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The status or role of Shanghan Lun (Treatise on Cold Damage Diseases) in Joseon is quite different compared to neighboring China and Japan. This is a unique aspect that distinguishes Joseon's medicine from other East Asian countries at that time. Prior studies have conducted research on non-professional books of Shanghan Lun; however, this study aims to analyze the transmission and utilization of professional books of Shanghan Lun. In the citations of medical books in the first half of Joseon period, the domestic introduction of professional books of Shanghan Lun used at the time occurred mostly from the mid-thirteenth century to the first half of the fifteenth century. In particular, the version of professional books of Shanghan Lun quoted in Euibangyoochui (Classified Collection of Medical Prescriptions) were centered on the Yuan edition. In other words, the acceptance of the theory of Cold Damage Diseases was based on the Yuan's medicine. Professional books of Shanghan Lun, which were published separately during the compilation or publication of Euibangyoochui, were intentionally selected. It is important to identify their characteristics. First of all, Shanghan Leishu (Classified Book of Cold Damage) was used as a textbook of Cold Damage in the first half of Joseon dynasty because the author of this book, Yang Shizhen and his practice acted as the basic text. The nature of Shanghan Leishu, which pursued the integration of "several symptoms of internal medicine" and "Cold Damage" instead of pursuing independent medicine of Cold Damage with different internal medicines, may have had some influence in forming the uniqueness of Joseon's medicine of Cold Damage. Shanghanfu (Harm Caused by Cold: A Poem) was an introduction for easy access to formal Cold Damage's content. Shanghanfu is presumed to be a medical book made out of prose poems, the core of Shanghanzhizhangtu. Non-professional books of Shanghanlun have also been cited in the first half of Joseon period's medical texts in relation to Cold Damage. However, these books were not used as textbooks in medical bureaucracy's education. The exclusion of major Cold Damage-related texts from the medical bureaucracy's education may have hampered the development of Joseon's Cold Damage medicine.

Despite persistent critiques of the rigor of surgical research, surgeons have actually pursued careful empirical studies for centuries. Their work has enriched not only surgical science but also the development of evidence-based medicine. From conducting landmark controlled trials, to using statistics, alternate patient allocation, randomization, and sham controls, surgeons have long embraced innovative trial approaches and played important roles in the development of key methods of randomized controlled trials (RCTs). However, historical contexts unique to surgery have shaped the implementation of RCTs in this field. Unlike the history of pharmaceuticals, in which substantial research funding has been devoted to testing new drugs before their approval, surgical trials have followed a different trajectory. New operations have repeatedly come into wide use in the absence of an RCT. On many occasions, when established procedures have become controversial, surgeons have then marshalled the resources to conduct RCTs reassessing the operations. Such trials have triggered powerful debates in which proponents of surgical RCTs battled against ingrained practices and preferences. In such cases, RCTs often were not decisive factors in determining the fate of surgical practices but supporting tools that followed and reflected changes in surgical judgment already underway. Surgical trialists also have encountered specific, recurring challenges, especially with the methodological and ethical complexity of blinded and sham-controlled trials. The history of surgical trials thus reveals major contributions from surgeons to the advancement of evidence-based medicine, as well as ongoing challenges. Strengthened and systematic support could advance the future of surgical RCTs.

The medieval cell doctrine was a series of related psychological models based on ancient Greco-Roman ideas in which cognitive faculties were assigned to "cells," typically corresponding to the cerebral ventricles. During Late Antiquity and continuing during the Early Middle Ages, Christian philosophers attempted to reinterpret Aristotle's De Anima, along with later modifications by Herophilos and Galen, in a manner consistent with religious doctrine. The resulting medieval cell doctrine was formulated by the fathers of the early Christian Church in the fourth and fifth centuries. Printed images of the doctrine that appeared in medical, philosophical, and religious works, beginning with "graphic incunabula" at the end of the fifteenth century, extended and evolved a manuscript tradition that had been in place since at least the eleventh century. Some of these early psychological models just pigeonholed the various cognitive faculties in different non-overlapping bins within the brain (albeit without any clinicopathologic evidence supporting such localizations), while others specifically promoted or implied a linear sequence of events, resembling the process of digestion. By the sixteenth century, printed images of the doctrine were usually linear three-cell versions with few exceptions having four or five cells. Despite direct challenges by Massa and Vesalius in the sixteenth century, and Willis in the seventeenth century, the doctrine saw its most elaborate formulations in the late-sixteenth and early-seventeenth centuries with illustrations by the Paracelsan physicians Bacci and Fludd. Overthrow of the doctrine had to await abandonment of Galenic cardiovascular physiology from the late-seventeenth to early-eighteenth centuries.

This work is based on the study of 150 majolica vases dated back to the mid XVII century that once preserved medicinal remedies prepared in the ancient Pharmacy annexed to the Ospedale Maggiore Ca’ Granda in Milan (Lombardy, Italy). The Hortus simplicium was created in 1641 as a source of plant-based ingredients for those remedies. The main objective of the present work is to lay the knowledge base for the restoration of the ancient Garden for educational and informative purposes. Therefore, the following complementary phases were carried out: (i) the analysis of the inscriptions on the jars, along with the survey on historical medical texts, allowing for the positive identification of the plant ingredients of the remedies and their ancient use as medicines, (ii) the bibliographic research in modern pharmacological literature in order to validate or refute the historical uses, (iii) the realization of the checklist of plants potentially present in cultivation at the ancient Garden, concurrently with the comparison with the results of a previous in situ archaeobotanical study concerning pollen grains. For the species selection, considerations were made also regarding drug amounts in the remedies and pedoclimatic conditions of the study area. Out of the 150 vases, 108 contained plant-based remedies, corresponding to 148 taxa. The remedies mainly treated gastrointestinal and respiratory disorders. At least one of the medicinal uses was validated in scientific literature for 112 out of the 148 examined species. Finally, a checklist of 40 taxa, presumably hosted in the Hortus simplicium, was assembled.

