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Biomedical subjects

Axel Karenberg

Publications and source records attributed to Axel Karenberg.

16 recordsLinked to original sources
PubMed2006

Dementia in the Greco-Roman world.

Greek and Roman physicians developed distinct and detailed ideas, which can be regarded as early versions of our modern concept of dementia. Several classical sources--some of them medical--offer intriguing descriptions of many cognitive and behavioral symptoms in dementia, which are currently used for diagnostic purposes. Limitations of this ancient concept are due to terminological and epidemiological factors, but also to the physicians' social role. Only a small part of this early literature is cited in contemporary work on the origin of the dementia concept, which can be clearly traced back to the Age of Enlightenment and whose earlier history still needs to be elucidated.

Aging↗
PubMed2006

Hallucinations in Parkinson disease in the prelevodopa era.

Whether chronic hallucinations belong to the natural history of untreated Parkinson disease (PD) remains undetermined. For early authors such as Gowers or Charcot and his followers, hallucinations that occurred in the course of PD either accompanied the final phase of the disease or reflected comorbidities. However, a few authors observed that hallucinations could occur in PD patients with severe depression, confusion, or dementia. Interest in hallucinations with parkinsonism increased with the outbreak of von Economo encephalitis, as they were more frequent than in PD, provoking new pathophysiologic questions. Later studies on mental symptoms in parkinsonism were often based on series that pooled patients with PD and postencephalitic syndromes, confounding a clear analysis. It remains difficult to estimate the prevalence of hallucinations in the natural course of PD before the introduction of levodopa therapy. The lack of prospective studies, the wide early use of anticholinergics and ergots compounds, and the absence of dementia with Lewy bodies in the nosology of the time are further limitations. Even with these limitations, historical descriptions of PD from the prelevodopa era suggest that hallucinations may be part of PD itself, especially in the context of late dementia, depression, or nonspecific encephalopathy.

Affective Symptoms↗
PubMed2005

The catheter and its use in late antiquity and the early middle ages.

PURPOSE: Based on Greek and Latin sources the use of the urinary catheter in Western medicine between 200 and 1000 CE was reviewed. MATERIALS AND METHODS: Computerized databank searches permitted the identification and analysis of ancient and early medieval texts that include material on the catheter. RESULTS: Ten medical authors mentioned the catheter and its use. In the Byzantine world they include the encyclopedists Oribasius, Aetius and Paul of Aegina. The best known Latin author is Caelius Aurelianus. These writers often put together summaries of earlier works. Innovation or independent research was not easily found at a time during which neither anatomical autopsy nor experimentation was widely practiced. CONCLUSIONS: Old texts contain numerous instructions on how to skillfully use the catheter. As a technical achievement, it was independent of philosophical trends. Its primary indications, namely urinary retention, bladder stones and the administration of cures, changed little with time. As one of the oldest and most important instruments at the disposal of physicians, the history of the catheter should be known to every urologist.

Byzantium↗
PubMed2005

The catheter and its use from Hippocrates to Galen.

PURPOSE: We comprehensively reviewed the history and use of the bladder catheter in Western medicine from 500 BC to 200 AD. MATERIALS AND METHODS: Greek and Latin texts were key word searched to identify descriptions of contemporary instruments and their uses. RESULTS: The catheter and its use were mentioned by about 10 ancient authors in more than a total of 20 texts dating to the end of the second century AD. The authors include Hippocrates, Celsus, Soranus, Rufus, Aretaeus and Galen. They described the use of the instrument in reference to contemporary anatomy and physiology, and indications and contraindications in regard to certain conditions, such as urinary retention, bladder stones and intravesical blood clots. Technical details and particularities of use were also reviewed, as were pharmacological considerations and underlying physical principles. CONCLUSIONS: Knowledge of the urinary catheter, and its usefulness and risks in ancient medicine can be dated from the 5th century BC. Our study of European texts documents its broad use. Because catheterization was perceived as a practical measure, it generated little scientific controversy.

History, Ancient↗
PubMed2004

[A report of St. Bonaventura in the mirror of the history of neurology].

Ancient and medieval literature contain few case reports of specific syndromes. But there is no lack of such accounts in theological literature, with its long tradition of gathering and documenting individual case studies involving miracle cures--a practice which stretches from the ancient sanctuaries of Asclepius to today's places of pilgrimage. Among the many miracles attributed to St. Francis, complied around 1260 by his biographer, St. Bonaventura, is the case of a young monk afflicted by a sudden hemiplegia accompanied by aphasia and mental confusion. According to legend, he was miraculously and completely healed by the appearance of St. Francis. The report can be interpreted from a number of different approaches: medical, theological, literary or even autobiographical. Neurologists may treat this "case history" as an early description of a "prolonged ischaemic neurological deficit" (PRIND).

Aphasia↗
PubMed2003

St. Francis came at dawn--the miraculous recovery of a hemiplegic monk in the Middle Ages.

