Alexandra General Hospital in Athens: Historical Connections to the Greek Royal Family.

Princess Alexandra of Greece (1870-1891), the eldest daughter of King George I of Greece (1845-1913), was known as the "beloved daughter of the Athenians". Her death at the age of 21 in 1891 due to a pregnancy complication caused nationwide grief. To honour her, the Alexandra Maternity Hospital in Athens was named in her memory. Affiliated with the University of Athens, Alexandra Maternity Hospital researches pregnancy and newborn care, including complications and maternal mortality. Today, the hospital contains various clinical and laboratory departments providing patients with exceptional health care.

Controversies and lessons from the history of smallpox: the case of massive vaccination in British Corfu (1852).

The study presents an anti-vaccination action in the 19th century involving both scientific and political motivation. The research is based on an unpublished archive, namely the registries of the British Executive Police during the massive vaccination campaign in Corfu, the capital of the British possession in the Ionian Islands-Greece (1815-1864), after the smallpox outbreak of 1852. The archival material provides information about the number of vaccinated people, namely their sex, age, nationality, the year of the previous vaccination, along with the last year when a citizen "had smallpox". The records indicated 40,858 citizens and of these, a total 21,845 (53.46%) were vaccinated. Despite the impressive organization, the vaccination project caused a great controversy at both the scientific and political level between the British authorities and the Greek Ionian Assembly. The archival material gives a diachronic message in the fields of public health, infectious disease control, and health crisis management. The lack of control by a State or local authority, combined with political instability and the public's ignorance or distrust of scientific matters, are the main factors behind the failure to prevent, restrict or eradicate infectious diseases even nowadays.

Milestones in the History of Pediatric Surgery During the Byzantine Times

During the Byzantine Times, medicine and surgery developed as Greek physicians continued to practice in Constantinople. Healing methods were common for both adults and children, and pediatrics as a medical specialty did not exist. Already Byzantine hospitals became institutions to dispense medical services, rather than shelters for the homeless, which included doctors and nurses for those who suffered from the disease. A major improvement in the status of hospitals as medical centers took place in this period, and physicians were called archiatroi. Several sources prove that archiatroi were still functioning in the late sixth century and long afterward, but now as xenon doctors. Patients were averse to surgery due to the incidence of complications. The hagiographical literature repeated allusions to doctors. Concerns about children with a surgical disease often led parents to seek miraculous healings achieved by Christian Protectors - Saints. This paper is focused on three eminent Byzantine physicians and surgeons, Oribasius, Aetius of Amida, Paul of Aegina, who dealt with pediatric operations and influenced the European Medicine for centuries to come. We studied historical and theological sources in order to present a comprehensive picture of the curative techniques used for pediatric surgical diseases during the Byzantine Times.

The Saint George Quarantine Station of Piraeus, Greece (1865-1947)

For centuries, the marine quarantine system was the major protection of the public health against serious infectious diseases around the world. The present study reconstructs the history of the Quarantine Station of Piraeus, one of the largest Mediterranean ports, known as the "Lazaretto of Saint George", as a vital element in the maritime sanitary protection of Greece. Our research will investigate the impact left by this institution on public health, as well as on the economic life of the port of Piraeus and the adjacent capital city of Athens. With regard to the first issue, we will seek to evaluate its role in relation to major outbreaks in the capital, as well as the arrival of 1.3 million Greek refugees after the Greco-Turkish War of 1922. The opening of Suez Canal (1865) was a great challenge and the institution was problematic at administrative and sanitary levels. During 20th century, the station complied with the national public health legislation and the international sanitary conventions. Until the Second World War, the Lazaretto of Saint George played a key role in both the protection of public health in general, but also in the economic and industrial progress of Piraeus and Athens.

The Knights Hospitaller of Rhodes and the Black Death of 1498: a poetic description of the plague.

The study is a presentation of the sole written testimony of the great plague epidemic that struck the island of Rhodes in 1498, at the time when the Order of the Knights of St. John was settled there. The Greek poem "The Thanatikon (i.e., plague) of Rhodes", which was written by Emmanuel Georgillas Limenitis in the late 15th century and recounts the terrible events of the epidemic, was used as a source of information. Among the 644 verses of the poem, elements like the place, time, duration and how the epidemic spread can be identified. Within the historical context of the era, evaluation and analysis of the data reveal the correlation between human activities and the physical history of the disease in the Mediterranean during the 15th century. The Plague of Rhodes confirms the value of non-medical sources in the medico-historical and historico-epidemiological study of the evolution of the disease caused by Yersinia pestis while highlighting an enduring intrinsic weakness of surveillance systems. Despite modern means of epidemiological surveillance, the risk of relaxation of a health system after a long period of absence of an infectious disease constitutes a major factor for future resurgence of the specific disease.

