Belly fat or bloating? New insights into the physical appearance of St Anthony of Padua.

Over the centuries, iconographic representations of St Anthony of Padua, one of the most revered saints in the Catholic world, have been inspired by literary sources, which described the Saint as either naturally corpulent or with a swollen abdomen due to dropsy (i.e. fluid accumulation in the body cavities). Even recent attempts to reconstruct the face of the Saint have yielded discordant results regarding his outward appearance. To address questions about the real appearance of St Anthony, we applied body mass estimation equations to the osteometric measurements taken in 1981, during the public recognition of the Saint's skeletal remains. Both the biomechanical and the morphometric approach were employed to solve some intrinsic limitations in the equations for body mass estimation from skeletal remains. The estimated body mass was used to assess the physique of the Saint with the body mass index. The outcomes of this investigation reveal interesting information about the body type of the Saint throughout his lifetime.

The "thirsty dropsy": Early descriptions in medical and non-medical authors of thirst as symptom of chronic heart failure.

BACKGROUND: Patients with chronic heart failure may suffer from severe thirst, even if mechanisms that cause thirst in subjects affected by this condition are not clear. Medical and non-medical authors may have already recognized this symptom during the classical age. METHODS: We analyzed association between thirst and dropsy (an ancient medical term used to indicate different conditions including chronic heart failure) in past medical and non-medical literature. RESULTS: Hippocrates and Celsus first recognized thirst as a symptom of dropsy in the classical age. Greco-Roman intellectuals (Polybius, Ovid, Horace) and theologians belonging to the first years of the Christian era (Augustine, Caesarius, Gregory I) showed to know that dropsy people were often thirsty. These authors also influenced medieval poets and writers, including Dante Alighieri. In the Renaissance, the physician and alchemist Paracelsus again evidenced this symptom and the iatrochemist Robert Fludd tried to explain pathophysiology of dropsy, basing on thirst. CONCLUSIONS: The relationship between thirst and dropsy was well known by physicians and intellectuals in the classical age and in the first years of the Christian era, so influencing the Renaissance physicians.

Análisis de la enfermedad dermatológica en 8 Cantigas de Santa María del Rey Alfonso X el Sabio. Parte II: mutilación genital, escrofulodermia, sarna, erisipela y los males del Rey Alfonso / Dermatologic Diseases in 8 of the Cantigas of Holy Mary of Alfonso X the Learned. Part 2: Genital Mutilation, Scrofuloderma, Scabies, Erysipelas, and the Ailments of the King

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Pharmacology in a Cup of Coffee The Virtue of Coffee and Vitamins Learned from the History of Scurvy and Dropsy.

Scurvy, a vitamin C deficiency, was rampant during the age of discovery in Europe. In the mid-17th century, "Pasqua Rosée," the first coffee house in London, put an ad in the newspaper "Publick Adviser" clearly stating, "It (coffee) is excellent to prevent and cure dropsy, gout, and scurvy." A Netherlands trade merchant carried the information to Nagasaki, Japan, along with coffee beans harvested in the Netherlands' new territory, Java Island. A Japanese physician in Nagasaki, Dr. Kai Hirokawa, translated the information into Japanese in his new book, "Dutch Medicines," published in 1803. According to the ancient documents stored in Wakkanai City, Japan, the coffee beans were distributed to Tsugaru Clan soldiers who were guarding the northern coastline from 1855 to 1856. The purpose of the distribution was the prevention of scurvy and dropsy. As the result, none of the soldiers died from scurvy during the winter of 1855-1856. This paper discusses the pharmacological relationship between coffee micronutrients and vitamin deficiency syndrome.

[Individual response to treatment: from Withering to contemporary medicine]. / La risposta individuale ai trattamenti. Da Withering alla medicina di oggi.

This is an essay dealing with the 1785 cohort study by William Withering (the "account"), in which he reported the results of the treatment with foxglove (Digitalis purpurea) in 163 patients suffering from various forms of hydropsy (water retention). Withering reported the results of all patients, and classified them into responders and non-responders. He identified the responders as suffering from heart failure. In the 18th century, medical treatments were judged as successful if they complied with the criteria a priori of the theory of the four humors, and not on the patient's response to the treatment. Withering was the first not only to compare the patient's conditions before and after treatment, but also to identify the individual clinical characteristics of the patients who responded. In modern medicine, drugs are released on the market and approved for use after what is known as "population-derived clinical research", principally randomized controlled trials, and guidelines. More than 200 years ago, Withering anticipated the current and growing trend towards individual responses to treatment, and personalized medicine.

[Quincke and his oedema]. / Quincke en zijn oedeem.

Heinrich Irenaeus Quincke (1842-1922), the son of a physician, was born in Frankfurt but was educated in Berlin where he also completed his medical studies in 1864. After a 'grand tour' that took him to Paris, Vienna and London, he was trained in Berlin, first in surgery and later in internal medicine, under Von Frerichs (1819-1885). In 1878, he became a professor of internal medicine in Berne; from 1883 he held the chair of medicine in Kiel, which he would hold for the next 30 years. In 1882, he published a synthesis of several observations of 'acute, circumscribed oedema of the skin'. Quincke accurately described the clinical features and distinguished the familial from the sporadic forms. He was correct in attributing the condition to increased vascular permeability, but he surmised the causal factors were neurogenic rather than humoral, according to current insights (excess of bradykinin due to external factors or hereditary deficiency of C1-esterase inhibitor). Quincke not only contributed to several other clinical observations, but also pioneered the lumbar puncture, initially not for diagnostic purposes, but to relieve headache in hydrocephalic children.

