Tuberculosis: a timeless challenge for medicine

History of Medicine is not a discipline destined to culturally enrich only those who work in the health sector. All historians know very well how some medical events have influenced the course of history. In particular, infectious diseases, being interconnected with political, social, economic and war issues, have an important historical significance.Microbial agents are invisible enemies ready to undermine mankind and to find prosperity in human misery.Tuberculosis, better than other, is well suited to study the epistemological path of medical thought, from its origins to the present day.From the Hippocratic and Galenic thought to the anatomo-clinical method, from the advent of microbiology to the antibiotic era up to the postantibiotic era, recognizing the timeless need to implement valid social policies and effective preventive medicine actions to achieve satisfactory results

COVID-19 and Spanish flu-18: review of medical and social parallelisms between two global pandemics

The intrusion of infectious diseases in everyday life forces humans to reassess their attitudes. Indeed, pandemics are able catalyze rapid transitions in scientific knowledge, politics, social behaviors, culture and arts. The current Coronavirus diesease-19 (COVID-19) outbreak has driven an unprecedented interest toward the influenza pandemic of 1918. The issue is whether history can predict our best preventive response and future scenarios. The aim of this review is to highlight the parallelism between the two pandemics. Starting from epidemiology and clinical features, but further focusing on social and cultural issues, it is possible to unreveal great similarities. Their outbreak pattern lead to hypothesize a similar duration and death burden in absence of effective vaccines or innovative treatments for COVID-19. Thus, then as now, preventive medicine represents the first and most effective tool to contain the course of the pandemic; being treatments available only supportive. Contemporary, both pandemics shared the same pattern of narration (e.g. scapegoating) and the same impact on minorities in high-income countries. Furthermore, visual art did not wait to respond with Graffiti art playing in 2020 the role that Expressionism movement had during the Spanish flu and photography capable to document both catastrophic scenarios. Thus, it is possible to find a lot of clinical and social similarities between the two pandemics. Nevertheless, if the Spanish flu was not unforseen, COVID-19 spillover was partially predictable and its global impact will not be overshadowed by a major crisis such as World War I

Anatomical theatre place of Knowledge – the pivotal role of anatomist in its realization

Human anatomy dissection represented a cornerstone in the evolution of medicine and modern scientific thought. The anatomical theatres, some of which are considered true masterpieces of architecture, are the place where concretely men learned to know themselves with a scientific method. Anatomists had a pivotal role in the buildings of anatomical theatres, using their knowledge in the research process of more functional architectures for demonstrative and experimental science. Antonio Scarpa (1752-1832) is an emblematic figure in this scenario. He studied anatomy at the University of Padua in the oldest permanent anatomical theatre of the world, originate in 1594 from a joint project conceived by Paolo Sarpi, scientist and church reformer, and Hieronymus Fabricius Ab Aquapendente, anatomist. In 1772, Scarpa became professor at the University of Modena. Bearing witness to the architectural value of the theatre in Padua is the fact that in 1774 Scarpa, involved in the planning for an anatomical theatre in Modena, had the professor of surgery in Padua, Girolamo Vandelli, send him a wooden model of the theatre there. Another project, less expensive, was selected instead. Later, in 1783, Scarpa was made professor of anatomy at the University of Pavia and promptly he promoted the building of an anatomical theatre there. The building was concluded in 1785, its semicircular layout is modeled on ancient theatres and the Palladian Olympic Theatre of Vicenza. Today, most of the anatomical theatres are lost or forgotten. The Thesa project will provide a census of anatomical theatres, both survived and not, which will allow us to identify connections among them, among the anatomists who studied there and the mutual influences that characterize their form. We believe the achievement of these objectives defines the essential conditions necessary to regain full awareness of the value of anatomical theatres in both the academic and popular contexts, thus creating a fertile cultural basis for new initiatives that can continue the quest for knowledge undertaken in the past in these places. From an architectural and evocative perspective, they are and will remain places where man puts himself at the centre and at the same time observes himself

The avid eaters of lives. New and old infectious diseases in Italy at the time of World War 1: a historical overview of military medicine and public health

