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[Knowledge of the "Gräfenberg zone" and female ejaculation in ancient Indian sexual science. A medical history contribution].

Ancient Indian texts in sexology (kamaśastra) from the 11th century onwards prove that their authors knew about the area later termed the "Gräfenberg zone" in Europe, as well as about the female ejaculation connected with the stimulation of this area. The Gräfenberg zone is a sexually arousable zone in the front part of the vagina, stimulation of which can lead to the discharge of liquid from the urethra, a phenomenon which is described as female ejaculation. The german gynaecologist Ernst Gräfenberg, who worked in America, described this zone, situated beneath the clitoris, for the first time (at least in this century) in Western medicine in an article published in 1950. (There are, however, evidences, that the 17th-century anatomist Regnier de Graaf had knowledge about the mentioned erogenous zone as well as female ejaculation.) Since the 1980s the so-called Gräfenberg zone, popularly termed "G-spot", and female ejaculation have been controversially discussed medically as well as in popular science, first in the United States, then in Europe; both phenomena have meanwhile been accepted as facts in medical manuals and reference books (e.g. the "Pschyrembel"). Whereas the oldest and most well-known sexological-erotological work of Ancient India, the Kamasutra, dating probably from the third century A.D., apparently did not know the Gräfenberg zone and female ejaculation, texts such as the Pañcasayaka (11th century), Jayamangala (Yaśodhara's commentary on the Kamasutra from the 13th century), the Ratirahasya (13th century), as well as the late kamaśastra-works Smaradipika and Anangaranga (16th century?) demonstrably describe both, the Gräfenberg zone and female ejaculation, in great detail. The female ejaculation is described already in the 7th century in a non-kamaśastra-text, in a work of the poet Amaru called the Amaruśataka.

Clitoris↗

Martin Van Butchell (1735-1814): the eccentric, "kook" dentist of old London.

This article is a thumbnail sketch of the life and times of Martin Van Butchell (1735-1814), an eccentric, "kook" advertising dentist of Old London. Van Butchell earned these descriptive labels by displaying an unorthodox lifestyle, an outrageous personal appearance and outlandish, extreme and socially unacceptable personal and professional behaviors. While the general populace seemed to be fascinated by his strange ways, dentists and physicians were generally alienated by them. Nevertheless, he was considered a good dentist for his time, and he was extremely popular with his patients. Martin practiced dentistry for 23 years, and he practiced medicine as well, specializing in the treatment of ruptures and anal fistulas. Van Butchell interacted greatly with both John and William Hunter, who became two of the most famous and talented physicians, surgeons, anatomists and biologists of all time. When his first wife, Mary died, Martin arranged for her body to be embalmed and publicly displayed in his dental office for advertising purposes. Her preserved body was shown at the Museum of the Royal College of Surgeons (London), until it was destroyed by a German fire bomb in May, 1941. Mary's remains were on public display for a total of 166 years.

Dentists↗

Dr. T. Dale Stewart's travels.

Renowned forensic physical anthropologist Dr. T. Dale Stewart traveled extensively to countries all over the world. The reasons for his journeys were manifold. He did fieldwork, took part in congresses, visited scientific institutions, and lectured by invitation at various universities. This paper deals with his journeys in general and with his four visits to Czechoslovakia in particular. Three of them were undertaken in connection with scientific congresses dedicated to Dr. Ales Hrdlicka. Dr. Stewart, as Hrdlicka's successor in the Smithsonian Institution, always chose an appropriate topic for his lecture. His visits to Hrdlicka's native country and town contributed to better mutual understanding and exchange of ideas between physical anthropologists and anatomists from both countries, the USA and Czechoslovakia (the today separate Czech and Slovak Republics).

Awards and Prizes↗

[Terminologia anatomica: a new reference work for anatomy].