Henri-Francois Secretan (1856-1916) and his syndrome.

Henri-François Secretan (1856-1916) was a Swiss physician, who in 1901 described a medical condition characterized by a hard, sometimes cyanotic oedema (Charcot's blue oedema) on the back of one or both hands and forearms. This condition was later known as Secretan's disease or Secretan's syndrome. This report discusses Henri Secretan and the syndrome that bears his name.

[The medical history and the death cause of Young-Jo based on the Seungjeongwon Ilgi : royal secretariat logs)].

Young-Jo, 83 years old, was the longest lived king of the Chosun Dynasty. Seungjeongwon Ilgi gives more detail about the diseases and prescriptions of Young-Jo. We could close look at what the Annals of the Chosun Dynasty just described that king received medical attention. In inspecting Jung-Jo`s constitution, to examine his medical history is very important. Yong-jo had a weak constitution, but he was always concerned about health care. Youn-jo complained of colic syndrom and heart fire when young; ascris and shoulder pain since middle age; severe fatigue and gait disturbance caused by edema in his latter years. During his last 20 years, he had taken and resorted to Ken-GongTang, the reason was not psychological disposion, but physical disease. Also, Yong-Jo's condition just before death could be assumed in Seungjeongwon Ilgi and Jonhyeongak Ilgi. According to continuous complaints such as edema of the lower limbs, faint(lethargy) and eating disorder caused by abnormal rising of GI (anorexia), we could presume that the cause of death was uremia. In addition, it has significance to correct feasible misconceaption about the cause of death grounded on The Annals of the Chosun Dynasty.

The Medical History and the Death Cause of Young-Jo Based on the Seungjeongwon Ilgi (Royal Secretariat Logs) / 의사학

Young-Jo, 83 years old, was the longest lived king of the Chosun Dynasty. Seungjeongwon Ilgi gives more detail about the diseases and prescriptions of Young-Jo. We could close look at what the Annals of the Chosun Dynasty just described that king received medical attention. In inspecting Jung-Jo's constitution, to examine his medical history is very important. Yong-jo had a weak constitution, but he was always concerned about health care. Youn-jo complained of colic syndrom and heart fire when young; ascris and shoulder pain since middle age; severe fatigue and gait disturbance caused by edema in his latter years. During his last 20 years, he had taken and resorted to Ken-GongTang, the reason was not psychological disposion, but physical disease. Also, Yong-Jo's condition just before death could be assumed in Seungjeongwon Ilgi and Jonhyeongak Ilgi. According to continuous complaints such as edema of the lower limbs, faint(lethargy) and eating disorder caused by abnormal rising of GI (anorexia), we could presume that the cause of death was uremia. In addition, it has significance to correct feasible misconceaption about the cause of death grounded on The Annals of the Chosun Dynasty.

The death of Wolfgang Amadeus Mozart: an epidemiologic perspective.

The early death of the composer Wolfgang Amadeus Mozart on 5 December 1791 has fascinated the world for more than 2 centuries. It has been suggested that his final illness was caused by poisoning, renal failure, Henoch-Schönlein purpura, trichinosis, and many other conditions. The official daily register of deaths in Mozart's Vienna was evaluated to provide an epidemiologic framework into which the observations of contemporary witnesses of his death can be integrated. All recorded deaths in Vienna during November and December 1791 and January 1792 were analyzed, together with the corresponding periods in 1790 to 1791 and 1792 to 1793. The deaths of 5011 adults (3442 men, 1569 women) were recorded over these periods. The mean ages of death were 45.5 years (SD, 18.5) for men and 54.5 years (SD, 19.9) for women. Tuberculosis and related conditions accounted for the highest number of deaths; cachexia and malnutrition ranked second, and edema was the third most common cause. According to eyewitness accounts, the hallmark of Mozart's final disease was severe edema. Deaths from edema were markedly increased among younger men in the weeks surrounding Mozart's death compared with the previous and following years. This minor epidemic may have originated in the military hospital. Our analysis is consistent with Mozart's last illness and death being due to a streptococcal infection leading to an acute nephritic syndrome caused by poststreptococcal glomerulonephritis. Scarlet fever, which represents the same underlying disease from an etiologic perspective, is a less likely possibility.

The hands of John Snow: clue to his untimely death?

The accomplishments of John Snow (1813-1858), physician-epidemiologist, inventor and anaesthetist to Queen Victoria, are well documented, but the causes of his untimely death at age 45 remain conjectural. Snow suffered a paralysing stroke while working on his magnum opus, On Chloroform and Other Anaesthetics, and died a few days later on 16 June 1858. Snow had a history of renal problems associated with tuberculosis. He also experimented on himself with ether, chloroform and other agents over several years, but whether this prolonged self-experimentation contributed to his early death is uncertain. A photograph of Snow taken in 1857 shows that the fingers of his right hand were swollen. Could this be a clue to the cause of his death? The "modern" view is that Snow's early tuberculosis and associated renal disease led to hypertension, chronic renal failure and stroke. The tuberculosis and renal involvement may have been worsened by vegetarianism and perhaps resulting vitamin D deficiency. However, the renal damage caused by tuberculosis is unlikely to have been progressive. Based on current evidence of renal toxicity associated with exposure to anaesthetic agents, it is perhaps more likely that extensive and prolonged self-experimentation with anaesthetics over a 9-year period led to Snow's renal failure, swollen fingers and early death from stroke.