Gregory Tsoucalas

Hippocrates (ca 460-375 bc), Introducing Thoracotomy Combined With a Tracheal Intubation for the Parapneumonic Pleural Effusions and Empyema Thoracis

Hippocrates was the first physician to describe in accuracy pleural effusion and pneumonia. To treat empyema thoracis he had introduced a combined method of tracheal intubation with a simultaneously thoracotomy. The surgical incision was used for the pus to be progressively drainaged. If the patient was too weak to eat, he had suggested for nutritional mixtures to be administered through an oral-gastric tube. Thus Hippocrates composed in his operating theatre, an icon similar to modern surgical operations.

Paul of Aegina (c. 625–690 AD), the Origins of the Early Correction of Pediatric Strabismus in Byzantine Empire

ABSTRACT The eminent Greek physician Paul of Aegina, native of the Saronic island Aegina and pupil of the Alexandrian School, understood both exotropia and endotropia, his designation for esotropia and proposed therapeutic measures for their treatment during baby or toddler age. He had introduced an innovative method for the newborns to have a straight vision, “the congenital strabismus of the newborns must be treated with the placement of a facial mask (with 2 open holes in the middle axes of the eyes), so that the babies could only see in a straight line”, combined with a small oil lamp to assure a direct eye alignment. Although not even a diagram of the masks was saved until nowadays, Paul was the first to suggest the early correction of the eyes deviation, and considered to be the father of orthoptics.

Ammonius Lithotomos (3rd Century BC), the Alexandrian Innovative Surgeon Who Introduced Lithoclastic Cystotomy

Alexandrian surgeon Ammonius Lithotomos, was the first to introduce lithoclastic cystotomy during the 3rd century BC in order to relieve a bladder’s stone blockage. He had used a metallic hook or crotchet to remove the stone, which was named at the era “thrombus” of the urinary tract.

Oribasius—Pediatric Skin Eruptions and the Origins of the Allergic Reaction to Breast Milk

Author Contributions: Drs Stevenson and Wang contributed equally to this manuscript. Drs Stevenson and Carucci had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Stevenson, Wang, Felsen, Krueger, Pavlick, Carucci. Acquisition, analysis, or interpretation of data: Stevenson, Wang, Abikhair, Roudiani, Krueger, Pavlick, Carucci. Drafting of the manuscript: Stevenson, Wang, Abikhair, Pavlick, Carucci. Critical revision of the manuscript for important intellectual content: All authors. Statistical analysis: Wang, Abikhair, Pavlick, Carucci. Obtained funding: Pavlick. Administrative, technical, or material support: Abikhair, Roudiani, Pavlick, Carucci. Study supervision: Wang, Felsen, Krueger, Pavlick, Carucci.

Paul of Aegina (ca 625-690 AD), and his orthopaedic surgical reconstruction of the preternatural fingers.

Paul of Aegina lived in a era when the preservation of the ancient Greek tradition was for him almost a necessity. Eager to follow the dogma of “oρθoπo(ε)δώ” (orthopodo: pace with no malformation), he introduced a series of surgical operations of reconstructive-cosmetic-plastic-orthopaedic nature to confront any disfiguration of the human body. The aim of our study is to present the atmosphere of the era concerning the congenital malformations, describe briefly Paul’s contribution on classic orthopaedics and present his views on the preternatural fingers. Our methodology mainly included the indexing of Paul’s treatise, as published by the Sydenham Society during the nineteenth century, while references from the ancient Greek scholars were added to compose a better understanding of Paul’s views. Inside his seven book treatise “Medical Compendium”, he dedicated a separate chapter “On preternatural fingers, and on persons having six fingers”, to introduce a detailed description of the extremities’ additional digits and propose surgical treatment for their correction. He classified polydactylism according both to the presence of bones and to the anatomical origin of each additional finger. Paul marked the beginning of a new era for orthopaedics.

Nicholas J. Giannestras (1908–1978): a distinguished orthopaedic surgeon, his work, life and times

The purpose of our study was to summarize all the knowledge concerning the innovative pioneer in the field of orthopaedic surgery, Nicholas J. Giannestras (1908–1978). A thorough study of texts, medical books and reports, in the field of history of medicine, together with a review of the available literature in PubMed, was undertaken. Giannestras left his mark in the history of orthopaedics with his clinical work and his publications, mainly his treatise “Foot Disorders: Medical and Surgical Management” (1973), while his name lingers in Greece with the introduction of spine fusion with the use of metallic implants. He was an eminent university clinical professor of orthopaedics who had harmonically combined academic writing, teaching and clinical research in every field of orthopaedic surgery.

