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Summary Surgeons and their patients recognise that one of the major advances in surgical technique over the last 20 years has been the growth of minimal access surgery by means of laparoscopic and robotic approaches. Partnerships with industry have facilitated the development of advanced technical instruments, light sources, recording devices and optics which are almost out of date by the time they are introduced to surgical practice. However, lest we think that technological innovation is entirely a modern concept, we should remember that our predecessors were masters of their craft and able to apply new technologies to surgical practice. The history of minimal access surgery can be traced back to approximately 5000 years ago and this review aims to remind us of the achievements of historical doctors and engineers, as well as bring more modern developments to wider attention. This review will comprise a three-part series: Part I 3000BC to 1850 Early instruments for viewing body cavities Part II 1850 to 1990 Technological developments Part III 1990 to present Organisational issues and the rise of the robots

The analysis of three characters corresponding to different spaces and times shows the close link between literature and the history of medicine. On one hand, Don Quixote of La Mancha, who reflects the thought of the last years of the Renaissance and that has been assimilated in contemporary Mexico. On the other hand, Doctors Miguel Francisco Jiménez and Rita Levi Montalcini, who lived in the 19th and 20th centuries, respectively. Despite the years that separate these three personalities, many elements in common are observed that do not lose their validity: the value that is given to health, ethics, tenacity and experience to attain successful results. All three characters refer to the medicine of their time, their achievements and the promotion of humanism, always inherent to medicine.El análisis de tres personajes correspondientes a espacios y tiempos diferentes muestra el estrecho vínculo entre la literatura y la historia de la medicina. Por un lado, don Quijote de la Mancha, quien refleja el pensamiento de los últimos años del Renacimiento y ha sido asimilado en el México contemporáneo. Por otro lado, los doctores Miguel Francisco Jiménez y Rita Levi Montalcini, quienes vivieron en los siglos XIX y XX, respectivamente. A pesar de los años que separan a los tres personaje, se advierten numerosos elementos en común que no pierden vigencia: el valor que se otorga a la salud, la ética, la tenacidad y la experiencia para obtener resultados exitosos, entre otros. Los tres personajes aluden a la medicina de su tiempo, los logros alcanzados y la promoción del humanismo, siempre inherente a la medicina.

Of the early-sixteenth century pre-Vesalian anatomists, Magnus Hundt in 1501 and Johannes Eichmann (known as Johann Dryander) in 1537 both attempted to summarize the anatomy of the head and brain in a single complex figure. Dryander clearly based his illustration on the earlier one from Hundt, but he made several improvements, based in part on Dryander's own dissections. Whereas Hundt's entire monograph was medieval in character, Dryander's monograph was a mixture of medieval and early-modern frameworks; nevertheless, the corresponding illustrations of the anatomy of the head and brain in Hundt (1501) and Dryander (Dryandrum 1537) were both essentially medieval. This article examines in detail the symbology of both illustrations within the context of the medieval framework for neuroanatomy and neurophysiology. These two woodcuts of the head and brain provide the most detailed pictorial representation of medieval cranial anatomy in a printed book prior to the work of Andreas Vesalius in 1543.

ObjectiveFor centuries, the tympanum has remained the only visible structure of the organ of hearing. This study aimed to trace the understanding of the tympanic membrane from antiquity to the early twentieth century.MethodsA review was conducted of primary and secondary historical and scientific literature describing the tympanic membrane anatomy.ResultsAlthough ancient polymaths sensed that sounds were vibrations that could spread in the air and be perceived by the hearing organ, there were numerous misconceptions about the tympanum until human dissections performed during the Renaissance. The tympanum was correctly described only centuries later when technological advances enabled otologists to understand it as a fundamental part of the hearing organ.ConclusionThe tympanic membrane history reflects key stages in medical knowledge; limited for centuries, a great technological leap was possible in the nineteenth century, contributing to the emergence of otologists and laying the foundations of modern otology.

For thousands of years, anatomical models have served as essential tools in medical instruction. While human dissections have been the regular source of information for medical students for the last few centuries, the scarcity of bodies and the religious and social taboos of previous times made the process of acquiring human cadavers a challenge. The dissection process was dependent on the availability of fresh cadavers and thus was met with a major time constraint; with poor preservation techniques, decomposition turned the process of employing bodies for instruction into a race against time. However, the advent of anatomical models has countered this issue by supplying accurate anatomical detail in a physical, three-dimensional form superior to that of the two-dimensional illustrations previously used as the primary adjunct to dissection. Artists worked with physicians and anatomists to prepare these models, creating an interdisciplinary interaction that advanced anatomical instruction at a tremendous rate. These models have taken the form of metal, wood, ivory, wax, papier-mâché, plaster, and plastic and have ultimately evolved into computerized and digital representations currently. We provide a brief historical overview of the evolution of anatomical models from a unique neuroanatomical perspective.

