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In 1981, Weinsier and Krumdieck described death resulting from overzealous total parenteral nutrition in two chronically malnourished, but stable, patients given aggressive total parenteral nutrition. This was the birth of what is now called the refeeding syndrome, a nutrition-related disorder associated with severe electrolyte disturbances. The purpose of this work is to demonstrate that refeeding syndrome was first described medically in Florence by Antonio Benivieni in 1507 in his book On Some Hidden and Remarkable Causes of Diseases and Cures. What we now know as refeeding syndrome was described in Report No. LVII of that book. The condition occurred as a result of the famine that affected Florence in 1496. The report documents (i) death due to starvation, (ii) death due to ingestion of deteriorated/toxic foods (inevitable in times of famine when healthy food is scarce), (iii) death caused by excessive food ingestion after forced, prolonged abstinence from food in adults, (iv) the death of breast-fed children and of their starved mothers eating to satiety and (v) the more favourable clinical outcome of those admitted to hospitals. It is possible that Benivieni was inspired by the description of the deaths of starved deserters in the book The Jewish War (70 AD) by the Romano-Jewish historian Flavius Josephus. Nevertheless, Benivieni wrote the first medical account of the central clinical features of refeeding syndrome. The main, broad clinical aspects of refeeding syndrome, described by Weinsier and Krumdieck in 1981, had been documented in medical literature four centuries earlier by Benivieni. [ABSTRACT FROM AUTHOR]

This manuscript explores the contributions of Jean Fernel to cardiorenal medicine by focusing on the kidneys as they emerge in his posthumous treatise Universa Medicina (1567). Jean Fernel (1497-1558) was born in Montdidier near Amiens, in Picardy, France. He studied at the College of St. Barbara of the University of Paris, receiving a Master of Arts degree in 1519. In the years 1527-1530, he followed the regular course of medicine at the University of Paris and lived by teaching philosophy at the College of St. Barbara. In 1534 he started his medical activity in Paris. In 1536 he became Professor of Medicine at the College of Cornwall. He died of an acute disease, at Fontainebleau, in 1558. Fernel has been the most important French physician and the first physiologist of the Renaissance. In the Universa medicina, chapter 7 (the kindneys) he wrote "The great vena cava lies upon the lumbar vertebrae, falling there from the convexity of the liver and then soon breaks into branches and is distributed to the thigh and all parts below. Beside it on each side lie the kidneys which are suited to the extraction of serum from the blood. (The Greek call it ouron. We call it urine). They lie a little below the liver, from which they extract a great deal of it and the right one is generally higher up than the left, though sometimes lower (Galen, On Anatomical procedures). Both lie upon the internal muscles of the back which the Greeks call psoas, and below the empty spaces between the rib ends and the hip bone, which the Greeks call loins because they are empty". He confirmed the existence of the colatorium (sieve) of the prevesalian anatomists, which was negated by Berengario da Carpi (ca.1460-ca.1530) and supported by Gabriele Zerbi (1445-1505). [ABSTRACT FROM AUTHOR]

Physiologia is the first section of Universa Medicina (1567), a posthumous masterpiece of Jean Fernel (1497-1558), the scientist who is considered the fullest expression of Galenism and the starter of Renaissance Medicine. Therein the heart, arteries and veins are described thoroughly without illustrations but with plenty of data on function which contributed to the birth of human physiology. This work aims at outlining the role of the heart in a treatise where medicine is the art to preserve the health of human body and of healing diseases. Fernel describes a centrifugal circulation. The liver is the seat of the second concoction and manufactures blood which through the vena cava is distributed to organs needing it. In the left ventricle of the heart originates the vital spirit through a process which utilizes the air-enriched blood coming from the lung through the venous artery (pulmonary vein). Then the blood is aspirated (facultas attractrix) to the organs where it is turned into natural spirit. Fernel did not envisage pores between right and left ventricle. The heart is not seen as a muscle since it cannot be guided by will and is not subject to fatigue. Blood from liver reaches through the great vena cava the periphery, driven by attraction. This mistake originating from Galen, was shared by Vesalius, who described it in his 1543 edition of the Fabrica. Finally the mechanism collapsed in 1628 when Harvey published De motu cordis. Moreover Fernel, although Galenist, did not hypothesize pores between right and left ventricle, which were equally still described by Vesalius in 1543. Fernel is considered with reason the father of physiology and the father of pathology. He must be seen as the last Galenist and as the fits of the Renaissance. [ABSTRACT FROM AUTHOR]