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SEULE, UNE PARTIE DES ARTICLES PRESENTES AU CONGRES INTERNATIONAL DE GALVESTON SERA INCLUSE DANS LES ACTES, PROCHAINEMENT PUBLIES MAIS L'INTEGRALITE DES RESUMES CORRESPONDANT AUX PRESENTATIONS ONLY A PORTION OF THE PAPERS PRESENTED AT THE INTERNATIONAL CONGRESS OF GALVESTON WILL BE INCLUDED IN THE PUBLISHED PROCEEDINGS BUT ALL THE ABSTRACTS OF THE ORAL PRESENTATIONS HAVE BEEN SOLO UNA PARTE DE LOS PAPELES PRESENTADOS DURANTE EL CONGRESO INTERNACIONAL DE GALVESTON SERA PUBICADA EN LOS ACTOS, PERO TODOS LOS SUMMARIOS ESTAN EN ESTA PUBLICACION. ATTITUDES TOWARDS PLAGUE EPIDEMICS IN OTTOMAN SOCIETY.
N.V.Akarsu. Istanbul, Turkey.
This study aims to approach the attitudes towards plague epidemics in Ottoman society and evaluate them within the framework of the history of medicine in the Ottoman empire. Questions as to the causes and origins of plague epidemics; the definition and description of the disease as seen by contemporaries; precautions to be taken and workable cures to fight it, will be treated on the basis of a nineteenth century translation of a sixteenth century Arabic manuscript: T evfikat-I Hamidiyye fi DefuÆl- EmraziÆl-Vegaiyye, as a typical example of sources written in the classical Ottoman period. This study reveals the fact that on the dawn of the rise of modern medicine in Europe, Ottoman society can still provide examples of thoughts and practices of old medicine, besides its gradual moderniztion and integration of new medical knowledge into it medical tradition. LA VIEILLESSE DANS LA LITTERATURE FRANÇAISE.
Ph. Albou, 18200 Saint-Amand-Montrond, France.
Ce poster propose de manière bilingue (anglais et français) un choix de citations de la littérature française concernant la vieillesse. Cette présentation est établie à partir d'un ouvrage que l'auteur a publié en 1999, qui est une approche à la fois historique, littéraire et sociologique du vieillissement, de l'Antiquité à nos jours Philippe ALBOU, L'image des personnes âgées à travers l'histoire, Glyphe et Biotem Editions, Paris, 1999. LES MEDECINS DE LOUIS XIV D'APRES LES LETTRES DE GUI PATIN.
Ph. Albou. 18200 Saint-Amand-Montrond, France.
Le médecin Gui Patin (1601-1672), qui fut doyen de la Faculté de médecine de Paris entre 1650 et 1652, puis professeur au Collège Royal de France à partir de 1655, passait la plupart de ses loisirs à écrire des lettres à quelques confrères de province. Dans l'édition de référence des Lettres de Gui Patin, publiée par Réveillé-Parise (l 846), on ne compte pas moins de 836 lettres, écrites entre 1630 et 1672, qui représentent un véritable “ gisement ” pour les historiens du XVII' siècle en France. Ces lettres sont écrites dans un style particulièrement plaisant, léger et humoristique, celui de la conversation entre amis. Certaines d'entre elles concernent les médecins de la cour du roi Louis XIV: Vautier, Valot, Daquin et quelques autres. Nous vous en proposons quelques extraits où l'on retrouve, de manière exemplaire, tout l'humour de Gui Patin. HISTOIRE DE LA MEDECINE GENERALE EN FRANCE AU XXè SIECLE.
Ph.Albou. 18200 Saint-Amand-Montrond, France.
Les statistiques établies par la Caisse Nationale d'Assurance Maladie (CNAM), en date du 31 décembre 1996, trouvaient la répartition suivante pour l'ensemble des médecins libéraux exerçant en France : En dépit du développement des spécialités médicales depuis un siècle, la Médecine générale restait donc la pratique médicale majoritaire en France à la fin du XXè siècle. Cette étude s'intéressera en particulier aux divers aspects démographiques, professionnels et sociologiques, des médecins généralistes (également appelés “ omnipraticiens ” ou encore “ médecins de famille ”). La pratique de la Médecine générale, qui reste très ancrée dans les mentalités françaises, sera aussi abordée dans le cadre de ses relations, parfois conflictuelles, avec les caisses de Sécurité sociale (crées en 1945), et aussi au sujet des “ conventions médicales ” qui se sont succédées depuis 1971. WOMEN'S HEALING ART: DOMESTIC MEDICINE IN THE OZARKS.
J. Allured, Lake Charles, Los Angeles, USA.
In the Ozarks of the late-nineteenth and early -twentieth centuries, as in most rural communities, women were the primary dispensers of health care. Women called upon an impressive knowledge of native herbs, modern pharmacology, traditional rituals, preventive medicine, and loving care to maintain their families' well-being. This paper will explore the holistic method of health care dispensed by Ozark women, which involved spirituality, prayer, community and family support, myth and ritual as well as effective pharmaceuticals. In addition, another purpose of my research is to resurrect the reputation of female healers and give them credit for discovering many of the most powerful medicines of their day. Nearly all medicines used by nineteenth-century doctors were natural-produced by plants- and were discovered by women, since they were the family members who worked most closely with herbs and plants. The thesis of this paper, then, is that while much was gained when medicine professionalized and became more scientific, much was lost when women, the traditional practitioners, were excluded in the process and from the process. Modern medicine too often neglects the psycho-social dimensions of illness and health, and by rediscovering the more traditional style of family- and community- based health care practiced by women, today's health care practitioners have much to gain. THE IMPORTANCE OF IATROGENESIS IN THE FOUNDING OF MODERN NEONATOLOGY.
B.F.Andrews, Louisville, Kentucky, U.S.A.
In the late nineteen fifties, a new field, Neonatology, began when small and sick babies could be studied with new micro-technology. The technology gained from research in physiology and biochemistry, new pharmacology and antibacterial drugs, and the micro-monitoring and chemistry technology gained directly from space research all contributed to the study and treatment of newborns, The infants of this day were already being looked upon as "Therapeutic Orphans." Drugs and technology used for adults were being applied. Iatrogenesis was being observed and reported, not only from new drugs and technology, but from the old and accepted ones. Iatrogenesis truly served as a major reason for necessary study and research. The cartoon "Neonatology-A Six-Finger Exercise" (1958) was designed to show the importance of looking at each newborn for clinical conditions, each body system, and for birth defects with special attention to the possible influence of iatrogenesis. A tied-off appendage was called pediatrica iatrogenesis. Infant mortality has decreased from 27/1000 to 7/100 and infants now survive down to 22-23 weeks gestation compared to 28-29 weeks in the late fifties. latrogenesis still occurs. In anticipation that emphasis of the cartoon will continue to be useful to future generations, comments will be made on major events over the past forty years. The ethics of "Obniti Iatrogenesi et Primum Non Nocere" (to strive against iatrogenesis and to first do no harm) demand our eternal vigilance. MEDICINAL PLANTS AND HIS CORRELATION WITH TOPOGRAFICAL AND ANATOMICAL
MYTHICAL CONCEPTS IN ANCIENT MEXICAN MEDICINE.
A.Aranda , C.Viesca, G.Sánchez, M.Ramos, Brasil 33, Col. Centro, Facultad de Medicina, UNAM.
México, D.F.
In this study, we make a correlation between medicinal plants, mentioned in sixteenth century mexican books and prehispanic nahua concepts concerning to anatomy-topographical items. The relationship between a plant and some specific body parts is clear as the tree foil yoloxochitl flower and its cardiotonic effects for example. Then, our outcomes permit us a better understanding expressed from and endocultural analysis about the practical medical use of these plants inside the practical medical nahuatl culture. HISTORY OF DISASTER RELIEF RED CRESCENT IN TURKEY IN CONNECTION WITH THE
EARTHQUAKE OF 17th AUGUST 1700.
A.Arikan, Cerrahpasa Tip Fakültesi, Istanbul, Turkey.
The aim of this survey is to draw a history of the Red Crescent activities in disaster relief starting from 1877 till the 17 h of August 1999, the date of the last earthquake that hit the region of Marmara in Turkey. Following the creation of the organization of the International Red Cross founded in 1864 in Geneva. the Red Crescent was founded in 1977 during the Ottoman-Russian war under the name of HILAL-I AHMER. After some period of services that were interrupt the present Red Crescent was created in 1935 under the name of KIZILAY and its services were spread not only to war period but also to peace periods, to natural disaster to earthquakes floods , fires etc. to epidemic diseases and to other health services. During the earthquake of 17 th August 1999 we noticed that the historical evolution of the Red Crescent services concept was unfortunately not sufficient in front of the changing word conditions as for example for the field hospital connected to a civil initiative. And, in the light of historical data. we have also understood that, assisting missions are going to change. TEACHING MEDICAL HISTORY : PAST, PRESENT, FUTURE.
B. Belicza, Zagreb, Croatia.
This study will concentrate on how present development in science, technology and medicine "per se", should reflect the teaching of history of medicine. This survey is based on literature, studies, reports, questionnaires and viewpoints expressed by the participants in teaching, including the conclusions and recommendations developed at meetings, symposia and recent conferences (Zagreb 1997, Strasbourg 1998, Tunis 1998, Naples 1998, Budapest 1999). Several major features are revealed which indicate that there is no unifying view of the history of medicine as an academic discipline. However, teaching history of medicine has recently undergone a remarkable intellectual development, although its broad educational value has not yet been adequately perceived by the very communities, which are directly affected by it. If we take for a fact that science education, in general, is essential for human development and that scientific knowledge and its application should be open to public debate which must be informed and democratic, new attitudes and goals of teaching history of medicine should be explored. In our time, international co-operation is necessary to define the strategy of implementing history of medicine in educational programs-by whom and for whom-with respect for specific requirements in each country. It would be very important for the future of the subject to form an International Permanent Forum for co-ordinating courses based upon the common strategy and goals, providing continual follow -up of the Teaching of History of Medicine. THE NOSOLOGICAL WAXING AND WAXING OF REITER DISEASE.
T.Benedek, Pittsburgh, Pennsylvania, U.S.A.
