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This study provides new data which suggest a novel interpretative hypothesis not only on the specific painting, but on the use of bloodletting as medical practice in the Florentine Quattrocento. As a part of a cycle of frescoes devoted to the Seven Corporal Works of Mercy, the examined lunette depicts the "Visit to the sick" in a domestic interior, but it has never been considered as an historical document of precise medical practices. The scene's definitive interpretation is still unresolved because of the uncertainty of some iconographic details. A campaign of in-situ and non-invasive technical investigations was performed to retrieve possible traces of previous details today concealed. The technical solutions adopted to implement the measurements campaign are illustrated, as an experimental example for remote sensing inspection of mural paintings in-situ. The position of the painting high up on a wall of an historical venue led to opting for stand-alone optical imaging techniques which could operate in remote sensing mode. By combining the use of portable Hyperspectral Imaging with Near Infrared photography a set of detailed images could be obtained that highlighted details not otherwise detectable. Focused on the objects held by the persons present, the analysis of the mural of Visit of the Buonomini in her Lying in Bed, the gift of swaddling cloth could be a tourniquet, shadows of folds of a blanket a thumb lancet, and an object held a blood collection bowl, supported the hypothesis that it could be a medieval bloodletting scene., (© 2024. The Author(s).)

Background: In 1922 the famous Italian novelist Giovanni Verga died in Catania (Italy). In Verga's works there are many suggestions to the world of medicine, in particular the diseases described in the poor society of southern Italy of that time. One of the most common diseases described by Verga was cholera., Methods: The authors researched and reviewed Verga's works, detecting references to public health. These are topical issues in the current period of the COVID pandemic. In Verga's works the theme of hygiene, epidemiology, and infectious diseases occur. There are many hints related to medicine, especially as far as the typical diseases of poor society and the difficult social environments of the time are concerned. One of the most common diseases described by Verga was cholera but also malaria and tuberculosis occur., Results: It was estimated that 69,000 people died of cholera in Sicily, of whom 24,000 in Palermo. The public health situation in Italy was difficult. Verga denounces people's ignorance and the survival of past beliefs., Conclusion: Verga describes a culturally and economically humble society, in a region characterized by large class gaps. It draws a difficult picture of the public health situation in the second half of the 19 th Century and people's daily lives. The authors believe that today it is important that the centenary of Verga's death be an opportunity to read his works, also from a medical historical point of view., Competing Interests: Each author declares that they have no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article., (©2023 Pacini Editore SRL, Pisa, Italy.)

Objective: There is little doubt that there are currently obstacles in measuring the impact of the history of medicine within medical training. Consequently, there is a clear need to support a vision that can historicize Euro-Western medicine, leading to a greater understanding of how the medical world is a distinct form of reality for those who are about to immerse themselves in the study of medicine., Methods: History teaches that changes in medicine are due to the processes inherent to the interaction among individuals, institutions, and society rather than individual facts or individual authors., Results: Therefore, we cannot ignore the fact that the expertise and know-how developed during medical training are the final product of relationships and memories that have a historical life that is based social, economic, and political aspects., Conclusion: Moreover, these relationships and memories have undergone dynamic processes of selection and attribution of meaning, as well as individual and collective sharing, which have also been confronted with archetypes that are still able to influence clinical approaches and medical therapy today., (Copyright © 2023 Silvia Iorio, Valentina Gazzaniga, Donatella Lippi.)

Background and Aim: This paper, in the 50th anniversary of the author's death, examines the overall impact and influence of medicine, in particular of infectious diseases, on the literary production of Italian writer and novelist Dino Buzzati (1906-1972)., Methods: Analysis of literary sources and historical study., Results and Conclusions: Buzzati's literary world is great fun for the reader, being both intriguing and anxiety forming at the same time. One finishes reading his books only to discover the one truth which overturns everything that seemed to be true. In particular, in his short stories, which stem mostly from episodes taken from everyday life, the plot suddenly comes to life. The atmosphere becomes surreal, and in a moment the incredible happens. Behind the apparent lightness of the fairytale narrative there lies hidden the important issues addressed by the author. He uses the hospital as a metaphor for a categorised life, in which we are at risk of no longer being masters of ourselves, in which we suffer a continuous steady drip that makes us head downwards day after day, floor after floor. We will come back up, but not today, tomorrow perhaps, or at the latest, the day after tomorrow. Corte on the second floor hopes, and screams to give strength to his hope, that he will soon return to the top, towards the seventh floor.