World War I bursted Italy from different perspectives. The one here described under an historical point of view reguards health of military and civil population, with a special focus on infective diseases. The 20th Century was the fuse of degeneration and eugenetics theories; which grew in the meliè of war and technological innovation. Indeed, war is interestingly depicted as an entity capable of blooming the differences between those who wore a uniform and those who do not. As a matter of fact, some infection spared the civilian population while others felt with greater vengeance on this subgroup. Moreover, the incidence of different feared diseases was brought back to the rates of the late 19th Century. Thanks to a statistician, Giorgio Mortara (1885-1967) the impact of infective diseases in Wolrd War I on Italian demography is well established. Moreover, different military and civilian contribute to enrich the picture of the consequences of war. In conclusion World War I could see considered as a litmus paper. The litmus paper of successes and failures of italian public health management to face new medical challenges exacerbated by the crisis

POVIJEST SIFILISA U XVI. STOLJEĆU I KLJUČNA ULOGA LUIGIJA LUIGINIJA U RENESANSI

...Syphilis is the prime example of a “new disease” which triggered a transnational (European) discussion among physicians. It appeared between the end of the Middle Ages and the beginning of the Modern Times (at the beginning of the sixteenth century), a time in which medicine was changing from a dogmatic to an experimental discipline. The main changes were in the field of anatomy: in 1543, the same year of the astronomy-disrupting work by Nicolas Copernicus, the new less dogmatic and more empirical approach to anatomy by Andreas Vesalius was published. Nevertheless, in the Renaissance, medicine remains a tradition-bound discipline, proud of its millennial history and its superiority over the empirical, non-academic healers. When syphilis appeared in Europe, several explanations were elaborated. In the mid-16th century, an Italian doctor Luigi Luigini (born in 1526) published in Venice a collection of all the works on syphilis that appeared until 1566. He wanted to entrust to colleagues, contemporary and future, a compendium of all that was known about the “new” disease (the Latin term Novus means both “new” and “strange”). According to the most authors of the collection, the disease is in fact “new” and “strange”. Some authors of the collection find it impossible that authorities like Hippocrates and Galen overlooked it. Luigini’s work shows the authors’ effort to absorb syphilis in the corpus of academic medicine and affirm the authority of academic physicians against the empirical healers.Sifilis je važan primjer “nove bolesti” koja je pokrenula transnacionalnu (europsku) raspravu među liječnicima. Bolest se pojavila između kraja srednjeg vijeka i početka modernog doba (početkom 16. stoljeća), u vrijeme u kojem se medicina iz dogmatske mijenjala u eksperimentalnu disciplinu. Glavne promjene dogodile su se na polju anatomije: u 1543., istoj godini u kojoj se pojavio rad Nikole Kopernika, koji je promijenio zakone astronomije, objavljen je novi, manje dogmatični i više empirijski pristup anatomiji u radu Andreasa Vesaliusa. Ipak, u renesansi medicina ostaje disciplina vezana uz tradiciju, ponosna na svoju tisućljetnu povijest i svoju superiornost nad empirijskim, neakademskim iscjeliteljima. Kada se sifilis pojavio u Europi, nekoliko je objašnjenja detaljno izloženo. Sredinom 16. stoljeća, talijanski liječnik Luigi Luigini (rođen 1526.) objavio je u Veneciji zbirku svih djela o sifilisu koja su se pojavila do 1566. Želio je prenijeti svojim suvremenicima i budućim kolegama sažetak svega što je bilo poznato o “novoj bolesti” (latinski pojam Novus znači i “novi” i “čudan”). Prema većini autora zbirke, bolest je “nova” i “čudna”. Neki autori čiji se radovi pojavljuju u zbirci smatraju nemogućim da su najveći autoriteti, poput Hipokrata i Galena, previdjeli tu bolest. Luiginijevo djelo pokazuje napor autora da uvrste sifilis u korpus akademske medicine i potvrde autoritet akademskih liječnika nasuprot empirijskih iscjelitelja

Gout in Duke Federico of Montefeltro (1422-1482): a new pearl of the Italian Renaissance

The article examines the truthfulness of historical accounts claiming that Renaissance Duke Federico of Montefeltro (1422-1482) suffered from gout. By direct paleopathological assessment of the skeletal remains and by the philological investigation of historical and documental sources, primarily a 1461 handwritten letter by the Duke himself to his personal physician, a description of the symptoms and Renaissance therapy is offered and a final diagnosis of gout is formulated. The Duke's handwritten letter offers a rare testimony of ancient clinical self-diagnostics and Renaissance living-experience of gout. Moreover, the article also shows how an alliance between historical, documental and paleopathological methods can greatly increase the precision of retrospective diagnoses, thus helping to shed clearer light onto the antiquity and evolution of diseases

Paolo Mascagni and Alessandro Moreschi: who discovered the vascular structure of urethra? Anatomy of an intellectual property dispute.