Leonardo da Vinci, the artist and scientist, was an archetype figure of the Renaissance era. He was an autodidactic polymath in natural sciences, engineering, and physical sciences, imbued with universality, prodigious inventive imagination, and curiosity to know and understand the world around him. Among his myriad activities, anatomy, physiology, and biomechanics of the musculoskeletal system and the underlying systems fully engaged him. Leonardo dissected dozens of human and animal corpses to study. His anatomical illustrations were precise, combining art and science with an impeccable integration of both. Multiple drawings, diagrams, sketches, and designs are found in his notes. Leonardo's style was intensely personal, unveiling his thoughts, passions, and emotions. We analyzed significant biographic aspects of Leonardo's life, remarking on his scientific and life conceptions and their manifestation in his anatomical designs. The contribution of preceding anatomists is reported as a source of his inspiration as well as motivation to successors. Leonardo da Vinci left no publications, but rather an extensive collection of personal notebooks. Leonardo's contribution to modern anatomy was enormous and he is considered by the scientific and medical community as the father of the modern anatomy.

OBJECTIVE: To discuss the historical relevance of the original illustrations and descriptions of the facial nerve during the Italian Renaissance (ca. late 14(th) – early 17(th) centuries) MATERIAL AND METHODS: Graphic and textual information related to facial nerve discoveries were harvested from the works of the study period’s anatomists, with special attention to those of Leonardo da Vinci, Andreas Vesalius, Gabrielle Falloppio, and Bartolomeo Eustachio. The importance of Galen’s anatomical works as a guide to these discoveries is discussed. CONCLUSION: The reviewed texts and the illustrations therein contained provided sufficient information to establish a sequence of discoveries that resulted in a near-modern knowledge of the anatomy of the facial nerve and the basis to comprehend its function.

Importance The recognition of the pulmonary circulation is a complex evolution in medical history and draws on theories across eras and cultures. Observations This narrative review summarizes evidence suggesting that the recognition of pulmonary circulation is older than the time of Ibn Nafis. The theory of pulmonary circulation originated in ancient Persia (ad224-637), was overshadowed by Greek theory from the 11th century, and reestablished by Ibn Nafis in the 13th century. Conclusions and Relevance The findings of this review may help contextualize the story of the discovery of pulmonary circulation in ancient Persian and Greek theories before Ibn Nafis.

After the European colonization of the Americas, there was a dramatic population collapse of the Indigenous inhabitants caused in part by the introduction of new pathogens. Although there is much speculation on the etiology of the Colonial epidemics, direct evidence for the presence of specific viruses during the Colonial era is lacking. To uncover the diversity of viral pathogens during this period, we designed an enrichment assay targeting ancient DNA (aDNA) from viruses of clinical importance and applied it to DNA extracts from individuals found in a Colonial hospital and a Colonial chapel (16th-18th century) where records suggest that victims of epidemics were buried during important outbreaks in Mexico City. This allowed us to reconstruct three ancient human parvovirus B19 genomes and one ancient human hepatitis B virus genome from distinct individuals. The viral genomes are similar to African strains, consistent with the inferred morphological and genetic African ancestry of the hosts as well as with the isotopic analysis of the human remains, suggesting an origin on the African continent. This study provides direct molecular evidence of ancient viruses being transported to the Americas during the transatlantic slave trade and their subsequent introduction to New Spain. Altogether, our observations enrich the discussion about the etiology of infectious diseases during the Colonial period in Mexico.The arrival of European colonists to the Americas, beginning in the 15

Historically, the weighing out and manipulation of dangerous chemicals frequently occurred without adequate protection from inhalation or accidental ingestion. The use of gloves, eye protection using goggles, masks or visors was scant. From Canary Girls and chimney sweeps to miners, stone cutters and silo fillers, these are classic exemplars of the subtle (and in some cases not so subtle) effects that substances, environments and practices can have on individual health.

During the 1536 siege of Turin in northern Italy, a young French barber-surgeon abandoned the conventional treatment of battle-inflicted wounds, launching a revolution in military medicine and surgical techniques. Ambroise Paré (1510–1590) was born into a working-class Huguenot family in Laval, France, during an era when surgery was not considered a respectable profession. He rose from humble origins as a barber-surgeon, a low-ranked occupation in the French medical hierarchy, to become a royal surgeon (chirurgien ordinaire du Roi) serving 4 consecutive French monarchs. His innovative ideas and surgical practice were a response to the environment created by new military technology on 16th-century European battlefields. Gunpowder weapons caused unfamiliar, complicated injuries that challenged Paré to develop new techniques and surgical instruments. Although Paré’s contributions to the treatment of wounds and functional prosthetics are documented, a deeper appreciation of his role in military neurosurgery is needed. This paper examines archives, primary texts, and written accounts by Paré that reveal specific patient cases highlighting his innovative contributions to neurotrauma and neurosurgery during demanding and harrowing circumstances, on and off the battlefield, in 16th-century France. Notably, trepanation indications increased because of battlefield head injuries, and Paré frequently described this technique and improved the design of the trepan tool. His contribution to neurologically related topics is extensive; there are more chapters devoted to the nervous system than to any other organ system in his compendium, Oeuvres. Regarding anatomical knowledge as fundamentally important and admiring the contemporary contributions of Andreas Vesalius, Paré reproduced many images from Vesalius’ works at his own great expense. The manner in which Paré’s participation in military expeditions enabled collaboration with multidisciplinary artisans on devices, including surgical tools and prosthetics, to restore neurologically associated functionality is also discussed. Deeply religious, in a life filled with adventure, and serving in often horrendous conditions during a time when Galenic dogma still dominated medical practice, Paré developed a reputation for logic, empiricism, technology, and careful treatment. "I have [had] the opportunity to praise God, for what he called me to do in medical operation, which is commonly called surgery, which could not be bought with gold or silver, but by only virtue and great experimentation."

Leonardo da Vinci, the Renaissance polymath, is still recognized today—above all for his oil paintings and mechanical inventions. His anatomical studies have attracted less attention, even though he devoted over 30 years of his life to them. This paper outlines Leonardo's career and research methods and focuses on the importance of his medical images for anatomical research and teaching. Following a short presentation of the state of (dental) medicine in the early Renaissance period, it offers a description of five of his cranial drawings that show the anatomy of the teeth, the nervous and vascular system on inner and outer tables of the skull and the paranasal sinuses in great detail. Leonardo da Vinci had obviously discovered and depicted the maxillary sinus 150 years before the anatomist Nathaniel Highmore, who is usually credited with this discovery. Other anatomical drawings by Leonardo address the correct human dental formula and describe the morphology of the four types of teeth. His handwritten notes show that he recognized the connection between tooth form and function. Finally, this paper evaluates the influence of these discoveries and innovations on the development of dentistry and its establishment as a scientific discipline. There is no doubt that Leonardo da Vinci's preoccupation with the anatomy of the maxillofacial region influenced the development of anatomy and dentistry, even though he never published his anatomical research., Leonardo da Vinci, the Renaissance polymath, conducted detailed anatomical studies. His anatomical drawings and notes address the human dental formula, describe the morphology of the different types of teeth, and highlight the relationship between tooth shape and function. Leonardo described the maxillary sinus 150 years earlier than the anatomist Nathaniel Highmore. Finally, the paper discusses his influence on the development of dentistry.

