Biomedical subjects
Ferdinand Peter Moog
Publications and source records attributed to Ferdinand Peter Moog.
Neurognostics question: an apoplexy, a murderess, poisoned mushrooms, and the death of an emperor.
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The catheter and its use in late antiquity and the early middle ages.
PURPOSE: Based on Greek and Latin sources the use of the urinary catheter in Western medicine between 200 and 1000 CE was reviewed. MATERIALS AND METHODS: Computerized databank searches permitted the identification and analysis of ancient and early medieval texts that include material on the catheter. RESULTS: Ten medical authors mentioned the catheter and its use. In the Byzantine world they include the encyclopedists Oribasius, Aetius and Paul of Aegina. The best known Latin author is Caelius Aurelianus. These writers often put together summaries of earlier works. Innovation or independent research was not easily found at a time during which neither anatomical autopsy nor experimentation was widely practiced. CONCLUSIONS: Old texts contain numerous instructions on how to skillfully use the catheter. As a technical achievement, it was independent of philosophical trends. Its primary indications, namely urinary retention, bladder stones and the administration of cures, changed little with time. As one of the oldest and most important instruments at the disposal of physicians, the history of the catheter should be known to every urologist.
The catheter and its use from Hippocrates to Galen.
PURPOSE: We comprehensively reviewed the history and use of the bladder catheter in Western medicine from 500 BC to 200 AD. MATERIALS AND METHODS: Greek and Latin texts were key word searched to identify descriptions of contemporary instruments and their uses. RESULTS: The catheter and its use were mentioned by about 10 ancient authors in more than a total of 20 texts dating to the end of the second century AD. The authors include Hippocrates, Celsus, Soranus, Rufus, Aretaeus and Galen. They described the use of the instrument in reference to contemporary anatomy and physiology, and indications and contraindications in regard to certain conditions, such as urinary retention, bladder stones and intravesical blood clots. Technical details and particularities of use were also reviewed, as were pharmacological considerations and underlying physical principles. CONCLUSIONS: Knowledge of the urinary catheter, and its usefulness and risks in ancient medicine can be dated from the 5th century BC. Our study of European texts documents its broad use. Because catheterization was perceived as a practical measure, it generated little scientific controversy.
[A lead seal of the "Germanos' Health Service" as an early forerunner of the health insurance card in ancient Byzantium].
The aim of this study is to present a Byzantine lead seal from the 6th century A. D. in the light of other comparable finds and to explain its function. According to the Greek inscription it was issued by the so-called "Germanos' Health Service". Its beneficiaries carried it probably around the neck or wrist. This charitable institution, settled in Constantinople, supported people in need. Feeding of the poor and free access to the baths certainly belonged to the standard services of the "Germanos' Health Service". Several reasons favour the assumption that medical help was also included in the range of benefits offered to people to whom it would have otherwise been out of reach. Contrary to the modern Health Insurance there was no legal claim to the medical care. It was rather a voluntary charitable supply that is to be seen in the context of Christian love and of personal striving for the salvation of the soul through good deeds. Therefore, the seal of the "Germanos' Health Service" belongs at least indirectly among the forerunners of the modern Health Insurance Card which ought to give access to participation in the blessing of good health.
Next emperor, please! No end to retrospective diagnostics.
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Roman emperors suffering from apoplexy: the medical and historical significance of classical literary sources.
According to various Greek and Latin texts, several Roman emperors died of "apoplexy". This paper presents a systematic collection and evaluation of these sources. The contents of the texts are compared with contemporary knowledge as well as present-day perspectives. In retrospect, few of the "royal cases" can be classified as cerebrovascular disorders.
[Defense of Ovid: annotations on Metamorphoses IV 119-123)].
The description of Pyramus' suicide in the Metamorphoses has been commented on by many scholars. There has been particular criticism of the comparison between the unfortunate lover's wound, squirting out blood, and a burst water-main. This has been supposed to show yet again how Ovid, in spite of his undoubtedly great talent, is capable of ruining a story by exaggeration. Nevertheless, a medical look at his wording leads to quite a different judgement. In his simile of the burst water-main Ovid obviously had in mind the haemorrhage from a damaged femoral artery, which can shoot blood to a considerable distance, sometimes over several yards. Only in this way can the fruits of the mulberry tree, hanging high over the wounded Pyramus, be moistened with blood and painted dark. This is, after all, the metamorphosis which justifies the inclusion of the story in the whole corpus. As it is possible for a person fatally wounded in this way to survive for some hours, the poet has to guarantee that Pyramus dies within minutes of turning his sword against himself. Only so can Thisbe, returning quickly, confess her love for Pyramus in such a heartfelt way and follow him at once. The haemorrhage from a femoral artery my indeed kill a person within a few minutes. Therefore Ovid's description is neither gruesome nor tasteless but simply natural and dramatically conclusive. The comparison with the water-main is one which would easily have occurred to the poet. From Ovid' point of view and that of his contemporaries, who had no knowledge of the circulation of the blood, no better comparison can be imagined than that between the blood vessels of the human body and urban water-pipes, a technical achievement of which the Romans were particularly proud.
