to obstetrics and gynecology, is expressed in ancient Greek by the phrase "οὐδὲ γυναικὶ πεσσὸν φθόριον δώσω" which translates directly to "I will not give to any woman a harming pessary." The words fetus and abortion were not present in the original Greek text of the Oath. Yet, this message of the Hippocratic Oath has been interpreted often as a prohibition against abortion. In this article, we present a critical linguistic and historical analysis and argue against the notion that the Hippocratic Oath was prohibiting abortion. We provide evidence that the words "foetum" (fetus) and "abortu" (abortion) were inserted in the Latin translations of the Oath, which then carried on in subsequent English versions. The addition of the words "fetus" and "abortion" in the Latin translations significantly altered the Oath's original meaning. Unfortunately, these alterations in the translation of the Hippocratic Oath have been accepted over the years because of cultural, religious, and social reasons. We assert that because the original Hippocratic Oath did not contain language related to abortion, it should not be construed as prohibiting it. The interpretation of the Oath should be based on precise and rigorous translation and speculative interpretations should be avoided.

[Medical practice in classical Greece : The dermatological case reports in the Hippocratic Corpus]. / Medizinische Praxis im klassischen Griechenland : Die dermatologischen Fallberichte des Corpus Hippocraticum.

OBJECTIVES: Which theoretical and practical competences do the dermatological case histories of the Hippocratic Corpus convey? MATERIALS: The 431 Hippocratic case histories have been studied for reports and communication on diagnostics, therapy and prognosis of individuals and groups of patients suffering from skin diseases. RESULTS: Within the seven books of the Hippocratic 'Epidemics', a total of 49 patients with dermatological symptoms are described; in 20 of these, skin disease was the leading suffering. The essential clinical signs were itching, red spots, blisters, pustules, aphthae, lichen, dandruff and hair loss. Most patients were male; one of the four women was pregnant, among the two children was a baby whose skin disease ended fatally. Eight patients were named. In addition, five waves of disease are reported, in the course of which the shape of the skin played an important role. The diagnostic workup was limited to inspection and palpation, but included the determination of the level of suffering. The follow-up checks often extended over months. Mostly, plasters and compresses with grain flour were primarily used for treatment. CONCLUSION: The Hippocratic doctor observed and described a large number of skin lesions and attempted to classify them in the differential diagnosis. In addition to changes in the color and tension of the skin, numerous lesions-for which the names are still often used in modern dermatology-are also described in detail. The skin manifestations associated with fever and abdominal symptoms are counted among the epidemic diseases. The condition of the skin was often regarded as an indicator of general health. In the case reports, conservative treatment adapted to the development of the disease dominated. In desperate cases, bloodletting was chosen as a last resort.

On the Heart of the Hippocratic Corpus: its meaning, context and purpose.

Though the Hippocratic text On the Heart has garnered significant attention in the twentieth and twenty-first centuries from classicists, physicians and historians of medicine alike, no commentary on this important work currently exists. There remain, however, central questions of interpretation concerning a number of important points: in particular, how the author understands the structure and functioning of the heart.The significance of this text for the history of cardiovascular medicine can be found first in its position as being radically advanced in its portrayal of the inner structure of the heart when compared with any other Hippocratic text. At the same time, the text falls dramatically short of the discoveries of the Alexandrian researchers who studied during the Hellenistic period-that is, around the same period as this text's likely composition. In addition, this work contains the first extant description of the valves of the heart, and its detailed descriptions of a cuspid valve and the chordae tendineae have led several scholars to imagine that this text even contains evidence of either a systematic dissection of an animal heart or-what seems impossible outside of Alexandria, Egypt at that time-evidence of the dissection of a human heart.This article intends to provide a full commentary on the text by consolidating, and in some cases correcting, previous interpretive attempts to understand an often referenced, and at times misinterpreted, ancient medical treatise.

Application of clinical and molecular profiling data to improve patient outcomes in psoriatic arthritis.

