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Two papyri are very interesting for Medicine history of the Antiquity. The first one (a Greek papyrus prolifically illustrated between 100 B.C. and 100 A.D.) reveals the value of the illustrators of works in the Greek and Roman period and the second (the famous papyrus of Milan 300 B.C.) includes a part about the epigrams of curing.
The first descriptions of facial injuries, especially about hurts of the nose, their diagnosis and their treatment are found in the writings of the old cultures. There are already corresponding references in the Papyrus Edwin Smith and in the Papyrus Ebers. There exist descriptions of the surgery of India and in the papers of Hippocrates, which contribute details to these injuries and their treatments. Here it is pointed to the splinting of the septum by inserting open tubes. A careful bandage, respecting the rebuilding of the nose, and the reposition of lower jaw fractures are remarked. In the Middle Ages there were some innovations in wound-treatment, especially in the technique of suture, but no important innovations in the medical care of middleface-fractures. There are only some modifications in the special treatment, but the surgeons always refer to the already available therapy-methods, mainly to those of Hippocrates. Only towards the end of the 18th century and the beginning of the 19th century, these themes, particularly the treatment of upper jaw hurts, got new impulses by Graefe, Lang and Le Fort, who also worked out new methods of the external and internal fixation by wire.
Group composition and mating system were investigated in wild Alaotran gentle lemurs (Hapalemur griseus alaotrensis) using genetic markers. These small-bodied herbivorous and cathemeral primates are endemic to the reed and papyrus beds around Lac Alaotra in Madagascar. They live in small groups in small, defended territories. Data were collected during the rainy seasons in 1996, 1997, and 1999, and include 99 individuals from 22 neighboring social groups and an additional 30 animals from other areas representing most of the geographic range. Animals were located by researchers canoeing in the marshes bordering the lake. After a group's size was determined by direct observation, all individuals were captured, marked, and released. During handling each individual was weighed and sexed, and hair samples for DNA extraction were collected. A 342 bp mtDNA control region sequence and 10 nuclear microsatellite loci provided multilocus genotypes that were used to assess pedigree relations and population structure. Alaotran gentle lemurs were found in groups of two to nine individuals (mean: 4.3), comprising one or two breeding females, their offspring, and one reproducing male. Solitary individuals of both sexes were encountered rarely. Breeding females were the permanent core of the social groups, whereas intergroup transfer of reproductive males was relatively frequent. Forty percent of all reproducing groups contained two breeding females, which were related to each other as closely as mother-daughter or full sisters. Parentage assessment revealed a variable mating system ranging from serial monogamy to polygyny within social groups. At least 8% of paternities involved extragroup males. Additional data on life history and reproduction are presented, and the social system of the Alaotran gentle lemur is discussed in the light of the new genetic findings.
The writing sheets made with strips from the stem (caulis) of papyri (Cyperus papyrus) are one of the most ingenious products of ancient technology. We extracted DNA from samples of modern papyri varying in age from 0-100 years BP and from ancient specimens from Egypt, with an age-span from 1,300-3,200 years BP. The copy number of the plant chloroplast DNA in the sheets was determined using a competitive PCR system designed on the basis of a short (90 bp) tract of the chloroplast's ribulose bisphosphate carboxylase large subunit (rbcL) gene sequence. The results allowed us to establish that the DNA half-life in papyri is about 19-24 years. This means that the last DNA fragments will vanish within no more than 532-672 years from the sheets being manufactured. In a parallel investigation, we checked the archaeological specimens for the presence of residual DNA and determined the extent of racemization of aspartic (Asp) acid in both modern and ancient specimens, as a previous report (Poinar et al. [1996], Science 272:864-866) showed that racemization of aspartic acid and DNA decay are linked. The results confirmed the complete loss of authentic DNA, even in the less ancient (8th century AD) papyri. On the other hand, when the regression for Asp racemization rates in papyri was compared with that for human and animal remains from Egyptian archaeological sites, it proved, quite surprisingly, that the regressions are virtually identical. Our study provides an indirect argument against the reliability of claims about the recovery of authentic DNA from Egyptian mummies and bone remains.
Reproduction of an ancient Egyptian mouth-opening device raises certain technological and historical questions. The most effective variation has proven to be a device made of strip iron built exactly according to the proportions given in the Hunefer papyrus. This device allows quick and safe intubation of intubation dummy CLA 8 without a supplementary light source. Originally, the device was a metal instrument made of meteoric iron, apparently produced only in small numbers. To data, the form of production remains a mystery, since the smelting and processing of iron was totally uncommon in ancient Egypt. Based on the material structure of the device and certain portrayals in graves in Deir el-Medina, mouth-opening as it was actually performed reveals a methodology that can be reconciled with modern pre-clinical polytrauma management. In principle, this indicates that the introduction of artificial respiration thousands of years ago would have been possible.