The Siberian lancet, one more possible innovative example of scalpel's contribution to the evolution of surgical anatomy and neurosurgery

BACKGROUNDnSeveral primitive scalpels were used since the eve of surgical procedures. Numerous bronze knifes discovered in the Altai mountains region from the Xiongnu-Xianbei-Rouran period mold a hypotheses for a possible medical use.nnnMETHODSnOn-sight archaeologic excavation brought into light the tools in question.nnnRESULTSnKnifes, similar to modern lancets, were unearthed alongside with a series of skulls demonstrating signs of trepanation.nnnCONCLUSIONSnStrong indications imply that those cutting tools, except for domestic usage, were one more example of scalpels contribution to the evolution of surgical anatomy and neurosurgery.

A Solution to Refugee Children Healthcare in Greece

the experience of paediatric healthcare provision through a mobile medical van in Dominican Republic for children of impoverished migrant Haitian workers [3]. Further, the mobile unit can undertake the registration of refugee children entering schools, and combine it with the routine examination and care [4]. Lastly, in the event of reported hate crimes, access to mental health services and social care can be in place via a triage system in the mobile unit, as children are especially vulnerable to emotional trauma [4]. From a financial perspective, the most beneficial model for acquiring such units for not for profit purposes seems to be through direct ownership, though adjustments in monthly payments would make leasing competitive [5]. Overall, it is the use of the asset that is more important than ownership, hence, an exit strategy should be in place to close the unit once the cost of running it exceeds the cost of referring those children to the hospital via the normal routes [4]. In this context, use of such a mobile paediatric unit could be an interim step before attempting integration in the national healthcare system and while the government is attempting to implement this education bill at pace.

Epilepsy and Neurosurgery: Historical Highlights

Epilepsy has been known since antiquity and trepanation has been documented as a therapeutic option. The Greek born physician Aretaeus of Cappadocia (2nd century BC) was the first to recommend trepanation for the treatment of refractory epilepsy to drugs, pointing out the efficacy of the method (Fig. 1). Trepanation was practiced throughout the Middle Ages, as it is proved by the book of Quattuor Magistri and during Renaissance as well. In 19th century, Sir Victor Alexander Horsley (1857-1916), combining analysis of clinical presentation with cortical stimulation, performed a series of craniotomies for the treatment of epilepsy Fig. 2. In the following years the advent of electrophysiology and neurosurgery provided a fertile ground for further progress in epilepsy surgery such as the preoperative use of electroencephalography (EEG) to determine the epileptogenic zone by Otfrid Foerster (1873-1941); the research of Wilder Graves Penfield (1891-1976) in Montreal Neurological Institute and the use of stereoelectroencephalography (SEEG) by the neurosurgeon Jean Talairach (1911-2007) and the neurologist Jean Bancaud (1921-1994)) Fig. 3. Nowadays, epilepsy surgery remains a valuable therapeutic option in cases of drug resistant epilepsy.

Trepanation Practices in Asclepieia: Systematizing a Neurosurgical Innovation

BACKGROUNDnAs ancient Greeks started looking for deities that could fulfill the pragmatic needs of common people, local heroes started being mythologized and worshipped through cults.nnnMETHODSnThe most widespread such example was Asclepius, possibly a skilled war surgeon who followed military expeditions to Colchis and Troy. Our study investigates the possibility of the early neurosurgery to have been started inside Asclepieia by Asclepius and his followers.nnnRESULTSnAsclepius was worshipped at religious temples called Asclepieia where certain specific medical and surgical techniques were followed. The most advanced technique was skull trepanation, which was most likely done as an acute operation to release intracranial pressure. The contemporary Hippocratic corpus provided extensive descriptions of the technique, and archaeologic evidence has shown that many patients survived the operation.nnnCONCLUSIONSnDecompressive craniectomy techniques have been practiced for millennia but it is possible that they were first systematized as a neurosurgical innovation through the Ancient Greek religious cult followed in Asclepieia.