This review discusses how renaissance artists such as Leonardo and Michelangelo had to undertake anatomical studies of human cadavers in order to understand the anatomy that then informed their artworks, whether they were drawings, paintings or sculpture. Around this time, anatomists, such as Vesalius and Estienne, had to in part become artists or engage with artists and artisans to illustrate their many discoveries. This review tries to portray how this was occurring in a period in history not only when there was a shift-taking place in philosophical and theological thinking about the human condition but also when there was a concurrent revolution in the visual language with the advent of print reproduction. This allowed the creation of essentially the first medical texts, and the wide dissemination of newly acquired knowledge for the advancement of surgery and medicine henceforth. A classic example of where this did not align is Leonardo de Vinci many of whose original works were hidden for 150-400 years. This review also describes how learning anatomy and artistic endeavours still have a mutually beneficial relationship in the modern world-a second 'Renaissance'. Examples are given such as body painting, exposure of art students human cadavers resources and lastly there is consideration of how modern anatomy relies on many new technologies that allow students and practitioners to 'dissect' in a virtual sense and with the advent of a new visual language, that is, 3D printing, to create novel artforms of educational significance.

St. Gallicanus Hospital in Rome, Italy, created by the will of Pope Benedict XIII (1649-1730) in 1725, was the first dermatologic hospital in the world. The strong bond between science and faith, humanitarian spirit and scientific research, and the profoundness and legacy of its entire history have all contributed to its legacy. We have traced its development by examining archival documents to understand the life of the institute and the diseases that were diagnosed and treated from the 18th century to the first half of the 20th century. Some of the main diseases were leprosy, mange, scabies, ringworm, and syphilis, which were widespread in Rome during the 18th and 19th centuries and were creating a mortal threat for much of the population. St. Gallicanus Hospital was dedicated to the diagnosis, treatment, and prevention of these diseases where possible. Special attention has been directed to syphilis and the use of penicillin therapy after its introduction in 1943, especially for curbing the extensive problems created by prostitution.

Facial maskings have been part of the human story since time began, and the reasons for their needs and the materials that went into their making would vary according to the reasons and materials available. The health-related needs took centuries to become established, but not until the germ theory of disease became recognized. The facial mask, seen as an essential defensive tool for prevention of respiratory transmitted disease continues to be the prime personal protective piece of equipment. With air-born contaminations, such as the present pandemic SARS- CoV-2 viral infestation, why would there be opposition to the use of this personal protective cover of our airways, when until an immunologic answer is available, it is the best single prevention we have. When supported with other measures, like distancing, washing and non-crowding, society would be much safer and secure, with probable less acute and drastic outcomes due to the spread of this virus.

We identify the putatively earliest extant print source of the neoclassical term psychologia, long presumed to have been a 1575 work, as two 1525 works, one by Pier Nicola Castellani and another by Gerhard Synellius. We provide a history of pertinent etymology and introduce the new sources. The full paragraph containing two uses of the term by Castellani is included in translation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

From the Egyptian Book of the Dead to the doctrine of the Greek philosopher Aristotle, ancient secular and religious cultures throughout the world often considered the heart — and not the brain — to be the home of the emotions, cognition and even the soul. Brandt and Huppert reflect on the reasons behind this belief.

Urbanization is one of the most important settlement shifts in human history and has been the focus of research within bioarchaeology for decades. However, there have been limited attempts to synthesize the results of these studies in order to gain a broader perspective on whether or how urbanization affects the biology, demography, and behavior of humans, and how these potential effects are embodied in the human skeleton. This paper outlines how bioarchaeology is well-suited to examine urbanization in the past, and we provide an overview and examples of three main ways in which urbanization is studied in bioarchaeological research: comparison of (often contemporaneous) urban and rural sites, synchronic studies of the variation that exists within and between urban sites, and investigations of changes that occur within urban sites over time. Studies of urbanization, both within bioarchaeology and in other fields of study, face a number of limitations, including a lack of a consensus regarding what urban and urbanization mean, the assumed dichotomous nature of urban versus rural settlements, the supposition that urbanization is universally bad for people, and the assumption (at least in practice) of homogeneity within urban and rural populations. Bioarchaeologists can address these limitations by utilizing a wide array of data and methods, and the studies described here collectively demonstrate the complex, nuanced, and highly variable effects of urbanization.

Before the 20(th) century many deaths in England, and most likely a majority, were caused by infectious diseases. The focus here is on the biggest killers, plague, typhus, smallpox, tuberculosis, cholera, typhoid, dysentery, childhood infections, pneumonia, and influenza. Many other infectious diseases including puerperal fever, relapsing fever, malaria, syphilis, meningitis, tetanus and gangrene caused thousands of deaths. This review of preventive measures, public health interventions and changes in behavior that reduced the risk of severe infections puts the response to recent epidemic challenges in historical perspective. Two new respiratory viruses have recently caused pandemics: an H1N1 influenza virus genetically related to pig viruses, and a bat-derived coronavirus causing COVID-19. Studies of infectious diseases emerging in human populations in recent decades indicate that the majority were zoonotic, and many of the causal pathogens had a wildlife origin. As hunter-gatherers, humans contracted pathogens from other species, and then from domesticated animals and rodents when they began to live in settled communities based on agriculture. In the modern world of large inter-connected urban populations and rapid transport, the risk of global transmission of new infectious diseases is high. Past and recent experience indicates that surveillance, prevention and control of infectious diseases are critical for global health. Effective interventions are required to control activities that risk dangerous pathogens transferring to humans from wild animals and those reared for food.

