On some paleopathological examples of amputation and the implications for healthcare in 13th-17th century Lithuania.

OBJECTIVE: To explore care that was likely provided to an adult male amputee from medieval Lithuania, positioning analysis within what is known of contemporary amputation practices. MATERIALS: Three sets of skeletal remains with evidence for amputation, dating to between the 13th-17th centuries AD and recovered during different archaeological excavations in Vilnius, Lithuania. METHODS: Macroscopic inspection of lesions, with additional X-ray analysis of the main subject. The Index of Care was used to investigate possible caregiving. RESULTS: Two individuals experienced amputation of a single element, and the third experienced bilateral hand amputation. Only one individual displayed healing. Historic sources suggest use of amputation for punitive purposes during this period, and judicial punishment is proposed as the most likely reason for amputation in at least two cases. CONCLUSIONS: Evidence of long-term healing in one individual suggests receipt of care. This individual likely relied on family and/or community members for survival immediately following amputation, and subsequently for support in managing disability. SIGNIFICANCE: Successfully combining osteology with history in a framework for analyzing care provision in past Eastern European society, this study underlines the critical importance of context in undertaking bioarchaeology of care analyses. It also adds two examples of perimortem abscissions in this region to the paleopathological record. LIMITATIONS: Our approach relied on skeletal interpretation. Soft tissue was lost to decomposition and no relevant archaeological evidence was found in association with the remains. SUGGESTIONS FOR FURTHER RESEARCH: A review of skeletal collections may allow identification of overlooked cases of amputation (and care).

Residential Institutions Redress Board of the Irish Government 2002-2018.

In 1999, the Irish Government commissioned a report into the abuse of children who were in the care of facilities managed and run under the auspices of the Roman Catholic Church in the Irish Republic in the 1940s and 1950s. It reported in 2009. A Redress Board was set up to investigate and compensate claimants who were abused physically and mentally as children when living in these facilities. The Board sat for 16 years. In total, 16,650 applications were processed with awards worth €970 million. Of these, 1069 applications were withdrawn, refused or had a nil award. This report on work of the Commission and the Board derives from the histories given and the expert assessment of 19 claimants for compensation. Their ages ranged between 47 and 72 years at the time of the expert's assessment.

Psychiatrists and the Transformation of Juvenile Justice in Philadelphia, 1965-1972.

In the late 1960s, Philadelphia psychiatrists evaluated every child who interacted with the city's juvenile courts. These evaluations had an important role in determining the placement and treatment of these children, and emphasized the therapeutic nature of the juvenile courts at the time. Relying on extensive case studies compiled by the Philadelphia Department of Public Welfare, this study reconstructs the roles of psychiatrists in the experiences of children interacting with the juvenile justice system, to shed light on a hitherto unknown aspect of these children's care. Gradually, the emphasis in juvenile justice shifted from a therapeutic approach to a more punitive one, from the mid 1970s and onwards. Yet the same structures of juvenile justice which allowed for individual discretion and "tailoring" of interventions to suit the child's perceived needs, rather than to fit the severity of his or her infraction, lost much of their therapeutic rationale. Still, many of these characteristics of the juvenile justice system, and in particular the practice of indeterminate sentencing, remain in place today. Questioning the role of mental health professionals in the creation and perpetuation of this flawed and often unfair infrastructure is an important first step in contemplating reforms.

Three cases of feet and hand amputation from Medieval Estremoz, Portugal.

Peri-mortem limb amputations are rarely reported in the paleopathological literature. The cases reported here concern severing of both hands and feet observed in three adult male skeletons, exhumed from the medieval Portuguese necropolis of Rossio do Marquês de Pombal, Estremoz, Portugal. The fact that they were found in the same site, in graves placed side by side, that all are young males, and that the three skeletons show similar perimortem injuries, make this a unique case meriting detailed analysis. Considering the lesions' location and pattern, as well as historical data, we hypothesize that this is a case of amputation as a consequence of judicial punishment. Estremoz was an important city in sustaining the Royal power at a regional scale during the medieval period.

Prison break: Karl Menninger's The Crime of Punishment and its reception in U.S. psychology.

In 1968, Karl Menninger, a highly visible and vocal U.S. psychiatrist, published a call to action on prison reform, The Crime of Punishment (Menninger, 1966/1968). This widely circulated book's central idea is that punishment as practiced in penal settings is an injustice amounting to a crime. At the outset, The Crime of Punishment quickly achieved national attention. Within mainstream psychology, its antipunishment message encountered a changed climate in which punishment, thought ineffective during the period 1930 through 1960, was redefined as an effective component in learning. It also met competition from the contemporaneous Stanford Prison Experiment (Haney, Banks, & Zimbardo, 1973), which quickly rose to equivalent media presence and superior disciplinary prominence. Both the Stanford Prison Experiment and The Crime of Punishment survived in the antireform era of hyperincarceration after 1974 as parallel examples of reform activism, one secular and one religious in character, illustrating some convergences of aim between psychology and psychiatry outside of specifically clinical issues. (PsycINFO Database Record

The Psychohistory of Child Maltreatment Among Antebellum Slaveholders.

