Asclepieia in ancient Greece: pilgrimage and healing destinations, the forerunner of medical tourism

Asclepios, the first physician-demigod in Greek mythology, was born in Thessaly of the God Apollo and Coronis, a mortal mother. Asclepieia were healing sanctuaries dedicated to Asclepios. Asclepieia were located throughout the Eastern Mediterranean area, in ancient Greece and the Roman world. Travelers from all over the Mediterranean area seeking healing made pilgrimages to the Asclepieia, the early forerunner of "medical tourism".

Hippocrates: A Pioneer in Orthopaedics and Traumatology

PURPOSE

Hippocrates, the ancient Greek physician, is considered the father of Medicine; however, his contributions to Orthopaedics and Traumatology have not been highlighted enough. The present historical review represents an effort to present and categorize his work, in this field, per clinical disorder and anatomical region.

METHODS

The "Hippocratic Corpus" original text was thoroughly studied to identify all Hippocrates' contributions in Orthopaedics and Traumatology. Volume III of his works, especially "On Fractures", "On Joints", and "Mochlicon" includes a plethora of information regarding the management of traumas, as well as other disorders and clinical entities of the musculoskeletal system.

RESULTS

In particular, Hippocrates describes reduction techniques for fractures, as well as joint dislocations, elaborates on the biology of the fractures' healing process and the basic principles of fracture management and fixation, presents the signs and symptoms of gangrene, teaches the treatment of osseous infections and offers valuable insight on the biomechanics and treatment of spinal diseases.

CONCLUSIONS

Hippocrates' contributions in Orthopaedics and Traumatology are unprecedented, making him a true pioneer in this field, while the basic principles that he presented were further studied and confirmed in the 19th and 20th centuries.

The Evolution of Orthopaedics in Greece: From Ancient Heritage to Modern Times

Greece, one of the oldest civilizations of the world, fundamentally contributed to the establishment and evolution of medicine and surgery. Undoubtedly, the foundations of the orthopaedic science are dated back to antiquity. The journey of the orthopaedic art was inaugurated with the poems of Homer and incarcerated through the practices of Hippocrates and Galen. Their deep knowledge of the musculoskeletal conditions and their treatment was generously bequeathed to humanity. This heritage acted as the catalyst for the establishment of orthopaedics in the modern Greek era. In this article, we tried to illustrate the evolution of the orthopaedic art in Greece from antiquity to modern times, reviewing the available evidence from scientific articles, books, historical manuscripts, old newspapers, and biographies. We summarize the most important events, and we identify the pioneers that shaped this new surgical branch, creating the modern Greek orthopaedic discipline.

Pheidias Apollonius (ca. 4th century BC), unveiling the ancient Greek medico-philosophical school of the island of Rhodes

The ancient Greek medico-philosophical school of the island of Rhodes was lost in the fog of history. However, the discovery of a stone column dedicated to Pheidias unveiled somehow some parts of its tale. The Island of Rhodes became in the 4th century BC a place of significant process in philosophy and medicine. Having both an Asclepieion and a Medical School with a rich library, the Rhodian Asclepiades transmitted their knowledge to future schools. Pheidias Apollonius was a member of the School of Rhodes, who was celebrated for his practise by the city-state of Athens. His magnitude testified in a way the supremacy of the school that he originated from.

The Hippocratic Method of Surgical Cauterization for the Tumescence Spleen in the Rare "Spetses Syndrome"

Spleen in antiquity was considered by the Hippocratic medicine as a viscerous organ of spongy character, which could clear human body of the black bile. According to the Hippocratic doctrine of the 4 humors, black bile could cause a series of diseases. Both the anatomical position and shape of the spleen were also recognized. In the case of a splenic hardening, with simultaneous augmentation of its dimensions and dermal ulceration and/or splenic abscess, some interventions were proposed. Thus, herbal medicine, phlebotomy, and minimal surgery with local cauterization were applied for treatment, to confront a disease that was considered serious but not fatal. The Hippocratic physicians encountered various spleen diseases and among them they most probably confronted a rare splenic pathological entity, named centuries later as "Spetses syndrome," a rare type of thalassemia of the Spetses island of Saronikos Gulf. Although the approach seems in modern terms rather primitive, the ancient Greek medico-philosophers most likely understood the significance of the spleen.

Hippocrates (ca 460-375 bc), Introducing Thoracotomy Combined With a Tracheal Intubation for the Parapneumonic Pleural Effusions and Empyema Thoracis

Hippocrates was the first physician to describe in accuracy pleural effusion and pneumonia. To treat empyema thoracis he had introduced a combined method of tracheal intubation with a simultaneously thoracotomy. The surgical incision was used for the pus to be progressively drainaged. If the patient was too weak to eat, he had suggested for nutritional mixtures to be administered through an oral-gastric tube. Thus Hippocrates composed in his operating theatre, an icon similar to modern surgical operations.

Ammonius Lithotomos (3rd Century BC), the Alexandrian Innovative Surgeon Who Introduced Lithoclastic Cystotomy

Alexandrian surgeon Ammonius Lithotomos, was the first to introduce lithoclastic cystotomy during the 3rd century BC in order to relieve a bladder's stone blockage. He had used a metallic hook or crotchet to remove the stone, which was named at the era "thrombus" of the urinary tract.

Hecamede: Homeric nurse of the battle-wounded in the Trojan War

The Homeric epics present the 10-year lasting Trojan War, offering the description of battle wounds and medical care of injuries. Hecamede is referred by the Homer as a battlefield nurse who had knowledge of the treatment of bleeding battle wounds.