This contribution aims to promote a dialogue between history and psychology by outlining a direction for future research at the intersection of these disciplines. In particular, it seeks to demonstrate the potential contributions of history to psychology by employing the category of mental health in a historical context. The analysis focuses on notions of psychological health that were developed in late antiquity, especially the equation between "health of the soul" and dispassion (apatheia) within the Christian monastic movement. This theologically informed notion of what constitutes positive human functioning and well-being is examined in view of modern attempts, in mainstream and positive psychology, to define mental health. The optimism concerning the naturalness of virtue and the malleability of human nature that underlies late antique notions of "health of the soul" becomes noticeable in its absence once we turn to modern notions of mental health. It thus provides an illuminating counter-example against which to compare and analyze modern attempts to define mental health. A comparison of these alternative notions human flourishing offers an opportunity to reflect on and test the validity of contemporary attempts to define this condition in a culturally sensitive manner. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Following three turning points in the historical development of psychology this study examines how the relation between mental health and the state of illness is linked to the concept of "passions." The first was the birth of modern psychiatry in 18th century France. The second was the development of the field of inquiry in antiquity about the psuchē and its mental activities, and the third was the turn of early Christian thought about mind and soul. A comparison between early modern and ancient concepts of "the passions" reveals the moral and ethical aspects of the concept "mental health," and shows that more than for any other kind of illness, the history of mental illness and mental health is embedded within a moralistic philosophical perspective. Pathology as a field of study of "the passions," whatever their definition was, enabled thinkers to refer to mental illness and health in moral terms. Although "passions" meant different things to different authors in different times, it was used by all as means to link between inner mental activities and the way the body react to the outside world. We can see it as an obligatory element to conceptualize illness, disorder, and health in regards to mental activities. Pagan ancient authors as well as early Christian authors used it to construct new theories and praxes about mental health, while early modern psychiatrists used it to develop corporeal methods of cure. In all currents of thought the concept of "passions" and the definition of the ways in which they affected the mind were used to distinguish mental illness and mental health from any other type of illness and health. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

BackgroundNasal lavage is an ancient practice that still has a fundamental role in the management of sinonasal conditions. The history related to these devices is extensive and remarkable. By reviewing it, it is hoped that a broader view can be achieved on what is currently possible with nasal lavage and how advances may be made in the future.MethodsA careful review of different sources, such as ancient manuscripts, registered patents and scientific papers, was conducted to achieve a thorough examination of the history related to nasal rinsing devices.ConclusionNasal lavage has evolved significantly since first considered for medical use and has always played a central role in the treatment of patients with sinonasal conditions. Further innovation is still necessary to surmount the shortcomings of current nasal lavage systems.

Ginseng started to emerge as an international medicinal material during the Joseon Dynasty. This paper examines ginseng as a tribute presented to the Ming royal family by Joseon Dynasty. Joseon Dynasty presented peeled and dried ginseng (white ginseng) to the emperor. The Ming Dynasty demanded chosam (natural ginseng) with no peeling in 1602. By the request of Joseon Dynasty during the period of Lord Gwanghae, the presented ginseng was again changed to pasam (boiled and dried ginseng). Although Nurhachi of the Jurchen (女眞) is known to have invented this method of processing pasam, Joseon was exporting pasam to the Ming Dynasty earlier than that. As such, the Nurhachi theory of the invention of the pasam should be reexamined. Joseon Dynasty presented ginseng to each emperor and heir to the throne through its envoys. The total amount of ginseng sent to the royal family of the Ming Dynasty during the Joseon Dynasty is estimated to be approximately 664 to 880 geuns (斤) per year in the fifteenth century, 300 to 500 geuns in the sixteenth century, and about 160 to 360 geuns in the 17th century. When the Japanese Invasion of Korea occurred in 1592, the Joseon government informed the Ming Dynasty of the miserable situation of the Joseon people and chose to reduce the tribute. However, even after the war, the amount of tribute ginseng in Joseon continued to be small. This is because the medical industry in the Ming Dynasty grew significantly, and medical books prescribing Joseon ginseng increased, and the rich people of the Ming Dynasty loved ginseng so much that they imported Joseon ginseng at high prices. Local residents of Guangdong, China, a major customer base of Joseon ginseng, also used ginseng as a preventive medicine for JangGi. From the fifteenth to the seventeenth centuries, the amount of ginseng that Joseon tributed to the Ming Dynasty continued to decrease, and the ginseng processing method also moved in the direction of reducing the burden of processing. This was caused by changes in the environment surrounding the use of ginseng, including changes in the international situation at the time, growth of the medical industry, increasing interest in ginseng by the people of the Ming, and economic considerations of the Joseon government. The two countries sought changes in the ginseng tribute through an agreement.