This review provides a brief history of the advances of cellular analysis tools focusing on instrumentation, detection probes, and data analysis tools. The interplay of technological advancement and a deeper understanding of cellular biology are emphasized. The relevance of this topic to drug development is that the evaluation of cellular biomarkers has become a critical component of the development strategy for novel immune therapies, cell therapies, gene therapies, antiviral therapies, and vaccines. Moreover, recent technological advances in single-cell analysis are providing more robust cellular measurements and thus accelerating the advancement of novel therapies.Graphical abstract.

The interconnection of scientific studies and art represented by Leonardo Da Vinci's (1452-1519) portraiture accentuates his role in documenting and archiving dermatologic conditions. His anatomical dissections, sketches, and paintings, including portraits, were all a means to observe, portray, and understand the nuances of the human body. In two of his most discussed portraits, Ginevra de' Benci (1474-1478) and Elisabetta del Giocondo, the Mona Lisa (1503-1506), Leonardo's execution of the exterior anatomy is so precise that he may have illustrated manifestations of disease that allow contemporary researchers to theorize diagnoses of dermatologic as well as neurologic, endocrine and vascular conditions. These include hypochromic anemia, muscular disorders, xanthelasma, thyroid disease, lipoma, and frontal fibrosing alopecia. Leonardo's extraordinary talent in recording his observations of shades and textures of skin and his ability to capture the nuances of subtle variations in the human body have produced a historical record that allows modern dermatology practitioners to make further observations not possible in his time. Here, dermatology and art intersect serving to document and explain the human condition, permanently archived in Leonardo's masterpieces.

The central brain region of interest for neuroendocrinology is the hypothalamus, a name coined by Wilhelm His in 1893. Neuroendocrinology is the discipline that studies hormone production by neurons, the sensitivity of neurons for hormones, as well as the dynamic, bidirectional interactions between neurons and endocrine glands. These interactions do not only occur through hormones, but are also partly accomplished by the autonomic nervous system that is regulated by the hypothalamus and that innervates the endocrine glands. A special characteristic of the hypothalamus is that it contains neuroendocrine neurons projecting either to the neurohypophysis or to the portal vessels of the anterior lobe of the pituitary in the median eminence, where they release their neuropeptides or other neuroactive compounds into the bloodstream, which subsequently act as neurohormones. In the 1970s it was found that vasopressin and oxytocin not only are released as hormones in the circulation but that their neurons project to other neurons within and outside the hypothalamus and function as neurotransmitters or neuromodulators that regulate central functions, including the autonomic innervation of all our body organs. Recently magnocellular oxytocin neurons were shown to send not only an axon to the neurohypophysis, but also axon collaterals of the same neuroendocrine neuron to a multitude of brain areas. In this way, the hypothalamus acts as a central integrator for endocrine, autonomic, and higher brain functions. The history of neuroendocrinology is described in this chapter from the descriptions in De humani corporis fabrica by Vesalius (1537) to the present, with a timeline of the scientists and their findings.

Finding order in disorder is a hallmark of science and art. In the time of Leonardo da Vinci, the schism between science and art had yet to arise. In fact, Leonardo freely used scientific methods for his art and vice versa; for example, when he used his observations of turbulent, whirling water to guide his artistic imagination. Half a millennium later, a cornerstone of modern biology is the continuing search for order in dynamic processes. In neuroscience, the search has focussed on understanding complex spacetime brain dynamics. Recently, turbulence has been shown to be a guiding principle underlying the necessary information processing, supporting Leonardo's search for order in disorder. Here, we argue that Leonardo's seminal insights have ongoing relevance for modern neuroscience.

Oscar Nerval de Gouvêa was a scientist and teacher in Rio de Janeiro, Brazil, whose work spanned engineering, medicine, the social sciences, and law. This paper presents and discusses a manuscript entitled “Table of mineral classification,” which he appended to his dissertation Da receptividade mórbida , presented to the Faculty of Medicine in 1889. The foundations and features of the table provide a focus for understanding nineteenth-century mineralogy and its connections in Brazil at that time through this scientist. This text was Gouvêa’s contribution to the various mineral classification systems which have emerged from different parts of the world. Resumo Oscar Nerval de Gouvêa foi um cientista e professor no Rio de Janeiro, Brasil, cuja obra abrange engenharia, medicina, ciências sociais e direito. Este artigo apresenta e discute o texto intitulado “Tabela de classificação mineral”, que ele anexou a sua tese Da receptividade mórbida, apresentada na Escola Superior de Medicina, em 1889. Os fundamentos e características da tabela propiciam a compreensão da mineralogia do século XIX e suas conexões no Brasil à época por intermédio desse cientista. O texto foi a contribuição de Gouvêa aos diversos sistemas de classificação de minerais originados de diferentes partes do mundo.

International audience; Zika virus (ZIKV) is an arthropod-borne RNA virus (arbovirus), belonging to the Spondweni serogroup. ZIKV was first described in Africa in 1947 and remained sporadic until Micronesia outbreak in 2007, which was followed by outbreaks in the Pacific Islands, Latin America, and the Caribbean. Subsequent to the epidemics, ZIKV revealed its severity as virus was sexually transmissible, and it was associated with serious fetal and neurological complications. ZIKV originated from Africa; however, little is known about the epidemiology of the virus in African populations. Following a recent study in Cameroon that evidenced low ZIKV epidemiology associated with a presumptive (peri-)sylvatic transmission, we performed a seroepidemiological study in Republic of the Congo, neighbor of Cameroon. To accomplish this, 386 serum specimens from volunteer blood donors collected in 2011 from rural and urban areas of Republic of the Congo were tested with ZIKV-specific methodology; primary screening with anti-NS1 ZIKV IgG ELISA followed by confirmation with cytopathic effect (CPE)-based virus neutralization test (VNT). ZIKV seropositivity was determined as low as 1.8%, varying slightly between urban and rural areas (1.7% and 3.6%). These results demonstrate that the majority of the population of Republic of the Congo is immunologically naïve against ZIKV with a presumptive (peri-)sylvatic transmission cycle, which emphasizes the importance of surveillance studies in Africa.

