The invention of gonioscopy by Alexios Trantas and his contribution to ophthalmology.

Gonioscopy is a technique used to examine structures in the anterior chamber angle (the fluid filled space inside the eye between the iris and the innermost layer of the cornea, the endothelium). It is an essential tool in ophthalmic practice, particularly in the diagnosis of glaucoma. In 1899, the Greek ophthalmologist Alexios Trantas was the first to visualise the angle in vivo and coined the term 'gonioscopy'. He made a number of other important contributions to ophthalmology.

″I will not cut, even for the stone″: origins of urology in the Hippocratic Collection.

The Hippocratic Collection, including the most of ancient Greek medicine, remains still interesting, despite the recent advances that transformed definitely the urological healing methods. Considering the patient as a unique psycho-somatic entity and avoiding high risk surgical manipulations were the leading principles dictating the everyday practice. Contemporary physicians can still learn from the clinical observations in times of complete absence of laboratory or imaging aid, from the prognostic thoughts, the ethics, and the philosophical concepts, represented by the Hippocratic writings, tracing into them the roots of Rational Medicine in general and Urology in particular.

History of leucotomies in Greece.

In order to present the social, scientific and institutional context which permitted the use of leucotomies in Greece, we have reviewed the Archives of the Medical Associations, the medical literature of the years 1946-56, a reader's dissertation and the memoirs of two psychiatrists. More than 250 leucotomies were done in the two public psychiatric hospitals in Athens from 1947 to 1954, as well as 40 leucotomies in the public psychiatric hospital in Thessaloniki. Although aware of the side effects, psychiatrists justified the use of the procedure. The performance of leucotomies in Greece declined because of reports of the dangers of the operation and its unpredictable outcome for the patients, but mainly because of the encouraging results with psychotropic drugs in the early 1950s.

“I will not cut, even for the stone”: origins of urology in the hippocratic collection

The Hippocratic Collection, including the most of ancient Greek medicine, remains still interesting, despite the recent advances that transformed definitely the urological healing methods. Considering the patient as a unique psycho-somatic entity and avoiding high risk surgical manipulations were the leading principles dictating the everyday practice. Contemporary physicians can still learn from the clinical observations in times of complete absence of laboratory or imaging aid, from the prognostic thoughts, the ethics, and the philosophical concepts, represented by the Hippocratic writings, tracing into them the roots of Rational Medicine in general and Urology in particular.

Holy fools: a religious phenomenon of extreme behaviour.

Monks in Byzantine times (330-1453 AD) often expressed their faith with extreme manifestations of behaviour, such as living on a high column (stylites), on a tree (dendrites) or in crowded urban centres of the empire pretending to be fools for Christ's sake. These Holy Fools exposed themselves to the ridicule and the mistreatment of the citizens, being protected, however, by their state of insanity to mock and violate moral codes and social conventions. The official Church barely tolerated these religious attitudes as promoting deviations from standard orthodoxy, and the Quinisext Ecumenical Council (592 AD) judged them as dangerous and formally denounced the phenomenon. The two most famous of them in Byzantium were Symeon of Emesa and Andrew of Constantinople, whose lives constitute unique testimonies to insanity and the simulation thereof. The survival and transplantation of the Holy Fools in Russia, called "yurodivye", where they met widespread acceptance, confirm their appeal in specific geographic areas and their endurance over time. We attempt to approach the symbolism of holy lunacy and to analyse the personality trends of these "eccentric" saints.

Penile representations in ancient Greek art.

OBJECTIVES: The presentation of the cult of phallus in ancient Greece and the artistic appearance of the phenomenon on vase figures and statues, as indicative of the significant role of the male genitalia in all fertility ceremonies. METHODS: The examination of a great number of penile representations from the ancient Greek pottery and sculpture and the review of the ancient theater plays (satiric dramas and comedies ). RESULTS: Phallus in artistic representation is connected either with gods of fertility, such as the goat-footed and horned Pan or the ugly dwarf Priapus or the semi-animal nailed figures Satyrs, devotees of the god Dionysus accompanying him in all ritual orgiastic celebrations. Phallus also symbolizes good luck, health and sexuality: people bear or wear artificial phalli exactly like the actors as part of their costume or carry huge penises during the festive ritual processions. On the contrary, the Olympic gods or the ordinary mortals are not imaged ithyphallic; the ideal type of male beauty epitomized in classical sculpture, normally depicts genitals of average or less than average size. It is noteworthy that many of these images belong to athletes during or immediately after hard exercise with the penis shrunk. The normal size genitalia may have been simply a convention to distinguish normal people from the gods of sexuality and fertility, protectors of the reproductive process of Nature. CONCLUSIONS: The representation of the over-sized and erected genitalia on vase figures or statues of ancient Greek art is related to fertility gods such as Priapus, Pan and Satyrs and there is strong evidence that imagination and legend were replacing the scientific achievements in the field of erectile function for many centuries.