Modern global surgery, which aims to provide improved and equitable surgical care worldwide, is a product of centuries of international care initiatives, some borne out of religious traditions, dating back to the first millennium. The first hospitals ( xenodochia) were established in the 4th and 5th centuries CE by the early Christian church. Early “missions,” a term introduced by Jesuit Christians in the 16th century to refer to the institutionalized expansion of faith, included medical care. Formalized Muslim humanitarian medical care was marked by organizations like the Aga Khan Foundation and the Islamic Association of North America in the 20th century. Secular medical humanitarian programs developed in the 19th century, notably with the creation of the International Committee of the Red Cross (1863) and the League of Nations Health Organization (1920) (which later became the World Health Organization [1946]). World War II catalyzed another proliferation of nongovernmental organizations, epitomized by the quintessential humanitarian health provider, Médecins Sans Frontières (1971). “Global health” as an academic endeavor encompassing education, service, and research began as an outgrowth of departments of tropical medicine and international health. The American College of Surgeons brought a surgical focus to global health beginning in the 1980s. Providing medical care in distant countries has a long tradition that parallels broad themes in history: faith, imperialism, humanitarianism, education, and service. Surgery as a focus of academic global health is a recent development that continues to gain traction.

In a time when social isolation heavily relies on the use of digital representation, photography, and e-books, it is easy to take for granted the impact imagery has on our society and the pedagogical purposes of illustration, particularly in the teaching of surgery. Illustrations after all are the basis of all anatomical atlases and are quintessential tools that allow for an expedient and thorough understanding of concepts underlying the fabric of the human body. Yet, surgery has not always been taught with an atlas. Illustrations, much like surgery, have seen an incredible transformative process spanning across the ages to achieve their status in modern medicine. Through this brief review, we will not only glean an understanding of the evolution of anatomical illustrations but also the social context in which surgery has also evolved throughout history.

In the time of the Renaissance, a major aspect of vision science was understanding how spatial information projected to the viewpoint of the observer, that is, visual perspective, which is one of the primary cues to depth perception. Perspective representation was thus an early form of virtual reality. Although accurate perspective representation was developed earlier in the 15th century, the first analytic perspective scheme was developed by Piero della Francesca, whose chef d’oeuvre is in the Church of San Francesco, Arezzo, in which the present lecture took place. The focus of the lecture was to evaluate some of the contributions of Piero della Francesca and his 15th-century contemporaries to the visual science, art and symbolism of his era, and its significance for the perception of depth structure from two-dimensional images.

This historical surgical retrospection focuses on the temporal de-escalation axillary surgery, focusing on the unceasing efforts of researchers toward new challenges, as documented by extensive studies and trials. Axillary surgery has evolved, aiming to offer the best oncologic treatment and improve the quality of life of women. Axillary lymph-node dissection (ALND) has been replaced by sentinel lymph-node biopsy (SLNB) in women with early clinically node-negative breast cancer, providing adequate axillary nodal staging information with minimal morbidity, and becoming the standard of care in the management of breast cancer. However, this is only the beginning. Strategies in defining systemic and radiotherapeutic treatments have gradually been optimized, offering increasingly refined and targeted breast cancer treatment tools. In recent years, the paradigm of completion ALND after a positive SLNB has been questioned, and several studies have led to revolutionary changes in clinical practice. Moreover, the increasingly pivotal role played by neoadjuvant chemotherapy (NAC) has had a profound effect on the extent of axillary surgery, paving the way to a more finite "targeted" procedure in women with node-positive breast cancer who convert to negative nodes clinically after NAC. The utility of SLNB itself and its subsequent omission in women with negative nodes clinically and breast conservative surgery is also under scientific evaluation. The changes over time in the surgical approach to breast cancer have been numerous and significant. The novel emerging perspective characterized by recent advances in biology and genetics, in dedicated axillary ultrasound imaging and chemotherapy regimens, is the present reality that points to the future of axillary node treatment in breast cancer.

Giovanni Andrea Dalla Croce was a Venetian physician who lived in the 16th century and was famous for his treatment of wounds, which was surprisingly modern. He was the military surgeon of the Venetian Republic’s naval fleet. In 1537, he published the Chirurgiae universalis opus absolutum (The absolute work on universal surgery) in Latin, then expanded and translated into vernacular Italian and published in 1574 with the title Cirugia universale e perfetta di tutte le parti pertinenti all’ottimo chirurgo (Universal and perfect surgery of all the parts necessary for the optimal surgeon). This monumental work was a comprehensive handbook of surgery, medicine, and the treatment of many kinds of wounds with techniques to be used on the battlefield. It is also notable for the inclusion of illustrations of various weapons and projectiles, for the most comprehensive description and illustrations of surgical instruments at that time, and for the first illustrations of a surgeon performing trephination of the skull in an operating room. Dalla Croce also considered the writings of his surgical forebears in formulating his own ideas. Dalla Croce was a leader of traumatology, a universal surgeon who exemplified the erudite Renaissance man, and left a tremendous legacy to military surgery of the 16th century and beyond.