To highlight the most relevant contributions of the Italian Renaissance surgeon Girolamo Fabrizi d’Acquapendente in the field of orthopaedics and traumatology. An extensive research on the life and achievements of Girolamo Fabrizi was conducted on University Libraries as well as on electronic databases like PubMed. Girolamo Fabrizi d’Acquapendente is known for his embryology and physiology studies, particularly on sensory organs and blood circulation. He founded the world’s first permanent anatomical theater established at the University of Padua and inaugurated in 1595. His most notable publications include surgical and definitely orthopedics works such as “De fracturis” (On fractures) and “De luxationibus” (On joint displacement). He outlined some principles of treatment that are still valid nowadays such as anatomical reduction and stabilization of the fracture, that were applied using the equipment available at that time. He described and illustrated maneuvers and instruments, such as pulleys, winches, splint, and bandages. He further depicted the famous “Oplomochlion” (“the armored man”), which is actually a collection of all of the braces used at the time to correct congenital and post-traumatic deformities. Bracing and prosthetic replacements have accompanied medical history throughout the centuries, from Ancient Egypt to the present, but it was the ingenuity of Renaissance surgeons that pushed biomedical technology to new heights: Girolamo Fabrizi d’Acquapendente was one of the most illustrious contributors to these great achievements.

Following Galileo's trial of 1633, the Jesuit theologian Melchior Inchofer, author of the most negative reports used by the Roman Inquisition against Galileo, repudiated the Copernicans for the 'heresy' of the soul of the world (anima mundi), in an unpublished manuscript. I show that Inchofer's arguments applied far more to the beliefs of Giordano Bruno than to those of Galileo. Since antiquity, various Christian authorities had repudiated several beliefs about the anima mundi as 'heretical', hence I review their critiques against Pythagoras, Origen, and Peter Abelard, for allegedly asserting animistic beliefs about the Earth, or a universal spirit, or that souls move the heavenly bodies. Still, in the Renaissance such beliefs were defended by several advocates of Copernicus, including Bruno, William Gilbert, Johannes Kepler, and Philips Lansbergen, who all claimed that Earth moves because it has a soul. By comparing Inchofer's works and some of the Roman Inquisition's earlier censures against Bruno, I argue that the repudiation by many prominent Catholic theologians of pagan notions of the anima mundi as heretical contributed partly to the later theological opposition to the Copernicans.

Several popular Shakespearean characters are dramatically portrayed on stage with striking physical appearances caused by medical and dermatologic disorders. Shakespeare's colorful portrayal of their maladies not only helps to entertain audiences but also serves to define the characters' personalities and behavior. Shakespeare himself emphasizes this point in his play Richard III, in which the notorious English king states that his evil nature is a direct result of his hideous spinal deformity. This contribution discusses four other famous Shakespearean characters: Bardolph, who appears to be suffering from rosacea; the Witches of Macbeth, who have beards; Juliet, who has green sickness (chlorosis); and Falstaff, who is morbidly obese. In all of these cases, their skin disorders and medical maladies serve to highlight their underlying nature.

This study examines how Choe Han-gi (1803-1879) developed his medical discourse which integrated the concepts of traditional Chinese medicine with modern Western anatomy, based on the philosophy of Seo Gyeong-deok (1489-1546), a scholar of the Neo-Confucianism of Joseon (1392-1910). Seo emphasized gi (C. qi, vital, material force) rather than yi (C. li, the principle of things) as a way of understanding the world. Since Choe's early academic interests pertained to Neo-Confucianism, it is reasonable to examine his philosophy in this context. Similar to Seo, Choe assumed that the most essential component of the world was the intrinsic and mysterious gi. Although Seo spoke of gi as a damil cheongheo ji gi (the gi which is profound, uniform, clear, invisible, and empty), Choe preferred to use the word singi (C. shenqi, the intrinsic, invisible, and mysterious gi). He believed that the earth, moon, and stars operated through the action of singi and that all creatures could only exist by relying on it. Singi was the most important premise in Choe's medical discourse, a fact demonstrating that although he could be very critical of traditional Chinese medicine, his perspective was part of that tradition. He believed that singi integrated and operated the entire human body and that it perceived external objects. He also emphasized the role of hyeongjil (C. xingzhi, a visible object with a form and quality; here it means all human bodies). This was the medium through which singi could appear in reality. Choe thought that singi could not reveal itself in reality without hyeongjil, and that hyeongjil became a dead thing without singi. His perception of the role of hyeongjil was expressed in his interest in modern Western anatomy, an interest that complemented his focus on singi. In light of his understanding of the singi-hyeongjil relationship, Choe criticized both modern Western anatomy and traditional Chinese medicine. He thought that modern Western anatomy lacked awareness of singi and that traditional Chinese medicine lacked accurate knowledge of human anatomy. Although he was not completely sympathetic toward any forms of medicine, he was open to ideas from both Western and Chinese medicine. Choe could not accept Western anatomy as fully as Japanese intellectuals did. The study of anatomy in Japan had developed in relation to the idea of Ancient Learning (C. guxue), which denied such theories of systematic correspondence as Yin and Yang and the Five Elements (C. yinyang wuxing) and tended to focus on the action of hyeongjil itself. Because Choe accepted modern Western anatomy without accepting Ancient Learning, his perspective was unique in the history of East Asian anatomy. From a medical history perspective, how does Choi Han-gi's medical discourse distinguish itself from other medical discourses, and what are its characteristics? In addition to other explanations, focusing on the political imagination associated with medicine can help illuminate the differences between the medical discourse of Choe and those of others. Discussion of medicine and the human body was tied to political thought, manifesting the political imagination of the society in which that discussion took place. The development of Western and Japanese anatomy reflected a vertical and hierarchical political order, exemplified by the belief that the brain was the center of the body. However, Choe doubted that organs like the brain or heart dominated the body. In his view, the singi ruled the body; it was not a specific organ, and it was equally inherent in all people. His political thought also emphasized the horizontal and equal order among people. His view of singi simultaneously influenced both his perspective on medicine and his perspective on society. Choe Han-gi's belief in this horizontal and equal political order was inherent in his singi-centered medical discourse.

