Series VI: Medical Sciences – SUPPLEMENT ... - Krongres

BULLETIN OF THE 

TRANSILVANIA UNIVERSITY 

OF BRASOV 

Vol. 2 (51) – 2009 

Series VI 

Series VI: Medical Sciences 

– SUPPLEMENT – 

PROCEEDING OF THE IV TH BALKAN 

CONGRESS OF 

HISTORY OF MEDICINE 

ISSN IS N 2065-2224 2065 2224

TRANSILVANIA UNIVERSITY OF BRAŞOV 

BULLETIN 

OF THE 


OF 

BRAŞOV 

VOL. 2 (51) – SERIES VI 

ISSN 2065-2224 

Special Issue No.1, 2009 

THE IV-TH BALCAN CONGRESS OF 


October 2009 

BRAŞOV, ROMANIA 

Published by 

Transilvania University Press 

Braşov, Romania 

2009 

Volume 1

Bulletin of the Transilvania University of Braşov. Series VI: Medical Sciences. Vol. 2 (51), 2009. 

ISSN 2065-2216 printed version; 

ISSN 2065-2224 CD-ROM version 

continues 

Bulletin of the Transilvania University of Braşov. Series VI: Medical Sciences. Vol. 1 (50), 2008. 

ISSN 2065-2216 printed version; 

ISSN 2065-2224 CD-ROM version 

and 

Bulletin of the Transilvania University of Braşov. Series B3. 

Vol. 14 (49), 2007. ISSN 1223-964X printed version. 

EDITORIAL BOARD 

Editor in Chief 

Ion VIŞA, Dr.Eng., Prof. 

Co-editors: 

Elena HELEREA, Dr.Eng., Prof. 

Anca DUŢĂ, Dr.Eng., Prof. 

Liliana ROGOZEA, MD, PhD, Prof. 

Coordinating Editor Series VI 

Gheorghe COMAN, PhD, Prof. chem. 

Editorial Assistant: 

Mihaela BADEA, PhD, Assoc. Prof. chem 

Nicusor Bagiu, M.D., Assist 

English Language Supervision 

Lucian RADU, Lecturer 

Web-site: http://but.unitbv.ro/BU2009 

Address: 29, Eroilor st., 500036, Braşov, Romania 

Phone: +40-268-410525 

E-mail: rector@unitbv.ro 

© All rights reserved

SCIENTIFIC COMMITTEE 

Assoc. Prof. chem. Mihaela BADEA, Ph.D., Transilvania University of Brasov, Romania 

Prof. Salem ABDEL-BADEEH, Ph.D., Ain Shams University, Cairo, Egypt 

Prof. Dr. Doina Paula BALABAN, PhD., Ovidius University of Constanta, Romania 

Prof. Cristina BORZAN, M.D., Ph.D., UMF Iuliu Haţieganu, Cluj-Napoca, Romania 

Prof. Sorin BUZINSCHI, M.D., Ph.D., Transilvania University of Brasov, Romania 

Dr. Daniel CATALAN, European Center for Disease Prevention and Control 

Prof. chem. Gheorghe COMAN, Ph.D., Transilvania University of Brasov, Romania 

Prof. Nina Micosa CADIZ, Ph.D., University of the Philippines Los Banos, Philippines 

Prof Dan Mircea CHETA, MD, Ph.D., UMF Carol Davila, Bucharest, Romania 

Assoc. Prof. Carmen DOMNARIU, M.D., Ph.D., University Lucian Blaga, Sibiu, Romania 

Prof. Alin CUCU, M.D., Ph.D., Transilvania University of Brasov, Romania 

Prof. Dan DUMITRASCU, M.D., Ph.D., UMF Iuliu Hatieganu, Cluj-Napoca, Romania 

Prof. Leonida GHERASIM, M.D., Ph.D, UMF Carol Davila, Bucharest, Member of Romanian 

Academy, Romania 

Prof. Ove HELLZEN, Ph.D., Faculty of Health Sciences, Norway 

Prof. Kornelia HELEMBAI, Ph.D., University of Szeged, Hungary 

Prof. Teodor LEASU, M.D., Ph.D., Transilvania University of Brasov, Member of the World Academy 

of Medicine, Romania 

Prof. Roger Maurice LEBLANC, Ph.D., University of Miami, USA 

Prof. Peter MANU, Ph.D., Albert Einstein College of Medicine, New York, USA 

Prof. Jean-Louis MARTY, Ph.D., Universite de Perpignan via Domitia, France 

Prof. Dan MINEA, M.D., Ph.D., Transilvania University of Brasov, Romania 

Prof. Aurel MIRONESCU, M.D., Ph.D., Transilvania University of Brasov, Romania 

Prof. Nicolae MIU, M.D., Ph.D., UMF Iuliu Hatieganu, Cluj-Napoca, Romania 

Assoc. Prof. Marius MOGA, M.D., Ph.D., Transilvania University of Brasov, Romania 

Prof. Ioana MOISIL, Ph.D., University Lucian Blaga, Sibiu, Romania 

Prof. Dimitrie NANU, M.D., Ph.D., UMF Carol Davila, Bucharest, Romania 

Assoc. Prof. Laurenţiu NEDELCU, M.D., Ph.D., Transilvania University of Brasov, Romania 

Prof. Dr. Marian NEGUŢ, M.D., Ph.D., UMF Carol Davila, Bucharest, Romania 

Prof. Codruta NEMET, M.D., Ph.D., Transilvania University of Brasov, Romania 

Prof. Gilvanda Silva NUNES, Ph.D., Federal University of Maranhao, Brasil 

Prof. Lazar ONISÂI, M.D., Ph.D., Transilvania University of Brasov, Romania 

Assoc. Prof. Candan OZTURK, Ph.D., Dokuz Eylul University, Turkey 

Prof. farm. Honorius POPESCU, Ph.D., UMF Iuliu Haţieganu, Cluj-Napoca, Member of the 

“Academie Internationale d’Histoire de la Pharmacie”, Romania 

Assoc. Prof. Mariusz PUSZCZEWICZ, M.D., Ph.D., Poznan University of Medical Science, Poland 

Prof. Mariana RADOI., M.D., Ph.D., Transilvania University of Brasov, Romania 

Assoc. Prof. Patrizia RESTANI, Ph.D., Universita degli Studi di Milano, Italy 

Prof. Ilia REUBEN, M.D., Ph.D., Ben Gurion University of the Negev, Israel 

Prof. Liliana ROGOZEA, M.D., Ph.D., Transilvania University of Brasov, Romania 

Prof. Iosif SAMOTA, M.D., Ph.D., Transilvania University of Brasov, Romania 

Prof. Erich SORANTIN, M.D., Ph.D., Medical University Graz, Austria 

Assoc. Prof. Claudia STIHI, Ph.D., Valahia University of Târgovişte, Romania 

Assoc. Prof. Mihaela IDOMIR, MD., Ph.D., Transilvania University of Brasov, Romania 

Prof. Caius ZAMORA, MD., Ph.D., UMF Iuliu Haţieganu, Cluj-Napoca

Conference Organizing Committee 

- Liliana Rogozea 

- Nicolae Marcu 

- Mariana Rădoi 

- Teodor Leaşu, 

- Gabriel Moraru, 

- Botezatu Maria 

- Curesciuc Cerasela 

- Manolachescu Doina 

- Dorina Popa 

- Leaşu Florin, 

- Corina Derczeni, 

- Adrian Rotaru, 

- Geta Miron, 

- Nemet Codruţa, 

- Mihai Ţurcanu, 

Scientific Conference Committee: 

- Philippe Albou - (France) 

- Miladin Apostolov (Bulgaria) 

- Dana Baran (Romania) 

- Gheorghe Bratescu - (Romania) 

- Victoria Burtea - (Romania) 

- Nicolae Constantin -(Romania) 

- Aysegül Demirhan Erdemir (Turkey) 

- Athanassios Diamandopoulos (Greece) 

- Daniela Ion (Romania) 

- Cristina Ionescu (Romania) 

- Teodor Leasu (Romania) 

- Elena Helerea (Romania) 

- Nicolae Marcu (Romania) 

- Emeritus Spyros G. Marketos(Greece) 

- Ioana Moisil (Romania) 

- Codruta Nemet (Romania) 

- Manu Peter (USA) 

- Honorius Popescu (Romania) 

- Liliana Rogozea (Romania) 

- Mariana Radoi (Romania) 

- Alfredo Musajo Somma (Italy) 

- Carlos Viesca-Trevino (Mexico) 

- Jean-Pierre Tricot (Belgium) 

- Giorgio Zanchin (Italy) 

- Pascu Alina, 

- Miclăuş Roxana, 

- Gabriela Sechel 

- Andreea Fleancu 

- Adela Bădău, 

- Gabriela Mailat, 

- Mioara Georgescu, 

- Bălescu Alexandru, 

- Sanda Hondor, 

- Ana Ionescu, 

- Crisitina Egri, 

- Tatiana Oglindă, 

- Mihaela Cardiş, 

- Godri Dora

Bulletin of the Transilvania University of Bra�ov • Vol. 2 (51) - 2009 

Series 6: Medical Sciences 

Supplement – Proceeding of The IV th Balkan Congress of History of Medicine 

LAWS ON MEDICAL ETHICS IN TURKEY 

FROM THE PAST TO NOWADAYS AND 

COMMENTS 

Ay�egül Demirhan ERDEMIR 1 

Abstract: The responsibility of the physician is also an important theme of 

the history of Turkish medical ethics. Turks believed in a polytheistic 

religion, namely Shamanism, before Islam. This religion is a religion with 

regard to nature. Ottoman physicians were educated in the form of masterapprentice. 

The responsibility of the physician was examined both by the 

Islamic Penal Code and by Ottoman Lawbooks in the Ottoman period. Some 

interesting characteristics were found in some medical manuscripts and some 

documents in the period of the Ottoman Turks. Afterwards, the responsibility 

of the physician showed a modern characteristic and some modern laws 

came into force. An education in the type of medrese (an Islamic High 

School) was seen in the Islamic World in the Middle Ages. A Medrese was a 

kind of high school, and this foundation was also seen in the field of 

medicine. The persons who graduated from medreses got their diplomas in 

the name of educator in the period of Otoman Turks. The period of high 

school began with the foundation of Tıphane and Cerrahhane-i Amire 

(Medical and Surgical School) in 1827. So, some modern laws were passed 

about the responsibility of the physician. So, today, a physician is responsible 

in all the medical practices according to Turkish Criminal Law, The Turkish 

Obligation Law, Turkish Civilian Law, Medicine and Its Branches’ Law, 

Turkish Medical Ethics Regulation, Health Protection Law, Turkish Medical 

Association. The Agreement on Patients Rights with the date of 1998 contains 

the subjects such as justice, the choosing of of foundation of health, informed 

consent, fidelity, confidentiality, privacy, veracity, the refuse of the treatment, 

the suing of the patient. In this paper, we will comment about laws on 

Medical Ethics in Turkey from the past to nowadays. 

Key words: law, history of medicine, malpractice 

1. Introduction 

In the world of Turks, remarkable 

developments have always taken place in 

terms of physician responsibilities and 

duties and there are many archive materials 

on it. This study gives examples from such 

materials and makes some comments. 

2. Historical context 

Before Islam, Turks followed 

Shamanism, which was a polytheist 

totemic religion of nature. In it, the sky, 

sun, moon, stars, earth and animals were 

all holy beings believed to have spirits and 

angels in them and Turks kept a deep kind 

of mysticism in their souls. 

Ottoman physicians held onto 

Islamic traditions too. For long years, 

medical training was given by masters to 

medical students. Therefore, the loopholes 

1 Department of Medical History and Ethics, Faculty of Medicine, Uludag University, Bursa/TURKEY.

6 

Bulletin of the Transilvania University of Bra�ov • Vol. 2 (51) - 2009 • Series VI 

in the Islamic law were tried to be closed 

and an alternative code of laws based on 

local traditions was developed. The 

statutes like those of Fatih Sultan Mehmed, 

Kanuni Sultan Süleyman and Mehmed IV 

closed some of the loopholes in the Islamic 

penal law. The sanctions on physicians 

were imposed by the edicts of the sultans 

and mandates of the head physicians until 

the 19th century. In all the decisions taken 

during that period, the emphasis was on the 

fact that physicians could not be held 

responsible for any medical situation 

unless the consent of patients was 

obtained. 

3. Aspects of medical ethics in XVI th 

Century 

The Ottoman Turkish physicians 

of the 16th century kept dealing with 

physician responsibilities in their books. In 

a document dated 1573, it is mentioned 

that the head physician Garaseddinzâde 

Muhiddin wants to prevent ignorant people 

from practicing medicine and those who 

want to do it need to take examinations to 

be awarded a diploma. A document from 

the Religious Court Records of the city of 

Ayıntap (Gaziantep) is dated 1540 and it 

talks about the removal of stones clogging 

up the urinary system. For such operations, 

the permission of patients and the religious 

court was needed and surgeons were paid a 

certain amount of money. Physicians could 

be sued when patients who gave their 

consent died during or after operations. 

4. Aspects of medical ethics in XVII- 

XVIII th Century 

In the 17th century, physicians and 

surgeons having informal training from 

masters were allowed to practice medicine 

only after taking some examinations and 

proving that they have perfected their 

crafts. This was the same in the 18th 

century and the offices and consulting 

rooms of the unauthorized physicians were 

all closed. Some medical manuscripts 

dated the 18th century and the Ottoman 

Archives of the Prime Ministry talk about 

physician responsibilities. In his “Ra’is al 

Cerrahin” written in 1720, Cerrah Mes’ud 

Efendi reports that good physicians are 

compassionate, good-humored and kind 

people who do their best to help other 

people. In 1704 when Ahmed III was the 

sultan and Nuh bin Abdülmennan the head 

physician, the decision was taken that 

ignorant and unqualified physicians were 

to be prohibited from practicing the 

profession. In a judgment dated 1729, it is 

written that medical practice was to be 

learned from master physicians in an 

informal training process and a diploma 

given after passing some particular 

examinations was needed to become a 

physician. 

5. Aspects of medical ethics in XIX th 

Century 

Some documents dated the early 

19th century give information about the 

understanding of physician responsibilities. 

A Prime Ministry Archives material dated 

1848 reports that the head physicians and 

physicians of Ayıntab (Gaziantep), Birecik 

and Haleb hospitals were all dismissed 

from their posts because of unacceptable 

behavior. A document dated 1849 is about 

some new regulations designed to impose 

that physicians should treat poor patients 

for free. 

Another one dated 1890 is about 

the investigation launched into the wrong 

treatment given by Cerrah Malik Efendi at 

Gümü�suyu Hospital. In the Ottoman 

Empire, patients’ consent was obtained 

before giving any treatment. It is written in 

a document dated 1899 that some of the 

wounded soldiers at Yıldız Hospital were 

to be operated on after obtaining their 

written consent. 

Before the foundation of the 

Republic, the Islamic Penal Law was in

A. D. Erdemir - Laws on medical ethics in turkey from the past to nowadays and comments 

force about abortion. A document dated 

1788 is a written copy of a final court 

decision and aims to inform the provinces 

that the physicians and pharmacists in 

Istanbul were prohibited from prescribing 

for abortion. There are also some 19th 

century documents about abortion. One of 

them dated 1826 talks about a midwife 

known as “the bloody midwife” to be 

punished for prescribing abortive drugs. 

Another document dated 1828 says that 

women should never be prescribed 

abortive drugs. A document dated 1838 is 

about the announcement of the decision 

which banned abortion. The 193rd article 

of the Imperial Penal Law dated 1857 says 

that people who cause or help abortion are 

to be sentenced to imprisonment between 6 

months and 2 years. The Ottoman 

Archives of the Prime Ministry show that 

there were also some physicians who wrote 

misleading reports. A document dated 

1900 says that the Mayor Adbullahim 

Efendi, who was a lecturer in the Mekteb-i 

Fünun Medical School then, wrote a 

misleading report. 

As it is the way today, the 

physicians of those times had to be careful 

about what they wrote in their reports of 

any type and abide by all the medical 

ethics rules. They always tried to adhere to 

the principles of privacy, loyalty, honesty 

and not harming patients. 

Afterwards, the responsibility of 

the physician showed a modern 

characteristic and some modern laws came 

into force. Penal Code and Civil Law had 

some articles about this theme. 

The medical education in Turkey 

showed three periods. These are the 

periods of medrese, high school and 

faculty. The period of high school began 

with the foundation of Tıphane and 

Cerrahhane-i Amire (Medical and Surgical 

School) on the 14th March, 1827, and it 

continued until the foundation of Mekteb-i 

Tıbbiye-i Adliye-i �ahane in Galatasaray 

in 1838, and then the period of faculty 

began. So, some modern laws were passed 

about the responsibility of the physician. 

For example Karantina Talimatnamesi 

(Quarantine Agreement) in 1838, Tababeti 

Belediye Nizamnamesi (Agreement of 

Medicine of Municipality) in 1861 

mentioned the responsibility of physicians. 

Articles 192 and 193 of Ceza Kanunname-i 

Humayunu (Penal Law) in 1857 mentioned 

the punishments for abortion. Article 215 

of this code had the responsibilities about 

the revealing of medical secrets .Moreover, 

according article 182, if a patient died 

because of his physician’s negligence that 

was punished. 

6. Aspects of medical ethics in XX th 

Century 

Today, if a doctor causes death of a 

patient because of a technical mistake he is 

punished with prison sentence according to 

the article 456 of the Turkish Penal Code. 

The Agreement of Patient’s Rights 

with the date of 1998, 1 August and with 

the number of 23420 contains the subjects 

such as justice, the choosing of of foundation 

of health, informed consent, fidelity, 

confidentiality, privacy, veracity, the refuse 

of the treatment, the suing of the patient. 

Moreover, Turkish Law of Patients’ 

Rights, the informed consent of persons is 

necessary in all of the medical practices. 

The law about population planning 

dated 1965 and numbered 557 was changed. 

It was issued on 12.06.1967 a population 

planning regulation and a bylaw about 

pregnancy termination and sterilization. 

The law about population planning dated 

1983 and numbered 2827 is a modernized 

version of the law issued in 1965. 

According to the Turkish Law of 

Family Planning with the date of 1983, 

curettage can be applied up to the 10th 

week with the desire of woman. Birth 

control drugs and apparatus can be used 

with the prescription of physician. 

7

8 


As there was not an administrative 

law concerning organ transplantation in 

Turkey before 1979, many operations were 

not possible to perform and physicians did 

not have much to do to save lives. The law 

numbered 2238 and dated 29.5.1979 on 

transplanting and keeping organs and 

tissues allowed the operations and relieved 

physicians of many hesitations. 

If a person allows it in his will 

orally and/or verbally, organ transplantation 

can be made from his body after 

he dies. Even if this is not mentioned in the 

will, the law suggests that the closest 

relatives can permit transplantation from 

the dead body. 

According to the 14 th article of the 

law, an organ of a person who dies with 

enormous damages in an accident or 

natural disaster can be given to an urgently 

needing patient not considering the will or 

consent in any way. 

7. Conclusion 

Moreover, some agreement drafts 

are present in Turkey. One of them is 

Rules on Ethics of Medical Profession. It 

was accepted by Turkish Medical 

Association. Another law is malpractice 

law. In near future, it will be passed. 

BIBLIOGRAPHY 

1) Ceza Kanunname-� Hümayunu (Penal 

Code). �stanbul: Takvimhane-i Amire 

Mat; 1857. 

2) Ceza Kanunname-i Hümâyunu (Penal 

Law): Takvimhane-i Âmire Matbaası, 

�stanbul, 1857, pp.45 

3) Hasta Hakları Yönetmeli�i (Patient’s 

Rights Regulation), Resmi Gazete, 

No.23420, 1998, p.67. 

4) Kahya, E., Demirhan, E. A.: Medical 

Studies and Institutions in the Ottoman 

Empire, Ankara, 2008. 

5) Nüfus Planlaması Hakkında Kanun 

(Family Planning Code): 2827. Date: 

25.5.1983 Resmi Gazete No: 18059 

(27.5.1983). 

6) Ottoman Archives Cevdet, Sıhhiye 

Book. Date: 1729 

7) Ottoman Archives, A.MKT.MHM. 

Dosya No: 50 Gömlek No: 42, Date 

1853. 

8) Ottoman Archives, Cevdet, Sıhhiye 

No: 1026, Date: 1788. 

9) Ottoman Archives, Cevdet, Sıhhiye 

No: 1790, Date: 1838. 

10) Ottoman Archives, Sadaret Evrakı 

Mektubi Mühimme Dosya No: 9, 

Gömlek: 63, Date:1849 . 

11) Ottoman Archives, Y.PRK.ASK. 

Dosya No: 240 Gömlek no: 40, Date: 

1909. 

12) Ottoman Archives, Y.PRK.SH. Dosya 

No: 68 Gömlek No: 68, Date Date: 

1891. 

13) Ottoman Archives, Y.PRK.SH. Dosya 

No: 7 Gömlek No: 13, 1900. 

14) Ottoman Archives. Cevdet, Sıhhiye 

Book, No.1128, Date: 1848. 

15) Ottoman Archives: Cevdet, Sıhhiye 

Defteri, No.566, Date :1828 

16) Resmi Gazete: No. 16655, 3.6.1979, 

Organ ve Doku Saklanması ve Nakli 

Hakkında Kanun (Organ and Tissue 

Transplantation Law): No. 2238, 

29.5.1979. 

17) Sehsuvaroglu B. N., Demirhan A., 

Güre�sever G., Türk Tıp Tarihi 

(History of Turkish Medicine). Bursa: 

Ta� Kitabevi; 1984. 

18) Tıbbi Deontoloji Tüzü�ü (Agreement of 

Turkish Medical Deontology with the 

Date of 1960) No: 4/12578, Jan 3, 1960. 

19) Türk Ceza Kanunu (Turkish Penal 

Code). No: 5237, Date: 26.09.2004. 

20) Ucok, C., Osmanlı Kanunnamelerinde 

�slam Ceza Kanununa Aykırı Hükümler, 

Ottoman Law Books, A.Ü. Hukuk Fak. 

Mec., 1946; 3: 124-46.




1 Bucharest University 

HISTORIC HIGHLIGHTS AND 

PERSPECTIVES OF BIOETHICS IN 

ROMANIA 

C. BOGDAN 1 

Abstract: The date of birth of bioethics in the world is the early 70s, when 

it was realized that medical ethics remained predominantly centered on 

physician-patient relationship and it covers no more the progress of scientific 

research in biology and medicine and their applications in genetics, 

reproductive medicine, transplant or end of life issues, bio-technology. 

Even if preoccupation about bioethics exist before 1989, until after this year 

it was possible to establish some governmental and non-governmental 

organization with experts in this field: doctors, researchers, lawyers, 

theologians. 

The first organization was the Committee of Bioethics attached to the 

Medical Sciences Academy, which has appeared as initiative of acad. St. M. 

Milcu and prof. dr. Constantin Maximilian, joined later by dr.Constantin 

Bogdan, dr. Sebastian Nicolau, dr. G. Litarczek and others. 

The echo of this committee inspired medical students, who develop “Student 

Society in Bioethics - Constantin Maximilian”, with an intense activity over a 

decade; the original animators of this group are Consuela Georgescu and 

Gabriel Raicu. 

With the death of the founders, the Academy Commission’s work was stopped 

and remain, only for a short time, a Bioethics Committee in addition of 

Forensic Institute lead by prof. Vl. Beli�. By tradition, bioethics remained 

linked with Forensic Medicine and History of Medicine. 

In the early 2000s it was set up the Romanian National Committee of 

Bioethics in addition to the Romanian National Commission for UNESCO. In 

the same period, in Iasi was developed a group of Bioethics with intense 

activity (including publishing a journal), animated by prof. dr. Vasile 

Astarastoae. Finally, appear bioethics committees in educational and 

research institutions, and in clinical hospitals. 

Key words: bioethics, Romania, historical landmarks. 

Bioethics is a relatively young discipline 

and science, its act of birth dating 

from 4 decades ago, at the same time with 

the launch of its concept and name by 

American biochemist dr. Van Renssalaer 

Potter at the beginning of the 70s. [2] 

Bioethics was born out of ethics, has 

focused on biologics and has gradually 

developed and diversified, along with the 

scientific advancement in bio-medicine 

research and biotechnologies and their 

applications’ development. 

In Romania, even if there were some 

physicians, researchers and lawyers’

10 


opinions regarding bioethics before the 

1989’s political changes, only after that 

date there were possible open debates, the 

set up of a movement, the appearance of 

governmental and non-governmental 

bodies, as a result of gaining the right to 

free speech and express thoughts, right to 

be informed, freedom of association [4]. 

Regarding the historic of bioethics, 

concerns can be identified even since 

Antiquity, that are to be found in the 

religious concepts, philosophical necessity, 

regulations and laws during time, medical 

practice codes. Towards the end of 19 th 

Century some attends to conceptualize a 

kind of bioethics were made, but bioethics, 

in its actual modern meaning is a recent 

concept, as I mentioned before, established 

in the second half of the last century, 

together with genetics and especially 

biotechnologies further developments, the 

term being introduced by dr. Van 

Renssalaer Potter in the paper “Bioethics: 

Bridge to the Future” (1971). [2] 

There are several definitions, the filed 

being complex and in full extension, 

imposed by new scientific developments, 

moral’s adjusted answers and the right to 

the “cascading” challenges of science and 

research developments. 

One of the said definitions considers 

bioethics which, based on using an 

interdisciplinary methodology, has as 

object the systemic exam of human 

behaviour in the field of life sciences and 

health, analyzed in the light of moral’s 

values and principles. 

Other more concise definition, but 

complete at the same time, was introduced 

by dr. Constantin Maximilian, the great 

geneticist and one of the pioneers of the 

revival of bioethics in Romania after 1990, 

in its modern, international concept: 

“bioethics is the meeting point of all who 

follow human destiny subject to science 

pressure”. [4] 

UNESCO’s General Director considers 

that the scope of bioethics is to frame the 

scientific and technological progress in a 

ethic reflection that is having the roots in 

the cultural, juridical, philosophical and 

religious background of diverse human 

communities. 

From other perspective, bioethics, 

beyond life and death and existential limits 

of human life, provide answers to any of 

science and technique’s real challenges 

under the form of new developments. [3]. 

Bioethics is seen by other specialists 

and as the moral’s answer to the reality of 

a science that evolves quicker than the 

human being as regards its capacity of 

understanding, reaction and adaptation. 

Bioethics becomes a source of law that 

is no more than a minimum of moral. 

Bioethics is the reconsideration of 

classic (medical) ethics beyond a strictly 

medical perimeter which remains however 

prevailing. 

As a conclusions of enumeration 

diverse definitions, we consider that a 

more comprehensive delimitation, more 

adjusted to its actual dimensions and 

mission, suggested also by its name 

“bioethics” could take into account the 

term of “ethics of life”, because nowadays 

bioethics covers not only health field but 

also the overall aspects of life, based on 

principles such as respect of life, autodetermination, 

universality, equality, 

justice and equity, utilitarianism, fact that 

indicates its extension in social and 

political areas – inter-human relationships, 

non-discrimination, relation with environmental, 

nature, the need for building up of 

a bridge balance between the progress of 

science and human rights; in other words, 

all the developments of science must be 

directed only for the common good of 

humanity. The great thinker and moralist 

Montaigne properly stated: “science 

without conscience is the ruin of soul” and 

physician and humanist Albert Schweitzer 

drew the attention on the fact the science’s

C. BOGDAN.: Historic highlights and perspectives of Bioethics in Romania 11 

successes have not always had as a result 

the happiness of mankind. 

Therefore, along with the 1990 change 

of politic regime and afterwards through 

our country’s accession to European 

structures (Council of Europe, European 

Union), bioethics, together with other left 

behind fields, wished to recover in the 

shortest possible period of time, all the 

existing gaps between us and “free” and 

developed countries. 

The first 4-5 years after 1990 had been 

necessary for the organisation, gathering of 

information regarding other countries’ 

related experience, debates, collecting of 

related data and comments, the adjusted 

implementation of international specialised 

institutions’ recommendations launched 

during diverse discussions forums. 

A first institutional structure that 

appeared soon after 1990 was Romanian 

Commission for Bioethics (Comisia de 

Bioetic� a României), affiliated to 

Academy of Medical Sciences; this 

“parrainage” had two reasons: on one hand 

the high patronage of a official and 

prestigious institution with authority in 

bio-medicine and research was needed in 

order to affirm itself and be known, and, 

on the other hand, the initiative came from 

two distinguished figures of medicine and 

medical scientific research – academician 

dr. �tefan-Marius Milcu, professor of 

Endocrinology and academician dr. 

Constantin Maximilian, professor of 

Medical Genetics, signer of The Oviedo 

Convention for Human Rights and Biomedicine 

in April 4, 1997. I personally had 

the great honour of being invited to take 

part in the Commission, being entrusted, 

based on my expertise and previous 

research, the following issues: ethical and 

social responsibility in health, end of life’s 

bioethics aspects, protection of vulnerable 

persons’ rights and dignity. [4] 

This first bioethics institution was the 

predecessor of the current Romanian 

National Committee for Bioethics (Comitet 

Na�ional Român de Bioetic�), that was 

affiliated, based on the same abovementioned 

reasons, to Romania’s National 

Commission for UNESCO (“Comisia 

Na�ional� pentru UNESCO a României”). 

Moreover, the major involvement of 

UNESCO in bioethics, beginning with the 

‘90s, bioethics being constantly included in 

its agenda, with two subordinated 

specialised entities and an ample program 

of activities, i.e. International Committe 

for Bioethics (Comitetul International 

pentru Bioetica - CIB) and Intergovernmental 

Committee for Bioethics 

(Comitetul Interguvernamental pentru 

Bioetica - CIGB). [3] 

It’s worth mentioning here that these 

patronages did not affect in any way the 

independent character of the committee, on 

the contrary they increased its power and 

efficiency; our relationship with CIB and 

CIGB was a privileged one and a very 

stimulating one for the activities of the 

committee. 

Also, we would like to mention that the 

initiative for the creation of a organised 

movement in bioethics belonged to 

physicians! 

If bioethics means also control, 

monitoring and arbitrage- a judge of the 

evolution of science and practice in 

biomedicine - then this control started from 

inside; in general, in other countries, the 

lawyers, to which in some cases the 

theologians rallied too, had been the ones 

that initiated movements and associations, 

attracting also obviously physicians and 

researchers. 

However, we should state also that 

neither a confiscation nor a domination of 

bioethics by physicians does not constitute 

a benefit for the further development of 

bioethics, due to the risk of a lack of an 

objective approach from outside of it and 

also due to the risk of an attempt to defend 

certain practice of minimize the effects.

12 


Therefore, through the decision of 

setting up these institutions, currently 

active in our country, a multi-disciplinary 

component was intended - bioethics 

experts, researchers, physicians, biologists, 

lawyers, theologians, philosophers, psychologists 

and sociologists and an active 

model of horizontal co-operation between 

all the other bioethics’ formations. 

Although, other important thing, with a 

negative impact, that must be specified is 

the relatively reduced interest of some 

indispensable specialists category – the 

lawyers – most of them being focused on 

other more interesting and profitable areas 

– as a consequence of the previous politic 

regime when justice was controlled by the 

state, the law domain being therefore 

guided and poorly remunerated; other 

explanations are the absence of bioethics 

from the universities’ programs of study 

and from the postgraduate specialization 

and, also, the lack of specializations in 

bio-law or medical law. We have managed 

to partially rectify this shortcoming by 

attracting within a partnership specialists 

from Romanian Institute for Human Rights 

(Institutul Român pentru Drepturile 

Omului); we are benefiting also from the 

expertise of physicians that graduated also 

law universities. The involvement of 

theologians is also very important – we 

mention here The Commission for 

Bioethics of the Patriarchate – then it’s 

worth mentioning the professors of 

bioethics within Orthodox and Catholic 

Theological Institutes and also the 

presence of theologians within other 

important commissions. 

Other bioethics entities currently active 

in Romania besides Romanian National 

Committee are the following: 

- Commission for bioethics of Ministry 

of Public Health (Comisia de Bioetic� a 

Ministerului S�n�t��ii Publice) whose 

members are appointed by the ministry, 

commission with an advisory role; 

- Committee for Bioethics of the 

National College of Physicians (Comitetul 

pentru Bioetica al Colegiului Na�ional al 

Medicilor), whose members are appointed 

by the College’s National Council and that 

has an advisory role especially regarding 

the changes in the Etichs Code related to 

the developments recorded in the medical 

bioethics field. 

- National Committee for clinical study 

on human subjects (Comitetul Na�ional 

pentru studiu clinic pe subiec�i umani) 

affiliated to the Medical Sciences Academy, 

that works together with the National 

Agency for Medication (Agen�ia Na�ional� 

pentru Medicament), the latter being the 

main institution involved in the regulation 

and control of the activity related to 

medication and clinical studies on human 

subjects. 

- Commission for Bioethics of the 

Patriarchate (Comitetul de Bioetic� al 

Patriarhiei), religious body that expresses 

its own position and participates in 

bioethics related debates. [1] 

There was also a honest initiative of 

medicine students materialised in mid ’90s 

in a body active for a few years, that 

developed a prestigious program of 

education and multiple other events: 

Medicine Students’ Group for Bioethics – 

“Constantin Maximilian” (Grupul de 

Bioetic� al studen�ilor în medicin� 

”Constantin Maximilian”). 

Other notable achievement is the 

outstanding activity of Iasi Group 

(“Grupului de la Ia�i”) conducted by Prof. 

dr. Vasile Ast�r�stoaie, that publishes 

Romanian Bioethics Magazine (“Revista 

Român� de Bioetic�”) under the aegis of 

Commission for Bioethics of Romanian 

National College of Physicians (Comisiei 

de Bioetic� a Colegiului Medicilor din 

România), prestigious magazine wellknown 

both locally and worldwide and 

also internationally classified and 

authorised, that publishes in each issue

C. BOGDAN.: Historic highlights and perspectives of Bioethics in Romania 13 

articles written by renowned bioethicians. 

Finnaly, there are the committees for 

bioethics (ethics) within National 

Authority for scientific research (Autorit��ii 

Na�ionale pentru cercetarea �tiin�ific�), 

Ministry of Education (Ministerului 

Înv��mântului �i Educa�iei), Universities 

(Universit��i). [5] Lately, the creation of 

many committees for ethics within 

academic centres and research institutions 

can be noticed, this fact being stimulated 

by the progressive introduction of 

bioethics courses in the university 

curricula or by the requests regarding 

research in general and on human subjects 

especially. Perhaps, as a particularity, can 

be considered also the absence of National 

Committee affiliated do the Parliament or 

Presidential Administration, entity that can 

centralise all the reflections and comments 

from other independent bodies (advises, 

expertises, recommendations, consultations) 

and would assure a more prompt 

materialisation of legislative initiatives. 

The debates and approaches at the high 

level of this two authorities - Parliament 

and Presidential Administration – have not 

fulfilled yet the needs in this field with the 

exception of the approval and change of 

important laws referring to bioethics 

aspects such as: research of human 

embryos, assisted pro-creation, transplant 

of organ and tissue, this being done due to 

alignment requirements, more or less 

adjusted, to models existing in other countries 

or as a result of acquiring international 

institutions’ recommendations. 

There is not a Bioethics law in Romania 

yet. 

The first activities of The Romanian 

National Committee for Bioethics that 

were considered as a priority for our 

country were the ones in the field of 

raising awareness and education. As a 

result, an Appeal entitled CONCERN 

(“ÎNGRIJORARE”) that drew attention in 

its ten points on the elimination of the risks 

related to the detriment of human rights, 

dignity and integrity as a result of the 

implementation of scientific research’s 

conclusions, and on the need for wide 

knowledge of the bioethics principles – not 

only by specialists, young researchers but 

also by the general public. [3] 

An extensive program of Bioethics 

Education was elaborated, distributed and 

implemented, program that is a permanent 

one. 

Romania is currently going through the 

process of alignment to the European 

regulations regarding Ethics in Research 

and Science. 

For the time being, there are regulations 

adopted for the most important and up-todate 

aspects in this field: [1] 

- general rules and regulations that 

constitute the framework for the 

development of specific legislation; 

- provisions in the Constitution of 

Romania (art. 11, International law and 

internal law chapter) based on which the 

Romanian State undertakes to respect the 

obligations assumed within international 

treaties and regulations, in the case that 

Romania does not have in place (or does 

not have yet in place) its own regulations. 

(“art 11 – Constitution of Romania: [3] – 

Romanian State undertakes to fully and in 

good faith comply with the obligations 

incumbent from all the treaties signed. [5] 

– The treaties ratified by the Parliament, in 

accordance with the law, are part of the 

internal right”. 

- there are laws in preparation, being 

currently under parliament procedure and 

having to be promulgated in the next 

period (e.g.: the law regarding the animal 

protection against being used for research 

or other purposes, the law regarding the 

protection of the wildlife etc.) 

One of the important laws ratified by 

Romania is: The law no. 17 from 2007 

regarding the ratification of European 

Convention for the Protection of Human

14 


Rights and Dignity of the Human Being 

with regards to Application of Biology and 

Medicine, the Convention regarding 

Human Rights and Biomedicine signed at 

Oviedo on April 4, 1997, the additional 

Protocol to Convention for the Protection 

of Human Rights and Dignity of the 

Human Being with regards to Application 

of Biology and Medicine signed in Paris 

on January 12, 1998, referring to the 

interdiction of human being cloning. 

The European Convention, the 

Convention regarding Human Rights and 

Biomedicine and the additional Protocol to 

the European Convention were submitted 

for ratification to Romanian Parliament by 

Ordinance no. 324 dated October 4, 1999. 

This law covers: Fair access to health 

care, Consent, Protection of persons 

suffering from mental disorders, Private 

life and right to be informed; Human 

genome: Non-discrimination, Predictive 

genetic tests, choosing of sex; Scientific 

research: protection of persons that are 

subject to research, protection of persons 

that are not in the capacity to give their 

consent for the research; in vitro embryo 

research, prelevation of organ and tissue 

from alive persons for the purpose of 

transplantation; interdiction of financial 

gain and use of a part of the human body. 

Finally, a enumeration of the main 

challenges that bioethics must answer 

today, is shaping also the concern and 

approach perspectives of Romanian 

bioethics, without forgetting that bioethics 

is aiming to maximize the benefits of the 

scientific acquisitions and to minimize the 

negative effects: 

- discrimination and genetic 

manipulation, use of embryo in research 

and experiments, research on human 

subjects, reproductive cloning, transplant 

of organ and tissue, commercialization 

trends within this field, pre-set of the sex 

of the future fetus, protection of vulnerable 

persons, defending the biodiversity, 

monitoring of genetic modified organisms, 

fair distribution of research’s benefits, 

euthanasia, assisted suicide etc. [4] 

Reference: 

[1]. Bogdan C., Ursu �.: Bioetica în 

activit��ile UNESCO, în vol. 

”Educa�ia în Bioetic� �i Drepturile 

Omului în România” editat de 

Comisia Na�ional� a României 

pentru UNESCO, Bucure�ti 2006 

[2]. Bogdan C.: Probleme actuale ale 

bioeticii – în “Maramure�ul Medical” 

nr. 5, 17 septembrie 2004 

[3]. Nicolau S.: Nevoia de bioetic�. 

Începuturile înv��mântului 

universitar de bioetic�, în volumul: 

”Educa�ia în Bioetic� �i Drepturile 

Omului în România” editat de 

Comisia Na�ional� a României 

pentru UNESCO, Bucure�ti 2006 

[4]. Raicu G.: Legisla�ia Na�ional� în 

domeniul eticii în cercetare în 

România, în vol.: ”Educa�ia în 

Bioetic� �i Drepturile Omului în 

România” editat de Comisia 

Na�ional� a României pentru 

UNESCO, Bucure�ti 2006 

[5]. *** Institutul Român pentru Drepturile 

Omului: Bioetica – Mijloace �i c�i de 

ac�iune, Bucure�ti 2004




THREE PERSONALITIES OF MEDICINE – 

REPRESENTATIVE FOR MEDICAL 

ETHICS WITHIN ROMANIA 

L. ROGOZEA 1 , F. LEA�U 1 , L. NEDELCU 1 , A. B�LESCU 1 , 

C. NEMET 1 , N. MARCU 2 

Abstract: Kernbach, Nicolae Minovici and I. St�nescu are three 

outstanding personalities of medicine, famous not only for their research, but 

also for their involvement in developing medical ethics. If Kernbach 

substantiated a few notions about medical responsibility in 1935, Nicolae 

Minovici, one of the most important forensic doctors of his time, is also 

known for his important research in the deontology field, illustrated by his 

two written works: “Professional Secret” and “Ethics of Medical 

Responsibility”, worked out in collaboration with I. St�nescu. We have 

recognized nowadays that medical ethics of our century must be approached 

and dealt with from historical perspective; the acquaintance with the 

predecessors’ point of view is a favorable element in the restoration process 

upon medical ethics in the current context of medical development 

Key words: M. Kernbach, N. Minovici, I. St�nescu medical ethics. 

1. Introduction 

Ever since the period of Hammurabi’s 

Babylon or Hypocrites’ Greece so far, 

medical ethics has stood for the system 

of moral and social laws that marked 

professional activity so that it should 

comply with the highest standards of 

society. 

In this context, the medical ethics of 

the 20 th century must likewise be 

considered from the historical 

perspective; therefore the acquaintance 

with our predecessors’ standpoints will 

constitute a favorable element in the 

process of restoring medical ethics in the 

framework of the medical progress. 

The fear of “public opinion”, the fear 

lest we should be considered nostalgic 

1 Faculty of Medicine, Transilvania University, Brasov 

2 UMF Carol Davilla, Bucharest 

has brought about that an everdiminishing 

number of physicians cope 

with the theoretical aspects of medical 

ethics. 

Within this very context there 

inscribes the tendency manifested by the 

leaders of Romanian medical education, 

to neglect the importance of medical 

ethics, as well as the emphasis we should 

lay on those materials which contribute 

to modeling the moral and spiritual 

profile of the future professionals within 

the medical staff. We make reference at 

this point to the history of medicine, to 

medical sociology, to medical 

anthropology or to medical psychology. 

We should not overlook that “The 

physician, through a happy dignity of his

16 


fate is likewise followed and obeyed 

outside his battlefield” (Ozun, Poenaru). 

Therefore, bearing in mind and 

bringing to memory the example offered 

by some forerunners is not only a duty 

incumbent on us, but also a necessary step 

for rekindling ethical and moral values in 

the attention of both medical staff and 

general audience. 

Noteworthy personalities of the 

Romanian medical world have been 

preoccupied with emphasizing the 

physician’s role, with positively assessing 

and appraising the particularities of the 

medical act, of the responsibility 

incumbent on the medical professionals, 

with the high moral standards applied by 

society to these professionals. 

2. Historical background. 

Since Antiquity so far, medical science 

has greatly evolved, however a series of 

ethical percepts have kept their 

authenticity. 

There is worth reminding at this point 

the muniment (charter) issued by Scarlat 

Calimachi in 1813, in his quality of 

waiwode of Moldavia, muniment that 

points out the obligations of the doctors 

of those times. 

“At any time, by night or in daytime, 

either called for by the boyars, or by the 

clergy or by the poorest and foreigner, no 

one should dare allege encumbering 

tasks or delay their medical examination 

for the following day, thereby therefore 

people’s life; who, either by carriage, or 

on foot, should run themselves out of 

breath towards the suffering ones.” 

The text emphasizes the fact that 

these doctors must provide medical 

assistance indiscriminately, whatsoever 

the patient’s material status or 

nationality; furthermore, the same text 

specifies that medical assistance can only 

be provided in case of illness; otherwise 

the patient being excluded from the 

medical corpus. 

We should not forget that this 

legislative act, regulating the person’s 

right to medical assistance and the 

physician’s duty to perform his duty, is 

dated in the 19 th century. 

That very century, however after 

approximately 50 years, the great 

reformer of medical assistance in 

Romania, physician Carol Davila put 

forth in writing: “The physician of the 

circumscription, beside his medical 

appointment, also performs a moral, 

foreseeing mission.” 

V. Gomoiu – “Within medical 

profession, nothing can be mechanical, 

reflex, this is the profession compelling 

to a permanent strain of consciousness, 

as our profession directly addresses 

human being, his life and health. 

3. Kernbach 

Great personality of Romanian forensic 

medicine Mihai Kernbach studies at 

Berlin, Graz, Lyon and Zürich and work in 

Cluj where he through all steps of the 

academics hierarchy up to professor. After 

Cluj period he became doctor at Iasi 

University, where he taught forensic 

medicine. 

Mihail Kernbach it was not only a 

distinguished educator but also a important 

researcher. He publish more than 250 

scientific paper, including article, books. 

In 1935, Kernbach substantiated a few 

notions in connection with medical 

responsibility: “No social group can avail 

from immunity. We have long overcome 

the epoch of the privileged classes upon 

the law”; however, not supporting the 

thesis of medical irresponsibility, 

Kernbach stated: “The tendency of the 

doctrine, within our days, is incontestably 

towards raising the physician’s 

responsibility, so that he should be brought 

to account for the slightest error, as soon as 

it may be framed within a text of law.”

L. ROGOZEA, et all, Three personalities of medicine – representative for medical ethics within 17 

Romania 

4. Nicolae Minovici and I. St�nescu 

In this context, we deem of usefulness 

to submit and analyze two works drawn 

up by the physicians Nicolae Minovici, I. 

St�nescu: “Professional Secret”, issued 

in the Bulletin of the College of 

Physicians, during 1938, and “Ethics of 

Medical Responsibility”, issued an year 

later, during 1939. 

In these two articles, the noteworthy 

physicians prove themselves to be 

valuable historians of ethics, who 

managed to achieve a tour of ethics 

history on worldwide level and 

throughout our country. 

Physicians of outstanding value, they 

likewise became conspicuous as ethics 

theoreticians of great value, given the 

proof of this statement: “As practicing 

physicians, we do not only cure the 

disease, but the individuals suffering 

from such or such illness; whatsoever the 

conscientiousness we would apply in 

repairing the motor propelling human 

life, it is almost utterly excluded to 

neglect a mere single piece within this 

system, whose perfect knowledge is only 

held by the one who created human 

being.” 