I will relate how the combination of urethritis, conjunctivitis and arthritis came to be associated with the name of Hans C. Reiter (1881-1969), a German public health physician and microbiologist, based in part on my correspondence with Dr. Reiter. This syndrome was called "gonorrheal arthritis" in the 19th century or, if it was associated with diarrhea, "dysenteric arthritis." The latter association became well documented, both epidemiologically and clinically, as a result of World War I dysentery epidemics. In 1915 Reiter became a co-discoverer of the spirochaete which causes 'Veil's (liver) disease. In military service in 1916 he received a febrile patient who had diarrhea, urethritis, conjunctivitis and arthritis. During one month of observation Reiter isolated a spirochaete from a blood culture of this patient. He considered this to be causative and to belong to a previously unknown species. His brief publication claimed incorrectly to be describing a new disease. Despite his post-war spirochaetal research, Reiter never performed cultures on patients with a similar syndrome, but criticized others for not confirming his solitary finding. Re never acknowledged that this syndrome had been described previously. However, subsequent authors whose descriptions were more complete referred to Reiter's publication rather than to earlier reports, to be cited. "Reiter's disease" was first used in an English language (Dutch) publication in 1937 and in an American article in 1942. Various intestinal and urinary tract pathogens have now been found to induce the syndrome, probably in genetically predisposed individuals. Antibiotic therapy has confirmed B.C. Brodie's inference of 1818 that this disease is distinct from gonorrheal arthritis. Reiter's dubious claim to his eponym is slowly being replaced by the less specific term, "reactive arthritis." BETWEEN CARITAS AND SCIENTIA NATURALIS – MEDICAL DOCTOR’S DAILY ROUTINE WORK
IN EUROPEAN ART FROM THE 14th TO THE 16th CENTURY.
K.Bergdolt, Cologne, Germany.
The presentation of medical doctors and patients in legends, "Vitae" of Saints or official court illustrations give us a beautiful and useful impression of the outer circumstances of the daily medical work in the late medieval and Renaissance period. The paper is based on a series of slides of very unknown manuscripts and frescoes in Italy and Germany. ROLE IN INTERNATIONAL RELATIONS.
C.A.Berry, Houston, Texas, USA.
Mankind has been fascinated with the thought of human spaceflight for centuries. When it became a reality in 1961, the global interest became an opportunity to demonstrate the nation's scientific technological capability and to improve international relations. This lecture will give a personal account of contacts with Kings, Queens, Presidents, natives and citizens of countries on many continents occasioned by the United States' space efforts. The results of East - West (USSR - US) competition and finally cooperation in the arena of space ill be highlighted. CREATING AND PUBLISHING A MEDICAL SCHOOL HISTORY.
W.Bryant Boutwell , Houston, Texas, USA.
Of the 124 medical schools in the United States, how many really know their institutional history and communicate that sense of past to their current constituents? The purpose of this descriptive study is to provide a practical overview of how to develop an oral history for a medical school. "Conversation With a Medical School" is a recently published book, co-authored with Dr. John P. McGovern, representing the first thirty years in the development of The University of TexasHouston Medical School. The presentation will review the 4-year methodology for developing and publishing this book along with constructive insights for those interested in developing working archives and writing conversational histories of their medical institutions. From concept development and videotaped interviews to distribution and innovative use of book sales to develop student scholarship funds, this talk will cover lessons learned and the importance of capturing history from those who were there. Applying lessons learned from the past to the present and future of healthcare delivery will also be included in this presentation.
CONCEPTIONS OF WHOLENESS AND HEALTH IN EARLY AMERICAN PAINTING.
H.Green Campbell, UTMB, Galveston, Texas, U.S.A.
For centuries, the medical profession's fantasy of health and wholeness has contained four basic dimensions: spiritual ease, physical ease, mental ease and social ease. Disease (disease) fundamentally threatens this ideal. Beginning in the Age of Enlightenment, scientific discoveries, better sanitary measures and increased medical facilities prompted men to imagine that they could exercise some measure of control over disease and death. Specific diseases of mind and body, contracted through intemperate living, were a perpetual threat because they led to premature death. Just as science altered the way man conceived of his life and death it also served as the handmaiden to traditional morality. Wholeness entailed living a life of moderation, eschewing vice and succumbing to death in old age. This paper will explore artistic conceptions of wholeness and health as expressed in early American painting. An examination of allegorical scenes, portraiture and paintings of still-life will demonstrate how artists grappled with the realms of art, science, and religion in framing their experiences and understanding regarding disease and death. Specific works by Benjamin West, Charles Willson Peale and Rembrandt Peale will serve as the basis for this study. AIRS, WATERS, PLACES, ACCORDING TO THE CARAKA SAMHITA.
R.C.Chakravorty, Salem, Virginia, U.S.A.
This paper examines the ideas about the environment affecting the health of the people as described in the Caraka Samhita. English translations of the original Sanskrit text are provided. The Caraka Sambita is one of three main components of Ayurveda, the ancient Hindu system of Medicine. For various reasons, die exact age of its compilation is still debated. The recension studied (that of Dridhabala) probably dates from the first century of the Christian era. The Caraka names ten specific topics that are the concern of Ayurveda or the Science of Life. One of these - Kala, specifically relates to the influence of age, seasons etc. on the health of individuals and peoples. The effects of the environment on health is discussed in three of the eight sections of the text - the Sutrasthanam, Vimanasthanam and Kalpasthanam. The much larger sections on the effects of foods and drinks (which also vary according to localities) will not be considered in this paper. The Kalpasthanam. and the Vimanasthanam discuss the various bodily types seen in areas with clearly marked geographical and climatic features. While individual health is affected by the balance of doshas (approximately the equivalent of humors) in the person's system, the Vimanasthanam indicates that external factors can have major catastrophic effects on the entire population. The Sutrasthanam points out the general effects of the seasons on the individuals. Medical teaching in ancient India took place at the homes of physicians and also in large residential complexes resembling Universities. Then as now, after training, physicians migrated to distant areas to practice. Some were probably peripatetic, Environmental variation was significant in Hindu areas as control of the environment was impossible. I believe that is why Caraka felt that medical students had to be instructed in the geography of disease. MEDICAL HISTORY, ART AND PHILATELY.
R.C.Chakravorty, Salem, Virginia, U.S.A.
This paper examines the portrayal of medical historical subjects on stamps (and other philatelic material not considered here) and its implications about popular culture of the times. A few illustrative examples of the vast numbers available are shown. Stamps are ubiquitous. In most countries, they represent the major interest in the history, geography and culture of the people. Stamps also convey these interests to people of other countries. I argue that while an individual artist may be occasionally driven to illustrate contemporary popular medical interest - stamps reflect these concerns more. In this limited examination, I will divide medical historical stamps in three categories and illustrate each with examples from various countries. 1) Paintings and Sculptures associated with medicine. Few persons have the opportunity of seeing the original -stamps bring them to the attention of many, Examples shown will be Trumbull's painting of the Declaration of Independence (U.S.A. and other countries) showing three of the five physician signers; Billroth in the Operation Theater (Austria) and the first public demonstration of Anesthesia (India). 2) Portraits of medical personnel, past and present. Examples include Hippocrates on stamps of various countries, Florence Nightingale (various countries), Clara Maass (USA and Cuba.) A subsection of this are people famous for some specific achievement such as the first Women Medical Graduates (various countries) and the Nobel Laureates in Medicine or Physiology (various countries). 3) Stamps that reflect and emphasize global concern of health and disease. Examples include Drug Abuse, Smoking, Cancer and AIDS, and on the positive side, the eradication of smallpox. Many nations (including the U.S.A.) are issuing stamps to celebrate the end of the Millennium. Often the subjects are chosen by popular vote. The stamps in this group particularly illustrate the people's concerns. This is a discussion of a minuscule portion of the popular representation of medical history and concerns of our times - an area that has been almost completely ignored by medical historians. PUBLIC SECTOR PSYCHIATRY IN TEXAS.
D.L.Creson, Houston,Texas, U.S.A.
The first psychiatric hospital, a state facility, was opened in Texas on the eve of the "War Between the States." This paper traces the evolution of public sector psychiatry in Texas from this early beginning through the intervening years to its current ubiquitous presence and institutional complexity throughout the state. Over time the role of public sector psychiatry in Texas has been subjected to a myriad of shifting public expectations and political agendas. During this period it has been a growth industry within the state, an industry that in recent decades with the advent of community services has moved from rural based institutions to complex urban systems for providing very diverse services. The shifting public expectations and public agendas and the interaction between the public and private institutions for training psychiatrists and the state policy for providing public sector psychiatric care provides some insight into the inability of the public sector to deal with fiscal limitations and achieve a clarity of purpose in its current configuration.
MILITARY VETERINARIANS AND FRENCH COLONIAL EXPANSION IN AFRICA.
D.K. Davis, Austin, Texas, USA.
The purpose of this study is to elucidate the multiple roles played by les vétérinaires militaires in nineteenth and early twentieth century Africa and to analyze the importance and impact of their actions on French colonial expansion during this period. The study is based on archival research conducted at several colonial archives and the national veterinary school at Alfort in France. By the early years of the nineteenth century, France had lost all of its overseas colonies, largely as a result of the Napoleanic wars. Within a few decades, however, and especially with its occupation of Algeria in 1830, France embarked on a vigorous and lengthy campaign of colonial expansion in Africa. Integral to the success of their colonial endeavors were the French military veterinarians (les vétérinaires militaires). These men were present on the front lines of the battles of occupation in all French campaigns in Africa and they remained important to French mechanisms of control throughout the colonial period. Although fully trained and practicing veterinarians, these men fulfilled a staggering variety of roles and functions for the French colonial regimes. They cared for those injured in battle, both human and animal, they conducted primary research on tropical and subtropical veterinary diseases, they founded and organized veterinary and range management services in the colonial territories, they promoted business ventures, they provided information for the intelligence services of the French government, and they actively aided in the pacification of the indigenous populations. The impact these military veterinarians made is still felt today in many contemporary development programs implemented in former French colonial African countries. REPRESENTATIONS OF EYEGLASSES ON GOTHIC WINGED ALTARS IN AUSTRIA.
F.Daxecker, Innsbruck, Austria.
The oldest representation of eyeglasses in the German-speaking area is found on the altar of Tyrol Castle in the Museum Ferdinandeum in Innsbruck, Tyrol, on an altarpiece depicting the death of the Virgin Mary (1370-1372). Other representations of eyeglasses are found in Klosterneuburg, Lower Austria, Albrechtsaltar, collegiate collection, death of the Virgin (1439); St. Lorenzen ob Murau, daughter church St. Lorenzen, Styria, Katharinenaltar, Disputation (1455-1460); Pettau (Ptuj), Pokrajinjski Muzej, Slovenia (then belonging to the archbishopric of Salzburg), Conrad Laib, St. Bernardine of Siena with a spectacle case (1460-1465); on two altars by Micheal Pacher: Pharisee, Gries near Bolzano (1471-1475), apostle mourning over the death of the Virgin Mary, and St. Luke, St. Wolfgang in Salzkammergut (148 1); St. Florian, Upper Austria, collegiate collection, altar of the provost Leonhard Riesenschmid of St. Florian, death of the Virgin (1487); museum of Wilten monastery, Innsbruck, Ludwig Konraiter, St. Ottilie with reading stones and death of the Virgin Mary with reading apostle (1485-1490); Austrian Gallery Belvedere, Vienna, Master of Grossgmain, St. Augustine (1498); Austrian Gallery Belvedere, Vienna, Master of Mondsee, St. Augustine (1490- 1500); Diocesan museum Graz, Styria, altar of Hirschegg, death of Virgin in (1503); Krenstettten, Lower Austria, Stefan-Altar, Disputation (1500-1520); Museum Ferdinandeum Innsbruck, Matheis Stöberl, Jesus and the scribes, scribe with a spectacle case (early 16th century). BURN CARE AND THE SECOND WORLD WAR.
