Costas Tsiamis

Lycanthropy in Byzantine times (AD 330-1453).

In this paper, the original Greek language texts of the Byzantine medical literature about lycanthropy are reviewed. The transformation of a human being into a wolf and the adoption of animal-like behaviour, which were already known from mythology and had been presented in the scientific works of ancient Greek and Roman physicians, were examined by six Byzantine physicians and explained as a type of melancholic depression or mania. In spite of the influence of Byzantine medicine, its rationality in the interpretation of lycanthropy was forgotten in medieval and Renaissance times when it was replaced by explanations based on demonic possession and witchcraft. More recently psychiatry has treated the phenomenon as a subject of medical inquiry and has again explained the condition in terms of mental disorder.

Is it time for a Refugees' Health Unit in Greece?

958 www.thelancet.com Vol 388 September 3, 2016 special treatment in order to cover specifi c needs such as lactation and personal hygiene. If migrants visit two or more health centres on the same day, in order to double-check the diagnosis or even to acquire a larger quantity of medicines for their personal stock, this problem would be addressed by the use of an individual health card. Coordination meetings should ideally take place on a weekly basis attended by one representative of the Secretariat for Refugees’ Aff airs and one representative of the UN Refugee Agency. Emphasis should also be laid upon diagnosing and treating victims of torture or other human rights abuses among the refugees. We believe that the creation of such structure is necessary. Greece is faced with the major challenges of managing a great humanitarian crisis, and of improving its health-care structures to meet demand.

Dromokaition Psychiatric Hospital of Athens: from its establishment in 1887 to the era of deinstitutionalization

Dromokaition Psychiatric Hospital opened its doors in 1887, following the donation made by Zorzis Dromokaitis from the island of Chios. Private donations and all forms of charities had contributed to a large extent in the establishment of hospitals across Greece, during the late 19th and the early 20th century. Dromokaition was one of them but it was also unique, as it was the first psychiatric hospital in Athens, admitting patients from every part of the country. This paper aimed at highlighting the long service of the institution through the different historical periods the country went through. We present the chronicle of its foundation, the development of its inner structure, and the medical and organizational influences which it received, along the way. The therapeutic methods used during the first decades of its operation reflected the corresponding European standards of the time. As a model institution from its foundation, it followed closely the prevailing European guidelines, throughout its historical path, either as an independent institution or as an integrated one within the National Health Service.

Time to Rethink Refugee and Migrant Health in Europe: Moving from Emergency Response to Integrated and Individualized Health Care Provision for Migrants and Refugees

In the last three years, the European Union (EU) is being confronted with the most significant influx of migrants and refugees since World War II. Although the dimensions of this influx—taking the global scale into account—might be regarded as modest, the institutional response to that phenomenon so far has been suboptimal, including the health sector. While inherent challenges of refugee and migrant (R&M) health are well established, it seems that the EU health response oversees, to a large extend, these aspects. A whole range of emergency-driven health measures have been implemented throughout Europe, yet they are failing to address adequately the changing health needs and specific vulnerabilities of the target population. With the gradual containment of the migratory and refugee waves, three years after the outbreak of the so-called ‘refugee crisis’, we are, more than ever, in need of a sustainable and comprehensive health approach that is aimed at the integration of all of migrants and refugees—that is, both the new and old population groups that are already residing in Europe—in the respective national health systems.

Biological Warfare Plan in the 17th Century—the Siege of Candia, 1648-1669

This incident illustrates how, within a framework of religious fanaticism, the use of biological weapons could appear to be acceptable.

