Spyros G. Marketos

The carbon monoxide poisoning of two Byzantine emperors.

CASE REPORT In this paper, two possible cases of acute carbon monoxide poisoning previously not identified in the medical and historical literature are discussed. The first concerns the famous Byzantine Emperor Julian the Apostate, who may have suffered mild carbon monoxide poisoning from which he quickly and completely recovered. The second case involves his successor, Jovian, who may have succumbed to severe carbon monoxide poisoning. Both cases were in all likelihood due to the burning of coal in braziers, a usual method of indoor heating during that epoch.

The Parallels between Asclepian and Hippocratic Medicine on the Island of Kos

At the end of the 20th century, Hippocratic medicine--which developed at the cross-roads between the occidental and oriental civilisations--acts as a link, a bridge and a symbol for the need to combine both the experience of traditional (Eastern) and the trends of modern (Western) medicine. Hippocratic medicine is one vital pathway to the proper study of the evolution of the medical art. Not only is it the beginning of the art and science of medicine, but modern medicine can still learn from the Hellenic medicine of ancient Greece. Hippocratic medicine is both an antidote to an overconcentration and overemphasis on medical technology and a stimulus to more humane technical achievements. Hippocratic bedside examination has not died, but is merely pushed aside temporarily by modern technology. The fact that ancient Hellenic medicine was based on the coexistence of both Asclepian (traditional) and Hippocratic (rational) medicine on the island of Kos reveals and symbolises the necessary coexistence and cooperation of both systems, a synthesis of their concepts being essential to solve the problems threatening the future of humankind. Hellenic medicine serves to highlight that the parallels between Asclepian and Hippocratic medicine are closer than medical historians usually realise, and that alternative medicine may function in a complementary way to conventional primary medical care.

Renal terminology from the Corpus hippocraticum

Accessible online at: www.karger.com/journals/ajn Hippocratic writings have not lost their nephrologic interest, despite the enormous recent advances in renal biotechnology. The present-day nephrologist can still learn not only from Hippocratic clinical observations but also from the prognostic thoughts, the ethical principles, the philosophic concepts and the humane messages of the ‘Father of Clinical Nephrology’ [1]. The Corpus Hippocraticum (Hippocratic Collection) represents the major source of the classical Greek world’s medicine. The 60 treatises of this work contain the theories of Hippocrates and the medical school of Kos about various diseases and the accurate description of the symptoms and signs, also including a great deal of information on renal and bladder affections. Focusing on the vocabulary used to characterize the organs of the urinary tract and their function as well as the nosology of this system, Hippocratic renal terminology reveals interesting linguistic parameters and mainly the adoption of the ancient Greek terms in contemporary languages, especially English. There are also many Latin terms, on account of the fact that medicine originates in Greek and Roman antiquity. Besides Hippocrates (fig. 1), the writings of Galen [2] and Aretaeus of Cappadocia [3], as well as Celsus and Plinius, remain the principal sources of the elements for medical terminology and the basis for the correctness of the Western scientific onomatology. However, the number of Latin terms, with the exception of the vocabulary for medical law matters, is inferior to the Greek number of scientific words in all the specialties of medicine. Moreover numerous hybrid formations, i.e. words composed of both Greek and Latin elements, exist in Western medical terminology. Fig. 1. Hippocrates the Koan (460–377 BC) by the Hungarian artist János Kass.

Kidney Disease in Byzantine Medical Texts

The most significant contribution of the great Byzantine physicians to the evolution of medicine is their effort to summarize all the medical knowledge of the Greco-Roman world, which included earlier sources in antiquity, lost forever in our days. The transition from ancient to medieval medicine included the adoption of Christian spiritual values, which took place in the early Byzantine period (4th to 7th century). In the field of nephrology, under the influence of Hippocratic and Galenic doctrines, the most prominent medical personalities, Oribasius of Pergamum, Aetius of Amida, Alexander of Tralles and Paul of Aegina, performed the role of the researcher and healer, as well as that of the encyclopedist. Their works on kidney disease are presented in this paper.

The penalty of blinding during Byzantine times

This paper which is based on the works of Byzantine chroniclers examines the imposition of blinding as a penalty in Byzantium. Punishment by blinding, though of extremely ancient origin, was imposed on Christians in the Roman Empire under the rule of Diocletian (AD 303). This continued up to the time of Constantine the Great and blinding as a penalty reappeared in the Byzantine Empire (AD 705) under the rule of Justinian Rhinotmitos. The writers investigate the grounds for the imposition of the penalty, and the methods employed, and a series of examples are given as handed down by Byzantine chroniclers. Finally, the ethical background of the penalty is examined according to the legislature and common-law extant in Byzantium.

Saint Marina: The Protectress of Nephrology

Saint virgin and martyr Marina (Margarita) of Antioch in Pisidia (255–270) is recognized as the patron saint of kidney sufferers and the protectress of nephrology. Beginning in the 13th century she heals in particular patients suffering from nephropathies, pregnant women having a difficult childbirth, barren women and sickly children. She protects the patients from every side effect and complication. Saint Marina is represented in hagiography as a victor, defeating the dragon satan, holding a hammer or a cross and wearing a belt around her back in the area of kidneys. According to writers, artists and sculptors the belt is the perceivable means of Saint Marina for the miraculous recovery from and healing of kidney diseases. Therefore, kidney sufferers and pregnant women put belts upon her relics for blessing and then wore them. From the Middle Ages and Renaissance and up to the contemporary period Saint Marina (Margarita) was considered the patron saint of kidney sufferers. Justifiably she is recognized by the modern medical world as the protectress of nephrology.

Ophthalmological therapy in hospitals (xenones) in Byzantium

Based on the typikon of the Imperial Monastery of the Pantocrator of Constantinople (12th century) and the manuscripts used in the Byzantine hospitals as well as the published Lives of the Saints and other related sources, it is undeniable that special Ophthalmological departments existed in the xenones of Byzantium. It is also proven, that specific Ophthalmological therapy was practised here including surgery and particularly in the cataract operation. This last operation is attested to, not only by the medical writings of Byzantine writers but also from the therapies of the physician-saints Cosmas and Damian.

Unknown ancient Greek ophthalmological instruments and equipment

Discoveries of some ancient medical instruments and equipment found in the Hellenic world have been published in magazines of general interest and in a rare Greek medical journal, yet none caught the attention of ophthalmologists. Among these instruments are two forms of the famous ‘Kenteterion’, dating from the Hellenistic period, used for the couching of cataract. These were found on the island of Milos in the last century. Two magnifying lenses of the Archaic period from the recent Cretan excavations gave us the opportunity to discuss the problem of their medical use. The two drop-bottles from the excavations on Cyprus and at Tanagra, which are also described, seem to be of medical, and possible ophthalmological, use.