Ch. Dhennin, Tours, France.
In 1931, all the burnt patients died when the total burnt surface area was above 20% (Riehl, 1905-1930 hospitalizations), and 60% in 1949 (Bull & Fischer, 1942-43 + 1945-47 hospitalizations). The improvement in burn care had not been continuous between the two dates. The Second World War appears as a turning point after centuries of passive and ineffective cares while the ground had been prepared, especially during the two previous decades: In 1923 Underhill had shown the haemoconcentration and the need of fluid replacement, in 1924 Berkow's tables allowed the measurement of the extensiveness of bum lesions after Du Bois & Du Bois works, in 1935 Cruickshank had demonstrated the early contamination with hemolytic streptococci and the presence of the germs in the air of the wards, as examples. The number of war bum casualties in military and civilian populations induced more active interest of surgeons on both sides of the Atlantic. However one must stress too that knowledge in bum physiopathology and care benefited from a plainly civilian disaster, the fire at the Boston's Cocoanut Grove Nightclub in Boston in 1942. The number of papers on bums including symposiums and even books between 1939 and 1945 -in war times - as well as their quality are quite impressive. At the end of the Second World War, fundamental data had been obtained and their therapeutic consequences in substitutive fluids based on areas of bums, cross infection, antibiotics fields were applied and new basis established (Lund & Browder, Colebrook, Harkins .). Bum surgery had improved too on technical and material levels and even as regards the approach mind (Mac Indoe, Brown . ). The place of allografts was more precise and the observations of Gibson would be subsequently the basis of immunological and organ transplantation researches and clinical applications. Yet improvements led to new problems and especially new infectious ones with a subsequent stagnation of vital prognosis. However during the war the most determinant fact had been established, the specificity of bum injuries with its logical consequence, the need for bums centres as remarkably reported by Colebrook four years and a half after the end of the war. Only owing to these structures the later evolution steps have been and will be obtained. THE ELIMINATION OF DISEASES THROUGH THE SKIN PURIFICATION. A MEETING OF THE IDEAS
ABOUT MACROCOSM AND MICROCOSM IN BYZANTIUM.
A.A.Diamandopoulos,P.Goudas and A.H. Diamandopoulou. Patras, Achaia, Greece.
We present in this paper the ideas of the Byzantine authors on the relationship of the human body to the natural and man-made world. Special emphasis is given to the relationship between purification through the skin and world purification. Based on the similarity of Empedokle’s ideas concerning the four elements and Hippocrate’s ideas concerning the four humors, the Earth itself was personified and became a living organism that was feeling cold, perspirating, becoming dry etc. Man started to seek a natural explanation for his diseases and alterations of body functions. Hence, perspiration, fever, urination, headache, stroke, were explained in cosmological terms. Extracts from Aristotle, the Fathers of the Church, Meletius latrosophista, Theophilus Protospatharius and other Greek and Byzantine sources are presented, in order to show the close relationship between an abundance of diseases and an array of natural phenomena. THE NON-SURGICAL TREATMENT OF EYE PROBLEMS ACCORDING TO THE BYZANTINE
LITERATURE.
A.H.Diamandopoulou-Drummond and A.A. Diamandopoulos.Patras, Achaia, Greece.
The purpose of this study is to examine the types of non-surgical treatments available for eye diseases and complaints during the Byzantine Era. Since eye disease was prevalent throughout history, many authors concerned thems elves with this topic because impairment of vision was a serious disability impeding man's ability to work and survive. We refer to and compare the treatments (animal, vegetable and mineral) recommended by amongst others, Oribasius, Aetius of Amida, Alexander of Tralles, Paul of Aegina, Nicolaus Myrepsus and Johanes Actuarius. Reference is also made to earlier relevant texts by writers such as Hippocrates, Celsus and Galen and to the echoes of these treatments which still exist in to-day's Greek Folk Medicine. The contribution of the Byzantine authors, while not being exclusively original, aided the transfer of knowledge of therapies for ophthalmic diseases from the Ancient World to the Islamic World and the Latin West. Many of the simple remedies are still in use in Modern Greece. FAILURE AT THE BOUNDARY: HOME CARE PHYSICIANS, SPECIALIZATION, AND THE
HOSPITALIZATION OF MEDICINE, 1945-1965.
J. L. Dieckmann, Chapel Hill, North Carolina, U.S.A.
The purpose of this study is to explore the development of clinical specialties in medicine through a case study of physicians practicing in the coordinated home care plans of 1945 to 1965. Although the aspirations of home care physicians to establish a medical specialty failed, their efforts provide a means to trace the boundary of acceptable advancement in American medicine at mid-twentieth century. Archival materials from the Montefiore Home Care Program, Bronx, New York, and the Philadelphia Home Care Plan are central to this historical analysis. Text materials include program files, letters, program reports, and scholarly and newspaper publications. Additional conference reports and published materials from the broader coordinated home care movement are incorporated. Seeking to reduce hospital costs through early discharge, to increase control over indigent and noncompliant patients, and to reclaim the physician's role in the family home, these physicians sought to build a specialty that would legitimize their role outside the hospital and reform home care services as a hospital department. Their expectations of a groundswell met insurmountable obstacles of increased cost, conflicts between hospital specialists and family physicians for control of the patient, and the growing hospital-based culture of technology that devalued extra-institutional medical practice. OTTOMAN PEDIATRICS AS REFLECTED IN Dr. VIOLI'S MONTHLY LA PÉDIATRIE EN TURQUIE /
TÜRKIYE' DE EMRAZ-I ETFAL.
G. Dinç and S Etker, Istanbul, Turkey.
Medical periodicals of the late 19th and early 20th centuries are rich sources of detailed clinical observations and contain particular information on relative social events. Dr. G.B. Violi published his monthly journal of pediatrics simultaneously in French and Turkish (in arabic characters) in Istanbul from 1909 to 1914. Dr. Violi's personal work focused on prophylactics and hygiene, and he established a private children's hospital in the city and a sanatorium on the island of Heybeli. His practice has influenced the specialization in child health in later Ottoman medicine, La Pédiatrie en Turquie / Türkiye'de Emraz-i Etfal commenced publication in a new era following the Young Turks' revolution and continued until beginning the First World War. Although, these were difficult years for the Empire engaged in the Balkan wars and the Libyan conflict with Italy, the journal's content was amazingly up-to-date and its international contributors were renowned contemporary pediatricians (Baginsky, Escherich, Bokay, Marfan and others). The journal also provided local medical statistics, a review of the world literature, and basic advice to mothers, highlighting a wide range of readership. Today, copies of La Pédiatrie en Turquie / Türkiye'de Emraz-i Etfal are very rare, owing to the period of its publication and a single incomplete collection exists. Dr. Violi himself was of Italian extraction, but historically his journal ranks Turkish before English as a language possessing a periodical devoted to pediatrics in Europe. ORGANIZATION OF MEDICAL ETHICS AND CULTURES : COPY AND PASTE ?
H. Dogan, Istanbul, Turkey.
As a result of rapid and progressive developments in clinical medicine in the 20th century, multidisciplinary approaches became important in linking new needs of medicine with the changing patterns of health care. Methods and applications of multidisciplinary approaches such as ethics committees, ethics consultation centers in the U.S. were imported by Turkey as well as by other cultures. The purpose of this study is to discuss the problems which might arise when these applications are transferred to different cultures. Clinical study results about ethical issues in Turkey and in some European countries were collected, reviewed and analyzed. This study puts forth that, potential problems, that might be created during and after the transportation of original local practices and methods from one culture to another, should be taken into consideration before application. LES MESURES PREVENTIVES PRISES CONTRE LE CHOLERA AU 19ème SIÈCLE DANS L'EMPIRE
OTTOMAN. R. Dramur, Istanbul, Turquie.
Nous avons examiné différents documents des archives ottomanes sur les mesures préventives prises contre le choléra au 19ème siécle dans l'Empire Ottoman. Les mesures préventives de quarantaine étaient prises au temps du Sultan Mahmud II dans l'empire ottoman. A côté des méthodes préventives,conservatives et hygiéniques, on employait en 1846 des plantes médicinales pour guérir les malades souffrant de cette maladie. Nous avons examiné un document d’archive ottomane sur lequel est inscrit l’existence d’ une épidémie de choléra en 1648 à Brousse ; nous apprenons ainsi que la lavandine (L. Stochas) qui est plantée à Uludag est employée contre le choléra et que l'on a utilisé cette drogue pour guérir les malades qui souffraient du choléra, grâc e à cette plante. Le médecin-chef Isak Efendi a donné l’ ordre pour que cette plante soit vendue dans toutes les pharmacies de l'Empire Ottoman. SOME UNKNOWN ASCLEPIONS IN ANCIENT GREECE.
Th. Drizis, Kalamata, Greece.
The purpose of this study is to present the Asclepions which existed in Ancient Greece but which didn't have the glamour of the renowned Asclepions, and which today they are unknown by most of physicians and historians. The material for this paper was collected from archaeological finds and inscriptions as well as the Ancient Greek Literature. The method used was visits to the archaeological sites on the one hand, and reviews of the relevant literature on the other. The results of this study are that there were Asclepions in Mytilini, Sparta, Asopos in Laconia, Messina, Avia in Messinia, Amphipolis, Moryllo in Kilkis and Veroia, which had the basic structure of a Asclepions, as, the sanctuary, the "egkoimitirion" (the place where people slept), baths etc. and served the needs of the inhabitants in the surrounding area. In conclusion besides the renowned Asclepions in Epidavros, Athens, Kos, Knidos etc., there were also other Asclepions but with local importance which today are unknown by most of people yet. THE TERM “ CANCER ” WITH CONTEMPORARY MEANING IN ANCIENT LATIN LITERATURE. Th.
Drizis, Kalamata, Greece.