Suicidal behaviour in the ancient Greek and Roman world.

OBJECTIVE: We attempt to present and analyze suicidal behaviour in the ancient Greek and Roman world. METHODS: Drawing information from ancient Greek and Latin sources (History, Philosophy, Medicine, Literature, Visual Arts) we aim to point out psychological and social aspects of suicidal behaviour in antiquity. RESULTS: The shocking exposition of suicides reveals the zeitgeist of each era and illustrates the prevailing concepts. Social and legal reactions appear ambivalent, as they can oscillate from acceptance and interpretation of the act to punishment. In the history of these attitudes, we can observe continuities and breaches, reserving a special place in cases of mental disease. The delayed emergence of a generally accepted term for the voluntary exit from life (the term suicidium established during the 17th century), is connected to reactions triggered by the act of suicide than to the frequency and the extent of the phenomenon. CONCLUSIONS: The social environment of the person, who voluntary ends his life usually dictates the behaviour and historical evidence confirms the phenomenon.

Representaciones fálicas en el arte griego antiguo / Penile representations in ancient Greek art

OBJETIVO: La presentación del culto del falo en la Grecia antigua y la aparición artística del fenómeno en figuras de ánforas y estatuas, como indicativo del papel significativo de los genitales masculinos en todas las ceremonias de fertilidad. MÉTODOS: La examinación de un gran número de representaciones fálicas en la cerámica y escultura griega antigua y la revisión de las antiguas obras teatrales (dramas satíricos y tragedias). RESULTADOS: El falo en las representaciones artísticas está conectado a los dioses de fertilidad, como Pan, el dios con pies de chivo y cuernos, o el enano feo Príapo, o los Sátiros, figuras con uñas parecidas a las de los animales, devotos del dios Dioniso que lo acompañan en todas las celebraciones rituales orgiásticas. El falo también simboliza la buena suerte, la salud y la sexualidad: la gente se pone falos artificiales exactamente como los actores, como parte de sus trajes, o lleva penes enormes durante las procesiones rituales festivas. Al contrario, los dioses del Olimpo o los mortales comunes no están representados como itifálicos; el tipo ideal de la belleza masculina resumida en la escultura clásica, normalmente representa genitales de tamaño mediano o aún más pequeño. Es notable que muchas de estas imágenes pertenecen a atletas durante o inmediatamente después de ejercicios duros con el pene reducido. Quizás los genitales de tamaño regular hayan sido sencillamente una convención para distinguir entre la gente común y los dioses de sexualidad y fertilidad, protectores del proceso reproductivo de la naturaleza. CONCLUSIONES: La representación de genitales de gran tamaño o en erección en figuras de ánforas y estatuas en el arte griego antiguo está relacionada con dioses de fertilidad como Príapo, Pan y los Sátiros, y existe una gran evidencia de que la imaginación y la leyenda estaban sustituyendo los logros científicos conseguidos durante muchos siglos en el campo de la función eréctil (AU)

OBJECTIVES: The presentation of the cult of phallus in ancient Greece and the artistic appearance of the phenomenon on vase figures and statues, as indicative of the significant role of the male genitalia in all fertility ceremonies. METHODS: The examination of a great number of penile representations from the ancient Greek pottery and sculpture and the review of the ancient theater plays (satiric dramas and comedies). RESULTS: Phallus in artistic representation is connected either with gods of fertility, such as the goat-footed and horned Pan or the ugly dwarf Priapus or the semi-animal nailed figures Satyrs, devotees of the god Dionysus accompanying him in all ritual orgiastic celebrations. Phallus also symbolizes good luck, health and sexuality: people bear or wear artificial phalli exactly like the actors as part of their costume or carry huge penises during the festive ritual processions. On the contrary, the Olympic gods or the ordinary mortals are not imaged ithyphallic; the ideal type of male beauty epitomized in classical sculpture, normally depicts genitals of average or less than average size. It is noteworthy that many of these images belong to athletes during or immediately after hard exercise with the penis shrunk. The normal size genitalia may have been simply a convention to distinguish normal people from the gods of sexuality and fertility, protectors of the reproductive process of Nature. CONCLUSIONS: The representation of the over-sized and erected genitalia on vase figures or statues of ancient Greek art is related to fertility gods such as Priapus, Pan and Satyrs and there is strong evidence that imagination and legend were replacing the scientific achievements in the field of erectile function for many centuries (AU)

Infectious disease control in the Ionian Islands during the British Protection (1815-1864).