They also deemed that “the physician 

has to continuously update his medical 

knowledge; he must not mistake his 

university diploma for a license patent, 

which might occupy him for his personal 

benefit and not for collective interests.” 

The obligation to comply in due time 

with any patient’s request is enforced, 

bringing forth to memory the fact that 

ever since 1813, Scarlat Calimachi 

stated: „The doctors and the midwives 

should be under obligation to get out of 

breath with running when called for not 

only by the boyars (only these ones were 

able to render themselves cured by 

doctors!) but also by the poor and by the 

wretched, as the word of Bible urges 

them to, which compels them to: „when 

being summoned and called for at any 

time, by night or during daytime, no one 

should dare to allege encumbering duties 

as pretext, or to delay the medical examination 

for the following day, therefore 

endangering people’s lives, otherwise, 

unless justified by well grounded reason 

of “bodily powerlessness”, any of the 

doctors will be cast out of the healers’ 

corporate body and his wages will be 

blasted and ultimately will count to 

nothing”. 

The main preoccupation consists in 

the professional secrecy, which he deems 

an enigma so great and so ancient, as this 

ever-rising edifice which, through social 

consciousness, constitutes “human soul”, 

“collective mentality”, as a “nervus 

rarum of consumption life.” 

Conspicuously, the most important 

thing should be “conscience – that form 

of manifestation put on by collective soul 

– and only afterwards the rigid article of 

law.” 

Consciousness is often deemed an 

abstract notion. For the two Romanian 

physicians, consequently for Minovici, 

too “Conscience cannot be conceived but 

as the wholeness of the “moral laws” 

precepts, as an expression of social 

harmony, on whose bases the individuals 

within an organized collectivity should 

cultivate the “good” and give a wide 

berth to “evil” “and obnoxiousness” from 

the standpoint of the individual or 

collective interest.” 

Minovici agrees with these 

information, the proof being the 

acknowledgement upon the fact that if 

“every individual only had rights and we 

denied him any duty, and especially his 

moral duty, then, within a State there 

would be a permanent fight, battled by 

the individual against community, and 

therefore battled by everybody against 

all. ” 

Furthermore, Nicolae Minovici’s

18 


brother, Mina Minovici declared his 

opinion in this respect, considering: 

“Much like a laic father confessor, the 

physician has ears to hear and eyes to 

behold; in comprehending his moral 

duty, he has no other judge than his 

conscience”, and “the duty dictated by 

consciousness needs no longer be 

defined.” 

We may remark on the occasion of 

reading these materials that the idea of 

absolute or relative secret is not new. 

This way, Ch. Vibert states that: 

“Whatever the authors might say, there is 

obvious that medical secrecy cannot be 

absolute in all cases. Name the physician 

who will decline informing the husband 

about his wife’s illness, informing the 

environment about an epidemic 

disease?!” 

A. Lacassagne places himself in 

favour of absolute secrecy: “the 

obligation to secrecy places upon the 

ones involved the interdiction to reveal 

it, even when they are called to testify in 

Courts of Justice.” 

Other preoccupations upon secrecy 

submitted in the article herein are the 

statements by: A. Lutaud: “Medical 

secret is not only a moral duty and a 

sacred obligation for the physician, but 

the secrecy is also formally enforced by 

law” ; or the rules advanced by Gabriel 

Tourdes and Ed. Metzquer: “The 

physician must never reveal what he has 

come up against during the exercise of 

his profession: however there are 

admitted exceptions, there are legal 

restrictions, debt conflicts, this issue 

having remained one of the most delicate 

and controversial.” 

“There are so many moral and legal 

restrictions in favour of the relative 

secret; the physician is under obligation 

to keep professional secret, however 

there are certain cases in which this 

obligation places one in a difficult 

position.” 

There is certain that, as Henri 

Contagne stated: “Medical secrecy 

displays within current practice multiple 

facets. In the matter of crimes against the 

State, the law requires revealing the 

secret, for the other crimes, divulging the 

secret will only occur in exceptional 

cases – dictated by the physician’s 

consciousness.” 

The two doctors also worked out a 

study correlated to the legislation in 

force. There is this way presented the 

article 350 in the former Penal Code: 

“The physicians, the surgeons, the 

pharmacists, the midwives any other 

such persons, who “following to be, in 

line with the nature of their profession, 

acquainted with and therefore stated as 

keepers of the secrets they have been 

entrusted – will let them out – excepting 

the occurrences when the law asks for 

such a disclosure – will be sentenced to 

prison, from one month to six months, 

and will be fined from 100 lei/Romanian 

currency to 500 lei.” 

In Romania, there were also other 

legal regulations connected to ethics. 

This way, the Penal Code of Charles the 

2 nd , article 505, paragraphs1, 2.5 

stipulated such regulations: 

1. The offence of revealing 

professional secrets, which was 

“stipulated by the ancient Penal 

Code, in the art. 305, has as 

constitutive elements: 1) the 

quality of the person acquainted 

with a secret “in virtue of one’s 

situation, position, profession or 

appointment 2) the secret that one 

of the persons enumerated above 

is under obligation to keep; 3) the 

divulging or the revealing deed; 

4) the divulgation of the secret 

might constitute a possibility of 

prejudice; 5) he who divulges the 

secret might not be authorized by

L. ROGOZEA, et all, Three personalities of medicine – representative for medical ethics within 19 

Romania 

law to divulge it, 6) intention of 

fraud.” 

2. The first element of the offence 

represented by the deed of 

divulging the professional secret 

is the quality of the person who is 

acquainted with a secret; the 

legislator only makes reference to 

those persons who, in virtue of 

their position, profession or 

appointment receive certain 

confidences from those who need 

the services falling into their 

attributions. If a person is 

entrusted a confidence that 

however has no direct connection 

with the situation, position 

profession or appointment of the 

person who was entrusted the 

secret, the offence of revealing 

the professional secret cannot 

have been performed. 

3. The second element of the 

offence represented by the deed 

of divulging the professional 

secret is the secret itself. Secret 

constitutes any confidence that 

one of the persons fitting within 

the provisions of the art. 505 has 

found out, only by virtue of the 

quality, of the position, of the 

profession or of the appointment 

he holds, there being obvious the 

desire of the confidant for his 

confidence not to be found out by 

others. 

The law refers to the conditions in 

which we do not speak of professional 

secrecy (the facts have no connection with 

the quality, with the profession of the 

confided person, the information are 

obtained on private path). 

There is afterwards mentioned Max 

Simon: “when the physician has taken hold 

on the patient’s spirit, when the former has 

raked up the most remote and hidden 

nooks of the latter’s soul, he has contracted 

against the patient a new obligation, the 

one of absolute discreetness, which seals 

within his conscience not only the secrets 

revealed to him, but also those he has 

caught glimpse of during his medical 

investigations.” 

Conclusion 

History brings forth that in life, the 

balance inclines more often towards lie 

than towards truth. Medical ethics is 

compelled to do its best so as to contradict 

statistics. When somebody wishes to 

become physician, pharmacist or nurse, we 

dare say one is naturally strongly 

motivated. Sometimes, nevertheless, one’s 

subsequent activity makes us doubt as to 

these motivations. 

This is the reason why the example of 

forerunners such the brothers Minovici, 

Kernbach or I. St�nescu is more than 

essential. 

Selective bibliography 

1. Dumitra�cu, D – Medicine between 

Miracle and Deception, Dacia 

Publishing House, Cluj Napoca, 1986 

2. Du�escu, B – Victor Gomoiu 1882- 

1960, Medical Publishing House, 

Bucharest, 1970 

3. Iorga, N – Medical Men and Medicine 

within Romanian Times of Yore, 

Bucharest 1919 

4. Marin, Fl. – Lives Dedicated to 

Human Being, vol. 1-6, Dacia 

Publishing House, Cluj Napoca, 1993- 

1997 

5. Ozun, R., Poenaru, E. – Professional 

and Social Responsibility incumbent 

on Physician, Medical Publishing 

House, 1973 

6. Rogozea L. - Nicolae Minovici �i 

Secretul Profesional, Al IV-lea 

Simpozion Na�ional de Istoria 

Psihiatriei, Bucure�ti, 20-22 Mai, 

2004, p.42 

7. Rogozea L., Marcu N. - Doctor

20 


Nicolae Minovici – un theoretician at 

medical ethical, 40 th International 

Congress on the History of Medicine, 

Budapest, Hungary, August 26- 30, 

2006 – pg. 775-77. 

8. The Handbook on Medical Ethics – 

Clarke, Doble and Brendon, London, 

1981 

9. Rogozea L. – Etic� �i deontologie 

medical�, vol. 1, Ed. Universit��ii 

Transilvania, 2006, 158 pg. 

10. Rogozea L., Beldean L. - Aspecte ale 

eticii medicale în România, Acta 

Medica Transilvanica nr.2, 2000, 

pg.141-142




ONE WRITING FROM �BRAHIM TEMO 

ABOUT THERMAL SPRINGS OF BURSA 

AND ROMANIA 

M. YAPRAK 1 N. GÖKÇE 2 

Abstract: 

Dr. �brahim Temo (1865-1945) one of the founders of The Committee of 

Union and Progress (�ttihat ve Terakki Cemiyeti) was born in Struga as an 

Ottoman citizen with Albanian origin. He graduated from Gülhane Military 

Medical School in 1892. He began his ophthalmology education in Istanbul 

but finished in Romania, because he had to escape from dictatorship of II. 

Abdülhamid. He opened a lot of bureaus of Committee in Bulgaria and 

Romania. Temo returned to �stanbul in 1908 but didn’t get on with his 

Committee. He founded Osmanlı Demokrat Partisi (Ottoman Democratic 

Party). In 1911 he returned to Romania because of pressures and threats. 

Temo was not only a doctor and a politician. He was also an author. He 

always wrote. He sent writings from Romania to Türkish journals especially 

the �çtihad of Abdullah Cevdet who was also one of the founders of The 

Committee. It is reported that achieve of Temo is in Tiran. In his writing in 

the �çtihat of 01 February 1925, he notices first the importance and misery of 

the Bursa thermal springs. Later he introduced some important thermal 

springs and hospitals of Romania. He gives communications about the 

attaining, prices and medical utilities of these organizations. According to 

this important writing about history of thermal medicine of Türkiye and 

Romania, thermal springs of Romania were in better condition than Bursa 

thermal springs in 1925 

Key words: Ibrahim Temo, Romania, Thermal Spring, Bursa, Türkiye 

In 1920’s hydrotherapy, balneotherapy, 

spa centres and sanitarium therapy were 

more popular treatment modalities than 

today’s modern medicine and physical 

therapies. There are a few articles focusing 

on thermal therapies of those times. 

An interesting and comparative article 

was written by Dr. �brahim Temo (3). He, 

in his article, compared Turkish and 

Pomanian thermal therapy centres from 

medical history point of view. Temo’s 

article provides important information on 

thermal therapies of 1920’s. 

Dr. �brahim Temo (1865-1945), one of 

the founders of the Committee of Union 

and Progress (�ttihat ve Terakki Cemiyeti), 

was born in Struga as an Ottoman citizen 

of Albenian origin (See Figure 1). 

After graduated from Gülhane Military 

Medical School in 1892, he started studing 

ophtalmology in Istanbul. Since he had to 

escape from the dictatorship of 

Abdülhamid II, he completes his training 

period in Romania. He opened a lot of 

1 Trakya University, Medical Faculty Departments of Physiology, Edirne - Turkye 

2 Trakya University, Medical Faculty Departments of History of Medicine - Edirne - Turkye

22 


bureaus of the Committee in Bulgaria and 

Romania. Temo returned back to �stanbul 

in 1908 but didn’t get along with his 

Committee. He founded Osmanlı 

Demokrat Partisi (Ottoman Democratic 

Party). Because of the pressures and 

threats, he returned to Romania in 1911 

[10, 11]. 

Figure 1: Dr. �brahim Temo as Red Cross 

physician in �stanbul, 1913. 

Temo was not only a doctor or a 

politician, but also an author. Before and 

later from his second migration to 

Romania, he wrote a lot of articles and 

several books. Some of his books are Aile 

Hekimi (Family Practitoner), Tagaddi ve 

Devam-ı Hayat (Nutrition and Life), 

Kuduz (Rabies), Türkçe-Romence 

Mükaleme (Turkish-Romanian Conversation), 

Tababet-i avam Dersleri (Lessons 

in Public Health), Hareket (Motion; coauthered 

by Ali �efik), Atatrürk’ü Niçin 

Severim (Why I Admire Atatürk; 1937- 

Medgidia, 2001 Prizen), �ttihat ve Terakki 

Cemiyeti’nin Te�ekkülü ve Hidemat-ı 

Vataniye ve �nkılab-ı Milliye Dair 

Hatrıratım (Foundation of the Committee 

of Union and Progress and my Memories 

of the national Revolution and Services to 

the Motherland; 1939 Medgidia, 1987 

�stanbul), Usul-ü Mükaleme (Method of 

Conversation) [3, 4, 5, 6, 7, 8, 9, 11]. 

It is reported that achieve of Temo is in 

Tiran [1-2]. 

He submitted his articles from Romania 

to Turkish journals, especially to the 

�çtihad of Abdullah Cevdet, who was 

another founder of the Committee (See 

Figure 2). 

Figure 2: �ctihad journal 

His article published in the February 

1925 issue of the �çtihat on the subject of 

the thermal springs of Bursa and Romania 

(See Figure 3). 

Figure 3: The title of Temo’s article

M. YAPRAK et al: One Writing from �brahim Temo about Thermal Springs of Bursa and Romania 23 

Temo made several journeys to Vienna 

(1901), Paris (1902, 1918), Egypt (1907), 

Türkiye (1913, 1923, 1930), Albania 

(1914) and two migration to Romania 

(1895, 1912). These expressions must be 

related with his first visit to Türkiye after 

the foundation of Republic [10-11]. 

The article begins with the expression 

of Temo about Bursa thermal springs. 

According to Temo the baths are 

miserable. They need reanimation, medical 

servants, water analysis and legal 

regulation. There isn’t any hotel and 

restaurant around the Bursa thermal 

springs [3]. 

In the second part of article, the thermal 

springs in Romania are introduced. He 

gave information about the transportation 

options, prices and medical utilities of 

these facilities [3]. 

According to the article, the important 

thermal springs of Romania are Episkubus 

or Krian (Baile 1 Mai), Feliks (Baile 

Felix), Moneasa (Moneasa), Gorgiya 

(Geoagiu), Dobruca (Spa Dobrich?), 

Kovana (Covasna Spa), Mangalya 

(Mangalia), Tekir Gölü (Lake 

Techirghiol), Lagülsarat (Salt Lake), 

Govora (Baile Govora), Herculane (Baile 

Herculane), Mohad (Mehadia), Moldovya 

(Slanic Moldova) Bijular, Siriya, and Vace 

[3]. 

In the study, Kasalata (Calimanesti- 

Caciulata), Pani (in Bukovina) and 

Devrnavanr mineral waters are praised. 

Some promanade like as Agpaya, Azoga, 

Bireza, Berabu, Berazova, Buztin Geçine, 

Kimpolonoa, Aliye�te, Çaba, Komurniki, 

Kurtedu, Erçi, Duverna, Morillan, 

Nemçen, Puya, Naçavluj, Brodevud, 

Grillet, Marillan, Nemçu, Payanaçabuluji, 

Borodeal, Rugfer, Sinaya, Suvi, Suzana, 

Tirguavgana, Tizmana, Valenda, Mevneta 

and Veratik are also praised in the writing 

[3]. 

Temo gives some information about 

important health centers of Romania like 

as Antuvaniyu, Diyaguneselur, Jeravta, 

Naturaliyust, Alberabeta, Alanaherakayede 

(Sabtane) Gayllart, Tekirgölü sanitariums; 

Kulçe, Brankuvenasa, Eforiya, Markoca, 

Bantalemun, Manernimate, Kuluj (Cluj) 

University and Çernaviçe hospitals and 

dentistry college [3]. 

The names in the writing need to be 

critized by an expert. It may be said that 

the study has some smell of advertising of 

thermal springs and other medical centres 

of Romania. 

References 

[1]. Kutlay N: �ttihat Terakki ve Kürtler. 

Beybun, Ankara, 1992 

[2]. Polat A: Arnavutluk Devlet Ar�ivleri 

Genel Müdürü Prof. Dr. Shaban 

Sinani ile mülakat. Türk Kültürü ve 

Hacı Bekta� Veli Ara�tırma Dergisi. 

Sayı: 33, 2005. 

[3]. Temo �: Romanya’nın sanatoryumları, 

kaplıcaları, hava almaya ve tedaviye 

mahsus mevsim istasyonları. �ctihat, 

February 1925, Year: 20, Nu: 174, 

pp: 3498-3501. 

[4]. Temo �: �ttihad ve Terakki 

Cemiyeti'nin Te�ekkülü ve Hidemât-i 

Vataniyye ve �nkılâb-ı Millîye Dair 

Hatıratım. Medgidia, 1939. 

[5]. Temo �: �brahim Temo'nun �ttihad ve 

Terakki Anıları. Arba, �stanbul, 

1987. 

[6]. Temo �: Atatürk'ü Niçin Severim, 

Medgidia, 1937. 

[7]. Temo �: Atatürk'ü Niçin Severim, 

BAL-TAM Yayınları, Prizen, 2002. 

[8]. Uygur S: �brahim Temo’nun Bilinmeyen 

Bir Eseri: Usûl-i Mükâleme. 

Modern Türklük Ara�tırmaları 

Dergisi, 5/2:65-73, 2008. 

[9]. Ülgen E, Aksu A: Mektep ve Aile 

Mecmuası (1915-1916). Constanta, 

2003.

24 


[10]. Ünver S: Doktor �brahim Temo. CTF 

Tıp Tarihi ve Dontoloji Ar�ivi (Cilt 

1). �stanbul, 1935. 

[11]. Yaprak M, Gökçe N: Dr. �brahim 

Temo. Proceedings of the 38th 

International congress on the History 

of Medicine. �stanbul, 1-6 September 

2002.




THE GREEK PHARMACIST GHERASIMOS 

ZERVOS (1842-1901) AND HIS 

SUCCESSORS, THE ZERVOS PHYSICIANS 

FROM ROMANIA 

1 SRIM, 

2 National Medicines Agency, SRIF, 

3 SRIF 

A. LUCASCIUC 1 , M.-G. SULIMAN 2 , 

O. ELEFTERIU 3 , C. GRECU 3 

Abstract: Hereby we intend to follow the road along Zervos family in 

Romania, from the first appearance in the city of Sulina (1872), the 

pharmacist Gherasimos Zervos, originating in Kefalonia Greece and up to its 

recent descendants, Zervos physicians from Bucharest, who expatriated 

themselves to New York in 1994. Sulina town located in the Danube Delta 

was under a great economic and cultural development due to the installation 

here, in 1856, of the European Commission for the Danube. Thus, the city 

becomes an attractive place for many physicians and pharmacists, as well as 

for young pharmacist Zervos, a diplomat of the University of Padova (Italy). 

He will soon become the owner of the pharmacy "Minerva" (1881), 

pharmacy which subsequently will receive the name of "Speranta" in 1895. 

From the six children of pharmacist Gherasimos Zervos, Jack and George - 

the first-born children - will be sent to a high school education and medicine 

in Greece capital, Athens. The first will meet a great professional ascension: 

he was the physician and personal adviser of Abyssinia’s Emperor, Haille 

Sellasie I (who reigned from 1930 to 1974), the second will continue the 

Zervos physicians „dynasty” in Romania. 

Key words: Zervos, pharmacist 

Hereby we intend to follow the long 

history of the Zervos family in Romania, 

during 1872-1994. 

At the very beginning of this adventure, 

the milestone was represented by 

Gherasimos Zervos, born in 1842, in 

Zervata, Kefalonia Island, Greece. 

His name was mentioned in 1872 [1] in 

the �free port� of Sulina located in the 

Danube Delta, where he was about to settle 

�a true and genuine dynasty�: five sons and 

two daughters, the first two born, Jack and 

George, would become physicians; other 

nephews and grand-grandchildren would 

be spread around the world. 

The last descendant in Romania was 

doctor Gherasim Tuchiditi Harilaos 

Zervos, who has emigrated, together with 

his wife, in 1994, in the USA, where his 

sons were living. 

The young Zervos, who graduated from 

the Faculty of Pharmacy in Padova (Italy),

26 


was already encountering a prosperous 

material status, which allowed him at his 

arrival, in 1872, to open a pharmacy in the 

free port of Sulina, under the name of the 

wise deity �Minerva� [2]. 

Notwithstanding, from the beginning he 

received the help of two business partners 

right from the beginning: dr. Contomihalos 

and after his departure, dr. Valentin Stais 

[3]. 

In this prosperous city, which was the 

residence of the European Danube 

Commission ever since 1856, the 

pharmacist Zervos was the sole owner of a 

pharmacy: a medical statistic study of 

November 14 th , 1879 (the official date of 

the Romanian administration commencement 

in Dobrogea), mentions only 2 

pharmacies in Sulina: �Minerva� and the 

pharmacy of the European Danube 

Commission’s Hospital [3]. 

The legal framework under continuous 

change brought amendments also for the 

�Pharmacy’s business carrying out�: by 

means of the Ministers’ Council Journal 

no. 8 of February 6 th , 1881, the pharmacies 

with foreign owners (without Romanian 

citizenship) as in the case of the �Minerva� 

pharmacy from Sulina, were only 

acknowledged under �personal right� [3]. 

The grounds of the name change, of 

Gherasimos Zervos’ pharmacy, are 

unknown in 1895, subsequently being 

renamed �Speran�a�. Under this optimistic 

name the pharmacy was run for another 

five years by Gherasimos Zervos, until his 

death on January 30 th , 1901 [4]. 

Starting that year, the family of the 

deceased Zervos gives under concession 

the pharmacy up to 1916 to the 

pharmacists: Nicolae Lupescu, Pavel 

Avram and Gh. C�lin [4]. 

The First World War breaks off the 

ordinary course of life in the Sulina free 

port as well: subsequently, the destiny of 

Zervos family and of the pharmacy 

changed, the documents of those times 

having provided no statement at all. Under 

the same silence were also placed the 

successors of the pharmacist Gherasimos 

Zervos (1842-1901) from Sulina. 

Their discovery was revealed upon the 

reading of the travel book �Abyssinia� [5], 

signed by the reporter-writer Mihai Tican- 

Rumano (1895-1967), who had travelled 

along five continents and represented a 

genuine ambassador of our country. 

In 1934, having journalistic interests 

concerning the Italo-Abyssinian conflict, 

recently begun at the country borders, he 

travels to Ethiopia, hoping that his dream 

would come true, namely that of seeing 

�an African Christian-Orthodox country 

by excellence, the country of the world’s 

most pious emperor, Haile� Selassié I� [6]. 

Being under preparation and alert due 

to the war, the audience to the emperor 

became unachievable. He was advised to 

ask for help from the personal counselor 

and physician of the Imperial Court of 

Abyssinia’s capital, Addis-Abeba. 

A cordial reception was held in the 

doctor’s house, a certain dr. Zervos. 

The business card of the Romanian 

writer stirred great emotions and 

enthusiasm: the doctor started to speak 

Romanian! 

Although having strong Greek 

influences, the Romanian language spoken 

in the heart of Abyssinia by the doctor 

caused a great surprise also to the reporter 

Mihai Tican-Rumano. 

He was in front of Dr. Jaques Zervos, 

the private physician of the Imperial Court 

and resident minister of Greece in Addis- 

Abeba. 

Jaques Zervos had confessed about his 

native and childhood city, Sulina, where 

his parents rest in peace, about his 

children, �a boy and a girl who learn at our 

schools�, about his big family from 

Romania and about the studies at the 

Faculty of Medicine in Athens, together

A LUCASCIUC et al: The Greek pharmacist Gherasimos Zervos (1842-1901) and his successors, 27 

the Zervos physicians from Romania 

with his brother George Zervos, physician 

in Bucharest [7]. 

Thus one of the most famous sons of 

Zervos was identified. Where are the 

others? 

60 years later. 

Bucharest, March 1995. 

In the most original way, we found out 

that the last Zervos was preparing to leave 

Romania: we are speaking about Dr. 

Gherasim T. H. Zervos (dr. George 

Zervos’ son), an obstetrician, former 

manager of Filantropia Hospital in 

Bucharest. 

Although surprised that there is another 

person who succeeded in solving the 

present �puzzle� regarding his family, the 

pharmacist’s nephew confirmed us the 

bibliography and the pages wrote by Mihai 

Tican-Rumano, in the chapter �A 

counselor of the Imperial Court� of 

�Abyssinia� [8]. 

The ZERVOS family, Gala�i 1930 

The first on the left on the third upper row is Dr. Jacques ZERVOS (Ethiopia), 

together with his four brothers. 

References: 

1. Georgescu-Tulcea N., Istoricul 

asisten�ei cu medicamente a popula�iei 

din Dobrogea de nord, p. 381-386, vol. 

Medical Retrospectives – studies, 

notes and documents, published by Dr. 

G. Br�tescu, Medical Publishing 

House, Bucharest, 1985, p. 382. 

2. Georgescu-Tulcea N., Istoricul 

asisten�ei cu medicamente a popula�iei

28 


din Dobrogea de nord, p. 381-386, vol. 





3. Georgescu-Tulcea N., Istoricul asisten�ei 

cu medicamente a popula�iei din 

Dobrogea de nord, p. 381-386, vol. 





4. Georgescu-Tulcea N., Istoricul asisten�ei 

cu medicamente a popula�iei din 

Dobrogea de nord, p. 381-386, vol. 





5. Tican-Rumano M., Abisinia, 2 nd Edition, 

Cartea Româneasc� Publishing House, 

Bucharest, 1935, 281 p. 



Bucharest, 1935, p. 128. 



Bucharest, 1935, p. 114. 



Bucharest, 1935, p. 112-122.




GREEK PHYSICIANS AND PHARMACISTS 

GRADUATED IN ATHENS 

PRACTICING IN ROMANIA 

A. LUCASCIUC 1 M.-G. SULIMAN 2,3 

O. ELEFTERIU 3 C. GRECU 3 

Abstract: The present work will present a bibliographical list containing 

only Greek physicians and pharmacists with specialist training in Athens 

(Greece). The few names that have been lost in obscurity are offset by other 

personalities who gave medical and pharmaceutical professions resonance in 

Romania. Amongst these physicians we mention: Jack and George Zervos, 

sons of the pharmacist Gherasimos Zervos (1842-1901) from Sulina, 

Comboti Nicholas with doctorate in medicine in 1845, which, subsequent to 

the achievement of the free practice right, became a prominent member of 

medical society and even the top of the scientific pyramid - chief doctor of 

Bucharest in 1869, doctor Androcles Fotino, born in Braila (1834) has 

accomplished higher education in Paris and Athens. Upon his return back 

home, he achieved higher grades as officer-doctor and professor at the 

Bucharest School of Medicine, Pharmacy and Veterinary Science. Amongst 

the pharmacists we mention: Petzalis Rasti Sophocles, which graduated with 

apothecary diploma in Athens in 1857, in 1864 is the owner of the pharmacy 

"Esculap" in Braila until 1883, when his son-in-law receives the ownership 

of the pharmacy, Dr. Mina Minovici (Father of forensics in Romania), 

continues to work in the laboratory, until his death (1894); Andreea Nicolae, 

master in pharmacy graduate from Athens, known in 1864 as owner of the 

pharmacy "Spiteria Romana" from Galati, etc. 

Key words: Athens, Romania, pharmacists. 

Within the bibliographical inventory 

presented are listed, in alphabetical order, 

the professionals with studies and medical 

and pharmaceutical diplomas achieved in 

Athens. The primary bibliographical 

source is presented abbreviated. 

Physicians 

1. Adamantis Apostol 

(„Veriotul-doctoru”) born in Veria 

(Macedonia) in 1822. 

1 ISHM, Bucharest. 

2 National Medicines Agency, Bucharest. 

3 RSHP, Bucharest. 

He was for 3 years the apprentice of 

medicine attached to Vretos (Serafim 

Vreton Ion „the Armenian”), born in 

Bucharest, „Parisian doctor, from 1815”; 

he was the physician and the teacher of the 

prince of Walachia, Ion Caragea. 

Vretos, physician, philosopher and 

remarkable bibliophile, dr. Adamantis 

wrote that his mentor had also the intention 

to publish the manuscripts collected, but 

all of them burned during the fire in April 

1847, together with Bucharest houses.

30 


Supposing that, the last journey 

performed by dr. Serafim Vretos in 

Greece, during 1841-1844, had as main 

goal the guidance of the young 

Hippocrates’ apprentice regarding the 

improvement of serious medicine studies 

in Athens. 

Therewith, we settle the return year in 

Walachia (1844), since, subsequent to this 

date, both of them are mentioned in the 

documents. Dr. Adamantis mentions him, 

„in a prologue”, as being his mentor and 

inoculating him the passion for introducing 

into thesaurus the written word, thus, he 

collected treasure, in his turn, consisting in 

books and manuscripts „800 volumes of 

medicine and literature”, which he had to 

offer for sale when his daily subsistence 

was threatened. [3 p.7; 392-393; 452; 461] 

2. Cantili Vasile 

1829 – medicine diplomat in Athens; 

1860 – unrestricted practice license in 

Bucharest; 

1863 – 1 st class regiment physician 

competition [2, No. 18 – 25 June]; 

1863 – member in the Hygiene and 

Sanitation Council of Ploiesti [3 p. 60]. 

3. Colovos Anastasie 

1854 – medicine diplomat in Athens; 

1858 – Bucharest; 

1863 – physician with the free consult 

service of the Col�ea Hospital health centre 

[2, No. 5]; 

1863-1876 – private clinic physician and 

the same position for free consults (Health 

Service Yearbook) [3, p. 77]. 

4. Comboti Nicolae 

1845 – PhD in medicine in Athens and 

unrestricted practice license in Bucharest; 

1860 – physician of the Black Sector, 

Bucharest; 

1863 – physician of the Red Sector, 

member of the Scientific Medical Society; 

1863-1866 - member of the Hygiene 

and Sanitation Council of Bucharest; 

1870 – Head of the Bucharest Health 

Division [3, p. 77]. 

5. Fotino Androcles (Andrei), 

11 th of November, 1834 Br�ila – 9 th of 

May 1907 Bucharest. 

1859 – PhD in medicine in Athens; 

1860 - unrestricted practice license in 

Bucharest; 

1860–1864 – regiment physician, 

promoted to head of the 5 th medical 

division of the Military Hospital, while 

teaching „the recruit and reform course at 

the National Medicine School” to the 

veterinary division; 

1864 – Head of the 1 st Surgery Division 

of the Military Hospital; publishes various 

scientific works and clinical observations 

from the division he runs; 

1865 – member of the Superior Health 

Council and promoted to 1 st class senior 

physician (1875); 

1876 – member of the Red Cross 

Committee; 

1877-1878 – takes part in the 

Independence War, driving the ambulance 

of the Main Sector of Mecika; starting with 

December 1877, he manages the military 

hospitals; awarded the Military Virtue; 

1882 – senator of Mehedin�i; Law 

Reporter of the Health Service 

Organisation Law; 

1885 – General Manager of the Civil 

Health Service; 

1891 – participated in the Hygiene and 

Demography Congress in London; 

1893 – severally awarded for his heroic 

deeds, honesty and professional 

competence, he reached his full retirement 

age [3, p. 148 – 149]. 

6. Kefalos Trasivul 

Son of physician Kefalos from 

Constan�a; 

1865 – medicine diplomat in Athens, 

returns in Constan�a;

A. LUCASCIUC et al.: Greek Physicians and Pharmacists Graduated in Athens Practicing in … 31 

1868 – dies due to typhoid, buried in the 

Greek Church’s yard (after dr. H. Serafidi 

„Medicine in Dobrogea”) [3, p. 223]. 

7. Micralopulo, physiscian 

Diplomat of the Athens Faculty of 

Medicine (-), he settled in 1864 in Tulcea, 

but the newspaper „Sanitarul” [3, p.280] 

mentions that he left Tulcea soon after that. 

8. Orlando, physician 

1865 – PhD in Athens, domiciled in 

Tulcea where he was employed „as family 

doctor” for 20 houses, later he went to 

Paris and never returned [3, p. 308]. 

9. Sacorafos Michail 

1850 – PhD in Athens and unrestricted 

practice license in Romania; 

1862-1866 – physician of districts II and 

III, Gala�i; 

December 1868 – 1873 – owner of the 

„Domneasc�” pharmacy in Gala�i (Dr. 

Cazacu and C. Frunz�) [3, p. 372]. 

10. Stavridi Constantin 

1857 – PhD in Athens and unrestricted 

practice license in Gala�i; 

1865 – publishes the „Report over the 

epidemic of cholera morbus occurred in 

Gala�i in 1865” [2 (nr. 3,4,6), 3 (p. 410)]. 

11. �u�u (�utzu) Alexandru 

1837 – 1919 Bucharest 

Subsequent to secondary school, went to 

Athens where he acquires the bachelor’s 

degree in medicine. 

1865 – PhD degree for the 

„Considérations sur la dyspepsie 

essentielle” (Paris); 

October 1865 – unrestricted practice 

license in Bucharest (M. M. no. 33); 

March 1866 – secondary physician; 

starting with 1867, chief physician of 

M�rcu�a asylum; 

1867 – 1868 – registered with the 

National Medicine School program for the 

course „mental illness clinic” (Sunday 

courses); 

1876 – 1877 – „The alienated in front of 

the society and in front of science. Medical 

and psychological studies” – psychiatry 

forensic study (DCMF); 

1877 – founder of the „Caritatea” 

Institute on Plantelor St., Bucharest 

(„Private health house for mental illness”); 

1879 – mental pathology and forensics 

professor, in 1881 became the Lecturer’s 

chair for mental and psychic diseases from 

the Faculty of Medicine in Bucharest; 

awarded the „Sf. Ana” Order, 2 nd degree; 

1884 – publishes „The Forensic and 

Psychiatry Magazine” (the first in this 

domain) where he publishes: „A few words 

about the intellectual epidemics” (No. 2), 

„Psychosis classification” (his last work); 

1901 – member of the Superior Medical 

Council and correspondent member of the 

Romanain Academy [3, p. 419 – 420]. 

12. Vaias Teodosie 

1862 – PhD in Athens; on October 17 th 

he achieved the unrestricted practice 

license in Bucharest [2, No. 28]; 

1863 – resigns from the Calafat city 

physician position and on June 10 th is 

appointed as Caracal city physician; 

1864 – physician in Tg. Jiu Hospital 

(Gorj County) [3, p.144]. 

Pharmacists 

1. Andreea Nicolae 

Magister in pharmacy with bachelor’s 

degree in Athens (1856). 

1858 – unrestricted practice license in 

Romania; 

1860 – opens a pharmacy in Gala�i (N. 

Angelescu, p. 170 - 171); 

1864 – owner of the pharmacy „Spi�eria 

Român�” in Gala�i (Health Service 

Yearbook/1864 up to 1875).

32 


2. Aescht Rudolf 

Diplomat in Athens mentioned in the 

Health Service Yearbook 1864 with 

unrestricted practice license [3, p. 7]. 

3. Mihailidis spi�erul 

Diplomat in Athens (-), opens a 

pharmacy in Tulcea between 1859-1860; 

due to competition grounds, he moves to 

Sulina [3, p. 382], where he is no longer 

certified by the bibliographies researched. 

4. Petzalis Rasti Sofocle 

1857 - Diplomat in Athens; 

1864 – owner of the pharmacy „Esculap” 

in Br�ila until 1883, when the pharmacy is 

taken-over by his son-in-law, dr. Mina 

Minovici, however he continues to work in 

the laboratory, up to his death in 1894. 

References 

1. Dic�ionar cronologic de medicin� �i 

farmacie – sub redac�ia G. Br�tescu, 

Editura �tiin�ific� �i Enciclopedic�, 

Bucure�ti, 1975 (DCMF). 

2. Monitorul Medical (M M). 

3. Repertor de medici, farmaci�ti, 

veterinari (personalul sanitar) din 

�inuturile române�ti vol. I (înainte de 

1870) - Dr. V. Gomoiu �i farmaci�tii 

Gh. Gomoiu �i Maria V. Gomoiu, Tip. 

„Presa” Br�ila, 1938 (RMFV).




THE BYZANTINE PHYSICIANS 

M. BESCIU 1 

“Orthodox Church remains intangible by extending its arms in the 

Eastern European territories and preserving an entire art and 

almost an entire civilization” (N.Iorga) 

Abstract: The organization level of the sanitary security shows the 

unquestionable level of Byzantine medicine. The people from that period 

believe in healings gods. Cosma and Damian are representatives for the cult 

of physicians without silver. During this period the charity institutions was 

developed, and the physicians could study individual or in dedicated schools. 

The schools activated near hospitals and the candidate who succeeded at the 

exam, receive a sort of symbol that made the difference between physicians 

and impostors. The interesting thing is that the doctor accord an important 

attention to the nutrition, not only to the medical treatment Rich professional 

libraries were also found in hospitals, and they are endow with important 

medical books such as magnificent manuscript which includes the work of 

Dioscoride, Materia Medica, since 512, wrote for Anicia Iuliana. All of these 

it will be presented to you with all the Byzantine medical personalities’ 

contributions: Oribas, Alexandru from Trales, Aetius from Amida, Pavel 

from Egina, Jac Psycristul. In 1453 the Byzantine medicine moved the torch 

in the young hands of the European medicine fated to lead the medicine 

further 

Key words: Byzantine medicine, physicians, manuscript, Dioscoride. 

The Byzantine Empire lasted for over 

1100 years and the organization of a 

functional health care system was 

undeniable merit of Byzantine medicine. 

Pagan healing gods were replaced by the 

"Saints healers”. 

Unmercenary physicians or "Doctors 

without Silver" cult – Cosma and Damian, 

with Theraphon, Tecla, Kyr, John, Julian- 

was established from the very beginning. 

According to data transmitted over the 

centuries, Cosma and Damian were 

brothers and doctors. They came from 

Arabia in the town of Cyr. Here they 

1 University of the Medicine and Pharmacy „Carol Davila” Bucharest 

dedicated themselves to patients, both 

human and animal. 

Unlike other doctors, they followed the 

Biblical advice: "as a gift you received as a 

gift you give” they did not want to receive 

any reward. For that reason they were 

called "Saints Doctors without Silver"- 

Anargyres. 

One day, however, in violation of the 

decision on which both brothers had 

agreed, Damian received a sum of money 

from a noble woman, Palade, who, in the 

name of Christ, asked him to accept her 

gift. His brother, Cosma, was so angry that

34 


he said he does not want to work together 

with his brother anymore. 

After Damian had explained him why he 

made that gesture, that is not to humiliate 

and not sad the noble lady who asked the 

name of Christ, they were reconciled and 

continued their work. 

Governor Lysis, finding that they are 

Christians and attract many to the Faith, 

called them into court and asked them to 

offer sacrifice to the gods of the empire. 

As they refused resolutely, they were 

sentenced to death and executed by 

decapitation. Their bodies were taken into 

town by Christians and buried in honor. 

In Byzantium, hospitals functioned near 

monasteries. The administrative head of 

the entire institution was called the 

nosocomos. Two doctors and a lot of 

assistants, who learned, not helped, were 

working in each section. Women were 

cared for by a woman doctor, and at night 

there was a service call. 

Two inspectors were visiting the hospital 

day and night inquiring whether patients 

are satisfied or have any complaint to 

make. 

Each hospital had a dispensary in which 

worked two doctors and a number of 

assistants 

There were specialized hospitals - i.e. 

hospital doctors in Mangane dealt exclusively 

with diseases of the digestive tract. 

Nurses were instructed on the spot and 

formed health care professionals’ 

associations. 

Doctors were trained in two ways, 

individually or in groups ie in school. 

Generally, medical profession was 

transmitted from father to son. 

Medical schools were established around 

hospitals and one of the doctors acted as a 

teacher. Students were practicing in 

hospitals or clinics. Education was free. 

Teachers were chosen very carefully and 

students had to accumulate a lot of 

experience before start practicing as 

physicians. This period of training was 

called kronia. 

After the training, the student had to pass 

proficiency exam and answer question of a 

maestro, the head of the school or the 

emperor’s physician, bearing the title of 

actuarios. 

The candidate who passed the 

examination received as a sign of 

promotion a medal or badge to distinguish 

himself from impostors. 

Medical practice was based on the theory 

of the four humors. 

In therapy, Byzantine physicians used, 

along with the old remedies, news exotic 

ones, made from the three regna. 

An important role was played by diet 

recommendations. There were used 

curative and preventive diets, but there 

were also exaggeration. Doctors used to 

recommend to their patients diets 

according to different seasons, months, 

professions or social class. 

In order to master these diets and 

astrological data, doctors had to read a lot 

and collect many books. So, they had 

copies of classical medicine textbooks and 

many copybooks of diets and complicate 

recipes. 

Hospitals sheltered vast libraries with 

valuable medical works. Till the 15th 

century, there was in Sarb King’s hospital 

in Prodrom a magnificent manuscript of 

Dioscoride’s work “Materia Medica”. It 

was written for the princess Anicia Juliana, 

daughter of the Roman emperor Olybrius. 

Nowadays, this manuscript is kept in 

Vienna. 

A copy of Dioscoride’s famous pharmaceutical 

textbook, written in the first 

century A.C., was made in 512 and it is 

now sheltered in the National Library in 

Viena. This manuscript was made for the 

Byzantine princess Juliana Anicia, Gallea 

Placida’s great grand daughter and 

Areobindus wife. The portraits of the 

author talking to Heuresis (the Gift of

M. Besciu: The Byzantine physicians 35 

discovery) and Epinola (Attention), groups 

of physicians and different plants’ drawings 

are closed imitations of ancient 

copies of the textbook, which were in a 

pure Roman-Greek tradition. The use of 

gold was, however, a Byzantine 

innovation. 

Only the damaged thumbnail portrait of 

Iuliana Anicia can be considered a genuine 

work of the 6th century painter. The 

princess, dressed up in a splendid heavy 

plated dress, according to her status, looks 

forward and has a solemn attitude, as aulic 

ceremonies imposed. She is surrounded by 

allegories of Intelligence, at her left, and 

Kindness, at her right. The last keeps gold 

coins in her lap that Juliana Anicia spreads 

on the book handled by a little genius, 

called “the passion of the one who loves to 

build”. She imitated the generosity acts 

made by consuls at their appointments. 

The whole composition remembers the 

consular ivory diptychs or the pictures of 

the Virgin surrounded by angels, as in an 

icon from the Mount Sinai. At the 

princess’s feet stays a woman, “the Arts’ 

Gratitude”, who kisses the princess’s right 

shoe. In the corners there are theme scenes, 

in gray “grisaille” tones, painted in a free 

Greek style, which evoke the generosity of 

the princess who build up or renovate 

many churches in Constantinople, winged 

genius, comparable to those in Pompey, 

who dealt with architecture and painting 

works. 

ORIBASIUS (329-403) 

No doubt, one of the famous Byzantine 

physicians was Oribasius, born in 

Pergamos, as Galenus, and received 

medical training under supervision of 

Zenon from Cyprus. He was the physician 

and friend of Flavius Claudius Julian, the 

Renegate. 

Julian the Renegate, appointed Cesar by 

Constantine when he was sent to Galls, 

asked Oribasius to follow him. Also, he 

ordered Oribasius to edit Galenus’ works 

in a short form. 

In 362, Julian succeeded Constantine on 

the throne, and his physician became 

Quaestor of Constantinople. Unfortunately, 

Emperor Julian was killed in 363; 

Oribasius lost his protection and was 

exiled between Goths. His exile ended 

before 369. 

ORIBASIUS’s medical works 

His first work, written for Julian and 

called “Galenus’s Synopsis” is lost. 

At the Emperor’s request, a Medical 

books collection was created. It contained 

70 books, but only 25 resisted through 

ages. 

He wrote another Synopsis in his old 

ages for his son Eustatios, who was also a 

doctor. He also wrote Euporistes, with his 

recommendations for travelers. In this 

book, he described symptoms for each 

disease; presented the main drugs and most 

common substances used for drug’s 

manufacture and their effects. 

Books 11 to 13 were dedicated to 

Diocoride’s Materia Medica exposition 

and books 14 to 16 described simple and 

complex remedies. Information was varied, 

rich and accurate, but his prudence in 

prescribing needs the reader’s full 

attention. 

Oribasius described for the first time the 

melancholy delirium, lycanthropy. He 

prescribed hot oil instillation for earaches; 

for poisoning he recommended a mix of oil 

with water in large quantities, then teriac in 

wine or juniper fruits and 20 rut fruits. He 

used pharmaceutical forms like 

trochiscusurile pills and purgatives bread 

(cathartics) and ”Buccellata cathartici” 

(purgative electuary). 

Oribasius presented Caryophyllus

36 


aromaticus as medicine for the first time. 

Through its research and knowledge of 

medical and pharmaceutical literature, 

Oribasius remains one of the leading 

authors and practitioners of the Byzantine 

Empire. 

ALEXANDER OF TRALES (525-605) 

The greatest physician from the times of 

Galen until the Renaissance was probably 

Alexander of Trales. 

His work, 12 medical books, inspired 

medical schools in the Middle Ages, even 

if he criticized some opinions of 

Hippocrates and Galenus. 

He studied medicine, in private, at 

Ephesus, Pergamus, Athens and, certainly, 

in Alexandria. After he finished studies, he 

arrived in Constantinople, where his 

brother Antemios, a well known engineer 

and mathematician, together with Isidor of 

Milet, was building famous church of Saint 

Sofia. 

He inspired from Hipocrates’s work, 

who considered that the first mission of a 

doctor was to ease the illness by all the 

means. 

He was cautious regarding the treatment 

of cerebral disorders with white hellebore, 

which could induce fainting, and he was 

against the use of opium drugs in patients 

with tuberculosis. 

He described remedies like: Mala punica, 

ether oils, of chamomile decoction, 

coriander seeds, pomegranate, and castor 

oil as treatment for intestinal worms, 

colchium autumnale as gout treatment. He 

was against opium abuse. In his work, he 

focused on eye drops. He described very 

well pleurisy and its treatment, he focused 

on digestive diseases, gout, ascites and 

made first differential diagnosis between 

edema and hypertrophy using thumb 

pressure, diagnosed intestinal worms and 

recommended powerful remedies for this 

disease. 

