The Hippocratic Method of Surgical Cauterization for the Tumescence Spleen in the Rare "Spetses Syndrome".

Spleen in antiquity was considered by the Hippocratic medicine as a viscerous organ of spongy character, which could clear human body of the black bile. According to the Hippocratic doctrine of the 4 humors, black bile could cause a series of diseases. Both the anatomical position and shape of the spleen were also recognized. In the case of a splenic hardening, with simultaneous augmentation of its dimensions and dermal ulceration and/or splenic abscess, some interventions were proposed. Thus, herbal medicine, phlebotomy, and minimal surgery with local cauterization were applied for treatment, to confront a disease that was considered serious but not fatal. The Hippocratic physicians encountered various spleen diseases and among them they most probably confronted a rare splenic pathological entity, named centuries later as "Spetses syndrome," a rare type of thalassemia of the Spetses island of Saronikos Gulf. Although the approach seems in modern terms rather primitive, the ancient Greek medico-philosophers most likely understood the significance of the spleen.

[Digestive diseases in the epistolary collection of 16th century]. / La enfermedad digestiva en una colección epistolar del siglo XVI.

Correspondence is an important source of documentation for studying health and, therefore, the gastrointestinal symptoms of diseases. We studied the gastrointestinal disease described in the Monumenta Borgia collection, which contains documents from the 16th century, mainly letters about Francis Borgia, the last great figure of a family originally from Valencia and with universal significance. Of the 2769 documents examined, 1231 (44.5%) contained some health-related descriptions and 42 items were related to gastrointestinal disease, representing 7.5% of the specific diseases of natural causes. The most frequently mentioned organ in the whole human body was the stomach, with 20 references. The most frequent references were to symptoms related to the upper gastrointestinal tract, with 18 references, and the lower gastrointestinal tract, with 16. The comments made on health related to gastrointestinal disease usually reflect the typical galenism of the medicine of the times. The disorders attributed to the stomach are described in varied terminology and include an acute episode of gastrointestinal bleeding. The most frequently mentioned symptoms and processes are diarrhea, flatulence, hernias, and, among those attributed to the lower gastrointestinal tract, lower gastrointestinal hemorrhages. Also mentioned are hemorrhoids and intestinal colic. Although little mention is made of the liver and spleen, there are various allusions that Francis Borgia was affected by disease or pathogenic alterations in this area. However, the postmortem examination of his corpse, refuted the existence of these anomalies.

Gamna-Gandy bodies in surgical neuropathology specimens: observations and a historical note.

Gamna-Gandy (G-G) bodies are classically defined as spheroidal yellow-brown foci consisting of dense fibrous tissue and collagenous fibers encrusted with iron pigments and calcium salts. These siderotic nodules were first described in the spleen early in the twentieth century and for a short time were considered to be caused by fungal infection due to the presence of unusual "bamboo-like and articulated" fibers in the lesions that vaguely mimicked mycelia forms. This notion was proven to be incorrect in the 1930s and G-G bodies are now considered to result from organization of small hemorrhages. Although originally reported in splenomegaly, G-G bodies are well-recognized findings in atrial myxomas where they form linear arrays of mineral-encrusted fibers, often at the edge of resolving hemorrhages. They rarely have been reported in lymph nodes, thymoma, thyroid adenoma, and renal cell carcinoma. Curiously, published examples of G-G bodies in central nervous system (CNS) neoplasms or vascular malformations have not appeared, despite the known tendency for bleeding, even recurrent episodes of bleeding, in several types of these lesions. Since 1999 I have accrued all the examples of G-G bodies that I have observed in my practice of surgical neuropathology. These cases are presented here and the historical aspects of the entity are reviewed.