The Nomina anatomica (6th edition in 1989) was the standard anatomical nomenclature until recently. It has been succeeded by the Terminologia anatomica (TA) by resolution of the International Federation of Associations of Anatomists in 1999. By now the TA has been published as a book and on cd-rom. The objective of the TA is to further uniformize the anatomical terminology, also internationally, and especially to democratize it, i.e. to ensure that it accommodates the needs of clinicians and medical scientists. The number of anatomical terms listed has grown to more than 7500. The increase is caused mainly by the insertion of clinical anatomical and neuro-anatomical names. A number of incorrect or misleading terms have been replaced. Each Latin term has a unique code number and is supplied with an English equivalent (International anatomical terminology; IAT) the spelling of which in either UK English or American English is considered equally correct. Based on the TA every language can formulate its own anatomical nomenclature. The nomenclature is presented per system or organ tract. An alphabetic index follows TA as well as the English IAT list. The use of eponyms is discouraged, but a list of well-known ones is appended to facilitate accessibility of older literature. Relevant suggestions about amendments are eagerly awaited and a broad basis of endorsement among the medical scientific world is hoped for. This journal will adopt the TA/IAT from now on as the work of reference regarding anatomical terms.

Anatomy↗

[New pedagogic methods in anatomy: experience at Cambridge University].

The expansion of knowledge in basic medical sciences is not linked to the time assigned for the teaching of anatomy to medical undergraduates. The question of "basic knowledge" in teaching anatomy during medical training arises as a need for education of future clinical doctors. Nowadays, two extreme views in teaching anatomy can be recognized: one adopted some pure anatomists who feel their existence threatened even by the idea of any reduction in their field, and one by some morphologists exclusively interested in cellular biology, who consider that classical anatomy is of no interest, since it has been exhausted as a field for research. An intermediate position is taken by some clinicians, who maintain that anatomy is indispensable but seek a severe reduction in the content to what they consider to be necessary. The above mentioned need for clinicians was reflected in recommendations of Education Committee of the General Medical Council (GMC) which in short, could be characterized by: the substantial reduction of factual information, the increase of student learning and the emphasis of clinically applied anatomy with its integration to the general medical education. GMC delegated the Department of Anatomy at the University of Cambridge by the developing of the new anatomy course. This new course was for the first time introduced in school year 1998-1999. In this study are presented ways and methods of undergraduate anatomy teaching at the University of Cambridge. These educational principles could serve as a model for teaching anatomy during its transformation in other medical faculties.

Anatomy↗

[The anatomic tradition in Venice].

Venice had a long tradition and great reputation in the study of anatomical science dating back to the 1300's. The "Serenissima" Republic favoured the study and practice of anatomy as part of medical professional formation. Before the construction of the anatomical theater of San Giacomo dell'Orio, which took place in 1671, anatomical dissections were performed in churches, convents, hospitals and private homes. Even though Venice was not a University seat, it boosted numerous Venetian anatomists, among whom Benedetti, Massa, Santorini, and the medical activity of illustrious professors at the nearby University of Padua such as Vesalio, Falloppio, Spigelio, Vislingio and Morgagni.

Anatomy↗

[History of the cerebral ventricles].

Along the centuries, the cerebral ventricles were thought by Ancient anatomists to be involved in rational judgement, imagination, and memory. The role played by the cerebral cortex in these functions was only identified during the XIX(th) century.

Anatomy↗

The surgical amphitheatre, history of its origins, functions, and fate.

The Surgical Amphitheatre, patterned after the earlier model of Anatomists, came into being in the 17th century and served the purpose of teaching the anatomy of operation to surgeons, but without hospital connections. A great decline of student and visitor interest in viewing operations attended disappearance of the gambler's risk of operations, followed at the turn of this century by a lesser interest of medical students in attending surgical lectures, a circumstance that provoked consternation in the ranks of surgical teachers. The demise of the surgical amphitheatre as a suitable site for surgical teaching and viewing operations marked the beginnings of a gradual decline of influence of surgery in medical school faculties. Acceptance by reluctant surgeons of the inescapable microbiologic principle that silence of the entire Operating Team is mandatory, when operations are in process, will obviously erode further usefulness of the operating arena for instruction of medical students. Over the past decade, the current sharpened focus upon dispersion of medical care has served to de-emphasize in our medical faculties the post-World War II stress upon research for medicine's advance. A gradual decrease of student interest in surgery has occasioned medical faculties to question the justification of continuing surgery as a major curricular discipline for undergraduate medical students. Surgeons need to cultivate the intimate teacher-student relationship reflected in the practices of Pierre Louis and William Osler. A critical reassessment by professors of surgery of their teaching responsibilities should serve to indicate to medical students and their faculties that surgery has much important and useful information to impart, and that their professors are ready, prepared, and anxious to meet the challenge.