Achieving a good outcome for a person with Psoriatic Arthritis (PsA) is made difficult by late diagnosis, heterogenous clinical disease expression and in many cases, failure to adequately suppress inflammatory disease features. Single-centre studies have certainly contributed to our understanding of disease pathogenesis, but to adequately address the major areas of unmet need, multi-partner, collaborative research programmes are now required. HIPPOCRATES is a 5-year, Innovative Medicines Initiative (IMI) programme which includes 17 European academic centres experienced in PsA research, 5 pharmaceutical industry partners, 3 small-/medium-sized industry partners and 2 patient-representative organizations. In this review, the ambitious programme of work to be undertaken by HIPPOCRATES is outlined and common approaches and challenges are identified. It is expected that, when completed, the results will ultimately allow for changes in the approaches to diagnosing, managing and treating PsA allowing for better short-term and long-term outcomes.

Improving outcomes in Psoriatic Arthritis Psoriatic Arthritis (PsA) is a form of arthritis which is found in approximately 30% of people who have the skin condition, Psoriasis. Frequently debilitating and progressive, achieving a good outcome for a person with PsA is made difficult by late diagnosis, disease clinical features and in many cases, failure to adequately control features of inflammation. Research studies from individual centres have certainly contributed to our understanding of why people develop PsA but to adequately address the major areas of unmet need, multi-centre, collaborative research programmes are now required. HIPPOCRATES is a 5-year, Innovative Medicines Initiative (IMI) programme which includes 17 European academic centres experienced in PsA research, 5 pharmaceutical industry partners, 3 small-/medium-sized industry partners and 2 patient representative organisations (see appendix). In this review, the ambitious programme of work to be undertaken by HIPPOCRATES is outlined and common approaches and challenges are identified. The participation of patient research partners in all stages of the work of HIPPOCRATES is highlighted. It is expected that, when completed, the results will ultimately allow for changes in the approaches to diagnosing, managing and treating PsA allowing for improvements in short-term and long-term outcomes.

An ordinary malaria? Intermittent fever in Denmark, 1826-1886.

Intermittent fever is a historical diagnosis with a contested meaning. Historians have associated it with both benign malaria and severe epidemics during the Early Modern Era and early nineteenth century. Where other older medical diagnoses perished under changing medical paradigms, intermittent fever 'survived' into the twentieth century. This article studies the development in how intermittent fever was framed in Denmark between 1826 and 1886 through terminology, clinical symptoms and aetiology. In the 1820s and 1830s, intermittent fever was a broad disease category, which the diagnosis 'koldfeber'. Danish physicians were inspired by Hippocratic teachings in the early nineteenth century, and patients were seen as having unique constitutions. For that reason, intermittent fevers presented itself as both benign and severe with a broad spectrum of clinical symptoms. As the Parisian school gradually replaced humoral pathology in the mid-nineteenth century, intermittent fever and koldfeber became synonymous for one disease condition with a nosography that resembles modern malaria. The nosography of intermittent fever remained consistent throughout the second half of the nineteenth century. Although intermittent fever was conceptualized as caused by miasmas throughout most of the nineteenth century, the discovery of the Plasmodium parasite in 1880 led to a change in the conceptualization of what miasmas were. The article concludes that the development of how intermittent fever was framed follows the changing scientific paradigms that shaped Danish medicine in the nineteenth century.

Hippocrates and the anatomy of the nervous system (Historical Note) / Hipócrates e a anatomia do sistema nervoso (Nota Hidtórica)

Hippocrates was one of the greatest physicians ever, and merited unquestionably, the title of 'Father of Medicine'. He, together with other authors, formed an assemble of texts known as 'Hippocratic Collection' (or 'Hippocratic Corpus'). There, the ample and brilliant medical experience remained documented, and left as a legacy. Even after almost two and a half millennia, these medical writings continue to be admired, and regarded as a lasting fount of inspiration. However, regarding anatomy, including that of the nervous system, and related structures, the texts are poor. About the nervous system, he mentioned the brain and its two hemispheres, the spinal cord, and the sensory organs. The related structures are also cited, comprising the meninges, the cerebrospinal fluid, and the blood vessels, as well as the skull, and the vertebral column. The functions of the brain were partly explained, and he ascribed to the brain the main ruling function of the body, a mark of encephalocentric position. Thus, counterposed to his ample medical accomplishments was his poor anatomical contribution. However, it must be recognized that the incipient contribution on anatomy that was legated, represented an important starting point for upcoming scholars and further studies on the subject.

