Halil Tekiner

Sella turcica: an anatomical, endocrinological, and historical perspective

IntroductionThe sphenoid bone has a superior depression called the sella turcica, Latin for “Turkish saddle,” where the pituitary gland is found. The availability of modern radiological imaging techniques has replaced plain radiography of the sella turcica in the investigation of hypothalamo–pituitary abnormalities. However, the size of the sella turcica, and smaller sella turcica size in particular, may cause pituitary dysfunction because of the changes in the structure of pituitary gland or may be associated with some genetic or acquired endocrine disorders. The name “sella turcica” is one of the most commonly used terms in everyday endocrine practice.MethodsIn this review, after a brief explanation of the anatomical and endocrinological features of the sella turcica had been given, a historical perspective of sella turcica nomenclature was presented for the first time.Findings and conclusionsAfter Andreas Vesalius’s description of it as a suitable cavity for the gland that receives the “phlegm of the brain” in DeHumani Corporis Fabrica (1543), medical scholars began to use seat/saddle-related terms such as the ephippium, pars sellaris, sella equina, sella ossis, and sella sphenoidalis. The real designation of the sella turcica, however, was introduced to the anatomical nomenclature by the anatomist Adrianus Spigelius (1578–1625) in his famous work De Corpora Humanis Fabrica (1627).

Aretaeus of Cappadocia and his treatises on diseases.

Aretaeus of Cappadocia is considered as one of the greatest medical scholars of Greco-Roman antiquity after Hippocrates. He presumably was a native or at least a citizen of Cappadocia, a Roman province in Asia Minor (Turkey), and most likely lived around the middle of the second century (A.D.) His eight volume treatise, written in Ionic Greek, entitled On the Causes, Symptoms and Cure of Acute and Chronic Diseases remained unknown until the middle of the 16th century when, in 1552, the first Latin edition was published. In this work, Aretaeus offered clinical descriptions of a number of diseases among which he gave classic accounts of asthma, epilepsy, pneumonia, tetanus, uterus cancer and different kinds of insanity. He differentiated nervous diseases and mental disorders and described hysteria, headaches, mania and melancholia. He also rendered the earliest clear accounts on coeliac disease, diphtheria and heart murmur, and gave diabetes its name.

A 450-Year-Old Turkish Poem on Medical Ethics

The Ottoman physician-poet Nidai of Ankara (1509 to post-1567) studied medicine in Crimea and served as a court physician in Istanbul during the reign of Sultan Selim II. Nidai marked the classical period of Ottoman medicine particularly with his acclaimed works and translations in Turkish, among which Manafi al-Nas (Benefits of People, 1566) became widely known. The final chapter of Manafi al-Nas also is known independently under the name Vasiyyetname (Last Will), which is a remarkable guide on medical ethics. This didactic, sixty-eight-line poem includes Nidai’s moral advice to physicians that they should be well mannered, trustworthy, and competent in their arts and should treat their patients with modesty, honesty, and compassion. Even after 450 years of existence, Vasiyyetname retains its ethical and artistic relevance and still serves as a vehicle for the transmission of humanistic ideals far beyond the time and place it was written.

King Ariarathes IV of Cappadocia: coins reveal enlarged thyroid (188 BC)

of Mount Erciyes, a snow-capped volcano with an altitude of around 4,000 m. On the obverse of the coins struck in Mazaca in the 33rd regnal year of Ariarathes IV, his diademed head with enlarged thyroid is represented (Fig. 1). The reverse features his name (ΒΑΣΙΛEΩΣ APIAPAΘOY EYΣEBOYΣ) together with monograms and Athena holding Nike in her right hand [1]. This might be one of the earliest artistic representations of King Ariarathes IV Eusebes (“The Pious”) ruled Cappadocia, a province of central Asia Minor (modern Turkey), between 220 and 163 BC. He supported his father-in-law Antiochus III, the King of Syria, in his war against the Romans. However, after the battle of Magnesia in 189 BC, he became an ally of the Romans. Ariarathes IV also moved the capital of his kingdom to Mazaca (modern-day Kayseri), founded on the outskirts

Pharmacy History Courses May – and Should – Offer More Than Professionalism

To the Editor: I have read with great interest the article by Baker and colleagues,[1][1] investigating how the 2016 Accreditation Council for Pharmacy Education (ACPE) Standards for pharmacy history were met by US pharmacy schools. I would like to thank the authors for providing such insightful