Anatomy↗

[Gaspard II Bartholin and the vulvovaginal gland].

Born in 1655 in Copenhagen to a renowned family, Gaspard Bartholin had the good fortune during his stay in Paris to meet Joseph Guichard du Verney, a French anatomist who had discovered the glandula vestibuloris major. Back in Copenhagen he was appointed professor of anatomy at the age of 21 described the physiology of the glandula vestibuloris major, later known as Batholin's gland. Ennobled, laden with honours, he was later appointed personal physician to the king of Denmark until his death in 1738.

Anatomy↗

Hand reconstruction.

To conclude, one must apologize for having introduced so many subjects and left so many loose ends. Hand reconstruction poses a multitude of problems which are presently in an evolutionary phase. In discussing the notion of hand surgery specialization one draws upon orthopaedic, plastic and microsurgical techniques. But is it not precisely this adaption of diverse techniques to one organ which constitutes a speciality? Rapid progress in hand surgery was achieved the moment surgeons confined the major part of their activities to the treatment of this organ. But let us repeat that progress implies collaboration and not isolation. Advances highlighted in this review resulted mostly from collaboration between the laboratory and the operating theatre. It is worthwhile creating hand centres not only for the benefit of patients but also for research and for training surgeons. These centres must become places of collaboration between numerous clinical and preclinical specialities: namely orthopaedics, traumatology, plastic surgery, rheumatology, neurology, physiotherapy, and applicance makers, as well as biologists and anatomists, all applied to the reconstruction of the hand.

Finger Joint↗

Max Brödel (1870-1941) and medical illustration in urology.

PURPOSE: Max Brödel (1870-1941) is known as one of the major medical illustrators of the turn of the last century. Some important aspects of his biography and his influence on illustration in the specialty of urology are discussed. MATERIALS AND METHODS: The German artist Brödel was invited to The Johns Hopkins Hospital, Baltimore in 1894 and soon became a well-known illustrator in gynecology. He introduced new innovative art media, such as his carbon dust and stipple board technique to reproduce vivid tissue, while developing an instructive and didactic manner of medical illustration. He is also known as an anatomist and scientist, mainly for his description of an avascular area of the kidney (Brödel's bloodless line) and an improved method of nephropexy using a suture that he designed. RESULTS: In 1911 Max Brödel became head of the first Department of Art as Applied to Medicine, establishing the profession of medical illustration. In addition to some work for Hugh Hampton Young, his most important influence on urology was through his student William P. Didusch, who was a medical illustrator at the Brady Urological Institute in Baltimore for more than 40 years. CONCLUSIONS: Brödel changed the appearance of medical illustration at the beginning of the 20th century and improved its role in medical literature. Max Brödel should be referred to as the man who put art into medicine.

Germany↗

Non-pathology: the bedrock of pathology.

Pathology, also called morbid anatomy, is macroscopically, microscopically, and molecularly so manifest an array of phenomena that it has compelled medical men to closely link it up with disease, dis-ease, and death. But there is more than meets the eye of the morbid anatomists, microscopists, and the molecular biologists. The obvious science of pathology is governed by numerous abstract, subtle, non-pathological factors. A pathological phenomenon is subservient to cosmic noumenon. Such a sea-change allows a newer perspective that cures modern medicine of many of its dogmas and provides epistemologically valid directions to research methodologies on the one hand and clinical practices on the other.

Disease↗

[Medical photography and cinematography before 1914: privileged rapport with the neurosciences].

Arthur Van Gehuchten (1861-1914), Belgian anatomist and neurologist, professor at the Université catholique de Louvain, was an enthusiastic user of photography and a pioneer of medical cinematography. He used these techniques widely in order to illustrate his lectures, papers and his neurological textbook. His films and photographic plates are at the present time being studied and restored. The nitrate films are the oldest belgian films surviving. Neuroscientists have played a major role in the development of medical photography and cinematography and in the use of these techniques for clinical, research or didactic purposes.

Belgium↗

Medical illustration. The impact of photography on its history.