“He is not a compiler, but a practitioner 

who knew how less valuable wors are at a 

patient bed”, said P.Brunet about 

Alexandre, whom work he has translated 

into French. 

Alexander also recommended the use of 

Ka-Ra-aa formula and amulets, but only if 

the treatment was unsuccessful. 

PAUL from EGINA (626-690) 

Alumni of Alexandria’s Medical School, 

Paul was well-known as a great surgeon 

who practice nasal polyps’ extraction, 

catheterize of the bladder, tracheotomy. He 

was the one who gave the name of cancer 

– Karkinos, crab – to malignant tumors, 

because he differentiated them from the 

benign ones and discover that malignant 

tumors send branches as a crab’s pincers in 

the surrounding tissues. He treated breast 

cancers by excision, not by cauterization. 

Paul from Aegina used rectal and vaginal 

speculum. In his days, medical art had no 

essential progress, but based on the known 

techniques it was improving. 

He thought of the use of catheter to treat 

liver abscess and he described correctly the 

technique of lithotomy. 

He remains in the history as an expert in 

lymph nodes surgery, superficial tumors 

surgery, uterine and breast tumors 

removal. 

Only Abreviar medical, a 7 volume 

textbook wrote by Paul lasted till our days. 

Books V and VII are dedicated more to 

pharmacology and describe venomous 

animal bites remedies, poison, antidotes, 

simple and complex medicines and their 

methods of fabrication. Book VI covers 

surgery issues and Book VII describes 

terrible plague epidemics. 

“… even if they have poor knowledge, 

surgeons’ technical abilities were so 

advanced that allowed them to have

M. Besciu: The Byzantine physicians 37 

important success in delicate and difficult 

interventions”, said Castiglioni about the 

surgeons of that period. 

AETIUS OF AMIDA (502-575) 

He was born in Mesopotamia and was 

trained in Alexandria. He became physician 

at imperial court of emperor 

Justinian. It is said that Aetius was the first 

Greek physician who embraced 

Christianity. 

He knew very well the Asian remedies. 

He wrote a medical synthetic textbook 

with medical recipes and mineral, vegetal 

and animal remedies. He was the first 

doctor who used camphor and cloves in 

therapy. 

His most important work is called Tetrabiblion 

and contains 16 books. It is Aetius’ 

worth to a better knowledge of surgical 

skills of Rufus of Ephesus and Leonidas, 

as well as of obstetrics and gynecological 

skills of Soran and Philumenos. 

The best Aetius’s clinical descriptions 

were his observations on the diphtheria 

with suffocation, palate paralysis and 

regurgitation through the nose. He made 

the first description of brachial artery’s 

ligature in case of aneurism. He was 

interested in intestinal worm infestation. 

Aetius used to recommend prayers in 

preparation of ointments and emplastres. 

NICOLAUS ALEXANDRINOS (Sec. 

XIII) 

Nicolaus Alexandrinos was known as 

Myrepsos – “The one who makes 

ointmens”. 

He wrote Dynameron, divided in 48 

chapters, an important work containing 

2656 drug formulations, as well as an 

important number of other pharmaceuticals 

remedies, based on their action. 

He was inspired by salarniteanian 

physician Nicolaus Salernitanus’s work 

Antidodarium. His work contains materia 

medica and pharmacology with therapy 

applications. His work had been the Paris 

Medical School’s Codex till 1651. 

SIMION SETH (SEC. XI) 

Simion Seth is the author of an 

encyclopedia of material medica – an 

alphabetical presentation of food beneficial 

effects. It contains an important number of 

remedies. 

Musk, amber and hashish are presented 

in his work from Arabian books. He 

noticed the camphor’s sedation effect on 

genitor-urinary tract. He presented the 

ointments and syrup from Arabian recipes. 

MIHAIL PSELLOS (1018-c.1078) 

Mihail Psellos, philosopher, historian, 

politician, naturalist physician, professor at 

the „High School” of Constantinopol. He 

wrote about „the action of the jinns 

(demons) in the diseases appearance” and 

the medicamentary effect of the jewels. 

In 1453 the byzantine medicine mooved 

the torch in the young hands of the 

european medicine fated to lead the 

medicine further. 

Bibliography: 

1. Ursea N. - Enciclopedia medical� 

româneasc� de la origini pân� în 

present, Bucure�ti, Ed. Universitar� 

“Carol Davila”, 2009; 

2. Iftimovici, R. – Istoria Universal� a 

medicinei �i farmaciei.- Bucure�ti: Ed. 

Academiei Române, 2008; 

3. Bologa. V. red - Istoria medicinei 

universale - Bucure�ti: Ed. Medical�, 

1970;

38 


4. Izsak, S. Farmacia de-a lungul 

secolelor .- Bucure�ti: Ed. �tiin�ific� �i 

enciclopedic�, 1979; 

5. Sprin�eroiu, M. L.; Vasile R. D. – 

Farmacia în civiliza�iile omenirii.- 

Bucure�ti, Ed. Multi Press 

International, 2003. 

6. http://sfintii-zilei.weblog.ro/2007-09- 

26/193889/Sfin%C5%A3ii-Cosma- 

%C5%9Fi-Damian-(sec--IV).html.




GREEK PHYSICIANS AND MEDICAL 

EMANCIPATION OF THE ROMANIAN 

LANDS 

D. BARAN 1 

Abstract: Constantinople, the second Rome, its orthodox Patriarchate and 

Academy, represented a model for the Romanian Lands. After the Byzantine 

Empire fall, Greek families settled in or travelling to Wallachia and 

Moldavia contributed to local society emancipation. In the Romanian 

Principalities, Phanariot rulers initiated «Early Enlightenment», 

strengthened Balkan “koinonia” and encouraged both national and western 

European values. «Homo Balcanicus» was becoming European. Italian, 

French and English contacts were frequent. Medicine was privileged. 

Nicolae Mavrocordat, the first Phanariot prince, the humanist owner of a 

famous library including medical books, wrote against tobacco. His wife 

preceded Lady Montague in variolating her children. Timoni, the Ghika 

princely family`s doctor, described variolation at the London Royal Society. 

Pylarino published in Venice the first scientific approach to variolation, a 

method he also presented to the British „Philosophical Transactions”, and 

which Romanians performed, too. While a Court physician, Pylarino 

encouraged medical education and hospital building in Wallachia 

Key words: Early Enlightenment, Phanariot rulers, variolation. 

Greek and Roman Confluences 

From ancient times, the ancestors of 

present day Romanians lived and forged 

their own cultural background mixing 

original ideas to strong Greek and Roman 

influences. This is true for Romania as a 

whole, but particularly for Dobrogea, 

Transylvania and Banat. The archaeological 

discoveries on the Black Sea shore, 

in Tomis-Constan�a, Callatis-Mangalia, 

Histria or Herakleia Pontike are in keeping 

with the vestiges in Apullum-Alba Iulia, 

Germisara-Geoagiu Spa, Aquae-C�lan and 

Herculaneum-Herculane Spa. Apollo, 

Artemis and the nymphs, Asklepios and 

Hygieia, Telesphoros and Glykon are 

always there next to Bendis, Darzos or the 

1 “Gr. T. Popa” University of Medicine and Pharmacy, Iasi, Romania 

Thracian Rider, assisting the environmental 

macrocosmic and the human 

microcosmic nature, providing health and 

mastering disease. Through the centuries 

Romanian history continued to evolve 

along these two coordinates of the „first 

and second Rome”. 

Medical European Renaissance in 

Moldavia 

In the XVI-th century, an intelligent, 

violent and ambitious Greek adventurer 

challenged Moldavia`s destiny. Jacob 

Basilides the Heraklid (1511–1563), a 

highly cultivated humanist, was born in 

Crete or, more probably, in Samos. 

Between 1548 and 1552 he studied

40 


medicine in Montpellier at the renowned 

Faculty founded there in 1220. [11] 

However, he soon proved fighting skills 

and followed a successful military career 

in the service of Carol Quintus. In 1561, 

Jacob became a short-lived Prince of 

Moldavia (1561-1563) and in 1562 

founded a Latin School (Schola Latina) at 

Cotnari, not far from Ia�i. As a fervent 

adept of Reformation, the Heraklid 

appointed protestant teachers, the first of 

them chosen among those in the city of 

Bra�ov, at the boundaries between 

Transylvania,Wallachia and Moldavia. 

Biological concepts were probably taught 

in this ante letteram Academy, whereas 

medical lectures were seemingly envisaged 

by Jacob Basilides to be also given, in a 

future that never came for him. [15] 

Historians surmise that the precious library 

of the Cotnari School included medical 

books, too. [1, 15] 

Early Enlightenment in Moldavia 

and Wallachia 

In the XVII-th century, once again, the 

Romanian Lands were reborn to a new life 

under the conjoint impact of Greece and 

Rome. On the one hand, Greek intellectuals 

fleeing the Turkish oppression 

potentiated the existence of a „Byzance 

after Byzance”, trying to maintain and 

further develop Greek values and culture. 

On the other hand, Italians were fulfilling 

diplomatic, religious and scientific 

missions in the vecinity of the “Sublime 

Porte” of Constantinople. Noble Greek 

families settling down in or travelling to 

the Romanian Countries of Wallachia and 

Moldavia contributed to local society 

emancipation and cultural flourishing. 

Phanariot rulers marked the «Early 

Enlightenment» period, opened these 

Lands towards both Western European 

horizons and ethnic ideals, stimulated 

national awakening. [4, 5] The Greeks 

mediated cultural contacts mainly with 

Italy, England and France, encouraging 

medical practice and teaching to develop, 

as they tried to restore their identity within 

this diasporas of a «historic exile». 

Constantin Cantacuzino 

Constantin Cantacuzino (1650-1716), 

high steward of Wallachia, studied 

medicine in Padua, travelled to Venice, 

and possessed an impressive library 

including updated medical works. (16) Part 

of them ended up in Nicolae 

Mavrocordatos` library. [2, 3] 

Fig.1. Constantin Cantacuzino 

He drew the first map of Wallachia 

with the aid of Ioan Comnen (Ioannis 

Comnenos), a Greek-born theologian and 

physician who graduated at the same 

famous University of Padua. [2, 3] It was 

Hrysant Notara (Chrysanthos Nottaras), 

patriarch of Jerusalem, who corrected and 

edited it in Padua in 1700. Born at Trikkala 

in Peloponnese, Notara studied medicine in 

Padua, spent many years in Wallachia and 

contributed to the flourishing of the 

Princely Academy in Bucharest and of its 

library. He probably promoted medical 

studies there. 

Nicolae Mavrocordat 

Nicolae Mavrocordat (Nicolaos 

Mavrocordatos, 1680-1730) of Chios, the 

first Phanariot prince, was the humanist 

owner of “the richest library in Oriental 

Europe” with medical treatises. He wrote a 

satire against tobacco “A Word against 

Nicotine” - and about life and death. 

(4,5,14) Prince of both Moldavia (1709- 

1710; 1711–1715) and Wallachia (1715–

D. BARAN, - Greek physicians and medical emancipation of the Romanian lands 41 

1716; 1719–1730), this “authentic citizen 

of the cosmopolitan «republic of letters»”, 

also interested, for instance, in the writings 

of Hobbes and Locke, introduced, 

reorganized and stimulated education and 

schools' activity. 

Fig.2. Nicolae Mavrocordat 

He used to practice medicine within his 

family and medically assisted his close 

friends. Among them Hrisant Notara was a 

remarkable personality. He suffered from 

“reumatika” and Mavrocordatos would 

have treated him from 1715 to 1731, as 

mentioned by chronicler Nicolae Costin. In 

1714, Notara donated books to the 

Academy of Ia�i and helped its 

reorganization. 

Alexander Mavrocordatos, the 

Exaporite 

Alexander Mavrocordatos (Alexandru 

Mavrocordat, 1641-1709), father to Prince 

Nicolaos Mavrocordatos, had married 

Princess Sultana, descending from the 

princely family of Alexandru Ilie�, who 

ruled over Wallachia (1616-1618; 1627- 

1629) and Moldavia (1620-1622; 1631- 

1633). Physician, philosopher and 

physiologist, Alexandros Mavrocordatos 

studied in Padua and Bologna, where he 

graduated in medicine. 

He was professor at the 

Constantinopolitan Academy of the 

Orthodox Patriarchate and, in 1644, he 

wrote a book on blood flow entitled “The 

Pneumatic Instrument of Blood Circulation” 

which disseminated information 

about Harvey`s discovery in this part of the 

world. Even though not directly involved 

in the history of Romanian medicine, 

Mavrocordatos` destiny was undoubtedly a 

representative example of “Balkan 

koinonia” which also included the 

Romanian Lands. 

Pulcheria, a “Lady Montagu” of Moldavia 

On February 19 th , 1713, Nicolae 

Mavrocordatos` second wife, Pulcheria 

Tzoukis (?-1716), variolated her two 

healthy children in Constantinople, after 

another one already got small-pox. 

Fig.3. Pulcheria 

As it comes out from a letter addressed 

to Hrisant Nottara, patriarch of Jerusalem, 

she could have done this herself since she 

had medical knowledge and skills. 

Pulcheria anticipated by several years the 

similar initiative of Lady Mary Wortley 

Montagu (1689-1762), who only in 1718 

had her son inoculated in Constantinople, 

probably by Dr. Timoni, and her daughter 

in 1721, in London. 

Emanuel Timonis 

Emanuel Timonis (Emmanouel 

Timonis,1669-1720) of Chios described 

variolation in Royal Society`s Philosophical 

Transactions, in 1714-1716, no. 29, 

pg. 72-82, in an article titled "An account, 

or history, of the procuring of the smallpox 

by incision or inoculation, as it has for 

some time been practiced at 

Constantinople, being the Extract of a 

Letter from Emanuel Timonius, Oxon. & 

Patav. M.D.SR.S. dated at Constantinople,

42 


December, 1713. Communicated to the 

Royal Society by John Woodward, M.D. 

Profes. Md. Gresh. and S.R.S“. [6] 

Timonis was Ghika princely family`s 

doctor, in Moldavia (1680-1700). [8] He 

was even accused of involvement in 

Grigore I Ghica's death in 1678 and 

plotting with the rival Cantacuzino family. 

In Padua, Timoni studied medicine, at the 

reputed Faculty whose pro-rector he 

became in 1691. [6] In 1703 he was doctor 

of the Oxford University and member of 

the Royal Society. In 1713, Timoni 

published in Constantinople “Historia 

variolarum quae per incisionem excitantur”, 

whereas, in 1721, in Leiden, 

appeared his “Tractatus de nova variolas 

per transmutationem excitanti methodo”. 

Better known than Pylarino, his contribution 

to immunology and vaccinelogy has 

been more frequently mentioned. [6] 

Jacob Pylarino 

Doctor Jacob Pylarino (Jakovos 

Pylarinos/ Giacomo Pilarino, 1659-1718) 

of Lixouri, Kefallonia, graduated in Padua. 

He learned in 1701 about “transplanttation”, 

as a popular means to prevent 

smallpox, from a woman in Thessaly who 

inoculated 40000 people. 

Fig.4. «Nova et tuta variolas» 

After having performed this technique, 

Pylarino published in Venice, in 1715, the 

first approach to variolation, his paramount 

opus "Nova et tuta variolas excitandi per 

transolantationem methodus, nuper inventa 

et in usum tracta qua rite per acta 

immuniaa in posterum praesenvatur ab 

hujus modi contagio corpora: Per Jacobum 

Pylarinum, Venetum M.D. et Peripublicae 

Venetae apud Smyrnenses Nuper 

Consulem“. 

Fig.5. Philosophical Transactions of the Royal 

Society, 1714-1716 

He also presented variolation in the 

British „Philosophical Transactions of the 

Royal Society”, in 1714-1716, no. 29, pg. 

393-399 as "Nova et tuta variolas excitandi 

per transplantationem methodus, nuper 

inventa et in usum tracta: Per Jacobum 

Pylarinum, Venetum M.D. et Peripublicae 

Venetae apud Smyrnenses Nuper 

Consulem“. [12] As a court physician, he 

travelled a lot to Germany and Russia, 

where he was the personal doctor of Tsar 

Peter the Great, Serbia and Moldo-Vlachia. 

[2, 6] In 1684 indeed, Pylarino came to 

Wallachia, as doctor to Prince �erban 

Cantacuzino and remained in Bucharest 

until 1687. Between 1694 and 1708, when 

appointed Venetian councilor in Smirna, 

Pylarino was again in Wallachia, as 

physician to the Ruling Prince Constantin 

Brâncoveanu. [3, 8] He encouraged 

medical lectures to be given at the “Saint 

Sava” Princely Academy in Bucharest, 

where teachers were usually Greek 

physicians and theologians. [2, 3] Among 

them: Markou Porphyropoulou, Ioan 

Comnen, Nicolaos Kerameos (Nicolae 

Kerameus). Remarkably, young Greeks 

living in Wallachia could get scholarships 

from Prince Brâncoveanu and study


medicine abroad, as did Giorgos 

Hypomenas of Trabzon, who after 

graduating in Padua, became a practitioner 

in Bucharest. [3] Pylarino supported the 

achievement of the “Col�ea” Hospital in 

Bucharest, in 1704, the first great hospital 

in the Romanian Lands. 

Fig.6. Bucharest. Col�ea Hospital and Church 

Fig.7. Venice. «San Lazzaro» Hospital 

Built at the expense of High Stewart 

Mihail Cantacuzino who studied humanist 

disciplines in Padua, the institution 

reproduced the model of the “San Lazzaro 

dei Mendicanti” («Saint Lazarus of the 

Beggars») Hospital in Venice. 

Fig.8. Mihail Cantacuzino 

Pylarino, who in his youth was a 

physician there, yielded the plan of the 

Venetian establishment. [3, 8] 

Variolation from Timoni and 

Pylarino to Jenner 

In 1722, convinced of the utility of 

inoculation or engrafting, Lady Montagu 

intervened to the College of Physicians of 

London for determining acceptation of 

variolation for anti-smallpox protection. In 

1796, Timoni`s and Pylarino`s method of 

vaccination, i.e. variolation, of 1713, 

reemerged. It was modified by Dr. Edward 

Jenner, who took the vaccination liquid not 

from smallpox patients, as Timoni and 

Pylarino, but from cowpox vesicles. [3] 

Jenner`s method gave better results, also 

because it caused a decreased mortality. 

Romanian popular medicine did the same. 

Variolation in Romanian Popular 

Medicine 

Alexander the Good, Prince of Moldavia 

(1400-1432), mentioned in his Code of Laws 

(«Pravila») of 1400 the «engrafting» 

technique of variolation. Doctor Andreas 

Wolf, who lived in Moldavia from 1780 to 

1797, related that the country had been 

severely affected by smallpox for three-four 

years and variolation officially introduced 

since 1780. In 1803, vaccination was 

performed by dr.Hesse and dr. Fröhlich, 

without any fee, and was recommended by 

the Princely Court. 

Griselini 

Francesco Griselini (1717-1784), an 

Italian biologist and painter, agrarian 

economist and journalist illustrating the 

Venetian Enlightenment, visited Banat. It 

happened between 1774 and 1777, when 

both Venice and Banat were under 

Austrian authority. 

Fig.9.Francesco Griselini

44 


In 1780, he published “Geschichte des 

Temeswarer Bannats” («History of 

Temesvarer Banat», Vienna, 1780). He 

described variolation, which only 

Romanians performed in various ways: 

pustular smallpox fluid from sick persons 

was inoculated to healthy children after 

scarifying or rubbing their arm skin; 

pustular fluid was directly placed on the 

arm skin previously strongly rubbed with a 

rugged cloth until it became inflamed or a 

superficial incision of the arm skin was 

performed into which smallpox pustular 

fluid was placed. [7] Griselini communicated 

his impressions about Banat in 

Letters addressed to outstanding personalities 

of his time, including Lazzaro 

Spallanzani (1729-1799). As in the case of 

Spallanzani, Griselini benefitted from the 

patronage of Habsburg officials during his 

travel through Banat and Wallachia. 

Franz Joseph Sulzer 

In 1781-1782, Franz Joseph Sulzer 

published his “Geschichte der 

Transalpinischen Daciens” («History of 

Transalpinian Dacians») where he 

reported variolation of young ladies on 

the forehead or wrist, practiced by 

Romanian girls of Transylvania”to 

preserve their beauty”. [3, 10] 

Nyulas Ferenc 

In 1802, the Hungarian Physician 

Nyulas Ferenc wrote about “Kolozsvári 

tehénhiml�” («Vaccination in Cluj»). He 

reported that peasants from Some� and 

F�g�ra� bathed their children in the milk of 

cows with cowpox, after washing with it 

the udder having cowpox vesicles. Other 

times, cowpox pustules were pricked with 

a fine needle which was then passed 

through the child’s ear lobe. In Ceanul 

Mare and Cicud, the Valach priests 

inoculated smallpox according a 

“mysterious” method known only by them. 

[3, 10] 

Famous Followers in Modern Times 

Ioan Cantacuzino 

The particular «genetic design» of this 

continous Greek-Romanian cohabitation 

generated towering medical specialists that 

continued to be involved in immunology 

and vaccinology. 

Ioan Cantacuzino (1868-1934) came 

from a mixed Greek-Romanian family, 

descending from its first «Enlightened» 

representatives of the XVII-th century, 

already mentioned: Constantin, Mihail and 

�erban. Ioan Cantacuzino studied in Paris, 

with Ilya Mechnikov (Nobel Prize, 1908). 

Fig.10 Ioan Cantacuzino 

A highly reputed microbiologist, he 

founded, in 1901, a laboratory of 

experimental medicine and in 1921, 

established the Institute for Sera and 

Vaccines in Bucharest, bearing now his 

name. 

Fig.11. Bucharest. “Cantacuzino” Institute 

He distinguished himself during the IInd 

Balkan War, when «the great Romanian 

experience» of 1912-1913 revealed the 

efficiency of his anticholeric mass 

vaccination performed in epidemic foci. 

[3]


The «contact immunity» was thus 

definitely proved. During World War I, 

Cantacuzino successfully fought epidemics 

by antityphic-paratyphic, anti-diphtheric 

and anticholeric vaccination. He efficiently 

set up antituberculosis and antimalaria 

strategies in Romania. Due to him, a close 

friend to Calmette, his country was the 

second one, after France, to introduce 

Calmette-Guérin bacillus-based antituberculosis 

vaccination. 

At the Faculty of Sciences in Ia�i, 

Cantacuzino was professor of Animal 

Morphology (1894-1896). 

In 1917, during World War I, he 

founded in Ia�i, along with Russian and 

French physicians, "The Medico-Surgical 

Society of the Russian-Romania Front”. 

At the end of the war, in 1920, 

Cantacuzino represented Romania in Paris 

at the peace treaty, a document he signed 

with Titulescu on behalf of their country. 

Constantin Levaditi 

Born at Gala�i as the son of a Romanian 

mother and a Macedo-Romanian (Vlach) 

father from the Pindos Mountains, 

Constantin Levaditi (1874-1953) studied 

medicine in Bucharest and was trained in 

Victor Babe�’ school for five years, as an 

eminent research assistant. He then left for 

Paris, were he had a brilliant career at the 

„Pasteur” Institute. [9, 13] 

Fig.12. Constantin Levaditi 

Levaditi laid the basis of virology and 

further developed immunology in universal 

medicine. He authored the first treatise of 

virology ever published -“Les ultravirus 

des maladies humaines” (Paris, 1937)- and 

pioneered viral cultures techniques, 

including viral multiplication in tumoral 

tissues. He investigated poliomyelitis, 

syphilis and cancer, their origin and 

therapy. [9, 13] 

Levaditi was nominated several times 

to the Nobel Prize for Medicine between 

1930-1934. 

Indirectly, he fathered microbiology in 

Romania, too, through his disciple, 

professor �tefan S. Nicolau (1896-1967). 

[3] 

They first met in 1921 in Cluj, where 

Levaditi was appointed professor and 

Nicolau graduated. Levaditi put a mark on 

Nicolau, who, in 1942, inaugurated in 

Bucharest the first Chair of Inframicrobiology 

in the world. 

Fig.13. �tefan S. Nicolau 

Nicolau contributed to the 

characterization of the Borna virus and 

virus replication in tumours. 

In 1939, when he returned to Romania, 

Nicolau was initially appointed professor 

of Bacteriology at Ia�i, where he remained 

only for a short lapse of time. 

Homo Balcanicus 

«Balkan countries» result to be more 

than simply a geographical concept. This 

south-eastern European region shared 

common historical circumstances and 

challenges. Balkan peoples developed 

related features and adopted comparable 

behavioural patterns. At the crossroads of 

Orient and Occident, of three great

46 


monotheistic religions - christianity, 

judaism and islam -, of three great empires 

- Austro-Hungarian, Ottoman and Russian, 

of three great ideologies - democracy, 

dictatorship, anarchy, and three great 

political systems - capitalism, communism 

and liberalism, the Balkan community 

seemed to display intertwined complementary 

faces. Paradoxically, the «powder 

barrel» of Europe enabled a transcultural 

melting pot to exist, living this diversity, 

revealing identities, transforming mentalities 

between health and disease, life and 

death. Medicine in the Romanian Lands 

evolved along both Western European and 

Balkan coordinates and its original 

contribution to the progress of science still 

awaits to be acknowledged and officially 

integrated to the universal history of the 

healing art. The peculiarities of Balkan 

medicine are in keeping with both homo 

balcanicus and homo europaeus and 

express the same aspirations of homo 

universalis. 

References 

1. Bârs�nescu �t, Schola Latina de la 

Cotnari, Litografia �i Tipografia 

Înv��mântului, Bucure�ti, 1957. 

2. Berza M, Pentru o istorie a vechii 

culturi române�ti, Ed. Eminescu, 

Bucure�ti, 1985, 173-193. 

3. Bologa V, Istoria Medicinei 

Universale, Ed. Medical�, Bucure�ti, 

1970, 284-8,398-9, 741-5. 

4. Bouchard J, L'aube des Lumières dans 

les Pays Roumains, Rev Hist Inst Rech 

Néohell, 2005, 2:31-51. 

5. Bouchard J,Nicolae Mavrocordat, 

domn �i c�rturar al Iluminismului 

timpuriu, Ed. Omonia, Bucure�ti, 

2006. 

6. De Raymond J-F, Querelle de 

l'inoculation, ou, Préhistoire de la 

vaccination, Librairie Philosophique 

J.Virin, Paris, 1982, 31-39. 

7. Giselini F, Încercare de istorie politic� 

�i natural� a Banatului Timi�oarei, 

Ed.Facla, Timi�oara, 1984. 

8. Iftimovici R., History of Science in 

South-Eastern Europe, Newsletter, 

2001, 5: 13:14. 

9. Iftimovici R, Grama S, Newsletter for 

the History of Science in Southeastern 

Europe, 2003, 7:13-14. 

10. .Ionescu C, Prophylaxis of Smallpox in 

Romanian Traditional Medicine, J 

Prev Med, 2001, 9: 74-76. 

11. Izsák S, Étudiants roumains à 

l`Université montpelleraine, 16e Cong 

Int Hist Méd, Montpellier, 1958. 

12. Karamberopoulos D, The medical 

European knowledge in the Greek 

region 1745-1821, Library on the 

History of Medicine, Publishing House 

Ath. Stamoulis, Athens, 2003, 1: 312. 

13. Lascaratos J,.Kalantzis G, Skiadas P, 

Constantin Levaditi: An unknown 

pioneer in immunology research, Arch 

Hell Med, 2003, 20, 3:319–325. 

14. Radu R, Cultura Mavrocorda�ilor, 

Economia, 2004, 2: 91-93. 

15. Romanescu C, Note medico-istorice la 

domnia lui Despot Vod�, Rev.Med, 

1969, XV, 1: 110-112. 

16. Ruffini M, Biblioteca stolnicului 

Constantin Cantacuzino, Ed. Minerva, 

Bucure�ti, 1973.




THE IMPORTANCE OF STUDYING GREEK 

PHILOSOPHERS AND PHYSICIANS (5 TH – 

3 RD CENTURY B.C.): CONTRIBUTION TO 

THE DEVELOPMENT OF NEUROSCIENCE 

IN MEDICAL SCHOOLS 

D. DIACONESCU 1 , S. TOMA 1 , 

R-S DIACONESCU 1 

Abstract: 

The nature of psychic life, the anatomical seat of cognitive, motor and 

sensory functions, and the origin of neurological diseases were broadly 

debated by ancient Greek scientists since the earliest times. Within a few 

centuries, speculation of philosophers and physicians laid to foundations of 

modern experimental and clinical neuroscience. In this review we shall 

present the most important Greek philosophers and physicians living between 

the 5th and the 3rd century before Christ (B.C.) and examine some of their 

leading theories concerning the mechanisms of cognitive activity, the nature 

of perception and voluntary movement, and the causes of neurological and 

psychiatric disorders 

. 

Key words: History of neuroscience; Presocratic philosophers; 

Alexandrian medicine; Hippocratic medicine. 

Introduction 

Since the earliest times ancient Greek 

scientists debated the nature of psychic life, 

the anatomical seat of motor, sensory and 

cognitive functions, and the basis of some 

neurological and psychiatric diseases. 

The aim of this study was to present the 

theories of the most important ancient 

Greek philosophers and physicians (5 th -3 rd 

century B.C.). 

Content 

The origin of thinking activity was 

explained by Greek philosophers and 

physicians based on two theories. The 

encephalocentrism considered the brain as 

1 Transilvania University of Brasov 

the seat of human consciousness, sensation 

and knowledge, all these faculties being 

attributed by the cardiocentrism to the 

heart. Both theories generated controversy 

within the scientific community [4]. 

a. Philosophers 

Hippon of Samos (4 th century BC) 

localized the main part of the soul to the 

head, particularly to the brain. Anaxagoras 

of Clazomenae (500–428 BC) and 

Diogenes of Apollonia (ca. 460 BC) 

believed that all sensations had connection 

to the brain [4].

48 


Empedocles of Acragas (490–430 BC) 

thought that “the blood around the heart is 

men’s thought” [5]. Thus, humans think 

with the blood and the level of intelligence 

depends on blood’s composition. That is 

why he considered the heart also as the 

seat of mental disorder [19]. 

In the opinion of Empedocles, sensation is 

a purely physical process, depending on pores 

and affluences. Affluences enter continually 

in another body through pores and sensation is 

a matter of symmetry of pores [5]. 

Fig.1. Empedocle – source Wikipedia 

Aristotle (384 BC – 322 BC) was 

probably the first anatomist in the modern 

sense of this term [11]. According to 

Aristotle, the soul is defined as the the 

form of a living body [18]. 

Aristotle had interesting contributions 

to brain anatomy. He observed that the 

brain was placed in the front part of the 

head and was surrounded by the meninges, 

two membranes containing blood vessels. 

The external membrane was the thickest 

and located next to the bone of the skull; 

the more delicat internal membrane was 

localized around the brain itself. 

For the first time an important 

anatomical distinction between cerebrum 

(enkephalos, brain) and cerebellum 

(parenkephalis, para-brain) was made by 

Aristotle. The para-brain was positioned 

beyond the brain, and its shape and tissues 

were different from those of the brain. 

Aristotle also identified three possible 

nerves - “poroi” (ducts) – two of them 

leading to the cerebellum and one to the 

brain [1]. These ducts might refer to the 

optic nerve and tract, and to trigeminal and 

oculomotor nerves [3]. He also described a 

cavity in the brain, probably the ventricular 

system, and made the observation that man 

has the largest brain in proportion of his 

size. He also referred to “liquidity about 

the brain”, probably the cerebrospinal 

fluid. Aristotle described the spinal cord as 

an extension of the brain and the similar 

constitution for both structures [1]. But 

Aristotle’s theories about brain function 

were rather dissapointing. In his view, 

brain had no sensory properties and was 

insensible when touched. He concluded that 

the brain was a cooling organ, after he 

noticed a lot of blood vessels on the surface 

of the brain, therefore having no intellectual 

meaning. Aristotle also considered the brain 

as the sleep generator [3]. 

Fig.2. Aristotle – source 

www.wicknet.org/.../gallery_of_the_greats.htm 

b. Physicians 

The sensory and cognitive significance 

of the brain was probably first recognized 

by Alcmaeon of Croton (500 BC) [15]. He 

asserted that “all the senses are connected 

with the brain” through channel-like 

structures called “poroi”, two of them, no

DIACONESCU et al.: The importance of studying Greek philosophers and physicians (5 th – 3 rd 

century B.C.): contribution to the development of neuroscience in medical schools 

doubt the optic nerves, joining the eyes to 

the brain. Alcmaeon claimed that the brain 

was the seat of consciousness and 

sensation because he recognized that all 

senses “are compromised if the brain is 

moved and changes its place” [5]. 

He distinguished sensation from 

understanding: “man differs from the other 

animals in that he alone has understanding, 

wheras, they have sensation but do not 

understand” [4]. 

Based on anatomical evidence, he 

proposed that the brain was essential for 

perception [6, 7] and “the seat, in which 

the highest, principal power of the soul is 

located” [5]. 

Alcmaeon was wrong saying that sleep 

occurs when blood vessels in the brain are 

filled and that waking is caused by the 

emptying of these vessels [16]. 

� 

Fig.3. Alcmeon – source philosophers.endlessgreece.com/alcmaeon.php 

In the fourth century BC, Hippocrates 

(ca. 460 BC – ca. 370 BC), the “Father of 

Medicine”, started a new way of looking at 

illness. The main theory stated that disease 

is the result of an imbalance of body 

constituents or humors and that disease has 

nothing to do with demons [10]. 

For Hippocrates the human brain is 

cleft into two symmetrical halves by a 

vertical membrane and is also the seat of 

human intellect and the cause of 

neurologcal disorders. In De morbo sacro, 

epilepsy, called in antiquity “the sacred 

disease”, is not “any more divine or more 

49 

sacred than other disease, but has a natural 

cause, and its supposed divine origin is due 

to men’s inexperience and to their wonder 

at its peculiar character”. In the same 

treatise, the brain was considered the seat 

of judgement, emotions and aesthetic 

activity [12]. Thus thinking activity, moral 

consciousness, perceptive elaboration and 

control of body’s movement, were 

functions all localized to the brain. 

Hippocrates explained mental insanity 

as a process of brain corruption induced by 

bile, one of the four humours. 

In a case report about sudden loss of 

speech and paralysis of the right hand, the 

term “spasm” is used [13]. 

It was stated that “an incised wound in 

one temple produces a spasm in the 

opposite side of the body” and that loss of 

speech occurred with “paralysis of the 

tongue or of the arm and the right side of 

the body” [2]. 

Hippocrates was also one of the most 

prominent ancient greek physician who 

practiced trepanation [17] 

Fig.4. Hippocrates – source 

http://commons.wikimedia.org/wiki 

Diocles of Carystus (ca. 375–300 BC) 

stated that the right half of the brain 

provided sensation and the left 

intelligence, and that the heart is the centre 

for hearing and understanding. In his 

opinion, madness was “boiling of the

50 


blood in the heart”, lethargy was “a 

chilling of the psychic pneuma about the 

heart and the brain and a freezing of the 

blood dwelling in the heart”, and 

melancholy was considered as a disorder 

arising “from thickening of black bile 

around the heart” [8]. 

Erasistratus of Chios (ca. 304 – ca. 250 

BC) founded, together with Herophilus, a 

school of anatomy in Alexandria, where 

the two performed human dissections on 

criminals [21]. 

Erasistratus described a system of 

humors consisting of nervous spirit - 

carried by nerves -, animal spirit - carried 

by arteries -, and blood - carried by veins. 

Erasistratus considered that atoms are the 

essential body element. Atoms were 

activated by pneuma (external air) that 

circulated through the nerves. He thought 

that the inspired air is transformed into 

“vital spirit” and transported to the brain’s 

ventricles, where it becomes “animal 

spirit”. The animal spirit filled the empty 

nerves and let them control the muscle 

movement [21]. 

According to Erasistratus, the dura 

mater had the greatest significance, being 

considered the center of sensitive, motor, 

and cognitive functions. Therefore, 

psychiatric and neurological disorders 

were thought to depend on pathological 

changes of this membrane. He considered 

that lethargy “arises from an affection of 

the psychic faculty in the meninx, which is 

precisely where lethargy occurs”. Delirium 

was “a disorder of the activity of the 

meninx” [9]. 

Erasistratus is one of the first who 

described the cerebrum and cerebellum. 

Initially, he asserted that nerves also 

originate from the meninges. Later, he 

recognizes that nerves originate from 

brain. He also established a relationship 

between the the number and complexity of 

the human brain convolutions and 

intelligence [8]. 

Fig.5. Erasistratus of Chios – source 

http://www.encyclopedia.com/ 

Herophilus of Chalcedon (335-280 

BC), the “Father of Anatomy”, is also 

considered the founder of human anatomy 

as a distinct branch of medicine [14]. 

Fig.5. Erasistratus of Chios – source 

womenshealth.medinfo.ufl.edu/.../slide5.html 

He made a series of accurate 

descriptions of neuroanatomical structures. 

He also made a clear distinction of the 

brain ventricles, identifying that they are in 

reciprocal communication and therefore 

allow passage of the psychic pneuma. 

He described precisely the cerebellar 

ventricle, the fourth ventricle or the 

posterior ventricle. He also described and 

nominated some structures visible on the 

floor of this cavity, such as the calamus

DIACONESCU et al.: The importance of studying Greek philosophers and physicians (5 th – 3 rd 

century B.C.): contribution to the development of neuroscience in medical schools 

scriptorius, the posterior median sulcus 

and the colliculus facialis. He accepted 

Aristotle’s distinction between enkephalos 

and paraenkephalos, recognizing that they 

are separated by a thick membrane – 

tentorium cerebelli. 

He described a membrane covering the 

ventricles of the brain as the “choroid 

meninx”. Along with Erasistratus, he was 

considered the first anatomist who 

identified motor and sensory nerves and 

who located their origin correctly in the 

brain or in the spine. He described the 

References 

1. Aristotle, Gotthelf A. Historia 

Animalium, vol. I: Books I-X - 

Cambridge Classical Texts and 

Commentaries, No. 38, 2002 

2. Chadwick J, Mann NW. The Medical 

Works of Hippocrates. Blackwell, 

London, 1950. 

51 

optic, oculomotor, trigeminal, motor root 

of the trigeminal, facial, acoustic and 

hypoglossal nerves [4, 20]. 

Erasistratus and Herophilus first 

identified that cutting nerves causes 

paralysis. 

Conclusions 

All these theories represent great 

achievements transmitted by Greek 

philosophers and physicians to later 

generations of neuroscientist. 

3. Clarke E. Aristotelian concepts of the 

form and function of the brain. Bull 

Hist Med All Sci 1963;37:1-14. 

4. Crivellato E, Ribatti D. Soul, mind and 

brain: Greek philosophy and the birth 

of neuroscience. Brain Research 

Bulletin 2007;71(1):327-338. 

5. Diels H, Kranz W. Die Fragmente der 

Vorsokratiker. 12th ed, Berlin, 1966.

52 


6. Doty RW. Alkmaion’s discovery that 

brain creates mind: A revolution in 

human knowledge comparable to that 

of Copernicus and of Darwin. 

Neuroscience 2007; 147(3):561-568. 

7. Doty RW. Alkmaion, ca 500 BC, 

discovers that mind is in the brain. 

Neuroscience Research 2007; 58 

(suppl.1): S243. 

8. Garofalo I. Figure della medicina 

ellenistica. In: G. Cambiano, L. 

Canfora, D. Lanza “Lo spazio 

letterario della Grecia antica”, vol. 1. 

2, Roma 1993:345-368. 

9. Garofalo I. Anonimi Medici, De 

Morbis acutis et chroniis. EJ Brill, 

Leiden 1997 

10. Garrison FH. History of Medicine. 

Philadelphia, W.B. Saunders, 1966 

11. Gross CG. Aristotle on the brain. The 

Neuroscientist 1995;1(4):245-250. 

12. Hanson AE. Hippocrates: The “Greek 

Miracle” in Medicine. In: Medicine, 

Lee T. Pearcy, The Episcopal Academy, 

Merion, PA 19066, USA, 2006 

13. Hippocrates. Of the Epidemics (400 

BCE). Section III, case 13. Translated 

by F. Adams. 

14. Longrigg J. Anatomy in Alexandria in 

the third century BC. Brit J Hist Sci 

1988; 21: 455-488. 

15. Lloyd GER. Alcmaeon and the early 

history of dissection. Sudhoffs Arch 

1975; 59: 113-147. 

16. Lyons AS, Petrucelli RJ. Medicine. An 

Illustrated History. New York: Harry 

N. Abrams, Inc., 1987:187,192 

17. Mission S. Hippocrates, Galen, and the 

uses of trepanation in the ancient 

classical world. Neurosurg Focus 

2007;23(1):E11. 

18. Movia G. Aristotele. Anima, Milano: 

Rusconi, 1996 

19. Phillips ED. Greek Medicine (Aspects 

of Greek and Roman Life). London, 

Thames and Hudson, 1973. 

20. Rowe CJ. Plato: Phaedo (Cambridge 

Greek and Latin Classics). Cambridge, 

University Press, 1993. 

21. Wright JP, Potter P. Psyche and soma: 

physicians and metaphysicians on the 

mind-body problem from antiquiry to 

Enlightenment. Oxford: Clarendon 

Press 2000.




DOCTOR-PATIENT RELATIONSHIP IN 

NEUROPATHIC PAIN: A COMPARATIVE 

STUDY BETWEEN URBAN AND RURAL ZONE 

L. TARTAU 1 , R. V. LUPUSORU 2 , C. E. LUPUSORU 1 , 

C. ANDRITOIU 1 , O. DUMA 3 

Abstract: A descriptive study, regarding some ethical issues within the 

physician-patient relationship in the management of neuropathic pain. 

Method: This study was performed on a sample of 278 patients with 

neuropathic pain, in a comparison between urban and rural area medical 

centers, from Iasi County. This investigation was based on medical records 

and anonymous questionnaire; the informal consent was required. Results: 

The doctor-patient relationship in rural medical centers is better than in 

urban, patients being more satisfied with the medical consultation and more 

likely to comply with the treatment than patients in urban area. Opioids, 

antidepressants and anticonvulsants were recommended especially in urban 

medical center, but in a small number of patients. Conclusion: Even though 

there are some differences and meanings of the interactions between the 

physicians and sick peoples in urban and rural medical care centers, the 

study shows that in both cases, neuropathic pain is often undertreated, due to 

insufficient acquainted of the literature data, regarding the new modern 

therapeutic strategies in this type of pain. 

Key words: neurophatic pain, ethic, doctor-patient relationship. 

Aim: The paper represents a descriptive 

study, concerning in a comparison between 

urban and rural area from Iasi county, one 

of the most representative in the region of 

Moldova, regarding the physician-patient 

relationship in the management of 

neuropathic pain. 

General data 

The family physician plays a key role, 

being the first contact person for the 

patient. Addressability to medical services 

takes a central position in patient-physician 

communication and relationship. [9] The 

1 Pharmacology, Algesiology Department, „Gr.T. Popa”, UMF, Ia�i, Romania 

2 Pathophysiology Department, UMF, Ia�i, Romania 

3 Public Health and Sanitary Management Department, UMF, Ia�i, Romania 

establishment of an optimal rapport 

between the physician and patient is 

essential to both parties, a successful collaboration 

depending on the physician’s 

ability to manage unhealthy person 

expectations. [1, 7, 18] 

This relationship concerns the 

foundation of contemporary medical 

ethics, and implies the existence of the 

physician, who offers specialized and 

responsible services first, and, on the other 

hand, the existence of the patient, who 

needs medical assistance. [22] These both 

parties can openly discuss the risks of

54 


patient during medical procedures, and 

choices regarding the possibilities to 

improve his quality of life. [3, 15, 21] 

In terms of bioethics, patient-physician 

interrelation comprises patient’s right to 

the confidentiality of his medical problem, 

his consent to treatment, but also the right 

to health and to not be at pains. Physician’s 

vocation implies all activities targeted to 

preserve population health status, to 

prevent illnesses, to improve the patient 

healthy living conditions. [1, 13, 15] 

The major requirements of this complex 

physician-patient relationship are based on 

friendship, effective communication, 

respect, and mutually trust. Patient health 

outcomes can be improved with good 

physician-patient communication. [14, 25] 

Working together, the potential exists to 

pursue interventions that can significantly 

improve the patient's quality of life and 

health status. [13, 17, 20] 

Pain plays a central role in the health 

care system, and is one of the most 

frequent reasons for consulting a doctor. 

Primary care is the most frequent care 

provider for pain. [11] 

Neuropathic pain is a complex, chronic 

pain state that usually is accompanied by 

tissue injury. Within neuropathic pain, the 

nerve fibers themselves may be damaged, 

dysfunctional or injured. Major pathophysiological 

mechanisms include peripheral 

sensitization, sympathetic activetion, 

disinhibition, and central sensitization. 

[4, 16] Neuropathic pain is 

associated with many diseases, including 

diabetic peripheral neuropathy, postherpetic 

neuralgia, human immunodeficiency 

virus – related disorders, and chronic 

radiculopathy. [5, 6, 10] Neuropathic pain 

is described as burning, electric, tingling 

and shooting in nature. [4, 10] Numerous 

therapeutic options are available, including 

systemic medications, physical rehabilitation, 

behavioural modification, and 

invasive procedures. [5, 8] Unfortunately, 

most neuropathic syndromes respond 

poorly to nonsteroidal antiinflamatory 

drugs and opioid analgesics. First-line 

agents for modern treatment of neuropathic 

include tricyclic antidepressants, 

pregabaline, gabapentin, topical lidocaine, 

tramadol, and opioids. [12, 19, 23, 24] 

Method 

This exploratory study was performed, 

during six months (September 2008 - 

February 2009) on a sample of 278 

patients with neuropathic pain, aged 25-70 

years, from urban (157 cases) and rural 

medical centers (121 cases) in county of 

Iasi. This investigation was based on both 

medical records and anonymous questionnnaire, 

to obtain detailed information, 

regarding intensity of pain, associated 

diseases, and the treatment of neuropathic 

pain. 

The purpose of this study was to 

describe the socio-demographic patterns, 

consultations, pathology and the treatment 

of attendants at general practitioners at 

these two primary health care centers. The 

questionnaires involved epidemiologic 

characteristics and also, patient-reported 

relevance and performance of the 

consultation aspects. It was also identified 

the impact that physician-patient interpersonal 

interactions have had upon the 

satisfaction of primary medical services. 