Andreas Vesalius initially accepted Galen's ideas concerning the

In the second century ce, Galen described seven pairs of cerebral nerves. He did not name the nerves, nor did he illustrate his work. Galen's descriptive texts survived until the mid-sixteenth century, when anatomists, influenced by the artistic and scientific revolution of the Renaissance, began a reformation in anatomical research. They closely observed their own dissected material and conveyed their results not only in words but commonly by lavish drawings. Many of the great anatomists reexamined the cerebral nerves, adding descriptive text or changing the classification. In 1778, Thomas Soemmerring (1755-1830) named 12 pairs of cerebral nerves upon which the modern cranial nerve nomenclature is based. Soemmerring matched his text with clear, decisive illustrations. This article describes the works of some of the great artists in the period from Vesalius to Soemmerring and how they used illustration to supplement and provide clarity for their textual descriptions of the cranial nerves.

During early modernity, medico-legal concerns with timing puberty gave way to physiological and medical-hygienic concerns with pubertal timing. Sixteenth- and seventeenth-century medical-jurisprudential tracts isolated rare cases of conception before the legal marriage age. Scattered reports of “monstrously” early menarche and “prodigious” male puberty were offered from the latter half of the seventeenth century. Tied to excess heat, moisture, plethora and climate since antiquity, in the second half of the eighteenth century pubertal timing attracted sustained commentary regarding the purported role of social stressors, from novel-reading to diet and trousers. Both the known variability and strikingly outlying instances of pubertal timing thus provided an inroad to unravelling such perennial explanatory devices as temperament, constitution, and life style. Despite and in part because of its explanatory significance in early modern physiology, leading eighteenth-century nosologists did not yet itemize precocious puberty. One precocious boy described in the 1740s, the Willingham Prodigy, provided the best documented early medical and public response. Formal nosological interest followed by the 1760s, initially under Haller’s heading of excessive growth (incrementum nimium, tied to enhanced circulation) and only much later under Meckel the Younger’s heading of premature development (vorschnelle Entwicklung).

Aim Sejong the Great (May 7, 1397-March 30, 1450), a king during Korea's Choson Dynasty, is the most respected historical figure in South Korean society, and consequently, many studies have been conducted on his achievements and the disease he suffered. The dominant trend of scholarship claims that Sejong suffered from diabetic retinopathy. However, this interpretation has not been medically verified. The present analysis aimed to demonstrate that Sejong's is the oldest documented case of ankylosing spondylitis. Methods The Annals of the Choson Dynasty (hereafter, The Annals) are daily records of the king. The Annals were recorded for 472 years (1392-1865) and contain 49 646 667 Chinese characters. Records in The Annals on Sejong span 1418-1450; the present study author reviewed these records. Results Sejong's medical records are mentioned 40 times in the source text. The king first experienced musculoskeletal pain in his knee at the age of 22 years. Sejong's knee pain is mentioned 3 times, and his back pain, which he described as "stiff and immobile", is mentioned 6 times. He complained most frequently of ocular symptoms described as "prickly or tingling," which are mentioned 12 times. Conclusions Based on the analysis of official documentation, the author argues that there is a high probability that Sejong suffered from ankylosing spondylitis, making this the oldest officially documented case of the disease.

Hieronymus Fabricius ab Acquapendente, famous anatomist of the medical school of Padua, Italy, marked a further step not only in the morphological studies, but also in anatomical illustration and physiology. His researches were inspired by the work of Aristotle which was focused on the understanding of biological "functions" in an anatomo-comparative way. The anatomo-comparative approach of Fabrici allowed him to discover several specific features of human anatomy. His focusing on function marked the transition from a descriptive to a functional anatomy, paving the way to the birth of human physiology in the following century. To enhance the teaching and learning of anatomy, Fabrici realized the importance of the "dimension" and "color" of anatomical illustrations and introduced for first full-scale and colour painted plates. In this way, the images were closer to representing "living" parts, than previous black & white and low scale images. Moreover, Fabrici was the first to create an "anatomo-phisiological" image, namely the one representing the valves in the veins. His work was a fundamental inspiration for his students, in particular Gaspard Bauhin and William Harvey.

Accounts of how the concept of temperature has evolved typically cast the story as ancillary to the history of the thermometer or the history of the concept of heat. But then, because the history of temperature is not treated as a subject in its own right, modern associations inadvertently get read back into the historical record. This essay attempts to lay down an authoritative record not of what people in the past thought about what we call 'temperature' but of what they thought about what they called 'temperature' (or one of its cognates), from medieval times to today. It is found that invention of the thermometer had little impact on the concept of temperature. Much more significant were Fahrenheit's invention of a reliable instrument and William Thomson's effort to make a degree of temperature a unit of measure. Overlapping definitions of temperature then emerged in the late nineteenth century, and twentieth-century scientific developments forced physicists to reconsider temperature's conceptual boundaries. It turns out that the concept of temperature has evolved through stages that correspond to four increasingly sophisticated types of measurement. Its maturity sheds light on the philosophy of conceptual change.

In a 1990 JAMA cover story Frank Meshberger reported that Michelangelo's central composition on the Sistine Chapel ceiling (1508-1512), The Creation of Adam, portrays God in the form of a brain. The present report suggests that Michelangelo's images on the chapel ceiling depicting Creation describe the course of vertebrate brain development. Further, on the front wall of the Sistine Chapel, within the work titled The Last Judgment (1525-1541), the central ellipse, where Jesus is making judgments about good and evil, represents a mid-coronal cross-section of a human brain, implying that the brain is man's instrument for making decisions.