The use of pessaries for the treatment of genital prolapse dates back prior to the days of Hippocrates and their use has been documented in early Egyptian papyruses. Throughout the centuries remedies such as honey, hot oil, wine and fumes have been used as treatment. Mechanical methods included succussion and leg binding. Pomegranates were also common remedies. In the middle ages, linen and cotton wool soaked in many different potions were used. As new materials were discovered, pessaries evolved and began to resemble those used today. Cork and brass were soon replaced with rubber. Modern day pessaries are made of non-reactive silicone and come in various designs and sizes to suit each individual. Pessaries can be used as an interim measure for women who wish to complete childbearing or women awaiting surgery. It can also be used as a permanent measure for women who are unsuitable for surgery. It remains to be established whether the use of modern pessaries over prolonged periods of time can prevent progression of or even cure, prolapse.
Caridina nilotica, a freshwater atyid prawn, is a vital component of the Lake Victoria ecosystem. Despite its important role in the food web leading to Nile perch, the diet of Caridina is not well understood. Caridina freshly collected from the inshore littoral and offshore plankton of Lake Victoria were cultured individually under laboratory conditions on (A) decomposing hydrophytes, (B) living hydrophytes, (C) planktonic algae, (D) zooplankton and (E) 35- microm filtered lake water (a 'starvation' control). Inter-moult intervals (IMI, days), size-standardized moult intervals (MI, days mm(-1)), per moult growth increments (PMI, mm) and survivorship (%) were monitored daily for up to 5 weeks. Significant effects of both food type and shrimp source on MI were revealed by ANOVA. MI increased progressively from treatment A to D, and was shorter in offshore than littoral shrimps. Food influence on IMI was confirmed by ANCOVA. PMI values were close to the limits of detection, but were generally in line with MI responses. PMI values were marginal in treatments A and B, and negligible or negative in treatments D and especially E. Survivorship values, although confounded by non-dietary factors, were generally consistent with dietary influences on MI, although values obtained for treatment E were inconsistently high for true starvation. Disparate responses between inshore and offshore shrimps hint at possible ecotypic differentiation, or perhaps the existence of cryptic species. Stable isotope analyses (SIA, delta13C and delta15N signatures) of cultured shrimps were further consistent with their utilization of food type A but not D. SIA signatures of feral shrimps maintained in situ in enclosure bags with three separate potential fresh hydrophyte food sources (Vossia cuspidata, Cyperus papyrus, and Eichhornia crassipes) reflected Caridina's probable dietary reliance on decomposed organic matter with accompanying bacterial exudates. Collections of feral shrimps from various locations yielded parallel SIA results. No support for zooplanktivory by shrimps occupying either inshore littoral/benthic or offshore planktonic habitats is provided by the delta15N signatures obtained from our data, which support Caridina's primary role as a detritivore.
The use of cold as a therapeutic agent has a long and colorful history. The Edwin Smith Papyrus, the most ancient medical text known, dated 3500 B.C., made numerous references to the use of cold as therapy. Baron de Larrey, a French army surgeon during Napoleon's Russian campaign, packed the limbs in ice prior to amputations to render the procedures painless. In the early twentieth century, a neurosurgeon, Temple Fay, pioneered "human refrigeration" as a treatment for malignancies and head injuries. In 1961, Irving Cooper developed the first closed cryoprobe system and ushered in the modern era of cryogenic surgery with his imperturbable convictions. Fay's early work fell victim to the disruptive sequel of the World War II. The Nazis confiscated his data (presented before the Third International Cancer Congress in 1939) forwarded to Belgium for publication and brutally applied his refrigeration techniques experimentally without any benefit of anesthesia in the concentration camps, especially Dachau. Hypothermia became associated in the public mind with the atrocities exposed at the war trials in Nürnberg. After lying dormant for decades, the interest was rekindled in the late 80s when mild hypothermia was shown to confer dramatic neuroprotection in a number of experimental models of brain injury. With several large multi-center clinical studies currently under way, hypothermia is receiving unprecedented attention from the medical and scientific communities.
Throughout medical history, suggestion is the oldest and most common method of relieving human distress and treating physical disease. One of the oldest Egyptian documents, the Ebers Papyrus (1552 BC) states, "Lay your hands upon him to quiet the pain in the arms and say that the pain will disappear." The psychogenic and therapeutic potency of Native American trance dances are also well documented. In a North American tribe practicing ancient traditions, such dances were found to produce an altered feeling for time, loss of conscious control, drastic emotional outbreaks, illusions, hypersuggestibility, and a deep feeling of restored youthfulness (Jilek, 1982). These and other historical documents show the deep historical connection between somatic and mental processes. From the viewpoint of a neurologist or a psychiatrist, a combination of somatic illness, depressive syndromes, organic psychosyndromes, and multimorbidity is frequent in elderly patients (Kortus, 1992). Thus, integrated psychotherapy in geriatric rehabilitation is necessary and useful. Practical psychotherapeutic methods are discussed in this manuscript.