In this article, developed from an oral presentation given at the thirty-seventh annual meeting of the B.P.A. in August, 1967 and first published in 1968 in the Journal of the Biological Photographic Association, some of the important stepping stones in the evolution of medical illustration are looked at--from the anatomists and artists of the fourteenth and fifteenth centuries, through the introduction of the camera obscura in the eighteenth century, and on to the advent of photography.

Anatomy, Artistic↗

[Extrarenal salt excretion in oceanic birds].

Oceanic birds feed mainly on marine invertebrates which are isosmotic with sea water. The kidneys of birds have a low concentrating ability and are unable to produce urine with a sodium concentration more than 300mmol/l. How do these birds avoid dehydration? The excess salt is eliminated by the secretory work of a paired gland in the head known for centuries to anatomists as nasal glands or supraorbitary glands, and now that their function is elucidated called salt excreting glands or simply salt glands. They connect through a duct with the nasal cavity. Oceanic birds expel by the nares a clear and colourless watery liquid that contains primarily Na(+) and Cl(-), at high and constant concentration, with a small amount of K(+) and HCO(3)(-). These salt glands do not function continually as the kidney does, becoming active only in response to an osmotic load. The salt gland of oceanic birds is one of the most efficient systems of ionic transport in the living world.

Animals↗

[In memory of Galen--on the 1800th anniversary of his death].

In the year 1999 or 2000 it is the 1800th anniversary of Galen's death. He was one of the leading thinkers in medicine and one of the best known physicians of all times. He was not only a gifted practitioner but also a first class anatomist, physiologist, pathologist, and pharmacologist of the ancient times. His work is present in all these parts of medicine. This article gives Galen's biography and contributions to the above mentioned medical disciplines and practice. During fourteen centuries Galen's works were undisputable textbooks for students of medicine and most valuable manuals for practitioners besides the works of Hippocrates. Galen founded a new medico-philosophical school, based on that of Hippocrates, but comprising all medical knowledge of that time as well as his remarkable medical experience. While Hippocrates formulated the basis of the clinical medicine and the members of the Alexandria school made the most important discoveries in anatomy and physiology, Galen compiled all the knowledge of his predecessors, added a philosophical basis and created a unified system for centuries believed to be a definitive one where nothing should be added. Besides Hippocrates, Galen was the most outstanding physician of the ancient times and one of the greatest of all times. He established the fundamentals of the medical science which are still significant.

Greece, Ancient↗

Studies on agenesis of third molars amongst populations of different origin.

This study contains information on the occurrence of agenesis of one to four third molars among the population and ethnic groups of Europe, North America, Africa and Asia (Japan), based on the results of investigations carried out by dozens of authors. Recent discoveries have been supplemented with corresponding data concerning the skeletal remains of the jaws of individuals living from the ice age to the middle ages. The results show unbelievably large diversities as regards the frequency of agenesis of third molars in different populations from practically zero (Tasmania) to nearly 100% (Mexican Indians). This remarkable fact is not, however, the only reason why the problem of third molars remains a major concern for anthropologists, anatomists and stomatologists. Indeed, agenesis of third molars present only one of the most important anomalies which characterizes this tooth. It is necessary to look for the roots of the said variability in the remarkably complicated phylogenetic development undergone by the third molar from the time of our predecessors to the present day. Most of today's authors are of the opinion that although significant involution changes have occurred in third molars, that with the advent of hominization the number of teeth in individuals has stabilized at eight for every quadrant of dentition. For this reason it is not possible to regard agenesis of third molars as the manifestation of the phylogenetic reduction in the number of teeth, but as the developmental anomaly which is the result of a mutation and selection process based on heredity. The results are completed with an analysis of the value of agenesis of one to four third molars according to the individual quadrants and gender. A knowledge of these indicators is necessary in order to study the relationship between agenesis of third molars and hypodontia of the other teeth.

Biological Evolution↗

The other brother--a brief account of the life and times of Frederick John Knox LRCSEd.

This article examines the career of Frederick John Knox (1794-1873), who was the younger brother and erstwhile assistant of Robert Knox the anatomist. He was licensed by the Royal College of Surgeons of Edinburgh in 1831, and in 1840 he emigrated with his wife and family to New Zealand, becoming a significant figure in the scientific community of the infant settlement of Wellington.

General Surgery↗