Asclepieia in ancient Greece: pilgrimage and healing destinations, the forerunner of medical tourism.

Asclepios, the first physician-demigod in Greek mythology, was born in Thessaly of the God Apollo and Coronis, a mortal mother. Asclepieia were healing sanctuaries dedicated to Asclepios. Asclepieia were located throughout the Eastern Mediterranean area, in ancient Greece and the Roman world. Travelers from all over the Mediterranean area seeking healing made pilgrimages to the Asclepieia, the early forerunner of "medical tourism".

Ancient Conceptions of the Human Uterus: Italic Votives and Animal Wombs.

The numerous votive uteri found across the central Italian peninsula from the fourth to first centuries BCE are puzzlingly evocative of the human simplex uterus, which is visually distinct from the bicornuate uteri characteristic of most other mammals. However, human dissection is not attested for this time and place, while animal butchery was common. This article uses modern veterinary anatomical imagery to argue that animal uteri - specifically as they appear when pregnant - were indeed models underlying the votive depictions. Some of the variant forms of the votives are highly evocative of various features of the pregnant bicornuate uterus. Further, medical views on the human uterus throughout classical antiquity were informed by animal uteri. Taken together, the visual and textual evidence indicate that animal models were inextricably integrated into ancient conceptions of the human uterus across the classical world, including in the production of the Italic votives in question.

Hippocrates: A Pioneer in Orthopaedics and Traumatology.

PURPOSE: Hippocrates, the ancient Greek physician, is considered the father of Medicine; however, his contributions to Orthopaedics and Traumatology have not been highlighted enough. The present historical review represents an effort to present and categorize his work, in this field, per clinical disorder and anatomical region. METHODS: The "Hippocratic Corpus" original text was thoroughly studied to identify all Hippocrates' contributions in Orthopaedics and Traumatology. Volume III of his works, especially "On Fractures", "On Joints", and "Mochlicon" includes a plethora of information regarding the management of traumas, as well as other disorders and clinical entities of the musculoskeletal system. RESULTS: In particular, Hippocrates describes reduction techniques for fractures, as well as joint dislocations, elaborates on the biology of the fractures' healing process and the basic principles of fracture management and fixation, presents the signs and symptoms of gangrene, teaches the treatment of osseous infections and offers valuable insight on the biomechanics and treatment of spinal diseases. CONCLUSIONS: Hippocrates' contributions in Orthopaedics and Traumatology are unprecedented, making him a true pioneer in this field, while the basic principles that he presented were further studied and confirmed in the 19th and 20th centuries.

The Evolution of Orthopaedics in Greece: From Ancient Heritage to Modern Times.

Greece, one of the oldest civilizations of the world, fundamentally contributed to the establishment and evolution of medicine and surgery. Undoubtedly, the foundations of the orthopaedic science are dated back to antiquity. The journey of the orthopaedic art was inaugurated with the poems of Homer and incarcerated through the practices of Hippocrates and Galen. Their deep knowledge of the musculoskeletal conditions and their treatment was generously bequeathed to humanity. This heritage acted as the catalyst for the establishment of orthopaedics in the modern Greek era. In this article, we tried to illustrate the evolution of the orthopaedic art in Greece from antiquity to modern times, reviewing the available evidence from scientific articles, books, historical manuscripts, old newspapers, and biographies. We summarize the most important events, and we identify the pioneers that shaped this new surgical branch, creating the modern Greek orthopaedic discipline.

The History of Epilepsy: From Ancient Mystery to Modern Misconception.

Epilepsy is an ancient disease, which has fascinated and frightened scientists and laymen alike. Before the working knowledge of the central nervous system, seizures were shrouded in mystery. In antiquity, this disease was accredited to gods and demonic possession, causing those with epilepsy to be feared and isolated. Epilepsy patients continued to face discrimination through the mid-20th century. This discrimination ranged from lack of access to health insurance, jobs, and marriage equality to forced sterilizations. Despite the strides that have been made, there are still many misconceptions globally regarding epilepsy. Studies show that patients with epilepsy in communities that understand the pathology and cause of seizures are generally more successful in social and educational environments. While there has been progress, there is more work which needs to be done to educate people across the globe about the pathology of epilepsy.