The purpose of this study is to present the use of the term “ cancer ” with contemporary meaning from various authors in Ancient Latin Literature. The method used in collecting and analyzing about this, was the “ Thesaurus Linguae Graecae und Latinae ” in lbycus Computer System, a work of the 1. Berkowitz and K. Squitier from California - Irvine University, USA. After analysis of this work is revealed, that the term “ cancer ”, used with contemporary meaning, is reported in the work “ De Agri Cultura ” of Marcus Porcius Cato (234-149 B.C.), in the work “ Metamorphoses ” of Publius Ovidius Naso (43 B.C.-18 A.D.), in the work “ Compositiones ” of Scribonius Largus (1st century A.D.), in the work “ De Medicina ” of Aulus Cornellius Celsus (lst century A.D.), in a work of Greek Philumenus translated in latin (2nd century A.D.) and finally in the work “ Apologia ” of Apuleius Madaurensis (2nd century A.D.). In conclusion, as has been indicated, there was use of the term << cancer >> with contemporary meaning in Ancient Latin Literature. ANATOMIC VOTIVE OFFERINGS IN CROATIA.
Z. Dugac, Zagreb, Croatia.
This work explores the votive gifts that people brought to sacred places, as a gift, in connection with various diseases in the last tree hundred years on the territory of Croatia. The main point explains symbolics of representation of body parts. The anatomic votives show the ancient customs and habits of the population dating from the preChristian heritage. They also unite the vernacular traditions, Christian religious conception and recent necessity Of Population. Votives stand between anthropology, medicine, history of art and culture. The field research has explored anatomic votive gifts from Croatia, offerings by people who were ill. It has established localities where this kind of votives were offered, including their expression, quantity and age. Throughout history, certain handicrafts were developed in connection with the making of the votive offerings. They were usually made of wax, wood, silver and gold. Some of them are valuable artistic objects with expressive figuration of human body. The customs of votive giving are rapidly disappearing, During the field research it was noticed that in the Adriatic area of Croatia people do not use the anatomical votives any more, while in the shrines of the continental Croatia, people still use the anatomic votive gifts. In the past votives were valuable artistic objects, recent votives have lost this quality.
THE IMAGE OF HEALING IN WORKS OF A 16TH CENTURY POET FROM DUBROVNIK.
M.-A. Dürrigl, S.Fatovi´c-Ferenci´c,Zagreb, Croatia.
In some of his most original works, the Croatian Renaissance poet Sabo Bobaljevi´c Glusac (1523?-1585) thematizes his deafness. For a while he was the patient of Amatus Lusitanus, one of the most prominent physicians of the 16th century and professor of anatomy at Ferrara university. Bobaljevi´c had contracted syphilis in early adulthood, and Amatus concluded that as a consequence of syphilis the interactive functioning of ear bones was not possible. Bobaljevi´c, by accepting the nickname Glusac, ie “ deaf man ” , identified himself by and with his impairment. His loss of hearing ability resulted in loss of (self)confidence, increasing loneliness and a dose of sarcasm. In his poems and poetic epistles healers - both learned physicians and quacks - are depicted with little sympathy and their art of healing ridiculed. Bobaljevi´c himself, with sad irony, writes about a magical cure which would restore his hearing and health. His poems, presented here, are not only a poignant expression of an individual artist's suffering, but they may also add to the understanding of the situation of deaf persons.
CREATING LOCAL MEDICAL HISTORY WITH ELECTRONIC DATA : A TEACHING TOOL FOR
EVERYONE.
N.P.Eckerman, Indianapolis, Indiana, U.S.A.
This presentation will discuss various research topics and methods appropriate for a wide variety of age groups for the study of the history of physicians within the students' communities. The emphasis will be on the use of electronic databases containing U.S. census data. Appropriate supplemental materials will also be discussed. The emphasis will be on the use of widely available electronic sources. Some topics for students and teachers using U.S. Census Data are as follows. A student could compare the ethnic origins of physicians and their patients in a given area then compare those findings to patterns in another community. Patterns of emigration and immigration of physicians from and to various communities could be studied. The census data could be used to study the life styles of physicians relative to members of another profession in a community. Or, a simple search for female or minority physicians could be undertaken. Most localities in the U.S. do not have printed histories of medicine and physicians in their state or community. Studies beginning with the simple manipulation of census data could be used as the building blocks for scholarly histories of medicine and physicians in many communities or used to include medical practice into local history projects. The encouragement of the careful study of local medical history insures an audience for the efforts of medical historians. The presentation will include demonstrations of searches for appropriate data. SPECIALIZATION IN MEDICINE AND RELATIONSHIP BETWEEN PHYSICIAN AND PATIENT IN THE
20th CENTURY.
Ö.Elçioglu,I.Üniüglu, N. Bozdemir Eskisehir, Turkey.
The great advances observed in medicine and technology in the 20th century have led to new professions and specialization in the field of medicine. As a result of the reflection of these developments on the hospital services, both the service units and the personnel have increased quickly in numbers. The personnel which were, divided in so many specializations, have had education in different fields and at different levels with respect to one another. This difference in the fields of specialization is affecting the relationship between physicians and patients in a negative way nowadays. In such a circumstance, it is unavoidable for breaks in communication, misunderstanding, tension, and conflicts to arise. It will be possible to eliminate these problems with a branch of specialization which provides primary care services continuously at home, in surgery, and sometimes in a clinic or hospital, and the purpose of which is the provision of health-education, early diagnosis and treatment, and home care. The family medicine, which has started to develop newly in Turkey, has the purpose of providing service of higher quality in the primary care, and is an academic and clinic discipline that gives education in this field, is showing great promise for elimination of these problems. RESUSCITATION OF LAZARUS ? - CONCEPTS OF SHOCK AND RESUSCITATION THROUGH
HISTORY.
G.L.Elgjo, Galveston, Texas, USA.
This study describes how the concept of shock has developed through history, and discusses how the understanding of this clinical syndrome has evolved along with efforts to find successful treatments. Understanding of shock has developed in stages, and groundbreaking advances were often made during times of war. The term "shock" first appeared in military surgical literature in the 18th century, where it was used to describe the force of a blow causing injury. As physicians gradually realized that apparently unrelated symptoms seen in wounded men were expressions of a common underlying pathophysiology, the term increasingly came to be used to describe the underlying process. From bloodletting "to decrease the reactive plethora" as the treatment of choice, therapy has evolved into its diametrical opposite over the past 200 years. Although at first glance apparently unrelated, pioneering attempts to use intravenous fluids in cholera marked a major milestone in shock therapy. However, not until years later was it realized that cholera had important clinical features in common with severe burns, crush injuries, and hemorrhage, and still more years passed before infusion therapy became clinically practicable. The interplay between the understanding of shock and its treatment is intriguing, in that sometimes new pathophysiological insight has led to new therapies, whereas at other times novel therapies have preceded medical comprehension. Today, shock is an umbrella term signifying a related group of clinical syndromes following severe injury from various causes, all rendering the patient dependent on life-supporting measures. Old and new definitions of shock are explored, and findings that may point to future therapies are discussed. EDUCATION OF MEDICAL HISTORY IN TURKEY AND SOME SAMPLES.
A.Demirhan Erdemir, Ö.Öncel, Bursa, Turkey.
The purpose of this study is to determine the development of education of medical history in Turkey and to point out the education of the medical history in two Turkish medical faculties. So, the education of medical history in these faculties is different from each other. The lectures of medical history are found in the programmes of education of basic sciences of the medical faculties in Turkey, today. in these faculties, lectures of medical history are 30 hours in a year. For example, these lectures are given as 30 hours both in Uludag University, Medical Faculty and in Istanbul. Medical Faculty. Put, Uludag Medical Faculty has applied integrity system since 1998. So, the lectures of medical history will he given according to this system in the third class in 2001. In this paper, the subjects of lectures of medical history of these two medical faculties are stressed in the form of tables and some scientific results are obtained.
CONSTANTINOPLE WOMAN'S COLLEGE MEDICAL DEPARTMENT : A BRIEF HISTORY.
S.Etker and G. Dinç, Istanbul, Turkey.
The Constantinople Woman's College (CWC) was founded by Woman's Board of Missions in 1871. The school flourished under Dr. Mary Mills Patrick, PhD LLD Litt D who was appointed principal 1883. Dr. Patrick's ambition was to start a medical school in Istanbul where Ottoma n women were not allowed to practice medicine. The medical department was finally inaugurated in the Arnavutkˆy campus of the college in 1920 after the armistice giving political control of the capital to the allies following World War 1. A nationalist congress convened in Ankara the same year. The school had adopted the curriculum of the Columbia University College of Physicians and Surgeons, and enrolled 19 girls from different nationalities. Two Turkish girls, Hamdiye (Maral) and Sabiha (Sayin) entered the school in its second year in 1921 to become the first students of medicine to be educated in the country. In 1922 the Istanbul University Medical Faculty after prolonged debates and under the pressure of the Ankara government, which had achieved sovereignty in Anatolia, accepted girls as students, including those attending the CWC. The CWC had completed construction of a separate hall for its Medical Department in 1923, but had run into financial difficulties by then. The proclamation of the Turkish Republic in the October of the same year affected the legal status of the college. The CWC Medical Department closed in March 1924. Four students in their fourth year, three Bulgarians and one Greek, were sent Geneva where they completed their medical training.
UN ANTECEDENTE DE ECONOMIA DE LA SALUD, 1904.
G.Fajardo, México, D. F.
La intención de este estudio es presentar un trabajo pionero en Economía de la Salud, llevado a cabo en México en 1904. La Economía de la Salud es una disciplina relativamente nueva. En Mexico en el puerto de Manzanillo, Colima, en la costa de « Océano Pacífico en 1904 se encuentran antecedentes de la relacion medicina-economía, en ese ano el Dr. J.F. Romero hizo un trabajo escrito que en la actualidad podria calificarse de costo-beneficio (formulación económica que se elabora para tomar mejores decisiones, en cuanto a la óptima utilización de los recursos de cara’cter pu’blico), presentó esquemàticamente, una acción rentable : el beneficio económico del uso de la quinina en la prevención del paludismo o malaria en cuanto a hospitalizaciones ahorradas, medicamentos no consumidos, servicios medicos no utilizados e inhumaciones evitadas. El estudio al parecer no trascendió, nonobstante de ser un llamado a médicos y a las autoridades pu’blicas y sanitarias para evitar gastos y danos a la salud.
ORIGEN Y EVOLUCION DEL CENTRO INTERAMERICANO DE ESTUDIOS DE SEGURIDAD SOCIAL
(CIESS).
G.Fajardo, México, D.F.
El propósito de este trabajo es exponer los antecedentes, evolución y situación actual del CIESS, organismo internacional de docencia, capacitación e investigación de la Conferencia Interamericana de Seguridad Social, instancia que contribuye al desarrollo de la seguridad social en los paÌses de America, agrupa a 72 instituciones de 37 países americanos. En 1963, se fundó en la Ciudad de Mèxico el CIESS a solicitud de varios países, sus a’reas de estudio son actuaría y planeación financiera, administración, jurídico social, informàtica, medicina social, salud en el trabajo, econom’a de la salud e investigación. En el aspecto de docencia e investigación en salud en el CIESS desde su creación se han impartido diferentes tipos de cursos y se han hecho varias investigaciones y publicaciones relacionadas con medicina social : administración de servicios médicos, gerencia de servicios de salud, enfermería, economía de la salud, prevención de riesgos en el trabajo, etc. Los eventos académicos han sido de diferente naturaleza : cursos, seminarios, talleres, diplomados y maestrías; se han realizado con la cooperación de universidades mexicanas y de otros países, del Instituto Mexicano del Seguro Social y de organismos internacionales como la OPS/OMS, OIT, OEA, etc. Muchas de las personas que han pasado por las aulas del CIESS han desempeoado importantes funciones no solo en las instituciones de seguridad social y salud, sino también en los sectores pu’blico, privado y universitario.