The authors designed the questionnaire 

according to those presented in the 

literature. The study was performed with 

the support of the family physicians, for 

data collection. All questionnaires were 

distributed and collected, trying to 

maintain the confidentiality of the recorded 

data. All patients were informed about the 

aim and purpose of the investigation and 

how to fill in the questionnaire. Once they 

had given their consent, patients were 

asked to complete the self-administered 

questionnaire. Incomplete questionnaires 

were excluded. Data were scored and

L. TARTAU, ez al.: - Doctor-patient relationship in neuropathic pain: a comparative study between 55 

urban and rural zone 

statistically analyzed with t test from 

Windows EXCEL program. 

Results and discussions 

This study intended to directly compare 

data about medical services between urban 

and rural primary care centres. Interviews 

in the practices of both general practitioners 

have indicated a higher prevalence 

of neuropathic pain in male subjects, of 

57% in urban, 55% in rural area. 

Analysis and statistical processing of 

data shows that in more than 75% of 

patients seeking medical advice in both 

medical centres, the pain was reported to 

be intense to severe (range 6 to 10) to 

visual analogue scale of 0-10 values (with 

0 being no pain, 5 mild pain and 10 being 

the worst pain imaginable). (Fig. 1) 

Fig. 1 

The average score computed by 

residence area didn’t show significant 

differences between urban and rural 

subjects (p>0.05). Impairment in everyday 

life caused by neuropathic pain was 

significant in both medical care centres. 

The fact that more than 72% see 

themselves as impaired in their daily 

activities illustrates the extent of the 

restrictions due to pain. Emotional changes 

due to pain lead to high psychological 

strain and loss of quality of life. 

The most frequent causes of neuropathic 

pain are represented by chronic 

radiculopathy, diabetic (55.4% in urban, 

61.2 in rural), followed by neoplastic and 

postherpethic neuralgia. (Fig. 2) 

Fig. 2 

In both medical centres the 

pharmacologic treatment of neuropathic 

pain consists of nonopioid analgesics 

administration, drugs that proved no 

efficacy in this type of chronic pain, 

according to the literature data findings of 

the checks. [12, 23] 

Nonsteroidal anti-inflammatory drugs 

were administered to all patients, 

associated or not with analgesic-antipiretic 

drugs. Opioid, antidepressant and anticonvulsant 

drugs were recommended especially 

in urban medical centre, but in a 

small number of neuropathic patients. 

Tramadol was the only one type of opioid 

medication recommended in patients with 

neuropathic pain, especially in urban 

medical centre. (Fig. 3) 

Fig. 3

56 


Regarding the physician-patients 

relations, the investigation showed that 

there are some differences and meanings of 

the interactions between the doctors and 

sick peoples in urban and rural medical 

care centres. 

However, only a few patients have 

received pain treatment properly adjusted 

to their needs. Around 18% of patients 

consider any of their therapies satisfactory 

in reducing their pain. 

In a rural medical centre, the patients’ 

satisfaction with the consultation was 

related to the longer consultation times. 

Opposite to this, in urban medical centre, 

most patients complains sometimes about 

busy doctor, who has too little time to 

listen, only a small number of patients 

being satisfied with the time given to 

medical consultation. (Fig. 4) This aspect 

is inconclusive, because it is possible that a 

patient’s estimation may be altered by his 

experience consultations. 

Fig. 4 

The results of questionnaires evaluating 

patient expectations prior to the visit have 

been compared with his satisfaction 

measured after the consultation. In rural 

area the patients are more satisfied and 

more likely to comply with treatment 

recommended. On the other hand, the 

urban patients tend to identify the doctor as 

their main source of information wishing 

to receive detailed data and explanation 

about their diagnosis, treatment and course 

of illness, attitude that may disturb the 

stages in the medical consultation 

procedure. 

These results are concordant with 

literature data which stipulate that the lack 

of sufficient attention to psychosocial 

issues may be even more related to 

dissatisfaction, than the presence of 

attention is related to satisfaction. [2, 25] 

Our study revealed a better physicianpatient 

interrelation in rural than in urban 

medical centre, because in the first case, 

the practitioner is more familiar with 

patient and his medical history, dealing 

that strongly increases patient trust in 

doctor. (Fig. 5) It is also true that in some 

situations this relationship may be 

impaired by the deficiency of communication, 

due to the poor intellectual level 

of the patients. The mentioned communication 

difficulties can be described with 

reference to problems of diagnosis, a lack 

of patient’s involvement in the discussion, 

or the inadequate provision of information 

to the patient. [2, 14] 

Fig. 5 

Secondly, despite the fact that the rural 

family physician is insufficient scientific 

documented about the new trends of 

pharmaco-therapeutic strategies in the

L. TARTAU, ez al.: - Doctor-patient relationship in neuropathic pain: a comparative study between 57 

urban and rural zone 

treatment of neuropathic pain, he proved 

high overall responsiveness to the patients 

and tasks performed complies their 

demands. 

Conclusions 

� in this two medical centres, the most 

frequent causes of neuropathic pain are 

represented by chronic radiculopathy, 

diabetic, neoplastic and postherpethic 

neuralgia; 

� in both medical centers, the pharmacological 

treatment of neuropathic pain 

consists of nonopioid analgesic drugs 

(especially the nonsteroidal antiinflammatory 

- ketoprofen, indometacin, 

and analgesic antipyretic – acetaminophen) 

administration. 

� opioid, antidepressant and anticonvulsant 

drugs were recommended especially in 

urban medical center, but in a small 

number of neuropathic patients. 

� in our country, most health care 

practices are not sufficiently prepared 

to manage neuropathic pain; 

� neuropathic pain is often undertreated, 

due to insufficient acquainted of the 

literature data, regarding the new 

modern therapeutic strategies in this 

type of pain. 

� primary health care system particularities 

are less important for doctorpatient 

communication that was 

expected; 

� patients in rural area are more satisfied 

with the medical consultation and more 

likely to comply with the treatment, 

than patients in urban area; 

� the doctor-patient relationship in rural 

health care is better than in urban 

medical care; 

� the obtained data has provided detailed 

understandings of the strengths and 

limitations of primary medical care 

services, not evident in official reports. 

References: 

[1]. Ast�r�stoaie V., Almo� T. B., Esentialia 

in Bioetica, Ia�i, Ed. Cantes, 1998. 

[2]. Bell R. A., Kravitz R. L., Thom D. et 

al., Unmet expectations for care and 

the patient-physician relationship, J. 

Gen. Int. Med., 2002, 17: 817-824. 

[3]. Benatar S. R., Public health and public 

health ethics, Acta Bioethica, 2003; 9 (2). 

[4]. Cavenagh J., Good P., Ravenscroft P., 

Neuropathic pain: are we out of the woods 

yet?, Intern. Med. J., 2006; 36: 251-5. 

[5]. Cruccu G., Anand P., Attal N. et al., 

EFNS guidelines on neuropathic pain 

assessment. Eur. J. Neurol., 2004 Mar; 

11(3):153-62. 

[6]. Cruciani R., Update on the management 

of neuropathic pain in cancer 

patients, in Burton, A. (ed.), Current 

Thinking in Trends in Cancer Pain 

Management: Towards optimal 

symptom management, The Biomedical 

& Life Sciences Collection, 

Henry Stewart Talks Ltd, London, 

2009. 

[7]. Dugdale L. S., Siegler M., Rubin D. T., 

Medical Professionalism and the Doctor- 

Patient Relationship, Perspectives in 

Biology and Medicine, Volume 51, 

Number 4, Autumn 2008, pp. 547-553. 

[8]. Finnerup N. B., Otto M., Jensen T. S. 

et al, An evidence-based algorithm for 

the treatment of neuropathic pain, 

Med. Gen. Med., 2007 May 15; 9 (2): 

36. 

[9]. Freeman G. K., Olesen F., Hjortdahl 

P., Continuity of care: an essential 

element of modern general practice?. 

Fam. Pract., 2003, 20: 623-627. 

[10]. Gore M., Dukes E., Rowbotham D.J., 

Clinical characteristics and pain management 

among patients with painful 

peripheral neuropathic disorders in 

general practice settings, Eur. J. Pain, 

2007; 11(6):652–64. 

[11]. Hasselstrom J., Liu-Palmgren J., 

Rasjo-Wraak G., Prevalence of pain in

58 


general practice. Eur. J. Pain., 2002, 6: 

375-385. 

[12]. Helme R. D., Drug treatment of 

neuropathic pain, Aust. Prescr., 2006; 

29:72-5 

[13]. Hottois G., Missa N. J., Nouvelle 

encyclopedie de bioethique, Bruxelles, 

DeBoeck Université éditions, 2001, 

229–35. 

[14]. Kerse N., Buetow S., Mainous A. et 

al., Physician-patient relationship and 

medication compliance: a primary care 

investigation, Ann. Fam. Med., 2004, 

2: 455-461. 

[15]. Knight B., The ethic of medical 

practice, Simpson`s Forensic Medicine, 

10 th Edition, Knight B. (ed.), 

Edward Arnold London Melbourne 

Aukland, 1991, pp. 236-243. 

[16]. Pasero C., Pathophysiology of 

neuropathic pain. Pain Manag. Nurs., 

2004; 5: 3-8. 

[17]. Rao J. K., Anderson L. A., Inui T. S. 

et al., Communication interventions 

make a difference in conversations 

between physicians and patient, 

Medical Care, 2007, 45: 340-349. 

[18]. Rogozea L., Etica si deontologie 

medicala, vol. 1, Ed. Universit��ii 

Transilvania, 2006. 

[19]. Saarto T., Wiffen P. J., Antidepressants 

for neuropathic pain, Cochrane 

Database Syst. Rev., 2007 Oct 17; 

(4):CD005454. [abstract] 

[20]. Safran D. G., Defining the future of 

primary care: what can we learn from 

patients?, Ann. Intern. Med., 2003, 138 

(3): 248–55. 

[21]. Street R. L., O’Malley K. J., Haidet 

P. et al., Understanding concordance in 

patient-physician relationships: personal 

and ethnic dimensions, of shared 

identity. Ann. Fam. Med., 2008; 6(3): 

198-205. 

[22]. Veninga C. C., Denig P., Zwaagstra 

R. et al., Improving drug treatment in 

general practice. J. Clin. Epidemiol., 

2000, 53:762-772. 

[23]. Wallace J. M., Update on pharmacotherapy 

guidelines for treatment of 

neuropathic pain, Curr. Pain Headache 

Rep., 2007; 11(3):208–14. 

[24]. Wiffen P., Collins S., McQuay H. et 

al; Anticonvulsant drugs for acute and 

chronic pain, Cochrane Database Syst. 

Rev., 2005 Jul 20; (3): CD001133. 

[25]. Williams S., Weinman J., Dale J., 

Doctor-patient communication and 

patient satisfaction: a review, Fam. 

Pract., 1998: 480-492.




A REFERENCE ANALYSIS ABOUT THE 

HUMAN SOUL 

L. ROGOZEA 1 , M. DRAGOMAN 1 , F. LEA�U 1 , 

M. �URCANU 1 , R. MICL�U� 1 , M. CARDIS 1 

Abstract: „The nervous and mental illnesses, prevention and treatment”, a 

work of the former doctor Aurel Dobrescu from Bra�ov, is one of the most 

interesting book edited by “Medical ASTRA”, and it is an analyze of the 

human soul, of the normal life against the sick life 

Key words: manuscript, Dobrescu, ASTRA 

The book was edited in 1919 and one 

year later was awarded by the Romanian 

Academy. It has 163 pages and it addresses 

to the general audience with new 

information about neurology and 

psychiatry. It has a special part about 

developing the child’s mind, and it is of a 

real use for teachers and parents. 

Fig. 1. - A. Dobrescu – Book cover 

1 Faculty of Medicine, Transilvania University of Bra�ov. 

The knowledge of nervous system’s 

structure and physiology represents the 

fundament of all nervous phenomenon, dr. 

Dobrescu presents in his study some 

general issues, then reflexes and instincts 

and in the end the analyzes of the most 

abstract psychological activities. 

First part of the book is called 

”Generalities about the nervous system” 

and it has 5 chapters. 

Chapter 1, “The knowledge of the 

brain, throw which the soul’s life is 

produced, is necessary for everybody” 

highlights the importance of discovering 

the human brain’s secrets. 

Fig. 2. - A. Dobrescu – book illustration – 

nervous system

60 


The next chapter “The new direction of 

psychology to laboratory and clinic” 

follows the evolution of psychology in a 

new direction, from simple auto-intuitive 

observation to laboratory and clinic 

methods and in the end to helping methods 

as intoxications and hypnotism. Following 

the new direction, the author studied the 

psychology of the child, abnormal people, 

primitive populations, criminals and 

animals. 

Considering that ”a psychology which 

wouldn’t consider all the actual data were 

collected from these new sources of 

knowledge, is obsolete and narrows the 

horizon of modern man”, the author 

stresses the importance of evolution in 

science 

. 


nervous cell 

Chapter 3 of the first part concludes: 

“Psychology proposed in nowadays 

schools is too theoretical” and recommends 

the use only of real data of 

physiology of the nervous system in 

textbooks, and then to study the causes, 

forms and means of preventing illness and 

treatment of nervous diseases. In Chapter 4 

we find that mental illness “however 

would be kaleidoscopic, are caused by the 

illness of a single organ, the brain”. 

Fig. 4. - A. Dobrescu – book illustration – brain 

The next chapter of the first part, ”The 

significance of the brain” shows that 

differences between humans and animals 

due to more complex structure of the 

human brain. 

The second part studies in 6 chapters 

the main functions of the nervous system. 

The first chapter presents, over 5 pages, 

the nervous cell, part of the nervous 

system. As the author states, "the nerve 

cell, the neuron, is composed of the actual 

cell and one or more threads that hang 

from it" Also, in this chapter, the author 

makes a distribution of the nervous 

system's tasks between sensory nerves, 

motor nerves, sympathetic nerves and 

central nervous system, which, in turn, is 

subdivided into large brain, hindbrain and 

spinal cord. 

Fig. 5. A. Dobrescu – book illustration – spinal 

cord

L. ROGOZEA et al.- A reference analysis about the human soul 61 

The next chapter, Chapter 2, is called 

"The reflex" and is defined as "the simplest 

form of collaboration between different 

kinds of neurons". If for the animals the 

reflex plays a major role, in human 

reflexes are controlled by the brain and 

replaced with complex mental processes. 

Chapter 3 presents the importance of 

instincts, which often break the barriers of 

reason, being inherited from generation to 

generation within the same species. 

"The superior reflex (controlled)" is the 

title of the fourth chapter of the second part 

and presents the reflex circuit in which the 

impulse passes from peripheral sensory 

nerves to sensory nerves connecting the 

spinal cord to the brain; from hear, the 

impulse reaches the muscles, which 

according to the decision taken by the 

brain, will move or not. 

Fig. 6. A. Dobrescu – book illustration – 

central nervous system 

Another chapter is titled "Locating the 

brain faculties". Here there are presented 

sensations reaching the brain and are 

printed at this level in the form of 

impressions, which, if the same kind, 

forms images. The images are grouped into 

concepts; concepts are divided into 

"faculties of intellect, feeling and will". 

Chapter 6 highlights "The map of the 

brain centers". Thus, "motor centers" are 

represented on the map corresponding to 

body parts and their illness it causes 

weakness or paralysis. "Intelligence is 

established throughout the cortex" and it is 

the resultant of the images and 

representations received by the senses. 

In Part III we take "a special look on 

the functioning of the nervous system". 

Chapter 1 provides the data "from the 

intimate life of the nervous system", thus 

being presented the evolution of our 

neurons as cells which develop many 

branches as they grow. The neurons' 

nutrition occurs through the process of 

assimilation, oxygen having a major role in 

this case. 

Fig. 7. A. Dobrescu – book illustration – 

physiological aspects 

In Chapter 2 we learn "how to develop 

spiritual life". As muscle fibers increase 

after physical activity, "nerve elements 

continually grow and strengthen" 

following receipt, selection and setting 

processes of the concepts. These findings 

were very useful in education and also in 

the fact that in some children some centers 

are more susceptible to impressions and 

other are more rudimentary. Hence, the 

author concludes: "education wouldn't be 

made after a general block, but for each 

student's individuality".

62 


Chapter 3 presents "the scheme of a 

psychological process". We'll see how 

sensory nerves transmit information to 

association centers, which, together with 

the memory centers and then via motor 

nerves will produce movement. 

In Chapter 4 we see a part "of the 

problems of intelligence" and find that the 

number of neurons you have at birth does 

not increase during life, innate concepts 

don't exist and genius and insanity are 

related. 

Part IV deals with "General pathology 

of the nervous system". 


pathological aspects 

Chapter 1 describes the causes of 

diseases of nerve substance; in inherited 

diseases, they will be worse if taken from 

the mother, and if true psychopaths, they 

are born of both parents sick. Among won 

causes are the infectious diseases considered 

"among the greatest enemies of 

mankind", typhoid fever, articular rheumatism, 

erysipelas, Staphylococcus, Streptococcus, 

smallpox and pneumonia. The 

social poisons mentioned are alcohol, 

opium, cocaine, hashish. Diseases of 

endocrine glands are also included in the 

category of causes; from that type is 

education "too wanton and too early", that 

can lead to insanity. Emotions or spiritual 

kicks are occasional cases in individuals 

with predisposition for nervous diseases. 

Part V studies "most common forms of 

sickness of the nervous system", which are 

divided into peripheral nerve diseases and 

diseases of the nervous center. 

Chapter 1 considered "peripheral nerve 

illness", the main causes of disease being 

cold, compression, blow, degeneration, 

acute or chronic infectious disease toxins. 

Illness is made by inflammation and 

muscles corresponding to these nerves will 

become atrophic, and will regenerate 

following cessation of the inflammation. 

Sensory nerve disease will produce 

anesthesia or callousness and neuralgia or 

nerve pain. The disease will cause motor 

nerve paralysis. 

In Chapter 2 we learn that "Treatment 

of the illness of peripheral nerves" should 

be above all a treatment of the factors that 

cause the disease: rheumatism, syphilis, 

alcoholism, infectious disease, diabetes. 

Treatment usually consists of electrifying, 

warm baths, hot compresses, ointments 

and Belladona extract opium, narcotics and 

not least, a substantially diet . 

In Chapter 3 are presented "Diseases of 

central nervous system" as being divided 

into functional diseases and organic 

diseases. 

The next chapter is entitled "General 

symptoms of diseases of central nervous 

system" and treats disorders of the sphere 

of intellect in 7 pages (illusion, hallucination, 

disturbance of consciousness, 

eclipsing intellectual life, stupor, obsessions, 

phobias, paranoid ideas, anger), 

disturbances in the sphere of sense (the 

soul, apathy, hipertimia) and disturbances 

in the sphere of the will (aboulia, feverish 

excitement, catalepsy, catatonia, impulsive 

actions, impulsive obsession) 

Chapter 5 is of great complexity and 

studies the functional diseases, and the 

organic ones.




The study begins with functional 

nervous disease, defined as "state of 

constant fatigue and irritability" following 

the weakening of the nervous system. The 

main symptoms of mild neurasthenia are 

the headaches, pain in the spinal cord, 

insomnia, digestive disorders followed by 

significant decrease in weight, angina 

pectoris. In patients with psychopathic 

predisposition will appear serious 

neurasthenia characterized by weakening 

memory, phobias appearance, imagination 

and fantasy taking the place of rational 

thinking. 



Ipocondria is considered an obsessive 

analysis of the bodily condition, these 

patients being considered "imaginative 

sick people". An important part of this 

chapter is given to hysteria, the disease of 

"slightly irritable, very significantly, 

whims, falling quickly from one extreme 

to another". Symptoms of hysteria are 

varied and sensory nerves are affected by 

anesthesia and hyperesthesia, motor nerves 

by lack of activity or by contractions of 

muscles. Epilepsy, mania, melancholy, paranoia 

and madness are the last functional 

diseases described briefly in this chapter. 



In organic diseases are studied idiocy, 

imbecility, cretinism, dementia, senile and 

especially alcoholism. In the following 

pages is the presentation of the forms of 

alcoholic psychosis: delirium, regular 

drunkenness, alcoholic dementia etc. 

The next topic is the influence of toxic 

syphilis on nervous system, leading to the 

progressive general paralysis, "an organic 

disease of the entire central nervous 

system, which arises in people who have 

been infected with syphilis" through fiber 

atrophy and degeneration of nerve cells. 

Another consequence of the ill with 

syphilis, is described in the following lines. 

Last of organic nerve diseases studied is 

apoplexy or cerebral hemorrhage, known 

as "damblaua" produced by tearing of 

arteries in the brain. We will stop to 

analyze the clinical picture for dorsal 

tabes, while trying to present known data 

in 1919 and that we have today about.

64 

Dorsal Dobrescu’s 

tabes book 

Defini- Destruction 

tion of peripheral 

sensory 

neurons and 

their 

continuation 

of the spinal 

cord. 

Walking Uncertainty 

walk, 

slouch, 

atactic 

Pain Killer pain 

in legs and 

torso 


In current 

work 

Demyelination 

of posterior 

cords, dorsal 

roots and 

dorsal roots 

ganglia 

Gait ataxia 

with broad 

base of 

support and 

stepaj 

Paresthesia , 

bladder 

disturbances, 

impotence, 

areflexia, loss 

of postural 

sensation, deep 

pain and 

thermal 

sensitivity 

Loss of pain 

sensitivity 

Joint 

degeneration, 

atrophic, 

perforated 

ulcers of the 

leg 

Pupil small, 

irregular, 

which reacts to 

accommodatio 

n but not light 

Tabel. 1. – Comparing the data from Dobrescu 

Book with the modern book 

Comparing data on disorders of intellect 

and the will of the book of Dr. Dobrescu 

with what we know today about the same 

concept, we see that differences are not 

large at all. 

Dobrescu’s 

book 

Illusion The patient 

receives via 

the senses 

all sorts of 

feelings 

about the 

things 

around him, 

but he 

exaggerates 

illness nerve 

centers, it 

turned into 

images that 

do not 

correspond 

to reality 

Hallucination The patient 

cause in 

nerve 

centers an 

image, 

without 

having 

received any 

outside 

perception 

In current 

psychiatric 

books 

In a false 

perception 

of real 

sensory 

stimuli 

False 

perception, 

failure in 

the 

absence of 

actual 

sensory 

stimulus 

Tabel. 2. – Comparing the data from Dobrescu 

Book with the modern book 

Part VI deals with &"prevention 

nervous system's diseases". 

Chapter 1 presents "the means of 

education" for prevention of these 

diseases: the fight against sexual diseases, 

combating alcoholism and overwork, the 

gym, exercise and trips. 

Chapter 2 highlights the role of spiritual 

education in preventing nerve diseases. 

The purpose of education is "to strengthen 

the will of the student, which can deal 

anytime with his impulses". It studies the 

importance of training character and 

temperament and the role of the character 

in preventing nerve diseases. Concluding,


Dr. Dobrescu says that "a strong character, 

meaning a mind that deals with tendencies 

and agitation (...) can do a lot to prevent 

nerve diseases". 

Part VII deals with the study of nervous 

diseases’ treatment. The author proposes 

treatment regimens in patients with 

nervous breakdown, the scheme which will 

include ensuring peace for the patient, 

removing him from the environment, food 

care, idrotherapeutic, electrotherapeutic 

and psychotherapeutic treatment, general 

treatment for strengthening. In the 

following pages of the Treaty are discussed 

at length all these therapeutic methods. 



Part VIII, the last part of this study is a 

warning, stating "how a family degenerate" 

by the appearance and inheritance of nerve 

diseases. Concluding, the author states that 

"the power of a nation depends on the 

ethical value of families", highlighting the 

importance of prevention and treatment of 

nervous diseases. 

The aim of this paper is to contribute to 

the development of the human race, as is 

clear even from the author's words: "In 

preparing this book, besides a brief 

appearance of normal and pathological 

mental life and the prevention and 

treatment of nervous diseases, I set one 

more goal: to draw attention to the 

significance of some agents of mental 

diseases on future generations; that is my 

contribution to the improvement of the 

human race”. 

Concluding, the book is a good 

example of the concerns of representatives 

of ASTRA in medicine. 

References 

[1]. Bologa V.L. – Istoria medicinei 

române�ti, Ed. Medical�; Bucure�ti, 

1972, 565 pg. 

[2]. Burtea Victoria — Manual de 

semiologie psihiatric�; Casa de 

Editur� Venus, Ia�i, 2003, 293 pag. 

[3]. Dobrescu Aurel — Boalele nervoase �i 

mentale, prevenirea �i tratamentul 

lor; Ed Institutul de arte grafice C. 

Sfetea, Bucure�ti, 1919, 163 pag. 

[4]. Harrison - Principiile medicinei 

interne; Ed Teora, Bucure�ti, 2001, 

2840 pag. 

[5]. Huttmann A., Barbu G. – Medicina în 

ora�ul Stalin ieri �i azi, Ed Societ��ii 

�tiin�elor medicale din R.P.R., Filiala 

regional� Stalin, 1959, 163 pag. 

[6]. Iftimovici R. – Istoria medicinei, Ed. 

ALL; Bucure�ti, 370 pg. 

[7]. Minea Dan — Neurologie, Reprografia 

Universit��ii Transilvania, Bra�ov, 

2003, 300 pg. 

[8]. Rogozea L. – Aspecte ale medicinii 

bra�ovene în perioada interbelic�, Acta 

medica Transilvanica, nr.1, 2003, 

pg.56-60 

[9]. Rogozea L. – Bra�ovul iatro-istoric, Ed. 

Universit��ii Transilvania, 2006, 217 pg. 

[10]. Rogozea L. – Doctorul Arnold 

Huttmann – iatroistoric transilv�nean, 

Acta Medica Transilvanica nr.2, 2002, 

an XVIII, pg. 121-123, ISSN 1453-1968 

[11]. Rogozea L. – Personalit��i ale

66 


medicinii române�ti, vol. 1, Ed. 

Universit��ii Transilvania, 2006, 

[12]. Rogozea L. – Rolul Astrei în editarea 

unor publica�ii medicale, Acta 

Medica Transilvanica, nr 2, 2005, pg. 

102-104 

[13]. Rogozea L., Micl�u� R. – Via�a 

medical� bra�ovean� din anii 40 

reflectat� în ziarele locale, Sesiunea 

de comunic�ri a C.R.I.F.S.T – 

Academia Român�, în Hermeneutica 

Historiae et Philosophiae Technicae, 

2003, Ed. Universit��ii Transilvania, 

pg.123-126, 

[14]. Sârbu A., Brânzei P.— Psihiatrie; Ed 

Didactic� �i Pedagogic�, Bucure�ti, 

1981, 340 pg. 

[15]. Setlacec D – Medicina Româneasc� 

– Medicina European� (1859-1916); 

Ed. Medical�; Bucure�ti, 1995, 328 

pg.




PROF. DR. HULUSI BEHCET (A FAMOUS 

TURKISH PHYSICIAN) (1889-1948) AND HIS 

BOOK ON CUTANEOUS LEISHMANIASIS 

(ORIENTAL SORE) 

AY�EGÜL DEMIRHAN ERDEMIR 1 , SEZER ERER 1 

Abstract: Prof. Dr. Hulusi Behçet (1889-1948) is a famous Turkish 

physician. He translated many foreign articles into Turkish to help the 

education of new generations and published original case reports in the 

international reviews in order to make contact with foreign countries. 

Moreover, he published many books. Fifty-three of those appeared in 

prestigious European Scientific Journals. We know that is infected with 

vector phlebotomus can be seen in many regions of the world and has been 

known in Mediterrenean Region and Middle East for centuries. Many 

Turkish researchers like Celal Mu¬htar, Hulusi Behçet and some foreign 

scientists investigated some subjects about this disease. Leishmaniosis 

(Oriental Sore) was another disease which Dr. Behçet worked on, beginning 

in 1923. He first described "the nail sign" appearing by the removal of the 

crust of an Oriental Sore. Hulusi Behçet wrote an important book with the 

name of the Therapy of Oriental Sore with Diathermy (�ark Çıbanının 

Diyatermi �le Tedavisi in Turkish). This book is 23 pages. In this book, the 

therapeutical ways of Oriental Sore and some cases are present. Moreover, 

Dr. Behçet mentions diathermy in his book. In this paper, Prof. Dr. Hulusi 

Behçet’s biography and his book with the name of the Therapy of Oriental 

Sore are stressed and some comments are pointed out 

Key words: medical history, oriental sore, epidemics 

Prof. Dr. Hulusi Behçet is a famous 

Turkish physician [13]. 

Fig. no.1 - Hulusi Behcet 

Hulusi Behçet’s book with the name of 

the Therapy of Oriental Sore with 

Diathermy (Haleb veya �ark Çıbanlarının 

Diyatermi ile Tedavisi in Turkish) is a 

monography of 23 pages and is with the 

date of 1925 [5]. 

In this book, some medical cases are 

given and commented. According to Behçet 

the “Oriental Sore” is seen in Baghdad, 

Diyarbakır, Aleppo, Sivas, Yemen etc. Its 

therapy continues one year and a good result 

cannot be obtained every time” [8]. 

1 Department of History of Medicine and Ethics, Faculty of Medicine, University of Uludag, Bursa –Turkey

68 


Fig.2. Prof.Dr.Hulusi Behçet’s Book Cover on 

Oriental Sore 

We know reports of a disease simulating 

the type of lesion seen in cutaneous 

leishmaniasis were first made in 1756 by 

Hasselquist and Russel. Also in the middle 

of the nineteenth century, the same type of 

lesion was described by French medical 

officers in Africa. Laveran demonstrated in 

1880 that this condition could be transmitted 

and that a fly was an important factor. In 

1885 Cunningham described a histological 

picture and stated that there were bodies 

within the cells which were circular to 

elliptic in shape. Ryan, in 1886, also 

described some cells which were filled with 

bodies which he regarded as cocci with 

capsules. He attempted cultures in human 

blood but obtained no results. It was not until 

1903 that Leishman and Donovan made 

independent reports describing the 

protozoan. During the same year Wright in 

Boston described the organisms found in the 

first case of cutaneous leishmaniasis reported 

in this country. 

In this book, Behçet specified that: 

“The 'tin-tack' sign (TTS) was the 

appearance of horny processes that project 

from the under-surface of a crust. 

Although it was a well-known feature of 

discoid lupus erythematosus it might be 

also seen in other crusted lesions 

particularly in cutaneous leishmaniasis.” 

So, Hulusi Behçet mentioned the tin-tack 

sign for the first time in the world. 

Leishmaniasis (Oriental Sore) was another 

disease which Dr. Behçet worked on, 

beginning in 1923. He wrote about it in 

many articles and succeeded in its 

treatment with diathermic. He first 

described "the nail sign" appearing by the 

removal of the crust of an Oriental Sore in 

1916. To Behçet, this symptom was the 

most important sign of oriental sore. 

Oriental Sore was diagnosed both 

microbiologic analysis of Leishmianias 

and nail sign. A Turkish physician, 

Abimelek mentioned in his book named 

Discuss on Oriental Sore (Cilt 

Leischmaniose’ları Hakkında Münaka�a 

Münasebetiyle in Turkish) with the date of 

1934 that Behcet described nail sign in 

Oriental Sore for the first time in the 

world. Moreover, the paper of Alfred 

Marcionini and Kemal Turgut dated 1944 

with the name of Essays on the Pathology, 

Clinic and Treatment of Oriental Sore in 

the Middle Anatolia (Orta Anadolu’da 

Görülen �ark Çıbanlarının �nti�arı, 

Patojenisi, Klinik ve Tedavisi Hakkında 

Tecrübeler in Turkish) gave some 

knowledge about the Oriental Sore in the 

Middle Anatolia. To this paper, Oriental 

Sore was named as Diyarbakır Çıbanı 

(Sore), Mardin Çıbanı, Urfa Çıbanı etc. to 

the cities of Turkey. These physicians and 

the entire world also accepted that Hulusi 

Behçet described the nail-sign in the 

oriental sore for the first time in the world. 

We know that there are a number of 

types of protozoa which can cause 

leishmaniasis. Each type exists in specific 

locations, and there are different patterns 

to the kind of disease each causes. The 

overall species name is Leishmania 

(commonly abbreviated L.). The specific 

types include: L. Donovani, L. Infantum, L. 

Chagasi, L. Mexicana, L. Amazonensis, L. 

Tropica, L. Major, L. Aethiopica, L. 

Brasiliensis, L. Guyaensis, L. Panamensis, 

L. Peruviana. Some of the names are

A.D. ERDEMIR et al- Prof. dr. Hulusi Behcet (a famous Turkish physician) (1889-1948) and his 69 

book on cutaneous leishmaniasis (oriental sore) 

reflective of the locale in which the 

specific protozoa is most commonly found, 

or in which it was first discovered. 

This famous physician mentioned that 

some drugs such as Neosalvarsan or carbonic 

acide couldn’t treat it. But, to Behçet, 

diathermy therapy was the best way. Behçet 

mentioned diathermy in every page of his 

book. To Behçet: “Diathermy method is 

applied in developed cities and good results 

are obtained. “Behçet treated some 

leishmaniasis cases with this way from 1920 

to 1922. In this book, 4 cases are given. One 

of them was the son of a merchant from 

Adana. This patient was 19 years old and 

travelled to Syria for the trade occasionally. 

Ulcers were located on his right neck and 

these were combined in time and became in 

the size of silver coin (mecidiye). Other 

doctors couldn’t treat this patient. 

In this case, Hulusi Behçet determined 

Leishmania by preparing culture and 

diagnosed this disease as oriental sore. 

Moreover, in his book, Hulusi Behçet 

wrote that Dr. Resat Rıza and Mustafa 

Bakar prepared Leishmania Tropica 

cultures and this research was published in 

Gulhane Seririyatı Journal in German. In 

this first case, Hulusi Behçet examined 

microorganisms by ultramicroscope and 

saw flagellums. He informed about their 

dimensions. So, he applied diathermy to 

his patient. Hulusi Behcet accepted 

diathermy as the best therapy [3, 7, 9]. 

The second case of Hulusi Behçet was a 

servant girl. She was 23 years old. Oriental 

sore was seen on finger of right hand and 

left cheek. It was of a dull red colour and 

was inflammatory, quite tender and 

painful. Hulusi Behçet also diagnosed this 

case as oriental sore. 

In his third case, Hulusi Behçet treated 

a porter from Diyarbakır. He was 42 years 

old. Sore was on his right eyebrow and left 

cheek. The fourth case belonged to a girl. 

She came from Tahran to Istanbul. She 

was relative of Iran Emperor. A deep sore 

was on her right cheek. Behçet also treated 

this case with diathermy. 

Famous Turkish physician Behçet gave 

some knowledge about the discovery of 

microorganisms and their names. Behçet 

mentioned that American scholar .Wright 

named this disease’s microorganism as 

Helcosome tropicum at that time and R. 

Ross gave the name of Leishmania 

tropicum ou furonculose to it. But, 

afterwards, Leishmania Donovani was 

known as its microbe. 

Moreover, Behçet gave some knowledge 

about Leismania kinds in his small book: 

“Leishmanias are in two forms: Forms with 

flagellums and without flagellums. Two kinds 

of Leismanias are present. One of them is 

Leishmania Donovani and another is 

Leishmania tropica L. We also know 

Leishmania Americana. Leishmania 

Donovani also causes Kala-azar. 

Hulusi Behcet also gave other useful 

knowledge in his important book. Oriental 

Sore was seen in India, South Asia, 

Mediterrenean Sea Region, North Africa, 

Crete and Greek Islands, Adana etc. 

Oriental Sore was named Halep (Aleppo), 

Nile, Tahran, Isfahan, Palestine, Ankara 

and Diyarbakır sores. Hulusi Behçet 

mentioned epidemiology of this disease. 

Especially, Oriental Sore was infected 

from animals to dogs, monkeys, mouses. 

Hulusi Behçet also mentioned the 

characteristics of oriental sore. To Behçet: 

“On an average a fully developed Oriental 

sore is an inch or so in diameter. While 

there is often but one, there may be several 

or more distinct and sometimes quite 

widely separated formations. An Oriental 

Sore, when developed, is of a dull red 

colour, is usually of sluggish nature 

throughout its course, unless constantly 

knocked, irritated, or having added an 

active pyogenic factor, when it may 

become much more inflammatory, and 

quite tender and painful [4, 6, 12]. The 

favourite regions are the face, hands and

70 


forearms, and legs, but no part is exempt. 

Moreover, Behcet gave some 

knowledge about some ways used in 

oriental sore therapy. According to Behcet, 

arseno benzol and salvarsan couldn’t treat 

oriental sore. Neosalvarsan was good for 

syphilis. Famous physicians, Resad Rıza 

and Abdülkadir Bey accepted this 

condition. The best method was the 

diathermy [10]. This was an apparatus with 

electric. Namely, electric was applied to 

the sore. But this apparatus was present in 

the modern cities of Turkey at that time. 

To Behcet, in the other cities of Turkey, 

frozen carbonic acid was used for the 

therapy. But, he preferred diathermy 

therapy more than frozen carbonic acide. 

Hulusi Behcet applied diathermy by 

anaesthetizing his patients and the patient 

healed in ten or twenty days. So, he 

advised application of diathermy to every 

physician in his book. 

Hulusi Behcet gave a paper on nail sign 

of oriental sore in 1932 .M. Mayer and 

Ernst Nauck also accepted Behcet’s 

thoughts on this topic. 

Hulusi Behcet again mentioned these 

topics in his paper with the date of 1934 

and named Two Important Points on 

Wright Sores (Wright Çıbanları 

Seririyatında �hmal Edilmi� �ki Mühim 

Nokta in Turkish). 

Approximately 350 million people in 8 

countries are estimated to be under the 

threat of leishmaniasis. Most of the drugs 

used for the treatment of leishmaniasis are 

toxic and have many side effects. At 

present there is no vaccine against 

leishmaniasis. Vaccine development for 

parasitic infections is more difficult than 

for viruses and bacteria because of the 

antigenic complexity and parasitehost 

interactions [1, 2, 11]. 

References 

[1]. Abimelek. Cilt leischmaniose’ları 

hakkında münaka�a münasebetile. Deri 

Hast Frengi Kl Ar� 1934; 1: 283-284. 

[2]. Berberian DA. Cutaneous Leishmaniasis. 

Arch Dermat&Syph, 1944; 

49: 433-435. 

[3]. Demirhan,E.A., Öncel,Ö.: Prof.Dr. 

Hulusi Behcet (A Famous Turkish 

Physician) (1888- 1948) and Behcet’s 

Disease from the Point of View of the 

History of Medicine and Some Results, 

ISHIM, 5(10):51-63 (2006). 

[4]. Forbes,M.A.: Exogenous Cutaneous 

Leishmaniasis Proved by Culture, 

Archives of Dermatology and 

Syphilology, 58( 3):301-307(1948). 

[5]. Hulusi Behçet. Haleb veya �ark Çıbanlarının 

Diyatermi ile Tedavisi. Dersaadet 

1925 (�kinci Tab’ı) Kader Matbaası. 

[6]. Marinkelle, C.J.: The control of 

leishmaniases. Bull. WHO. 58: 807- 

819, 1980. 

[7]. Mutlu S, Scully C.:The person behind 

the eponym: Hulusi Behcet (1889- 

1948). J Oral Pathol Med. 1994 Aug; 

23(7):289-90. 

[8]. Saylan T. Life Story of the Dr. Hulusi 

Behçet. Yonsei Med J 1997; 38: 327-332. 

[9]. �ehsuvaro�lu,B.N.: Yurdumuzda Deri 

Hastalıkları Tarihçesi, ve Muallim 

Dr.Hüseyin Hulki Beyden Bir 

Hatıra(History of Dermatology i,n 

Turkey), Deri Hastalıkları ve Frengi 

Ar�ivi, 3(8):462-504 (1966). 

[10]. Templeton HJ. Cutaneous Leishmaniasis 

Experimentally Produced. California& 

West. Med., 1941; 54:70-71. 

[11]. Turgay N. Leishmaniasis A�ı Çalı�malarında 

Son Geli�meler: Ne Zaman 

A�ılanabilece�iz? Türkiye Parazitoloji 

Dergisi, 29(4):232-234, 2005. 

[12]. Unat,E.K.: Leishmania’lar ve 

Leishmania’lı �nfeksiyonların 

Epidemiyolojisi Üzerine, Deri 

Hastalıkları ve Frengi Ar�ivi 

5(15):869-880(1968). 

[13]. Yemni O. Ord. Prof. Dr. Hulusi Behçet. 

Deri Hast Frengi Ar� 1964; 1: 58-59.




THE EFFECTS OF THE MEDICAL 

FUNCTIONS ON ARCHITECTURE IN 

SÜLEYMAN�YE DAR’US SIFA OF THE 

OTTOMAN DAR’US SIFAS 

BETÜL BAKIR 1 , �BRAHIM BA�A�AO�LU 2 

Abstract: While the domed, yard type or closed yard type system had been 

holding on since Anatolian Seljuks constructed the main theme again in 

Ottoman, the devotion of Seljuks to the yawn-dome-yard-crown door 

relationship turned into complicate projects which responded to the needs 

more towards improving architectural orders, static improvements, the needs 

of the patients and the effects of renaissance which was the demand mode of 

the west. So that, Ottoman Dar’us Sifas, formed a prototype of the first 

hospitals in the West and America. 

Süleymaniye Dar’us Sifa was a treatment center for mental patients and 

other patients serving for a high number of patients in its period and was 

greatly improved with its bath, pharmaceutical warehouse, special part 

sheltering heavy mental patients, wide patient rooms with high ceiling and 

aeration, madrasah related to the construction just on the opposite, shops 

providing income for the vaqf, bakery, fountain, toilettes, Darüzziyafe 

(restaurant) building on the east side. 

After we give the architectural specialties of Seljuk and Ottoman Dar’us 

Sifas in this article, we will deal with Süleymaniye Dar’us Sifa of Sinan 

Period Dar’us Sifas as a whole. 

Key words: Süleymaniye Dar’us Sifa, treatment, architectural specialties 

Süleymaniye Dar’us Sifa which was 

designed within the body of social 

complex and constructed by Mimar Sinan 

in the years 1553-1559 when was called as 

his masterbuilder period, confronts us with 

a different design of central composition 

between rectangular shaped two yards and 

bodies lined up around them. There is a 

ward in the cellar in which hopeless mental 

patients were sheltered in bulk and shops 

that are opening to the exterior street. 

There is Medicine Madrasah and 

Darülâkâkir (pharmaceutical warehouse) 

1 Yildiz Technical University Istanbul / Turkiye 

2 Istanbul University, Medical Faculty of Cerrahpasha, Istanbul / Turkiye 

just on the opposite of the construction. 

Treatment with music was also carried 

out in the hospital in which approximately 

thirty employees were serving till XIX 

century. 

As it was in Seljuks, in Ottoman Dar’us 

Sifas, the treatment purpose baths serving 

to the patients have taken part in the social 

complex, as for Süleymaniye Dar’u Sifa, 

the bath is not on another construction but 

it is incorporated into the Dar’us Sifa. 

The fountain which is providing 

freshness and mental relaxation with the

72 


flux of the water is in the second yard to 

which all the rooms are opened. 

In the west entry of the first yard of the 

construction, there is a double domed, 

wide area bakery place where a kind of 

bread named fodla is baked for the 

patients. 

Süleymaniye Dar’us Sifa was a 

treatment center for mental patients and 

other patients serving for a high number of 

patients in its period and was greatly 

improved with its bath, pharmaceutical 

warehouse, special part sheltering heavy 

mental patients, wide patient rooms with 

high ceiling and aeration, madrasah related 

to the construction just on the opposite, 

shops providing income for the vaqf, 

bakery, fountain, toilettes, Darüzziyafe 

(restaurant) building on the east side. 

The Specialities of Ottoman Dar’us 

Sifas 

Ottoman Empire had had its greatest 

period under the rule of Suleiman the 

Magnificent, its lands extended from 

Austria to Arabia while Egypt was 

included in North Africa, in addition, The 

Red Sea and East Mediterranean had 

become Turkish Seas. In every part of the 

empire art and culture were paid attention, 

many works of art, bridges, fountains, 

baths, schools, mosques, dar’us sifas, etc 

were built. 

�stanbul, which was the capital of 

Ottoman is magnificently reflecting most 

of the works of art that we talk about today 

and exhibiting the richness of the period. 

The Selatin mosques and magnificent 

social complexes which were built by 

Sultans or their wives in �stanbul, today 

also constitute the landmarks which 

determine the silhouette of the city. 

1. Military Hospitals: Mobile and 

stable military hospitals were built in 

different parts of the empire in order to 

cover the needs of the army (1) 

2. Palace Hospitals; The Hospital of 

odalisques which were built in Topkapı 

Palace in 15th century by Conquror Sultan 

Mehmed and The Palace Hospital made by 

Turkish-Mongol Emperor Ekber in 

Fatehpur-Sikri in the date 1569 are the 

oldest palace hospitals standing today with 

their original conditions (2). 

3. Dar’us Sifas and Madrasahs which 

were built for public; Ottomans went on 

working their dar’us sifas which were 

coming from Seljuk Period with the 

foundations. Some of these were 

respectively dar’us sifas such as Bursa, 

Edirne, �stanbul ve Selanik, Belgrad, 

Budape�te extending to the Balkans 

afterwards. Especially in the 16th century, 

many treatment centers had been built but 

apart from the Hospital of the odalisques in 

the Topkapı Palace and the ones made by 

Architect Sinan any of them determined to 

reach our day. Generally, the aim of the 

dar’us sifas built within the body of a 

social complex is to serve for public and 

benefit from the other places serving. 

Fatih social complex was the first big 

extensive constructions group and 

education unit was built by Conqueror 

Sultan Mehmed. Positioned on a hill 

prevailing to �stanbul by Architect Sinan 

and ordered by the sultan to be done by 

selecting the best marbles, stones and 

masters of the country, Süleymaniye social 

complex which was built after nearly 

hundred years from Fatih social complex is 

an important religious and social center 

with its dar’us sifa which we can accept as 

a step in the development of Ottoman 

health institutions with its library among 

the counted libraries of our day, in the 

medicine madrasah of where the best 

professors of the period give lessons and 

bring up famous doctors. 