Hipócrates foi um dos maiores médicos de todos os tempos, merecendo, de modo inquestionável, o título de 'Pai da Medicina'. Ele, juntamente com outros autores, constituiu um conjunto de textos conhecido como 'Coleção Hipocrática' (ou 'Corpo Hipocrático'). Lá, a ampla e brilhante experiência médica permaneceu documentada e deixada como um legado. Mesmo após quase dois e meio milênios, estes escritos médicos continuam a ser admirados e vistos como uma fonte duradoura de inspiração. Entretanto, considerando a anatomia, os textos são pobres, inclusive os sobre o sistema nervoso e estruturas relacionadas. Quanto ao sistema nervosa, ele mencionou o cérebro e seus dois hemisférios, a medula, e os órgãos sensoriais. As estruturas relacionadas também são mencionadas, compreendendo as meninges, o líquido cefalorraquidiano, e os vasos sanguíneos, assim como o crânio e a coluna vertebral. As funções cerebrais foram explicadas em parte e ele atribuiu ao cérebro a principal função de controle do corpo, uma marca de sua posição encefalocêntrica. Assim, contraposto às suas amplas realizações médicas foi sua contribuição anatômica pobre. Entretanto, deve ser reconhecido que a contribuição incipiente sobre anatomia que foi legada representou um ponto de partida importante para os estudiosos porvindouros e os estudos que prosseguiram sobre o assunto.

Exploring medical terminology inexpediencies: Tripledemic vs. triple epidemic.

Accurate and consistent medical terminology has a fundamental value in medicine. It enables medical students to understand the meaning of each term, medical physicians to communicate with each other, and it also enables science to adopt a logical language of high-level understanding and scientific regularity. Medical terminology inexpediencies caused by the adoption of etymologically illogical or linguistically false terms lead to misunderstanding and confusion among clinicians. The medical terms epidemic and pandemic are as old as Hippocrates and Sophocles, respectively. The present article evaluates the new medical terms tripledemic and triple epidemic, which were introduced during the recent COVID-19 pandemic.

Venae spermaticae post aures: The early modern angiology-neurology of virility.

The famous discussion of Scythian cross-dressers in Hippocrates' Airs Waters Places (Aer.) 22 puzzled perhaps most medieval and Renaissance medical authorities. The text wrestled with a pre-Hippocratic, encephalocentric theory of spermatogenesis. Modern reception of the convoluted hypothesis put forward here gradually distilled three etiologies of failing virility: impotence, subfertility, and unmanliness. A gradual shift is discernable from increasingly Galenic neuro-andrological theories (sixteenth century) to neuropsychiatric (late-seventeenth through eighteenth century), phrenological and psychopathological (early- and late-nineteenth century), and finally early psycho-endocrinological (early-twentieth century) ideas about masculinity. Aer. 22 was a ubiquitously recurring reference across all of these episodes, indeed well beyond medicine, rendering it a highly sensitive index of change in neurodevelopmental and neuropsychiatric thinking. The pre-Enlightenment, neurology-centric onset of this extended modern history of sexual/gender medicine is briefly discussed, as well as its phrenological afterlife.

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 .

Conceptualizing disabilities from antiquity to the middle ages: A historical-medical contribution.

OBJECTIVE: This paper provides some conceptual guidelines for interpreting the phenomenon of impairment-disability between Antiquity and the Middle Ages from an historical-medical perspective. The paper illustrates application of these guidelines in an historical-medical reassessment of a published paleopathological case-study. MATERIALS AND METHODS: The skeletal remains of a woman who experienced bone fusion and osteoarthritis (Rome, VIII century AD) were selected. We first contextualize her impairments through a paleopathological approach, then locate her experience of disability and care within the cultural and social background to which she belongs. RESULTS: This study illustrates the difficulty of reconstructing one consistent single model of disability. CONCLUSIONS: The traditional idea of disability as a parameter of exclusion is not appropriate for every historical context. SIGNIFICANCE: The paper attempts an integrated and transdisciplinary approach to historical reconstruction of lifestyle in the presence of impairments between late Antiquity and the Early Middle Ages. LIMITATIONS: The main research obstacle is the difficulty of going beyond documented Christian interpretation of disability and provision of welfare to identify detail of lived experience for individuals with impairments. SUGGESTIONS FOR FURTHER RESEARCH: The transdisciplinary historical-medical approach can be adapted for inclusion in any bioarchaeological study of impairment in historic times; future applications of this model will lead to its refinement.

[Countertraction method for reduction of irreducible subcoracoid dislocation of the shoulder joint with Hill-Sacks lesion].