A NARRATOLOGICAL ANALYSIS OF HEALERS IN NINETEENTH-CENTURY AMERICAN POPULAR
LITERATURE.
E. Fife, New Paltz, New York, U.S.A.
The purpose of this presentation is to analyze selected representations of healers, including physicians and herbalists, from popular American prose fiction of the nineteenth century. The protagonists of Nathaniel Hawthorne's short stories "The Birth-Mark" and "Rappaccinís Daughter" and Sarah Orne Jewett's novels A Country Doctor and The Country of the Pointed Fir will be analyzed following Mieke Bal's theory of narratology. Both writers create very human healers, with strengths and weaknesses, individuals who must confront the validity, or lack thereof, of their paradigms. Existing paradigms must be modified or new ones constructed to accommodate the healer's and patient's experiences and beliefs. Failure to do so results in the patient's death. Furthermore, paradigms must include both objectivity and empathy in order for the healer to heal, and not kill. Hawthorne's healers are medical scientists who become trapped by their medical dogma, unable to predict or prevent the unfolding tragedy. Each possesses the paradigm that changing the fundamental nature of human beings is both possible and desirable, a paradigm motivated by false security in his own objectivity despite uncontrolled emotions. Jewett's healers are more successful in their treatments of patients because their paradigms are organic, changing to include both empathy and objectivity.
WHY THE AUTHOR OF IN FLANDERS FIELDS DECLINED A CHAIR AT GALVESTON.
D. Gardner-Medwin, Newcastle-upon-Tyne, England.
The family letters of John Mc Crae (1872-1918), written between 1899, when he left his Fellowship in Pathology at McGill to go as an artillery subaltern to the Boer War, and 1917, just before his death in a Canadian Military Hospital during the Great War, largely remain in the possession of his family. He also wrote diaries of his artillery service in those wars and of an adventurous canoe trip with Earl Grey, the Governor General of Canada, from Winnipeg to Hudson Bay in 1910. The letters and diaries, together amounting to more than 350,000 words, have been transcribed and edited. They form the basis of this paper. Between the wars, they gave a detailed chronicle of Mc Crae's medical and social life in Montreal and his constant driving work load, ambitions, frustrations and diversions. Reading and writing, and occasional voyages to Europe provided his main diversions; his poems and choice of reading clearly indicate his aspirations and enthusiasms, and it was while he was en route to Europe that the Great War was declared and in London that he made the fateful decision to enlist with the Canadian Field Artillery. In June 1905, he was invited to apply for the Chair of Medicine at Galveston, Dr George Adami acting as intermediary, probably at the instigation of Dr William Osler, « salary 3,000 and no consultant in the County ». His letters home at the time, and the wider picture his letters paint of his affections, loyalties and ambitions help to explain his decision to decline. McCrae was an adventurer, a passionate imperialist (like many of his contemporaries) and at heart an artillery man. Only secondarily was he a clever and dutiful physician, pathologist and teacher of medicine.
HALLAZGO DE NUEVAS EDICIONES DE BIBLIAS Y DE DOS OBRAS GRAMATICALES
"PERDIDAS" DE MIGUEL SERVET .
F.González Echeverriá, T. Ancián Chandiá, Tudela (Navarra), Espana.
Del genial y polígrafo Miguel Servet se conocian tres Biblias, dos en 1542, en folio y en octavo respectivamente, y otra en siete volu’menes, de 1545, las cuales nunca f ueron reeditadas y no existían otras variantes del exegéta Servet que las tres citadas. Desde nuestras aportaciones se deben de admitir que Servet, fue editado en la ediciÛn conocida de la Biblia sacra ex postremis doctorum., es decir, la de octavo, hasta 10 reediciones màs, no descritas hasta ahora, e incluso en 1542 (por los impresores Giunta, Porta y Boulle), e incluso después de su muerte, hasta el ano de 1563 con los impresores, entre otros, de Boulle, Paganus, Millis y Rovilio. También se debe de anadir una edición mas de la de 7 volu’menes impresa en 1588 en Venecia, aportada por nosotros por primera vez a la conocida lyonesa de 1545. Además se anaden dos -al menos por ahora - , obras « perdidas » de Servet, realizadas con el impresor Frellon, en 1551, en Lyon. Se sabía que había realizado traducciones de obras gramaticales del latín al espanol, por contrato con Frellon calificàndose de "perdidas". Aportamos « Los Dísticos de Catón » (Disticha de moribus nomine Catonis . ) en Lyon y el « Commentarius puerorum de Latinae Lingua Elegantia et Varietate. » impresa en Lyon y Lovaina, por el genial Servet. y, como a Erasmo o Cordier, anadírsele su labor humanística de ensenanza gramatical.
EL MEDICO MIGUEL SERVET ERA DESCENDIENTE DE JUDIOS.
F.González Echeverriá,T. Ancín Chandía, Tudela (Navarra), Espana.
Desde su muerte en Ginebra quemado vivo, el médico Miguel Servet (1551 ? - 1553) a instancias de Calvino, numerosos investigadores han opinado sobre su ascendencia pero sin no habián podido afirmar o negar su ascendencia judía por falta de pruebas. Nosotros por primera vez, y por protocolos notariales de su tía Beatriz demostramos que Miguel Servet, cuyo verdadero nombre era Miguel Serveto Conesa Meler Zaporta, alias Revés, es descendiente por línea materna de una importante familia judía, los Zaporta. Su madre Catalina Conesa Zaporta, era hija de Beatriz Zaporta, abuela de Servet, judía y hermana de Gabriel Zaporta, importante judeoconverso y banquero de Carlos V. A partir de ahora se puede entender mucho mejor « La restitución del Cristianismo » , impresa en 1553, obra que le supuso la doble quema de Servet (en efigie por los católicos y real por los protestantes), pues a la primera impresión de la circulación menor, además, del Corpus Hermeticum o el Corán entre otros, se entiende mejor como pudo citar obras de rabinos que no estaban impresas, así como su sabiduría hebraística que le permitía rebatir en sus obras teológicas a Lutero, Calvino o Melanchton, entre otros, por su dominio del hebreo de su. ascendencia judía demostrada por nosotros documentalmente por primera vez. Servet quiso buscar la unión entre judíos, católicos y reformados, para restituir el cristianismo a su pureza de los primeros siglos.
ALGUNAS PROPUESTAS PARA LA ENSENANZA DE LA HISTORIA DE LA MEDICINA.
M.González-Guerra, Caracas, Venezuela.
El propósito del presente trabajo es presentar algunas propuestas que permitirían lograr que los estudiantes de medicina desarrollen mayor interés por el estudio de la historia de su profesión. Se toma como punto de partida la afirmacion, muy generalizada, de que ellos muestran poco interés hacia el estudio de la historia de su profesión, fuertemente presionados por el deseo de mantenerse al día con la avasallante tecnologia que pareciera dar poco espacio para la formación humanística. Se hacen algunas reflexiones acerca de la función de la historia de la medicina en la formación médica, enmarcándola dentro de uno de los tres grandes componentes de la formación médica integral, concluyendo en la necesidad de redefinir jerarquizadamente los objetivos de la historia de la medicina en tres niveles progresivos y considerar ciertos aspectos metodológicos de caracter practico que harian mas viable el logro de estos objetivos y el cumplimiento de aquella función. Finalmente, se plantea la conveniencia de considerar la integració funciona de las Cátedras de Historia de la Medicina con los Archivos Históricos y Museos de las Facultades de Medicina para el desarrollo de un ágil programa de Historia de la Medicina, lo cual tendría su manifestación estructural en la creación de un Instituto Centro de Estudios Historicos y Humanisticos como formidable recurso de apoyo a ese efecto.
A STUDY OF TEACHING MATERIALS AVAILABLE FOR THE DEVELOPMENT OF A MEDICAL
HUMANITIES PROGRAM FOR SECOND YEAR MEDICAL STUDENTS ENTITLED « AFRICAN-
AMERICANS AND MEDICINE ».
R.Gordon, S.Heard, M.McLeod and E.Nebblett, Kalamazoo, Michigan, USA.
The purpose of this study was to investigate and try out various bibliographic sources available for a newly developed seminar on the history of medicine. This is a course dealing with the interaction of African-Americans with health care systems in the antebelum era during slavery up through the current period. Because the amount of time allotted to this course was only two hours per week for four weeks it was necessary to locate very succinct writings that made specific points and stimulated discussion of the subject matter. The broad categories encompassed include biological and medical theories used to help justify slavery, health problems of the slaves, medicaI problems of black soldiers in the American Civil War, the development of medical and nursing education programs for African-Americans, the black hospital movement, the Tuskegee Syphilis Study aid the theory that HIV virus was invented for the annihilation of the black race. The findings were that certain materials were well suited and continue to be used while others were discarded. Three years of experience will be presented and specific titles reviewed.
MISSED INTENTIONS - A REINTERPRETATION OF VESALIUS' GOALS FOR THE FABRICA.
S.R.Gregory, Galveston, Texas, U.S.A.
Modern literary criticism contends that an author's intentions are far less significant than the impact of an important text on society. This, however, does not justify the substitution of a historical text's impact over the author's original intent to the extent that the latter is forgotten. Accomplished Vesalian scholars such as Roth, Singer, and Cushing have contributed much to our understanding of Vesalius' landmark text, De Humanis Corporis Fabrica by careful analysis of the text itself and of the era in which it was written. What is scarcely, if ever, stressed is that the author's expressed intentions were not at all in accordance with the outcomes of Fabrica's release that are now widely held. If Vesalius can be believed for his own words, he never intended to create or define the study of anatomy as a separate and distinct discipline nor did he intend advance a new way of scientific methodology for medical study and practice. I will demonstrate that Vesalius' intentions were quite the opposite of the historically purported outcomes of his Fabrica through a careful interpretation of his dedication of the text to Charles V. Rather than scrutinizing the original (Latin) text, I will rely on a modem translation and other secondary sources to characterize Vesalius' words in the context of the academic environment surrounding him.
CHAUNCEY D.LEAKE 1896-1978, PHARMACOLOGIST, HISTORIAN AND FRIEND.
F.Guerra, Madrid, Spain.