Orders were made to extract and bring 

valuable marbles, colored columns from the 

historical constructions in the empire in order

B. BAKIR, et al: The effects of the medical functions on architecture in Süleymaniye Dar’us SIFA 73 

of the ottoman DAR’us SIFAS 

to use valuable stones in the Süleymaniye 

social complex which is the proficiency 

achievement of the famous Architect Sinan, 

valuable marble columns were barged from 

distant countries such as Alexandria. 

The madrasahs in the south and north of 

the social complex was a complex 

education center with the guesthouse and 

ottoman elementary primary school (fig.1). 

There was a rich employee and doctor staff 

in the dar’us sifa, constructions such as the 

medicine madrasah, darulakakir, 

guesthouse and darüzziyafe positioned as a 

whole in the northwest of the mosque in a 

different construction was showing the 

developing madrasah understanding in the 

best way. 

Fig.1. Süleymaniye Complex (from Cantay) 

It was normal that superior scientists 

gave lectures and palace doctors were 

appointed as professors to the medicine 

madrasah in the most developed social 

complex of the period (3). The difference 

of the Ottoman Dar’us Sifas from the 

Seljuk’s was the separation made in the 

Dar’us sifa according to the qualifications. 

While the women and men were treated in 

different parts generally, in the final stages 

hospitals for women and for men were also 

built. Besides separating according to 

sexuality, there were also different 

departments in which every sickness was 

treated such as dermatologic disorders, 

surgical, mental, inflammatory diseases 

and etc, which can be accepted as the first 

samples of recent “clinic” concept (4). 

Separation according to the illnesses in the 

hospitals guided dar’us sifa plans, a 

distinct department was made in the cellar 

for the heavy mental patients who were 

isolated from the other patients in the 

Süleymaniye Dar’us Sifa. In the 19th 

century, the pointed separation was made 

and it became an institution in which just 

male patients were sheltered. 

Architect Sinan: 

The big architect of Suleiman the 

Magnificent, worldwide reputated artificer 

Sinan was born in 1490, in the village 

A�ırnas of Gesi town in Kayseri. 

According to the written sources, he was 

given to the conscript boys school as a 

recruit in 1512, he had become a janissary 

before Sultan Selim the Stern’s 1521 

Belgrad campaign and he was elected as 

the Royal Architect of the palace in 1539 

when he became 50 years old. It is recoded 

in the sources that he made 364 works of 

art throughout his life. Among these, 

bridge, aqueduct, tap, fountain, tomb, 

mosque, social complex consrtuctions, 

bath, bazaar, madrasah, dar’us sifa and etc 

took place. His fist work of art in �stanbul 

was Haseki social complex and Dar’us Sifa 

that he made for Hürrem Sultan. �ehzade 

Mosque that he finished in 1544 when he 

was 54 years old is his apprenticeship 

work. Süleymaniye social complex that he 

finished in 1557 when he was 67 is his 

headworker piece and Edirne Selimiye 

Mosque that he finished when he was 80 in 

1574 is his proficiency work (5). 

Doctors and Patients in Dar’us Sifa 

In the 16th century, the greatest period 

of Ottoman Empire, within the frame of 

the new steps in the fields of science, art, 

economy, education, medicine, astronomy 

in Süleymaniye medicine madrasah and in 

its other madrasahs, reformary superior 

student educating program was carried up 

by Sheikh ul-islam Musa Kazım Efendi 

and Hayri Efendi which will reach up to 

the 20th century in education and qualified

74 


doctors and scientists were brought up (6). 

Süleymaniye Dar’us Sifa which was built 

in 1577 had served in a different 

construction with the madrasah for the first 

time. Endowments were assigned for each 

dar’us sifa in Ottomans in order to provide 

their needs. Besides, according to the 

sources, helps were made by the 

endowment in the social complex where 

the dar’us sifa took place. In the 

Süleymaniye social complex endowment 

and records, the services, servants and 

helps given to the dar’us sifa were also 

listed. In the researches of S. Ünver, as the 

social complex’s endowment was 

determined in 1557, the administrative 

records about the guesthouse, medicine 

madrasah and dar’us sifa authenticate that 

the hospital was serving in that date (7). 

According to its endowment, the medicine 

madrasah’s professor had to be wise 

enough to be palace doctor. In the dar’us 

sifa where various illnesses had been 

treated, just the mental patients started to 

be treated after 1843 (8). It is indicated in 

the records that the poor patient were 

boarding in the hospital, polyclinic service 

was also given and doctors were working 

from morning hours to afternoon in the 

hospital (9). When Guraba Hospital was 

built by Bezm-i Alem Valide Sultan in 

1845, male patients were transferred from 

various hospitals to this hospital and male 

mental patients were sent to Süleymaniye 

Dar’us Sifa. Male patients were accepted 

while serving for quarantina in the colera 

outbreak of 1865 (10). Different from the 

other samples of the period there was a 

neurology service in the dar’us sifa. The 

method of curing with music which was 

used in Edirne dar’us sifa was applied to 

the mental patients treated in the neurology 

service, the medicine compositions 

prepared in the darülakakir on the opposite 

were distributed not only to the patients 

here but also to all of the hospitals and 

patients in �stanbul. In the beginning of the 

20 th century, Dar’us sifa construction 

served for military printery till 1927 (11). 

According to Peçevi, Tabip Ahmed Çelebi 

was the first one assigned here and 

Mustafa Bin Celâlüttevkii was chief 

physician in 1567 in the period of 

Suleiman the Magnificent. The chief 

physician between the years 1858-1873 

was the famous Italian doctor Louis 

Mongeri (12). 

The location of the constructions in 

Süleymaniye social complex and 

architecture of the dar’us sifa: 

Apart from the Süleymaniye Dar’us 

Sifa which was built by Architect Sinan on 

behalf of Suleiman the Magnificent 

between the years 1550-1557, there were 

darulhadis, bath, darülkurra, rabi and salis 

madrasahs on the south-east, Architect 

Sinan’s tomb on the north, sani and evvel 

madrasahs, medicine madrasah, dar’us 

sifa, darüzziyafe, darülakakir (pharmacy), 

library, fountain, guesthouse and Tiryakiler 

Bazaar (Bazaar of addicts), caravansary, 

ottoman elementary-primary school and 

lieutenant cabins on the south-west (the 

mosque regarded as the center of the social 

complex)(fig.2). 

Fig.2. Medicine Madrasah and Tiryakiler 

Bazaar 

Süleymaniye social complex, located 

prevailing to the city, was constructed in 

the land in which the old palace built by 

Conqueror Sultan Mehmet had a fire and 

destroyed (13). While the mosque forming 

the center of the social complex was 

located on a high hill, the madrasahs on its



right and left were separated from the 

mosque via a narrow street. Rabi and Salis 

madrasahs on the slope looking to the 

Golden Horn in the east, Evvel and Sani 

Madrasahs on the other side, ottoman 

elementary primary school and Tiryakiler 

Bazaar consisting of 36 shop rooms under 

the medicine madrasah provide income for 

the complex (14). Guesthouse, daruzziyafe 

and dar’us sifa constructions were built 

with high ceilings because of topographic 

circumstances, the rooms were built to the 

downward slope through Golden Horn 

under the dar’us sifa and caravansary was 

built to the lower elevation of the 

daruzziyafe (15). Although the ending date 

is written as 1557 on the inscription on the 

main door (cümle kapi) of the mosque, the 

dar’us sifa and medicine madrasah were 

finished in 1556 and the constructions in 

the complex together with the other 

buildings were finished in 9 years (16). 

Plan organization: 

There is a different design from the 

central formations of the period in the 

dar’us sifa with two rectangles designed 

domed and porched courtyards and domed 

cabins with ovens lined up around them. In 

the cellar floor of the double floored 

constructions, there are shops opening to 

the outer street and an isolated ward 

without windows where hopeless patients 

sheltered as a whole. In the first courtyard 

there were administrative units and daily 

policlinic patients were accepted, in the 

second courtyard with a fountain, boarding 

patient rooms, and bath and in the cellar 

the places of the isolated mental patients 

were planned. When the plan of the 

complex is compared with the other 

constructions with courtyard, it is clearly 

seen that one court yarded madrasahs are 

generally square formed, but in the dar’us 

sifa draft, the rectangle shape is exerted to 

open place for a second courtyard. This 

order is spoiled just in Tabhane 

(guesthouse) construction; rectangle plan is 

used here also because of the locations of 

the other constructions in the area within 

the complex and the topographic reason of 

the land. All the usage fields of the bodies 

in the courtyard with fountain in the dar’us 

sifa are arranged equal to each other, so 

that, in order to give entrances to the 

corner places, these corners of the 

courtyard were beveled and a small 

entrance hall was opened. Beveled corner 

has taken place in the plan typology of 

“middle sofa” understanding in Turkish 

Architecture, the other reason of corner 

entrances may also be prevent to shrinks 

which would be due to entrances to the 

places. On the north of the medicine 

madrasah, an one floored darülakakir 

(pharmacy) is positioned where medicine 

compositions were made and stored, on the 

opposite of this building dar’us sifa is 

positioned. Building dar’us sifa and 

madrasah as different constructions from 

each other has started with Süleymaniye 

Dar’us Sifa. Medicine madrasah taking 

place within the body of the hospital until 

that time separated for the first time in this 

construction and turned into two buildings 

positioned facing one another. When 

entering to the first courtyard of the dar’us 

sifa from the hospital street, there is a 

bakery where a flat bread named “fodla” 

was cooked for the patients in the last of 

the three domed-bodies lined up on the left 

side as to the entrance and west facade, the 

body in the middle is opening to the other 

courtyard where the bath is (p.4). 

Fig.3. Bakery Building

76 


The body on the corner which is on the 

east facade of the first courtyard was used 

for entrance to the second courtyard. 

According to the pictures in the sources 

there was a rectangle pool which had lion 

figures on its four corners in the middle of 

the courtyard and an octagon fountain in 

the second courtyard (17). The lions and 

other animals transported to the dar’us sifa 

in 1843 may be the reason for the location 

of the lion monuments in the first 

courtyard. Despite making out negative 

news about the lions put in the hospital by 

the foreign broadcasts, it is probable that 

these animals were held in caravansary 

rooms in the cellar floor or in some of the 

non-used rooms of the bath next to the 

hospital, however, these animals died in a 

short time in an airless and dark 

environment 

It could be only gone from the first 

courtyard to the barrel vaulted, narrow and 

long place where heavy mental patients 

were held in the cellar floor throughout 

stairs serving to that body. Ventilationillumination 

was made by the embrasures 

on the colonnade borders in the second 

courtyard. The chains and rings used here 

for the heavy mental patients haven’t 

removed till recent times. 

Structural Features: Although not so 

deep, the construction of the groundworks 

in the Süleymaniye social complex built on 

a hill looking to Golden Horn in �stanbul, 

had taken such a long time as 3 years 

according to the sources. In the drilling 

works made in 1970s, no deeper than 

6.20m was encountered (17). Khorasan 

mortar was used in the walls of the 

building constructed with (küfeki) stone, 

fairly high floor walls of the double 

floored construction were straightened 

with horizontal brick lines in every 1.20m 

and horizontal lying wooden binding 

elements sized 5/5cm. were settled 

between these brick lines. The higher the 

stone walls went, the thinner they were 

built. 

Entrance door and other doors: It is 

assumed that supplies were carried for the 

bakery in which bread was cooked from 

the courtyard entrance on the south-east 

facade. It is seen from the bare, plain 

tracks and tablet of the door that it was 

restored in the 19 th century. There is a bare, 

flat archway made of (küfeki) stone and its 

tablet on the wall. The main entrance wall 

is also remains from the period when the 

military used it. There is a “printery of 

Military” writing written on green 

background and Ruler Abdül Hamid’s 

signature in embossment cartridge. The 

whole archway from küfeki stone on the 

wall and its frames on the both sides are 

plain. It is a strong probability that supply 

entrance was made to the kitchen on the 

upper floor from a door reached by going 

down throughout stairs to the cellar from 

the second courtyard. The gap on the 

kitchen flooring is tied to the wall in 

question vertically and the supplies coming 

from the down door was pulled up from 

this hole. 

Windows: elevation differences in 

construction membranes affected also the 

windows, while there is rectangle shapes 

on the floor elevation in the south-west 

facade looking to the inner courtyard and 

obtuse arched window types on the up, on 

the fairly high, double floored north-west 

facade, discharging arches, obtuse arched 

rectangle windows on the shops in the 

down floor, the windows of the dar’us sifa 

rooms on the shops are first line 

discharging arched rectangle windows and 

obtuse arched plaster ornament (revzen) 

covered top window lines lie all along on 

the north-west facade on the up. 

Vault and arches: Entrance holes to 

the corner rooms in the second courtyard



and barrel vault cover was used on the 

ceilings of the places in the down floor. 

Courtyard colonnades, window and door 

arches are obtuse arches named as Turkish 

arch or panj arch. 

Column headings: Marble column 

headings in the courtyard colonnades are 

muqarnased which reflect Ottoman 

architecture. Almost all headings were 

made in the same decoration sample. There 

is rosette motif on most of them. 

Courtyard colonnades: The bodies on 

the entrance made polyclinics take place 

on the right and left of the entrance door 

but the rooms are lined up just in three 

dimensions in the second cortyard where 

the patient rooms are. Colonnades obtain 

spatial coherence surrounding both 

courtyards in four dimensions. 

Buttress and waterspout: Yüksek, iki 

katlı kuzey-batı ve güney-batı cephelerinde 

belli aralıklarla, zemine do�ru geni�leyen 

payandalar mevcuttur. There are buttresses 

which are expanding towards ground on 

the double floored north-west and southwest 

facades in certain intervals. 

Physical features in structure: There 

are fireplace for heating, windows in both 

side of the fireplace furthermore a door 

opening to the courtyard and a window 

next to it in every room (fig.4). the 

windows were opening both to outside and 

to the courtside, so they were making light 

places while supplying adequate air and 

light for the patients. Windows opening to 

outside in the dar’us sifa shows that the 

patients were not isolated from the outer 

environment. Ventilation of the places in 

the cellar where the heavy mental patients 

were staying was made by the wide loophole 

on the upper floor opening to the 

second courtyard. The pools designed in 

both courtyards not only provided visional 

aesthetic but also created relaxing effect on 

the patients with the action of the water. 

On the south-west corner of the 

hospital, bath attendants were on duty in 

the bath, built next to the dar’us sifa, just 

to serve the patients here. As known, the 

bath of the dar’us sifa was also used to 

cure mental patients with hydrotherapy 

method apart from providing hygiene. 

Fig.4.Patient Room 

Restoration works of 2009: 

The construction is being tried to return 

its original condition in the restoration 

studies by fixing the changes of the 

construction made in the 20th century and 

the accessories made during its usage as 

military printer in 19th century. The 

separation walls between the colonnades in 

the courtyard were destroyed; closed fire 

places in the patient rooms were opened. 

The stairs entrance going down from 

north-west facade of the second courtyard 

to the cellar floor was re-opened; east 

courtyard ground where the bath and 

bakery constructions take place was 

lowered and brought to its original 

elevation. The pool in the first courtyard 

with lion monuments on its four corners 

which was closed in the past will be rebuilt 

in the last restoration study and lion 

monuments will be put on their places 

(fig.5). The fountain closed with concrete 

in the second courtyard will be functional 

again (18). The small bath located next to 

the dar’us sifa on the south-east dimension 

was only for the patients and bath

78 


attendants working here were washing the 

patients. In the digging workout made for 

restoration, hot water wandering canals 

were discovered beneath the bath flooring. 

P.6. The Pool with Lion Statues (from Cantay) 

Footnotes: 

1. A big mobile hospital was built 

consisting of 70 surgeon tent and 40 

doctor shops serving to the 

wounded soldiers in the Crete 

blockade mentioned by Evliya 

Çelebi. In 16th century, the 

presence of a hospital serving for 

navy in the �stanbul Kasımpa�a 

dockyard is figured out in the 

sources. Apart from the two 

hospitals bound to Ottoman navy in 

Kasımpa�a, there were naval 

hospitals in Crete, Basra, Preveze 

and hospitals in Gemlik, �zmit, 

�znik, Rusçuk, Tulci, Vidin, Crete, 

Suez dockyards. Terzio�lu, 

Osmanlılarda Hastaneler…,p.5-6; 

Evliya Çelebi, Seyahatname, 

publisher: Zuhuri Danı�man, c.12, 

�stanbul 1943, p.202. 

2. “It is seen that hospitals were 

established for bondmaids in the 

hareem, for truckers in the Birun 

and for Ottoman hists in the palaces 

of Ottoman Sultans in Edirne and 

�stanbul. Terzio�lu, A, 

Osmanlılarda Hastaneler, p.2, 15. 

3. There had been Greeks, Rums, 

Armenians, Georgians, and Syrians 

when the Turks came to Anatolia. 

These had not recognized the 

attitude of the Orthodox Church. 

They welcomed the Seljuks with a 

great pleasure. Ortaylı, Türkler ve 

Ermeniler, p.128, Kahya, Erdemir, 

Medical Studies and Institions in 

the Otoman Empire, p.72. 

4. Say.”Türk Tıp Kurumları”, Türkler, 

C.11, p.321. 

5. We understand the informations 

about Koca Sinan from the 7 

handwritten works of art written 

down in the 16 th century. 1.Risaletül 

Mi’mariye, 2. Monography of 

Dayızade Mustafa Efendi named as 

Selimiye, 3. Padi�ahname of poet 

Eyyubi, 4.Adsız Risale, 5.Tezkiretül 

Bünyan, 6.Tezkiret-ül Ebniye, 

7.Tuhfet-ül Mi’marin. According to 

the sources, he was born in the 

village A�ırnas in the Cappadocia 

area and he was not exiled to 

Cyprus as the other region society 

of the period, he attended to many 

campaigns such as Iranian, Egypt in 

the period of Sultan Selim the 

Stern, Belgrad campaign of 1521 

and campaign of Vienna in 1529, 

and he built bridges here and 

worked as “sekban”, “zemberekçiba�ı”, 

“infantry colonel” in the 

army. He had built 3 galleys on his 

Iranian campaign, he gained 

appreciation of the Sultan by 

building a high bridge in 13 days on 

a marshland in Moldovia campaign 

of 1538. Aslanapa, Türk Sanatı, 

p.251-266; Kuran, Mimar Sinan, 

p.16-27. 

6. Calendar and astronomy studies 

were being done in the 

muvakkithane until 16 th century. 

But a observatory couldn’t be built. 

The famous astronomer Takiyeddin



built an observatory in Tophane in 

the period of 3 rd Murad in the years 

1574-1595. There were various 

astronomy tools, mechanical clocks, 

astronomy drawing tools, miters, 

rulers, compasses and etc in the 

observatory of �stanbul. There were 

madrasahs and dar’us sifas in 

Manisa, Amasya, Bursa and Edirne 

in Anatolia and Trakya on the same 

period. There were very rich 

libraries serving to the madrasahs 

near these or within the body of the 

social complex, especially in 

Süleymaniye social complex and 

Haghia Sophia. Kahya, Erdemir, 

Medical Studies and Enstitions in 

The Otoman Empire, p. 72-74. 

7. Ünver, Süleymaniye Külliyesinde 

Darü��ifa, Tıp Medresesi ve 

Darül’akakire dair”, Vakıflar 

Journal II, Ankara 1942, p. 196. 

8. As to its endowment, there were 1 

professor, 8 counselors, 1 

doorkeeper, 1 ferra�, 1 pointillist in 

Süleymaniye Dar’us Sifa and 1 

head doctor, 2 doctors, 2 kehhal, 2 

surgeons, 2 chemists, 1 drug store 

official, 1 steward, 1 doorkeeper, 2 

cooks, 1 kaseke�, 4 trustees, 2 

ferra�, 4 manservants, 2 laundryen 

and a bath attendant in the dar’us 

sifa on duty. The fees of the 

personnel were provided from the 

income of 217 villages, 30 arable 

field, 2 districts, 7 mills, 2 

fishponds, 2 ports, 1 meadow, 2 

farms and 2 islands. Bayat, 

“�stanbul Süleymaniye 

Darü��ifası”, Ülker Erke’nin 

Yorumu ve Fırçasıyla, p. 55. Ünver 

read in Ankara Endowments Head 

Directorate that the daily wages 

given in the dar’us sifa were written 

down by Hüsameddin Efendi in the 

Sultan Süleyman Hanı Evvel 

Endowment of 1557; 1 chemist, 2 

chemist helpers, pantry worker, 

steward, clerk, tabbahı e�rife (some 

people), 4 trustees, 2 laundrymen, 

barber, bath attendant… Ünver, 

“Süleymaniye Külliyesinde 

Darü��ifa…”, Vakıflar Journal II, 

p.196-198. 

9. Ünver, “Süleymaniye Külliyesinde 

Darü��ifa, Tıp medresesi ve 

Darül’akakire dair”, Vakıflar 

Journal II, p. 198-199. 

10. There is a record about taking 4 

manservants because of the increase 

in the amount of the mental patients 

coming to the asylum in a 

document dated 1850-1851. Ünver, 

“Süleymaniye Külliyesinde 

Darü��ifa….”, Vakıflar Journal II, 

p205, 206. 

11. Kahya, Erdemir, Medical Studies 

and Instıtıons ın the Otoman 

Empire, p. 79. 

12. Cantay, a.g.e., 99. 

13. Bayat, A.H. “�stanbul Süleymaniye 

Darü��ifası”, Ülker Erke’nin 

Yorumu ve Fırçasıyla Türkiye’de 

Tarihi Sa�lık Kurumları , 38 th 

International History of Medicine 

Congress, Editor: Nil Sarı, �stanbul 

2002, p.55. 

14. There is the list of the recruiting 

staff taken from the ruins and from 

the constructions on various areas 

of the country in handwritten 

manuscripts of M. Cevdet, 

Seyahatname of Evliya Çelebi and 

Tezkeret-ül Bünyan. Ömer Lütfi 

Barkan published in 1974 the orders 

and records in the account books 

that he investigated in the archieves 

in the Topkapı Palace. Aslanapa, 

Osmanlı Devri Mimarisi, second 

edition, 2004, p. 220-228. 

15. Today, Süleymaniye maternity 

hospital is built on the land of 

medicine madrasah. Cantay, 

Anadolu Selçuklu ve Osmanlı

80 


Darü��ifaları, p.97. 

16. Cantay, Anadolu Selçuklu ve 

Osmanlı, p.97. 

17. Two of the four lion monuments are 

in the garden of �stanbul Town 

Hall, one of them is in the park of 

Courthouse. Cantay, Anadolu 

Selçuklu ve Osmanlı, p.98. 

18. There is a record about taking 4 

temporary manservants because of 

the increase in the amount of the 

mental patients coming to the 

asylum in a document dated 1850- 

1851. Ünver, Süleymaniye 

Külliyesinde Darü��ifa….”, 

Vakıflar Journal II, p205, 206. 

19. The things found in the drilling 

study according to Barkan; a 

concrete groundwork surface with 

khorasan mortar of 20cm thickness, 

oak grills put on these, 3 lines of 

fire stones with 2 meters height 

going on narrower with küfeki 

stone until the sub basement. 

Ö.L.Barkan, Süleymaniye Camii 

Ve �mareti �n�aatı, p.49, 50.. 

20. The lion monuments which were 

sent to Sultanahmet park and public 

building will be taken from here 

and put back to their original places 

on the corners of the pool in the last 

restoration work of 2009. 

Reference: 

[1]. Akyol,T. Ortaylı, �, Anadolu’da 

beraberlikten çatı�maya, Türkler ve 

Ermeniler, Do�an publications, 2009, 

p.127-132. 

[2]. Aslanapa, O., Osmanlı Devri Mimarisi, 

�nkılap Bookstore, second edition, 

�stanbul 2004. 

[3]. Aslanapa, O., Türk Sanatı, Remzi 

Bookstore, �stanbul 1984. 

[4]. Bakır, B. Ba�a�ao�lu, �., How Medical 

Functions Shaped Architecture in 

Anatolian Seljuk Darüssifas (hospitals) 

and Especially Divri�i Turan Malik 

Darüssifa, Journal of The International 

Society for the History Of Islamic 

Medicine (ISHIM), 10 October 2006, 

p. 64-82. 

[5]. Barkan, Ö. L., Süleymaniye Camii ve 

�mareti �n�aatı, (1550-1557), book I, 

Ankara 1972. 

[6]. Cantay, G., Anadolu Selçuklu ve 

Osmanlı Darü��ifaları, Publication of 

Atatürk Culture Center Yayını, 

number: 61, Ankara, 1992. 

[7]. Erke, Ü., Ülker Erke’nin Yorumu ve 

Fırçasıyla Türkiye’de Tarihi Sa�lık 

Kurumları, 38.Uluslararası Tıp Tarihi 

Kongresi, Editör: Nil Sarı, �stanbul, 

2002. 

[8]. Evliya Çelebi, Seyahatname, yayınayan: 

Zuhuri Danı�man, cilt 12, 

�stanbul 1972, s.202; cilt 10, �stanbul 

1970, s.39. 

[9]. Kahya, E, Erdemir, A. D., Medical 

Studies and Instıtıons in the Otoman 

Empire, Nobel yayın da�ıtım a.�, 

Ankara 2008 

[10]. Kuran, A., Mimar Sinan, Hürriyet 

Vakfı Yayınları, 1.baskı, �stanbul 

1986. 

[11]. Say, Y., Türk Tıp Kurumları, 

Türkler, C.11, s.320-347. 

[12]. Terzio�lu, A., Osmanlılarda Hastaeler, 

Eczacılık, Tababet ve Bunların 

Dünya Çapında Etkileri, �stanbul, 

1999. 

[13]. Ünver, S., Süleymaniye Külliyesinde 

Darü��ifa, Tıp Medresesi ve 

Darül’akakire dair (1557-1555), 

Vakıflar Dergisi II, Ankara 1942, 

s.195-208




SUMMARY OF THE HISTORY OF THE 

THRACE FIGHTING MALARIA 

ORGANIZATION 

N. GÖKÇE 1 M. YAPRAK 2 

Abstract: Malaria was the most serious illness among the epidemic 

diseases in the Thrace Region of Turkey. Swamps caused by Meriç, Tunca, 

Arda and Ergene Rivers flooding and rice farming used to provide ideal 

conditions for mosquito breeding. 

Malaria was seen in Edirne Palace during Ottoman Empire and caused 

deaths. Ottomans try to drain swamps by planting Eucalyptus trees; however, 

they were not succeeded. 

Fighting against malaria was continued in Thrace during Turkish Republic. 

Fighting Malaria Commission, founded in Edirne in 1924, aimed to drain 

swamps, detect and treat malaria patients, and raise public awareness. 

Fighting Malaria Law, numbered 839, was accepted in 1926. Urgent 

Fighting Malaria Law, numbered 4707, and Fighting Malaria Law, 

numbered 4871, was legislated in 1945 and 1946, respectively. The goal was 

to wipe out malaria in the country. 

Thrace Fighting Malaria Center was founded in Edirne in 1936. Branches of 

the organization were also founded in the counties of Edirne. Significant 

gains in the fight against malaria were made with the public support. Edirne 

still has a risk of malaria. Only one patient was diagnosed in last five years. 

Key words: malaria, Thrace, history of medicine. 

1 Introduction 

History of malaria, an infectious 

disease whose notification is obligatory, is 

as ancient as the history of mankind. 

Hippocrates was the first to describe the 

manifestations of the disease. He stated 

that malaria was a diseases characterized 

by intermittent fevers. 

Malaria is also one of the oldest and the 

most frequently occurring diseases in 

Thrace. People have developed different 

strategies to recover from malaria. In the 

old times, they tried to repel mosquitoes by 

burning fire and by fuming. During 

Ottoman period, water absorbing plants 

such as eucalyptus trees (eucalyptus 

globulus) and chamomile were grown up 

in order to wipe out the malaria in the 

region. Eucalyptus seeds and medicines 

such as sulfane and physicians were send 

from Istanbul to the regions affected by 

malaria. Malaria did not only affect the 

public, but also, sometimes, it affected the 

Sultan and the people living in the palace. 

Çadır Kö�kü (Tent Pavilion), on the 

shoulders of Muradiye, was reserved for 

the people living in the harem and affected 

by malaria [1]. 

Fight against malaria was continued 

after the foundation of the Turkish 

1 Trakya University, Medical School, Department of History of Medicine and Deontology, Edirne, Turkey 

2 Trakya University, Medical School, Department of Physiology, Edirne, Turkey

82 


Republic. In the early years of the republic, 

not only malaria but also other infectious 

diseases such as smallpox, trachoma, and 

typhus were widespread in Turkey. 

Turkish Republic has placed much 

emphasis on fighting against infectious 

diseases. However, the first target had been 

malaria. ”Fighting Malaria Law”, 

numbered 839, was legislated in May 13, 

1926. In 1928, Malaria Institute was 

founded in Adana for research and 

education. Fighting malaria organizations 

and malaria clinics started to be found in 

the cities. A malaria hospital was opened 

in Adana. Number of malaria centers grew 

to 11 in 1937 and increased to 16 in 1937. 

Branches of these organizations were also 

founded in the neighbor cities and 

counties. Malaria Field Hospital was 

founded in Aydın. 

In this study, we investigate the efforts 

of Turkish Government in the early years 

of Turkish Republic (1926-1960) to 

control and prevent the malaria disease in 

Thrace. The next section presents the 

foundation of the Thrace Fighting Malaria 

Organization and its studies. 

2 Thrace Fighting Malaria 

Organization 

In the early years of Turkish Republic, 

malaria was widespread in the cities and 

the villages of Thrace. Thrace Public 

Supervisor, Dr. �brahim Öngören, wrote in 

his report about the health conditions of 

the population in Thrace: “I discovered 

many sources of malaria at each part of 

Thrace. This is the main health problem of 

Thrace. Çanakkale region, especially 

Menderes area, has the same problem”. 

Malaria was mostly seen in rice-growing 

regions, lakes, and rivers. Gala Lake in 

Enez was one of the main mosquito 

breeding-places. Overflow of Meriç River 

causes swamps around �psala area. In 

Thrace, Malaria was not only widespread 

around Meriç, but also around the Black 

Sea coast. 

It is mentioned that Mustafa Kemal 

Atatürk affected by malaria infection 

during military trainings in Thrace in 1936. 

In the same year, Thrace Fighting Malaria 

Organization based in Edirne was founded. 

In a very short-time period, the fight 

against malaria came a long way with the 

support of public. Channels were 

constructed; swamps were drained; 

hollows and trenches were filled. Dams 

and bridges were built. Humans were 

inspected; patients were treated. Table 1 

and Table 2 show the activities of the 

Thrace Fighting Malaria Organization in 

1936 and the numbers of malaria patients 

treated in Thrace in the years 1936-1939, 

respectively. However, beginning of World 

War II slowed down the fight against 

malaria. Large number of people 

immigrated and Territory was almost 

empty of people. 

Table 1: Activities of Thrace Fighting 

Malaria Organization in 1936[2] 

Activity Statistics 

Number of counties 10 

i d 

Number of villages 137 

Number of people inspected 177,744 

Number of patients treated 54,888 

Number of people blood 65,933 

d 

Amount of free quinine 582 

Amount of vitamin 1,680 

Amount of sulphane used 71,627 

Number of quinine tube used 1,067 

Amount of gas used (kg) 1,940 

Amount of pure uranium 100 

d(k ) 

Amount of wihz solution 290 

Amount of klesckt solution 3,000 

Number of house and barn 26.678 

Length of canal opened (m) 21.002 

Length of drain opened (m) 6.545

N, GÖKÇE: Short history of Thrace fighting malaria organization 83 

Length of stream cleaned 55.035 

Volume of gutter filled (m 3 ) 14.678 

Number of bridge 4 

Number of dam constructed 4 

Table II: Number of Malaria Patients 

Treated In Thrace 

Year Patients 

1936 37425 

1937 55489 

1938 59085 

1939 54954 

Total 206953 

In 1945, a course was offered by the 

Thrace Fighting Malaria Organization. 

Total number of person attended this 

course was 37; 11 of them were women. 

After successfully completing the course, 

attendees were assigned in the fight against 

malaria in Edirne. 

In the years 1950-1960, fight against 

malaria was very intensive. In 1957, a 

National Malaria Eradication Program, a 

cooperative undertaking by The World 

Health Organization and UNICEF, was 

established in Turkey; organizational 

structure was defined. In the new 

organization, Dr. Kemal Erdem was 

assigned as the Regional Director of 

Tekirda� Province and Dr. Ferruh Tepeköy 

as the Regional Director of Kırklareli 

Province. Dr. Ratip Kazancıgil, the 

Director of Organization of Thrace 

Fighting Against Malaria at that time, 

became the Group Regional Director of the 

group founded in Edirne. Some of the 

members of the organization can be seen in 

the picture below. Under the National 

Malaria Eradication Program, a group of 

malaria fighter was send to Italy for 

training. The group had been trained for a 

month in an institute, called “Istituto 

Superiore Di Sanita”, in Rome. 

Members of the Organization of 

Thrace Fighting Against Malaria (1952) 

� top row, from left to right 

Physician of the Edirne Branch Dr. Sacit 

Balkan, Physician of the Babaeski Branch 

Dr. Ferruh Tepeköy, Physician of the 

Saray Branch Dr. Osman, Physician of the 

Lüleburgaz Branch Dr. Kemal, Physician 

of the Kırklareli Branch Dr. Turhan, 

Physician of the Ke�an Branch Dr. Fuat 

� front row, from left to right 

Physician of the Gelibolu Branch Dr 

Mustafa, Physician of the Uzunköprü 

Branch, the Director of Organization of 

Thrace Fighting Against Malaria Dr. Ratip 

Kazancıgil, Physician of the �psala Branch 

Dr. Zeki Akçol, Physician of the Hayrabolu 

Branch 

Dr. Ratip Kazancgil, the Group 

Regional Director of Malaria Eradication 

Program at that time, narrates his 

experiences on fighting against malaria 

[3]: 

“We were fighting against malaria in 

the whole Trace Region. It was required to 

collect a blood sample from each suspect 

who was suffering from high body 

temperature. To analyze blood samples 

rapidly, mobile medical teams and services 

were formed. These mobile teams were 

picking up collected blood samples and 

delivering them to central laboratory 

quickly. This approach helped us 

determine malaria patients very fast. Our

84 


efforts were being monitored by UNICEF 

Malaria Group who was working at Head 

Office of Fighting Against Malaria at 

Turkish Ministry of Health. Finally, it was 

decided that fighting against malaria was 

successful in Edirne. I, Dr. Ertu�rul Akel, 

Assistant Adviser at Turkish Ministry of 

Health, and Dr. Ferruh Çoruh, General 

Director of Malaria, were invited to 

UNICEF Head Office of Fighting Against 

Malaria in Copenhagen to discuss the 

status of malaria in Edirne. As a result, it 

was decided that malaria was eradicated 

in Edirne and the yellow dot, the malaria 

warning sign, on Edirne was removed from 

map of Turkey.” 

3 Conclusions 

Malaria is one of the oldest and the 

most frequently occurring diseases in 

Thrace. In the early years of Turkish 

Republic, malaria was also widespread in 

the cities and the villages of Thrace. In 

1936, Thrace Fighting Malaria 

Organization based in Edirne was founded 

with the aim of eradicating malaria in the 

Trace region. The organization achieved its 

goal with the support of public in a very 

short-time period. 

References 

[1]. Ahmet Süheyl Ünver and Rıfat Osman. 

Edirne Sarayi. Turkish Historical 

Society Publications.Ankara, 1989. 

[2]. Edirne Postası. May 11, 1938. 

[3]. Ratip Kazancıgil. Personal 

Communication. April 18, 2006.




AMBROISE PARÉ’S BROKEN LEFT LEG 

IN 1555 

P. ALBOU 1 

Abstract: The scene occurs in 1555: when Ambroise Paré (1510-1590), 

the famous French surgeon of the Renaissance, crossed in boat a river to 

go to visit with a horse a patient in the surroundings of Paris, his horse 

gave him “such a kick” that the two bones of his left leg were entirely 

broken, a few centimeters over the foot… The description of this accident 

and its consequences was written by Ambroise Paré himself and can be 

red in a text named History of the author having a broken leg that we can 

find in his Surgical Works. 

We will recall in this paper this accident and its consequences, which 

lasted several months. Beyond its biographical and anecdotic interest, 

this observation informs us about various aspects of the surgical practice 

of this time. It illustrates also Georges Canguilhem’s reflection: “The 

doctor have to know that he is a potential patient and he is not better 

assured than his patients to succeed, if necessary, to substitute its 

knowledge for its anguish” 

1 St-Amand-Montrond, France. 

Key words: Ambroise Paré, 1555. 

«Plato was therefore right to say that to be 

a true doctor would require that anyone 

who would practice as such should have 

recovered from all the illness which he 

claimed to cure and have gone thought 

all the symptoms and conditions on 

which he would seek to give an opinion. 

If doctors want to know how to cure 

syphilis it is right that they should first 

catch it themselves! I would truly trust 

the one who did» 

Montaigne, Essays, III, 13 

Ambroise Paré (1510-1590) was the 

surgeon of King Henry II and his 

descendants: François II, Charles IX and 

Henri III. 

The scene occurs in 1555: when 

Ambroise Paré (1510-1590), the famous 

French surgeon of the Renaissance, 

crossed in boat a river to go to visit with a 

horse a patient in the surroundings of Paris, 

his horse gave him “such a kick” that the 

two bones of his left leg were entirely 

broken, a few centimetres over the foot… 

The description of this accident and its 

consequences was written by Ambroise 

Paré himself and can be red in a text 

named History of the author having a 

broken leg, that we can find in his Surgical 

Works (Œuvres d’Ambroise Paré,1579, 

Livre 14, Chap. 23 to 28).

86 


Ambroise Paré (1510-1590) 

(Copyright BIUM) 

Oeuvres d’Ambroise Paré (1579) 


We will recall in this paper this 

accident and its consequences, which 

lasted several months: 

After his leg was broken, his first 

thinking was to be afraid to have his leg 

cut off and he began to pray... Ambroise 

Paré tells us that when he fell on the 

ground, "the fractured bone through flesh, 

the trousers, and even the boot”, then he 

felt "such a pain it is possible for man to 

endure." 

After being rescued by his friends, he 

was transported to a nearby house with a 

lot of pain because, he says, "one brought 

the body, the other leg, the other foot and 

walking one rose on the left and the other 

bent on the right." 

First medical care 

While sweating profusely, a plaster was 

applied over the injury from the available 

ingredients: egg white, wheat flour, 

furnace soot, all mixed with fresh butter 

melted. 

He asked his friend Richard Hubert 

reduce the fracture "and forget the 

friendship he bore him, pulling hard on his 

foot and digging in the wound with a 

razor" to recover more easily bones in their 

normal position. 

Splints were then implemented his leg 

resting on a cushion "as you see in this 

figure": 

Paré’s figure 

(Copyright BIUM)

PHILIPPE ALBOU: Ambroise Paré’s broken left leg in 1555 87 

Medical treatment 

After being transported home, he was 

treated as follows: 

− bleeding in the left basilica vein 

− applying ointment (Onguent rosat) 

− light diet with prunes and bread, with 

water; 

− few mild purgatives as cassia or 

rhubarb, and suppositories or soap "to 

stimulate my abdomen." 

The evolution was complicated by two 

problems: 

− muscle cramp, so violent that the 

bones moved and had to be again pull 

to replace the leg in the good way… 

while he said feeling "more pain than 

first time " 

− fever on the 11th day, which lasted a 

week, with the appearance of an 

abscess on which a patch was applied 

to help evacuate. 

Prevention of bedsores 

The main Ambroise Paré’s thinking 

was to avoid pressure sores, especially in 

the sacrum and heel "because in these 

places there is little flesh." 

Techniques used for the prevention of 

bedsores: 

− regular elevation of the heel or lift 

from the bed by pulling on a rope 

attached to the foot of his bed, to “give 

breath to support zones” ; 

− use of a pillow under the buttocks and 

also under the heel; 

− application of plasters, ointment or 

cooked alum to "take out the bone 

fragments separated" and promote "the 

generation of callus" 

Albou’s figure 

Ambroise Pare’s invention of a notched 

splint 

Pare noted that he invented, after his 

own experience, “cassole de fer blanc”, or 

splint, notched heel so that it does not 

touch the bed. 

Paré’s figure 


Epilogue 

Let Paré concluded himself that 

episode: "I waited over three months that 

the callus is done. During this time, I lay in 

my bed, which is not agreeable to a sad 

sick. It took another month to put my feet 

on the ground without my cane... My good

88 


leg was helping the injured leg, as does a 

sister’s hand or a friend’s arm, helping to 

lift, turning in one direction or the other... . 

Conclusion 

Beyond its biographical and anecdotic 

interest, this observation informs us about 

various aspects of the surgical practice of 

this time. 

It illustrates also Georges Canguilhem’s 

reflection: “The doctor have to know that 

he is a potential patient and he is not better 

assured than his patients to succeed, if 

necessary, to substitute its knowledge for 

its anguish”. 

References 

[1]. Ambroise Paré, Œuvres, divisées en 

vingt-sept livres, revus et augmentés 

par l’auteur pour la seconde édition. A 

Paris, chez Gabriel Buon, 1579 

(disponible sur www.gallica.fr) 

[2]. Georges Canguilhem, Puissance et 

limites de la rationalité en Médecine 

(1978), in « Etudes d’histoire et de 

philosophie des sciences », Vrin, Paris, 

2002, p. 409.




SIGNIFICANCE OF PHYSICIANS’ 

SOCIETY IN ODESSA IN GENERATION 

AND FORMATION OF PHAGOCYTAL 

(I.I. MECHNIKOV’S) THEORY 

(DEDICATED TO CENTENARY OF I.I. 

MECHNIKOV’S NOBEL PRISE 

AWARDING) 

YURIY K. VASYLYEV 1 

Abstract: The history of Mechnikov’s phagocytal theory of immunity deals 

with the physicians’ Society in Odessa. As early as 1874 Mechnikov was 

elected to be a full member of the physicians’ Society in Odessa. However his 

active participation in the work of the Society began later on, i.e. in the 80ies 

of the XIX century, when Mechnikov formulated his phagocytal theory of 

immunity. The fact that he came to the physicians’ Society in Odessa was 

quite logically and it characterizes Mechnikov as a scientist who searches for 

qualified auditorium to discuss his hypotheses. Mechnikov attended 34 

meetings of the physicians’ Society in Odessa and made 6 reports, devoted to 

proofs of phagocytal theory of immunity. Meetings of the physicians’ Society 

in Odessa were the first auditorium where reports on the phagocytosis 

theory, suggested by Mechnikov, were thoroughly discussed, subjected to 

criticism and it promoted generation and formation of the theory that 

afterwards was internationally recognized. 

Key words: Physicians’ Society In Odessa, I.I. Mechnikov 

Ilya Ilyich Mechnikov (1845-1916) and 

Paul Ehrlich (1854-1915) became the 

Nobel Prize winners in Physiology or 

Medicine, 1908. They were Nobel Prize 

awarded «in recognition of their work on 

immunity». 

Considerable amount of literature is 

devoted to I.I. Mechnikov’s life and 

activities and at the same time the analysis 

of appearance and formation of the 

phagocytal theory idea, which became one 

of the bases in teaching on immunity 

against infectious diseases of a human 

1 Sumy State University, Ukraine. 

organism, takes a prominent place. 

However, a very important transition of 

Mechnikov’s-biologist to the field of 

studying a human organism’s fight against 

causative agents of infectious diseases has 

not been traced back yet, but the step was 

made by I.I. Mechnikov in the very 

beginning of the phagocytal theory 

formation in 1883-1887. I.I. Mechnikov’s 

collaboration with the prosectors Nicolay 

A. Stroganov (1843-1894) and Cheslav I. 

Chentsinsky (1851-1916) as well as 

discussion of Mechnikov’s reports in the

90 


meetings of the physician’s society in 

Odessa was of great importance. 

The physician’s society in Odessa was 

formed in 1849. At that age Odessa was a 

main commercial port of the Russian 

Empire in the Black Sea. The society 

united the physicians who worked in health 

stations of the city, maritime quarantine as 

well as general practitioners and military 

doctors. After establishment of 

Novorossiysk University in 1865 in 

Odessa some of the teachers of the 

University became its members. 

In 1867 I.I. Mechnikov arrives in 

Odessa after his election as an associate 

professor of Novorossiysk University but 

next year he moves to St. Petersburg 

University. In 1870 he returns to Odessa as 

professor of zoology department of 

Novorossiysk University. 

In 1874 the professor Mechnikov was 

elected as a full member of the society by 

Grygory N. Mynch’s (1836-1896) proposal 

who was a chairman of the latter at that 

time. However, his active participation in 

the work of the society began later and it 

dates back to the 80-ies of XIX century 

when I.I. Mechnikov formulated clearly 

his phagocytal theory as well as entirely 

devoted himself to its proof. 

As there could be a birth of this theory 

immunologist L.A.Zilber tells: « In the 

summer of 1882 of I.I.Mechnikov with a 

family has a rest in Italy on the bank of the 

Messinsky gulf. Tired sick eyes do not 

come off a microscope. He observes a life 

of mobile cells in a larva of starfishes. The 

larva is transparent and these cells are 

perfectly visible. And suddenly there is a 

thought that similar cells should serve in a 

human organism for „counteractions to 

harmful agents”» [1] 

It is difficult now to tell how much 

exact L.A.Zilbera's story was, but it is 

well-known, that the theory of 

phagocytosis arose just in 1882 and 

numerous zoological and embryological 

I.I.Mechnikov's researches about a role of 

intracellular digestion and protective 

function of cells, formed of mesoderm, 

preceded its occurrence. 

In the summer of 1883 VII Congress of 

naturalists and doctors of Russia gathered 

in Odessa and in August, 28th 

I.I.Mechnikov made the report «About 

curative forces of a human organism» on a 

general meeting of the congress. Then a 

victorious road of the phagocytal theory 

began. 

In Odessa, where I.I.Mechnikov lived 

and worked at that time, microbiological 

researches were started on botany 

department of Novorossiysk University by 

the professor L.S. Tsenkovsky, and after 

his departure from Odessa in 1871, they 

were continued by Odessa doctors G.N. 

