Self-healing forces and concepts of health and disease. A historical discourse.

The phenomenon of self-healing forces has again and again challenged doctors in the different historical periods of medical science. They relied on effects of self-healing forces in diagnosis and therapy. They also tried to explain these effects based on the current model of organism. The understanding of this phenomenon has always influenced the understanding of therapy and played a role in defining the concept of health and disease. In the 17th and 18th century the idea of self-healing force was interpreted as a phenomenon related to the organic forces, whereas in the 19th century the explanation was reduced to a materialistic mechanism. Nowadays the knowledge of heath-shock-proteins open the way of a new understanding of the organic defense mechanisms.

Facts and philosophy in neurophysiology. The 200th anniversary of Johannes Müller (1801-1858).

Johannes Müller was the founder of the first school of physiology in Germany. His anatomical, morphological and physiological research as well as his epistemological view of scientific medicine opened the way to a deeper understanding of the structure and the function of the organism. With important discoveries like the law of sense energy, the reflex movement and the definition of different organic stimuli, he enriched the knowledge of neuroanatomy, neurophysiology and sensory physiology and smoothed the way to an experimental physiology. All his famous students like Hermann von Helmholtz, Emil Du Bois-Reymond, Ernst Brücke, Jakob Henle, Robert Remak, Rudolf Virchow and Ernst Haeckel solved many crucial research problems, which Müller identified and pointed out to them as open questions, due to the insufficient methods of investigation. Müller's research method, epistemological view of biological sciences, and his open-minded personal style encouraged the development of new methods adapted to particular problems.

[1899: the first mathematical description of the pressure-volume diagram by Otto Frank (1865-1944)]. / Das Jahr 1899: Die erste mathematische Beschreibung des Druck-Volumen-Diagramms durch Otto Frank (1865-1944).

Not until 60 years after 1899 Otto Frank's mathematical formulation of the volume-pressure diagram and his concept of the mechanism of the cardiac work of the left ventricle cardio-physiologists began to rediscover Frank's work systematically. Frank's scientific development proves his constant commitment to and deep interest in understanding and analysing physiological problems mathematically. Consequently Frank worked on the quality and theory of physiological instruments and the problems of measurement, to calculate the influence in experimental research of the cardio-vascular system. Besides Frank's publications on different types of manometers his theory of "Windkessel" function as a model of the mechanics of the left ventricle and the different energies of the cardiac work are of importance even today, although we know only few details of his life as a pupil of Carl Ludwig and Carl von Voit and as a professor of physiology in Giessen and Munich.

Johannes Muller and the beginnings of experimental neurophysiology: concepts and strategies.

Between 1828 and 1838 Johannes Muller (1801-1858) published his important neurophysiological and anatomical investigations (primary fibres, cranial nerves, reflex movement, experimental proof of Charles Bell's law). Muller's strategies and concepts in neurophysiology can be used as an example for his scientific approach. An analysis of the four editions of Muller's Handbook of Physiology shows that he specified his arguments continuously by introducing clear definitions of physiological terms (stimulus, excitability, cosensual movement, reflex), which were based on his own manifold experiments and a critical review of recently published researches. Following his own epistemological view of physiological sciences he changed his fundamental belief in the incompatibility of the force of nerves and physical electricity in regard to Du Bois-Reymond's electrophysiological investigations. Muller's strategy in explaining scientific problems provides information for a historical understanding of why he had such a great influence on the development of physiology, anatomy and marine biology in the 19th century.

Natural defenses and autoprotection: naturotherapy, an old concept of healing in a new perspective.

Recent molecular-biological and molecular-genetic research has shown that important cellular-based autoprotective mechanisms are mediated by heat-shock proteins (HSPs) or stress-response proteins, also called 'chaperones'. This can happen because cells react to extracellular stimuli by activating signal transduction pathways which result in activating the genetic program. Molecular biologists and cardiologists are tempted to evaluate these phenomena in respect to their potential meaning for a better understanding of the complex notions of health and disease. When molecular geneticists or cardiologists talk about autoprotective or natural defense mechanisms, and physicians talk about salutogenesis, they all mean something very specific. The phenomenon seen here belongs to the body's own defense mechanisms which make it capable of reacting to harmful influences and allow it to stabilize a structure and/or function of the body for a certain period. Here we see a connecting link to the historically grounded term self-healing forces, which has challenged medical doctors in the different historical periods of medical science. They tried to explain these effects based on the current model of the organism. Their understanding of this phenomenon played a role in defining the concept of health and disease. Thus, it seems very fitting to look back into history, since the phenomena discussed here as well as the insights into autoprotective mechanisms will continue to influence medical understanding of health and disease.