This review presents the medical and social role of British military doctors in the formation of the British sanitary campaign in the Ionian Islands during the period 1815-1864. They were the core of a health system based on the old sanitary model of the Venetian Republic, which was the former ruler of the region. The British innovation and reorganisation of the old lazarettos (a quarantine system for maritime travellers), the new marine sanitary procedures, the determination of quarantine duration for major infectious diseases along with the introduction of the vaccination system resulted in a satisfactory defence against epidemics in Greece during the 19th century. The British military physicians applied and established West European medical ideas, as well as the principles of preventive medicine, for the first time in the Greek territory and this is a historical example of a successful sanitary campaign based on the experience of military physicians and their collaboration with civilian physicians.

[Mental disease in two classical music composers].

A study οn two neglected classical music composers suffering a not syphilitic mental disease, is attempted here, syphilis of the central nervous system being frequent in that time. A brief overview on the psychiatric ailments of many great composers reveals suicide attempts and more or less severe depression following external events. The issue of a possible relationship between mental disease and (musical) creativity can be discussed, as mood swings and a certain tendency to melancholia are frequent features of a talented brain (a fact that can also be detected in their works). The first case presented here is Hans Rott from Austria, the beloved student of Anton Bruckner, who was considered to be at least equal to his famous classmate Gustav Mahler. The great expectations of his teacher and his friends suddenly came to an end, when he suffered a crisis of schizophrenia and was hospitalized in an insane asylum in Lower Austria. The tragic psychiatric adventure of the young musician lasted almost four years. He was diagnosed as a case of "hallucinatory insanity" and "persecution mania" by the medical staff, before dying of tuberculosis, aged only 26, and having completed only one symphony and several smaller works. His name came again on surface only a century after his death, when in 1989 his Symphony in E Major was discovered and premiered with great success, permitting to its creator a posthumous recognition, among Bruckner and Mahler. The second case of mental illness is that of the Armenian Komitas Vardapet. He was an orphan who grew up in theological schools and became a monk and later a priest, though he spent some years in Berlin in order to develop his musical skills. He is considered to be an authority of Armenian ecclesiastic music, introducing polyphony in the Armenian Church's music and collecting numerous traditional songs from all parts of Armenia. In 1915, during the Armenian genocide he was deported, tortured but finally saved, due to interventions of influential friends and politicians. His mental health was destabilized and he spent almost 20 years in psychiatric hospitals in France. He never recovered from a mental disease, whose cause is still debated, as some researchers do not admit its schizophrenic character and consider it as a severe post traumatic syndrome. The issue of a mental disease in relation to artistic creation is discussed, especially concerning biographies and mental diseases of these two gifted but strangely forgotten music composers.

Epidemic waves during Justinian's plague in the Byzantine Empire (6th-8th c. AD).

The aim of the present study is to collect the epidemic outbreaks and the epidemic waves of the bubonic plague of the Byzantine Empire during the first pandemic (541-751 AD). Human activities, such as trade and military movements have been speculated as underlying factors for the causation of the pandemic. Historical data combined with geographical spreading of the plague, allows an alternative speculation of suspicious enzootic areas in the Middle East. We conclude that the possible existence of enzootic areas in that region might have been responsible for the causation of the numerous outbreaks of the bubonic plague in the Eastern provinces of the Byzantine Empire during the 6th-8th century period.

The three last years of Manuel II Palaeologus' reign between two stroke attacks: aphasia or not?

The authors attempt to solve the enigma about the possible aphasia of the Byzantine Emperor Manuel II Palaeologus (1391-1425) in the 3-year period between his first and his second and fatal stroke. The texts of historians and chroniclers reveal that Manuel remained semi-paralyzed at bed and his motor disability alienated him from the state affairs and condemned him to isolation from all embassies and contact with others, except his family. Only the funeral oration of the Bishop Bessarion raises the suspicion of a speechless emperor. All testimonies referring to this infirmity are examined.

The lack of a child, the loss of a throne: the infertility of the first royal couple of Greece (1833-62).

The first dynasty in Greece after its independence in 1830 was founded in 1833 with Otto, the son of Ludwig I of Bavaria. In 1836 Otto married Amalia, the daughter of the Grand Duke of Oldenburg. The people of Greece anticipated that the marriage would result in an heir to the throne, establishing the new dynasty. The failure of the royal couple to produce an heir was a major reason for their subsequent abdication. For many years both were subjected to repeated examinations by Greek and German physicians, especially Amalia, who was considered to be largely responsible for the infertility. In this paper we discuss possible diagnoses and describe the various treatments suggested for, and applied to, the infertility. We also review the consequent political controversies and the problems created among the royal families of Europe who wanted to replace the Wittelsbach dynasty with another royal line--a situation that led, in 1863, to the succession of the Danish Schleswig-Holstein-Sonderburg-Glücksburg dynasty to the Greek throne.

Historical consequences of the infertility of Otto (1815-67) and Amelia (1818-75), first Royal couple of Greece.