Minh, O.O. Mochutkovsky, Ch.I. 

Hentsinsky, N.A. Stroganov who were full 

members of the physicians’s society in 

Odessa and they reported about the results 

of their researches at its sessions. 

Thus physicians of Odessa, represented 

by the society, were ready for perception 

of I.I. Mechnikov’s ideas. On the other 

hand, Illya Ilyich required a medical 

audience for discussion of the hypothesis 

put forward by him. 

On November 26th, 1883 I.I. 

Mechnikov made the report «Comparative 

pathological research on inflammation in 

connection with a question on intracellular 

digestion» [2] at the session of the society. 

Here he stated the theory of phagocytosis 

for the first time after his report at VII 

Congress of Russian naturalists and 

doctors. 

In March issue of the magazine 

«Russian medicine» in 1884 the “Open 

letter to the professor I.I. Mechnikov» was 

published by Odessa doctor Semyon 

Moiseyevich Shor (1845-1917). He wrote 

that doctors listened to Illya Ilyich’s report 

with a great interest, but at the same time it 

was necessary to prove that principles of

Y.K. VASYLYEV: Significance Of Physicians’ Society In Odessa In Generation And Formation Of 

Phagocytal (I.I. Mechnikov’s) Theory 

the theory of phagocytosis were applicable 

for infectious diseases of a human 

organism [3]. I.I. Mechnikov did not 

disregard the questions which were put 

before him. 

On May 12th, 1884 the society heard 

I.I. Mechnikov's report «About 

relationship of anthrax bacilli to 

phagocytes» [4]. It was his first research 

on medical microbiology problems which 

at the same time had immunological 

nature. New proofs of the phagocytal 

theory rightness were given in his work: it 

was shown that the phagocytosis 

phenomenon naturally occurs among 

vertebrates as well as invertebrates. 

In 1886 I.I. Mechnikov made two more 

reports in the society. The first of them, 

reported on May 17 th , was «About 

relationship of streptococci to phagocytes» 

[5] and the second one, made on October 

18th, was «About destiny of microorganisms 

in blood» [6]. These works were 

further substantiation of the phagocytal 

theory. The debate, caused by those reports 

in the society, definitely affected the 

subsequent course of I.I. Mechnikov’s 

work. So, on October 18th N.A. Stroganov 

and K.K. Iskersky told dissatisfaction with 

hypothetical explanation of phagocytes 

role in case of diseases progressing with 

crises. In his reply I.I. Mechnikov spent a 

series of new researches and on February 

7th, 1887 he represented the report 

«Concerning the doctrine about malaria» 

[7] and on May 16 th in the same year he 

made the report «About fight of 

phagocytes in case of relapsing fever» [8]. 

The doctrine on phagocytosis was not only 

disproved by supervision over these 

infections, but, on the contrary, it received 

a new acknowledgement. 

In all during 1883-1887 I.I. Mechnikov 

was present at 34 sessions of the 

physicians’s society in Odessa and he 

made 6 reports. The sessions, at which he 

told about the researches, were among the 

91 

most visited and on November 26th, 1883 

when the society heard I.I. Mechnikov's 

report «Comparative pathological research 

concerning inflammation in connection 

with a question on intracellular digestion», 

maximum number of visitors for those 

years, i.e. 69 full members and 16 visitors, 

gathered (in 1883-1887 there were 37-38 

full members at the society sessions on the 

average, taking into account that in 1883 

there were 11 honorary members, 92 full 

members and 9 correspondent members in 

the latter) [9]. 

It is also necessary to notice that 

researches with use of medical 

microbiology methods were performed by 

I.I. Mechnikov in the prosectorium of the 

city hospital along with consultation and 

assistance of the full member of the 

Society doctor of medicine N.A. Stroganov 

who headed hospital prosectorium since 

1877. In 1887 I.I. Mechnikov worked in 

collaboration with the assistant N.�. 

Stroganov who was then a military doctor 

in the prosectorium; it was his second job. 

Ch.I. Hentsinsky was studying malaria 

causative agents for many years. 

Summarising all abovementioned it is 

possible to assert that sessions of the 

physician’s society in Odessa were the first 

audience where reports on the theory of 

phagocytosis, offered by I.I. Mechnikov, 

were not only heard both at VII Congress 

of naturalists and doctors, but also they 

were thoroughly discussed, subjected to 

criticism and it promoted formation and 

becoming the theory that obtained 

international recognition afterwards. And 

full members of the society not only 

discussed and criticised I.I. Mechnikov's 

reports, but also assisted in laboratory 

researches (N.A. Stroganov, Ch.I. 

Hentsinsky). 

References: 

[1]. �� .�. �� 

��. – ��, 1945. – �. 10.

92 


[2]. �� .�. �� 

�� . – ��, 

1954. – �. 5. – �. 22-30. 

[3]. �� .�. // �� . – 

1884. - � 12. – �.284-286. 

[4]. �� .�. �� 



[5]. �� .�. �� 



[6]. �� .�. �� 



[7]. �� .�. �� 



[8]. �� .�. �� 


1950. – �. 6. – �. 91-101 

[9]. �� 

�� 1882-1883 ��. – 

��, 1882-1883. – 23, 211 �.




MILESTONES PHYSICIANS AND THEIR 

CONTRIBUTIONS IN TURKISH 

ORTHOPEDICS AND TRAUMATOLOGY 

ELIF ATICI 1 , TEOMAN ATICI 2 

Abstract: Orthopaedics, dealing with the treatment of the irregularities in 

the locomotors system and traumatology, dealing with the treatment of 

injuries after trauma have been serving as independent treatments in the 

surgery clinics in Turkey as in the whole world. The independent science 

field becoming of Orthopaedics and Traumatology in Turkey has been 

released by the efforts and contribution of many respected physicians. In this 

presentation the efforts of the physicians Orhan Abdi Kurtaran, Akif Sakir 

Sakar, Burhaneddin Toker, Dervis Manizade and Rıdvan Ege who have 

contributed in the development of Orthopaedics and Traumatology in Turkey 

is going to be mentioned. 

Key words: Orthopaedics and Traumatology, History of Medicine, Turkey. 

Like in whole world, in Turkey as well 

the proceeding of surgery into a modern 

appearance has been in the 19 th century. 

The later separation of orthopaedics and 

traumatology from general surgery like 

urology, gynaecology and alike fields and 

its becoming as an independent science 

field has been in different dates and ways 

in every country. Orthopaedics, dealing 

with the treatment of the irregularities in 

the locomotor system and traumatology, 

dealing with the treatment of injuries after 

trauma have been serving as independent 

treatments in the surgery clinics until 

recent years [3]. 

The independent science field 

becoming of Orthopaedics and Traumatology 

in Turkey has been realized by the 

efforts and contribution of many respected 

physicians. In this essay, the efforts of the 

physicians Orhan Abdi Kurtaran, Akif 

Sakir Sakar, Burhaneddin Toker, Dervis 

Manizade and Ridvan Ege who have 

contributed in the development of 

Orthopedics and Traumatology in Turkey 

is going to be mentioned. 

Dr. Orhan Abdi Kurtaran (1877-1948) 

After graduating from Military Medicine 

School in 1899, he worked as a surgery 

assistant with Prof. Reider and Dycke Pasha 

in Gulhane Hospital [1]. Dr. Orhan Abdi was 

sent to University of Bonn by Sultan 

Abdulhamid in 1900. He got training 

orthopaedics from Dr. Max Shede and 

learned the production of orthopaedics 

equipments from Eschaum. Later, he became 

an assistant of Prof. Hoff in University of 

Wurzburg (Baviera) and Prof. Sick in 

University of Eppendorff (Hamburg) [3, 12]. 

In 1905, by the order of the Padishah, he 

returned to Istanbul and began to work as a 

trainer at Gulhane Hospital, “Orthopaedics 

and War Surgery” [13]. 

1 Uludag University, Faculty of Medicine, Medical History and Ethics Depart., Bursa, Turkey 

2 . Uludag University, Faculty of Medicine, Orthopedics and Traumatology Depart., Bursa, Turkey

94 


Fig. no.1. Dr. Orhan Abdi Kurtaran 

So, involvement of orthopaedics in 

medical training began in 1905 with Dr. 

Orhan Abdi. At the same year, he used ether 

in the operations and contributed for 

developing anaesthesia. With the foundation 

of Medical Faculty in 1909 it was seen that 

for the first time orthopaedics branch has 

become semi private and the name of the 

lesson was changed to “Orthopaedics and 

Big Surgery Operations” [13]. During those 

days there were three surgery clinics. The 

third one’s name was “Surgery and 

Orthopaedics” and the chairman of it was Dr. 

Orhan Abdi. However, when he became as 

the chairman of the second surgery clinic, the 

name orthopaedics was removed [3]. 

Akif �akir �akar (1888-1961) 

After graduating from Military 

Medicine School in 1910, he underwent a 

period of training in Gulhane Military 

Practice Hospital, surgery clinic. At the 

end of 1911 he was inducted as a surgeon 

to Van Military Hospital. In 1912 he 

worked as an assistant in Vienna 

University with Prof. Eiselberg in surgery 

clinic and with Dr. Breitner in emergency 

service for a year. In the I. World War he 

worked as a physician in Jerusalem, Syria 

and Palestine. He was captured in 

Damascus. In 1919 he returned to Istanbul, 

in 1921 he graduated as a surgeon and 

began to work with Dr. Mouchet who was 

working with orthopaedics patients and 

giving lectures on “Paediatric Surgery and 

Orthopaedics”. He was appointed as an 

interpreter of Dr. Mouchet by Dr. Akil 

Muhtar Ozden, the Dean of that time. After 

becoming an associate professor in 1923, 

he began to give lectures between the years 

1923-1925. In 1925, after Dr. Mouchet 

changed to teach in “Surgery Operation 

and Techniques” he became the head of 

Paediatric Surgery and Orthopaedics 

Department, which did not have a clinic 

[6]. In 1927-1929, he worked in Hamburg 

University surgery clinic with Dr. Sudeck 

on bone and joint surgery. Seeing that fractures 

treatment and orthopaedics was not 

sufficient in Turkey, he showed effort to 

establish a modern orthopaedics clinic 

[13]. 

Fig.no.2. Akif �akir �akar

E. ATICI, et al: Milestones physicians and their contributions in Turkish orthopaedics and 

traumatology 

Dr. Akif Sakir had three goals; the 

establishment of the clinic, paediatric 

surgery and orthopaedics becoming a 

specialization branch and separating 

paediatrics surgery from orthopaedics. In 

1930, the first Paediatric Surgery and 

Orthopaedics Clinic, which contained 30 

beds was founded by him [3]. In 1931, he 

became professor. For the first time in 

Turkey, he used visual materials 

(photographs and operation images of 

orthopaedics patients) in education, also he 

always demonstrated patients related with 

lesson [13]. The first book of the clinic 

was published by him in 1936 with the title 

“Paediatric Surgery and Orthopaedics”. 

With the aim of acceptance Paediatric 

Surgery and Orthopaedics as a 

specialization branch, he established 

“Turkish Orthopaedics and Traumatology 

Association” in 1939. The department took 

its place among 22 specialization branches 

in the date of 1947. In 1955, with the 

special efforts of Dr. Akif Sakir Sakar, the 

clinic moved to the new building that was 

formed of 5 floors and 100 beds. So, Dr. 

Sakar has founded the modern 

orthopaedics clinic that was his ideal [6, 

11, 13]. 

He had a book with two volumes titled 

as “Lectures on Paediatric Surgery and 

Orthopaedics Clinic”, 100 papers publicshed 

in Turkish medical journals and 40 

papers published in German, French and 

Swiss medical journals [6]. 

Turkish Orthopaedics and Traumatology 

Association has been given scientific 

prize in the name of Akif Sakir Sakar since 

1995. Also the same association arranged 

“28 th Akif Sakir Sakar Days” this year. 

Dr. Burhaneddin Toker (1890-1951) 

He began his medical education in 

Damascus Medical Faculty and completed 

in Istanbul in 1910. He went to Germany 

in 1913 to make his residency in surgery 

95 

and worked together with the popular 

surgeons of that period, Brauer and 

Küttnerfor for 7 years in Berlin and 

Hamburg [2]. During that period fracturesdeformations 

and injuries were cured in the 

general surgery. He specialized in modern 

bone surgery. After returning to Turkey, he 

started to work as an operator and the 

clinical director of the surgery department 

in Cerrahpasha Hospital. Surgery treatment 

opportunities were insufficient. Fracturedeformation 

treatment was mostly done by 

the bonesetters. 

Also most of the physicians were not 

interested in fracture treatment and plaster 

structure. He was aware of the lacking 

points in this field, so he dealt with 

especially with traumatology [3]. 

Fig.no.3. Dr. Burhaneddin Toker 

In order to increase the number of 

patients, he made friendships with the 

policemen who take injured people to the 

hospital, and assured that all injured 

around were taken to Cerrahpasha. In a 

short time Cerrahpasha Hospital started to 

work as an accident surgery centre. He 

attained a mobile roentgen device and by

96 


doing fractures reposition under radioscopy, 

he released the first conservative 

modern fracture treatment in Turkey. 

He brought Braun device schema and 

measures, which was used in fractures 

from Germany and had the smith done it. 

The first surgery journal “Journal of 

Turkish Surgery” was published by him in 

1927. 

Also, he took the lead in the foundation 

of “Turkish Surgical Association” in 1929 

with the aim of improvement in the 

scientific worlds [8, 9, 11]. 

Subsequent to the "University Reform" 

in 1933, the world famous German 

surgeon Ord. Prof. Dr. Rudolf Nissen has 

been assigned as the "Director of the 1 st 

Surgery Clinic and the clinic was moved 

from Haydarpasha to Cerrahpasha. Dr. 

Burhaneddin Toker was first assigned to 

the staff of Dr. Nissen as an associate 

professor; five months later he became 

professor. Nissen went to U.S.A. because 

of his sickness and Dr. Toker became the 

director by proxy in 1941 and subsequent 

to definitive departure of Nissen, the new 

director of 1 st Surgery Clinic at Medical 

School [7, 8]. Dr. Toker opened surgery 

building in 1943, the plan of which was set 

and started to build by Nissen in 1939. So, 

the clinic took a modern appearance [8]. 

He had the degree of "Ordinaries 

Professor" in 1943 and leaded cardiovascular 

surgery, neurosurgery and 

anaesthesia departments in addition to the 

formation of new traumatology [7]. 

He was also the first implementer of 

some medical applications: first 

systematically blood transformation, first 

stomach resection operation (1928), 

implementation of first Smith-Petersen nail 

(1941), first book on fracture and 

dislocation [2, 9, 11]. He had over 150 

papers and 3 books: Surgical Treatment of 

Lung Tuberculosis, Fracture and 

Dislocations, Lung Apses. 

Dr. Dervi� Manizade (1902-2003) 

After graduating from Vienna Medical 

Faculty in 1932 he began to work in the 

Traumatology Service of the II. Surgery 

Clinic in the same place and was preparing 

for associate professorship. Prof. Nissen 

decided Dr. Manizade for the assistantship 

would be appropriate. In 1937 he started to 

work as an assistant of Nissen and Toker in 

Istanbul. He was established archive 

system for the first time in the clinic 

(1938). He prepared patient follow forms 

and made sure that these forms were filled 

completely and regularly for each patient. 

During those days fracture-deformation 

treatment, which was done within the 

general surgery, began to discuss that it 

should be the subject of orthopedics 

branch. After the death of Dr. Toker in 

1951, Cerrahpasha Surgery Clinic divided 

into two with the directorship Dr. Kazım 

Ismail Gurkan and Dr. Fahri Arel. In 1960, 

Dr. Manizade was appointed to the 

directorship of the third clinic and for the 

first time he gathered the traumatologic 

cases in one place. 

Fig.no.4. Dr. Dervi� Manizade


traumatology 

Between the years 1962-1963 by 

combining surgery clinics, one clinic with 

six sections was established. One of these 

sections was Traumatology Service with 

30 beds only for bone-joint injuries and 

orthopaedics cases. Dr. Manizade, who 

assured its establishment, was appointed as 

a director of this section [10]. 

First intrameduller nail implementation 

in tibia fractures was performed by him in 

1950 [9, 11]. Turkish Orthopaedics and 

Traumatology Association has been given 

scientific prize in the name of Dervis 

Manizade since 2001. Also the same 

association is going to arrange “8 th Dervis 

Manizade Orthopaedics Days” on 

December in this year. 

Dr. Rıdvan Ege (1925- ) 

After graduating from Istanbul Medical 

Faculty in 1948, he underwent a period of 

training in Gulhane Military Medical 

Academy, surgery clinic. In 1949, he was 

inducted to Erzincan and then Diyarbakır. 

In 1952 he worked as an assistant in 

Gulhane with Prof. Dr. Recai Erguler in 

surgery clinic. Although traumatology was 

very important for military, there was no 

specialization in Turkey. So, he went to 

U.S.A (Colombia University) in order to 

take orthopaedics and traumatology 

training in 1956. After returning to Turkey, 

he worked in general Surgery Clinic of 

Gulhane since Orthopaedics was not 

established yet [4]. He believed that 

skeleton traumatology was not the field of 

general Surgery and should be the 

specialist of orthopaedics. His aim was 

including Trauma into Orthopedics and 

separate Paediatric Surgery. To reach this 

aim first he completed 262 orthopaedic 

operations in a year and published these in 

Turkish and English. Then he visited three 

Medical Faculties in Turkey that dealt with 

orthopaedics and four Bone and Joint 

Illness Hospitals to start a communication 

97 

with colleagues. After presenting his works 

Professors Committee accepted to establish 

a clinic and also accepted Dr. Ege’s 

suggestion for naming the clinic as 

“Orthopaedics and Traumatology”. So, the 

separation of orthopaedics from paediatric 

surgery and traumatology from general 

surgery and joining them as an 

independent clinic was realized first in 

Gulhane Military Medical Academy in 

1961 by him [5]. Also after working with 

Dr. Carroll (New York Colombia 

University) and with Dr. Boyes (Los 

Angeles S California University) on hand 

surgery, he established first hand Surgery 

Clinic in Turkey. 

Fig.no.5. Dr. Rıdvan Ege 

Also he established Mediterranean and 

Middle East Orthopaedics and 

Traumatology Association (1960), Turkish 

Rehabilitation of Disabled Association 

(1960), Turkish Orthopaedics and 

Traumatology Union Association (1966), 

Modern Surgical Training and Research

98 


Association (1970), Turkish Foundation of 

Traffic Accidents (1972), Turkish Hand 

and Upper Extremity Surgery Association 

(1977). He organized many national and 

international congresses. He has 111 

books, 451 papers. Today, he continues his 

works in Ufuk University (Ankara), which 

was established in 1999 by Turkish 

Foundation of Traffic Accidents. He is the 

president of board of trustee [4]. 

Table 1. Contribution of physicians to 

Turkish Orthopaedics and Traumatology 

Dr. Orhan 

Abdi 

Kurtaran 

Dr. Akif 

Sakir Sakar 

� First lesson in 

orthopaedics: 

� “Orthopaedics and 

War Surgery” 

(Gulhane Hospital- 

1905) 

� “Orthopaedics and 

Big Surgery 

Operations” (Medical 

Faculty-1909) 

� Used ether in the 

operations (1905) 

� First Clinic: “Surgery 

and Orthopaedics” 

(1909) 

� Establish modern 

orthopaedics in 

Turkey 

� Use visual materials 

in education for the 

first time 

� Establish Paediatric 

Surgery and 

Orthopaedics Clinic 

(1930) 

� Publish first book: 

Paediatric Surgery 

and Orthopaedics” 

(1936) 

� Establish Turkish 

Orthopaedics and 

Traumatology 

Association (1939) 

Dr. 

Burhaneddin 

Toker 

Dr. Dervis 

Manizade 

� Establish the first 

modern orthopaedics 

clinic (1955) 

� Released the first 

conservative modern 

fracture treatment in 

Turkey 

� Published the first 

surgery journal 

“Journal of Turkish 

Surgery” (1927) 

� He took the lead in 

the foundation of 

“Turkish Surgical 

Association” (1929) 

� Leaded traumatology, 

cardiovascular 

surgery, neurosurgery 

and anaesthesia 

departments 

� The first implementer 

of some medical 

applications: 

� first systematically 

blood 

transformation 

� first stomach 

resection operation 

(1928) 

� first 

implementation of 

Smith-Petersen nail 

(1941) 

� First book on fracture 

and dislocation 

� Established archive 

system for the first 

time in the clinic 

(1938) 

� Prepared patient 

follow forms 

� First intrameduller 

nail implementation in 

tibia fractures (1950) 

� Gathered the 

traumatologic cases in 

one place (1960)


traumatology 

Dr. Rıdvan 

Ege 

� Established 

Traumatology Service 

with 30 beds only for 

bone-joint injuries and 

orthopaedics cases 

(1962-1963) 

� Established the first 

“Orthopaedics and 

Traumatology” clinic 

(1961) 

� (separation of 

orthopaedics from 

paediatric surgery and 

traumatology from 

general surgery and 

joining them as an 

independent clinic 

was realized by him) 

� Established 

� Mediterranean and 

Middle East 

Orthopaedics and 

Traumatology 

Association (1960), 

� Turkish Rehabilitation 

of Disabled 


� Turkish Orthopaedics 

and Traumatology 

Union Association 

(1966) 

� Modern Surgical 

Training and Research 


� Turkish Foundation of 

Traffic Accidents 

(1972) 

� Turkish Hand and 

Upper Extremity 

Surgery Association 

(1977) 

Conclusion 

Orthopaedics began to its journey in 

Turkey in 1905 with Dr. Orhan Abdi 

Kurtaran by getting its place in the 

medicine training and got its first clinic 

99 

with the intensive efforts of Dr. Akif Sakir 

Sakar in 1930. Although it was accepted as 

a separate branch in 1947, until 1960 the 

clinic’s name was Paediatric Surgery and 

Orthopaedics. The development in 

Traumatology began with Dr. Burhaneddin 

Toker and as an effort of Dr. Dervis 

Manizade first Traumatology Service was 

established within General Surgery. With 

the efforts of Dr. Rıdvan Ege Orthopaedics 

was separated from Paediatric Surgery and 

Traumatology was separated from General 

Surgery in 1961 and took the name 

Orthopaedics and Traumatology. 

References 

[1]. Altınta� A. Turk Cerrahisinin Onemli 

Bir Sahsiyeti: Operatör, Muallim 

Orhan Abdi (Kurtaran). Sendrom 

1996; 8 (2): 80-85. 

[2]. Arel F. Ord. Prof. Dr. A. Burhaneddin 

Toker. �stanbul klinik Dersleri 1951; 

5 (27): 2-6. 

[3]. Atıcı E, Atıcı T. The Development of 

Orthopaedics and Traumatology in 

Turkey and Some Results. JISHIM 

2004; 3(5): 50-59. 

[4]. Ege R. 80 Yılın Ardından. Vol. 1. 

Ankara: Ufuk University 

Publications 2007. 

[5]. Ege R. Opening Speech. XV. National 

Congress of Turkish Orthopaedics 

and Traumatology. Proceedings 

Book. Publication of Turkish 

Ortopedics and Traumatology Union 

Assosiation. 1997. p.1-28. 

[6]. Frik F. Turkiye’de Ortopepedi Kurucusu 

Ord. Prof. Dr. Akif Sakir Sakar. 

Dirim 1958; 33(9-10): 227-228. 

[7]. Goksoy E. Ord. Prof. Dr. A. 

Burhaneddin Toker: Türk 

Cerrahisine Katkılar. Turkish Journal 

of Surgery 2005; 21(2): 102-111. 

[8]. Goksoy E. The Biography and Work of 

Prof. Dr. Burhaneddin Toker-On 

Occasion of the 50 th Anniversary of

100 


His Death. The New History of 

medicine studies 2001; 7: 387-409. 

[9]. Manizade D. 65 Yıllık Cerrahpa�a 

hastanesi. �stanbul 1976: 82. 

[10]. Manizade D. Kemik ve Mafsal 

Travmatolojisi. In: Kırık Çıkıklar. 

Vol 1. �stanbul: Publication of 

Cerrahpasha Medical Faculty, no: 

119, 1983. p.1-21. 

[11]. Manizade D. Ortopedi ve 

Travmatoloji. In: Unat EK, editor. 

Dünyada ve Türkiye’de 1850 

Yılından Sonra Tıp Dallarındaki 

�lerlemelerin Tarihi. �stanbul: C 

Publisher; 1988. p. 338-343. 

[12]. Naderi S, Hakan T, Dinc G. Orhan 

Abdi Kurtaran ve Ameliyatı- 

Cerrahiye adlı Eserindeki Norosirurji 

ile Ilgili Bolumler. Turkish Journal 

of Neurochirurgia 2006; 16(3): 197- 

202. 

[13]. Tanacan H. Turk Ortopedisinin 

Tarihcesi I. Acta Orthop Traumatol 

Turc 1993; 27: 151-159.




SILICOSIS DISEASE HISTORY IN 

EXPLOITATION OF COAL IN JIU VALLEY 

M. FULGA 1 , V. ANDREESCU 2 , D. LUPULESCU 1,3 

Abstract: Since 1964 there were written papers on the history of mining, in 

general (Ion Lungu, 1964: “The beginning of coal mining in Transilvania”, 

Acta Musei Napocensis) and of Valea Jiului mining (Sargetia V, 1968: “The 

beginnings of the industrial revolution in Valea Jiului mining”), in which the 

work conditions and the life of the miners were described. Coal was known 

and extracted in the ancient times. The first coal extraction in Europe was 

officially mentioned in 1113, at Kerkrade, near the border between Holland 

and Germany. In 1183 there opened the first mines in Shefield, England, in 

1240 in Durham and in 1291 in Walles. In our country, the first coal mines 

were discovered in 1771 at Doman, then, in 1788 at Secu and in 1790 at 

Anina, by Nicolae Hammer. The first mining was mentioned in 1792 at 

Seierdorf, Anina. The development of mining began at the end of the XVIII th 

century and the beginning of the XIX th century. The growing industry of coal 

mining and the lack of a careful monitoring of the work environment led to 

an increased risk of pneumoconiosis during the ‘50’s, when the pathology of 

coal dust was not recognized. Since then, the number of miners grew and so 

the number of diseases induced by dust inhalation. 

Key words: coal, silicosis, history of medicine. 

Introduction 

Jiu valley is the region located in the 

south of Hunedoara County, at the border 

among Transilvania, Banat, and Tara 

Romaneasca, region generic called “the 

country of the black diamond due to the 

exploitation of the pit coal deposit. This 

area started to be known since 1782 when 

layers of coals burning were noticed and 

those layers burnt much time after this. 

Although in Jiu valley there were rich 

deposits of coal, the interest for natural coal 

raised considerably just in the 4th decade of 

the 19-th century, as a consequence of the 

request of fuel, this request being a result of 

the development of the capitalism and also 

due to the extension of the internal and 

external market. 

1 Institute of Public Health Bucharest 

2 County Public Health Authority Hunedoara 

3 University of Medicine and Pharmacy “Carol Davila” Bucharest 

Historical aspects 

The human being has been an energy 

consumer since the primitive epoch. 

The coal has been known and used 

since antiquity. In 1113 started the first pit 

coal exploitation from Europe, officially 

registered in Kerkrade, at the border 

between Holland and Germany. In 1183 

the first coal mining exploitations were 

also opened and officially registered in 

England near Sheffield, after this appeared 

those from Durham, and in 1921 those 

from Walles. The coal was for a long time 

the only source of energy, it was used at 

the beginning as domestic fuel being the 

only source of heating in houses, after a 

while the coal started to influence the 

international economy.

102 


The facts are mentioned in the work 

“The coal research history from ancient 

times till 1900” written by A Semaka, 

published in the Mine magazine, 13 in 

1962, also in the one written by N. 

Maghiar – ‘From the history of exploittation 

and using of mineral coals “publicshed 

in Mine Magazine nr 21 from 1971. 

The 19 th century was metaphorical 

defined the “coal” century. The increasing 

needs of energy used by the society led to 

the discovery and exploitation of new 

energy sources (petrol, natural gases, 

hydro electric power and atomic power 

etc.), without eliminating the coal as a 

source of energy. 

Moreover, the coal production increased 

also in other countries, the coal mining being 

different regarding their type, structure of the 

coal layers. The most important coal mining 

is the pit coal mining these contains coking 

coal used in chemical industry. The coal 

mining containing brown coals and lignite 

are composed of superior coals used as fuel. 

An inferior type of coal is peat coal; this is 

frequently used in the North Europe, Asia 

and North America. The most profitable coal 

mines are those of surface as they are in Germany. 

In USA the coal is extracted from coal 

mines in average of 50 % and in C.S.I. (The 

Independent Community) in average of 35% 

Europe was on the first place regarding 

the universal production of coal, but the 

production decreased more than 50 % 

around 1980, nowadays Europe produces 

just 1/3 from universal production. 

C.S.I. is known as one of the greatest 

coal manufacturer in the world and it has 

in stored about 2/3 of the universal 

reserves of coal and from these 90% is 

located in Asia zone. 

In our country the first discoveries of 

natural coal were made in 1771 in Doman, 

in 1788 in Secul and in 1790 in Anina by 

Nicolae Hammer. The first exploitments 

started in 1792 at Steierdorf-Anina. In our 

country the development of coal mining 

started at the end of 18-th century and the 

beginning of19-th. The first works were in 

1835 followed by those from 1840 done by 

Hoffmann brothers and Carol Maderspach, 

the owners of mines from Rosia Montana. 

The Maderspach brothers made exploittations 

in Jiu Valley and they were the ones 

who put the basis, develop and improved 

the rudimentary mining coals the likely 

areas could be Petrosani, Petrila, their 

work was continued in the 6-th decade of 

the 19 th century. 

In 1896 Hoffmann Rafel, made a serial 

of coal analyses of the coal extracted from 

Lupeni, he reached the conclusion that this 

coal belonged to the group of pit coal with 

long flame and weak agglutinated. He 

showed the difference between the coal 

from East part of Jiu Valley and the ones 

from Lupeni, which contained a higher 

value in carbon and less in oxygen .The 

coal was used as raw material, as domestic 

fuel, later as a development of exploitation 

industry the coal was used as raw material 

for energetic industry (hydro and energetic 

power) metallurgy, iron and steel industry, 

afterwards was used in chemical industry. 

As a consequence of the crisis and because 

many vacancies were eliminated, after 

1990 the coal exploitation industry decreased 

much being replaced by other sources 

of energy which are, more profitable, 

sources like petroleum or natural gases. 

About the beginnings and the 

development of mining in general and 

especially of Jiu valley was much written 

beginning with 1964 some works being as 

follows: ” Ion Lungu, 1964: “The beginning 

of the development of coal mining in 

Transilvania”, Acta Musei Napocensis) 

and “Aspects of the beginning of industrial 

revolution from Valea Jiului mining 

(Sargetia V, 1968: In these works was 

described miners’ work and life conditions 

from JIU valley and the history of 

exploitation and the usage of coal from old 

times – thing reflected in Mircea Baron’s

M. FULGA, et al.: Silicosis disease history in exploitation of coal in Jiu valley 103 

book ‘The coal and society in Jiu Valley – 

inert-war period. (Fig. no. 1). 

Fig.no.1 

The work “Custom and continuity in 

the country – the stone which burns” is a 

monography of the mining in Jiu Valley, 

followed by the history of the Jiu Valley 

with the social and artistic development of 

the area, the customs and also the 

evolution of death rate due to the 

occupational disease as a consequence of 

the exposure to the coal dust (fig. nr 2) 

Fig.no.2 

In the work “Consideration regarding the 

coal usage in Romania” by Ion E Bujoiu and 

‘What is taken from coal” by I. Simionescu, 

are presented diverse aspects related to the 

development of the mining industry in 

connection with the social and economical 

conditions from Transilvania and Banat. 

Furthermore, during 1857-1858 the 

Uricani, Barbatenii de Sus, Lupeni, 

Macesd-Paroseni, Jiu Vaidei –Vulcan, 

Dalja, Petrila were bought by the 

Anonymous Society of mines and furnaces 

Brasov, which becomes a huge coal 

manufacturer of the Hungarian Austrian 

monarchy. The state made the first 

acquisition of coal fields in 1865. 

Other studies were made by the Blum 

engineer and were mentioned in 1939 in the 

study work “Le basin de charbons Petrosani- 

Jiu Valley. Etude chimico-technic, stade de 

metamorphose et classification” ans the dr M 

marinescu studies on 24 samples of coal 

from the mines described in the work ‘Piscu, 

Aninoasa,Petrosani- Est”. 

Other pieces of work in which is concluded 

that Jiu valley has superior coal are the works 

of the professor Ghe. Macovei- “Course of 

general geology and stratigraphy” another one 

is written by Ion E.Bujoiu “Encyclopedia of 

Romania “written in 1939. 

The studies made by Wartha Wincze in 

1876 proved that the coal from Petrosani 

can be used in the manufacture of coke 

needed in metallurgic industry and also in 

producing the light gas. 

Around 1950 the public opinion sustained 

the idea that the dust coal from the mines in Jiu 

Valley doesn’t cause occupational disease of 

lungs. In the same time was also a wrong idea 

that the deposit of pit coal dust in the lungs can 

lead to pulmonary fibrosis which could protect 

the lungs against the bacillus tuberculosis. The 

development of mining industry led to the 

increase of personnel .The lack of means of 

control against dust the number of people ill 

because of inhaling coal dust started to rise. 

The quantity of dust, in the absence of 

the means of control, rises in accordance 

with the quantity of coal extracted. 

Statistics from 1968 showed that during 

the last two decade, in Romania were 

declared 24000 cases of illness of silicosis. 

Over 80% were among the personnel of 

mining industry.

104 


Regarding the existence of pneumoconiosis 

of ore coal were a lot of debates. 

Some considered the coal as an inert 

gas which is stored in lung and it could 

cause just a weak fibrosis called black lung 

disease (anthracosis) which has the 

opposite effect of the dust from barren 

gangue that led to silicosis a serious 

illness, irreversible with lethal end (due to 

the high level of quartz). 

There are different consequences when we 

talk about the place of work in a coal mine. 

The miners from mines of barren gangue 

exposed to the dust rich in silicon (sillicium) 

can get ill with classic silicosis and the ones 

who work in mines of coal will be ill with 

black lung. Between the two pure types there 

are also mixed ones, encountered to those 

who work with stone and coal. 

During 1950-1970 the level of dust was 

of 32, mg/mc air, and the ratio of working 

places which were exposed to a higher 

level than the maximum admitted doze was 

of 63%. During 1982-1996, as a 

consequence of mechanization and the 

improvement of the work environment the 

level of dust decreases at 25 mg/mc. 

When we want to establish the risk of 

getting ill because of dust in a working place 

we must take into consideration 3 factors: the 

type of dust, quantity, and the dimension of 

particles. In each mine the risk is different 

and it is in accordance with the technology of 

exploitation used, types of work and the 

operations done during the cycle of work In 

the same time the introduction of 

mechanized working in cutting and evacuate 

the coal led to an increase of the level of dust 

in mining mechanized excavations, so it 

appears “the second wave” of illness and by 

black lung. For this were taken measures 

against of the dust and the number of 

diseases and their frequencies to decrease. 

If between 1953-1996 the statistics 

showed that there were 2420 cases of disease 

due to inhaling of coal dust in Jiu Valley and 

the average of life was 42, today the 

incidence decreased at 1-0,5% and the 

average of age increased at 50.8 years. 

An estimation made before 1975 presented 

that from 100 ill people 24,9% have worked 

exclusively in coal extraction (and these were 

with black lung) 40,8% who worked in 

combined environment with stone and coal 

were ill with pneumoconiosis due to mixed 

dust and 34,3% who worked just in quarry they 

were ill with silicosis. Regarding the 

classifying of silicosis grade there can be emphasized 

the following percents: the first phase 

-84.4% the second 9,9% and the third 2,8% 

Beginning with the setting up of the 

commission of silicosis in Petrosani and 

the establishing of the criterion declare the 

illnesses the silicosis and black lung started 

to decrease. The level of dust decreased so 

that the number of cases of silicosis 

disease is much rarer. 

To sum up the morbidity of the personnel 

which is hired nowadays in mines from Jiu 

Valle, in comparison with the past? Decrease 

very much due to the mechanized 

technology used now in mines. 

References: 

[1]. Badea L. – Valea Jiului, Ed. �tiin�ific�, 

Bucuresti, 1971, p.7-26. 

[2]. Baron M. – C�rbune �i Societate în 

Valea Jiului, Ed. Universitas 

Petrosani, 1998. 

[3]. Baron M. – Tradi�ii �i continuitate în �ara 

«Pietrei care arde», Petro�ani, 1994. 

[4]. Darlea G. - Antracoza, Ed. Favior & 

Vidra, Or��tie, 1992. 

[5]. Fodor D., Baican, G. – Situa�ia actual� 

a mineritului românesc, Rev. Univers 

ingineresc. nr. 11/2002 si nr. 12/2002 

[6]. Fodor, D., Baicon, G. – Impactul 

industriei miniere asupra mediului, 

Ed. INFOMIN, Deva, 2001. 

[7]. Mocanu C., Tufescu V. – Depresiunea 

Petrosani, Ed. �tiin�ific� Bucure�ti, 

1964, p.11.




SOME CONTRIBUTIONS OF ROMANIAN 

MEDICAL SCHOOL IN THE TREATMENT 

OF NEUROSYPHILIS BEFORE THE 

DISCOVERY OF ANTIBIOTICS 

S. G�BREAN 1 

Abstract: In the first decades of the XX th century, neurosyphilis was a 

frequently disease in the world, for which different types of treatments were 

experienced, for example drugs containing arsenic (Salvarsan and 

Neosalvarsan). These drugs were not 100% effective, especially in tertiary 

syphilis. In the years following the First World War, based on the 

observations that in same cases high fever is favourable in the treatment of 

syphilis, it was induced the malaria infection which determines a high and 

prolonged fever, at patients with late syphilis. The risk for the patients was 

acceptable because malaria could later be treated with quinine. We present 

some dates concerning the contributions of Ghe. Marinescu, M. Ciuca and 

their fellow-workers, who used paludotherapy and Salvarsan or 

Neosalvarsan as adjuvant therapy in treating neurosyphilis 

Key words: neurosyphilis, treatment, Romanian medical school 

Syphilis is caused by the spirochaete 

Treponema pallidum, which is 5-15�m in 

length and less than 0.3�m in thickness. 

This organism is generally sexually 

transmitted through mucosal membranes or 

small lesions of the skin. T. pallidum can 

be observed by silver stain, immunofluorescence, 

with dark-field, phasecontrast 

or electron microscopy. In 1913, 

after centuries of discussions concerning 

syphilis, H. Noguchi, a Japanese scientist, 

demonstrated the presence of T. pallidum 

on sections from the brain obtained at the 

necropsy of a patient with progressive 

paralysis, proving that T. pallidum was the 

cause of the disease. Short time afterwards, 

in the same year, Gheorghe Marinescu 

together with his assistant I. Minea, 

confirm this discovery and identify T. 

pallidum not only on sections from 


necropsies but also, for the first time, on 

sections from small fragments of brain 

obtained by the surgeon I. Jianu from a 

patient with progressive paralysis. 

The various manifestations of syphilis 

are time dependent. Acquired syphilis has 

four stages: primary, secondary, latent and 

tertiary. Neurosyphilis refers to a site of 

infection involving the central nervous 

system and may occur at any stage of 

syphilis. There are four clinical types of 

neurosyphilis: asymptomatic neurosyphilis, 

meningo-vascular syphilis, general 

paresis of the insane and tabes dorsalis. 

Before the treatment with antibiotics, 

neurosyphilis was observed in 25-35% of 

patients with syphilis. General paresis, also 

known as dementia paralytic is a severe 

manifestation of neurosyphilis, which 

occurs approximately 20-30 years after the

106 


initial infection with Treponema pallidum 

and represents a chronic progressive 

fronto-temporal meningo-encephalitis with 

especially psychiatric symptoms [6, 12]. 

Syphilis has been a major health 

problem since the XVI th century and was 

treated with some ineffective remedies 

(guaiacum, mercury and others) until the 

beginning of the XX th century, when 

treatments based on arsenic as Salvarsan 

(arsphenamine, developed in 1908 by S. 

Hata in the laboratory of Paul Ehrlich) and 

Neosalvarsan were used. Malario-therapy 

was used as treatment for neurosyphilis 

due to high prolonged fever (a form of 

pyreto-therapy), an acceptable risk because 

the malaria could later be treated with 

quinine. For discovering the treatment of 

dementia paralytica by malaria inoculation 

(1917), J.Wagner-Jauregg was awarded 

with The Nobel Prize for Medicine in 

1927. Malariotherapy was followed by 

either Salvarsan or Neosalvarsan as 

adjuvant therapy [1, 10]. 

In our country, a number of medical 

personalities showed interest for the 

treatment of syphilis: Gh. Marinescu, C. 

Levaditi, M. Ciuc�, C. I. Urechia, Elena 

Pu�cariu-Densu�ianu and their co-workers. 

At the beginnings of Romanian medical 

education, the first reference concerning 

syphilis prevention was made by Carol 

Davila in his doctoral thesis sustained on 

23 February 1853, thesis which was 

entitled “Syphilis prophylaxis” [3]. 

Gh. Marinescu was one of the first 

physicians in the world who received 

(1910) from Ehrlich the small doses of 

Salvarsan, which he managed to prepare in 

order to be tested in the great hospitals of 

the world [9]. If Salvarsan produced 

healing in some forms of syphilis (skin 

syphilis, for example), in neurosyphilis 

(tabes, general paresis) it gave no results. 

Gh. Marinescu tried to introduce 

Neosalvarsan into the body not by 

intramuscular or intravenous injections, 

but directly into the spinal canal or brain. 

He asked a former student, surgeon Ion 

Jianu, to do some small trepanations of the 

skull (it has to be mentioned that I. Jianu 

had never before worked on living brain); 

using these entries, Gh. Marinescu injected 

Neosalvarsan directly into the brain of the 

patients with dementia paralytica, but he 

didn’t obtain good results. 

Fig.no.1. 

As it was mentioned above, Treponema 

pallidum was identified in the brain of 

general paralytics in 1913 so, in 1910, Gh. 

Marinescu was only suspecting the 

presence of the spirochete in the brain of 

these patients. In order to destroy the 

spirochete, Marinescu introduces 

Neosalvarsan by intraspinal injections 

directly into the cerebrospinal fluid, but 

once again without the desired results, the 

drug being irritable and caustic for the 

nervous tissue. Together with his assistant 

I. Minea, Marinescu realized at the 

Pantelimon Hospital an original method of 

treatment for general paresis, which was 

based on injecting salvarsanized serum 

into the cerebrospinal fluid. The serum was 

obtained from patients with syphilis who 

were injected with an important quantity of 

Neosalvarsan. After a few hours, were 

taken 40-50 ml of blood from which the 

serum was obtained after coagulation; this 

serum contained both a very small dose of 

Salvarsan and the syphilis antitoxin 

produced by the organism. Injected to the 

patients with general paresis, this serum 

showed good results, even curative 

properties [5].

S. G�BREAN - Some contributions of romanian medical school in the treatment of neurosyphilis 107 

before the discovery of antibiotics 

After two years, in 1912, two American 

physicians, Swift and Ellis publish the 

same method of treating neurosyphilis with 

salvarsanized serum. Although Ehrlich 

himself, the discoverer of Salvarsan, 

mentions at a medical congress held in 

Königsberg in 1913, the world priority of 

Marinescu’s researches regarding the 

intraspinal injection of the salvarsanized 

serum, the discovery is attributed to the 

two American physicians, who later 

recognized that the paternity of treatment 

was belonging to Gh. Marinescu. 

However, they were saying that they had 

“improved” the serum, improvement 

which meant putting into phials the 

salvarsanized serum and commercializing 

it worldwide. There were also 

disapproving opinions regarding the 

treatment with salvarsanized serum, being 

considered that “it is a complicated 

method, and if sometimes may have a 

more or less curative effect, it still does not 

represent a preferable treatment or a 

progress in the treatment of nervous 

syphilis” (C. I. Urechia) [12]. 

Fig.no.2. 

In the 1920s, Constantin Levaditi and 

Robert Sazerac introduced bismuth 

therapy. For the treatment of neurosyphilis, 

bismuth therapy was done as in the case of 

visceral or skin syphilis, taking into 

account possible accidents like stomatitis, 

intestinal problems, jaundice etc. 

Generally, bismuth drugs seemed to have 

good results. There were patients who 

reacted very well at this therapy and there 

were also cases in which the patients 

showed inability to tolerate the bismuth. 

As a consequence, it was preferred a 

combined treatment, based on alternating 

bismuth salts with Salvarsan [2, 7]. 

In Romania, the artificial infection with 

malaria (malariotherapy) was successfully used 

in the treatment of neurosyphilis. The method 

was simple and consisted in the intravenous or 

subcutaneous injection of blood taken from a 

patient presenting a malarial attack; on average, 

in 8-10 days, the patients had malarial attacks 

and after 10-12 attacks they were given quinine 

and Salvarsan. 

The principle of treating neurosyphilis 

by impaludation was based on the high 

fever which, probably, nonspecifically 

inactivated T. pallidum and generated a 

complex neuro-immuno-endocrine defense 

and repair reaction of the body. 

Malariotherapy was performed at Socola 

Hospital in Ia�i under the direction of M. 

Ciuc�, at the Psychiatry Clinic of the 

Faculty of Medicine in Cluj under 

Professor’s C.I. Urechia direction, at the 

Neurological Service of the Institut for 

Mental, Nervous and Endocrine Diseases 

from Bucarest [11]. 

Fig.no.3 

A special attention should be accorded 

to the researches made at Socola Hospital, 

the second internationally acknowledged 

centre for pyretotherapy, after Horton 

centre from England. At first, only 

Plasmodium vivax was used in treating 

neurosyphilis, being considered relatively 

safe and easy to control by quinine. After a 

few years, in 1925, Plasmodium

108 


falciparum was used, first at Horton center 

and soon afterwards at Socola Hospital. 

The team working here under the direction 

of Professor M. Ciuc�, general secretary of 

the International Commission of Malaria 

for the League of Nations (1928-1938) also 

used in its researches indigenous strains of 

Plasmodium malariae, thus having an 

important contribution to knowledge of the 

sporogonic cycle of malaria parasites [4,8]. 