[A drill-bow in Horace, Odes 3.6.7].
With the short poem Odes 3.26 Horaces says--ostensibly--farewell to the subject of love. A symbol of his retreat is the order given to his followers: they ought to lay in the Temple of Venus the three objects which he has used in his night escapades struggling for the girls' love: lucida funalia (torches), vectis (jemmies), and arcus. The last words has been puzzling the scholars for centuries. Many took offence at the transmitted text and offered conjectures of their own. Some, however, defended arcus using different arguemtns, for instance that arcus refers to bows and arrows as weapons of the lascivious night-reveller. Also the author of this article retains arcus in the text. The context and grammatical construction let assume that also this noun denotes a tool of a burglar, preferably a drill driven by a fiddle-bow. Such instruments were use by carpenters, joiners, and surgeons. Apart from this, gigantic drill-bows were known among military machines. These were frequently applied in sieges. Horace might have seen descriptions and drawings of them in military handbooks which he presumably read in order to prepare himself for his short and rather inglorious career as an officer in the army of Caesar's murderers. For Romans without military experience who suddenly obtained a high rank at war this was a typical way of making good their shortcomings. The parallel between the siege of a town and the attack upon the beloved girl's house must be regarded as a poetic exaggeration; the reader should be amused by an impracticable idea. Furthermore, a possible connection between Horace's poem and the Heracles of Euripides is pointed out here for the first time. In Heracles 942-6 the hero, driven insane by Lyssa's work, asks for his bow, his arrows and siege instruments to take Mycenae, the fortress of his tormentor Eurystheus. In fact he brakes into his own bedroom and kills his spouse and his son.
[A report of St. Bonaventura in the mirror of the history of neurology].
Ancient and medieval literature contain few case reports of specific syndromes. But there is no lack of such accounts in theological literature, with its long tradition of gathering and documenting individual case studies involving miracle cures--a practice which stretches from the ancient sanctuaries of Asclepius to today's places of pilgrimage. Among the many miracles attributed to St. Francis, complied around 1260 by his biographer, St. Bonaventura, is the case of a young monk afflicted by a sudden hemiplegia accompanied by aphasia and mental confusion. According to legend, he was miraculously and completely healed by the appearance of St. Francis. The report can be interpreted from a number of different approaches: medical, theological, literary or even autobiographical. Neurologists may treat this "case history" as an early description of a "prolonged ischaemic neurological deficit" (PRIND).
St. Francis came at dawn--the miraculous recovery of a hemiplegic monk in the Middle Ages.
We present the English translation of a remarkable case report from the 13th century. A collection of miracles ascribed to St. Francis contains the story of a young monk suddenly afflicted by a neurological disorder characterized by hemiplegia, speech problems and confusion. St. Francis' appearance led to complete recovery. From a theological and literary point of view, the text includes many allusions to the miracles performed by Jesus and to pagan traditions from Asclepius to Ovid. Retrospective neurological diagnoses range from a prolonged ischemic neurological deficit (PRIND) to psychogenesis. This case history is a rare example of faith healing in its contemporary context.
Between horror and hope: gladiator's blood as a cure for epileptics in ancient medicine.
Between the first and the sixth century a single theological and several medical authors reported on the consumption of gladiator's blood or liver to cure epileptics. The origins of the sacred or apoplectic properties of blood of a slain gladiator, likely lie in Etruscan funeral rites. Although the influence of this religious background faded during the Roman Republic, the magical use of gladiators' blood continued for centuries. After the prohibition of gladiatorial combat in about 400 AD, an executed individual (particularly had he been beheaded) became the "legitimate" successor to the gladiator. Occasional indications in early modern textbooks on medicine as well as reports in the popular literature of the 19th and early 20th century document the existence of this ancient magical practice until modern times. Spontaneous recovery of some forms of epilepsy may be responsible for the illusion of therapeutic effectiveness and for the confirming statements by physicians who have commented on this cure.
[Saints as protectors against falling sickness].
In Christian Europe of the High Middle Ages, saints played a central role in the everyday life of the ailing. Alongside healing attempts which involved magic and/or scientifically-based medicine, the invocation of specific patron saints for protection against evils or for the curing of ailments was a widespread practise. A large choice of patron saints was "ävailable" for a wide range of diseases, especially those nowadays classified as neurologic or psychiatric. For the falling sickness alone, e.g., there is evidence of some twenty patron saints reputed to have a particular involvement. Surprisingly, there is no evidence of a comparable devotion to patrons for apoplectics. This "negative result"is confirmed by a thorough examination of medieval sources. St. Wolfgang and St. Andreas Avellino are the only two proven stroke patrons. Both, however, were only known within their respective locations. The absence of a specific supportive Christian figure for stroke victims deserves particular analysis: The high fatality rate of apoplexy and the lack of commercial interest on the part of the Christian places of pilgrimage may serve as possible explanations.