Background Intracranial meningiomas are brain tumors that have probably been known the longest, largely because of the occasional production of grotesque cranial deformities that have attracted the attention and interest of humankind. Because of the tendency of some intracranial meningiomas to cause skull deformation and thickening, these tumors have given rise to various speculations and theories related to their origin, starting in prehistoric times up to the present. Methods From the Steinheim skull and “pharaonic meningiomas” to the first meningioma monograph and the first explanations of Harvey Cushing regarding the mechanism of hyperostosis, this review aims to weave again the story of Arachne. We identify the main contributors who have tried to understand and explain the tendency of some of these tumors to cause hyperostosis or other skull bone involvements. Conclusions The contribution of neurosurgeons or pathologists over the centuries is of undeniable importance and is the basis for understanding future molecular mechanisms.

This review traces the growing burden of cancer in India from antiquity. We searched PubMed, Internet Archive, the British Library, and several other sources for information on cancer in Indian history. Paleopathology studies from Indus Valley Civilization sites do not reveal any malignancy. Cancer-like diseases and remedies are mentioned in the ancient Ayurveda and Siddha manuscripts from India. Cancer was rarely mentioned in the medieval literature from India. Cancer case reports from India began in the 17th century. Between 1860 and 1910, several audits and cancer case series were published by Indian Medical Service doctors across India. The landmark study by Nath and Grewal used autopsy, pathology, and clinical data between 1917 and 1932 from various medical college hospitals across India to confirm that cancer was a common cause of death in middle-aged and elderly Indians. India’s cancer burden was apparently low as a result of the short life expectancy of the natives in those times. In 1946, a national committee on health reforms recommended the creation of sufficient facilities to diagnose and manage the increasing cancer burden in all Indian states. Trends from the Mumbai population-based cancer registry revealed a four-fold increase in patients with cancer from 1964 to 2012. Depending on the epidemiologic transition level, wide interstate variation in cancer burden is found in India. We conclude that cancer has been recognized in India since antiquity. India’s current burden of a million incident cancers is the result of an epidemiologic transition, improved cancer diagnostics, and improved cancer data capture. The increase in cancer in India with wide interstate variations offers useful insights and important lessons for developing countries in managing their increasing cancer burdens.

Until well in the 19th century, the Aristotelian concept of the scala naturae (ladder of nature) was the most common biological theory among Western scientists. It dictated that only humans possessed a rational soul that provided the ability to reason and reflect. Michel Eyquem de Montaigne (1533-1592) was the first philosopher influential enough to lastingly posit that animals are cognitive creatures. His view stirred a fierce controversy, with René Descartes (1596-1650) leading among his many adversaries. Only after it became accepted that animals and humans alike have cognitive abilities, did the research on the influence of conscious awareness and intention on the behavior of an animal become possible in the 20th century. We found the anatomist Andreas Vesalius (1515-1564) to have already rejected the Aristotelian view on the lack of the rational soul in animals in his 1543 opus magnum De Humani Corporis Fabrica Libri Septem. His observation "that there is a difference in size according to the amount of reason that they seem to possess: man's brain is the largest, followed by the ape's, the dog's, and so on, corresponding to the amount of rational force that we deduce each animal to have" resonated some 330 years later when Darwin concluded that "the difference in mind between man and the higher animals, great as it is, certainly is one of degree and not of kind." We conclude that Vesalius was instrumental in breaking with two millenniums of dominance of the concept of lack of animal cognition.

Semseddin-i Itâki is a key Turkish scientist in the field of anatomy. His book entitled Tesrih-ul Ebdan ve Tercumâni Kibale-i Feylesufan which was written in the seventeenth century is accepted as the first illustrated anatomy handwritten textbook in Turkish language. In this article, it was examined an original copy of Tesrih-ul Ebdan ve Tercumâni Kibale-i Feylesufan, which is available at the Suleymaniye Library in Istanbul, Turkey, as well as the transliteration of this book from old Turkish (Ottoman-Turkish) alphabet to contemporary Turkish alphabet by Esin Kâhya. In this book, the anatomical drawings and their descriptions were evaluated. In this ancient handwriting, Itâki begins with thanking God and then describes the general structure of the organs, bones, nerves, muscles and vessels, supporting with various illustrations. These illustrations are mainly focused on cranial bones, muscles, cranial nerves, spinal nerves, stomach, intestines, urogenital system, bladder, trachea, larynx and bronchi. While some of these illustrations are similar to the illustrations of the earlier authors such as Ahmed Ibn Mansur, Andreas Vesalius and Juan Valverde de Amusco, others are peculiar to this book. This book is highly significant for it’s being the first Turkish book in the field of anatomy in Ottoman-Turkish medicine and the text’s being supplemented by illustrations. This book is also a fundamental source for translation of anatomical terms into Turkish. Our knowledge of anatomy continues to improve thanks to the contributions of leading scientists such as Itâki and, therefore, he deserves praise.

Objectives Physiological disturbances in early life have been shown to increase individual mortality risk and impact health in adulthood. This study examines frailty through analysis of lesion status of two commonly collected skeletal indicators of stress (cribra orbitalia [CO] and porotic hyperostosis [PH]) and their association with mortality risk in the precontact U.S. Southwest. Several predictions are addressed: (a) individuals with active skeletal lesions are the frailest; (b) individuals with healed lesions are the least frail; (c) CO lesions, regardless of status, are associated with increased mortality risk. Materials and methods Odds ratios and Kaplan-Meier survival analysis are used to examine the association between stress indicators and mortality in the U.S. Southwest. This study includes 335 individuals (75 females, 81 males, 20 adults of unknown sex, and 159 juveniles) from precontact New Mexico archaeological sites dating to A.D. 1,000-1,400. Results Active CO and PH lesions are associated with lower survivorship and greater mortality risk than healed or absent lesions. Only juvenile individuals have active CO and PH lesions, as is expected given their physiology. CO lesions in any state are associated with greater mortality risk and earlier ages of death. Discussion Individuals with active lesions are the frailest; while individuals with healed lesions are the least frail. CO and PH likely have different etiologies: CO lesions are associated with increased mortality risk and decreased individual longevity. These results indicate that CO's presence suggests a more severe underlying condition than PH lesions alone.