C.I. Urechia recommended for the 

treatment of neurosyphilis pyretotherapy 

using intravenous injections with beer yeast, 

which were painless and induced the required 

high fever (39,6-41 0 C). The method was 

easily applicable and seemed to produce an 

important improvement, especially in the case 

of general paralysis [12]. 

A special interest for neurosyphilis also 

showed Elena Densu�ianu-Pu�cariu (1875- 

1966), the first woman in the world professor 

at a clinic of ophthalmology. She had better 

established the share of syphilis in the 

etiology of ocular diseases and was one of the 

first authors in the world who concluded that 

malariotherapy had no curative effect in the 

optic nerve syphilis [12]. 

From this short presentation, one may 

conclude that in a difficult socioeconomical 

context, the Romanian medical 

school managed to come with important, 

even original contributions in the treatment 

of neurosyphilis until the discovery of 

antibiotics. 

Bibliography 

[1]. Austin S., Stolley P., Lasky T.: The 

History of Malariotherapy for Neurosyphilis, 

JAMA, 268(4), 1992, 516-519. 

[2]. Bittner J.: Paul Ehrlich, Ed. �tiin�ific�, 

Bucure�ti, 1971, 128-133. 

[3]. Br�tescu G. Tinere�ea lui Carol Davila, 

Ed. Albatros, Bucure�ti, 1979, 113-117. 

[4]. Ciuc� M., Ballif L. et al: Note du 

secretariat resumant un rapport sur le 

progress des travaux de la station 

permanente de malariatherapie et 

d’etudes experimentales sur le 

paludisme (Institut Rockefeller) de 

Socola, Jassy, Roumanie, jusqu’au 

31/12/1933, Societe des Nations, 

Organisation d’Hygiene, Commission 

du Paludisme, Geneve, 1934. 

[5]. Floda L., Marioara G. Marinescu, 

Radovici. A.: Gheorghe Marinescu, 

Ed. Tineretului, 1958, 244-246. 

[6]. French P., Gomberg M. et al: IUSTI: 

2008 European Guidelines on the 

management of Syphilis, Internat. J. 

of STD & AIDS, 20, 2009, 300-302. 

[7]. Levaditi C.: Bismuthoprévention de la 

syphilis, Volume jubilaire en l’honneur 

du Professeur G. Marinesco, Institut 

d’Arts Graphiques E. Marvan 

Bucarest, 1933, 395-400. 

[8]. Lupa�cu G., Constantinescu P., Negulici 

E. et al: Parasitological and Clinical 

Investigations on Infections with the 

VS Romanian Strain of Plasmodium 

malariae Transmitted by Anopheles 

labranchiae atroparvus, Bull. Wld. 

Hlth. Org., 38, 1968, 61-67. 

[9]. Marinescu G.: Coresponden�a (1889- 

1938), Ed. �tiin�ific�, Bucure�ti, 

1968, 99-100. 

[10]. Rudolf G. de M.: Recent advances in 

therapeutic (induced) malaria, J. 

Neurol. Psychopathol., January 

16(63), 1936, 239–255. 

[11]. Paulian D.: Les résultats de la 

malariothérapie dans le Service 

Neurologique de L’Institut 

des Maladies Mentales, Nerveuses et 

d’Endocrinologie de Bucarest, 

Volume jubilaire en l’honneur du 

Professeur G. Marinesco, Institut 

d’Arts Graphiques E. Marvan 

Bucarest, 1933, 537-538. 

[12]. Urechia. C. I., Mih�lescu S.: Tratat 

de patologie neuro-mintal�, Ed. 

Lepage, Cluj, 1928, 491-502.




LAZZARO SPALLANZANI, IN 

TRANSYLVANIA DRIVE 

A. MUSAJO SOMMA 1 , L. MUSAJO SOMMA 1 

Abstract: 

The Enlightment Revolution is a core element to understand grand narratives 

of the emergence of modern biomedical science. Despite attempts to create a 

more nuanced taxonomy of the remarkable transformation of knowledge of 

nature in this period, the hodoeporic writings by the Italian abbot Lazzaro 

Spallanzani are fundamental to understand a positivist and internalist 

approach in the development of experimental methods. During 1786 the 

sapiens’ travel from the Black Sea through Transylvania till Tara 

Ungureasca was full of natural, biological, social experiences coupled with 

medical and epidemiologic observations 

Key words: Natural science, medicine, hodoeporics. 

Science enlightment 

Collecting rare and ancient objects or 

things of aesthetic value, both natural 

and man-made, became very popular in 

European culture in the fifteenth and 

sixteenth centuries. These centuries 

witnessed the birth of Kunst und 

Wunderkammern “Rooms of Art and 

Wonders” in which the aim was to 

collect objects of astonishing originality 

which would stir and amaze visitors, as 

well as preserve the memory of 

Antiquity - indisputable aesthetic canon 

also for the modern. 

Naturalia that is nature byproducts - 

even if featured as monsters - and 

Artificialia that is human artifacts, 

stimulated the common sense of 

observation and, most important of all, 

scientific interest and curiosity. 

Those collections were the very start 

of natural history museums: tools for 

scientific research and cultural and 

social development. New technologies, 

1 ACTI Department, University of Bari, Italy 

geographic exploration and scientific 

traveling opened the pathway to famous 

scientists’ work. At the edge of XVIIIth 

century Antonio Vallisneri (1661-1730), 

Italian physician and biologist - a 

scholar at Bologna University with 

Marcello Malpighi (1628-1694) - 

appointed to the chair of Practical 

Medicine at the University of Padua, 

wrote: 

“Many have observed and many still 

expect to observe, but not everyone has 

observed well, and others do not know 

how to observe, nor perhaps do they 

know how tricky the art of observation 

is, easily misunderstanding one thing 

for another, being blinded by the light, 

or not looking with due attention and 

diligence at what is to be looked at”. 

He was one of the first researchers in 

medicine to reject the Aristotelian 

theories and he started the collection

110 


which is one of the best examples of 

those scientific gabinetti (laboratories) 

which turned to be university research 

laboratories where the experimental 

method in which Galileo was a master, 

became daily practice for scientists. 

Padua, Pavia, Bologna, and Modena at 

different periods in the XVIII century 

bloomed with the discoveries of their 

brilliant teachers and philosophers. 

Biography 

In the very shadow of the Northern 

Italy institutions of learning, Lazzaro 

Spallanzani (1729-1799), another Italian 

researcher, was keenly interested in the 

natural sciences and over his lifetime 

collected numerous specimens of 

animals, minerals and other natural 

objects. 

He became a priest and eventually 

professor of natural history at Pavia, 

and was an enthusiastic traveller in 

pursuit of specimens for the natural 

history museum there as well as for his 

home private museum in Scandiano. 

Fig.1. Spallanzani marble statue in his 

home town Scandiano, Italy 

He was educated at the Jesuit 

College and studied law for three years 

before getting frustrated and 

dissatisfied. He then turned his great 

hunger for knowledge to science. He 

became a biologist and physiologist, 

studying body functions and the 

unknown wonders of the natural world. 

He also studied philosophy and 

mathematics and discovered that 

microbes can move through the air and 

can be killed by boiling. Almost a 

century later, Louis Pasteur (1822-1895) 

studied and then expanded his work, and 

got many of his ideas from Spallanzani. 

The Italian scientist studied many topics 

and stated that digestion is a chemical 

process and not just the grinding of 

food. He was first to do an artificial 

insemination of a dog. He wondered 

why a stone skipped over the water 

when it was thrown. 

In 1768 an offer by Empress Maria 

Theresa, then ruling over Austrian 

Lombardy, to give him the chair of 

natural history and keeper of the 

museum at Pavia proved too attractive 

to be refused. He held this position until 

his death thirty-one years later. During 

this period (1768-1799) he distinctly 

disproved the theory of spontaneous 

generation which had been done by Redi 

(1626-1697) before the discovery of 

microscopic organisms had given its 

exponents a new basis for argument. His 

work on fertility blazed the trail for 

future investigators. 

Mineralogy received distinct 

contributions from his labours. He was 

perhaps the first to study the ability of 

bats to avoid obstacles in flying after 

they had been blinded. The dissertations 

on digestion were read in all scientific 

circles; their contribution to physiology 

was monumental. The studies on 

circulation contained original and 

important observations. By his work on

A. MUSAJO SOMMA, et al: Lazzaro Spallanzani, in Transylvania drive 111 

respiration he first showed the real seat 

of combustion. Spallanzani was a 

Fellow of the Royal Society of London 

and a member of the Academies of 

Prussia, Stockholm, Gottingen. 

The first known exploration into 

ultrasound physics happened in the 

1790’s. Lazzaro Spallanzani wondered 

why bats could navigate at night and 

catch insects as they flew. He 

blindfolded them and they still 

manoeuvred very well. He then plugged 

their ears and found that they bumped 

into obstacles. He concluded that their 

primary mode of navigation was 

hearing. He deduced that they must emit 

ultrasound waves that are inaudible to 

humans and listen to the echoes to 

determine distance and direction of 

objects. This idea was received by his 

fellow scientists with ridicule and 

scepticism. 

After the French army under 

Napoleon invaded Italy in 1796 

Spallanzani was offered the position of 

professor of natural history at Paris but 

he declined because of his advanced 

age. On February 11 th 1799, three days 

after an attack of apoplexy, having 

recovered sufficiently to recite Latin 

verse and having received the papal 

benediction, he died suddenly at 2:30 

am suffering for a bladder cancer. 

Hodoeporics: eastbound travel 

Quite a few Italian travellers went to 

the Romanian area to work, to study, to 

make commerce, business and researches: 

Tommaso Alberti in the XVII century 

and in the following century 

Maiolino Bisacioni (1582-1663), 

Francesco Griselini (1717-1783) and the 

“Astrologer” Lazzaro Spallanzani, as he 

was called by his scholars after he 

showed an early penchant for 

astronomy. 

Also another Italian naturalist, 

Domenico Sestini of Florence (1750- 

1832), crossed the Romanian area 

during the Century of Light almost in 

the same years when Maria Theresa’s 

son and previous co-regent Joseph II 

(1741-1790) was running the empire. 

In August 1785, at the end of 

university lessons, Lazzaro Spallanzani 

sails from Venice to Constantinople. In 

the places he visits, he studies plants 

and animals, weather, the life and habits 

of those populations. He comes back 

travelling on land so he visits some 

mines and collects minerals in 

Transylvania, in the salt pan of 

Salzburg, in the gold and silver deposits 

of Zalatina, in the Carpathian 

metalliferous mountains. On December 

7 th , 1786 he arrives in Vienna and rich 

collection of minerals will be delivered 

to his university town one year later. 

Transylvania experience 

On August 16 th , 1786 Spallanzani 

left Constantinople asking for the 

permission to go back home through the 

Transylvania drive to allow a deeper 

knowledge of mines and the natural area 

of Carpathian region. 

Fig.2. Spallanzani drive 

He comes back travelling on land so 

he visits some mines and collects 

minerals in Transylvania. The deep 

desire to visit new geographic areas and 

to learn as much as possible prompted 

Lazzaro Spallanzani to travel back from

112 


Constantinople joining the carriages of 

the prince of Walachia for a safer trip 

and to save money. Indeed he had 

already collected by Baron Sperges and 

the Austrian government a huge amount 

of money, worth 100 Venetian sequins, 

through Baron of Herbert in 

Constantinople. 

On August 27 th the caravan crossed 

Donau River and stopped in Skiera- 

Ollenza, in Walachia. Simplicity of life 

and a sincere hospitality welcomed the 

Italian scientist. Women are almost 

dressed as in the Ottoman area and 

Bulgaria but their face is not covered by 

any clothes. Crossing the village of 

Valek-Negest he was surprised to detect 

that people was dark skinned and 

curiously, dark skinned women were not 

at all beautiful and their breasts were 

pendulous offering from time to time a 

bare-thorax to the visitors eyes, “but 

they do not smell at all”! 

After 12 nights he was forced to rest 

in the carriage, he arrived on August 

28 th in Bucarest where he was hosted by 

the prince Ypsilandi for five days. 

Indeed that nobleman was an employee 

of the realm, temporary nobility granted 

only to collect duties and local taxes, 

according to the arhondology’s laws. 

Spallanzani visited the salt mines of 

Hani-Hanik and collected a huge 

amount of minerals. On the 5 th of 

September he started his trip towards 

Kronstadt (Brasov) and the day after he 

stopped in the lazaret of Buza. Nearby 

the Bodza River a lazaret was open for 

quarantine every time plague was 

affecting people living in or crossing 

through Constantinople. The Empress 

Maria Teresa forced people crossing the 

borders to Transylvania to stop 3 or 6 

weeks in Buza lazaret if infection was 

affecting the Ottoman area. 

Corona or Kronstadt was only seven 

hours travelling from the lazaret and 

Spallanzani arrived there in the evening 

of 7 th September while a cold eastern 

wind was blowing across the area. Not a 

word he wrote on his trip from 

Kronstadt to Hermannstadt (Sibiu) - 

under the military protection of 30 

soldiers offered by Ospodaro 

Mauroceno - where he arrived on 12 th 

September. 

He visited the salt mine of 

Saltzbourg (Witazna) and gold and 

silver deposits of Zalatna, where he 

arrived, crossing through Portu, on 24 th 

September, in the metalliferous 

mountains very well known since 

ancient Roman time. 

In that geographical area and near 

Alba Iulia many illegal coin minters - an 

ethnic group called Moti - were working 

as outlaw gold dealers and moreover 

“they know how to mint gold coins of 

the best quality and having the right 

weight”. 

Moti lived in very miserable 

conditions and Spallanzani was very 

impressed by their skin chronic ulcers 

clearly related to advanced clinical 

syphilis: a terrifying map of typical 

open ulcers was covering all over their 

body. 

The Italian scientist underlines that 

in the Turkish area he was unable to 

detect such big amount of venereal 

diseases’ skin tags. Moreover he states 

that in the Moti villages there were 

almost no children, clearly relating 

advanced syphilis to impossible 

pregnancies. 

In Transylvania, the Walachi were 

about 1 million people; other inhabitants 

were Hungarians - the land owners - 

Siculi, Saxons, Germans, Armenians, 

Greeks (mainly merchants) and 

Bohemians. These were Gypsies 

classified as musicians, handcraft 

workers and Egyptians - that is gypsies 

working around and “mainly thieves”!

A. MUSAJO SOMMA, et al: Lazzaro Spallanzani, in Transylvania drive 113 

He left Transylvania for the Banat 

region and he arrived to Temeswar on 

the evening of 14 th October when a 

stormy weather and rain offered to the 

Italian biologist an awful welcome. He 

will report the poor quality of air 

because of several ponds and local 

people affected by intermittent fevers. 

Transylvania is left and Vienna 

welcomes the Italian scientist on 7 th 

December 1786. 

His hodoeporic writings about the 

scientific tour through the eastern 

European countries were printed only a 

century after his death. 

Conclusion 

Spallanzani, in all his life as well as 

in his Transylvania drive, took a 

necessary and decisive step away from 

scholastic Aristotelian natural 

philosophy, with its sterile metaphysics 

and reputed reluctance to value 

laboratory experience. Laboratory tools 

joined Spallanzani’s travels and his 

studies reoriented the research of natural 

sciences away from the world of 

common sense observation and made it 

rigorously measurable and testable. 

Beyond the stones, he collected 

through the Romanian area biologic, 

ethnologic, medical and social notes. 

A great biographer, as great as a 

botanist, the Transylvanian academician 

Emil Pop (1897-1972) paid his tribute to 

the extraordinary personality of the 

Italian savant printing in 1942 a study 

of great erudition related also to 

Spallanzani personality. In the 

supplement of Emil Pop’s paper, as 

published in Timisoara in 1942, there is 

also a list of 60 different minerals 

collected by Spallanzani in the region. 

Three big cases of minerals were 

dispatched, on Spallanzani order, by the 

Zalatna mines’ inspector, Immanuel 

Will by ship along the Donau River to 

Vienna. The acquisition of exhibits 

proved congenial to the most 

magnificent Museum of Natural History 

at University of Pavia. A great amount 

of natural history material items were 

collected in Spallanzani private museum 

in Scandiano, his hometown. The 

preservation of his private collection 

was a responsibility of his sister 

Marianna, a single woman who offered 

a great strength in the early attempts to 

preserve the items. She gained 

experience in taxidermy and in the 

preservation of stuffed-skins allowing a 

satisfactory preservation of the 

collections. 

Difficult Mountain passes, floods and 

torrents, brigands and cut-throats, mines 

inspection to collect more specimen 

allowed to set up a unique natural 

science collection and the written 

records by Spallanzani feed social 

history information and therefore the 

wider world of individuals and 

researchers interested into medical 

history. 

References 

[1]. Ellenberger F., Ovide et la géologie, 

Travaux du Comité Français 

d’Histoire de la Géologie, 3 e série, t. 

V, n° 3, 1991, pp. 17-24. 

[2]. Ferrone V., I profeti 

dell’illuminismo. Le metamorfosi 

della ragione nel tardo Settecento 

italiano, Laterza, Bari 1989, p. 446. 

[3]. Generali D., Antonio Vallisneri. La 

figura, il contesto, le immagini 

storiografiche, Olschki, Firenze 

2008. 

[4]. Musajo Somma A., Musajo Somma 

L., Italian doctors cruising on the 

Bosphorus, Proceedings 38 th 

International Congress on the 

History of Medicine (Istanbul 2002), 

Ankara 2005, vol. 2 pp.1009-1012. 

[5]. Pop E., Naturali�tii italieni din

114 


veacul al XVIII-lea, cercet�tori ai 

�inuturilor române�ti (Italian 

naturalists of the 18th century, 

researcher of the Romanian land) 

Timisoara, 1942. 

[6]. Roman V., Notes from Lazzaro 

Spallanzani’s travel to the 

Roumanian lands, Comptes Rendues 

XXII International Congress ISHM 

(Bucarest 1970), 1972, pp. 261-262. 

[7]. Spallanzani L., Viaggio in Oriente, a 

cura di Naborre Campanili, Bocca 

Editori Torino, 1888. 

[8]. Vaccari E., Lazzaro Spallanzani: 

une naturaliste italien de dixhuitième 

siècle et sa contribution 

aux sciences de la terre, Travaux du 

Comité Français d’Histoire de la 

Géologie, XI, Paris 1996, pp. 72-89. 

[9]. Vaccari E., Spallanzani e le scienze 

geologiche del Settecento: un 

percorso interpretativo tra carteggi 

e diari di viaggio, Teorie e pratiche 

dell’esperienza scientifica. Lazzaro 

Spallanzani e le scienze della natura 

nel Settecento, “La sfida della 

modernità” Atti del Convegno di 

Studi a cura di W. Bernardi e P. 

Manzini, Olschki, Firenze 1999. 

[10]. Maiolino Bissaccioni �i r�zboaiele 

civile din Moldova (Maiolino 

Bissaccioni e le guerre civili in 

Moldavia), Arhiva Societ��ii 

�tin�ifice �i Literare (A.S.S.L.) di 

Ia�i, 1892: 645-651. 

[11]. C�l�toriile lui Domenico Sestini în 

Muntenia, 1779 (I viaggi di 

Domenico Sestini in Valacchia, 

1779), Arhiva Societ��ii �tin�ifice �i 

Literare (A.S.S.L.) din Ia�i, 1893: 

571-589.




VICTOR GOMOIU AND THE 

CANTACUZÈNE-COMMISSION 

J. P. TRICOT 1 

Abstract: Thanks to the interacting efforts of the Belgian professor J.J. Tricot- 

Royer (1875 – 1951), founder -president of the International Society for the 

History of Medicine (I.S.H.M.) and of the Romanian professor V. Gomoiu (1882- 

1960), third president of this one, the study of medical folklore has been 

acquainted with huge development from the thirties of the XX Century on. During 

his whole life, prof. Gomoiu fully applied himself, not only to an exemplary 

surgical career and to the field of medical-social relief work (with the support of 

the Royal Family of his country) but also to the history of medicine. After having 

founded in 1929 the Romanian Society for History of Medicine and having 

organized in Bucharest in 1932 the IX congress of the I.S.H.M., prof. Gomoiu 

was elected in 1936 president of that society. During the whole fourth decade of 

the XX Century, medical folklore was one of the main issues of most of the 

congresses of the I.S.H.M. And so Gomoiu established in September 1935 a 

special international commission for the study of medical folklore: the 

Cantacuzene – Commission. The contribution of prof. Gomoiu to the study of 

Romanian medical folklore was very important. In this paper, reference will be 

made to a lot of unpublished documents: the letters sent by prof. Gomoiu and by 

the French prof. Guiart (his general secretary in the I.S.H.M.) to Prof. Tricot- 

Royer between 1934 and 1939. Prof. Gomoiu can be considered as an 

emblematic and exemplary figure into the study of History of Medicine and of 

medical folklore, as well on a national as on a international level. 

Key words: Victor Gomoiu, Cantacuzène-Commission 

On the 15 th of April 1939, the report 

upon the proceedings of the Cantacuzene 

Commission for the study of Medical 

Folklore was submitted by the Belgian 

prof. Tricot – Royer at the yearly General 

Assembly of the International Society for 

the History of Medicine (I.S.H.M.), held in 

Paris under the presidency of the 

Romanian prof. V. Gomoiu. 

Who was the third president of the I.S.H.M.? 

How important was that Commission? 

Short biography of Prof. Victor 

Gomoiu [1, 3] 

Victor Gomoiu was born in 1882 in 

Vinju Mare (district of Mehenditi) in 

1 Univ. Leuven, Univ. Antwerpen (Belgium). 

Romania. After ending his secondary 

studies at the Lyceum of Turnu Severin, he 

enrolled himself at the Faculty of Medicine 

in Bucharest, where he finished his 

university curriculum in 1906 and obtained 

afterwards in 1909 his PHD magna cum 

laude. The subject of his thesis was: “The 

Anasplasties of face and head.” 

Between 1914 and 1942 he took up a 

successful surgical career and a lot of new 

procedures inherited his eponyme. He also 

invested himself within the field of 

medico-social assistance programs. He 

became Ephore of the public hospitals of 

Bucharest in 1920 and 1921 and thereafter 

from 1926 on he was appointed as trustee

116 


of the “Princess Ileana” charitable fund 

(“A�ez�mintele A.S.R. Principesa Elena”) 

and also he became a relative of the 

Romanian Royal Family. After the Second 

World War he was blamed for it. 

In 1927 Gomoiu founded in a poor 

neighbourhood in one of the suburbs of 

Bucharest, Bariera Virgului, a hospital 

complex, Princess Ileana, on behalf of the 

most unprovided patients. Shortly 

thereafter this establishment became the 

“Children Hospital Victor Gomoiu”, still in 

activity nowadays. 

Gomoiu obtained plenty of official duties in 

the Ministry of Health and became at least 

Minister of Health from July to September 

1940, but he resigned quickly to not undergo 

the military- fascist dictatorship. Between 1940 

and 1950 he devoted himself only to his 

surgical and medical-historical activities. From 

1950 to 1954 he was imprisoned during 60 

months by the regime for political purposes. 

Nevertheless in 1956 the communist Minister 

of Health suggested him to accept a position at 

the Center for Health Organization and the 

History of Medicine, but he refused this offer 

which he viewed as a form of collaboration 

[15]. He died in Bucharest in 1960, almost 

forgotten by everyone. 

Doctor Gomoiu and the History of 

Medicine 

Already as student Gomoiu disposed of 

an important personal library, where as 

well medical as philosophical and 

historical works were assembled. In 1923 

he published a first important medico- 

historical book: “The History of Medicine 

and of Medical Teaching in Romania.” [4]. 

In 1927 he sent to the French prof. 

Laignel-Lavastine, secretary-general of the 

very young I.S.H.M. (founded in 1921) the 

abstract of a communication he wanted to 

represent at the VI th congress of this 

association in Leiden and Amsterdam: 

“The first traces of Physicians in 

Romania” [5]. That was his first 

connection with the I.S.H.M. In 1929 prof. 

Gomoiu founded the Romanian Society for 

the History of Medicine under the high 

protection of Princess Ileana [6]. 

Within the I.S.H.M. he shaved more and 

more ambition: he became national delegate 

of his country in 1928, attended the Congress 

of Oslo (1928) and Rome (1930) and 

organised his own congress in Bucharest 

from the 10 th to the 18 th of September 1932 

[8, 18]: a successful manifestation with the 

participation of the most famous historians of 

that time like e.g. the doctors and the 

professors Sigerist, Singer, Diepgen, 

Rolleston, Neuburger, Süheyl, De Lint, 

Jeanselme, Tricot-Royer, Castiglioni, and 

so on. The wife of the congress president, 

Mrs. Viorica Gomoiu, acted as general 

secretary of it. 

In 1933 prof. Gomoiu was elected vicepresident 

of the I.S.H.M. and president in 

1936, to the deep annoyance of the then 

acting Secretary General, prof. Maxime 

Laignel-Lavastine, who also competed for 

this position, but who statutory could not 

obtain it [16, 17]. In this connection 

Gomoiu would write in 1939 at the end of 

his mandate: “To believe to be hated by 

someone you love, is a more unendurable 

pain than mourning for his death”. [13]. 

Laignel-Lavastine resigned and was 

replaced by prof. Jules Guiart (7). This one 

had particular links with Romania. As 

professor of Parasitology and of History of 

Medicine at the University of Lyon, he 

concluded a special agreement as titular 

professor of History of Medicine, of 

Pharmacy and of Medical Folklore at the 

University of Cluj (23), founded in 1919, 

and within the professors were chosen by an 

University Commission with the representtatives 

of the two Romanian universities, 

existing at that time: the one of Bucharest 

and the other of Iassy. Guiart was teaching at 

the medical faculty of Cluj between 1921 

and 1930, the year within he was replaced by 

his assistant, prof. Valeriu Bologa (1892-

J.-P. TRICOT: Victor Gomoiu and the Cantacuzène-Commission 117 

1971), originating from Bra�ov. 

Within the I.S.H.M., prof. Gomoiu was 

not conspicuous by his sense of diplomacy, 

and he took a lot of initiatives without the 

approval of his bureau and of his 

administrative council. 

Prof. Guiart confirmed there were 

sometimes troubles within the bureau. He 

wrote the following comments (14):: “I 

told him (= Gomoiu) firmly that the 

President has no rights to make some 

propositions without the preliminary 

approval of the Bureau. Otherwise he 

exposes himself to what happened to him: 

his proposals are not voted. He has no 

right to owe someone a grudge for it, 

because with having the right to vote, we 

got the duty to vote, not with the purpose to 

please him, but conscientiously! “ 

The mandate of Gomoiu ended 

normally at the beginning of 1940, but, due 

to the Second World War, his successor, 

prof. Laignel-Lavastine could only begin 

his term in 1946, because during the 

conflict, all activities of the I.S.H.M. were 

interrupted [16]. 

Medical folklore and the congresses 

of the I.S.H.M. 

The proposal to create a commission 

with the purpose to study medical folklore 

was formulated by prof. Gomoiu in 

September 1935, during the X th 

International Congress for the History of 

Medicine and has been approved 

unanimously. Previously during the VII th 

Congress of the I.S.H.M. in Oslo in 1928, 

prof. Gomoiu showed his interest for this 

aspect of medical history, submitting a 

paper entitled: “Medical Folklore in 

Romania”. On the occasion of the next 

congress, the VIII th one in Rome in 1930, 

prof. Castiglioni from Padua, enumerated 

the two sources of medical folklore: the 

magical conception common to all 

primitive people and the experience [2]. 

As for him, prof. Gomoiu described the 

contribution of medical folklore from an 

etymological, historical and medical point 

of view [12]. He drew the attention that, 

from an ethnological point of view, the 

folklore documents his adepts upon the 

way, man was feeling or thinking in the 

course of ages. It increases the number of 

characters which permit establishing 

resemblances and differences among the 

nations, and so new appreciation – criteria 

are acquired upon their degree of 

superiority and culture. For his part, the 

historian, comparing the different kinds of 

folklore with each other, can more easily 

deduce the relationships between the 

nations he is studying and consequently the 

moving of their migration. As for the 

physician, he often discloses in the popular 

practices the germs of the most modern 

therapeutics. 

On the other hand, very curiously, that 

same medical folklore was not hold back 

as a theme at the IXth Congress of the 

I.S.H.M., organized in Romania in 1932. It 

was only a delay, because during the next 

congress, the Cantacuzene Commission 

was born. The topics of the Bucharest 

Congress were: “The Evolution of 

Medicine in the Balkanic countries” and 

“Defence of Europe against the pest”. 

This last theme was the subject of the very 

last posthumous publication of prof. 

Tricot-Royer [22]. 

The Cantacuzene Commission 

This commission was baptized 

“Cantacuzene”, after the name of a famous 

Romanian physician, bacteriologist and 

professor, Ion Cantacuzino (1863 – 1934), 

founder of microbiology and of 

experimental medicine in Romania. He 

was even Minister of Health, Work and 

Social Security [9]. 

Although he has published nearly 

nothing about History of Medicine, 

Gomoiu proposed him as second president 

of the Romanian Society for the History of

118 


Medicine. In his funeral oration, Gomoiu 

will say about him: “Our president, 

creator of his own history and also of 

others, passed himself into the history”. 

In a letter of the 21th of October 1935, 

written to prof. Tricot-Royer (10), 

founding president of the I.S.H.M., thus a 

short time before becoming himself 

president of the I.S.H.M., prof. Gomoiu 

specified the work to be done by the 

members of his commission: 

The first question that had to be asked was 

how to draw the bibliography of medical 

folklore and of folklore generally spoken in 

their respective country that means the names 

of the authors, their works, the specialized 

journals, the institutions, etc. Then the 

question of standard forms comes to collect 

the folkloristic material, which can be 

discussed some months afterwards. Firstly the 

names of the pathological entities have to be 

discussed as they are designed by the 

peasants of the different countries and their 

clinical pictures, so that people can conclude 

to their synonymy and compare their 

treatments. For each country a card of the 

territories, where the different denominations 

or treatments are used, has to be established. 

Prof. Tricot- Royer, nominated as 

president of this commission, was the 

Belgian delegate, whereas prof. Gomoiu 

became the secretary general and delegate 

for Romania. The commission included also 

Mrs Gomoiu, the doctors Bologa from Cluj, 

Laignel-Lavastine from Paris, Giuart from 

Lyon, Thaller from Zagreb, Süheyl from 

Istambul, and Ali Mihali from Albania. 

It is not astonishing that the tandem, 

Tricot-Royer – Gomoiu, was the most 

important pivot of this commission, 

because these two scholars have already 

published a lot of papers concerning the 

medical folklore in their respective 

country, and because they respect each 

other for many years. 

Concerning it, prof. Tricot-Royer had 

already made a through inquiry upon 

medical folklore in Belgium (21). He made a 

distinction, on the one hand between 

mystical folklore with the invocation of God, 

the Holy Mary or the Saints specialized in 

the cure of some illnesses, and on the other 

hand empiric folklore in which the Belgian 

popular remedies, originating from the fauna, 

the flora or of the third kingdom are 

described. His research works lead him to 

contact all the parish priests of the whole 

country, to give him all the useful 

information of that purpose. 

At the beginning of 1936, Gomoiu 

considered the possibility to create either 

an International Academy for Medical 

Sciences, with a special section devoted to 

medical folklore, or an “Academia 

Demoiatrica“ (Academy for the study of 

the folklore), independent of the I.S.H.M., 

but his projects were never realized. 

The Romanian physician distinguished 

4 categories of folklore: 

1. the original or primitive folklore; 

2. the altered original folklore either with 

foreign contribution or with borrowing 

from scientific medicine; 

3. the folklore adapted to the new times; 

4. the folklore completely based upon 

scientific medicine and practised by 

people without any qualification. 

Before being presented to the General 

Assembly of the I.S.H.M. in 1939, a part 

of the report of the Cantacuzene 

Commission has been already published 

by prof. Tricot-Royer in Brussels: 

“The Medical Folklore in the Balkan 

Area” [20] with a survey of the works of 

Prof. Süheyl (Turkey), Gomoiu 

(Romania), Stoianoff (Bulgaria), Ali 

Mihali (Albania) et Thaller (Yugoslavia). 

This last one, prof. Lujo Thaller, would 

preside in 1938 the XI th Congress of the 

I.S.H.M., the last one before the Second 

World War, where two themes were 

discussed: “The mystical medical folklore 

“and” Flora, Fauna and Minerals in popular 

medicine” [16]. During that congress the unti-

J.-P. TRICOT: Victor Gomoiu and the Cantacuzène-Commission 119 

ring prof. Gomoiu presented the report of another 

commission he set up within the I.S.H.M., 

concerning the teaching of medical history 

within the different countries of the world [15]. 

During 10 years, from 1928 on (VII th 

congress of the I.S.H.M. in Norway) until 

1938 (XI th congress of the I.S.H.M. in 

Yugoslavia), medical folklore played a 

preponderant role among the topics dealed 

with. Even after the Second World War the 

Romanians continued to show their interest 

for that subject. In 1970, during the 2 

Congress of Bucharest (the 22 of the 

I.S.H.M.) presided by prof. Bologa, and with 

Dr Manoliu and Dr Br�tescu as general 

secretaries, “The scientific value of folklore” 

was one of the main topics [16]. In 2009, at 

the VII th specific flora of Dacia, throwing a light upon 

the medicinal properties of some plants. 

On the other way, Gomoiu established 

that, ignorant the real cause of illness, people 

attribute it to God, to the devil and to other 

invisible genies, and the treatment will 

include incantation and conjuration tricks. 

Besides it, the Romanian people owns a 

traditional medicine, deprived of each 

supernatural element, constituted on one’s 

own found, increased with scientific 

contributions. During a: the centuries, 

original practices and imported ones 

mingled, but these last ones, either of an 

empiric or of a scientific nature, were 

modified or adapted according to the tastes 

Balkanic Congress for the History and the preferences from people adopting 

of Medicine, justice was again done to the them. Gomoiu believed that in Romania the 

popular Romanian Medicine. 

medicine with supernatural involvement and 

empirical medicine play an even important 

The contribution of Prof. Gomoiu to the part, but in most of the cases, one is being 

study of Medical Folklore 

serving as an assistant to the other. Plenty of 

In the beginning, the members of the examples of the prescience of our modern 

Cantacuzene Commission proceeded to 

make a survey of the folklore material of 

medicine were given by Gomoiu. 

each respective country. In this paper we Conclusion 

limited ourselves to the work of prof. The importance of the Study of Medical 

Gomoiu [12]. 

Folklore didn’t get past the historians of 

During all times, the inhabitants of medicine during the decade before the 

Romania were acquainted with a kind of Second World War. The contribution of 

medicine, as well empiric as religious. the I.S.H.M., of her third president 

Before the arrival of the Romans in Dacia Gomoiu and of her founding president 

(actually a region in South-East of Europe, Tricot- Royer is far from being negligible. 

on the left bank of the Danube, Prof. Gomoiu can be considered as an 

corresponding to the actual Romania), the emblematical and exemplary figure into 

inhabitants knew on an empiric way the the study of the History of Medicine, 

properties of medicinal plants. About 500 particularly in the study of medical 

years before Christ, when he conquested all folklore, as well on a national as on an 

these peoples, Darius already observed the 

curative properties of many sources in that 

international level. 

region. The Romans conquered the country References 

between 101 and 107, and erected many [1]. Baran D., personal communication, 

altars and monuments in honour of 22/06/09 

Aesculapios and Hygia. Dioscorides, [2]. Castiglioni A., Le folklore médical, 

physician of Greek descent, accompanied quoted by Tricot-Royer J.J., o.c., 1936 

those Roman legions, and studied the [3]. Dutescu B., Victor Gomoiu, french

120 


summery, p. 244-258 in: Victor 

Gomoiu (258 p.) Ed. Medical�, 

Bucuresti, 1970 

[4]. Gomoiu V., Din istoria medicinii si a 

invantamintului medical din 

Romania, Bucuresti, 1923 

[5]. Gomoiu V., Les premières traces de 

médecine en Roumanie, p. 293-295 

in: Actes du VI Congrès 

International d’Histoire de la 

Médecine (Leyde-Amsterdam/ 18- 

23/7/1927), (De Lint J.G., éd.), 

Anvers, 1929 

[6]. Gomoiu V., Societatea Regala Romana 

de Istoria Medicinei, p. 5-17 in: Analele 

Asezamintelor A.S.R. Principesa Elena 

(112 p.), Cultura, Bucuresti, 1932 

[7]. Gomoiu V., Biographie (de 1870 à 

1932) de Jules Guiart (1870-1965) , 

p 45-48 in Gomoiu V., o.c. 

(Analele), 1932 

[8]. Gomoiu V. et Gomoiu V., Neuvième Congrès 

International d’Histoire de la Médecine, 

Comte-Rendu, Bucuresti 

(Romania), 10-18 septembre 1932, 794 

p., 1932 

[9]. Gomoiu V., Eloge funèbre de Jean 

Cantacuzène (1863-1934), non 

published text, 1934 (personal 

collection of the author) 

[10]. Gomoiu V., Letter sent on 21th 

October 1935 to prof Tricot-Royer 

(pers. coll. of the author) 

[11]. Gomoiu V., Letter sent on 21th April 

1936 to prof Tricot-Royer (pers. coll. 

of the author) 

[12]. Gomoiu V., La médecine populaire 

en Roumanie, p. 10-23 in o.c. Tricot- 

Royer, 1937-1938 

[13]. Gomoiu V., Letter sent on 9 th May 

1939 to prof. Tricot-Royer (pers. coll 

of the author) 

[14]. Guiart J., Letter sent on 28th 

December 1938 to prof Tricot-Royer 

(pers. coll. of the author) 

[15]. Manoliu V., The report of Victor 

Gomoiu at the XI th International 

Congress for the History of Medicine, 

Zagreb-Belgrade, 1938, on the State of 

Education in History of Medicine in 

Various Countries. P.301-306 in: 

Proceedings of the 37 th Congress on the 

History of Medicine, (Burns C., O’Neill 

Y.V., Albou P. and Rigau-Perez J.M., 

University of Texas Medical Branch, 

Galveston, 2000 

[16]. Tricot J.P., Esquisse Historique de la 

Société Internationale d’Histoire de la 

Médecine/ Historical Sketch of the 

International Society for the History of 

Medicine/ Boceto Historico se la 

Sociedad Internacional de Historia de la 

Medicina (35 p.), ISHM, Galveston, 2000 

[17]. Tricot J.P., La Société Internationale, 

fille de la Société Française d’Histoire 

de la Médecine, Histoire des Sciences 

Médicales, 37 (3): 357-366, 2003 

[18]. Tricot-Royer J.J.: Le IXème Congrès 

International d’Histoire de la Médecine- 

Bucarest (1932) – Comte Rendu: 

Aesculape, 23 : 121-144, 1933 

[19]. Tricot-Royer J.J.Le Xème Congrès 

International d’Histoire de la 

Médecine (Madrid-1935)- Compte- 

Rendu, Asculape, 26: 145-168, 1936 

[20]. Tricot-Royer J.J. : Le folklore 

médical dans les Balkans, 36 p., 

Revue catholique des idées et des 

faits, 1937-1938 

[21]. Tricot-Royer J.J., Le folklore 

médical belge, Petrus Nonius, 1: 1- 

52, Lisboa, 1938 

[22]. Tricot-Royer J.J., Comment l’Europe 

s’est-elle défendue contre la peste?, La 

Roumanie, 11 p., Le Scalpel n 30, 1951 

[23]. x x x: La Faculté de Médecine de 

l’Université «Roi Ferdinand le Ier» 

de 1919 à 1928. Cluj (Roumanie- 

Transsylvanie), 48 p, 1928.




MEDICAL AND TOXICOLOGICAL 

ASPECTS IN ARTHUR CONAN DOYLE’S 

WRITINGS 

O. MURE�AN 1 , L. SAFTA 1 

Abstract: 

Several medical doctors turned their hand to writing at some point in their 

career, thus embedding their medical knowledge and expertise in valuable 

works of fiction. One of the most renowned of these practitioners remains Sir 

Arthur Conan Doyle (1859-1930), well-known as the creator of the most 

famous fictional detective, Sherlock Holmes. The paper presents aspects of 

Conan Doyle’s writings which pertain to his medical background, with a 

focus on drugs and poisons featuring in several of his stories. 

Key words: medicine and literature, detective fiction, drugs, poisons. 

After graduating from the Edinburgh 

University in 1881 with degrees of 

Bachelor of Medicine and Master of 

Surgery, Arthur Conan Doyle practised 

medicine for about ten years before giving 

up his first occupation to become a fulltime 

writer. He turned to medicine again 

only during the Boer War in South Africa 

where he volunteered as a surgeon. His 

public support of the British policy in this 

war led to his being knighted in 1902. 

Conan Doyle’s experience as a 

physician started with two sea voyages as a 

ship’s surgeon (to the Arctic on a whaling 

boat in 1880 and to the west coast of 

Africa in 1881). 

After that he practised medicine shortly 

in Plymouth and then opened his own 

practice in Southsea resort, where he 

gained reputation as a good practitioner. In 

1885 he was awarded an MD degree by the 

University of Edinburgh. 

Conan Doyle obtained a diploma in 

ophthalmology in Vienna in 1890 and then 

opened a practice in London. In the 

1 “Iuliu Ha�ieganu” University of Medicine and Pharmacy, Cluj-Napoca 

meantime, he also dedicated himself to 

writing, an activity he had always felt 

drawn to. While in Southsea, he created 

the famous sleuth Sherlock Holmes, who 

first appeared in the novel A Scarlet in Red 

(1887). The author acknowledged that the 

celebrated detective was actually inspired 

by Dr. Joseph Bell, a professor at the 

University of Edinburgh whom Conan 

Doyle admired for his remarkable skills of 

observation, logic and deduction in making 

a diagnosis, which helped him identify not 

only the disease, but also the patient’s 

occupation and character. 

Besides the detective stories which 

made him famous, Conan Doyle’s vast 

literary work includes historical novels, 

science-fiction stories, plays, romance 

novels, poetry and reality-based texts, 

revealing a complex versatile writer with 

various interests and concerns. Later in his 

life, the author became interested in 

spiritism and travelled the world to deliver 

lectures on this topic. 

Critics have often presented Conan

122 


Doyle as an unsuccessful physician, in 

spite of evidence which shows the 

contrary. Rodin and Key argue that in fact 

“he left the practice of medicine not 

because he was a failure, but because he 

was so successful that it interfered with his 

writings.” [11] 

Although Conan Doyle’s scientific 

medical writings are few in comparison 

with his literary work, they reveal both his 

keen interest in the medical research of the 

time and his potential for becoming a 

renowned medical professional. 

Publications related to infectious 

diseases indicate Doyle as a supporter of 

compulsory vaccination to prevent 

smallpox, which at the time aroused public 

opposition, and of inoculation for the 

prevention of typhoid fever. On the other 

hand, he was the first to draw attention to 

the hasty world-wide use of tuberculin as a 

cure for tuberculosis in 1890, after 

analyzing its effects and the pathological 

changes in lung tissue. [6, 7, 11] 

Medical bacteriology, a science that 

was just emerging at the time, was another 

field where Conan Doyle’s insights into 

the pathology of infectious diseases were 

remarkable. Thus, for example, he 

predicted the eradication of bacterial 

diseases several generations in the future 

and in 1883, as a general practitioner, 

wrote that many human diseases were 

caused by bacteria, whereas at the time 

only a few were identified to be so. 

Given his humanistic formation, Conan 

Doyle sustained causes related to the need 

for physical and psychological well being. 

Thus, for instance, he supported 

vivisection as an important means to 

alleviate human suffering. [9, 11] 

Conan Doyle was described as being 

“ethical and compassionate” in all aspects 

of his life: as a doctor and writer, in his 

private life and public activities, and a true 

“Renaissance Man” with vast knowledge 

and active interest in various areas of life. 

[8, 11] 

Significant for Doyle’s scientific 

curiosity is the publication in the British 

Medical Journal (1879) of a letter 

presenting his self-experimentation with 

gelsemium. “Gelseminum as a Poison” 

contains a detailed description of the 

experiment in which he tried to find out 

“how far one might go in taking the drug, 

and what the primary symptoms of an 

overdose might be”. One of his 

conclusions was that “the system may 

learn to tolerate gelseminum, as it may 

opium, if it be gradually inured to it.” [11] 

At the end of the 19 th century, when 

Conan Doyle practised medicine, old 

methods of treatment were still in use, 

whereas new, more scientific and rational 

ones emerged. The most dramatic 

improvement occurred in the field of drug 

therapy, with a strong reaction against 

overdosing, a practice that had been in use 

for centuries. An analysis of Conan 

Doyle’s work, concepts and knowledge of 

diseases suggests that he was familiar with 

and followed the new trends in medicine. 

Thus, an examination of the drugs referred 

to in the canon of Sherlock Holmes (fiftysix 

short stories and four novels) would be 

conclusive. 

The drugs and chemicals mentioned in 

the Canon include alkaloids, ammonia, 

amyl nitrate, belladonna, chloroform, 

cocaine, curare, ether, hormones, morphine, 

opium, prussic acid, snake venom, 

and strychnine. This is the highest number 

of drugs that has appeared in a series of 

detective stories [11]. Several poisons are 

mentioned as well, but in most cases their 

nature is not specified. 

According to Rodin [10], drugs are 

used for several purposes in the Canon: for 

treatment (e.g. ammonia and brandy to 

revive someone who has fainted, amyl 

nitrate for catalepsy, morphine for pain); 

for simulating disease (e.g. in “The Dying 

Detective” Holmes placed belladonna in

O. MURE�AN et al: Medical and Toxicological Aspects in Arthur Conan Doyle’s Writings 123 

his eyes to produce dilated pupils, as are 

those of a dying person); for poisoning 

(e.g. curare in “The Sussex Vampire”, 

strychnine in The Sign of Four); to induce 

anaesthesia (e.g. ether and chloroform); for 

addiction (cocaine, morphine, opium). 