Chauncey D.Leake was born at Elizabeth N.J., studied at Princeton and received his PhD at the University of Wisconsin. His first teaching appointment was at the University of California, San Francisco in 1928, where he established the Department of Pharmacology and remained there until 1942. That year he became Vice-President of the University of Texas at Galveston and was professor of Pharmacology until 1956. He then went to Ohio State University as an assistant dean and professor of Pharmacology until 1962, when he returned to San Francisco UCSF to direct a program on research and training of medical students. He was the president of the American Association for the Advancement of Science, American Society for Pharmacology and Experimental Therapeutics, American Association for the History of Medicine and others. He was a warm and inspiring friend who influenced deeply my life. Since 1945, when I met him first at Mexico City, where I was the professor of Pharmacology, we exchanged weekly correspondence, some times in long hand, for over thirty years.
STATUS, SPACE AND SAFETY : ASPECTS OF SPECIALIST DEVELOPMENT IN BRITISH
RADIOLOGY.
J.M.Guy,Lavenham, Suffolk, UK.
This paper examines the factors promoting and retarding the development of radiology as a clinical specialty in Britain up to 1930. There are points of contrast with the situation in the USA. Articles in medical journals and the unpublished records of hospital committees reveal the considerable problems of those wishing to practice radiology in a hospital setting. Private radiology is less well documented but faced similar difficulties, financial, technical and interprofessional. Voluntary hospital management was slow to accept radiologists on the regulatory board. Fellow doctors were reluctant to accept specialists of any kind. Rather than being given status as "honorary" physicians or surgeons, the radiologists were paid a meager salary for their services. Accommodation was generally in cramped, dark basements, equipment grudgingly supplied, electrical power unreliable, radiation protection inadequate. Radiologists themselves claimed that their knowledge of the nature and dangers of radiation gave them the qualification for specialist status. Though aware of its dangers they were not for the first several years able to measure the radiation to which they, the patients and their assistants were exposed, and failed to prevent damage.
RELATIONSHIPS BETWEEN THE UNITED STATES AND LEBANON.
Farid S Haddad. Paradise Valley, Arizona, USA.
After the massacres of 1860 in Syria and in Lebanon, a few American Missionaries felt the urge to enlarge their educational work, and to found, in 1866, an institution of higher learning in Beirut which they named the Syrian Protestant College (SPC); this name was changed, in 1922, to "American University of Beirut", an Institution built on American educational principles. At first, and until 1882, the language of instruction was Arabic. The American Professors learned Arabic, wrote textbooks in Arabic, and had them published by the American Press in Beirut. In 1882, it was decided to change the language of instruction from Arabic to English which continued to be used up to the present time. In 1867, the College started a Department of Medicine which later became known as the School of Medicine. Schools of Dentistry, Pharmacy, Nursing, and Public Health were subsequently added. The AUB and particularly its Medical School had a very preponderant influence on Medicine in Lebanon, as well as the whole Middle Eastern Countries. Out of a total of 2684 medical graduates, from 1871 to 1986 inclusive, only 58.5 % came from Lebanon. As an unexpected bonus, medical graduates emigrated to the United States where several of them occupied important positions in the various prominent American medical institutions such as Harvard, Johns Hopkins, the Mayo Clinic etc. Through them the United States was amply repaid for its generous efforts.
PNEUMATOLOGY, GREEKS AND LEONARDO DA VINCI: MODERN TREATMENT OF ERECTILE
DEFICIENCY.
R. Hilloowala. Morgantown, West Virginia, U.S.A.
This study correlates the modern treatment modalities, implant and chemical (Viagra), for erectile deficiency with the concepts and principles promulgated in early Greek medicine by Alcmaeon (c.530 B.C.), Hippocrates (c.460-370 B.C.), Herophilus (c. 300 B.C.) , Erasistratus (c.290 B.C.) and Galen (130-200). Leonardo da Vinci (1452-1519), little more than a century after the Greeks, illustrated, though anatomically and functionally incorrect, the mechanism underlying the tumescence of the penis as understood by the Greek school. Unknowingly, Leonardo also demonstrated the principles underlying the modern treatment of erectile deficiency. The Greek cephalocentrics held the belief that the brain is the seat of motor and. sensory function. Pneuma, as defined in Greek philosophy and physiology, is the soul, the spirit, and the breath of life. The psychic pneuma, transformed in the ventricles of the brain from the vital pneuma then travels through the spinal-cord and the nerves to activate muscles and organs. Leonardo illustrated the Greek ideas showing therefore two passages in the penis, one for urine, the other for the pneuma that is responsible for inducing erection. The conceptual principles underlying the idea of pneuma is similar to the function of the implant, or chemical intervention. In the first case, fluid is pumped into the penile prosthesis. In the second, the drug stimulates the parasympathetic system increasing the blood flow to the organ. In both cases, infusion of fluid (pneuma) results in an increase in the size of the organ.
COMPARISON OF HEALTH CARE SYSTEMS BETWEEN JAPAN AND U.S.A.
T. Hirose. Shumei University, Tokyo, Japan.
Japan has universal health insurance so everybody enjoy comprehensive health-care at anytime, anywhere. U.S.A. have a governmental and private insurances which is dominated by managed-care, and also has many uninsured. Although, the priverated enjoy the best medical care. The participants of Medicare and Managed-care are exposed to restrictive medicine. Medicaid's enrollee and uninsured may receive a rationed medicine.
THE HISTORY OF THE ISHM’S CONGRESSES DURING THE PAST 25 YEARS /EMPHASIS ON THE
PARTICIPANTS OF THE AMERICAN CONTINENT/ - WITH A LOT OF DIAPOSITIVES.
J.Honti, Budapest, Hungary.
The topic is a large one. The author summaried this theme in Moscow March 1998 / national congress, emphasis was on the participants of the Eastern Block countries / and in Tunis - Carthage in September 1998 36th International Congress / and continues it now. In Galveston’s Congress, the emphasis is on the participants of the American continent. He discusses the topics of the congresses and the most interesting lectures. There are a lot of diapositive illustrations.
DISABLED EX-SERVICEMEN IN EARLY MODERN ENGLAND.
G.L.Hudson, London, UK.
The English men who survived the havoc wrought on their bodies needed and demanded relief Mutilation and illness brought poverty. In this paper I examine the relief of chronically disabled ex-servicemen from two perspectives: how the disabled worked systems of relief, and the ways in which the state attempted to regulate the bodies of the men. From these perspectives our understanding of the social relations of the period is altered significantly, and the image of unimpeachable progress presented by historians is suspect. In this investigation, I use sources for the Elizabethan county pension scheme for ex-servicemen (1593-1679), and rich records from the army and navy hospitals of Chelsea and Greenwich respectively (created in the late seventeenth century). The materials used include petitions from the men themselves, as well as detailed accounts of the ongoing discipline exercised within the county and hospital systems. Such records illuminate the increasing regulation of the men within the county pension scheme, and the underlying reasons why these specialised hospitals were created and maintained--how they exercised social regulation and control. They also reveal how the ex -servicemen actively worked the systems for their own benefit, demonstrating a keen sense of entitlement. Within this analysis I consider also the effects of war on the body-- quantifying the physical damage--and contemporary attitudes to disability. I explore both life-cycle poverty and its import for notions of pensionable disability, and how the men's bodies were experienced by themselves in the light of Immoral medical theory. Progress was indeed made by the state, but towards increased control and discipline of the men rather than necessarily towards improved relief. This change was not simply imposed however. Instead of subordination a process of negotiation developed between those impoverished by war and the governing elites in early modem England. A process in which the disabled, although the lesser party, nonetheless played their hand with a fair bit of skill, energy and, indeed, some success.
DR. ESAD FEYZI,A PIONEER OF MILITARY RADIOLOGICAL SURGERY.
Yesim Isil ILMAN. Istanbul Turkey.
The invention of X-rays by W.C. Roentgen was a very important step for the development of science. The penetration of these rays into solid matters and the reflection of their shadow oil a screen was a revolutionary technique for scientists, all around the world. On tile other hand, this technique vas immediately applied for medical anus. Tile start of radiology in Turkey owes a great deal to the scientific curiosity of a physician, Dr. Esad Feyzi who installed the first Roentgen apparatus and took the first radiographics at the Faculty of Medicine in Istanbul, in 1996, just a few months after Roentgen's discovery. Dr. Esad Feyzi (1974-1902) was also one of the pioneers who took advantage of X-rays for medical diagnosis, having established the Roentgen apparatus at the Yildiz Military Hospital, in Istanbul. He and his colleague, Dr. Rifat Osman, succeeded in imaging, by X-rays, the bullets and shrapnels embedded into the body of the soldiers wounded during the Turkish-Greek war in Thessaly, in 1897. In this way, they were able to facilitate the surgical operations much more than ever. This is one of the earliest examples to the X-ray technique application in military surgery. The physicians and authorities of the German Red Cross delegation, who visited the Yildiz Hospital, witnessed this quite early use of Roentgen rays for war-surgery and expressed their admiration. In this paper, this historic event will be evaluated primarily basing on the passages of Dr. Esad Feyzi's life-story.
HISTORY OF MEDICAL EDUCATION IN NIGERIA.
T.F.Ipaye , and O. A. Sofola, College of Medicine, Lagos, Nigeria.
This presentation has made an attempt at tracing the development and growth of formal Medical Training at the tertiary level in Nigeria, the most populous black African country with an estimated total population of about 96 million people. This paper tried to trace the development of formal training in Medical Education leading to the establishment of university based medical training. with the College of Medicine of the University of Lagos as the focal. point of this study. Information was gathered from earlier write-ups in newspaper, journals, prospectives and government policy papers. The growth of medical education which started in Nigeria. in the 1920's eventually culminated in the establishment of Universities in the 1960's. From 1962 to date, the country has witnessed a remarkable growth in the number of Colleges of Medicine and this is reflected in the number of qualified manpower being produced. This has to a considerable extent greatly improved the doctor/patient ratio in Nigeria. It is hoped that the next millennium will witness a significant reduction of healthcare personnel per patient ratio to an acceptable level in the most populous black nation in Africa.
ULTRASOUND IN CARDIOLOGY : HISTORICAL ASPECTS.
B.W. Johansson. Malmö, Sweden.