Summary Many women around the world and throughout history have made tremendous sacrifices to provide surgical care to patients and further advance the field of surgery. In the process, many have become recognized surgeons, leaders, and mentors and continue to make tremendous contributions to the advancement of surgery. Queen Shubad of Ur (circa 3500 BC) may be the first documented female surgeon in history, as she was found buried with bronze and flint surgical instruments. Through the majority of recorded history, women were barred outright from practicing medicine or surgery. Certain fields (pediatrics, obstetrics and internal medicine) opened up earlier to women, but most surgical specialties were deemed too masculine. To circumvent bias, and perform surgery, women often posed as men. Dr. James Barry (1795-1865) was a renowned army surgeon in the United Kingdom, performing the first successful caesarian section in Africa by an Irish surgeon. Only upon death was it discovered that “he” was in fact Dr. Miranda Stewart. She had lived her entire public and private adult life as a male in order to attend the University of Edinburgh medical school and to be able to pursue a surgical career. Elena or Eleno de Cespedes (1545- c. 1588), a Spanish surgeon in the 16th century, grew up as a female Mulatto slave. She practiced for the majority of her career as a male and was even subjected to medical examinations for gender confirmation. In the 19th century, pioneers, such as Dr. Elizabeth Blackwell in the United States and Dr. Emily Jennings Stowe in Canada, opened the doors for women to enter medical school and the surgical profession as women. In the coming years, Dr. Mary Edwards Walker (1832-1919) in the United States and Dr. Vera Gerdroits (1870-1932) in Russia served on the frontlines for their countries as military surgeons. Contemporaries, such as Dr. Angelita Habr-Gama, FACS (H), have paved the way for individualized patient care and nonoperative management in colorectal surgery through robust academic careers. All in all, despite great adversity, female surgeons have challenged societal, academic, and political norms to further the art and science of surgery, to care for patients, and to facilitate a pathway for generations of women who have followed.

The betaretrovirus Mouse Mammary Tumor Virus (MMTV) is the well characterized etiological agent of mammary tumors in mice. In contrast, the etiology of sporadic human breast cancer (BC) is unknown, but accumulating data indicate a possible viral origin also for these malignancies. The presence of MMTVenv-like sequences (MMTVels) in the human salivary glands and saliva supports the latter as possible route of inter-human dissemination. In the absence of the demonstration of a mouse-man transmission of MMTV, we considered the possibility that a cross-species transmission could have occurred in ancient times. Therefore, we investigated MMTVels in the ancient dental calculus, which originates from saliva and is an excellent material for paleovirology. The calculus was collected from 36 ancient human skulls, excluding any possible mouse contamination. MMTV-like sequences were identified in the calculus of 6 individuals dated from the Copper Age to the 17th century. The MMTV-like sequences were compared with known human endogenous betaretroviruses and with animal exogenous betaretroviruses, confirming their exogenous origin and relation to MMTV. These data reveal that a human exogenous betaretrovirus similar to MMTV has existed at least since 4,500 years ago and indirectly support the hypothesis that it could play a role in human breast cancer.

Tuberculosis (TB), which is caused by bacteria of the Mycobacterium tuberculosis complex, is one of the oldest diseases known to affect humans and a major cause of death worldwide. Tuberculosis continues to be a huge peril disease against the human population and according to WHO, tuberculosis is a major killer of the human population after HIV/AIDS. Tuberculosis is highly prevalent among the low socioeconomic section of the population and marginalized sections of the community. In India, National strategic plan (2017-2025) has a national goal of elimination of tuberculosis by 2025. It requires increased awareness and understanding of Tuberculosis. In this review article history, taxonomy, epidemiology, histology, immunology, pathogenesis and clinical features of both pulmonary tuberculosis (PTB) and extra-pulmonary tuberculosis (EPTB) has been discussed. A great length of detailed information regarding diagnostic modalities has been explained along with diagnostic algorithm for PTB and EPTB. Treatment regimen for sensitive, drug resistant and extensive drug resistant tuberculosis has been summarized along with newer drugs recommended for multi drug resistant tuberculosis. This review article has been written after extensive literature study in view of better understanding and to increase awareness regarding tuberculosis, as a sincere effort that will help eliminate tuberculosis off the face of the earth in near future.

Intracranial pressure (ICP) monitoring has become an important tool in neurocritical care. Despite being used in intensive care units all over the world, many are unfamiliar with its origins and the people and events that shaped the development of this technique. Herein, we provide a comprehensive historical review of the evolution of ICP monitoring, beginning with the earliest descriptions of cerebrospinal fluid (CSF). We conducted a database search in PubMed, Google Scholar, and Google Books for relevant articles using the key words "cerebrospinal fluid," "intracranial pressure," and "monitoring." Papers were further snowballed using reference lists of relevant papers. Although the earliest descriptions of CSF date back several hundred years bce, the history of ICP monitoring itself is not a long one. Alexander Monro and his student George Kellie laid the foundation of CSF physiology in the early 1800s through the Monro-Kellie doctrine. Their principles were later consolidated by John Abercrombie and Harvey Cushing. However, 10 years earlier than Cushing's work on CSF physiology, Hans Queckenstedt's utilization of a lumbar needle to measure the pressure in CSF marked the beginning of the era of ICP monitoring. Thenceforward, ICP monitoring technology underwent progressive improvements through the contributions of French scientists Jean Guillaume and Pierre Janny, Swedish neurosurgeon Nils Lundberg, among others. Nowadays, ICP monitoring can be performed via direct and indirect methods using a potpourri of devices such as, but not limited to, subarachnoid bolts, microtransducer catheters, and telemetric monitors. Nevertheless, despite advancements in ICP monitoring technology, the criterion standard remains an extraventricular drain catheter connected to an external pressure transducer.