OBJECTIVE: To investigate clinical outcomes of countertraction method in treating irreducible subcoracoid dislocation of shoulder joint combined with Hill-Sacks injury. METHODS: A total of 56 patients with irreducible subcoracoid dislocation of the shoulder joint combined with Hill-Sacks injury admitted from December 2013 to June 2020 were retrospectively analyzed. Under the anesthesia of shoulder joint cavity injection, the reduction was performed by using anti-traction method (experimental group) and traditional Hippocrates method (control group), 28 cases in each group. There were 11 males and 17 females in experimental group, with an average age of (61.95±19.32) years old, 9 cases on the left side, and 19 cases on the right side. Twelve males and 16 females in control group, with an average age of (63.13±12.75) years old, 11 cases on the left side, 17 cases on the right side. The curative effects between two groups were evaluated before and after operation, including the success rate of reduction, the duration of reduction, the distance from successful reduction to injury, complications and functional rehabilitation(Constant score of shoulder joint). RESULTS: The success rates of reduction in experimental group and control group were 92.86%(26/28) and 67.86% (19/28), respectively, and the difference was statistically significant (P<0.05). The duration of simple reduction was (4.25±2.13) min and ( 6.31±1.69) min, the difference was statistically significant (P<0.05);the time from successful reduction to injury was (9.16±0.94) h and (8.94±1.31) h, respectively, with no significant difference(P>0.05). There were no complications such as vascular nerve injury and fracture in experimental group, 2 cases of axillary nerve injury and 1 case of humeral head fracture in control group. Constant scores of shoulder joint between experimental group and control group were (92.34±5.62) points and (90.91±4.73) points, respectively, with no significant difference (P>0.05). CONCLUSION: For patients with irreducible subcoracoid dislocation of the shoulder joint with Hill-Sacks injury, the countertraction method under anesthesia of the shoulder joint cavity achieved a higher success rate and few complications.

Hippocrates: father of mini-invasive nasal surgery.

Hippocrates, a Greek physician during the fifth century BC., is often considered the father of medicine. The Corpus Hippocraticum comprising of 58 volumes was writing between 450 and 150 BC. The objective of our study was to detail the management of nasal polyps during this period. We read and analyzed all volumes of the Corpus Hippocraticum in French translation and extracted all passages dealing with nasal polyps (n = 6). Surgical procedures in the Corpus Hippocraticum are described in great detail. The first surgical strategy for the removal of nasal polyps was by mini-invasive nasal approach: the lopping method and the sponge method. We explain the two mini-invasive nasal approaches with drawings. The meticulously detailed observations of the corpus give us a precious insight into the early perception of diseases, their progression and early attempts of treatment.

WHEN QUARTAN FEVER RELIEVED DEPRESSION: THE INCEPTION OF PYRETOTHERAPY IN THE GRECO-ROMAN ANTIQUITY.

OBJECTIVE: The aim: This paper explores the documentation of the effect of quartan fever on, the ancient Greek equivalent of conditions falling nowadays under the spectrum of depression, in Greco-Roman medical sources. PATIENTS AND METHODS: Materials and methods: The authors searched original medical texts written in Greek by physicians who lived and practiced Medicine in the broader Mediterranean region from the 5th century BC to the 7th century AD for records related to quartan fever and neuropsychiatric diseases. CONCLUSION: Conclusions: Quartan fever was used as a treatment for neuropsychiatric conditions until the middle of the 20th century. Although malaria can have severe neuropsychiatric sequelae, the neuroimmunological underpinnings of the effect of fever and heat on depression warrant further investigation.

Liver and gall bladder channel parallels in the Hippocratic Corpus and Huang Di Nei Jing with theoretical considerations.

Chinese history contains an abundance of records discussing contact with the outside world. In the ever elusive search for the origin of the meridian theory, an extended investigation into the Hippocratic Corpus reveals parallels with the Huáng Dì Nèi Jing () medical text of the Chinese tradition that provide an alternative perspective into the origins of meridian channels theory. Though this topic has been discussed in the past, this paper provides new and developed insight into theories associated with the liver and gallbladder channel systems of each tradition. Condensing the scope of the analysis between the Huáng Dì Nèi Jing and Hippocratic text traditions and focusing on the liver and gall bladder channels aids to expound on the theoretical background required to advance the comprehension and understanding regarding the origins of each tradition. This paper reveals content that further the relationship between the two traditions, including demonstrating the existence of theoretical parallels existing between the liver and gall bladder channels of these two texts.

