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CADUCEUS

Definition: It’s a winged rod, entwined by 2 snakes.

The rod was chosen because it was the first surgical instrument used to extract worms beneath the skin.

EVENTS RELATED TO THE CADUCEUS MEANING:

 Earlier than Greek age in Mesopotamia an ancient bowl of king Guda was found. Maybe this archaeological

find was used by Guda to carry out the functions of a priest, like a sort of primitive physician.

 In Egypt Anoubi, god of death, was associated to the Caduceus for the dark meaning linked to the 2 snakes

 In Greece Apollo fathered Ascelpio, the God of Medicine, who had 2 sons: Panacea and Hygeia, Goddess of

the Health. This last one became the God of Health in the Greek culture.

2 SNAKES

They symbolize intelligence, mystery, capacity of secreting poison, renewal, divinity, symbol of good and

evil.

People went to (the) Epidaurus temple (the greatest of Greece) to seek for their healing. Here snakes crept

in the temple while people was sleeping. These animals influenced guests’ dreams which were interpreted

by the priest, the day after.

In this period the doctor and the prophet figures start to be fused into the priest.

MYTH

“the end of plague in Rome” : two Greek snakes moved (travelled) to Rome from Epidaurus; when they

plunged into Tever and plague subdued (subsided).

The ages of medicine:

anatomy ( 16th century),

physiology (17th century),

–

pathology (18th 19th centuries),

genetics (our age).

VIP of History of Medicine

Hippocrates (460-370 BC)

–

Galen (129 210 AD)

- Lasting principles(a thousand years)

- Theory of humours

- Early development of anatomy

Avicenna (980-1037)

With the fall of Rome medical knowledge and traditions went to the East.

“Canon

The of Medicine” by Avicenna was translated into Latin by Costantine the African (a Benedictine

Monk).

The first school of Medicina was in Salerno.

Trotula was a woman attending at Salerno school.

Trotula de Ruggiero [1], conosciuta anche con il nome di Trottula, Trotta, Trocta o Troctula, stata un

è

medico italiano che, nel XI secolo, operò nell'ambito della scuola medica salernitana.

Mondino de Liuzzi (1300)

The first anatomical dissection was carry out in Bologna by Mondino de Liuzzi.

Mondino de' Liuzzi fu il primo anatomista che riprese la pratica delle dissezioni del corpo umano, che,

iniziata da Erofilo nel III secolo a.C., era stata abbandonata già dai suoi immediati successori (la Scuola

Medica Salernitana aveva ripreso lo studio dell'anatomia ma praticando solo dissezioni di animali).

L'esempio di Mondino fu imitato ben presto dagli anatomisti di Montpellier e poi da quelli delle altre

principali università europee. Guy de Chauliac, considerato il fondatore della chirurgia francese e, come

tanti, discepolo dell'ateneo bolognese, lo citerà nella sua Chirurgia Magna riconoscendolo quale Maestro di

Anatomia. –

Paracelsus (1493 1541): He was a Iatrochemist.

Iatrochemistry (or chemiatry) is a branch of both chemistry and medicine. Having its roots in alchemy,

iatrochemistry seeks to provide chemical solutions to diseases and medical ailments.

Vesalius (1500): in his book images are more important than the text itself and it’s a paradox.

Renaissance coincides with scientific revolution.

There is the spread of information by means of press.

–

Napoleon Bonaparte (15 August 1769 5 May 1821).

He built up military hospital.

In the 16th-century Europe medical practitioners in army and university settings began to gather

information on cause and manner of death.

Ambroise Paré (1530), a French army surgeon, systematically studied the effects of violent death on

internal organs. He is considered one of the fathers of surgery and modern forensic pathology and a

pioneer in surgical techniques and battlefield medicine, especially in the treatment of wounds. He was also

an anatomist and invented several surgical instruments. Paré also introduced the ligature of arteries

instead of cauterization during amputation. The usual method of sealing wounds by searing with a red-hot

iron often failed to arrest the bleeding and caused patients to die of shock.

Two Italian surgeons, Fortunato Fidelis and Paolo Zacchia (1600), laid the foundation of modern pathology

by studying changes that occurred in the structure of the body as the result of disease.

In the late 18th century, writings on these topics began to appear. These included A Treatise on Forensic

Medicine and Public Health by the French physician Fodéré and The Complete System of Police Medicine by

the German medical expert Johann Peter Franck.

Laennec (1816): Lo stetoscopio fu inventato in Francia nel 1816 da René-Théophile-Hyacinthe Laennec. Si

narra che l'ispirazione gli venne utilizzando un quaderno arrotolato, per percepire i battiti cardiaci

appoggiando l'orecchio.

Simon: (“vecsius”??) social, epidemiology, prevention. (???) NON RIESCO A TROVARE ULTERIORI

INFORMAZIONI, DA COMPLETARE!!

Theurgy: temples as healing places.

It describes the practice of rituals, sometimes seen as magical in nature, performed with the intention of

invoking the action or evoking the presence of one or more gods, especially with the goal of uniting with

the divine, achieving henosis, and perfecting oneself.