Ignác Fülöp Semmelweis (1818-1865) and Florence Nightingale (1820-1910) were two important personalities in the history of medicine and public health. They dealt with the problem of handwashing. Semmelweis is also known as the "father of hand hygiene"; just in 1847 he discovered the etiology and prophylaxis of puerperal sepsis and imposed a new rule mandating handwashing with chlorine for doctors. He also tried to persuade European scientific community of the advantages of handwashing. During the Crimean War, in Scutary (Turkey), Florence Nightingale strengthened handwashing and other hygiene practices in the war hospital where she worked and her handwashing practices reached a reductions in infections. Unfortunately the hygiene practices promoted by Semmelweis and Nightingale were not widely adopted. In general handwashing promotion stood still for over a century. During current pandemic SARS-CoV-2 (COVID-19) one of the most important way to prevent the spread of the virus is still to wash the hands frequently., Competing Interests: Conflict of interest statement The authors declare no conflict of interest., (©2021 Pacini Editore SRL, Pisa, Italy.)

Roderigo Lopez, former Physician-in-Chief to Queen Elizabeth I of England, was a controversial figure in his time and continues to be the subject of controversy. Much has been written about his religious practice, politics, and guilt, or lack thereof, with regard to charges of treason to the Crown. However, the fact remains that Lopez was the only physician to the Crown to be sentenced to death. All evidence points to an anti-Semitic mindset that played in the background. Yet Lopez so endeared himself to the Queen that although he was indeed sentenced to death, almost all of his property was restored to his family. This brief paper pays tribute to the Jewish physician, Roderigo Lopez, whose story was indeed a triumph over prejudice, despite his fate.

Born in Portugal and the son of Marranos (Christianized Jews from Spain), Eliahu de Luna Montalto lived during a particularly harsh period for the Jewish people. Throughout Europe, the situation for Jews was unfavorable; laws had been passed forbidding them to live in England for the past 300 years, and for the past 200 years in France. Additionally, in France, while Jews were permitted to study at some universities, the practice of medicine was forbidden to them. It is within this context that Eliahu de Luna Montalto, who had returned to his original faith (Judaism), was recruited to the French court. This paper pays tribute to Montalto's life and medical practice-so exemplary that the Queen of France would ask Montalto to serve at the court and receive Papal permission for Montalto openly to observe his faith as a Jew, this despite the objections of the King of France., Competing Interests: No potential conflict of interest relevant to this article was reported.

Cholera is an acute disease of the gastrointestinal tract caused by Vibrio cholerae. Cholera was localized in Asia until 1817, when a first pandemic spread from India to several other regions of the world. After this appearance, six additional major pandemics occurred during the 19th and 20th centuries, the latest of which originated in Indonesia in the 1960s and is still ongoing. In 1854, a cholera outbreak in Soho, London, was investigated by the English physician John Snow (1813 to 1858). He described the time course of the outbreak, managed to understand its routes of transmission, and suggested effective measures to stop its spread, giving rise to modern infectious disease epidemiology. The germ responsible for cholera was discovered twice: first by the Italian physician Filippo Pacini during an outbreak in Florence, Italy, in 1854, and then independently by Robert Koch in India in 1883, thus favoring the germ theory over the miasma theory of disease. Unlike many other infectious diseases, such as plague, smallpox, and poliomyelitis, cholera persists as a huge public health problem worldwide, even though there are effective methods for its prevention and treatment. The main reasons for its persistence are socioeconomic rather than purely biological; cholera flourishes where there are unsatisfactory hygienic conditions and where a breakdown of already fragile sanitation and health infrastructure occurs because of natural disasters or humanitarian crises.

Deformity of the breast and axilla observed in famous paintings is a fascinating field for the medico-artists. The attempt of a retrospective diagnosis of breast tumors is highly challenging. This paper deals with a Rubens painting portraying the heroine Judith with a visible but previously unreported left breast mass. Though speculative, the present medico-artistic diagnosis is of a tumor likely to be of benign nature. It is of interest that the present case is the sixth breast disease discovered in Rubens's works.