Gender medicine as a subject began with Bernadine Healy’s 1991 article ‘The Yentl Syndrome’ which showed that women had worse outcomes following heart attacks since their symptoms are different from men. Since then gender-specific clinical research protocols have been progressively included so that evidence for guidelines can be better informed such that women are then less disadvantaged and care become more personalised. This paper traces back the historical roots of gender bias in medicine in Western culture, which is reflected in the pictorial arts and writings of each historical period, beginning with Hippocrates. It describes the changes that have led to attempts at improving the place of women, and the treatments of disease, on an equal footing with men, precipitated by Healy’s paper.

The mold of the human cerebral ventricles produced in 1918 by Walter E. Dandy had an experimental precedent, a wax cast of ox ventricles made four hundred years earlier (1508-9) by Leonardo da Vinci (1452-1519). This paper is an homage to the epitome of Renaissance and polymath Leonard da Vinci, as well as to Walter Edward Dandy (1886-1946) who developed the ventriculography (1918) and pneumoencephalography (1919) techniques. Pneumoencephalography was applied broadly up to the late 1970s, when it was replaced by less invasive and more accurate neuroimaging techniques.

This paper explores the heritage and the essential significance of worship of the twin Christian saints -St. Cosmas and St. Damian- in the history of medicine. These saints are well known in Western culture as one of the leading Christian saints to heal diseases, whose cults have spread to Europe through Byzantium, which have continued to spread widely to the present, starting from areas where Christianity had been proselytized. Although it is true that their life journeys have undergone many processes of embellishment and beautification over the course of time, the attributes that distinctively characterize the two saints exist apart from such mythical fabrications. This paper categorizes the characteristics of the two saints as being those of “professional doctors,” “ideal doctors,” and “holders of healing powers” as intermediaries of God, examining how these characteristics came to affect various medical organizations during the era when Medieval medicine was gradually transitioning toward a rational approach based on reason. In addition, it discusses how some of the practices of ancient temple medicine were transplanted into the Christian culture, the process by which it finally arrived at human doctors through the two saints, and how it affected the establishment of professional work ethics -albeit in nascent form- as their medical ethics came to be accepted and practiced by the Medieval guild of surgeons. Furthermore, the paper considers how the existence of the two saints has acquired symbolism in modern medicine, which has made remarkable progress in organ transplantation, and in particular, how it constitutes a significant part of the history of organ transplantation. It is not easy to objectify and attach meaning to an era that was substantially influenced by myths, legends, or religious events. This is because it is easy to fall into the trap of simplifying and passing judgment on the past based on the realities of the present day, without making efforts to understand the unique circumstances and contexts of the past. This is especially the case when the distinction between “religious events” and “medical events” is ambiguous, or when dealing with a social culture where religious influence was paramount. From a broader perspective, the study of St. Cosmas and St. Damian is not concerned with the rights or wrongs of religious myths amid the advancement of medicine and its adherence to science and reason, but with the attempt at a deep and broad understanding of human diseases and human conditions of being prone to such diseases throughout life.

The Indian Ocean Dipole (IOD) affects climate and rainfall across the world, and most severely in nations surrounding the Indian Ocean1–4. The frequency and intensity of positive IOD events increased during the twentieth century5 and may continue to intensify in a warming world6. However, confidence in predictions of future IOD change is limited by known biases in IOD models7 and the lack of information on natural IOD variability before anthropogenic climate change. Here we use precisely dated and highly resolved coral records from the eastern equatorial Indian Ocean, where the signature of IOD variability is strong and unambiguous, to produce a semi-continuous reconstruction of IOD variability that covers five centuries of the last millennium. Our reconstruction demonstrates that extreme positive IOD events were rare before 1960. However, the most extreme event on record (1997) is not unprecedented, because at least one event that was approximately 27 to 42 per cent larger occurred naturally during the seventeenth century. We further show that a persistent, tight coupling existed between the variability of the IOD and the El Nino/Southern Oscillation during the last millennium. Indo-Pacific coupling was characterized by weak interannual variability before approximately 1590, which probably altered teleconnection patterns, and by anomalously strong variability during the seventeenth century, which was associated with societal upheaval in tropical Asia. A tendency towards clustering of positive IOD events is evident in our reconstruction, which—together with the identification of extreme IOD variability and persistent tropical Indo-Pacific climate coupling—may have implications for improving seasonal and decadal predictions and managing the climate risks of future IOD variability. Coral records indicate that the variability of the Indian Ocean Dipole over the last millennium is strongly coupled to variability in the El Nino/Southern Oscillation and that recent extremes are unusual but not unprecedented.