Examining the inner workings of the slaveholder family, including slave caretakers, this article probes the psychodynamics of slaveholder development to assess the extent of child abuse in the Old South. Childcare was haphazard and premised on paternal absence, maternal ambivalence, and the exigencies of slave surrogacy. Corporal punishment, sanctified by southern religion, was the rule. The likelihood of slave negligence and retaliatory attacks against slaveholder children are addressed. Childrearing practices such as swaddling, aunt adoption, and maternal incest are considered, as well as the possible usage of a West African cleansing ritual. The article classifies planter families within the Ambivalent Mode of parent-child relations and suggests the restaging of childhood trauma as the underlying dynamic in the march to civil war.

On the skin of a soldier: The story of flogging.

After Farrier-Major Critton struck the 150th lash on the back of Private Frederick John White, at the end of a common disciplinary session at Hounslow Barracks, West London, in 1846, the soldier, whistling, walked himself to the infirmary to have his wounds dressed. His skin healed promptly, but 4 weeks later, he was found dead in his dormitory. The army medical officers, after performing an autopsy, reached the conclusion that the soldier had died from inflammation of internal organs but excluded any connection with flogging. This version of facts did not convince the coroner for Middlesex, who decided to open an inquest. After 3 more weeks of inquiry and 2 more postmortem examinations, the famous dermatologist Erasmus Wilson contradicted the army officers by affirming that the soldier had indeed died from the effects of flogging as the analysis of the cutaneous lesions and underneath would demonstrate. This contribution will detail how the inquest into the death of Private John White sparked a medical debate on the effects of military flogging to the skin. The discussion raised by the publication of the details of the autopsies demonstrated that different and opposing points of view coexisted in the Victorian period concerning the relation between external lacerations and internal organs in cases of flogging.

From punishment to education--juvenile delinquency in Romanian criminal law.

For centuries children were considered "mini-adults". Together with expressing the need to educate children and putting a stop to their integration in the work field from the earliest years the 19th century also displayed a new image of the child, which clearly separates him from the adults. In this paper the authors analyze the Romanian legislation addressing juvenile delinquency in criminal temporal evolution. On the one hand the minority age limits are sought and modulation of legislative provisions according to these, and on the other hand, types of penalties for minors are discussed. The authors conclude that the approach to juvenile delinquency in the current Romanian Criminal Code is the result of a long process of reflection of the legislators on adopting a different system of sanctions for juvenile offenders and on creating special regulations concerning the prosecution, trial and enforcement of the decisions regarding them.

Orthopedic surgery in ancient Egypt.

BACKGROUND: Ancient Egypt might be considered the cradle of medicine. The modern literature is, however, sometimes rather too enthusiastic regarding the procedures that are attributed an Egyptian origin. I briefly present and analyze the claims regarding orthopedic surgery in Egypt, what was actually done by the Egyptians, and what may have been incorrectly ascribed to them. METHODS: I reviewed the original sources and also the modern literature regarding surgery in ancient Egypt, concentrating especially on orthopedic surgery. RESULTS: As is well known, both literary sources and the archaeological/osteological material bear witness to treatment of various fractures. The Egyptian painting, often claimed to depict the reduction of a dislocated shoulder according to Kocher's method, is, however, open to interpretation. Therapeutic amputations are never depicted or mentioned in the literary sources, while the specimens suggested to demonstrate such amputations are not convincing. INTERPRETATION: The ancient Egyptians certainly treated fractures of various kinds, and with varying degrees of success. Concerning the reductions of dislocated joints and therapeutic amputations, there is no clear evidence for the existence of such procedures. It would, however, be surprising if dislocations were not treated, even though they have not left traces in the surviving sources. Concerning amputations, the general level of Egyptian surgery makes it unlikely that limb amputations were done, even if they may possibly have been performed under extraordinary circumstances.

Punitive limb amputation.

BACKGROUND: Limb amputation has been carried out through the ages as a punitive method in various parts of the world. This article highlights the historical and societal background associated with the use of punitive limb amputation. METHODS: We performed an extensive electronic search of the pertinent literature augmented with a hand-search of additional sources. RESULTS: Evidence for punitive amputation is available as early as the court of the Babylonian Code of King Hammurabi (circa 1750 Before the Common Era [BCE]), which imposed punitive limb amputations on slaves who used force against free citizens. Other reports provided evidence that punitive amputation was used as early as the 4th century BCE in ancient Peru. Limb amputation restored law and order during the Roman and Byzantine periods. Amputation as a punitive instrument prevailed in Europe throughout the 17th century. During the Enlightenment, the intellectual movement in Europe approached criminal law from a humanistic perspective, incorporated it into societal practice, and promoted its preventive dimensions. Punitive limb amputation still exists in several Arab and African countries. CONCLUSION: Amputation as a punitive or correctional method has its roots in old civilizations. It has been used through the ages in various parts of the world. While it has been abandoned in modern western societies, punitive amputation is still used in several third-world countries.