Whilst painting the vault of the Sistine Chapel, Michelangelo Buonarroti left an autographical sketch that revealed a prominence at the front of his hyper-extended neck. This image was recently diagnosed as goiter. The poet Michelangelo in a sonnet dated 1509 described himself as being afflicted by goiter similarly to the cats in the northern Italian Lombardy, a region with endemic goiter. Several narratives extended this sonnet into a pathological theory. The analyses of Michelangelo's works, however, his portraits and self-portraits, of poems and major biographies, have not indicated the likelihood of goiter. This investigation makes an attempt to assess the diagnosis on clinical as well as iconographical grounds.

Judith was a legendary Hebrew heroine who beheaded the general Holofernes and saved the children of Israel from destruction by the Assyrian army. In the Book of Judith, which is still present in the Catholic and Orthodox Christian Bibles, Judith is presented as an illustrious woman who defeated the enemy using her virtue and fortitude. The present investigation has revealed 24 portraits in which Judith has been depicted with variable grades of thyroid gland enlargement on the scene where she decapitates Holofernes. There is no doubt that the integration of a slight thyroid enlargement in the paintings is a stylistic hallmark that portrays an idealized female beauty with a balanced neck and graceful body. The large extended goiter was probably depicted by the artists as a symbol of a powerful masculine body and her courage, and at the same time, it probably also reflects better anatomic accuracy and knowledge of artists from that period.

Throughout history, chocolate has been used to treat a wide variety of ailments, and in recent years, multiple studies have found that chocolate can have positive health effects, providing evidence to a centuries-long established use; this acknowledgement, however, did not have a straight course, having been involved in religious, medical and cultural controversies. Christian Europe, in fact, feared the exhilarating effects of new drinks, such as chocolate, coffee and tea. Therefore, these beverages would have been banished, had not doctors and scientists explained that they were good for the body. The scientific debate, which reached its peak in Florence in the 18th century, regarded the therapeutic effectiveness of the various chocolate components: it was necessary to know their properties first, in order to prepare the best cacao concoction for every patient. When Dietetics separated from Medicine, however, chocolate acquired the role of vehicle for easing the administration of bitter medicines, being associated to different health problems. The recent rediscovery of the beneficial use of cacao and chocolate focuses upon its value as supplemental nutrition. Building a bridge to the past may be helpful to detect the areas where the potential health benefits of chocolate are likely to be further explored.

Objective: To evaluate the dentoskeletal features of the "Habsburg jaw" by analyzing the skull of Joanna of Austria., Materials and Methods: The skull, the panoramic radiograph, and the lateral cephalogram of Joanna of Austria were analyzed. The cephalometric values of Joanna were compared to cephalometric standards for adult female subjects., Results: The analysis of the dentition on the dry skull and on the panoramic radiograph showed a generalized horizontal alveolar bone resorption with severe bone loss that was interpreted as a sign of severe periodontal disease with respect to the young age (31 years). The cephalometric analysis revealed the presence of a skeletal Class III disharmony associated with maxillary retrusion and normal sagittal position of the mandible. The maxilla exhibited a reduction in the sagittal dimension while the mandible presented with increased dimensions both in total mandibular length (Co-Gn) and in the mandibular body (Go-Gn). The skeletal open bite contributed to the lack of mandibular protrusion though in presence of increased mandibular sagittal dimensions., Conclusion: Joanna of Austria appeared to be affected by a peculiar type of "Habsburg jaw" as the Class III skeletal disharmony was due to a retrognathic maxilla rather than to a prognathic mandible.