In the beginning of the XIX century, when both vascular and cellular texture theories concerning the penis structure were still coexisting, three figures were involved in the controversy about the priority of the discovery of the vascular nature of human erectile tissues: Paolo Mascagni (1755-1815), represented by his pupil Tommaso Farnese (1780-1829), and Alessandro Moreschi (1771-1826). In the Elogio del celebre anatomico Paolo Mascagni (1816), Farnese attributed to his mentor the demonstration in 1809 of the continuity between arteries and veins and the description of venous plexuses, this term replacing the previous and misleading name of spongy body attributed to the inner part of penis. But in 1817 Moreschi inflamed the dispute, claiming for the priority of that discovery, with the publication of his anatomical work and a polemical essay against Farnese. Farnese promptly replied with Note addizionali del Dottore Tommaso Farnese al suo elogio di Paolo Mascagni (1818), where he reported a meeting with Moreschi in Bologna in 1810. In that occasion, Farnese explained a Mascagni’s technique to perfuse urethral blood vessels that Moreschi would have plagiarized. Furthermore, Farnese also included eight testimonies claiming to have seen Mascagni performing such injections before 1810. The Prodromo della grande anatomia, a posthumous work of Mascagni edited in1819, includes a plate dedicated to the structure of the urethra and a comprehensive view of this scientific story. In short, Mascagni developed a technique to inject urethral blood vessels, but Moreschi was the first to publish an accurate work on this subject. For this reason, many Italian and international authors have attributed to the latter the discovery of the venous circulation of the urethra

Flaminio Rota: Fame and Glory of a 16th Century Anatomist without Scientific Publications

Academic activity is intrinsically composed of two aspects: teaching and research. Since the 20th century, the aphorism “publish or perish” has overwhelmingly established itself in the academic field. Research activity has absorbed more attention from the professors who have neglected teaching activity. In anatomical sciences, research has focused mainly on ultrastructural anatomy and biochemical aspects, far removed from the topics addressed to medical students. Will today’s anatomists be rewarded by their choice? To generate a forecast, we should entrust what history has already taught us. For this analysis, an example was taken, concerning the fate that history reserved for the anatomy teachers of the University of Bologna in the second half of the 16th century. Thanks to Vesalius (1514–1564), experimentation on the human body replaced the old dogmatic knowledge, and didactic innovation was one with research. Some figures were highly praised despite their poor scientific production. The present article focuses on the figure of Flaminio Rota, who was highly esteemed by his colleagues in spite of no significant scientific activity. Reasons for this paradox are examined. Then, history also whispers to us: publish, but without perishing in the oblivion of students

Flaminio Rota: Fame and Glory of a 16th Century Anatomist without Scientific Publications

Academic activity is intrinsically composed of two aspects: teaching and research. Since the 20th century, the aphorism “publish or perish” has overwhelmingly established itself in the academic field. Research activity has absorbed more attention from the professors who have neglected teaching activity. In anatomical sciences, research has focused mainly on ultrastructural anatomy and biochemical aspects, far removed from the topics addressed to medical students. Will today’s anatomists be rewarded by their choice? To generate a forecast, we should entrust what history has already taught us. For this analysis, an example was taken, concerning the fate that history reserved for the anatomy teachers of the University of Bologna in the second half of the 16th century. Thanks to Vesalius (1514–1564), experimentation on the human body replaced the old dogmatic knowledge, and didactic innovation was one with research. Some figures were highly praised despite their poor scientific production. The present article focuses on the figure of Flaminio Rota, who was highly esteemed by his colleagues in spite of no significant scientific activity. Reasons for this paradox are examined. Then, history also whispers to us: publish, but without perishing in the oblivion of students