Introduction Although pre-Hispanic hunter-gatherer and horticulturalist (known as Guarani) societies from the lower Parana River Delta (Argentina) presented differences in diet, pottery decoration, mortuary practices, and places of origin, differences in skeletal morphology between such groups have never been systematically explored. This work focuses on variations in humeral and femoral external linear measurements and derived structural properties of adult individuals from both societies as well as on variations in body mass and stature. Materials and methods Bone length, epiphyseal size, and midshaft breadth were measured in 82 adult humeri and 100 femora from hunter-gatherer and Guarani archeological sites. Epiphyseal and midshaft robusticity, residual strength, midshaft shape and area, stature, and body mass were then estimated. Mann-Whitney tests were run to compare the hunter-gatherer and Guarani samples. Results Male Guarani individuals presented stronger humeri and more robust femoral and humeral proximal epiphyses than hunter-gatherers. In addition, female Guarani individuals showed rounder femoral diaphyses in comparison with female hunter-gatherers. Concerning stature, the Guarani individuals were found to be shorter than hunter-gatherers, regardless of sex. No statistical differences were found in body mass. Discussion Despite the fact that skeletal variations between Guarani and hunter-gatherers could be a consequence of differences in mechanical loadings and genetic composition, bone robusticity is also positively correlated with increased age, but as the age composition of the Guarani sample could not be estimated, skeletal variation between the samples could be a consequence of differences in age distribution.

The aim of this work is to discuss the frequency of traumatic bone injuries in a quite unique skeletal assemblage of enslaved people from Valle da Gafaria, Lagos, Portugal (15th-17th centuries). In all, 30 males, 58 females, and 15 individuals of unknown sex were included in the study. The skeletal remains were macroscopically observed for traumatic lesions. When present, the traumatic bone injuries were classified as having occurred ante or perimortem. The antemortem lesions were also studied through radiological analysis. Traumatic lesions were identified in 11 men (36.7%), 23 women (39.7%) and two individuals of unknown sex (13.3%). From these 36 individuals, 61.1% presented antemortem trauma, 25.0% perimortem trauma and 13.9% exhibited simultaneously ante and perimortem trauma. The mechanism of all traumatic injuries was blunt force trauma. From the 9965 analysed bones, 186 exhibited traumatic lesions (87 antemortem, 97 perimortem, and two with both ante and perimortem lesions). The bone more affected by antemortem trauma was the 5th right intermediate foot phalange (40.0%) and by perimortem trauma was the skull (11.4%), probably related to accidents and interpersonal violence, respectively. When analysed by sex, the only significant differences were found in the skull and the right 5th proximal foot phalanges, men (57.1%) presenting more lesions than women (15.4%). The obtained results are consistent with an arduous life, corroborating historical sources which document labour accidents, physical punishments and hard work in the populations of slaves.

The aim of present report was to briefly review the history of the anatomical studies during the Italian Renaissance and to outline their relationship to the figurative arts, focusing, in particular, on neuroanatomical studies that have been at the center of the medical and philosophical debate from the 14th to 16th centuries. Therefore, we have presented the interpretation of different Renaissance masterpieces for which some references to brain anatomy have been previously reported. We propose a new interpretation, in neuroanatomical key, of the fresco of the universal judgment in the vault of San Giorgio's Cathedral in Ferrara, Italy, painted around the end of the 16th century.

In 1708, Adam Christian Thebesius, a 22-year-old student at Leiden University, presented his graduate thesis, Disputatio medica inauguralis de circulo sanguinis in corde. More than a doctoral dissertation, this groundbreaking work opened new channels into the study of the human coronary venous system. Thebesius' theory about the vascular communication between the coronary arteries and the chambers of the heart helped to advance understanding of hemodynamic principles and to clarify the physiologic pathways of the coronary circulation. The following article—the third in a trilogy about Lower Silesian scientists—provides an overview of the life story and achievements of this Silesian physician and innovator, whose name was immortalized in 2 cardiac eponyms: the Thebesian veins and the Thebesian valve.

This paper integrates our knowledge from traditional Chinese medical texts and archeological findings to discuss parasitic loads in early China. Many studies have documented that several different species of eukaryotic endoparasites were present in early human populations throughout China. Nevertheless, comprehensive paleoparasitological records from China are patchy, largely due to taphonomic and environmental factors. An examination of early Chinese medical texts allows us to fill in some of the gaps and counteract apparent biases in the current archeoparasitological records. By integrating the findings of paleoparasitology with historic textual sources, we show that parasites have been affecting the lives of humans in China since ancient times. We discuss the presence and prevalence of three groups of parasites in ancient China: roundworm (Ascaris lumbricoides), Asian schistosoma (Schistosoma japonicum), and tapeworm (Taenia sp.). We also examine possible factors that favored the spread of these endoparasites among early humans. Therefore, this paper not only aims to reveal how humans have been affected by endoparasites, but also addresses how early medical knowledge developed to cope with the parasitic diseases. Nanyang Technological University Published version This research was fully supported by NAP Start-Up Grant from Nanyang Technological University. We thank our assistant, Zhu Chuan, from the School of Art, Design and Media who provided expertise on illustrating images that greatly assisted the research. We also truly thank the editors from International Journal of Paleopathology for their great works and assistance.

"Lupus nephritis", a serious complication of systemic lupus erythematosus (SLE), is an entity of recent vintage. The term "lupus", derived from Latin for wolf, was introduced in the Middle Ages to denote nondescript erosive skin lesions which resembled wolf bites that were known theretofore by their Greek name of "herpes esthiomenos", used in the Hippocratic Corpus for the spread of the lesions like a crawling snake. The specific dermatologic features of lupus were characterized as an "erythematous" butterfly rash in 1828 and dubbed "lupus erythematosus" in 1850. Their association with systemic manifestations was described in 1872 and termed "disseminated lupus erythematosus" by the close of the century. A preference for "systemic" rather than "disseminated" was suggested in 1904 but would not prevail until the 1960s. The generic term "nephritis", denoting "inflammation of the kidnies" dating to the 1580s, was first used to describe the renal lesions of SLE in 1902. Although albuminuria and abnormal urine sediment were often noted in SLE patients, the early study of their renal changes was limited to postmortem studies. Refinements in their identification came in the late 1950s after the introduction of kidney needle biopsies and refined thereafter by immunofluorescent and electron microscopic studies. Subsequent lupus nephritis studies paralleled the emerging discipline of immunology that identified autoimmunity as the cause of SLE. The varied lesions observed were classified by glomerular changes in 1975 and refined in 2003. Advances in genetic and molecular profiling have enriched the management of lupus nephritis based on kidney biopsies.

