History and evolution of surgical treatment for spasticity: a journey from neurotomy to selective dorsal rhizotomy.

The evolution of neurosurgical approaches to spasticity spans centuries, marked by key milestones and innovative practitioners. Probable ancient descriptions of spasmodic conditions were first classified as spasticity in the 19th century through the interventions of Dr. William John Little on patients with cerebral palsy. The late 19th century witnessed pioneering efforts by surgeons such as Dr. Charles Loomis Dana, who explored neurotomies, and Dr. Charles Sherrington, who proposed dorsal rhizotomy to address spasticity. Dorsal rhizotomy rose to prominence under the expertise of Dr. Otfrid Foerster but saw a decline in the 1920s due to emerging alternative procedures and associated complications. The mid-20th century saw a shift toward myelotomy but the revival of dorsal rhizotomy under Dr. Claude Gros' selective approach and Dr. Marc Sindou's dorsal root entry zone (DREZ) lesioning. In the late 1970s, Dr. Victor Fasano introduced functional dorsal rhizotomy, incorporating electrophysiological evaluations. Dr. Warwick Peacock and Dr. Leila Arens further modified selective dorsal rhizotomy, focusing on approaches at the cauda equina level. Later, baclofen delivered intrathecally via an implanted programmable pump emerged as a promising alternative around the late 1980s, pioneered by Richard Penn and Jeffrey Kroin and then led by A. Leland Albright. Moreover, intraventricular baclofen has also been tried in this matter. The evolution of these neurosurgical interventions highlights the dynamic nature of medical progress, with each era building upon and refining the work of significant individuals, ultimately contributing to successful outcomes in the management of spasticity.

The History of Orthopedics in the Long Term: From General Medicine to Medical Specialties.

A thorough literature search was done in PubMed and Google Scholar as well as in physical books in libraries to summarize the literature on the history and evolution of medicine and orthopedics. The philosophical ideas that emerged in ancient Greece served as a foundation for the development of medicine. In the 5th century BC, the schools of Knidos and Kos emerged as influential centers for the development of medical thinking. The field of orthopedics can be traced back to early human civilizations. Ancient Egyptians perpetuated the tradition of employing splinting techniques. Hippocrates provided insights for the diagnosis, correction and treatment of many musculoskeletal entities. The field of medicine experienced a period of limited advancement during the Middle Ages. The Renaissance provided for the foundation of modern orthopedics and important contributions to the understanding and implementation of antisepsis. The discovery of x-ray and advancements in infection control and anesthesia have shown substantial progress in the domain of orthopedics and have contributed to the development of orthopedic subspecialization. Orthopedic surgery holds a historical lineage deeply entrenched in ancient practices and early human civilizations. Physicians specializing in orthopedics should be aware of the historical origins of their discipline and continue to evolve through further subspecialization and enhanced research.

Doctor, Indian nationalist and humanitarian: Mukhtar Ahmad Ansari (1880-1936).

Mukhtar Ahmad Ansari was a doctor and remarkable political figure in the late 19th century and the first half of 20th century. After studying medicine in Edinburgh, he returned to his country and became interested in political issues. Not unlike other educated Indian Muslims, Ansari first expressed his concerns about the situation in the Ottoman empire and went to Istanbul as the head of the medical mission. Ansari, who became more interested in politics after his days in Istanbul, came to the forefront as one of the leading figures of the Indian independence movement. Along with Mahatma Gandhi (1869-1948), Ansari did not engage in violence but supported the unity of Muslims and Hindus and opposed communalism. Despite his active political life, Ansari continued his medical studies with great seriousness and played an active role in establishing the Delhi Medical Association in 1914. During this period, his most important aim was to graft animal testicles onto human beings.

[Sir William Osler: facets of personality].

William Osler is one of the most honored and influential physicians in the English medicine late 19th early 20th century, who has made a great contribution on development of medical science and it's teaching. The scope of his multifaceted personality goes far beyond the characteristics of an outstanding doctor and scientist. The historical essay presents various aspects of the Osler's personality, highlighting his uniqueness as a doctor, teacher and philosopher.