American juvenile justice system: history in the making.

The original theory behind separating juvenile offenders from adult offenders was to provide care and direction for youngsters instead of isolation and punishment. This idea took hold in the 19th century and became mainstream by the early 20th century. In the 1950s and 1960s, public concern grew because of a perceived lack of effectiveness and lack of rights. The Supreme Court made a series of rulings solidifying juvenile rights including the right to receive notice of charges, the right to have an attorney and the right to have charges proven beyond a reasonable doubt. In the 1980s, the public view was that the juvenile court system was too lenient and that juvenile crimes were on the rise. In the 1990s, many states passed punitive laws, including mandatory sentencing and blanket transfers to adult courts for certain crimes. As a result, the pendulum is now swinging back toward the middle from rehabilitation toward punishment.

Plastic surgery in 17th century Europe. case study: Nicolae Milescu, the snub-nosed.

The rising and the existence of plastic and aesthetic surgery in early modern Europe did not have a specific pattern, but was completely different from one nation to another. Colleges of Physicians could only be found in some places in Europe; different Parliaments of Europe's nations did not always elevate being a surgeon to the dignity of a profession, and being a surgeon did not always come with corporate and municipal privileges, or with attractive stipends. Conversely, corporal punishments for treacherous surgeons were ubiquitous. Rhinoplasty falls into the category of what Ambroise Paré named "facial plastic surgery". The technique is a medical source from which many histories derive, one more fascinating than the other: the history of those whose nose was cut off (because of state betrayal, adultery, abjuration, or duelling with swords), the history of those who invented the surgery of nose reconstruction (e.g. SuSruta-samhita or Tagliacozzi?), the history of surgeries kept secret in early modern Europe (e.g. Tropea, Calabria, Leiden, Padua, Paris, Berlin), and so on. Where does the history of Nicolae Milescu the Snub-nosed fall in all of this? How much of this history do the Moldavian Chronicles record? Is there any "scholarly gossip" in the aristocratic and diplomatic environments at Constantinople? What exactly do the British ambassadors learn concerning Rhinoplasty when they meet Milescu? How do we "walk" within these histories, and why should we be interested at all? What is their stike for modernity? Such are the interrogations that this article seeks to provoke; its purpose is to question (and eventually, synchronise) histories, and not exclusively history, both in academic terms but also by reassessing the practical knowledge of the 17th century.

'He plays on the pillory'. The use of musical instruments for punishment in the Middle Ages and the Early Modern Era.

Illustrations by the Dutch renaissance artists Pieter Bruegel the Elder and Jan Wierix both show a man imprisoned on a pillory, a former place of enforcement of judicial sentences, and playing a musical instrument. Taken as legal iconographic sources, these illustrations of the old saying 'He plays on the pillory' can be understood as references to a specific kind of punishment used in the Middle Ages and the Early Modern Era. Specifically, delinquents had to wear wooden or iron 'neck violins' or 'neck flutes' while being pilloried or chased through the streets in order to be humiliated in public. As well as this historical fact, there also exists an interpretation that takes the illustrations by Bruegel and Wierix literally. It suggests that these punishment practices originally date back to a more ancient use of real instruments in a penal system that was applied and understood as a 'healing punishment' (poena medicinalis) to banish the ill and re-establish the good in the delinquent, the community and the world as a whole due to musical sounds. By means of legal iconographical and historical methods, this article explores the different nuances of punishment that employed real or symbolic musical instruments. Thus, it examines a historical aspect of 'music in detention' where the (symbolic) sounds do not emanate from the punisher but from the punished themselves.

God's punishment or bad strategy: anti-epidemic measures in the lower Neretva basin at the time of cholera in 1886.

The epidemic of cholera that took place in the Neretva basin in 1886 was part of the fifth pandemic wave that was spreading throughout Europe. Based on the death records, vital statistics and the newspaper articles from that period, in this paper we present the emergence and the course this epidemic. In the context of analysis and experience of the epidemic of cholera in the lower Neretva basin, the newspaper articles have been recognized as a sensitive register of the changes of behavioural patterns, the way of speaking, the mechanisms of reacting and adjusting to the spreading epidemic, but also the resistance to it. It is based on this material that we can make conclusions about the relationship between the individual and the collective in the time of danger, as well as about the particularities of historical events that have been left out in other sources. Two potential paths for cholera to enter the area of the lower Neretva basin have been identified: one from the sea and the other from land, via the neighbouring country of Bosnia and Herzegovina. Quarantine measures had been taken in order to prevent the onslaught of the epidemic, a sanitary cordon was organized, disinfection of the land was carried out and a cholera hospital organized in Metkovic. However, despite the undertaken measures, an inefficiency of the government organs was obvious, because their actions mainly applied to formal fulfilment of anti-epidemic measures and they quite easily handed over individual initiatives to physicians. The analysis of strategies concerning the application of anti-epidemic measures in the past can be useful for learning more about the multilayered nature of social mechanisms in the time of epidemics, which makes it convincing and valuable even in the present day.