Medical and Social Aspects of Syphilis in the Balkans from the mid-19th Century to the Interwar.

The current study presents some aspects of syphilis in the Balkan Peninsula from the 19th century until the Interwar. Ever since the birth of modern Balkan States (Greece, Bulgaria, Turkey and Serbia), urbanization, poverty and the frequent wars have been considered the major factors conducive to the spread of syphilis. The measures against sex work and sexually transmitted diseases (STDs) were taken in two aspects, one medical and the other legislative. In this period, numerous hospitals for venereal diseases were established in the Balkan countries. In line with the international diagnostic approach and therapeutic standards, laboratory examinations in these Balkan hospitals included spirochete examination, Wassermann reaction, precipitation reaction and cerebrospinal fluid examination. Despite the strict legislation and the adoption of relevant laws against illegal sex work, public health services were unable to curb the spread of syphilis. Medical and social factors such as poverty, citizen's ignorance of STDs, misguided medical perceptions, lack of sanitary control of prostitution and epidemiological studies, are highlighted in this study. These factors were the major causes that helped syphilis spread in the Balkan countries during the 19th and early 20th century. The value of these aspects as a historic paradigm is diachronic. Failure to comply with the laws and the dysfunction of public services during periods of war or socioeconomic crises are both factors facilitating the spread of STDs.

Milestones in the history of diabetes mellitus: The main contributors.

Diabetes mellitus is a group of metabolic diseases involving carbohydrate, lipid, and protein metabolism. It is characterized by persistent hyperglycemia which results from defects in insulin secretion, or action or both. Diabetes mellitus has been known since antiquity. Descriptions have been found in the Egyptian papyri, in ancient Indian and Chinese medical literature, as well as, in the work of ancient Greek and Arab physicians. In the 2(nd) century AD Aretaeus of Cappadocia provided the first accurate description of diabetes, coining the term diabetes, while in 17(th) century Thomas Willis added the term mellitus to the disease, in an attempt to describe the extremely sweet taste of the urine. The important work of the 19(th) century French physiologist Claude Bernard, on the glycogenic action of the liver, paved the way for further progress in the study of the disease. In 1889, Oskar Minkowski and Joseph von Mering performed their famous experiment of removing the pancreas from a dog and producing severe and fatal diabetes. In 1921, Frederick Banting and Charles Best extended Minkowski's and Mering's experiment. They isolated insulin from pancreatic islets and administrated to patients suffering from type 1 diabetes, saving thus the lives of millions and inaugurating a new era in diabetes treatment.

Jean-Baptiste de Sénac's (1693-1770) Important Work on Cardiology and Valvular Disorders.

In the 18(th) century clinical cardiology was based on pulse examination and auscultation by placing the ear directly on the patient's chest, while diagnosis of heart diseases was done in postmortem examination. In 1749, Jean-Baptiste de Sénac, physician of King Louis XV, published his work on the heart Traité de la structure du coeur, de son action et de ses maladies. It was the result of years of anatomical and physiological study, in an attempt to illuminate heart and its functions. Sénac recognized among several heart disorders, aortic regurgitation, mitral calcification, and mitral regurgitation. His work remained a landmark in valvular pathology and cardiology until the early 19(th) century.

The "Endura" of The Cathars' Heresy: Medieval Concept of Ritual Euthanasia or Suicide?

The aim of the study is to explore the medieval concepts on the voluntary death of severely sick people, as they emerge through the endura (endurance) of the heresy of the Cathars in France (twelfth to fourteenth centuries). The endura was the prerequisite act of repentance that would allow the fallen soul to return to heaven. The endura was a necessary act of repentance, after the performance of a ceremonial purification of the soul (consolamentum), and consisted of the patients' voluntary abstention from vital food. The consolamentum and endura could be performed in the final stage of a disease with the consent of the patients or their relatives. The role of the Cathar physician was only to determine the severity of the disease and the forthcoming death of the patient. The physician was not allowed to take steps that would deprive the life of the patient, and the performance of the ritual endura was duty of the spiritual leaders of the community. The modern ethical approach to this subject is dictated by the medieval belief on the salvation of the soul and tries to answer the question of whether the endura could be seen as a medieval concept of a ritual euthanasia or fell within the theological sin of suicide.

