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Identifier 000440694
Title Περιγραφική και ερμηνευτική προσέγγιση των νοσημάτων του αναπνευστικού συστήματος στην Ιπποκρατική Συλλογή
Alternative Title A descriptive and interpretive approach to respiratory diseases in the Hippocratic Collection
Author Στεφανάκης, Γεώργιος Ε.
Thesis advisor Ασκητοπούλου, Ελένη
Reviewer Παπαϊωάννου, Αλεξάνδρα
Τρομπούκης, Κωνσταντίνος
Τζανάκης, Νικόλαος
Τσιαούσης, Ιωάννης
Νύκταρη, Βασιλεία
Abstract There is no doubt that Hippocrates was the most important physician in the golden age of Pericles, the founder of medicine as a science, who freed it from the shackles of religion, magic and mischief. Historically, his name has been associated with the medical school of Kos, a school that emphasized the common nature of diseases, their prognosis, the overall body' systems’ derangement and issues of medical philosophy and ethics. A number of treatises known as "Hippocratic Collection" have been associated with the name of Hippocrates, although the authorship of many of them is under dispute. Within the context of the basic principles of approaching the patient and the disease, extensive reference is made to anatomy, physiology, clinical examination and diseases of the respiratory system in the treatises of the Hippocratic Collection. However, until nowadays there is no such systemic approach in the literature that explores whether the origins of the current medical concepts of respiratory diseases in the Hippocratic Collection. The aim of this study is the analysis and interpretation of respiratory diseases, as they are presented in the Hippocratic Collection, with a scope to map them and trace the origins of respiratory medicine. References to anatomy and physiology, acute and chronic diseases, respiratory symptoms and signs were used as criteria for inclusion in the study. The search for the relevant terms was initially conducted on the online digital library Thesaurus Lingua Graeca (TLG) of the University of California. The references found were then studied in the classic edition of the Hippocratic Collection, Loeb Classical Library (which includes both the ancient Greek text and its translation in English) as well as in the modern Greek translation of the Greek "Cactus" and "Zitros" editions. The search results were analysed in four sections: respiratory system terminology, clinical examination of the respiratory system, description of respiratory diseases, and interesting cases regarding the respiratory system. The search in the Hippocratic Collection of terms relating to the anatomy and physiology of the respiratory system revealed many terms still used, even under a different meaning. The function of respiration, which is the distinguishing feature of living beings, is described in full detail. According to this description, the air stream enters the brain and then it diffuses to other organs, while only a part of the initial air inflow ends up in the lungs. The Hippocratic quotes regarding respiratory diseases focus in particular on abnormal types of breathing, using a variety of different terms to describe them. The Hippocratic clinical examination of the respiratory system is based on inspection, auscultation, palpation and examination of sputum and pus. Inspection findings include the pattern of breathing, the appearance of the tongue and the "Hippocratic fingers". Auscultation is based both on the direct detection of existing abnormal sounds and on their production by the "Hippocratic method of shaking the patient". The clinical assessment of the respiratory system also includes the palpation of the texture of the tongue, the uvula and tumours, such as nasal polyps, and the examination of excreted material (sputum, pus) complete. The following respiratory diseases are presented in the study: otitis, rhinitis, nasal polyps, tonsillitis, staphylitis, inflammation of the oral cavity (palate and floor), angina, pneumonia, pleurisy, tuberculosis, pulmonary erysipelas, pulmonary varices, pulmonary oedema, tumours of lungs and ribs, pleural effusions and empyema. These diseases are analysed in full detail based on data on epidemiology, pathogenesis, diagnosis, treatment and prognosis. This analysis highlights their common principles in terms of pathogenesis –due to disequilibrium of the human body humours– and the clinical symptoms and signs. Treatment is multifactorial and individualised according to the case. Conservative management is based primarily on the enhancement of expectoration through laxatives and expectorants and baths. In case of its failure or in case of emergencies, invasive treatment methods, such as incision, cauterisation and securing the airway, are applied. Prognosis depends to a large extent on the course of expectoration –if it is unhindered, there is the possibility of cure, while if it stops, the formation of an empyema is likely to take place. The aforementioned basic principles are also documented in the cases analysed in the seven treatises of "Epidemics". These works include both descriptions of epidemic situations and recordings of individual cases, several of which could be among the earliest reports of timeless disease entities. These reports can be considered to correspond to the modern concepts of "case reports" and "case series". The Hippocratic Collection includes certain concepts that constitute the origins of the management of respiratory system diseases, through a holistic approach connecting both the upper with the lower respiratory system and the respiratory system with the rest of the body. Diagnosis is based on accurate observation and a high degree of clinical suspicion, while treatment is individualised and revised depending on the course of the disease, as an approach similar to evidence-based medicine would dictate. According to the principles of Hippocratic respiratory medicine it is possible to identify the origins of much later concepts, such as the concept of "theragnostics", which is based on a combination of diagnosis and targeted therapy. However, several Hippocratic medical concepts differ significantly from current views, the main examples being the rejection of the humoural doctrine and phlebotomies. However, this fact should not be used to diminish the impact of Hippocrates and the School of Cos on the subsequent medical progress, including the management of respiratory diseases.
Language Greek
Subject Hippocrates
Respiratory system
Αναπνευστικό σύστημα
Issue date 2021-07-30
Collection   School/Department--School of Medicine--Department of Medicine--Doctoral theses
  Type of Work--Doctoral theses
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