Konstantinos Markatos

Ambroise Paré (1510–1590): on the diagnosis and treatment of shoulder dislocations

Aim of studyThis article aims to summarize the treatment methods for shoulder dislocations supported by Ambroise Paré, and his clinical and academic contribution to this subject.IntroductionAmbroise Paré (1510–1590) was one of the most prominent surgeons of his time, and one of the most significant innovators of the Renaissance in the fields of military operation, bandages, wound healing, bloodletting, close blood vessels techniques and cesarean section. For many, he is considered “the Father of Modern Surgery”.MethodsIn our search we went through the literature in Pubmed and Google Scholar as well as the works of Hippocrates and Galen and several other ancient and medieval authors.ResultsHis work on shoulder injuries and dislocations is outstanding. In this work, he uses the classifications of Hippocrates (460–377xa0BC) and Galen (130–201xa0BC). He also uses the reduction techniques, ointments, bandages, cooling creams and treatment options described by the ancient medical authors.DiscussionParé is heavily based on the work of previous authors on shoulder dislocations. He uses the work of Hippocrates and Galen as well as the additions made in the Cannon of Medicne of Avicenna.ConclusionAmbroise Paré in his excellent work on shoulder dislocations uses the classifications of Hippocrates and Galen and the reduction techniques, cooling ointments, bandages and post-reduction management options as previously described by Hippocrates himself.

Ambroise Paré (1510-1590) and His Innovative Work on the Treatment of War Injuries

The purpose of this study is to summarize the innovations of Ambroise Paré (1510-1590) on the treatment of war wounds and improving amputation technique through ligature in arteries and veins. Ambroise Paré debunked the widely accepted idea that gun powder was poisonous for wounds. He also minimized the use of cautery of wounds by his dressing methods and the application of ligature during amputations. All these innovative rationales revolutionized the practice of war surgery during the Renaissance and paved the way for the introduction of modern surgery. Nevertheless, although his wound dressing innovations became widely accepted, the same did not happen with ligature and amputation; those techniques could become widely applicable if one could somehow control bleeding until the blood vessels had been tied. This became possible much later in the 18th century when Jean Louis Petit invented the first useful and efficient tourniquet.

Congenital anomalies of the limbs in mythology and antiquity

Congenital anomalies of the limbs have been observed since ancient human civilizations, capturing the imagination of ancient physicians and people. The knowledge of the era could not possibly theorize on the biologic aspects of these anomalies; however, from the very beginning of civilization the spiritual status of people attempted to find a logical explanation for the existence of such cases. The next logical step of the spiritual and religious system of the ancients was to correlate these anomalies with the Gods and to attribute them to a different level of existence in order to rationalize their existence. In these settings, the mythology and religious beliefs of ancient civilizations comprised several creatures that were related to the observed congenital anomalies in humans. The purpose of this historic review is to summarize the depiction of congenital anomalies of the limbs in mythology and antiquity, to present several mythological creatures with resemblance to humans with congenital anomalies of the limbs, to present the atmosphere of the era concerning the congenital anomalies, and to theorize on the anomaly and medical explanation upon which such creatures were depicted. Our aim is to put historic information in one place, creating a comprehensive review that the curious reader would find interesting and enjoyable.

A Cranial Trauma was the Cause of Death of Charles VIII of France (1470–1498)

This article summarizes the reign, life and death, of Charles VIII of France. Also we intend to investigate current views on his cause of death, contradictions and opinions of his biographers. Poisoning, disease, and injury are the possible causes of his death but, according to the literature, cranial trauma was the most probable cause of death of the King Charles VIII of France.

Paul of Aegina (625–690): His Work and His Contribution to Neurologic Surgery: Trephinations and Laminectomies in the Dark Ages

The purpose of this historical review is to summarize the work of Paul of Aegina, especially his contribution to the treatment of neurosurgical disorders and trauma. Paul performed trephinations for head injuries in the tradition of the Egyptian and the Greek schools of medicine. However, he was an innovator in the treatment of several spine injuries, as his choice to perform laminectomies and his description of them as safe and successful is unprecedented in the history of the recorded medicine and surgery. Our search of the literature shows that Paul was the first to include in his practice such a surgical technique, and, in this way, he is an innovator, since Hippocrates described the results of spine surgery as disastrous for the patient. Thus, he may be considered the historic father of spine surgery for his pioneering surgical innovations. This shows clearly that innovation in science and medicine was significantly increased through the rise of Islam and the Arabic conquest of the Middle East. The so-called Dark Ages were not so dark after all.