After the Greek Independence (1830), the first King, Otto from the Wittelsbach dynasty (Bayer), was married to Amelia from the House of Oldenburg (1836). Their failure to produce an heir to the throne, eagerly expected by the people, contributed much to their abdication in 1862, as an additional factor at the general, opposition to their way of governing. The responsibility for the couples sterility became a matter of political controversies among their families, their countries and the other European thrones after the unsuccessful medical diagnoses and treatments of the most eminent Greek and German physicians. This paper examines their failure to continue the throne, the medical circumstances, and the historical and political consequences.

Urological diseases of the Byzantine emperors (330-1453).

OBJECTIVES: To offer historical evidence of Byzantine urology and the variety of operations or other healing techniques as applied on the selected group of the Emperors who presented with diseases of the kidney and the urinary tract. METHODS: The health problems of all 87 Byzantine Emperors have been reviewed and focus has been made on the urological diseases, followed by an analysis of the diagnostic and therapeutic processes. RESULTS: Byzantine medicine is the heir of the Ancient Greek and Roman scientific knowledge, enriched by the personal experience of the physicians of the era and the evolution in anatomic researches. In the field of urology, various operative techniques were applied and the surgeons attempted to cure problems of the bladder, urethra, and external genitalia, aiming to restore the health of the State leader. The healing methods applied to the urological problems of the Emperors represent the highest level of this branch of Byzantine surgery, because the best quality of surgeons performed their profession in the capital of the Empire, Constantinople, and were also responsible for the health of the Royal Family. The descriptions of all of these well-known diseases of the urological system and their therapies are contained in the extended compilations of the medical authors of the era, and historical and other nonmedical sources complete the panoramic view of Byzantine urology. CONCLUSIONS: The diagnosis and the healing methods for the urological diseases of the Emperors represent the general level of Byzantine Surgery and especially of urology, as well as the anatomic knowledge of the genital and the urological systems.

Anton van Leeuwenhoek (1632-1723): father of micromorphology and discoverer of spermatozoa.

The Dutch merchant and naturalist Anton van Leeuwenhoek is considered to be the father of optic microscopy and the precursor of bacteriology. Among others, he discovered and studied the spermatozoon.

Lycanthropy in Byzantine times (AD 330-1453).

In this paper, the original Greek language texts of the Byzantine medical literature about lycanthropy are reviewed. The transformation of a human being into a wolf and the adoption of animal-like behaviour, which were already known from mythology and had been presented in the scientific works of ancient Greek and Roman physicians, were examined by six Byzantine physicians and explained as a type of melancholic depression or mania. In spite of the influence of Byzantine medicine, its rationality in the interpretation of lycanthropy was forgotten in medieval and Renaissance times when it was replaced by explanations based on demonic possession and witchcraft. More recently psychiatry has treated the phenomenon as a subject of medical inquiry and has again explained the condition in terms of mental disorder.

[Theories and cures of the rheumatic diseases during the byzantine period (330-1453 a.D.)]. / Teorie e trattamento delle malattie reumatiche nel periodo bizantino (330-1453 d.C.).

Most Byzantine medical texts described the rheumatic diseases. The Byzantine physicians, based on the ancient Greek texts, explained the causes of rheumatic diseases, described their symptoms and proposed certain treatments. The Byzantine medical sources described various types of rheumatic diseases, as inflammatory arthritis, chronic deformans polyarthritis, and gout. As it can be concluded by the available medical sources, during the Byzantine period rheumatic diseases constituted a serious medical and social problem, representing a remarkable cause of disability, and this complaint was part of the epidemiological interest of the Byzantine physicians.

Nursing homes for the old ('Gerocomeia') in Byzantium (324-1453 AD).

BACKGROUND: Research into the welfare institutions for the elderly, which were established in the Byzantine Empire. OBJECTIVE: The purpose of the study is the research into the texts of the Byzantine chroniclers and the contemporary historical sources so as to determine the social policy of the Byzantine State regarding the homes for the aged. METHODS: The histories and chronicles of the Byzantine writers, written in the original Greek language, were studied and analysed, so as to locate the extracts in the texts concerning the interest shown by the Byzantine State to establish institutions for old and ailing people. RESULTS: The care for the elderly in Byzantium was undertaken in special infirmaries, called 'gerocomeia', which operated all over the empire mostly in or near the monasteries. All these nursing homes were highly esteemed and the governor of the institution seems to have been a person of high importance. The most important nursing home was located in Constantinople and was established by Emperor John II Comnenus in the 12th century in the famous monastery and hospital of the Pantocrator. CONCLUSION: The study and analysis of the historical texts of the Byzantine period (324-1453 AD) prove that human-oriented behaviour, which derived from the intervention of religion, contributed to the foundation of many welfare institutions for the elderly by the Byzantine emperors, the church and some individuals who showed great interest in them.