Cooperation between I. Edler and H. Hertz resulted in the first echocardiogram in May 1953 in a patient with mitral stenosis at the University of Lund, Sweden, using Firestone's ultrasound reflectoscope. As funding authorities were negative, W. Gellinek, medical research director of Siemens, Erlangen, Germany, provided an "Ultraschallimpulsgerät" and with this device the first ultrasound cardiograms were recorded on October 29th, 1953. Gellinek stimulated German doctors to learn the technique at Lund. At the end of the 1950s, interest in this technique arised in Japan but the progress was greater in China, and, in 1961, the Shanghai Medical Ultrasonics Group published its first book on ultrasound as a diagnostic tool. Funding authorities were reluctant also in the USA and, in 1968, H.Feigenbaum invited I.Edler among others to give a lecture at a course, in Indianapolis. Already, during the 1950s, Hertz and Edler discussed two dimensional echocardiography. The first 2-D tomographic ultrasound pictures of the human heart were shown by Hertz and Aberg at the 5th International Conference on Medical Electronics in Liège, Belgium. The technique was improved by Hertz and Lindström. Edler and Hertz were awarded the American Lasker Prize. GODS, QUACKS, HEROES, AND HOLOGRAMS: CHANGING IMAGES OF HEALERS IN WESTERN
LITERATURE AND POPULAR CULTURE.
A.H.Jones, UTMB, Galveston, Texas, USA.
This presentation will offer a brief historical overview of major changes in images of healers in Western literature and popular culture, from the gods of ancient Greece to the quacks of Chaucer's and MoliËre's times, and from the heroic images of the early 20th century to holographic representations at century's end.
LA ENSENANZA DE LA HISTORIA DE LA MEDICINA EN LA ARGENTINA
A. G.Kohn-Loncarica. Norma Isabel Sànchez.
La ensenanza de la Historia de la Medicina (HM) se inició en la Argentina en 1853 en el caràcter de asignatura de pregrado, dictada en uniÛn con Patología y Medicina Legal. En 1880 fue suprimida de los planes de estudio, para reaparecer màs de medio siglo después, pero con el nivel de materia de posgrado. En 1929 se creó en la Facultad de Medicina de Rosario como càtedra independiente y en 1936 en la de Buenos Aires. En esta u’ltima se dicta, en la actualidad, HM para la « carrera docente », es decir para aquellos profesionales que aspiran a ser profesores de la Facultad de Medicina. Desde fines de la década de 1980 la ensenanza de la HM se vincula cada vez màs con el ascendente movimiento de las llamadas "Humanidades Médicas" (en particular relacionada con la Bioética). HEALING ART IN ANCIENT GREEK TRAGEDY.
T.D.Kontopoulou,S.G.Marketos,International Hippocratic Foundation of Kos, Greece.
The purpos e of this paper is to point out and to explore the elements of healing art in the tragic texts, one of the most important literary sorts in the classical period of ancient Greece. The tragedies of the three eminent representatives - Aeschylus, Sophocles and Euripides - were studied and analyzed to a large extent. The related literature was also utilized. Gods hold an important position in the healing art of human diseases. Mortals though often appear as healers. Pharmaceutical treatment is followed in many cases. There are, however, several mentions of operative treatment. The way of life of the patient, the diet, the psychological state, the position in his family and the social environment and his relation to the attendant doctor are supposed to be considerable factors that not only influence, but determine the therapeutic issue of the disease as well. The great significance of prevention - primary and secondary - is emphatically underlined. In conclusion, ancient greek tragedy, a ripe fruit of ancient greek spirit, forms an inexhaustible knowledge spring of the healing art in classical greek antiquity. THE DRIVE TOWARD MORE MODERATE THERAPIES IN BRITISH MEDICINE, 1750-1800.
P.Kopperman, Corvallis, Oregon, U.S.A.
This paper will focus on a shift in British medical practice that occurred during the latter half of the eighteenth century. The aim of those who advocated this development was to make therapy at once less debilitating and less painful for the patient, and more effective, as well. The period 1680-1750 saw a considerable turnover in the group of drugs that were widely used in British professional medicine. During the subsequent half-century, the aim in drug therapy, and in the use of particular drugs, was refined, as progressively more medical authorities came to look to nature to cure disease, and saw drugs mainly as agents that might influence the patient's system in such a way as to facilitate a cure. Associated with this revision in the essential aim of drug therapy was a movement away from reliance on treatments that focused on physical expulsion or on removal of fluids. Medical writers regularly cautioned that bloodletting was being used too generally and advised that emetics, cathartics, and sialogogues be prescribed with greater caution than was common in practice. Patients, too, often favored milder therapies. The demand for moderation in treatment was not universal. Nevertheless, the impetus was great enough to promote a decided shift in professional therapy. PICTURING BLOODLETTING: A UNIQUE MEDIEVAL HEBREW LASSMANN.
S. Kottek, Jerusalem, Israel.
One of the masterpieces featured in the Catalogue of Medieval Manuscripts of the BibliothËque Nationale in Paris is the Hebrew Lassmann, i.e., a representation of a nude, male, circumcized body where the places where phlebotomy may be performed are indicated. The names of the veins, and the ailments for which bloodletting should be carried out at that specific place, are marked in Hebrew. This Lassmann is also a Homo Zodiacus , the signs of the Zodiac being handsomely portrayed at the side of the organs on which they are known to preside. The manuscript (360 folios) contains a number of medical texts in Hebrew, taken from the works of Serapion, Gentilis, Juhannah ibn Massawayh and Ibn Sina. The picture, of fine artistic quality, appears at the end of the manuscript, full-page, without any related text, There is on the next page a smaller picture, featuring the tunics of the eye. This Hebrew Lassmann is generally considered to be a unique drawing of this kind, but we have found another one, of rather low artistic quality, at the Cambridge Library. THE SURGEON AS DEPICTED TN TALMUDIC LITERATURE.
S. Kottek, Jerusalem, Israel.
AIthough there is in the Talmud no clear-cut terminological differentiation between physician and surgeon, the latter was usually called umman, i.e., artisan - a manual worker. The social status of the surgeon was apparently rather low, significantly lower than that of a physician (rofe). On the other hand, he was closer to the plain population, and was therefore often consulted on medical, or halakhic-medical questions. Physicians and Rabbis stood one step higher in the hierarchy of those who could be consulted. While commenting on a rather disparaging maxim on healers: ìThe best of physicians to Gehenna!î, the Talmud focuses on the bad reputation of bloodletters. On the other hand, one individual surgeon, named Abba, is singled out by Talmudic Sages as an example of a devoted and disinterested professional. Such diverging statements exemplify once again how the Talmud describes Jewish society at large, as it looked like in the late classical and early Byzantine periods. COMMENTS OF SABUNCUOGLU ON ABDOMINAL INJURY.
Namik Kemal Kurt, Istanbul, Turkey.
The transfer of surgical information from the antique period to Islamic surgery, primarily that of Zahrawís, who was influential on a large geographical area, can be traced to one of the most eminent surgical writings, the illustrated surgical manuscript of Sabuncuoglu, a 15 th century Turkish surgeon. Sharp injuries of the abdominal wall was described by Sabuncuoglu as slight, moderate or heavy, as in Zahrawi's text. In slight injuries, the intestine protrudes through the injury and swell s in a short time and must be pushed in urgently. In case of delay, there are two methods to be tried. One is to reduce it by dressing with warm water using a sponge or cloth. The second method is widening the wound. When the wound is large and in the upper abdomen, the patient's head should be placed higher; but if in the lower abdomen, the patient should have his legs higher than his head, so that the internal organs will not be effected by gravity. Various types of sutures are described; and needles, fine, medium and thick; and different threads, such as double and twisted are mentioned. A comparative study of Sabuncuoglu's and Zahrawi's works prove that, like Zahrawi, Sabuncuoglu too, put forth new ideas and introduced modifications in surgical treatments, as well as bringing forth his case studies as proof of alternative treatment and different prognosis. This text is a very good example of the transfer of medical information from one civilization and period to another, with the addition of new knowledge.
PORCEILAN TEETH: A BADKNOWN CHEMIST INVENTION DEVISED AT SAINT- GERMAIN-EN-
LAYE HOSPITAL.
R. Slioberg, A. Lelloucb, St-Germain-en-Laye, Yvelines, France.
The aim of this study is to do better know a significant invention devised by a chemist working at Saint-Germain-en-Laye hospital. The village is situated at 27 kin from Paris, in the western area. The present hospital, built in 1881, has been preceded by the edification, in 1640, of << Hôtel-Dieu de la Charité ” . In 1776, Alexis Duchateau devised porcelain teeth which us efully took the place of ivory teeth and other animals teeth. With the help of Dubois de Chamant, dental surgeon, Duchateau took an individual moulding of the teeth. In 1786, he read successfully his paper to the Royal Academy of Surgery. However Duchateau's invention was significant, the chemist was supplanted by the dental surgeon (<< Dissertations sur les avantages des dents et rateliers artificiels, incorruptibles et sans odeur>>, Paris, 1788) who took out, before him, a patent, in 1791. The last becomes rich ; the first had, at least, the pleasure to use for himself beautiful porceilan teeth introduced into a mouth without bad breath.
ETUDES MEDICALES ET SPECIALISATION DANS LA PRESSE PROFESSIONNELLE :
50 ans D'ANALYSE (1895-1944) DU CONCOURS MEDICAL.
A. Lellouch, Saint-Germain-en-Laye, France.
Le Concours Médical contribue à la formation continue des Généralistes. A l'occasion de son centenaire (1979), le journal a réédité une série les textes concernant la médecine, l'enseignement médical (dont celui des spécialités et les médicaments). Notre analyse a porté sur la période 1895-1944 à propos des études médicales. Hormis l'organisation de la spécialité d'électroradiologie, les thèmes principalement retrouvés sont les suivants : hantise de la “ pléthore médicale ”, numerus clausus exigé, culture générale gréco-latine ardemment défendue, ambivalence face à une spécialisation risquant d'amputer l'omnipratique avec refus du certificat d'études supérieures de spécialité, importance primordiale donnée à la clinique et à l'anatomie plutôt qu'au laboratoire, rôle majeur de l'hôpital et du concours de l'internat. Ces thèmes, récurrents et finalement peu variés, résument bien les caractéristiques de la médecine libérale française de l'époque. Ils reflètent aussi les préoccupations d'un corps médical frileux, inquiet pour son avenir et, dans l'ensemble, assez conservateur.
J.B. CLERC'S (1790-1875) PREMONITION ON THE “ ANTISEPTIC PRINCIPLE ” AT ST- GERMAIN-
EN-LAYE HOSPITAL.
R. Sliosberg, A. Lellouch, St-Germain-en-Laye, Yvelines, France.
Documents collected by Dr. Louis Moret in a lecture, given on January 10, 1942 to the “ Amis du Vieux Saint-Germain ”, Dr. Clerc practiced at St-Germain-en-Laye from 1831 until he died, in 1875. “ Maison de la Charité ” was both, civilian and military hospital. Including 216 beds, Dr. Clerc's department took in charge patients with fevers, wounds, poor people and elderly. “ If cuts suppurate and if patients who had undergone an operation die, it is because surgeon hands, surgical instruments and bandages introduce living germs which generate suppurations, gaseous gangrene, tetanos and hospital corruption ”. Clerc's premonition preceded both Lister's “ Antiseptic principle in the practice of surgery ” (1867) and Pasteur's microbes discovery (“ La théorie des germes et ses applications à la médecine et a la chirurgie ”, 1878). Instruments and bandages were set in the oven of Clerc's gas-cooker; the linen which envelopped them was left in the oven until it becomes browned. Before using the chirurgical instruments, he obliged himself and his assistant surgeons to wash the hands with a soap during a very, very long time. Thus, despite their historic and present importances, Clerc's assumptions remained nowadays mostly unknown.
