Abandonment of terminally ill patients in the Byzantine era. An ancient tradition?
Our research on the texts of the Byzantine historians and chroniclers revealed an apparently curious phenomenon, namely, the abandonment of terminally ill emperors by their physicians when the latter realised that they could not offer any further treatment. This attitude tallies with the mentality of the ancient Greek physicians, who even in Hippocratic times thought the treatment and care of the terminally ill to be a challenge to nature and hubris to the gods. Nevertheless, it is a very curious attitude in the light of the concepts of the Christian Byzantine physicians who, according to the doctrines of the Christian religion, should have been imbued with the spirit of philanthropy and love for their fellowmen. The meticulous analysis of three examples of abandonment of Byzantine emperors, and especially that of Alexius I Comnenus, by their physicians reveals that this custom, following ancient pagan ethics, in those times took on a ritualised form without any significant or real content. (+info
Alexander Pope (1688-1744): his spinal deformity and his doctors.
Alexander Pope was the towering figure of 18th century England. A poet and a wit he commanded unswerving loyalty from his friends and penetrating hatred from his enemies. His spinal deformity, either due to tuberculosis, trauma or congenital weakness, shaped his career. This brief report highlights the illness and the medical men who were involved in treating Alexander Pope. (+info
Michelangelo: art, anatomy, and the kidney.
Michelangelo (1475-1564) had a life-long interest in anatomy that began with his participation in public dissections in his early teens, when he joined the court of Lorenzo de' Medici and was exposed to its physician-philosopher members. By the age of 18, he began to perform his own dissections. His early anatomic interests were revived later in life when he aspired to publish a book on anatomy for artists and to collaborate in the illustration of a medical anatomy text that was being prepared by the Paduan anatomist Realdo Colombo (1516-1559). His relationship with Colombo likely began when Colombo diagnosed and treated him for nephrolithiasis in 1549. He seems to have developed gouty arthritis in 1555, making the possibility of uric acid stones a distinct probability. Recurrent urinary stones until the end of his life are well documented in his correspondence, and available documents imply that he may have suffered from nephrolithiasis earlier in life. His terminal illness with symptoms of fluid overload suggests that he may have sustained obstructive nephropathy. That this may account for his interest in kidney function is evident in his poetry and drawings. Most impressive in this regard is the mantle of the Creator in his painting of the Separation of Land and Water in the Sistine Ceiling, which is in the shape of a bisected right kidney. His use of the renal outline in a scene representing the separation of solids (Land) from liquid (Water) suggests that Michelangelo was likely familiar with the anatomy and function of the kidney as it was understood at the time. (+info
The eye injury of King Philip II and the skeletal evidence from the royal tomb II at Vergina.
The Royal Tomb II was discovered in Vergina, Greece, in 1977. It contained a male skeleton and a rich array of grave goods. Evidence of trauma supposedly in the orbital bones of the skull has been thought to correspond to an eye injury that King Philip II is historically known to have suffered. However, reexamination of the orbital morphology showed no evidence of such pathology. Therefore, the skeleton does not belong to Philip II. New skeletal evidence shows that the skeleton belongs to King Philip III Arrhidaeus. In this case, the tomb may well contain some of the paraphernalia of Alexander the Great. (+info
Marcel Proust (1871-1922): reassessment of his asthma and other maladies.
Marcel Proust endured severe allergies and bronchial asthma from early childhood. Those who suffer from the frightening and recurrent pangs of asthma often become dependent on their parents particularly mother; Proust was no exception. In his time asthma was poorly understood by physicians who considered the illness to be a type of hysteria. Decades later, we now understand that the severe, poorly controlled, suffocating episodes of asthma were responsible for the complex persona that Marcel Proust had assumed. (+info
Effect of death of Diana, princess of Wales on suicide and deliberate self-harm.
BACKGROUND: The death of the Princess of Wales in 1997 was followed by widespread public mourning. Such major events may influence suicidal behaviour. AIMS: To assess the impact of the Princess's death on suicide and deliberate self-harm (DSH). METHOD: Analysis, using Poisson regression, of the number of suicides and open verdicts ('suicides') in England and Wales following the Princess's death compared to the 3 months beforehand, and the equivalent periods in 1992-1996. Similar analysis on DSH presentations to a general hospital. RESULTS: Suicides increased during the month following the Princess's funeral (+17.4%). This was particularly marked in females (+33.7%), especially those aged 25-44 years (+45.1%). Suicides did not fall in the week between the death and the funeral. Presentations for DSH increased significantly during the week following the death (+44.3%), especially in females (+65.1%). Examination of case notes suggested that the influence of the death was largely through amplification of personal losses or exacerbation of existing distress. CONCLUSIONS: The death of a major public figure can influence rates of suicidal behaviour. For DSH, the impact may be immediate, but for suicide it may be delayed. (+info
Machado de Assis's own writings about his epilepsy: a brief clinical note.
Machado de Assis's own writings about his epilepsy are here given. They come from his correspondence with his friend Mario de Alencar during the last 8 months of Machado de Assis's life. These are the only places where Machado de Assis dealt clearly with his epilepsy during his entire life. (+info
Deafness and liver disease in a 57-year-old man: a medical history of Beethoven.
Ludwig van Beethoven had a number of medical conditions, including deafness and chronic liver disease, for which there are contemporary descriptions. An autopsy was performed on the day after his death. Physicians and historians have tried to reinterpret original sources to determine the causes of his deafness and systemic illnesses. We have reviewed the differential diagnoses that have been proposed by otologists and physicians. Clinical and post-mortem findings point to renal papillary necrosis and liver cirrhosis of unknown aetiology. In the absence of further histological examination, there is no definitive answer to the cause of his deafness and gastro-intestinal symptoms. (+info