Oskar Kobylinski (1856-1926) and the first description of Noonan syndrome in the medical literature.

While a student of University in Dorpat (now Tartu, Estonia) Oskar Kobylinski published an article reporting on his 22-year-old patient Leisar Eischikmann, who suffered from a congenital deformity of the neck. Kobylinski described this rare anomaly and called it "flüghautige Verbreitung des Halses" (wing-like extension of the neck). It was only in 1902 when the name pterygium colli was introduced, and it has been in use ever since. This malformation is part of some congenital syndromes, most prominently, Turner syndrome and, more rarely, of Noonan syndrome. As Opitz et al. pointed out, the patient described in the 1883 article from Archiv für Anthropologie is probably the first person with Noonan syndrome to have been pictured in the medical literature. The article was signed only by "O. v. Kobylinski, student of medicine." Further archival research was needed to identify this physician and provide more details about his unusual career.

[The mark of envy: metaphysics and embryology according to Descartes]. / Les "marques d'envie": métaphysique et embryologie chez Descartes.

This paper explores the interaction between medicine and metaphysics in modern natural philosophy and especially in Descartes' philosophy. I argue that Descartes hypothetical account of birthmarks in connection with his embryology provides an argumentative proof of the metaphysical necessity of a substantial union between mind and body, which however does not threaten his doctrine of the real distinction between these two substances. It would appear that his argument relies on a temporal conception of alethic modalities and provides a new answer to Henricus Regius who in 1641 claimed that, for Descartes, the human being is an ensper accidens.

Precursores de la cirugía dermatológica española / Pioneers of spanish dermatologic surgery

Aun antes del nacimiento de la Dermatología como especialidad a principios del siglo XIX, la mayoría de las lesiones cutáneas y dermatosis eran materia de los cirujanos más que de los médicos. Después de la unificación de la Medicina y de la Cirugía, y del nacimiento de la Dermatología como especialidad moderna, esta relación se fue desdibujando y los dermatólogos españoles se aproximaron más a la Medicina que a la Cirugía. Las mejoras en la técnica quirúrgica, en la antisepsia y la asepsia, el nacimiento y difusión de la anestesia y el mayor interés en los estudios micrográficos llevaron a la recuperación, casi de novo, de esta vieja tradición quirúrgica en la segunda mitad del siglo XIX. En España, no se puede hablar de una auténtica «cirugía dermatológica» hasta el primer tercio del siglo XX, cuyos principales exponentes fueron Enrique Álvarez Sainz de Aja y Vicente Gimeno. El primero de ellos fue el mejor práctico de la incipiente cirugía dermatológica que basaba en su experiencia previa en Cirugía General y Obstetricia. El segundo nos dejó un interesante opúsculo de cirugía dermatológica, publicado en 1923 y que fue el texto de su discurso de recepción en la Real Academia Nacional de Medicina (AU)

Even before dermatology was born as a specialty at the beginning of the 19th century, most skin lesions and dermatoses tended to be treated by surgeons rather than physicians. After medicine and surgery were unified into a single discipline and dermatology emerged as a modern specialty, this relationship became blurred and Spanish dermatologists leaned more towards medicine than surgery. Then improvements in surgical techniques, knowledge of antiseptic and aseptic procedures, the development and introduction of anesthesia, and the greater interest in micrographic approaches led to the rediscovery and almost complete rebirth of this old surgical tradition in the second half of the 19th century. In Spain, dermatologic surgery as such did not really exist until the first third of the 20th century, when Enrique Álvarez Sainz de Aja and Vicente Gimeno emerged as the main exponents of this discipline. Of these 2, Álvarez Sainz de Aja-drawing on his previous experience as a general surgeon and obstetrician-was the better practitioner of the incipient dermatologic surgery. The other, Gimeno, wrote an interesting booklet on dermatologic surgery that was published in 1923 and that formed the basis of his inaugural speech to the Spanish Royal National Academy of Medicine (AU)

The Helena syndromes.

The author gives a personal account on how he was introduced to the field of clinical genetics as a student of John Opitz in Helena, MT. That process was facilitated by the study of several malformation syndromes. Particularly instructive were the approaches to the cardio-facio-cutaneous, the Perlman, and the FG syndrome. These three conditions are briefly revisited with a critical perspective, made possible by the elapse of 20 years, since the time when the author became acquainted with them.

The ideal prepuce in ancient Greece and Rome: male genital aesthetics and their relation to lipodermos, circumcision, foreskin restoration, and the kynodesme.

This study examines the evolution of Greek and Roman medical conceptualizations of preputial aesthetics, utilizing evidence found in classical medical texts as well as clues from literature, legal sources, and art. A conclusive picture emerges that the Greeks valued the longer prepuce and pathologized the penis characterized by a deficient prepuce--especially one that had been surgically ablated--under the disease concept of lipodermos. The medical conceptualization of lipodermos is also placed in the historical context of the legal efforts to abolish ritual circumcision throughout the Seleucid and Roman empires.