PATTERNS OF EUROPEAN NEUROSURGERY.
B. Lichterman. Moscow, Russia.
Although craniotomy is the oldest known surgical operation neurosurgery as a specialty was formed in the first decades of the 20th century. The purpose of this study is to show significant difference in its development in three European countries: United Kingdom, France and former Soviet Union. The structure of Soviet neurosurgery was highly centralized. At the top level there were three Neurosurgery Research Institutes - in Leningrad (1926), Moscow (1932) and Kiev (1950). Central Institute of Neurosurgery in Moscow was headed by Nikolai Burdenko (1876-1946) who viewed neurosurgical interventions as human experiments aimed to confirm neurophysiological concepts of Iv an Pavlov (1849-1936) and Vladimir Bekhterev (1857-1927). Three basic principles of brain surgery were declared: anatomical availability, technical possibility and physiological permissibility. In the UK neurosurgery was launched by a small group of Harvey Cushing's pupils (G. Jefferson, H. Cairns, N. Dott and some others). The Society of British Neurological Surgeons founded in 1926 was initially limited to 15 members and resembled rather a private convivial club than a scientific body. French neurosurgery of the first half of the 20th century was represented by two Paris -based persons Thierry de Martel (1876 -1940) and Clovis Vincent (1879-1947). Both centralized and decentralized patterns of the development of neurosurgery had their advantages and drawbacks. They still have a strong impact on contemporary neurosurgery.
LET THE CHILDREN DIE!
C. M. Lindroos, Helsinki, Finland.
The situation of the children in many cultures has been very weak. In ancient times the firstborn child within many religions was offered to the Gods. A similar request is found in our Holy Bible there it says that the firstborn should be killed. Also enemies were tried to annihilate by killing all male children. Weak, sick children were left to die due to religious reasons that the dead children came to heaven. But the reasons were also practical-, the poor food was saved for the stronger individuals which had an opportunity to survive. Children have also been killed as a form of birth control. Lying a child to death which was known by everyone, was not punished by the church. From the late 16th century the comprehension about the children changed. The clerks, physicians and midwifes tried with intensive information the people to realise the value of a little child. With suitable food, cleanliness and the introduction of vaccinations the child mortality has diminished to a minimum in most countries.
LAST OUTBREAK OF THE SPANISH FLU IN 1920. INFLUENZA IN LAPLAND, FINLAND.
E.Linnanmäki , Helsinki, Finland.
The influenza pandemic called the Spanish flu was one of the most devastating demographic catastrophes in history. It affected the entire world killing over 30 million people in less than a year. Mortality was peculiarly high among young adults. Influenza occurred in four distinct waves. The first appeared in spring 1918 being reasonably mild. The second and the most fatal wave arose in fall 1918, and the third wave during the spring 1919. In previous studies, the last wave or outbreak in winter 1920 has remained poorly investigated. In Finland, influenza spread widely in January and February 1920. Although the overall mortality was not as high as during the previous waves, some regions were hit hard. This study describes the fate of three isolated parishes in the northernmost Finland during the outbreak 1920. The study focuses on the mortality impact of the flu. Archival data for this study comes from parish death records and annual reports of the District Medical Officers and municipal doctors. The parishes of Lapland were severely afflicted. The highest mortality was detected in the municipality of Inari: according to the death records influenza killed approximately 10% of the population over the period of two months. Apparently the flu virus was still in full force and/or the attacked population was extremely vulnerable. The sparsely populated northern parishes had more or less escaped the previous flu waves. But, in the beginning of 1920, whole villages were suddenly laid up with flu. No supportive care was available and many died from a lack of basic needs.
TEACHING HISTORY OF THE XX CENTURY MEDICINE AT RUSSIAN MEDICAL SCHOOLS.
Y. Lisitsyn, T. Zhuravleva, Moscow, Russia.
Teaching medical history at medical schools usually does not go beyond I 9th - early 20th century because it is postulated that one needs half a century gap to consider events objectively. It is also thought that the last 30-50 years does not belong to history but to the life-time of our contemporaries. Nevertheless social and scientific changes in the 20th century are unparalleled (WWI and Russian revolution, WW2 and fall of totalitarian regimes, final decay of the colonial system and formation of newly independent states, replacement of socialist system by market economy). Thes e and some other events created the background of scientific development including medicine. We are witnessing the so-called <<information explosion>> - the amount of information doubles every 10-15 years. Information technology became a key element of scientific development. Modem medicine and healthcare is shaped by events, breakthroughs and illusions of the last century. That is why it should be studied, investigated and taught to medical students. In our opinion teaching modem medical history should be shared by all medical specialties. Each clinical course should include information about recent developments of the relevant field. Such information should be delivered at lectures, seminars and included into examination tests of medical subjects (special medical history). General trends and philosophy of 20th -century medicine constitute general medical history which should be taught at the chairs or courses of medical history.
GLIMPSES OF ANCIENT INDIAN (AYURVEDIC) MATERIA MEDICA.
Sisir K. Majumdar, Calcutta, India.
The aim of this paper is to throw light on materia medica in ancient India. India's medical and cultural heritage is very ancient; our unparalleled books of knowledge and wisdom in all aspects of science and philosophy - the four VEDAS (meaning knowledge) are dated 5000 BC - RgVEDA, SAMVEDA, YAJURVEDA and ATHARVAVEDA. AYURVEDA (AYU = life; VEDA = knowledge/science) Science of Life, is a part of ATHARVAVEDA. its texts included three big treatises "SANHITAS" (600 - 500 BC) - viz Charaka Sanhitas (Book of medicine), Susruta Sanhitas (Book of Surgery) and Vagbhat Sanhitas (mixed ) . Susruta - "Father of Surgery" mentioned in his Sanhitas 395 plant preparations where as in Charaka Sanhitas the corresponding figures are 341, 177 arid 64 respectively. Medicinal plants were classified according to their therapeutic action (50 such groups in Charaka Sanhitas). The pharmacological basis of therapeutics in Ayurveda is based on the concept that the human body is composed of natural elements like Air, Fire and Water. When these are disturbed, it leads to diseases of Air (Vayu), Pitta (Bile) and Kapha (phlegm) in the human system as described in the Tridosha Theory. The effects of medical plants are conceived to correct those derangements. Ayurvedic Materia Medica included easily available cruder drugs of plant., animal and mineral origin, probably for economical reasons for the people of a simple society.
BIRTH OF MODERN MEDICAL, EDUCATION -IN THE INDIAN SUBCONTINENT.
Sisir K. Majumdar, Calcutta, India.
The aim of this paper is to throw light on the evolution of modern medicine in the Indian Sub-continent (South Asia). Modern medical education started in the Indian Subcontinent during the British Colonial rule (1757 - 1947). Today it includes India, Pakistan, Bangladesh, Sri Lanka (Ceylon), Myanmar (Burma) and Nepal. During the Indus Valley civilisation (c2500 - 1600 BC) and the Aryan civili-sation from around 1500 BC till the 10th century A.D., Ayurvedic (Ayurbed = "Science of Life") System of medicine was v ery developed. Since the 16th Century, India came in close contact with the West when Portuguese, Dutch, French and English traders started establishing trading bases on the sea coasts. During the Seven Years War (1756 - 1-763), the British East India Company, eliminating the French rivals made themselves masters of Bengal. in the East and the Carnatic (Madras) in the South. Within a century direct or indirect British rule was established all. over India. After the Indian Mutiny (Sepoy Mutiny) of 1857 - 1858 - the first flame of Indian independence struggle, the rule of East India Company was abolished, and India passed under the British Crown as its brightest jewel. In fact, even during the rule of the Company, English education started in India. Medical education was also on top of the Company's agenda. In a word, during the British Colonial rule, the seeds of modern medical education were sown in India. Then, it flowered and flourished.
THE REPORT OF VICTOR GOMOIU AT THE XIth INTERNATIONAL CONGRESS FOR THE HISTORY
OF MEDICINE, ZAGREB-BELGRADE, 1938, ON THE STATE OF EDUCATION IN HISTORY OF
MEDICINE IN VARIOUS COUNTRIES.
V. Manoliu, Savannah, Georgia, U.S.A.
Dr. Victor Gomoiu (1882-1960) was a prominent Rumanian anatomist and surgeon, a founder of the Rumanian Society for the History of Medicine and Pharmacy in 1929, and the president of the IXth International Congress for the History of Medicine, Bucharest, 1932. He was also President of the International Society for the History of Medicine, and later an honorary member. At the XIth International Congress, Zagreb-Belgrade, 1938, he presented in French an ample report on the then current state of education of History of Medicine in various countries The documentation for the report was compiled on the basis of the answers provided by historians of medicine from twenty-two countries to a questionnaire he had sent out. The report was published in the Compte-Rendu of the Congress, pp. 58-77. Thirty years later, Prof G. Miller approached the same subject, but this time only for the U.S. and Canada, in a paper presented at the XXIth International Congress, Siena, Italy, 1968.
DR. RICHARD DENNIS ARNOLD (1804-1876): AN IMPORTANT PERSONALITY OF MEDICAL
PRACTICE, INTELLECTUAL AND POLITICAL LIFE IN SAVANNAH, GEORGIA.
V. Manoliu, Savannah, Georgia, U.S.A.
At the XXth International Congress of History of Medicine, Berlin, 1966, 1 was privy to a discussion between Prof. G. Miller and Prof. V.I. Bologa where I first learned of the activities of Dr. Richard Dennis Arnold. Since 1972, 1 have lived with my family in Savannah, Georgia, where my interests in the history of medicine eventually led me to research the multifaceted life of Dr. Arnold, a noted physician and important intellectual and political figure.Dr. Arnold was born in Savannah in 1804 and is buried at the Bonaventure Cemetery. He was educated at the College of New Jersey, completing his medical studies at the Medical College in Pennsylvania, graduating in 1830. Dr. Arnold began his medical career as public vaccinator for the city of Savannah. He entered politics and was elected alderman, and then mayor of the city. He was also the publisher and editor of the "Georgian." A noted physician, he was also a co-founder of the Georgia Historical Society, and a member of the Georgia Medical Society and the American Medical Association. He was a member of the committee that drafted the American Code of Ethics. Dr. Arnold was a founder of the Savannah Medical College and the Savannah Journal of Medicine. As mayor of Savannah, he surrendered the city to General Sherman in 1864.

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