[On the simile of the courageous general in Herophilos].
Herophilos of Chalcedon is certainly an outstanding representative of ancient medicine. He rightly counts the Father of anatomy. He was, nevertheless, interested in all branches of medicine and should have written on numerous special subjects. Unfortunately only scarce fragments of his writings have survived till now. A nowadays rather neglected fragment deriving from Herophilos' scripts on drugs has survived in Plin. nat XXV 57 f. It reports on the effects of helleborus albus (probably White Hellebore, i.e. Veratrum album L.) which evokes strong vomits. In a pregnant simile the remedy is compared to a courageous general who having stimulated his soldiers goes into battle in front of them. Editors and commentators do not say much about this passage, perhaps bewildered by the appropriate, but in the technical prose certainly striking simile. A surprising parallel occurs in the Gospel according to St. John 10:1-6 - the core of Jesus' self-description as the Good Shepherd. Comparing both passages leads to the conclusion that this select metaphor must have been a well-known motif in the literature of the Hellenistic and imperial periods. Moreover, a look at the ancient historiography and military writings shows that we have to do with a commonplace: both the talent to deliver a vigorous speech encouraging the soldiers to go into battle and the personal bravery in the fight are virtues necessary to an eminent military commander. Furthermore, we get insight into a general understanding of Herophilos as a writer. It was stressed frequently that Herophilos' epoch-making results in the field of medicine had found their way into the belles-lettres and poetry. Now we see that the inspiration was mutual. When Herophilos wished to give prominence to an important statement, he also did not hesitate to borrow effects of style from the poets and writers of the Kunstprosa. In his care for a literary form he exceeds what we unusually observe in the writers of 'technical' prose.
[The death of emperor Valentine I in the descriptions of Ammianus Marcellinus and other authors].
The history of neurology, especially before 1800, has been treated almost completely as "literary history". Most interest centred around the works of famous physicians and their writings. Especially in the classical era, non-medical testimonies have received little attention. This makes it a particularly pleasant surprise for a medical histroical in search of such material to come across a description of a "neurological illness" in a history book from ancient times. 'Rerum gestarum libri' by Ammianus Marcellinus, the last Roman historiographer of note, gives a fairly descriptive account of the fatal illness of Emperor Valentine I (30, 6, 1-6). Valentine was suddenly taken ill with apoplectiform symptoms during a campaign in Pannonia in 375 AD. He died few hours later, despite the attempts of a physician quickly brought to the scene. The account of Ammianus Marcellinus combines literary features with a clear interpretation of medical symptoms according to contemporary doctrines. This description was later to become a model for non medical references and commentaries dealing with this "famous case", written by Christian authors including Orosius, St. Jerome, Socrates and the pagan historian Zosimos.A retrospective diagnosis of Valentine's last disease is difficult. It is impossible to prove that he really died from a stroke. Death by infectious disease might also be supposed. Finally, similar symptoms can be found in the case of the Emperor Claudius, who was poisoned by his last spouse in Agrippina in 54 AD. Our study is an attempt to analyse this very important case report from a medical, historical and cultural perspective, thus contributing to the historiography of "neurology in the ancient world".
[Traumatology due to ancient lead missile projectiles].
The lead missiles of slingers in antiquity, known as glans or molybdis, are widely considered to have been very dangerous projectiles of the ancient armies. Ballistic investigations and results of experimental archaeology seem to confirm this. However, the findings of medical history concerning these missiles disagree with this view. In ancient medical texts these missiles are only mentioned sporadically, as in Celsus or Paul of Aigina, and wounds caused by them are merely discussed incidentally. There is so far no evidence at all on them in palaeopathology. It is undisputed however that in individual cases these missiles were able to cause serious injuries, especially when they hit unprotected parts of the body. Accordingly, their main effect seems to have consisted in the intimidation of the enemy.
[The "hornet spider" of Plinius].
Pliny the Elder describes in his 'Natural History' XXIX 86 a species of spider dangerous for human beings and looking like a hornet without wings. This description corresponds to Solipugae of the genus Karschia, living in arid areas of Central Asia. These animals are not venomous but can cause harm by their powerful bite and in some cases by a following inflammation of the wound. On the contrary, an animal called "wasp-like", mentioned by Nikander of Kolophon ('Theriaca', v. 738-746) and often regarded to be the same creature, seems to be a typical venomous spider which causes an acute intoxication by its bite.