Zeus' pain: did he experience a thunderclap headache? / A dor de Zeus: fora ele acometido por uma cefaleia em trovoada?

Zeus is known as the king of the gods and god of the sky. His attributes are lightning and thunder and he is often depicted about to hurl them. According to Greek mythology, Zeus molested the titan Metis and decided to swallow her when she was pregnant, which resulted in an excruciating headache, only relieved after a craniotomy performed using Hephaestus' axe. The result of this procedure was the birth of Athena, Zeus' daughter. We conducted a combined analysis of some writings such as the classical mythological poem Theogony by Hesiod, and some other books that examine and retell myths and legends of ancient Greece, with medical papers on this topic, trying to characterize Zeus' headache. Would it be possible to fit Zeus' headache into the group of thunderclap headaches?

Zeus é conhecido como rei dos deuses e deus dos céus. Tem como atributos os raios e os trovões e é frequentemente representado prestes a lançá-los. De acordo com a mitologia grega, Zeus molestou a titã Métis e resolveu engoli-la grávida, o que resultou em uma cefaleia excruciante, apenas aliviada após uma craniotomia realizada por meio do machado de Hefesto. O fruto deste procedimento foi Atena, filha de Zeus. Realizamos uma análise combinada utilizando escritos mitológicos clássicos como o poema Teogonia de Hesíodo, além de outros livros sobre mitologia e artigos médicos que tratam deste tema, para tentar caracterizar a cefaleia de Zeus. Seria possível enquadrar a cefaleia de Zeus no grupo das cefaleias em trovoada?

Head Injuries in Homer's Iliad.

The Iliad is an epic poem chronicling the journey of Achilles in the Trojan War. The poem is one of the earliest sources of written literature in the Western canon. It is not a medical text, but the many and varied descriptions of injuries and their consequences mean that it is an important source for examining the earliest notions of anatomy and knowledge of the pathologies that result from trauma. Head injuries feature prominently in the text and represent written accounts of neurotrauma from nearly 3000 years ago. Previous work on the poem has suggested an awareness of neurological concepts such as nystagmus, syncope, and pupillary dilatation after trauma. In this paper, we identify and categorize all of the head injuries detailed in the text and examine these to identify concepts of functional neuroanatomy that are revealed by the descriptions. We identify and discuss 2 detailed descriptions of head injury, suggesting an awareness of decerebrate posturing after brainstem injury and cerebrospinal fluid leakage following a basal skull fracture.

The Asclepian art of medicine and surgery.

PURPOSE: To summarize the available information from mythology, archeology, and classical literature aiming to compose the image of Asclepieia, Asclepius, and the Asclepiads, and to depict the atmosphere of medicine in its infancy. METHOD: A thorough literature search was undertaken in PubMed and Google Scholar as well as in physical books in libraries to summarize the pharmacies and pain practices used for trauma in ancient Greece. RESULTS: The antiquity of medicine is confirmed by the worship of God Apollo and Asclepius, who were the persons who possessed the knowledge of medicine and surgery, and delivered it to mortals. The available archaeological data, stone offerings, and inscriptions from Asclepieia were the first testimonies of divine and human knowledge and provide insights on individual cases of patients cured by the Asclepiads. Sparse descriptions offer a first glimpse of the methods and means used by the first priests-physicians for wound healing and diseases treatment. CONCLUSION: Asclepieia established the roots of medicine and the first step of human knowledge, and contributed to the field of surgery and pharmacology that gave birth to the rational medicine. With Hippocrates and his research, the circle of Asclepieia ended, and the era of the organized medical schools with theories and experiments on every aspect of medicine begun.

Praxagoras of Cos (4th Century BC) and His Innovative Method of a Diverting Enterocutaneous Fistula to Relieve Small Bowel Obstruction.

Born in an island with huge medical tradition in ancient Greece, Praxagoras of Cos became an esteemed medico-philosopher and surgeon. The evolution made by the Hippocratic School of Medicine further boosted his talent and helped him perform surgical operations, which were believed impossible for his era. Praxagoras introduced an innovative surgical technique to confront small bowel obstruction, by creating an enterocutaneous fistula. This historical review connects all available data to present the life and work of an important medical figure of the ancient Hellenic School.