Objectives From a genetic perspective, relatively little is known about how mass emigrations of African, European, and Asian peoples beginning in the 16th century affected Indigenous Caribbean populations. Therefore, we explored the impact of serial colonization on the genetic variation of the first Caribbean islanders. Materials and methods Sixty-four members of St. Vincent's Garifuna Community and 36 members of Trinidad's Santa Rosa First People's Community (FPC) of Arima were characterized for mitochondrial DNA and Y-chromosome diversity via direct sequencing and targeted SNP and STR genotyping. A subset of 32 Garifuna and 18 FPC participants were genotyped using the GenoChip 2.0 microarray. The resulting data were used to examine genetic diversity, admixture, and sex biased gene flow in the study communities. Results The Garifuna were most genetically comparable to African descendant populations, whereas the FPC were more similar to admixed American groups. Both communities also exhibited moderate frequencies of Indigenous American matrilines and patrilines. Autosomal SNP analysis indicated modest Indigenous American ancestry in these populations, while both showed varying degrees of African, European, South Asian, and East Asian ancestry, with patterns of sex-biased gene flow differing between the island communities. Discussion These patterns of genetic variation are consistent with historical records of migration, forced, or voluntary, and suggest that different migration events shaped the genetic make-up of each island community. This genomic study is the highest resolution analysis yet conducted with these communities, and provides a fuller understanding of the complex bio-histories of Indigenous Caribbean peoples in the Lesser Antilles.

Thanks to collaborations with anatomists and the possibility of performing public dissections during the Renaissance period, artists started to represent the human body more accurately and objectively in their drawings. This cultural change provided the basis for subsequent advances in education and learning as well as the institution of an obligatory anatomy course in the Academies of Arts. The encounter in Pavia between the eclectic artist Leonardo Da Vinci (1452-1519) and the physician Marco Antonio Della Torre (1481-1511), Professor of Theoretical Medicine at the University of Padova, who near the end of his short life founded the "Anatomical School" of the University of Pavia, could be considered a perfect example of this collaboration. According to the historian Giorgio Vasari, while Della Torre practiced dissection, Leonardo made a book of drawings with red chalk annotated by pen. All these anatomical drawings by Leonardo, preserved at Windsor Castle as the property of the Queen of England, date from 1513, after the death of Della Torre. During the same period, Leonardo started his own dissections in the crypt of Santa Maria Nuova in Florence with his anatomical knowledge already mature and consolidated. The aim of the present study is to present the life of Della Torre, his intense scientific activity between Padova and Pavia, and his relationship with Leonardo Da Vinci. In particular, we found the only available manuscript of Della Torre in the Marciana library of Venice. Clin. Anat. 32:744-748, 2019. © 2019 Wiley Periodicals, Inc.

Before the Enlightenment, the mentally ill in the Hispanic world received standard medical care. After the foundation of the first hospital for specific treatment for mentally ill in Valencia in 1409, a number of hospitals opened their doors to patients with mental illness across the Iberian Peninsula during the 15th century. This model of medical care for people with mental illness was carried to America and the Philippines soon after the arrival of the Spaniards. The treatment for the mentally ill in the Hispanic World influenced the development of Pinel's moral treatment and the care of the mentally ill during the Enlightenment. This article will explain the circumstances leading to the foundation of a number of specific hospitals for the mentally ill in the Hispanic territories as well as the kind of care that these patients received at the so-called casas de locos.

There is a distinctive Venetian carnival mask with sinister overtones and historical significance to physicians because it belongs to the 'Doctor of the Plague'. The costume features a beaked white mask, black hat and waxed gown. This was worn by mediaeval Plague Doctors as protection according to the Miasma Theory of disease propagation. The plague (or Black Death), ravaged Europe over several centuries with each pandemic leaving millions of people dead. The cause of the contagion was not known, nor was there a cure, which added to the widespread desperation and fear. Venice was a major seaport, and each visitation of the plague (beginning in 1348) devastated the local population. In response, Venetians were among the first to establish the principles of quarantine and 'Lazarets' which we still use today. Plague outbreaks have occurred in Australia, notably in Sydney (1900-1925), and continue to flare up in poorer communities, most recently in Madagascar (2017). Antibiotics are the mainstay of treatment, but there are concerns regarding the emergence of resistant pathogenic strains of Yersinia pestis, and their potential use in bio-terrorism.

Very often, descriptions of the scientific discovery of the lymphatic system start with Gaspare Aselli, probably because of his so captivating account. Nevertheless, there was prior and even very old evidence of the lymphatic vessels, which was of course known to Aselli himself, as he cited most of these antique references. In fact, the first insights were contributed by the Hippocratic School. The Alexandrian School added quite a lot but unfortunately most of that knowledge is not extant and can only be appreciated by translations or citations by other authors such as Galen. The 'dark' middle ages did not add to the anatomical knowledge of the lymphatics, and only the rise of the Renaissance brought new insights. Even at that time, Aselli was not the first to identify at least some components of the lymphatic system, but he was actually the first to present a proper account in a book dedicated to the "lacteal veins". Afterwards the interest rose enormously and cumulated in one of the first priority - or plagiarism - disputes, the Rudbeck-Bartholin feud. Surprisingly, William Harvey, the discoverer of the systemic blood circulation, ignored, at least in part, the progress of the discoveries in lymphatic circulation. This narrative review tries to summarize the major contributions to the anatomical knowledge of the lymphatic system from the ancient times up to the end of the European Renaissance.

The term "azygos vein" is in common use in modern anatomical and cardiovascular textbooks to describe the vein which ascends to the right side of the vertebral column in the region of the posterior mediastinum draining into the superior vena cava. "Azygos" in Greek means "without a pair", explaining the lack of a similar vein on the left side of the vertebral column in the region of the thorax. The term "azygos" vein was utilized firstly by Galen and then was regenerated during Sylvius' dissections and Vesalius' anatomical research, where it received its final concept as an official anatomical term. The purpose of this study is to highlight the origin of the term "azygos vein" to the best of our knowledge for the first time and its evolution from the era of Hippocrates to Realdo Colombo.