Objectives: To offer a second opinion on the recently published retrospective diagnosis of Cardinal Carlo de' Medici (1596-1666), a prominent member of the grand ducal family then ruling Tuscany., Methods: Retrospective diagnosis of historical figures is difficult and at times controversial, even with modern technology. It is based on contemporaneous medical descriptions and historical reviews, inherited iconography, and rarely - as in the case of the Medici of Florence - skeletal assessment, completed with radiological, histological and even immunological studies. Modern clinical work is often complemented with a second opinion obtained from specialists in the relevant fields. It is this type of second opinion that our collaborative Australian and Italian team, comprised of an orthopaedic/spinal surgeon, a rheumatologist and two medical historians, now offers., Results: The authors concur with the first opinion's diagnosis of Klippel-Feil syndrome in Carlo de' Medici, but disagree with the diagnoses of tuberculosis (Pott's disease) and rheumatoid arthritis. We find evidence, instead, for a psoriatic-DISH arthropathy with involvement of Klippel-Feil syndrome., Conclusions: A psoriatic-DISH arthropathy, previously described by the present authors as the 'Medici syndrome', was commonly found in the males of the primary branch of the family. The diagnosis of this condition in Cardinal Carlo de' Medici represents its first identification in a male of the secondary (grand ducal) branch of the family.

Healing sounds have always been considered in the past an important aid in medical practice, and nowadays, medicine has confirmed the efficacy of music therapy in many diseases. The aim of this study is to assess the curative power of music, in the frame of the current clinical relationship.

Aphorismatic literature and private correspondence represent interesting sources to reconstruct the relationship between physician and patient, throwing light on particular aspects of it. The letters, which were written by Maria Teresa of Austria to her sons, appear very interesting from this point of view and contribute to understand the organization of health care system in Austria and in Tuscany during the years of Enlightenement.

The Medici ruled Florence during the golden centuries of the Renaissance and all of them are buried in the Cappelle Medicee (Florence). In 2004 started the Medici Project, a paleopathological and historico-medical research, based on the exhumation and the study of their corpses of the Medici, in order to reconstruct their diseases, their causes of death, their daily life, comparing the paleopathological results with the literary and iconographical tradition. The historical and paleopathological study includes the identification of all the stigmata which have left a sign on these remains: the research involves a number of specialistic approaches, from macroscopic study to palaeonutrition and molecular biology. The first step, however, regards the literary and iconographical study: starting from the examination of these sources it was possible to reconstruct the history of the archeological situation, which was upset by other exhumations, which took place in the past, and by the flood of the Arno river (1966). Thanks to the combination of these different approaches, it was possible to confirm the poisoning of Francesco I and his second wife Bianca Cappello and the murder of Giovanni dalle Bande Nere.

Foxing of paper is a deterioration phenomenon occurring in the form of brown-yellowish spots, the abiotic and/or biotic causes of which are not yet completely understood. Nevertheless, microbiological infection has been recognized that may contribute to paper damage and therefore it becomes important to know the taxonomic position and the degradative activity of the potential infectious biological agents which mostly are fungi, but also bacteria and yeasts. A cellulolytic bacterial strain isolated from a foxed paper sample exhibited morphological and physiological characteristics of the Bacillus genus. To study its taxonomic position, different identification methods were used: the Biolog system, the direct amplified polymorphic DNA-polymerase chain reaction analysis (DAPD-PCR) and the partial sequencing of the 16S rDNA gene. Biolog system and partial sequencing of 16S rDNA gene assigned the strain to the Paenibacillus polymyxa species. DAPD-PCR analysis indicated a high similarity with Bacillus circulans, by comparing the isolated strain with some closely related Bacillus species.

The Medici Project is a paleopathological and historico-medical research, based on the exhumation of corpses of the Medici Family buried in the Medici Chapels (Florence, San Lorenzo). The scientific research carried out on these remains permits us to reconstruct habits and causes of death of members of this famous family of Italian Renaissance. The comparison between the literary sources and the paleopathological evidence is also important to reconstruct different therapies. Physicians, who assisted the most important persons of the Medici Family, have left a rich literature about their patients: the treatments were based on the use of plants and natural substances. Analyzing these sources is of unique importance and throws light on the therapeutical choices of the time.

The Authors report the hypotheses about Torquato Tasso psychiatric illness, formulated along two centuries. Correspondence, more than his poetic works, and his good interpersonal relations also with people who shut him in Sant'Anna, suggest the diagnosis of an Affective Disorder: "Bipolar Disorder with mood incongruent delusions" or "Schizoaffective Disorder".

The history of atherosclerosis represents a very interesting and intriguing charter of the history of medicine. Atherosclerosis was present even in the old age, as demonstrated by paleopathological studies. Starting from these observations, recent evidences highlighted the crucial role of inflammation in the genesis of atherosclerosis.