Back to the future: Covid-19 and the recurring debate over social determinants of disease, and health.

Since the 1980s, a large literature has developed on the social determinants of health, primarily non-communicable diseases for which mortality and morbidity can be shown to change across a socioeconomic gradient. Primarily regional or national in focus, they are joined, today, with an increasing focus on international health and the effect of inequalities between nations effect disease generation and spread. Similar and earlier literatures first considered socioeconomic factors influencing disease incidence and intensity primarily at local and regional levels. One such literature was primarily "sanitarian," focusing on general infrastructure needs (safe water, for example) to create a beter health environment. A second, primarily nineteenth century literature focused on social inequalities and the epidemic diseases in specific populations. This paper seeks to review these separate foci and then combine them into a more comprehensive understanding of both the general and specific determinants of health and disease at local, national, and international scales of address. It notes that while disease dynamics have been long known that current literatures typically consider socioeconomic determinants at local, national, and global scales as a new phenomenon.

History of closed reduction techniques and initial management for shoulder dislocations: From classical antiquity to modern times.

This review gives a summary of the records of shoulder dislocation management throughout history until the point that anaesthetics were introduced and modern medicine improved dislocation management exponentially. A dislocation is a mechanical injury that has been managed in different ways throughout history. The shoulder reduction methods described in Hippocrates Corpus have been described and adjusted throughout history by later physicians. For example, in ancient Greek, Hippocrates considered the ambe, a device used to reduce the shoulder, to be the most powerful tool. However, Cooper, a physician in the 19th century, considered it to be the last resort due to substantial damage to the ribs and discomfort of the patient. This review demonstrates that there were many physicians that contributed to shoulder dislocation management. These physicians paved the way for modern shoulder dislocation treatment strategies.

Anorexia and bulimia in late antiquity and early Byzantine period in the eastern Mediterranean region.

OBJECTIVE: The purpose of this study is to identify clinical manifestations of eating disorders in the Eastern Mediterranean region from the first century AD until the seventh century AD and evaluate relevant awareness among the physicians of the era. METHOD: The authors searched original medical texts written in Greek by physicians practicing in the Eastern Mediterranean region from the first century AD to the seventh century AD. The search focused on passages that include possible references to clinical entities analogous to anorexia nervosa (AN) and bulimia nervosa (BN) as described in the DSM-5 and the contemporary literature. RESULTS: Descriptions of conditions that resemble AN or BN can be found in the work of Galen, Oribasius, Aetius of Amida, Leon Philoumenos, Alexander Trallian, and Paul of Egina. Successive physicians confirmed the observations of their predecessors and add to the description of the clinical presentations and their etiology. DISCUSSION: This research provides evidence of awareness of presentations resembling currently defined eating disorders in the Eastern Mediterranean region during a period with different norms and values. Observations from the period can serve as a point for reflection about the characteristics and etiology of AN and BN in the 21st century.

Ofeleein i mi Vlaptin-Volume II: Immunity Following Infection or mRNA Vaccination, Drug Therapies and Non-Pharmacological Management at Post-Two Years SARS-CoV-2 Pandemic.

The persistence of the coronavirus disease 2019 (COVID-19) pandemic has triggered research into limiting transmission, morbidity and mortality, thus warranting a comprehensive approach to guide balanced healthcare policies with respect to people's physical and mental health. The mainstay priority during COVID-19 is to achieve widespread immunity, which could be established through natural contact or vaccination. Deep knowledge of the immune response combined with recent specific data indicates the potential inferiority of induced immunity against infection. Moreover, the prevention of transmission has been founded on general non-pharmacological measures of protection, albeit debate exists considering their efficacy and, among other issues, their socio-psychological burden. The second line of defense is engaged after infection and is supported by a plethora of studied agents, such as antibiotics, steroids and non-steroid anti-inflammatory drugs, antiviral medications and other biological agents that have been proposed, though variability in terms of benefits and adverse events has not allowed distinct solutions, albeit certain treatments might have a role in prevention and/or treatment of the disease. This narrative review summarizes the existing literature on the advantages and weaknesses of current COVID-19 management measures, thus underlining the necessity of acting based on the classical principle of "ofeleein i mi vlaptin", that is, to help or not to harm.