Holy Fools: A Religious Phenomenon of Extreme Behaviour

Monks in Byzantine times (330–1453 AD) often expressed their faith with extreme manifestations of behaviour, such as living on a high column (stylites), on a tree (dendrites) or in crowded urban centres of the empire pretending to be fools for Christ’s sake. These Holy Fools exposed themselves to the ridicule and the mistreatment of the citizens, being protected, however, by their state of insanity to mock and violate moral codes and social conventions. The official Church barely tolerated these religious attitudes as promoting deviations from standard orthodoxy, and the Quinisext Ecumenical Council (592 AD) judged them as dangerous and formally denounced the phenomenon. The two most famous of them in Byzantium were Symeon of Emesa and Andrew of Constantinople, whose lives constitute unique testimonies to insanity and the simulation thereof. The survival and transplantation of the Holy Fools in Russia, called “yurodivye”, where they met widespread acceptance, confirm their appeal in specific geographic areas and their endurance over time. We attempt to approach the symbolism of holy lunacy and to analyse the personality trends of these “eccentric” saints.

Demographic and clinical characteristics of refugees seeking primary healthcare services in Greece in the period 2015–2016: a descriptive study

Background In 2015-2016, more than a million refugees entered Greece. Along with other organizations, PRAKSIS, a local non-governmental organization, deployed mobile medical units on three islands and in temporary settlements in Athens. Methods This is a descriptive cross-sectional study aimed at analysing the demographic and clinical characteristics of the population (n=6688) that received services from PRAKSIS between October 2015 and June 2016 in different locations (islands of Samos, Kos and Leros in the southeastern Aegean Sea and on the mainland at Athens-Piraeus Port Gate E) before and after the closure of European borders in March 2016. Results The majority (88%) of the population came from Syria, Afghanistan and Iraq. Among them, 53% were women and children. Infectious diseases decreased as the population moved from the islands to the Athens-Piraeus Port, while all other disease categories increased in relative frequency, the difference being statistically significant (p<0.05). Among all consultations, dental and oral cavity health complaints also increased in the Athens-Piraeus Port, but failed to reach statistical significance (p=0.11). Referrals from the mobile health units to specialist care rose from 4.2% of all patients clinically examined on the islands to 9.9% in the Athens-Piraeus Port, and the difference was statistically significant (p<0.05). Conclusions More research and systematic data collection are needed to inform appropriate policies for the humanitarian challenges posed by the recent refugee and migrant waves in Europe.

Dementia on the Byzantine throne (ad 330-1453).

Aim:  To present the consequences of the prolonged age of the emperors, especially if combined with symptoms of dementia, during the Byzantine period (ad 330–1453).

Lord Byron's first voyage in Greece (1810) and the neglected case of malaria

The aim of our report is to present the case of the illness which probably affected Lord Byrons health for the rest of his life. We present three letters of the famous British poet and fighter of the Greek Revolution in 1821, which were sent between 25 September and 3 October 1810. These letters are associated with Byrons illness during his excursion in the ancient monuments of Peloponnese. Lord Byron describes his clinical features with an irregular fever close to malaria but the identification of Plasmodium spp is difficult. According to the environmental conditions and the endemicity of the area, the hypothesis of a mixed species malaria cannot be excluded.

Cross-sectional study on awareness and knowledge of torture investigation and documentation among Greek doctors and senior medical students

Doctors in Greece face the possibility of encountering a person that has suffered torture, especially since the high rates of refugees’ and migrants’ inflows that took place over the last years. In order to assess the awareness and the knowledge of doctors and senior medical students in Greece regarding a manual on effective investigation and documentation of torture such as Istanbul Protocol (official United Nation document since 1999), a cross-sectional study was conducted using a structured anonymous questionnaire. The sample was doctors practicing in public hospitals in Greece, doctors volunteering at a non-governmental organization (NGO) and undergraduate medical students in their final year of studies in the Medical School of National and Kapodistrian University of Athens. The data were analyzed using IBM SPSS version 23, using descriptive statistics and statistical significance tests.In a total of 289 participants, the mean total score of Istanbul Protocol knowledge was 4.43 ± 1.104 (the maximum possible score was 10) and the mean total score of Istanbul Protocol awareness was 2.04 ± 1.521 (the maximum possible score was 10). The most important conclusion was that among doctors and senior medical students, there seem to be knowledge, awareness, and information deficit about Istanbul Protocol and several issues relating to torture. The overall research outcome highlights the need for the development of a relevant informative/educational program, in order to cover the corresponding existing needs of the population of doctors in Greece.