We present the English translation of a remarkable case report from the 13th century. A collection of miracles ascribed to St. Francis contains the story of a young monk suddenly afflicted by a neurological disorder characterized by hemiplegia, speech problems and confusion. St. Francis' appearance led to complete recovery. From a theological and literary point of view, the text includes many allusions to the miracles performed by Jesus and to pagan traditions from Asclepius to Ovid. Retrospective neurological diagnoses range from a prolonged ischemic neurological deficit (PRIND) to psychogenesis. This case history is a rare example of faith healing in its contemporary context.

Christianity↗
PubMed2003

Between horror and hope: gladiator's blood as a cure for epileptics in ancient medicine.

Between the first and the sixth century a single theological and several medical authors reported on the consumption of gladiator's blood or liver to cure epileptics. The origins of the sacred or apoplectic properties of blood of a slain gladiator, likely lie in Etruscan funeral rites. Although the influence of this religious background faded during the Roman Republic, the magical use of gladiators' blood continued for centuries. After the prohibition of gladiatorial combat in about 400 AD, an executed individual (particularly had he been beheaded) became the "legitimate" successor to the gladiator. Occasional indications in early modern textbooks on medicine as well as reports in the popular literature of the 19th and early 20th century document the existence of this ancient magical practice until modern times. Spontaneous recovery of some forms of epilepsy may be responsible for the illusion of therapeutic effectiveness and for the confirming statements by physicians who have commented on this cure.

Blood↗
PubMed2003

[Saints as protectors against falling sickness].

In Christian Europe of the High Middle Ages, saints played a central role in the everyday life of the ailing. Alongside healing attempts which involved magic and/or scientifically-based medicine, the invocation of specific patron saints for protection against evils or for the curing of ailments was a widespread practise. A large choice of patron saints was "ävailable" for a wide range of diseases, especially those nowadays classified as neurologic or psychiatric. For the falling sickness alone, e.g., there is evidence of some twenty patron saints reputed to have a particular involvement. Surprisingly, there is no evidence of a comparable devotion to patrons for apoplectics. This "negative result"is confirmed by a thorough examination of medieval sources. St. Wolfgang and St. Andreas Avellino are the only two proven stroke patrons. Both, however, were only known within their respective locations. The absence of a specific supportive Christian figure for stroke victims deserves particular analysis: The high fatality rate of apoplexy and the lack of commercial interest on the part of the Christian places of pilgrimage may serve as possible explanations.

Disease↗
PubMed2003

[The death of emperor Valentine I in the descriptions of Ammianus Marcellinus and other authors].

The history of neurology, especially before 1800, has been treated almost completely as "literary history". Most interest centred around the works of famous physicians and their writings. Especially in the classical era, non-medical testimonies have received little attention. This makes it a particularly pleasant surprise for a medical histroical in search of such material to come across a description of a "neurological illness" in a history book from ancient times. 'Rerum gestarum libri' by Ammianus Marcellinus, the last Roman historiographer of note, gives a fairly descriptive account of the fatal illness of Emperor Valentine I (30, 6, 1-6). Valentine was suddenly taken ill with apoplectiform symptoms during a campaign in Pannonia in 375 AD. He died few hours later, despite the attempts of a physician quickly brought to the scene. The account of Ammianus Marcellinus combines literary features with a clear interpretation of medical symptoms according to contemporary doctrines. This description was later to become a model for non medical references and commentaries dealing with this "famous case", written by Christian authors including Orosius, St. Jerome, Socrates and the pagan historian Zosimos.A retrospective diagnosis of Valentine's last disease is difficult. It is impossible to prove that he really died from a stroke. Death by infectious disease might also be supposed. Finally, similar symptoms can be found in the case of the Emperor Claudius, who was poisoned by his last spouse in Agrippina in 54 AD. Our study is an attempt to analyse this very important case report from a medical, historical and cultural perspective, thus contributing to the historiography of "neurology in the ancient world".

Cause of Death↗
PubMed2002

Toxicology in the Old Testament. Did the High Priest Alcimus die of acute aconitine poisoning?

The Bible contains several interesting contributions to the history of neurology, as is the case of the High Priest Alkimos, who died suddenly in 159 BC. He was regarded as a stereotypical stroke victim for a long time. The reports on his death in the Septauginta and the later 'Jewish Antiquities' of Flavius Josephus present some typical symptoms of stroke (collapse, loss of speech and death within a short time), but they also describe severe pains, which are very unusual among patients with stroke. Similar symptoms can be found in the case of the Roman emperor Claudius, who was poisoned by his spouse Agrippina. It was thought that she used aconitine, an ingredient of the monkshood plant (Aconitum napellus L.), which imitates an apoplectic insult, but also causes vehement pains. It was therefore possible that something similar had happened to Alkimos, as aconitine was a common poison in ancient times and the surroundings of his death may confirm the suspicion. Reigning during a time of great upheaval, Alkimos was able to maintain his high office chiefly because of the help of the Seleucides. He has just begun construction work on the temple of Jerusalem, an order, which was regarded as a sacrilege by his foes. This impression was enhanced by his subsequent illness which could be considered as a divine punishment.

Aconitine↗