Congenital orthopaedic limp deformities in Corpus Hippocraticum.

During the fifth century BC in ancient Greece during the eve of orthopaedics, the Hippocratic School of Medicine diagnosed a series of congenital limb deformities. Congenital dislocation of the arm, elbow, wrist, hip, knee, tarsotibial joint, apex leg, as well as talipes valgus (clubfoot), congenital clavicle fractures, and thumb malfunction were all discussed by Hippocrates and his followers. Ancient Greek medico-philosophers, fond of a "perfect" human body, proposed an immediate non-interventional approach, while archaic orthotics and specialized footwear were suggested. The Hippocratic methodology was once more re-emerged in the sixteenth century by Ambroise Paré and in the nineteenth century by Wilhelm Roser, becoming since then the main principle for the confrontation of congenital deformities. Various surgeons until nowadays are still being influenced by the Hippocratic doctrine.

The Hippocratic Doctrine of "the Acute Brain Suffering" as the Brain Stroke.

BACKGROUND: The ancient Greek term "apoplexy" as is repeatedly mentioned by the Hippocratic School of Medicine, included a cluster of diseases, mainly those concerning the central nervous system. The term was wrongfully infiltrated in Western European medicine as synonymous to what is called today a "stroke" of the brain. OBJECTIVE: While in "Corpus Hippocraticum" the definition of the stroke was rather ambiguous; our study aims to unveil those fragments referring to it, in order to compose the Hippocratic theory of what it stood for "Acute Brain Suffering" (Greek: Οξείες Οδύνες του Εγκεφάλου) during the Classical era of ancient Greece. METHOD: A bibliographic research of the "Hippocratic Collection" was conducted during our study in order to connect all fragments from the original ancient Greek text, and reconstruct the "Hippocratic Stroke Theory". Three editions have been used as reference. French edition by Littré, and two Greek ones by Kaktos and Pournaropoulos. RESULTS: The "Acute Brain Suffering" seems to be the entity we call "Stroke" in modern clinical practice. Edema (collection of fluids-humours theory) was considered to be the most significant element which though could have been addressed by a cranial decompression for the symptoms to improve. The symptoms in question were, acute brain pain, diplopia, vertigo, ataxia, saliva, and urine loss as well as feces incontinence. CONCLUSION: Both therapeutic approach and symptomatology exhibited significant similarities with the modern concept of the stroke. The Hippocratic School was a scientifically advanced sect of medicophilosophers who promoted global medicine.

Pharmacies for pain and trauma in ancient Greece.

PURPOSE: To summarize pharmacies for pain and trauma in ancient Greece, to present several pharmaceutical/therapeutical methods reported in myths and ancient texts, and to theorize on the medical explanation upon which these pharmacies were used. METHOD: A thorough literature search was undertaken in PubMed and Google Scholar as well as in physical books in libraries to summarize the pharmacies and pain practices used for trauma in ancient Greece. RESULTS: Archeological findings and historical texts have revealed that humans have always suffered from diseases and trauma that were initially managed and healed by priests and magicians. In early Greek antiquity, the term pharmacy was related to herbal inquiries, with the occupants called charmers and pharmacists. Additionally, apart from therapeutic methods, ancient Greeks acknowledged the importance of pain therapy and had invented certain remedies for both acute and chronic pain management. With observations and obtaining experience, they used plants, herbs, metals and soil as a therapeutic method, regardless of the cultural level of the population. They achieved sedation and central and peripheral analgesia with opium and cold, as well as relaxation of smooth muscle fibers and limiting secretions with atropina. CONCLUSION: History showed a lot of experience obtained from empirical testing of pain treatment in ancient people. Experience and reasoning constructed an explanatory account of diseases, therapies and health and have provided for the epistemology of medicine.