Abdominal Physical Signs and Medical Eponyms: Part I. Physical Examination of Palpation, 1876–1907

Background Abdominal palpation is a difficult skill to master in the physical examination. It is through the tactile sensation of touch that abdominal tenderness is detected and expressed through pain. Its findings can be used to detect peritonitis and other acute and subtle abnormalities of the abdomen. Some techniques, recognized as signs or medical eponyms, assist clinicians in detecting disease and differentiating other conditions based on location and response to palpation. Described in this paper are medical eponyms associated with abdominal palpation from the period 1876 to 1907. Data Sources PubMed, Medline, on-line Internet word searches, textbooks and references from other source text were used as the data source. PubMed was searched using the Medical Subject Heading (MeSH) of the name of the eponyms and text words associated with the sign. Conclusion We present brief historical background information about the physician who reported the sign, original description of the sign, and its clinical application and implication in today’s medical practice.

Cultural Context in Medical Humanities: Lessons from Turkey

In the past few decades, there has been increasing interest in establishing medical humanities as the core integrated provision in medical curricula, especially in the US, Canada, the UK, and Europe. Several papers, including a brief observation in The American Journal of Medicine, have tried to set out a vision for medical humanities’ role in teaching empathy in medical education. However, little attention has been paid to local experiences about the implementation of this concept in different countries. During my 3-year experience in teaching medical humanities at a Turkish university that enrolled both Turkish and international students from Africa, Europe, and the Middle East, I have observed that higher rates of cultural diversity among students have had significant influence on the efficiencies of medical humanities courses, and the expected outcomes from the course and students’ interest in course materials have had a large amount of variance. This is presumably because of the non-culture-specific educational materials used for the course. Hooker and Noonan have argued that the current concept of medical humanities is culturally limited by “a distinctive emphasis on Western cultural artefacts” and “a tendency to enact an uncritical reliance upon foundational concepts within Western medicine”. Agreeing with this,

Ethical Considerations Related to Narrative Medicine

Narrative medicine is of great significance in the area of health care, which underpins the ability of acknowledgment, absorption, and interpretation according to which plights and stories of patients are extensively considered for the commencement of actions. It reflects the manifestation of a model that entails effective medical practice with the aim to achieve best possible outcome. Adopting different approaches to narrative medicine (such as the method of close literature reading and reflective writing) facilitates with the opportunity to examine and explore central medical situations. Narrative medicine is responsible for the development of effective communication between patient and healthcare professionals, alongside inaugurating substantial discourse with the community regarding health care. With the advancement in clinical conditions, the scope of narrative medicine has become a growing need, and thus, several developed countries have already included narrative medicine as an integral part of health care. However, the major ethical problem associated with patient narratives is the use of data with intention other than treatment which may result in maleficence. Therefore, the practice of narrative medicine requires balancing all the aspects of health care against any possible harm.

Turhan Baytop (1920−2002): A pioneer historian of pharmacy from Turkey

Turhan Baytop, a Turkish professor of pharmacognosy (the scientific study of crude drugs of animal, vegetable, and mineral origin), received international acclaim not only for his contributions in collecting and identifying the Anatolian plants, but also for his extensive research shedding light on the history of Turkish pharmacy. As a devoted researcher, collector, and lecturer, T Baytop was a genuine pioneer of the history of pharmacy as a discipline in Turkey.

The opium poppy as a symbol of sleep in Bertel Thorvaldsen's relief of 1815

Danish sculptor Bertel Thorvaldsen (1770-1844) is one of the most remarkable representatives of Neoclassicist sculptural art in Europe, which was largely inspired by the classical art and culture of Greek and Roman antiquity. A pair of marble reliefs, Night and Day, exhibited in the Thorvaldsen Museum (Copenhagen), marks the culmination of Thorvaldsens relief art and is of particular interest to the history of sleep medicine. In the first relief, Night, an angel with her neck bent and eyes closed has two babies in her embrace and seems to be floating down in grief, with an owl hovering behind her. Her hair is also twined with opium poppies, the symbol of sleep and death in antiquity. Our findings suggest that this relief not only indicates a mythological association between the opium poppy and sleep but also has a strong connotation with the poppys medicinal use for inducing sleep throughout the centuries.