Inventing diagnosis : Theophilus' De urinis in the classroom

This paper shows how the two earliest Latin expositions of Theophilus' De urinis understood diagnosis in different ways. The «Chartres» commentator sees urine as a sign of physiological process and something which is derived from a disease state. By contrast, the Digby commentator is more concerned with how uroscopy functions at the bedside as a tool that enables us to infer disease states from urine. Though they understand the role of diagnosis differently, both commentaries reflect the new intellectual context of twelfth century medicine, where physical signs cease to be mere prognostic omens, and become tools for attaining knowledge of processes otherwise inaccessible to the senses

Salsamenta pictavensium: Gastronomy and Medicine in Twelfth-Century England

This article presents a collection of culinary recipes from a manuscript produced in England from the later twelfth century. The suite of ten recipes for ‘Poitou sauces’ or ‘Poitou relishes’ (salsamenta pictavensium—literally ‘of the Poitevins’) to garnish various kinds of meat, fish and fowl are introduced and analysed, with an appended edition and translation. These are, to date, the oldest extant medieval recipes for such sauces, and in their role as gastronomic enhancements, the earliest surviving medieval culinary recipes. The historical and cultural contexts for the recipes at Durham Cathedral Priory are explored: the nature of the community for whom the recipes were written, its choices of library acquisition, its relationships with the bishopric, and attitudes within the community towards food and medicine in a monastic setting. The Poitevin designation of the sauces is also considered. Above all the article investigates the question of the relationship between gastronomy and medicine in the twelfth century, and seeks to demonstrate that any distinction between medical and culinary recipes suggests a false dichotomy, particularly in the case of salsamenta. The authors argue against the position that medieval cuisine is, in its origins and essence, applied dietetics, and suggest that in the twelfth century salsamenta belonged in the first instance to gastronomy, but were in the process of being appropriated as medicines by the authors of the new literature of therapeutics

Biodegradable polyesters and low molecular weight polyethylene in soil: Interrelations of material properties, soil organic matter substances, and microbial community

Conventional and also biodegradable polymer microplastics have started to be broadly present in the environment, if they end up in soil, they may influence both abiotic and biotic soil properties. In this study, the interactions of polyethylene wax together with three biodegradable polyesters PLA, PHB and PBAT with a soil matrix were investigated over a 1-year incubation period. Soil organic matter content was measured using UV-VIS, the microbial biomass amount was measured using qPCR, the mineralisation of polymers was measured using UGA 3000, the surface of polymers was observed with SEM, live/dead microorganisms were determined by fluorescent microscopy and microbial consortia diversity was analyzed using NGS. The amount of humic substances was generally higher in incubations with slowly degrading polyesters, but the effect was temporary. The microbial biomass grew during the incubations; the addition of PHB enhanced fungal biomass whereas PE wax enhanced bacterial biomass. Fungal microbial consortia diversity was altered in incubations with PHB and PBAT. Interestingly, these two polyesters were also covered in biofilm, probably fungal. No such trend was observed in a metagenomic analysis of bacteria, although, bacterial biofilm was probably formed on the PE520 surface. Different methods confirmed the effect of certain polymers on the soil environment

Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial.

BACKGROUND: Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection. METHODS: In this multicentre, randomised, double-blind, placebo-controlled trial, adults (≥18 years) with S aureus bacteraemia who had received ≤96 h of active antibiotic therapy were recruited from 29 UK hospitals. Patients were randomly assigned (1:1) via a computer-generated sequential randomisation list to receive 2 weeks of adjunctive rifampicin (600 mg or 900 mg per day according to weight, oral or intravenous) versus identical placebo, together with standard antibiotic therapy. Randomisation was stratified by centre. Patients, investigators, and those caring for the patients were masked to group allocation. The primary outcome was time to bacteriologically confirmed treatment failure or disease recurrence, or death (all-cause), from randomisation to 12 weeks, adjudicated by an independent review committee masked to the treatment. Analysis was intention to treat. This trial was registered, number ISRCTN37666216, and is closed to new participants. FINDINGS: Between Dec 10, 2012, and Oct 25, 2016, 758 eligible participants were randomly assigned: 370 to rifampicin and 388 to placebo. 485 (64%) participants had community-acquired S aureus infections, and 132 (17%) had nosocomial S aureus infections. 47 (6%) had meticillin-resistant infections. 301 (40%) participants had an initial deep infection focus. Standard antibiotics were given for 29 (IQR 18-45) days; 619 (82%) participants received flucloxacillin. By week 12, 62 (17%) of participants who received rifampicin versus 71 (18%) who received placebo experienced treatment failure or disease recurrence, or died (absolute risk difference -1·4%, 95% CI -7·0 to 4·3; hazard ratio 0·96, 0·68-1·35, p=0·81). From randomisation to 12 weeks, no evidence of differences in serious (p=0·17) or grade 3-4 (p=0·36) adverse events were observed; however, 63 (17%) participants in the rifampicin group versus 39 (10%) in the placebo group had antibiotic or trial drug-modifying adverse events (p=0·004), and 24 (6%) versus six (2%) had drug interactions (p=0·0005). INTERPRETATION: Adjunctive rifampicin provided no overall benefit over standard antibiotic therapy in adults with S aureus bacteraemia. FUNDING: UK National Institute for Health Research Health Technology Assessment

The Book of the Head and The Book of Skin: Compilation and Decompilation in Two Medieval Manuscripts of Practical Medicine in the Osler Library, McGill University

Abstract Two fifteenth-century codices in the Osler Library illustrate processes of compilation and “decompilation” in the domain of medicine. MS 7586 contains selections from a comprehensive manual of therapeutics, but only from the section concerning the head. The text in MS 7579 is advertised as a general compilation of therapeutics in six parts; but only the first part, covering the skin and surgical interventions, is included. The first text is a decompilation; the second is a compilation-in-progress. Keywords: McGill University Osler Library MS 7579, McGill University Osler Library MS 7586, compilation, decompilation, medieval manuscripts, history of medicine, antidotes, medical recipes, surgery, cosmetics, Pantegni practica, Copiosa, Euporista, Rhazes, Liber ad Almansorem, Avicenna, Johannes Reglus   Résumé Deux codices du XIIe siècle conservés à la Bibliothèque Osler illustrent des processus de compilation et de « décompilation » dans le domaine de la médecine. MS 7586 comprend des extraits d’un manuel compréhensif de thérapeutique, mais seulement à partir de la section concernant la tête. Le texte de MS 7579, en revanche, est présenté comme une compilation générale de thérapeutique en six parties ; mais seule la première partie est inclue, portant sur la peau et les interventions chirurgicales. Le premier texte est une décompilation ; le second est une compilation en cours de préparation. Mots-clés : McGill University Osler Library MS 7579, McGill University Osler Library MS 7586, compilation, décompilation, manuscrits médiévaux, histoire de la médecine, antidotes, recettes médicales, chirurgie, cosmétique, Pantegni practica, Copiosa, Euporista, Rhazès, Liber ad Almansorem, Avicenna, Johannes Reglu