Pheidias Apollonius (ca. 4th century BC), unveiling the ancient Greek medico-philosophical school of the island of Rhodes

The ancient Greek medico-philosophical school of the island of Rhodes was lost in the fog of history. However, the discovery of a stone column dedicated to Pheidias unveiled somehow some parts of its tale. The Island of Rhodes became in the 4th century BC a place of significant process in philosophy and medicine. Having both an Asclepieion and a Medical School with a rich library, the Rhodian Asclepiades transmitted their knowledge to future schools. Pheidias Apollonius was a member of the School of Rhodes, who was celebrated for his practise by the city-state of Athens. His magnitude testified in a way the supremacy of the school that he originated from.

Pearls of Neonatal Intertrigo in Ancient Greek and Byzantine Medicine.

OBJECTIVE: Confirmation of knowledge of neonatal intertrigo in ancient Greek and Byzantine medicine. METHOD: A search of Thesaurus Linguae Graecae was conducted with the following terms as key words, "syggama", "xyggauma", "paratrimma" and "ektrimma". RESULTS: Ancient Greek medico-philosophers introduced therapeutic measures based upon herbs and minerals, while a similar therapeutic approach was also used by the Byzantines. Hippocrates of Kos (460-377) was among the first to introduce written instructions, also proposing preventive treatment with palliative and aromatic herbs. Cataplasms, thalassotherapy, and fumigation were used, combined with hygienic measures in the affected area. Chalk powder was also prescribed to absorb moisture. CONCLUSION: The main principles in the treatment of intertrigo remain the same, celebrating the ancient Greeks' methodology and rationalism.

The thyroid gland in ancient Greece: a historical perspective.

Thyroidology is a discipline of Endocrinology which has evolved markedly over the past few decades. However, its historical roots can be seen in the literature of, among others, ancient Greek medicine. In the present article, we present the descriptions of the thyroid gland by ancient Greek physicians and its depiction in ancient Greek art.

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.

Medical Philosophy in Ancient Greece and Its Enlightenment / 中国医学伦理学

Medical philosophy has important guiding significance for the development of medicine. Ancient Greek medical philosophy has rich connotation and strong vitality. In the study of ancient Greek medical philosophy and combined with"the positioning of basic medicine"and"doctor-patient relationship"and other outstanding is-sues in the current development of medicine, we found that the rational examination of medical theory and medical treatment in ancient Greek medical philosophy, ways of thinking and analytical methods of medical philosophy and the character that physician should have had an important value in the development of modern medicine. We should pay attention to basic medical research,pursue innovative thinking, be good at using critical thinking and pay atten-tion to the training of humanistic spirit among medical workers.

Epilepsy, Theories and Treatment Inside Corpus Hippocraticum.

An archaic surgical procedure, the skull trepanning, was introduced in ancient Greece to treat brain derangement, and endured until the 18th century with the same use. Hippocrates recognized epilepsy as a common entity and categorized it as a brain disorder, removing any divine origin. He proposed that the excess of black bile and mucus is due to the infiltration of air inside the blood circulation (veins). For him it was a hereditary disease that could be cured. Thus, he suggested a non-invasive treatment based on herbal potions, and a surgical treatment by using the most advanced operation of the era, the open brain drilling, known as trepanning, or trephination, setting the beginning of neurosurgery.

Trepanation Practices in Asclepieia: Systematizing a Neurosurgical Innovation.

BACKGROUND: As ancient Greeks started looking for deities that could fulfill the pragmatic needs of common people, local heroes started being mythologized and worshipped through cults. METHODS: The most widespread such example was Asclepius, possibly a skilled war surgeon who followed military expeditions to Colchis and Troy. Our study investigates the possibility of the early neurosurgery to have been started inside Asclepieia by Asclepius and his followers. RESULTS: Asclepius was worshipped at religious temples called Asclepieia where certain specific medical and surgical techniques were followed. The most advanced technique was skull trepanation, which was most likely done as an acute operation to release intracranial pressure. The contemporary Hippocratic corpus provided extensive descriptions of the technique, and archaeologic evidence has shown that many patients survived the operation. CONCLUSIONS: Decompressive craniectomy techniques have been practiced for millennia but it is possible that they were first systematized as a neurosurgical innovation through the Ancient Greek religious cult followed in Asclepieia.