Il valetudinarium era l'ospedale in epoca romana, il cui significato derivava dal termine latino valetudo,

ovvero "buona salute". Furono costruiti lungo l'intero limes fin dal tempo dell'imperatore Augusto, quali

ospedali militari all'interno di ciascun castrum legionario o ausiliario.

Infirmary: A place where sick or injured people are cared for, especially a small hospital; sickhouse.

th th

The 12 and 14 centuries

The age of first epidemics and pandemics.

http://dsc.discovery.com/tv-shows/curiosity/topics/10-worst-epidemics.htm

These disease have marked a cultural shift in the history of mankind:

Smallpox / vaiolo

The 1918 flu

The black death 1348

Malaria

Tuberculosis Phthisis

Cholera 1848

AIDS 1980 –

Yellow virus Yellow Jack

Typhus epidemic 1600

Jaundice / itterizia

Polio

Type of medicine

Holistic Medicine

Holistic medicine is a system of health care which fosters a cooperative relationship among all those

involved, leading towards optimal attainment of the physical, mental emotional, social and spiritual aspects

of health.

It emphasizes the need to look at the whole person, including analysis of physical, nutritional,

environmental, emotional, social, spiritual and lifestyle values. It encompasses all stated modalities of

diagnosis and treatment including drugs and surgery if no safe alternative exists. Holistic medicine focuses

on education and responsibility for personal efforts to achieve balance and well being.

The more we go in depth in medicinal known, the less we can see the patient as an all.

Bedside Medicine medicina assistenziale, dell’intero paziente (??)

Library medicine: Medicina scientifica

Osmolality, Osmolarity and Fluid Homeostasis

This PatientPlus article is written for healthcare professionals so the language may be more technical than

the condition leaflets. You may find the abbreviations list helpful.

In the steady state, our total body water content and salt content remain constant. An increase or

decrease in water and salt intake is paralleled by an equivalent change in renal water and salt excretion.[1]

Homeostasis is achieved through the process of glomerular filtration of plasma to produce an ultrafiltrate.

The tubules then process this ultrafiltrate so that the final urine flow rate and solute excretion meet the

homeostatic needs of the body.

Osmolality and osmolarity are measurements of the solute concentration of a solution. In practice, there is

negligible difference between the absolute values of the different measurements. For this reason, both

terms are often used interchangeably, even though they refer to different units of measurement.[2]

Osmolality

Osmolality is an estimation of the osmolar concentration of plasma and is proportional to the number of

particles per k ilogram of solvent; it is expressed as mOsmol/kg (the SI unit is mmol/kg but mOsmol/kg is

still widely used). This is what is used when values are measured by a laboratory. Osmolality is measured by

clinical laboratories using an osmometer - either a freezing point depression osmometer or a vapour

pressure depression osmometer. The normal osmolality of extracellular fluid is 280-295 mOsmol/kg.

Osmolarity

Osmolarity is an estimation of the osmolar concentration of plasma and is proportional to the number of

particles per litre of solution; it is expressed as mmol/l. This is what is used when a calculated value is

derived.

It is derived from the measured Na+, K+, urea and glucose concentrations. The osmolarity is unreliable in

various conditions - eg, pseudohyponatraemia such as hyperlipidaemia in nephrotic syndrome, or

hyperproteinaemia.

The following equations can be used to calculate osmolarity:

Calculated osmolarity = 2 (Na+) + 2 (K+) + Glucose + Urea (all in mmol/L). OR Calculated osmolarity = 2

(Na+) + Glucose + Urea (all in mmol/L).

The doubling of sodium accounts for the negative ions associated with sodium and the exclusion of

potassium approximately allows for the incomplete dissociation of sodium chloride.

The term osmolarity has largely been superseded by osmolality, even when discussing calculated values.

Osmolality is used for the rest of this article.

Osmotic gap

The osmotic gap (also called osmolal gap) is an arbitrary measure of the difference between the actual

osmolality (measured by the laboratory) and the calculated osmolality. It is normally less than 10-15

mOsmol/Kg (see local laboratory for range). Where the osmotic gap is increased, it indicates the presence

of other osmotically active solutes which are not taken into account in the calculated osmolality - eg, in

methanol or ethylene glycol ingestion.

Clinical relevance of osmolality

As cell membranes in general are freely permeable to water, the osmolality of the extracellular fluid (ECF) is

approximately equal to that of the intracellular fluid (ICF). Therefore, plasma osmolality is a guide to

intracellular osmolality.

This is important, as it shows that changes in ECF osmolality have a great affect on ICF osmolality - changes

that can cause problems with normal cell functioning and volume (may even induce cytolysis).

 In normal people, increased osmolality in the blood will stimulate secretion of antidiuretic hormone

(ADH). This will result in increased water reabsorption, more concentrated urine, and less

concentrated blood plasma. Diabetes insipidus is a condition caused by hyposecretion of, or

insensitivity to, the effects of ADH. Elevation may be associated with stroke mortality.

 A low serum osmolality will suppress the release of ADH, resulting in decreased water reabsorption

and more concentrated plasma