Surgeons removed bladder stones by perineal lithotomy in ancient times. The first surgeon who dared to invade a body cavity knew human anatomy and was skilled in the use of surgical instruments. The operation probably originated in India since the Sushruta Samhita, a surgical text, antedates Hippocrates by several hundred years. Sushruta's knowledge of bladder of stones, surgical complications and instrumentation identifies him as originator of vesicolithotomy. Why did Hippocrates advise his students to leave operations for bladder stones to practitioners who were skilled in the art? Who were these practitioners and how did knowledge of vesicolithotomy reach Greece from India? Our research suggests that the operation came to Greece from India over ancient trade routes and with surgeons who accompanied Alexander the Great's army. The Sushruta Samhita was translated in Arabic and may have reached Europe during the dark ages by way of Arabian surgeons such as Albucasis. Chelseldon, an eighteenth century English surgeon, brought Sushruta's vesicolithotomy to a peak of perfection.

Aims and objectives This article reports on diet variability in the Dogon Country (Mali) through a bio-archeological study of pre-Dogon and early Dogon human remains (7th century to 19th century AD) from collective burial caves in the Bandiagara Escarpment. Materials and methods Two hundred and twenty crania from collections curated in Leiden, Paris, and Bamako were studied for dental diseases. In a subset of teeth (n = 175), δ13 C and δ15 N were measured in bulk dentine samples. Results δ13 C and δ15 N values vary widely (-15.4 to -6.0‰ for δ13 C, 6.0-14.8‰ for δ15 N, n = 175), and indicate diets dominated by C4 -based foods with a focus on plants; animal products played a minor role. There are significant differences between the δ13 C values from older (pre-Dogon) and younger (Dogon) periods. Frequencies of caries, antemortem tooth loss, and abscesses increase significantly through time. Individuals from northern caves have more positive δ13 C and δ15 N values than southern ones. Discussion and conclusions The temporal shifts are probably due to progressive diversification of foods, consistent with archeological evidence showing the addition of rice and vegetables to pearl millet. The geographical disparity is explained by a combination of climatic, environmental, and cultural factors. Last, intersite differences imply that different communities (or subsections thereof) disposed of their dead in different caves. Based on a large sample extending over a wider area and longer time frame than previous work, our study shows that diets in the Dogon Country were neither uniform nor continuous through time, as previously proposed. Our results attest to a complex history of settlement and foodways.

Leonardo da Vinci (1452-1519) contributed to the study of the nervous system. His earliest surviving anatomical drawings (circa 1485-93) included studies of the skull, brain, and cerebral ventricles. These works reflected his efforts to understand medieval psychology, including the localisation of sensory and motor functions to the brain. He was also the first to pith a frog, concluding that piercing the spinal medulla causes immediate death. After a 10-year interval in the early 1500s Leonardo resumed his anatomical studies and developed a method to inject hot wax into the ventricular system, creating a cast that showed the shape and extent of the ventricles. During this period he also progressed in his understanding of the anatomy of the cranial nerves. Besides being the first to identify the olfactory nerve as a cranial nerve, his dissections showed him that contrary to previous theories, the nerves do not converge on the lateral or third ventricles. Leonardo also performed detailed studies of the peripheral nervous system. Although his discoveries had little influence on the development of the field of anatomy, they represent an astonishingly sharp break from the field that had seen little if any progress in the previous 13 centuries. His work reflects the emergence of the modern scientific era and forms a key part of his integrative approach to art and science.

This chapter will cover the evolution of forceps and vacuum-assisted delivery of the foetus in cephalic presentation. The options available before the development of obstetric forceps are briefly reviewed. The invention of the forceps in the early 17th century was followed by their evolution over four centuries with the introduction of the pelvic curve, axis-traction and rotational forceps. The phase of prophylactic forceps delivery will be discussed. The development of vacuum-assisted delivery has evolved over the past 150 years. However, in practical terms, the modern era of vacuum-assisted delivery began with Tage Malmström's vacuum extractor in the early 1950s. The evolution of the modern vacuum extractor with metal, soft and hard plastic cups will be reviewed.

Though resulting from a long-term process, the need to manage pregnancies both medically and bureaucratically became a state concern, especially from the 1920s onwards. A woman’s official obligation to notify the state of her pregnancy (and therefore to know it on time) goes beyond a matter of biopolicies and poses a range of contradictions. ‘Pregnant or not?’ – as an issue of knowledge – is a powerful tool for apprehending the tensions between individual freedom, privacy, institutional requirements and professional powers.In order to better understand the historical meaning of pregnancy diagnostics in mid-twentieth-century France, this paper combines three dimensions: uncertainty and its management; the informational asymmetry between institutional agents and women; and the diachronic dimension of gestation. Writing this history sheds more light on an apparent paradox: while knowing and notifying one’s own pregnancy became a duty, the tools that could help women eliminate some doubt right from the first months of their pregnancy – in particular the innovation of laboratory diagnosis – was seen as a danger. When, in 1938, private laboratories began publishing advertisements for the laboratory test in the most widely-read newspapers, tending to reframe it as a commercial service, the anti-abortion crusade was increasing its propaganda and its political pressure. This crusade’s legal victory proved incomplete, but for a long time some of the most conservative physicians recommended great parsimony in prescribing testing. Combined with reducing the legal time limit for notification, this conflict shows how the state injunctions towards women could look like a ‘double bind’.

This article provides a narrative review of seven key issues relevant to pediatric onset of spinal cord damage not due to trauma, or spinal cord dysfunction (SCDys). The first topic discussed is terminology issues. There is no internationally accepted term for spinal cord damage not due to trauma. The implications of this terminology issue and an approach to addressing this are discussed. Second, a brief history of SCDys is presented, focusing on conditions relevant to pediatrics. Third, the classification of SCDys is outlined, based on the International Spinal Cord Injury Data Sets for Non-Traumatic Spinal Cord Injury. Following this, a summary is given of the epidemiology of pediatric SCDys, primarily focused on the incidence, prevalence, and etiology, with a comparison to traumatic spinal cord injury. Next, important clinical rehabilitation principles unique to children with SCDys are highlighted. Then important prevention opportunities for SCDys in children are discussed. Finally, trends, challenges, and opportunities regarding research in SCDys are mentioned.