The anatomical textbook in the late Middle Ages was one part of a greater pedagogical process that involved students’ seeing, hearing, reading, and eventually knowing information about the human body. By examining the role of the anatomical textbook and accompanying bodily images in anatomical learning, this article illuminates the complexity and self-consciousness of anatomical education in the medieval university, as professors focused on ways to enhance student memory of the material. Traditionally, the history of anatomy has been heavily influenced by the anatomical Renaissance of the late-sixteenth century, highlighting a focus on innovative medical knowledge and the scientific method. However, if we engage a pedagogical lens when looking at these medieval authors, it becomes quickly obvious that the whole point of university medicine was not to explore unknown boundaries and discover new ideas of medicine, but rather to communicate the current and established body of knowledge to those not familiar with it.

This article reviews the collaboration between clinician and illustrator throughout the ages while highlighting the era of cardiac surgery. Historical notes are based on Professor Sanjib Kumar Ghosh’s extensive review, literature searches, and the archives of the Johns Hopkins University Department of Art as related to Medicine in Baltimore. Personal communications were explored with medical illustrators and medical practitioners, many of whom are colleagues and trainees, to further chronicle the history of medical illustration and education in the era of cardiac surgery. Medical illustrators use their talents and expressive ideas to demonstrate procedures and give them life. These methods are (1) hovering technique; (2) hidden anatomy, ghosted views, or transparency; (3) centrally focused perspective; (4) action techniques to give life to the procedure; (5) use of insets to highlight one part of the drawing; (6) human proportionality using hands or known objects to show size; and (7) step-by-step educational process to depict the stages of a procedure. Vivid examples showing these techniques are demonstrated. The result of this observational analysis underscores the importance of the collaboration between clinician and illustrator to accurately describe intricate pathoanatomy, three-dimensional interrelated anatomic detail, and complex operations. While there are few data to measure the impact of the atlas on medical education, it is an undeniable assertion that anatomical and surgical illustrations have helped to educate and train the modern-day surgeon, cardiologist, and related health-care professionals.

It is known that throughout the seventeenth century the world system proposed by Tycho Brahe (1546-1601) assumed a preponderant position in the Iberian cosmological debate, according to many opinions the one showing the best agreement to empirical evidence. Moreover, the Tychonian model (or variants thereof) did not present the difficulties of apparent contradiction with scriptures, as the heliocentric system of Nicolaus Copernicus (1473-1543) did, since it kept the earth fixed at the centre of the world. However, Tycho, as a Lutheran author, was targeted by the Inquisition. Passages of various works of the Danish astronomer were included in the Spanish Indices of 1632, 1640 and 1707, although the formal condemnation of the Roman Inquisition never materialized. In the network of the Society of Jesus a seemingly informal censorship also circulated, apparently based on Tridentine determinations, published in 1651 in the influential work of Giambattista Riccioli (1598-1671) Almagestum novum. In this paper I will discuss the scope, effects and limitations of the censorship of Tycho's scientific books in Portugal and Spain, through the analysis of several annotated copies, preserved manly in Iberian libraries, with a special attention to books with a well-established provenance in past Jesuit colleges.

The set of essays in this issue of Annals of Science provides a convenient occasion for some brief reflections on the present state of studies about Inquisition and Science. Although this collectio...

A scholarly consensus has long held that in redefining alchemy, Paracelsus rejected metallic transmutation. I show here, however, that for most of his career Paracelsus believed that it was possible to change one metal into another, and even late in his short life he did not break with that view. Furthermore, in certain places in his works he also represented himself, occasionally directly and more often obliquely, as a practical transmutationist. Because Paracelsus not only acknowledged that metallic transmutations were theoretically possible but also claimed to have carried them out in practice, we must regard him as (among other things) a transmutational alchemist. As such, he had more in common than historians have generally admitted with both his medieval predecessors and his posthumous followers. The Paracelsian alchemists of the late-sixteenth and seventeenth centuries were not wrong to situate Paracelsus within the alchemical tradition, nor to connect their own goldmaking interests to his.

My essay focuses on Charles Rosenberg's provocative and enduring ideal type of epidemic drama in three acts, which he assembled from a vast knowledge of disease history that stretched from the end of the seventeenth century to his then-present pandemic, HIV/AIDS of the 1980s. Reaching back to the Plague of Athens, my essay elaborates on Rosenberg's dramaturgy by questioning whether blame, division, and collective violence were so universal or even the dominant "acts" of epidemics not only before the nineteenth century but to the present. Instead, with certain pandemics such as yellow fever in the Deep South or the Great Influenza of 1918–20, unity, mass volunteerism, and self-abnegation played leading roles. Finally, not all epidemics ended "with a whimper" as attested by the long early modern history of plague. These often concluded literally with a bang: lavish planning of festivals of thanksgiving, choreographed with processions, innumerable banners, commissions of paintings, ex-voto churches, trumpets, tambourines, artillery fire, and fireworks.