With the rapid development of digital imaging modalities in medicine, there is an increasing need for an efficient management and archival of medical images in digital form. Picture Archiving and Communication Systems (PACS) are becoming an essential component of medical imaging equipment, allowing for medical images to be accessed and stored directly in digital form. This paper describes a hospital-wide PACS currently under development at the University Hospital of Geneva, based on an open architecture, regrouping equipment from different vendors in a distributed topology. The image archival is organized in multiple locations geographically distributed in the hospital. The PACS database is fully integrated with the concurrent Radiology Information System (RIS) and Hospital Information System (HIS). A standard image storage format called the PAPYRUS format was developed for the storage of medical images from a variety of imaging modalities. To provide a more uniform user interface on a variety of different workstations, a common platform for image display and manipulation called OSIRIS was developed.
The treasured ancient papyri provide a glimpse into understanding of common concepts and practices in ancient Egypt. The Kahun gynecological papyrus and other texts unveil the traditions of reproduction, conception and delivery. This article addresses the rationale of beliefs and practices of that era. Frequently, the reason for common traditions exercised at the time is based on medical knowledge of female anatomy and physiology during pregnancy. Surprisingly some of the remedies commonly used in ancient Egypt were recently explored and found intriguing. This paper was aimed to look at the reflection of archaic practices and concepts of ancient Egypt by the modern mirror of evidence-based medicine.
INTRODUCTION: Papyrus manuscripts nearly 2000 years old, can still be read, but documents composed on a Wang or other word processor just 30 years ago are gone forever. Standards and formats used for storing and accessing information are constantly changing, and the required hardware or software will likely be obsolete or no longer exist in the near future. PURPOSE: To understand how to urgently address the data preservation issue as we migrate to greater use of e-records, in particular 'lifetime' electronic health records (EHR's), as our primary, perhaps sole, e-record. In principle, these dynamic and critical health data must be preserved and capable of real-time access on a 7/24/365 basis for perhaps 125 years. Without forethought, only a small fraction of the data currently stored within any healthcare jurisdiction will survive for more than a decade or so, or be exchangeable between jurisdictions. The situation will only be compounded as EHR's become ubiquitous. APPROACH: The literature was reviewed to identify data preservation issues and potential solutions, and guide development of policy recommendations to minimise the impact of this potentially catastrophic system failure. These recommendations are directed at the practice, program, and decision-making levels, and in both the public and private sectors. CONCLUSION: Data preservation poses a critical barrier to e-health and future healthcare systems. At this time broad awareness of data preservation issues is poor. This paper offers policy recommendations to stimulate debate and development of suitable strategies.
A small minority of Africa's wild plant foods are C4. These are primarily the seeds of some of the C4 grasses, the rootstocks and stem/leaf bases of some of the C4 sedges (especially papyrus), and the leaves of some of the C4 herbaceous dicots (forbs). These wild food plants are commonly found in disturbed ground and wetlands (particularly the grasses and sedges). Multiple lines of evidence indicate that C4 grasses were present in Africa by at least the late Miocene. It is a reasonable hypothesis that the prehistory of the C4 sedges parallels that of the C4 grasses, but the C4 forbs may not have become common until the late Pleistocene. CAM plants may have a more ancient history, but offer few opportunities for an additional C4-like dietary signal. The environmental reconstructions available for the early South African hominid sites do not indicate the presence of large wetlands, and therefore probably the absence of a strong potential for a C4 plant food diet. However, carbon isotope analyses of tooth enamel from three species of early South African hominids have shown that there was a significant but not dominant contribution of C4 biomass in their diets. Since it appears unlikely that this C4 component could have come predominantly from C4 plant foods, a broad range of potential animal contributors is briefly considered, namely invertebrates, reptiles, birds, and small mammals. It is concluded that the similar average C4 dietary intake seen in the three South African hominid species could have been acquired by differing contributions from the various sources, without the need to assume scavenging or hunting of medium to large grazing ungulates. Effectively similar dominantly dryland paleo-environments may also be part of the explanation. Theoretically, elsewhere in southern and eastern Africa, large wetlands would have offered early hominids greater opportunities for a C4 plant diet.