A Brief History of Antimicrobial Resistance.

Despite mounting attention in recent years, health threats posed by antimicrobial resistance are not new. Antimicrobial resistance has dogged infectious disease treatment processes since the first modern antimicrobials were discovered.

A historical and palaeopathological perspective on cancer.

Cancer is often wrongly considered to be a modern disease in many popular medical venues. Cancers have been known to humanity since ancient times. In fact, its antiquity can be identified through the application of palaeopathological methodologies. The present perspective demonstrates by means of a historical and palaeopathological analysis how oncological manifestations were present long before the emergence of anatomically modern humans and addresses the epidemiological transition from ancient times to the contemporary world. The final section of the article examines breast cancer and its identification in ancient human remains.

The enlightenment.

The period begins with the work of Richard Wiseman who was associated with royalists in the English Civil War. A little later Dionis was the first to note a relationship between a disturbance of consciousness and extravasation of blood. This notion was continued and expanded by Le Dran, Pott, and Benjamin Bell, with Pott providing a pathophysiological explanation of the phenomenon. Daniel Turner commented on how confusing Galenic teaching was on the topic of consciousness. Heister further emphasized the relationship between clinical disturbance and the extravasation of blood. Le Dran stated that symptoms following cranial trauma related to cerebral injury, an opinion supported by Pott and never subsequently challenged. Latta noted the importance of meningeal arteries in the development of hematomas. Benjamin Bell considered trepanation only appropriate for a clinical deterioration consistent with hemorrhagic extravasation. The two Irish surgeons made it clear that the presence of periosteal separation was not in fact a reliable indicator of an extravasation. The most striking change of instruments was disappearance of simple straight trepans with non-perforating tips for making small holes safely. The use of scrapers gradually declined as did that of lenticulars. There was a great debate about the value of a conical rather than a cylindrical crown. The former was said to be safer. But this opinion faded and the cylindrical crown became preferred. Another improvement in technique involved the use of constant probing to check the depth of the drilled groove.

[On the formation of Russian pulmonology: the development of the doctrine of lung diseases (first half of the 20th century)].

The articles on the history of Russian pulmonology presented in the historical, medical and therapeutic literature contain materials for this history, but their authors did not solve the problem of its consistent presentation, highlighting the stages of formation and founders. The authors of this study critically reviewed the literary and archival primary sources, for the first time proposed the identification of three stages in the development of Russian pulmonology and indicated eight of its founders at these stages. The abundance of material did not allow us to present it in one article. This article is devoted to the 1st stage of the history of pulmonology - the formation of the doctrine of lung diseases. The second (development of pulmonology as an independent scientific direction in internal diseases) and the third (organizational design of pulmonology as a new independent clinical scientific and educational discipline and medical specialty, i.e. its institutionalization) stages will be discussed in the next articles.

Prisoner, Sailor, Soldier, Spy: Hobbes on Coercion and Consent.

This article examines Thomas Hobbes's notorious claim that "fear and liberty are consistent" and therefore that agreements coerced by threat of violence are binding. This view is to a surprising extent inherited from Aristotle, but its political implications became especially striking in the wake of the English Civil War, and Hobbes recast his theory in far-reaching ways between his early works and Leviathan to accommodate it. I argue that Hobbes's account of coercion is both philosophically safe from the most common objections to it and politically superior to the seemingly commonsensical alternatives that we have inherited from Hobbes's critics.

Neo-Confucianism and the Development of German Idealism.

This article analyzes the influence of Chinese Neo-Confucianism on the development of German idealism. Information obtained by Leibniz from Jesuit missionaries included key concepts in Neo-Confucian philosophy that not only confirmed Leibniz's belief in the universality of his organic image of the cosmos but also influenced Leibniz's later writings. Such influence is also exhibited in Kant's work, especially in his crucial noumenon-phenomenon distinction, as well as in Hegel's phenomenology and philosophy of history. Recognition of these influences, unacknowledged by either Kant or Hegel, enhances our assessment of the import of both Neo-Confucianism and German idealism in international religio-philosophical discourse.

The meninges.