Lord Byron's death: a case of late malarial relapse?

The study examines the pathological circumstances related to Byron's death, the primary issue being malaria. Lord Byron died during the Greek War of Independence against the Ottoman Empire, in Messolonghi on 19 April 1824. Byron's medical profile consists of recurrent onsets of fever, which gave rise to the issue of malaria relapses. According to Byron's letters he reported crises of fever in Greece (1810), Malta (1811), Italy (1817-1819) and England. Evidence from Byron's autopsy, specifically the absence of hepatosplenomegaly, does not support a hypothetical diagnosis of malaria. Nonetheless, the relapsing fevers cannot be ignored and the same applies to the possibility of malaria relapse or re-infection in line with the endemic nature of the Messolonghi area. Our research on the chronologies of Byron's reported fevers found that new attacks occurred at intervals of 540 days on average. Moreover, the most outstanding feature of Plasmodium vivax and Plasmodium ovale is their ability to form dormant forms of hypnozoites in the liver which, when reactivated (110-777 days), cause true relapses of clinical disease. Of course, an ex post facto diagnosis is under debate, because the diagnosis is not clinical but microscopic. Byron's example raises alarm over a current medical problem, i.e. the diagnosis of unexplained fevers, and the need for a detailed travel or immigration history, which will include malaria in the differential diagnosis.

The first case of pagophagia: the Byzantine Emperor Theophilus.

The Byzantine Emperor Theophilus (829-842 AD) died from dysentery, the exact nature of which is unknown. However, based on the original Greek texts of the Byzantine historians and chroniclers of that era, the possible cause of death may be connected to Theophilus' pagophagia (snow eating), in order to relieve the symptoms of gastric inflammation. Additionally to the symptoms from the gastro-intestinal system, the Emperor seemed suffering from depress after the defeat of his army and the loss of territories, among whom his native town, Amorion. The current study supports the theoretical possibility that the case of pagophagia in the 9th century AD, so well described by a great number of historians because of the sufferer's royal identity, extends in the past the knowledge on pica, still attracting the medical interest.

Dromokaition Psychiatric Hospital of Athens: from its establishment in 1887 to the era of deinstitutionalization.

Dromokaition Psychiatric Hospital opened its doors in 1887, following the donation made by Zorzis Dromokaitis from the island of Chios. Private donations and all forms of charities had contributed to a large extent in the establishment of hospitals across Greece, during the late 19th and the early 20th century. Dromokaition was one of them but it was also unique, as it was the first psychiatric hospital in Athens, admitting patients from every part of the country. This paper aimed at highlighting the long service of the institution through the different historical periods the country went through. We present the chronicle of its foundation, the development of its inner structure, and the medical and organizational influences which it received, along the way. The therapeutic methods used during the first decades of its operation reflected the corresponding European standards of the time. As a model institution from its foundation, it followed closely the prevailing European guidelines, throughout its historical path, either as an independent institution or as an integrated one within the National Health Service.

The anatomical knowledge of Joaquín Albarrán (1860-1912).

Joaquín Maria Albarrán (1860-1912) is broadly known as a brilliant mind and a pioneer of modern urology, in spite of his short life. Born in Cuba and being early an orphan, he was sent to Barcelona to study Medicine. Graduate at the age of seventeen, he continued his studies in Paris, where he was trained in surgery and urology, and spent the rest of his life having an extraordinary career as urology surgeon, chief of the Urology Department in Necker Hospital and professor at Paris Faculty of Medicine. Since his first studies, he had been passionate with anatomy, histology, pathology and microbiology and embodied in his books, today considered as classics, a great amount of the special knowledge he had for these fields and the most accurate descriptions of the operative techniques for the urinary tract system.

Biological Warfare Plan in the 17th Century­the Siege of Candia, 1648­1669.