Paragraph 55 of the London Medical Papyrus describes burns derived from red waters and which later became infected with larvae in the wounds. The prescribed treatment for the burn is unusual as it calls for no rinsing and requires bandaging with alkaline materials only. Refraining from washing in the Nile (the single most readily available source of water in ancient Egypt), and the use of alkali-neutralizing agents indicates that the red caustic waters came from the river, and were acid in nature. A red, acid Nile is consistent with the first biblical plague of Egypt, which killed fish, and kept people from drinking from the river. In turn, the sulfate-laced waters of the medical document also offer a plausible insight into the subsequent biblical plagues. Amphibians would have stayed away from the deadly river, left to die on the banks, just as described in the second biblical plague. Similarly, the larvae in the wounds mentioned by the medical document re-echo the third and fourth biblical plagues: the kînnîm invertebrates and the subsequent 'arob (varied insects) are consistent with larvae and the subsequent adults thereof. In pre-industrial Ancient Egypt, sulfates from a massive volcanic fall out provide the simplest and most exhaustive origin for such waters. A massive precipitation that would account for the waters in the medical document and the biblical texts is known from sediments at the bottom of lakes along the Nile Delta. The site is downwind from the island of Santorini, and the deposit of volcanic ashes took place during the Middle Bronze Age, i.e. at a time consistent with the eruption at the Greek volcanic island.
Alum sludge discharge effects on a natural wetland on the shores of Lake Victoria at Gaba in Uganda has been investigated. The water quality in the swamp, the sediment chemistry and plant growth and productivity were monitored. The subsequent application of alum sludge discharges shows no immediate, noticeable, adverse overall effects on the water quality and sediment chemistry. A distinct effect on plant productivity was noted in Cyperus papyrus L. the dominant macrophyte in the Gaba swamp resulting in a low productivity rate of 5.1 g/m2 d and the apparent phasing out of this macrophyte in the swamp. Phragmites mauritianus (Kunth) exhibited better tolerance to alum sludge. Clear indications are cited of the ecosystem degrading and cumulative effects being marked over a longer time frame.
PURPOSE: To describe the implementation and use of an electronic patient-referral system as an aid to the efficient referral of patients to a remote and specialized treatment center. METHODS AND MATERIALS: A system for the exchange of radiotherapy data between different commercial planning systems and a specially developed planning system for proton therapy has been developed through the use of the PAPYRUS diagnostic image standard as an intermediate format. To ensure the cooperation of the different TPS manufacturers, the number of data sets defined for transfer has been restricted to the three core data sets of CT, VOIs, and three-dimensional dose distributions. As a complement to the exchange of data, network-wide application-sharing (video-conferencing) technologies have been adopted to provide methods for the interactive discussion and assessment of treatments plans with one or more partner clinics. RESULTS: Through the use of evaluation plans based on the exchanged data, referring clinics can accurately assess the advantages offered by proton therapy on a patient-by-patient basis, while the practicality or otherwise of the proposed treatments can simultaneously be assessed by the proton therapy center. Such a system, along with the interactive capabilities provided by video-conferencing methods, has been found to be an efficient solution to the problem of patient assessment and selection at a specialized treatment center, and is a necessary first step toward the full electronic integration of such centers with their remotely situated referral centers.
According to official census returns from Roman Egypt (first to third centuries CE) preserved on papyrus, 23.5% of all documented marriages in the Arsinoites district in the Fayum (n = 102) were between brothers and sisters. In the second century CE, the rates were 37% in the city of Arsinoe and 18.9% in the surrounding villages. Documented pedigrees suggest a minimum mean level of inbreeding equivalent to a coefficient of inbreeding of 0.0975 in second century CE Arsinoe. Undocumented sources of inbreeding and an estimate based on the frequency of close-kin unions (corrected downwards to 30% for Arsinoe) indicate a mean coefficient of inbreeding of F = 0.15-0.20 in Arsinoe and of F = 0.10-0.15 in the villages at the end of the second century CE. These values are several times as high as any other documented levels of inbreeding. A schematic estimate of inbreeding depression in the offspring of full sibling couples indicates that fertility in these families had to be 20-50% above average to attain reproduction at replacement level. In the absence of information on the amount of genetic load in this population, this estimate may be too high.
The use of zinc in medicinal skin cream was mentioned in Egyptian papyri from 2000 BC (for example, the Smith Papyrus), and zinc has apparently been used fairly steadily throughout Roman and modern times (for example, as the American lotion named for its zinc ore, 'Calamine'). It is, therefore, somewhat ironic that zinc is a relatively late addition to the pantheon of signal ions in biology and medicine. However, the number of biological functions, health implications and pharmacological targets that are emerging for zinc indicate that it might turn out to be 'the calcium of the twenty-first century'.