Karl Ludloff (1864-1945): An Inventive Orthopedic Surgeon, His Work and His Surgical Technique for the Correction of Hallux Valgus

The purpose of this article is to summarize the work and pioneering achievements in the field of orthopedic surgery of the German orthopedic surgeon Karl Ludloff. Ludloff had an impact in the diagnostics, physical examination, orthopedic imaging, and orthopedic surgical technique of his era. He was a pioneer in the surgical treatment of dysplastic hip, anterior cruciate ligament reconstruction, and hallux valgus. His surgical technique for the correction of hallux valgus, initially stabilized with plaster of Paris, remained unpopular among other orthopedic surgeons for decades. In the 1990s, the advent and use of improved orthopedic materials for fixation attracted the interest of numerous orthopedic surgeons in the Ludloff osteotomy for its ability to correct the deformity in all 3 dimensions, its anatomic outcomes, and its low recurrence rate and patient satisfaction.

The Hippocratic Method of Surgical Cauterization for the Tumescence Spleen in the Rare “Spetses Syndrome”:

Spleen in antiquity was considered by the Hippocratic medicine as a viscerous organ of spongy character, which could clear human body of the black bile. According to the Hippocratic doctrine of the 4 humors, black bile could cause a series of diseases. Both the anatomical position and shape of the spleen were also recognized. In the case of a splenic hardening, with simultaneous augmentation of its dimensions and dermal ulceration and/or splenic abscess, some interventions were proposed. Thus, herbal medicine, phlebotomy, and minimal surgery with local cauterization were applied for treatment, to confront a disease that was considered serious but not fatal. The Hippocratic physicians encountered various spleen diseases and among them they most probably confronted a rare splenic pathological entity, named centuries later as “Spetses syndrome,” a rare type of thalassemia of the Spetses island of Saronikos Gulf. Although the approach seems in modern terms rather primitive, the ancient Greek medico-philosophers most likely understood the significance of the spleen.

Apollonius of Citium (first century BC) and his work on the treatment of joint dislocations

The purpose of this study was to summarise the life and work of the Cypriot physician Apollonius of Citium (first century BC). His overall work on medicine is presented, and special emphasis is given to his work on the treatment of joint dislocations. The most famous work of Apollonius is Treatise On Joints, which was preserved on the whole in a manuscript of the tenth century AD. In that manuscript, Apollonius is obviously influenced by the Hippocratic Corpus of Medicine. His description, diagnostic methods and reduction techniques are all based on those described by Hippocrates in his work “On Joints”. Apollonius’ contribution to this subject concerns accurate depiction in images of the reduction techniques he proposes. His simplifications describe the techniques of Hippocrates in a way they can be understood and used by athletes and nonphysicians in the Greek gymnasia. Perhaps his treatise is one of the earliest works of popularised medicine and surgery in the history of human civilisation.

Correction to: Ambroise Paré (1510–1590): on the diagnosis and treatment of shoulder dislocations

The original version of this article was revised: The published online version contain mistake in author list. The corrected name is shown above.

Hallmarks of amputation surgery

PurposeTo highlight the most important innovations and milestones in the historical evolution of amputation and disarticulation surgery through the ages, from the early antiquity until the modern era.MethodA thorough search of the literature was undertaken in PubMed and Google Scholar as well as in physical books in libraries to summarize current and classic literature on the hallmarks of the history of amputation surgery in the course of medical history.ResultsAmputation of a limb is one of the oldest surgical procedures. Initially, it was fraught with complications and dismal outcome of the patients because of hemorrhage and infection. Due to lack of analgesics and narcotics the operation had to take only a few minutes. Obtaining experience, the surgeons evolved the operative technique and refined the procedure, anesthesia and perioperative analgesia was introduced, instruments were developed, and rehabilitation has enabled functional and social reintegration of amputees.ConclusionFrom the Hippocratic era until currently, the surgical approach to amputation has changed little. However, the indications for amputations have changed a lot and had been refined, especially in diabetic patients and in those with severe chronic peripheral vascular disease. An exponential decrease in mortality for an operation once fraught with complications was due to the development of the tourniquet, proper vessel ligation and repair, antisepsis, and anesthesia.