The dura was first described in ancient Egypt. Hippocrates insisted that it should be protected and not penetrated. Celsus proposed an association between clinical findings and meningeal damage. Galen proposed that the dura was attached only at the sutures, and he was the first to describe the pia in humans. In the Middle Ages, new interest in the management of meningeal injuries arose, with renewed interest in relating clinical changes to intracranial injuries. These associations were neither consistent nor accurate. The Renaissance brought little change. It was in the 18th century that it became clear that the indication for opening the cranium following trauma was to relieve pressure from hematomas. Moreover, the important clinical findings on which to base an indication for intervention were changes in the level of consciousness.

The pericranium.

The purpose of this chapter is to present how past surgeons have viewed the pericranium and how they have reacted to its appearances. In ancient times, the membrane was considered formed by the dura through the sutures and it retained a relationship with the dura via vessels in the sutures. It was considered advisable to strip it totally from any area to be examined for fissure fractures and also for any area to be trepanned, as pericranial injury was thought to lead to fever and inflammation. In the 18th century, a new idea arose that posttraumatic spontaneous separation of the pericranium from the bone was a reliable indicator of the development of intracranial suppuration. This idea was subsequently refuted. For over two millennia, the pericranium was considered to be an important membrane requiring the close attention of the surgeon. It is no longer required to receive more than minimal attention.

Overview.

The chapter begins with also an outline of the characteristics of four surgeons who changed the direction of thinking and hence of practice. This is followed by a review of the changing ideas which governed surgical practice. Chapter "Two surgical instruments" by Jeremy C. Ganz has examined the uses of drills and lenticulars. In this chapter there is an appraisal of the other instruments used during cranial surgery and how their use related to changing ideas. Finally, there is a concluding section which ties all these elements together.

Evolution of understanding.

From the time of Hippocrates to the early 19th century, knowledge advanced but that was an uneven process. Anatomy was basically defined by Galen and remained cast in stone until the early 16th century. Neuroanatomy was described by Galen but had little practical value, as brain surgery was not possible. The anatomy of the cranium was known and was largely correct. Care was taken to avoid the frontal air sinuses and the venous sinuses and the temporal region. The role of the brain in consciousness was not understood. It was considered the seat of the soul but there was a lack of understanding that damage to it could induce clinical symptoms such as stupor or paralysis. These were variously attributed to injuries to the meninges or the bone. This error was finally corrected in the 18th century when the brain was identified as responsible for much of the clinical disturbance following cranial trauma. All awareness that post traumatic neurological deficit was contralateral was ignored until the late 18th century, although several authors noted it. Likewise, the presence of CSF had to wait until the 18th century until it was recognized. Fissures were treated with trepanation, because of a perceived risk of infection developing between the bone and the dura. Depressed fracture fragments were elevated, replaced, or removed according to the details of the injury. Finally, for centuries surgeons blocked patients ears to reduce the sound of drilling, despite the fact that such a blocking would amplify the noise.

[Alexander Grigoryevich Lyutkevich - a prominent figure in Russian ophthalmology and public health. (On the 155th anniversary of his birth)]. / Aleksandr Grigor'evich Lyutkevich ­ vidnyi deyatel' otechestvennoi oftal'mologii i zdravookhraneniya. (K 155-letiyu so dnya rozhdeniya).

This article, composed using literary sources and archival materials, is dedicated to the 155th anniversary of Alexander Grigoryevich Lyutkevich - a prominent Russian ophthalmologist of the late 19th and early 20th centuries (12.09.1867-18.04.1928) and one of the founders of the Voronezh Medical Institute. The paper traces the main stages of his biography, notes his work in rapid-reaction emergency care units, and pays attention to his teaching activities. The importance of Lyutkevich's doctoral dissertation on the treatment of high myopia is emphasized. The article also highlights his important role as editor of the classic textbook "Course of eye diseases" by A.A. Kryukov. In Lyutkevich's public activities, his contribution to the establishment of the Society of Ophthalmologists in Moscow is particularly noteworthy. Lyutkevich's high organizational skills are highlighted, which were clearly manifested in the Yuriev University and in the creation of the medical faculty of the Voronezh University.