Mechanisms of autoprotection and the role of stress-proteins in natural defenses, autoprotection, and salutogenesis.

We hypothesize that in all physiotherapeutically oriented procedures of naturotherapy -- such as helio-, climate-, thalasso- or hydrotherapy or certain forms of physical exercise -- the transient expression of stress-proteins (heat-shock proteins, HSPs) is an important element of salutogenesis. These therapeutical procedures all cause a transitory 'disturbance' by an unspecific stressor that leads to functional responses. These functional responses can be trained and thus increase the forces and the capacity for resistance of the organism. The autoprotective mechanisms which we want to deal with in more detail are based on the functions of the heat-shock proteins (HSPs, stress-response proteins, 'chaperones') and represent archaic autoprotective responses. In addition, more complex mechanisms of autoprotection seem to have evolved that may play a role in the natural defenses against disease and which show a hierarchy of various genomically conserved strategies with different time-constants and time windows. This becomes apparent by studying autoprotective responses of the cardiovascular system of warm-blooded animals under ischemic stress. Recent extensive experimental protocols and clinical observations in elucidating the molecular basis of cardiac ischemia show that powerful autoprotective mechanisms are involved in the phenomena of 'hibernation', 'stunning', and 'ischemic preconditioning'. The system of the heat-shock proteins may therefore be regarded as a basic model for the principle of autoprotection and salutogenesis.

[Friedrich Rumpf and his contributions to modern gynecologic surgery]. / Friedrich Rumpf und seine Beiträge zur modernen gynäkologischen Chirurgie.

The German gynecologist Friedrich Rumpf from Berlin performed the first radical hysterectomy in Europe. This pioneering achievement is even more remarkable as Rumpf was working in private practice without the support of one of the major Berlin university hospitals. Very few biographical data can be found. Fortunately, his views of gynecologic surgery are expressed in his publications. This aim of this article is to remind us of Rumpf's reflections on surgical technique which are still relevant today and to contribute to Rumpf's memory.

[Reception of Johann Georg Zimmermann's manuscripts in Montpellier]. / Die Rezeption der Werke Johann Georg Zimmermanns in Montpellier.

At the end of the 18th century the French physicians discussed Johann Georg Zimmermann's medical concepts (i.e. medical experience, the influence of the soul on health and disease). In contrast to the German scientists, the French, especially those from the School of Montpellier, accepted Zimmermann's medical views as a confirmation of vitalism and neohippocratic medicine. In Germany, Zimmermann's medical works fell into oblivion after his death until the middle of 20th century. This may be a consequence of his intimate contacts to the European high nobility and of his polemic attacks against friends and enemies as well as his contempt for all forms of democracy and the French Revolution.

[Not Available]. / Der Organismus im Spiegel physiologischer Forschungen und diagnostischer Verfahren.

For a century and a half medicine depended increasingly on graphic registration methods and clinical images. Technical developments were not the only condition for that. In the middle of the 19th century the scientists got another perspective of their research-object - the organism. This concept of an experimental and more physical medicine led to the idea, that the graphic curve registrated by an appartus was identical with the inner organic processes. Consequently, connected with this principle of visualization, the diagnostic and the therapeutic strategies were influenced, and also the comprehension of illness.

[The history of the concept of vital force]. / Zur Geschichte der Lehre von der Lebenskraft.

This article deals with the term "Lebenskraft - vital force' from the terminological point of view (life vs. force), as well as from the historical one-(1774-1848), also considering the place this term occupies in colloquial speech. This term, however, first introduced into medicine by Kasimir Medicus in 1774, cannot be defined in a philosophical sense. Historically though, it can be proved that four different starting positions have caused the different ways of interpreting this "vital force'. Alongside the physical interpretations, i.e. the impossibility of a perpetuum mobile, there were some reflections on the chemical mode of action (chemical dynamism, J.Chr. Reil). Another aspect developed from the irritability concept (G.R. Treviranus); furthermore a special interpretation resulted from the microcosmos-macrocosmos-analogy (Fr.L. Augustin). Thus these different positions had influenced the investigations carried out in the fields of biochemistry, neuro-physiology and comparative anatomy. Since the investigations of Emil Du Bois-Reymond and his articles on "Lebenskraft' the term and the hypothesis of vital force was no longer of scientific importance. The term lived on in colloquial speech and thus became a characteristic of the difference between a scientific and non scientific approach to life.