A little-known effort to conduct biological warfare occurred during the 17th century. The incident transpired during the Venetian­Ottoman War, when the city of Candia (now Heraklion, Greece) was under siege by the Ottomans (1648­1669). The data we describe, obtained from the Archives of the Venetian State, are related to an operation organized by the Venetian Intelligence Services, which aimed at lifting the siege by infecting the Ottoman soldiers with plague by attacking them with a liquid made from the spleens and buboes of plague victims. Although the plan was perfectly organized, and the deadly mixture was ready to use, the attack was ultimately never carried out. The conception and the detailed cynical planning of the attack on Candia illustrate a dangerous way of thinking about the use of biological weapons and the absence of reservations when potential users, within their religious framework, cast their enemies as undeserving of humanitarian consideration.

The impact of ancient Greek medicine in India: the birth of Unani medicine.

BACKGROUND: Unani Medicine, also called "Unani-tibb", has a long and impressive record in India based on the grecoarabic medicine and teachings of Hippocrates, Galen and Arab physicians. Its main principle is the maintenance of equilibrium among the various aspects of the body, made up of four elements, different temperaments, simple and compound organs, and four humours. METHODS: The main bibliographic sources concerning the impact of ancient Greek medicine in India and the principles of Unani Medicine have been investigated and analysed. RESULTS: The assimilation of Hippocratic principles in a country with a different philosophy and worldview was successful. The ancient Greek medical system enriched with local elements encountered a large response to the Indian people and to the physicians. CONCLUSION: Nowadays Unani medicine is not only popular in India where several Unani practitioners are registered but it enjoys a worldwide upsurge of interest.

The Medical Vestment and Surgical Instruments of Saint Cosmas and Damian on Sinai Icons From the Seventh to the Eighteenth Century.

The iconography of the doctor saints Cosmas and Damian and the artistic representations of their miracles are important sources for the history of medicine. Within the sphere of physician-saints, Cosmas and Damian have the greatest number of iconographic depictions in Byzantine and Post-Byzantine art. In most of their representations, they wear long robes as a sort of professional mantles and carry surgical instruments and boxes indicating their status as doctors. The progress of Byzantine surgery could be attested by these objects, some of them mentioned in collections of miracle stories and documented in medical sources.

Health care for refugee children during the Greek Civil War (1946-1949).

This paper focuses on physical and psychological traumas of children during and after the Greek Civil War (1946-1949). There were two evacuation programmes: one organised by the Greek Communist Party to seven countries of Eastern Europe and the other by the Greek government and Queen Frederica to children's homes (paidopoleis) in the country. The paper also argues that Greek refugee children experienced war terror and violence, voluntary or forced separation from their families, and institutionalisation for a shorter or longer time, and that both sides sought to provide shelter, food, medical treatment, and psychological support to the victims.

The Venetian lazarettos of Candia and the Great Plague (1592 - 1595).

The present study highlights the history of lazarettos in Candia (modern Heraklion, Crete, Greece), which was the most important Venetian possession in the Mediterranean at the time, while at the same time it recounts the terrible plague which went down in history as the Great Plague of Candia (1592-1595). The study will also attempt to give a satisfactory answer to the epidemiological questions raised by the worst epidemic that Crete had experienced since the era of the Black Death in the 14th century. The city was about to lose more than a half of its population (51.3%), although it was saved from complete annihilation by the composure, courage and inventiveness of its Venetian commander, Filippo Pasqualigo, whose report to the Venetian Senate makes an invaluable source of information regarding the events of this dramatic period. Candia would also witness the emergence of typical human reactions in cases of epidemics and mass deaths, such as running away along with the feeling of self-preservation, dissolute life and ephemeral pleasures, as well as lawlessness and criminality. The lazaretto proved inefficient in the face of a disaster of such scale, whereas the epidemic functioned as a "crash-test" for the Venetian health system. Eventually, in an era when the microbial nature of the disease was unknown, it seems that it was practically impossible to handle emergency situations of large-scale epidemics successfully, despite strict laws and well-organized precautionary health systems.

Queen Cleopatra and the other 'Cleopatras': their medical legacy.

Cleopatra is a female figure widespread in Greece (especially in Macedonian territory), Egypt and Syria during the Hellenistic era. Ancient women doctors bearing the name Cleopatra have been identified by a systematic search through the ancient Greek, Latin and Egyptian bibliography, including original resources from the first century BC. Fictional and non-fictional figures have been distinguished and their works identified. Queen Cleopatra of Egypt, Galen's physician assistant, the outcast Metrodora, Cleopatra the Alchemist and Cleopatra the Gynaecologist deliver a story of medicine and name-giving that confuses researchers of the past and intrigues those of the present.