The most medical story in the Canon is 

considered to be “The Resident Patient”, 

where both Holmes and Watson 

demonstrate an understanding of the 

medical practice. Alcohol is presented not 

as an addictive drug but as a favorite 

medicament in the Canon. For instance, in 

“The Engineer’s Thumb”, Watson uses 

brandy and water as a painkiller, and in 

“Blue Carbuncle”, brandy is given to the 

hotel attendant as a stimulant. Holmes also 

makes use of his knowledge of chemistry 

to solve crimes, such as in “The Naval 

Treaty”. The most fanciful use of poisons 

in the Canon appears in “The Devil’s 

Foot.” The hallucinatory and lethal effects 

of “devil’s-foot root” described in this 

story seem to have no correspondence in 

the pharmacopoeia or in the literature of 

toxicology. [5] ““Radix pedis diaboli” ... 

has strange properties … it stimulates 

those brain centres which control the 

emotion of fear and … either madness or 

death is the fate of the unhappy native who 

is subjected to the ordeal by the priest of 

his tribe.” [1] Billings believes that in this 

way Conan Doyle might have deliberately 

attempted to “divert prospective users of 

poisons by switching the type of one lethal 

alkaloid for another.” [3] 

Conan Doyle’s heavily annotated 

Pharmacopoeia [3] (containing, in the 

margins, brief summaries of detailed 

topics, directions for preparing medication 

and descriptions of effects of drugs on the 

human body) appears to have contributed 

to the accurate presentation of drugs 

mentioned in the Canon and other literary 

works. This evidence accounts for the 

professionalism the physician writer 

employed in approaching the interdisci- 

plinary attempt to write stories combining 

his literary talent and imagination with 

knowledge and good research skills in the 

field of medicine and other related 

sciences. 

To conclude, although Sir Arthur 

Conan Doyle changed his first profession 

as a physician to that of full-time writer, he 

continued to show interest in medicine. 

Moreover, the influence of his medical 

training and experience on his work and 

activities also contributed to the 

recognition he received as an author even 

during his lifetime. Although his second 

profession was the one that brought him 

fame and fortune, he was always proud of 

being a physician: “The title I value most 

is that of ‘Doctor’, which was conferred by 

your self-sacrifice and determination”, he 

wrote in a letter to his mother. [2] 

In the article The Romance of Medicine, 

he also stated that “a medical training is a 

most valuable possession for a man, even 

if he did not afterwards engage in practice” 

[4], a belief that has been shared by other 

renowned writers and artists throughout 

the time. 

References 

1. Baring-Gould WS. The Annotated 

Sherlock Holmes, 2 vols. Clarkson N. 

Potter, New York 1967. 

2. Bendiner E. Elementary My Dear 

Doctor Doyle. Hosp Pract 1982, 

17:180-212. 

3. Billings H. The Materia Medica of 

Sherlock Holmes. Baker Street Journal 

2006, 56(3): 37-46. 

4. Doyle AC. The Romance of Medicine. 

Lancet 1910, 2: 1066-8. 

5. Jones KI. The Sherlock Holmes 

Pharmacopoeia: Being an 

Examination into the Uses and Effects 

of Drugs and Poisons in the Sherlock 

Holmes Stories. Oakmagic Books, 

Weston-super-Mare, England, 2002.

124 


6. Lycett A. The Man Who Created 

Sherlock Holmes: The Life and Times 

of Sir Arthur Conan Doyle. Free Press, 

New York, 2007. 

7. Markel H. The Medical Detectives. N 

Engl J Med 2005, 353(23): 2426-8. 

8. Owen AH. Doctor Behind the 

Supersleuth. Br Med J, Oct 1977: 33- 

57. 

9. P.H. William Osler et Arthur Conan 

Doyle contre les antivivisectionnistes: 

quelques leçons de l’histoire pour un 

débat actuel. Med et Hyg 1985, 43: 

1996-7. 

10. Rodin AE. The Nature and 

Significance of Drugs and Poisons in 

the Sherlock Holmes Canon. Calabash 

1982, 1:42-49. 

11. Rodin AE, Key JD. Medical Casebook 

of Doctor Arthur Conan Doyle: From 

Practitioner to Sherlock Holmes and 

Beyond. Robert E. Krieger Publishing 

Company, Inc. Malabar, Florida, 1984.




ORD. PROF. DR. CEMIL TOPUZLU (1866-1958) 

AND HIS CONTRIBUTIONS TO TURKISH 

SURGERY 

H. ERTIN, O. USMANBAS, I. BASAGAOGLU 1 

Abstract: Cemil Pasha was the most important figure in the history of 

Turkish surgery. He was a pioneer in a modernizing country thorough 

observing new approaches, models, techniques in the advanced countries and 

applying them in his own country. Establishing novel surgery techniques in 

Haydarpa�a Military Hospital, Zeynep Kamil Hospital, Demirkapı and 

Haydarpa�a Medical Hospitals Cemil Pasha strived to present the Turkish 

surgeons how hospitals and clinics should have been organized in a modern 

way; the efforts that resulted in high confidence of Turkish public opinion to 

surgeons. With his contributions to anesthesia and asepsis-antisepsis field 

Dr. Topuzlu is a path-breaking medical scientist, a fervent professor and 

administer in Turkey, who executed Istanbul mayoralty as well 

Key words: Turkish Surgery, Cemil Topuzlu. 

Introduction. 

The history of surgery in our country is 

in parallel with the West. Nevertheless, it 

is generally accepted that Islamic world 

had advanced in surgery comparing it with 

the West in the middle Ages. For instance, 

Ebul Kasım Zehravi’s (X-XI centuries) 

work, Cerrahiyet-ül Haniye, was 

noteworthy at that time. 

Treatment and surgery of the eyes in 

the Ottoman period, was conducted by 

professional experts, “Kehhals”, and 

surgeons were never involved in 

operations. 

Till mid 19th century the profession 

was the arena of barbers, bonesetters, 

circumcisers and the dressers, in way 

transferring the skills from father to son. 

The emergence of surgery as a school 

based profession was in 1827 through the 

establishment of the Cerrahhane-i Amire, 

which was a military organization 

1 Istanbul University Istanbul Faculty of Medicine. 

administered by a French man Sade de 

Calliére. After establishment of this 

institution, opening in 1839 the Military 

Medical School began to offer special 

surgery classes. By the way, distinction 

made between doctors and surgeons in 

Military Medical School ended in 1892. 

In 1890’s, the new generation doctors, 

who owned modern surgery apprehensions 

and techniques through their observations 

and experiences at the abroad, started to 

take over the profession in the hospitals of 

Istanbul. That means those old generation 

medicals out of modern comprehension on 

medicine and their collaborators, the old 

surgeons without antisepty knowledge 

were discharged. Emergent surgeons with 

their new label, the operators, discarded 

old devices of wooden-handle tools and 

medical dressing kits composed of mohair, 

balm, sponge and mush. Putting exported 

modern devices and sterile materials into

126 


use they also change the image of the 

operations. In this way, modern surgery 

occurred initially in Istanbul then after 

extended to whole country and western 

innovations at surgery were transferred by 

new European style surgeons such as 

Cemil Pasha and his friends. 

Looking to his biography we coincide 

with a fast, attractive and amazing life. 

Biography 

Born in March 6 in 1866 in �stanbul, 

Cemil Pasha graduated from Medical High 

school of Çengelkoy in Istanbul in 1881. In 

1886, as a young captain he completed 

Military Medical School ranking first in 

class and began to work in Military 

Hospital of Sütlüce Kumbarhane Military 

Hospital. He was officially sent to Paris 

and served at Tillenx and Péan clinics and 

after his return he became assistant of 

Aristidi Pasha in Military Medical School. 

In 1894 he started giving lecture as a 

professor and in two years time he was 

promoted from lieutenant colonel to 

general. Following his surgery service for 

wounded in war at Yıldız Hospital, in 1897 

he was appointed to the membership of 

Tıbbiye-i Mülkiye and Sıhhiye-I 

Umumiye. After his membership to 

Turkish Medical Association in 1902, he 

was granted marshal degree by the Sultan 

Hamit in 1905. Cemil Pasha was the first 

dean of the Medical Faculty of Ottoman 

University and also was a professor at the 

Surgery Clinic I in that school. Both of 

these two services came to an end in 1911 

and he continued his civil life as a mayor 

and later lieutenant governor of Istanbul. It 

is worth mention here that during his 

period, the city of Istanbul met with 

automobiles for the first time. Despite his 

resign from official jobs in 21 November 

1914, he became mayor again in 1919 and 

moreover he was assigned minister of 

public works at this time. In 1945 he was 

elected as a honorary president of Turkish 

Medical Association. After having deemed 

worth of honorary professor in ordinary by 

Istanbul University, he passed away 

because of pneumonia in 1958. 

Having a social and sympathetic 

personality Cemil Pasha drove an effective 

and attracting surgeon portrait in early 

years of Turkish surgery through putting 

forward the truths that was based on his 

professional observation and instinct. His 

performance of educating is arguable. 

Moreover, he tried to make a carrier on 

politics as well. 

According to his grandson, Topuzlu 

was fully an action men. He never deviated 

from the right way in his occupations as 

surgeon, dean, mayor and ministry of 

public work and when he realized that the 

things were halting or locked, he preferred 

resigning or directing himself new fields 

rather than waiting to see what would 

happen. 

Surgery was the most long-lasting and 

the most popular identity of him. Indeed, 

he was indebted all of his reputation 

gained in his life to the operations that he 

made successfully. 

Attending Just-Lucas Championniére’s, 

Lefort’s, Trelat’s, Guyon’s, Tillaux’s and 

Péan’s surgery operations and lessons in 

France he got a certificate thanks to Péan’s 

close attention and sympathy devoted to 

him. During 1890- 1911, when he was at 

the peak of his carrier, Cemil Pahsa 

worked at the surgery clinics of 

Haydarpa�a Military Hospital, Military 

Medical Faculty and Civil Medical Faculty 

of Haydarpasa. 

Apart from his official duties he 

operated a private office in Istanbul and 

even he made operations at patient’s home 

but “medico-social” objections deterred 

him to follow this path. He worked also 

Zeynep Kamil and �i�li Etfal Hospitals at 

the same time and continued his operations 

in Egypt at summers. In addition to his 

contribution of asepsis and antisepsis and

H. ERTIN et al - Ord. Prof. Dr. Cemil Topuzlu (1866-1958) and his contributions to Turkish surgery 127 

anesthesia with chloroform Cemil Topuzlu 

provided pyloroplasty, scapula-torasik 

amputation and caesarian section. 

Moreover his contributions to surgery can 

be counted as follows: 

1. Stitching of cut arteries while blood 

stream goes on. 

2. An apparatus easily sterilized in 

hemorrhoidectomy 

3. A genuine technique in “Z” plasty of 

Achilles tendon. 

4. Clamp for circumcision, clump for 

suturing technique 

He brought institutionalization of 

internship at the faculty, publishing 

operation statistics and researches at 

national and international level and the 

membership to international associations 

into his country. 

He retired officially from surgery when 

he was 80 but went on giving conferences 

publishing articles, working in his clinics. 

In his article “Preventive measures before 

the operation”, he mentioned that it was 

not just sufficient to obey “asepsis and 

technique operatoire”. “The history of 

surgery in our country” in 1943, “How the 

surgery progressed just in 50 years” in 

1947 were the two most important article 

of him that is shedding light on the history 

of modern surgery in Turkey. In addition 

to these he wrote several articles about 

medicine, surgery, municipal works and 

educational matters in newspapers and 

journals. 

Other works 

1- Clinical Instruction of Surgery 

(Seririyat-ı Cerrahiye), published in 1897 

in �stanbul, with 107 pages and 155 case 

presentations 

2- Memories and Medical Observations 

(Mémories et observation médicales), 

Published in French in 1905, �stanbul. 

Having 196 pages, the most specific aspect 

of this book is its first chapter in which 

Cemil Topuzlu’s own invention the artery 

suture is presented. 

3- Scientific Surgery and painless 

delivery translated from Crener and 

Conbet. The book of 318 pages deals with 

anesthesia in surgery and gynecology. 

Despite its a translation Cemil Pasha 

included his own original observations and 

methods 

4- Systematic appendisectomy on 

terminal phase appendicitis, presentation 

made in 15 December 1936 at French 

Academy of Surgery 

5- Is circumcision beneficial to health? 

Presented at the meeting of Turkish 

Medical Commission in 30 January 1934 

6- Senile spots, presentation made in 

Turkish and French in 18 April 1944 at the 

conference held by Turkish Medical 

Association 

7- Tongue Cancer presented at the 

meeting of Turkish Medical Association in 

2 February 1937. 

Apparatus invented by Cemil Pasha 

1- Clamp that can be fixed on pinpoint 

of Reverdin needle and that provides 

operating deeply It was published in Presse 

Médicale in 03.02.1932. 

2- A specific apparatus for holding and 

pushing hemorrhoids and tying them off 

the body 

3- Clamp for circumcision 

A Memory From Cemil Topuzlu 

Pasha 

First published in 1951, in his book 

“My Memories of 80 years in Autocracy- 

Constitutional Monarchy and Republican 

Period” Cemil Topuzlu narrated his several 

precious observations and memories about 

the periods of Sultan Abdulhamid II and 

Constitutional Monarchy in the Empire. 

The memory below cited from this book. 

“I am operating on an Albanian in a 

house in �ehzadeba�ı. Besim Omer Pasha 

chloroformed the patient while Suleyman 

Numan Pahsa was assisting me. In the

128 


room only another Albanian, close relative 

of the patient and swordsmen of the Sultan, 

was standing. When the operation was 

about to finish, patient’s respiration and 

pulse stopped suddenly. Besim Omer 

Pasha mentioned in French “we have lost 

the patient”, hearing this fact that the 

swordsmen who understood also French, 

went out and yelled the bad news at the 

outside. In a moment all relatives of the 

patient gathered in front of the door and 

shouted: “If you can not save our patient 

we all are going to kill you”. Meanwhile 

we were striving for artificial respiratory. 

We tightly shut the door and hilled table 

and chairs behind the door. We told them 

their patient had not died and not to baffle 

us through coming inside the room 

otherwise we could not going on the 

operation. Under this condition, we made 

an effort about 20 minutes and saved the 

patient from an absolute dead. That is to 

say we also survived with patient. 

Cemil Pasha was not the first and the 

single one among the Turkish surgeons, he 

was one of the most precious one. Indeed, 

he was a member of “the revolutionary 

surgeon generation” emerged in 1890’s 

whose profound success was not only 

considering antisepsis and asepsis 

important but also reaching a modern 

comprehension at surgery and establishing 

bases of modern surgery in a modernizing 

country. 

We remember him with respect. 

References 

[1]. Ada, �., Prof. C. Topuzlu’nun Meslek 

Hayatına Ait Hatıralar, Vatan Gazetesi. 

15.04.1953 

[2]. Enis, R., �eyhületibba Meslek Hayatını 

Anlatıyor, Cumhuriyet. 28.10.1953. 

[3]. Gürkan, K. �., Cemil Topuzlu. Türk 

Tıp Cemiyeti Mecmuası, 5.04.1958 

den aynı baskı. 

[4]. �.Ü. �stanbul Tıp Fakültesi. Deontoloji 

ve Tıp Tarihi Anabilim Dalı Ar�ivleri. 

Lexicon. Cemil Topuzlu Dosyası. 

[5]. Kadıo�lu, S., Türkiye’de Cerrahi 

Devrim. Doktora Tezi Tıpkı Basım 

Sa�lık Bilimleri Enstitüsü .Ankara. 

[6]. Kavur, Ekrem. �., Askeri Hekimli�in 

Sıhhiye Hizmetlerinde Bir Etüd, Dirim, 

No.8. s. 376. 

[7]. Namal. A., Ö. Öncel., A. Demirhan 

Erdemir: Ülkemizin �lk Di�hekimli�i 

Okulu. �stanbul Üniversitesi 

Di�hekimli�i Fakültesi 100. Yıla 

Arma�an. �st. 2008. 

[8]. Topuzlu, Cemil. 80 Yıllık Hatıralarım. 

Hüsrev Hatemi, Aykut Kazancıgil 

Dördüncü Baskı 2002 Edit. Cemalletin 

Topuzlu 

[9]. Topuzlu, Cemalettin. Günümüzde 

Genel Cerrahi Hipokrat Aylık Sa�lık 

Meslek Dergisi. S. 38 (5). 1995.




TRADITIONAL YORUBA MEDICINE IN 

NIGERIA: A COMPARATIVE APPROACH 

O. AWOJOODU 1 D. BARAN 2 

Abstract: From the earliest beginnings of medicine, mankind has 

associated the act of curing disease with gods, goddesses and other forms of 

divine forces. Deities were greatly thought to be responsible for people’s 

wellness and preservation of their wellness. Sickness was regarded as a 

consequence of disobedience to or sin against these supernatural agents and 

their moral rules. Concurrently, empiric medicine developed, mainly based 

on herbs, minerals and animal-derived substances, which were directly 

linked to the above mentioned supernatural elements. Spirits, gods and 

goddesses had tremendous effects on the early practice of medicine. Magicalempirical 

approaches to health and disease, still vivid today, characterized 

all archaic civilizations, being also identified in Nigeria. This presentation 

focuses on the significance of such comparable behavioural archetypes. An 

intercultural and transcultural insight into this early, yet classical, stage of 

medical practice in a tribe on the west coast of Africa - the Yoruba Land- is 

given. 

Key words: magical-empirical medicine, transcultural archetypes, yoruba. 

Introduction 

African traditional medicine is a 

mystery to much of the western world. It is 

misunderstood, sometimes to the point of 

causing fear. 

The traditional medical practices of the 

Yoruba in Nigeria, however, offer fresh 

outlooks on the concept of health and 

unique healing treatment to the world 

medical community. [1, 2] 

These methods should be examined 

with an open mind, further developed, and 

finally integrated with western medical 

procedures in order to provide the best 

medical service possible. [4] 

Traditional medicine, as is well known, 

represents a cultural gem of various 

communities around the world and 

encompasses all kinds of folk medicine, 

1 Nigeria. 

2 „Gr.T.Popa” University of Medicine and Pharmacy, Ia�i, Romania 

unconventional medicine and indeed any 

kind of therapeutical method that has been 

handed down by the tradition of a 

community or ethnic group. [3] 

In this study, emphasis will be more on 

the history of Yoruba medicine than on the 

actual practices and methodology. 

A brief insight into these practices will 

put popular medicine into perspective 

before taking a more detailed look at its 

beginnings. 

Yoruba medicine and healers in 

Nigeria 

Among the Yoruba in Nigeria, as in 

many African cultures, health and religion 

are tightly interrelated. In the Yoruba 

mindset, all healing comes from God, 

including that of the western medical

130 


doctor. [3] 

The Yoruba tribes believe in a power 

called Ifà which is God’s angel thought to 

have been choosen to possess an infinite 

source of knowledge. Ifà’s knowledge 

includes animals, plants, oral incantations 

or ofo, divination, medicinal plants, and all 

sciences associated with healing diseases. 

This “wise man to whom nature has 

taught her secrets” is the controller of 

language, culture, philosophy, and religion. 

Ifà knows the causes, secret names, 

origins, and chemical compositions of all 

things. 

This Supreme Being gives the 

knowledge of healing through the power of 

Ifà to those who prove themselves worthy. 

[1, 2, 7] 

It is important to realize that there are 

several aspects of Yoruba healing 

practices. 

The main types are herbal medicine and 

rituals including incantations, prayer and 

sacrifice. [6, 7] 

The feature most accepted by western 

doctors is herbal medicine. [7, 12] 

Since the dawn of time, leaves, fruits, 

seeds and roots of plants were selected 

beneficial for the maintenance of health 

and cure of the ailments man suffered 

from. 

Yoruba doctors have an impressive 

store of knowledge on a wide range of 

plant species. 

These plants are often used in a similar 

way to medications provided by western 

doctors. 

Much less accepted are ritual healings. 

Rituals are open to the public, as healing is 

seen as a group effort. [7, 12] 

Orunmila and Babalawos 

Orunmila, the herbal healer 

In Yoruba medicine, the «Ifà Corpus» 

is considered the foundation of divine 

herbal medical practice. [13, 14] 

It was revealed by the mystic prophet 

Orunmila (Orula or Orunla), about 4,000 

years ago in the ancient city of Ile-Ife, now 

known as Yoruba Land. Orunmila taught 

people the customs of divination, prayer, 

dance, symbolic gestures, personal, and 

communal elevation. 

He advised them on spiritual baths, 

meditation, and herbal medicine in 

particular. In Yoruba mythology, Orunmila 

corresponds to the «highly knowledgeable 

Irunmole», deity of destiny and prophecy. 

He is recognized as "ibi keji 

Olodumare", i.e. second only to 

Olodumare (Almighty God)) and "eleri 

ipin", i.e. witness to creation. Orunmila is 

the Orisha of divination, the Supreme 

Oracle, the great benefactor of humanity 

and its main adviser. He reveals the future 

from the secret of Ifá, is a great healer and 

those who ignore his advice may suffer 

avatars produced by Eshu. Also referred to 

as Ifá ("ee-FAH"), Orunmila personifies 

knowledge and wisdom and the highest 

form of divination practice among the 

Yoruba people. Orunmila carried Ifà, the 

wisdom of Olodumare, to Earth. [1, 12, 14] 

A Yoruba legend explains that the first 

who practiced the art of herbal healing was 

Orunmila, whom God had endowed with 

this knowledge and skill. [3] 

Orunmila is not Ifà itself, but he leads 

the priesthood of Ifà. He embodies the 

archetype of the civilizing and healing 

hero. [9, 10]. 

Babalawo, the diviner-priest 

Priests of Ifà are called «Babalawo», ie 

father of mysteries, or, for a female Ifà 

priest, Iyan Ifà. Babalawos possess an 

additional Orúnmila consecratio. 

They divine and interpret for people the 

word of Orunmila, such as revealed by the 

oracle of Ifá. 

Babalawos communicate with Orula 

and with the Yoruba pantheon. Orunmila 

(«Orun-ni-mi-Ela»), whose name means

O. AWOJOODU et al: Traditional Yoruba medicine in Nigeria: a comparative approach 131 

“only heaven knows the keys to my 

salvation”, is imagined as a sage. [1, 13, 

14] 

Babalawos can give the "Hand of 

Orula", known as "Ikofa" for women, and 

"Awofakan" for men and other various 

deities. 

Orishas in Yoruba Medicine 

The Yoruba religion has a multitude of 

deities, the major of which are called 

Orisha. [1, 13, 14] 

There are around 201 deities, thirty of 

which are commonly worshipped. In 

diagnosing illness, each one of the Orishas 

manifests interdependent physical qualities 

and herbal attributes, each affecting one 

another. 

The Orishas stand for higher energies 

that govern living matter destinies, 

transcend sensory faculties, and 

intermediate contact with the supreme 

God, Olodumare. [12, 14] 

Eshu, the mediator and accomplisher 

Olodumare used the command known 

as "Ashe" (ase) to accomplish his 

assignments. 

Eshu, Èsù or Elegbara,, his best friend, 

exerts this «ashe» to this day and will use 

it forever. Nothing, good or bad, can be 

done without Eshu, who mediates between 

humans, Irunmole and Orisha. Eshu is 

indispensable to man and Orishas. 

As Irumnole, he carries sacrifices for 

whatever purpose to the appropriate 

quarters. [1, 2, 13, 14] 

Èsù, Gateman of the Heavens, is prime 

negotiator between negative and positive 

forces in the body. He enforces the "law of 

being” and enhances the power of herbs. 

He mainly acts on the sympathetic 

nervous system and is involved with all 

herbal effects. 

Osain, the herbalist, God of traditional 

medicine 

Osain is the other most important 

Orisha in Yoruba medicine. Osain rules 

over all wild herbs. 

He is regarded as the greatest herbalist 

who knows the powers of all plants. 

The plants and herbs of Osain have 

their purely medicinal value as well as 

their magical value. 

Some plants have to be gathered at 

certain times of the day or night, according 

to cosmic rhythms of sacred events. (2,3) 

Osain is the God of traditional medicine 

and all of nature is at his disposal. 

Without the necessary herbs provided 

by an Olú Osain, the consecration of an 

orisha would be impossible. 

Obatala, the creator and healer of 

humans 

Deity of Creation, custodian of the Ifà 

Oracle, Obatala is an alternative source of 

knowledge. 

Creator of Human Form and Purity, he 

cures illness and deformities. 

His priests are the Babalawos and his 

primary effects are on the brain, bones, and 

white fluids of the body. 

Herbs he controls Body skullcap, sage, 

kola nut, basil, hyssop, blue vervain, white 

willow, and valerian are [4, 13, 14] 

Ogun, the iron like power of health 

Orisha of Iron, Ogun is the divinity of 

clearing paths, specifically in respect to 

blockages or interruption of the flow of 

vital energy at various points in the body, 

and he is the liberator. 

Effects are on the heart, kidney (adrenal 

glands), tendons, and sinews. Herbs used 

are eucalyptus, alfalfa, hawthorn, 

bloodroot, parsley, motherwort, and garlic. 

[2, 12] 

Ogun, Irunmole of war, of the hunt, 

iron or steel expresses the force of this 

deity who can be powerful or/and cruel. [5, 

13, 14] 

Yemoja, the mother goddess 

Mother of Waters, Primal Waters, and

132 


Nurturer, Yemoja symbolizes the amniotic 

fluid in the womb of the pregnant woman, 

as well as the breasts which nurture. 

She signifies the protective energies of 

the feminine element, manifesting her 

specific effects at the level of the womb, 

liver, breasts and buttocks. 

The medicinal herbs she governs are 

kelp, squaw wine, cohosh, dandelion, 

yarrow, aloe, spirulina, mints, passion 

flower, and wild yam root. [6, 14] 

Oshun, the goddess of feminine energy 

and hydrotherapy 

Sensuality, Beauty and Gracefulness, 

are personified by Oshun. 

She is responsible for clarity and 

flowing motion and has power to heal with 

cool water. She is also the divinity of 

fertility and feminine essence. 

Women appeal to her for child-bearing 

and for the alleviation of gynaecologic or 

obstetrical disorders. 

She is fond of babies and is sought if a 

baby becomes ill. Oshun is known for her 

love of honey. 

She acts on the circulatory system, 

digestive organs, elimination system, and 

women’s pubic area. [6, 14] 

Herbs consecrated to her include yellow 

dock, burdock, cinnamon, damiana, anis, 

raspberry, yarrow, chamomile, lotus, uvaursi, 

buchu, myrrh, Echinacea. 

Shango, the god of masculine energy 

Kingly, virile Shango, associates with 

masculinity, fire, lightning, stones and 

magnetism. 

This Great Warrior and protector 

transform base substances into pure and 

valuable essences. 

He controls the male reproductive 

system, bone marrow, life force. 

Herbs incorporating his virtues are 

plantain, saw palmetto, hibiscus, foti, 

sarsaparilla, nettles, and cayenne. [6, 14] 

Oya, the goddess of death and rebirth 

Guardian of the Cemetery, Oya is 

connected with Tempests, Winds of 

Change, Storms, and Progression. Usually 

in the company of her masculine 

counterpart, Shango, she is the deity of 

rebirth. 

Things must die so that new beginnings 

arise. In the same way, disease must come, 

so that evil can be destroyed, enabling 

living beings to heal and be reborn to a 

new life. [9, 10] 

Oya`s effects are on the lungs, 

bronchial passages, mucous membranes. 

Herbs used for such pathologies are 

mullein, comfrey, cherry bark, pleurisy 

root, elecampane, horehound, chickweed. 

[6, 14] 

Intertwined archaic and modern 

medicines 

As in many other vivid traditional 

civilizations from Asia, Americas and 

Africa, modern medicine intermingles with 

popular concepts and therapies. 

Nigeria is no exception. In a fascinating 

melting pot, local ancient African healing 

techniques combined not only with 

western scientific practices and theories, 

but also with different religious and 

magical approaches. 

Archaic ethomedicine mixed up with 

Christian and Islamic perspectives to 

health and disease. In Cuba, eg, in the 

second half of the XVIII-th century, 

syncretism between the Yoruba cult and 

the Catholic religion resulted in the 

“Santeria”. Santeria is similar to the «Rule 

of Osha» and expresses the oracular 

revelation mystery of Ifá. Even though an 

animistic system of beliefs and rituals, Ifà 

is a monotheistic religion with one God, 

creator of everything, with polytheistic 

worshipping rules. [6, 13, 14] 

Every natural object is enlivened by a 

spirit, similar to angels and saints 

(Spanish: santo-saint; «Santeria»-multitude


of saints). 

Potentiating the power of Ifà, the 

Judeo-Christian God bestows the 

knowledge of healing to those who prove 

themselves worthy of him/them. [12] 

Eleggua, the trickster at the crossroads 

In Santeria, Eleggua is probably the 

most important of the Orishas for many 

practitioners. 

He is a trickster, constantly testing 

people's character, waiting for them at 

crossroads. Without him, one cannot take 

advantage of opportunities, and the proper 

way in a given situation might not be 

easily found. Like Eshu, Èsù or Elegbara, 

Eleggua delivers sacrifices to the other 

Orishas. 

Receiving Eleggua is the first thing any 

practitioner must do in the religion of Ifà- 

Santeria. Both the trans- Atlantic Slave 

Trade and the colonization of Africa, 

contributed to this evolution. [12] 

Voodoon magic medicine 

Yoruba religion metamorphosed and 

different species of it emerged. One of 

them is Vodoun, Voodoun or Vodou, a 

mixture of Nigerian and Congolese 

Yoruba, Haitian traditional belief system, 

Catholicism, and even Freemasonry. 

It is usually met in Haiti, South 

America, the Caribbean, and Central 

America. In Haiti, it is considered to have 

shaped almost every aspect of cultural 

patterns and health practices. Commonly, 

lower or peasant classes have recourse to 

Voodoo rituals. [8] 

Art of Advertising and Medical 

Ethics 

In countries, such as Nigeria, where 

traditional medicine encounters official 

„Western scientific medicine”, advertising 

the supremacy of ancestral healing systems 

becomes an important market strategy. 

Herbal therapies are presented as 

transformed and updated by nominated 

"pathfinders", "pioneers" and "pacesetter, 

each of them a "first among equals” 

personality, „the vanguard of the 

innovation”. 

Herbs and popular remedies are 

described in accordance with current 

medical diagnoses and defined as capable 

of treating incurable diseases. Inherited 

etnomedical botany is „different and 

unique", an evidence based alternative to 

orthodox medicine. 

The dominant „compare and contrast” 

propaganda labels hospital medicine 

negatively and performed by inhuman 

unprofessional practitioners. 

If appealing to natural therapies: "..no 

doctor can sentence you to death" any 

longer. In traditional as well as in scientific 

medicine, market policies often infringes 

professional ethics and deontology. 

Educated practitioners should be 

assisted in their endogenous expert roles of 

archaic techniques, whereas herbalists 

should become aware of the risks they 

take. [11] 

Attention has to be drawn, indeed, not 

only to the ethics of orthodox practitioners, 

but of traditional herbalists and healers, 

too. Claims that Agencies for Drug 

Administration and Control, or Ministries 

of Health approved traditional herbal 

remedies and alternative or complementary 

practices always need critical examination. 

Charlatanism, ignorance and despair often 

go together. 

Discussion 

The Yoruba tribe is one of the largest 

tribe in Africa with an estimated 30 million 

people throughout West Africa. 

The Yoruba medicine is Orisha (deity 

or spirit) based and closely associated with 

the Yoruba religion. 

Therefore this presentation focused 

primarily on the Orishas that form the 

foundation of Yoruba medicine, in the

134 


same way that Hippocrates addressed the 

Greek gods when solemnly swearing to 

assist his patients properly: ”....and I take 

to witness all the gods, all the 

goddesses....” (Hippocratic Oath). [5] 

Analyzing Yoruba medicine, numerous 

convergences with other cultures and 

medical systems are brought to light. 

Comparable archetypes are found. Magical 

and empirical medicines are closely related 

in everyday practices. 

The Supreme Almighty God and 

derived divine entities are deeply involved 

in causing diseases, life and death. Gods 

and vital energies work together with 

priests, prophet-diviners and humans. 

Civilizing deities and heroes testify the fact 

that life, knowledge and health depend 

upon supernatural entities. [9, 10, 13] 

Their course is strictly dependent on 

human moral behaviour and respect of the 

divine rules and laws. 

Consequently, openness to medical 

mystical experiences has to be maintained. 

[12] 

Undoubtedly, herbal medicine holds a 

place of choice in all archaic medicines 

that preceded and equally coexist with 

contemporary ”evidence based medicine”. 

Ancient Asian, European and African 

medicines perfectly agree from this 

perspective. In ancient Dacia, too, herbal 

remedies were many and highly 

appreciated. [9] 

Syncretism is another characteristic 

feature of cultures and civilizations. It can 

also be distinguished in the Yoruba 

medical tradition. 

It occurs due to the likeliness of basic 

conceptions and practical approaches, 

which express common archaic religious 

principles and ancestral ideas about health 

and disease, life and death, destruction and 

rebuilding, essential intertwined realities. 

Errors are thus corrected or mitigated, 

lest evil be eternal. 

Yoruba medicine has recourse to gods 

and goddesses, energies and vital forces, 

all able to produce and cure illnesses. 

Beside them specific gods of medicine 

exist: Osain, the herbalist, God of 

traditional medicine and Obatala, the 

creator and healer of humans. Osain 

resembles Asklepios, a celebrated master 

of vegetal drugs in Ancient Greece, or to 

Zamolxis, in Dacia, - ancient name of 

today`s Romania. [9] 

Fathering Humans and Purity, Obatala 

recreates or reshapes human beings - body 

and soul-, as he cures disorders and 

deformities. Oya, the goddess of death and 

rebirth, teaches that getting rid of disease 

signifies killing evil and decayed matter, 

restoring robustness and welfare. 

Death as a source of improved life is 

another mental archetype religions and 

related traditional civilizations share. 

(9,10) In many respects, the rich Yoruba 

pantheon reminds various North African, 

Greek, Indian or pre-Columbian 

mythologies: masculine and feminine 

elements complement each others, 

goddesses of beauty, grace and fertility rub 

shoulders with frightening gods of war and 

disaster. Ogun, Orisha of Iron, the cleanser 

that opens the paths, hints to Chinese and 

Indian energetic points, meridians and 

networks. The vital trajectories he surveys 

seem to ensure an enviable health 

condition. 

As defined in a well known Romanian 

traditional New Year`s wish for health, 

humans should become or maintain 

themselves “hard as iron, sharp as steel”, 

able to “blossom like apple-trees” and 

roses all lifelong. 

As in ancient Egypt and other pagan 

mystic beliefs, but also in Christianity, 

deities specialize in curing specific organs 

and diseases. [5] 

Eleggua, the trickster at the crossroads, 

reiterates the role of Hercules, the Greek 

civilizing hero, healer and savoir. [5] 

Tradition gives authority. Both human-


and divine-revealed testimonies keep hope 

alive. 

Important ethical issues equally result. 

The true relationship between disease 

and healing experiences and their spiritual 

and behavioural expression are still to be 

determined. 

Hermeneutics should aim at the 

transformative potential of the experience 

of the world, at identifying the sacred and 

profane roots of magical and empirical 

medicine. 

Conclusion 

The Yoruba tribe`s members are 

convinced believers in natural preventive 

and curing medicine. 

They are obvious criticizers of modern 

western medicine where problems caused 

by drug use and abuse are masked, 

whereas the person as a whole is largely 

neglected. 

According to the medicine-men of 

Yoruba, if humans listen to their bodies, 

these bodies will provide them with the 

preparation and appropriate knowledge 

necessary to regain the balance with the 

Earth and cosmic environment. 

Modern-day technology, innovations 

and education have, however, made a lot 

of impact on the herbalist and on the 

practice of traditional medicine in Yoruba 

Land. 

The general populace now wants to 

compare the herbalist with the orthodox 

medicine general practitioner. 

Herbalists have now to be encouraged 

to improve on the quality of their practice, 

to be stimulated to identify correctly the 

medicinal plants and other ingredients used 

in the preparation of herbal products. 

They should be mindful of the sources 

of their raw materials and avoid 

adulteration and mystification, in an effort 

to ensure safe and efficient medicines. 

The intercultural and transcultural 

approaches to Yoruba medicine display 

interrelated mental and behavioural 

patterns. 

Reference: 

1. Abimbola K., Yoruba Culture: A 

Philosopical Account, IAP, 

Birmingham, 2006, 90-129. 

2. Ademulegun Z.A., The Relevance of 

Yoruba Medicine Men. In Pub Health 

Rep Nigeria, 1969, 84, 12: 1085-1091. 

3. Babalola, E. O., The Relevance of 

Herbal Medicine to the Practice of 

African Traditional Religion, Islam 

and Christianity in Yoruba Land, 

Ekpoma JRelS, 2003, 5, 1: 103–110. 

4. Babalola, E. O., The Scientific Basis 

of African Traditional Medicine. The 

Yoruba Example, Ekpoma JRelS, 

2005, 6, 1- 2. 

5. Baran D, An outline history of 

medicine, Ed. Tehnopress, Ia�i, 2007 

6. Buckley A. D., Yoruba Medicine, 

Athelia Henrietta PR, 1997. 

7. Danesi, Mustapha A., Traditional 

Medicine in Africa. In: Oluwole, S. B., 

Faluyi K., (eds.), The Essentials of 

African Studies, Lagos, 1998, 2: 143– 

163. 

8. DeSantis, Thomas J.T., The immigrant 

Haitian mother: Transcultural nursing 

perspective on preventive health care 

for children, JTranscult Nurs, 1990, 2: 

2-15. 

9. Eliade M,De la Zalmoxis la Genghis- 

Han, Ed. �tiin�ific� �i Enciclopedic�, 

Bucure�ti,1980,80 . 

10. Eliade M., Istoria credin�elor �i ideilor 

religioase. De la epoca marilor 

descoperiri geografice pîn� în prezent 

(vol.4), Ed. Polirom, Ia�i, 2007. 

11. Iroegbu P., Harvesting Knowledge of 

Herbal Resources and Development of 

Practitioners in Nigeria, Indilinga: 

African Journal of Indigenous 

Knowledge Systems, 2006, 5, 1: 32– 

50.

136 


12. Olson J., Nkiwane S., Integrate for 

Efficiency: Traditional Yoruba 

Medicine in Nigeria, GS 218 

Introduction to Africa, Colorado 

College, 2006. 

13. Orisha Net, 

http://www.orishanet.org/ocha.html 

14. Yoruba_Medicine, wikipedia 

http://en.wikipedia.org/wiki/Yoruba_ 

medicine




DR. VICTOR GOMOIU, BALKAN PARADIGMS 

AND LESSONS OF A LIFETIME 

D. BARAN 1 

Abstract: 

Victor Gomoiu founded the Romanian Royal Society for the History of 

Medicine and was member of the International Academy for the History of 

Science. He was elected vice-president, president and honorary president of 

the International Society for the History of Medicine. Enabling the 

expression of Balkan medical identities, he created a Center for South- 

Eastern European Medical Ethnographic Studies. Gomoiu tried to save 

Romanian Jews from atrocities perpetrated by fascist movements. Eminent 

surgeon, he implemented original sympathectomy techniques and 

participated in medical missions during the Balkan War, and World Wars I 

and II. He developed an outstanding social and educational work within the 

“Vergului Barrier” Establishments. Doctor Gomoiu was imprisoned and 

then rehabilitated by the communist regime. He embodied the paradigm of 

the idealistic intellectual who endeavored to affirm traditional Romanian 

medical, cultural and moral values. His lesson equally bears upon the 

continuous trial between intransigent resistance and lucrative compromise in 

history. 

Key words: Romanian surgery, medical ethnology, philanthropy, 

resistance 

Biographical and professional 

landmarks 

Undoubtedly, Dr. Victor Gomoiu`s 

name remains tightly connected with 

History of Medicine in Romania, in the 

Balkans and in the world, as a whole. He 

was born on April 18th, 1882, in the 

village of Vânju Mare, in the Mehedin�i 

County, not far from the Danube shore and 

the Roman ruins of the Apollodor of 

Damascus` bridge at Turnu Severin (today, 

Drobeta-Turnu Severin). 

Son of an orthodox priest, he was a 

strictly moral and diligent pupil. In 1900 

he began his medical studies and in 1906 

he graduated the Faculty of Medicine in 

the Romanian capital. From 1906 to 1908, 

he was vice-president and president of the 

1 University of Medicine and Pharmacy “Grigore T. Popa”, Ia�i 

Medical Students` Society. 

He equally began law studies.(10) 

Between 1903 and 1909, Dr. Gomoiu was 

trained in various hospitals of Bucharest. 

In 1909 he passed magna cum laude his 

doctoral degree thesis entitled “Anaplastic 

Surgery of Face and Head” which earned 

him the gold medal. He chose the position 

of librarian of the Bucharest Faculty of 

Medicine Library between 1909 and 1911. 

In 1911, Dr. Gomoiu was appointed 

physician and director of the «Sanatorium 

for the Fight against Tuberculosis in 

Children» of Tekirghiol, a Romanian 

Black Seaside resort. 

Between 1914 and 1927, he was again 

present as a surgeon in the great Bucharest 

hospitals of “Philanthropy”, “Coltzea” and

138 


“Brâncovenesc”. From 1927 until soon 

after World War II (1948), he continued 

his medical activity within the “Verg 

Barrier Medical Social Complex” which he 

was the founder of. 

Dr. Victor Gomoiu also became 

professor of surgical clinique at the Faculty 

of Medicine of Bucharest. [6] For his 

professional qualities, he was the private 

physician of Queen Elena of Romania. 

He married Dr. Viorica Tincutza 

Ionescu who shared with him the same 

passion for both medicines - surgery above 

all- and medical history. Dr. Gomoiu died 

on the 6 th February 1960, at 78 years of 

age. 

Fig. no.1. Dr. Victor Gomoiu 

Political interferences and civic 

consciousness 

Since he was a good and extremely 

honest manager, in 1929 Dr. Gomoiu was 

appointed Technical Counselor and in 

1930 General Secretary at the Ministry of 

Health. Eventually he was Minister of 

Health for about three months, from July 4, 

to September 14, 1940. 

He was soon dismissed by the National 

Legionary government instituted in 

Romania on September 6 th , 1940, and 

overthrown on January 23 rd , 1941. 

An incident troubled his life in 1933. 

After the Romanian Prime Minister I. G. 

Duca`s assassination by “The Iron Guard” 

fascist movement, several suspects were 

put into jail including important names of 

Romanian political and cultural life: Nae 

Ionescu, Nichifor Crainic, Grigore For�u. 

Dr. Victor Gomoiu was among them. Once 

their innocence was proved they were 

released. [4] 

In 1941, he stood in front of the Martial 

Court for having revealed the toxic effects 

of Prontosyl abusively given to soldiers, 

whereas, in December 1918, he refused to 

mystify the necropsy results of some 

victims of the dramatic typographers` 

strike in Bucharest. 

In 1942, Queen Mother Elena learned 

from Dr. Victor Gomoiu that a new group 

of Jews was to be sent to Transnistria and 

how miserable their condition was. 

Seemingly, Barbu L�z�reanu 

(Lazarovici) (1881-1957), a Romanian 

Jewish literary historian and publicist, 

member of the Romanian Academy, 

informed his friend, Dr. Gomoiu, about 

this scheduled deportation and was himself 

finally saved due to Gomoiu`s intervention 

with the royal family. 

Later, the constant defence of the Jews 

against fascist persecution, enabled by her 

decisive influence on her son, King 

Michael, earned Queen Elena the title 

“Righteous among Nations” conferred by 

Yad Vashem. [5] 

Dr. Victor Gomoiu developed a 

multifaceted activity based on his interest 

and skills in surgery, social medical 

projects and history of medicine. His 

intransigent character made him suffer 

throughout his entire lifetime. In 1945-

D. BARAN: Dr. Victor Gomoiu, Balkan paradigms and lessons of a lifetime 139 

1946, Gomoiu took part in debates on the 

foundation of a social-christian party, able 

to oppose communism. In 1950, after 

having lost almost all his goods, due to 

nationalization, after having witnessed the 

partial destruction of his archives, when 68 

year old, he was imprisoned by the 

communists and spent approximately five 

years in prison. [7] 

The imprisonment was due to his 

closeness to the «exploiting class», to the 

Royal Family of Romania, and his position 

of Minister of Health under a previous 

regime. 

The real cause was his constant refusal 

to «enroll» and cooperate with the 

communist government, give up 

correspondence with foreign scientists, 

deny his friends, and formally recognize 

the new political order. Gomoiu could not 

worship these international and national 

«last-minute masters» whose portraits 

already replaced, even in his office, 

beloved figures: Stalin - Queen Elena; Ana 

Pauker and an unknown woman - his 

“marvelous angels”, his two deceased little 

girls; another bearded man - his father. [7] 

After the relative opening of the 

communist camp towards a more humane 

attitude, in 1964, Dr.Gomoiu was 

rehabilitated and his heritage officially 

reconsidered. 

Monographs, communications and 

studies were dedicated to him. In 1970, his 

widow, Dr. Viorica Gomoiu participated 

with a communication in the XXII-nd 

Congress of the ISHM held in Bucharest 

once more. In 1972, she accepted to donate 

Dr. Gomoiu`s remnant collections and 

other personal objects to the History of 

Medicine Museum founded in Craiova, 

under the auspices of the local University 

and its Faculty of Medicine. [6)] 

Soon it became a famous establishment 

and gathered some other important 

collections belonging to towering 

personalities of Romanian medicine. 

Unfortunately, following the revolution 

of 1989, other problems, especially 

economical, but also moral ones, impeded 

the full valorization of this great spiritual 

heritage. 

Thus, in 1996, the “Gomoiu” History of 

Medicine and Pharmacy Museum in 

Craiova was itself dismantled after the 

building retrocession to former owners. 

Dr. Victor Gomoiu, the surgeon 

Victor Gomoiu was professor, 

practitioner and passionate researcher in 

the field of surgery and topographic 

anatomy. 

In the domain of surgery, Victor 

Gomoiu greatly contributed to plastic 

surgery, sympathetic system surgery, 

traumatology and urology, imagining and 

implementing new operatory techniques 

and procedures. 

Cervical sympathectomy was such a 

personal procedure, often recommended in 

treating angina pectoris crises. 

Solarectomy was another original method. 

His approaches were appreciated by the 

French surgeon René Leriche (1879-1955), 

famous for his pain and sympathetic 

system surgery. [6] 

From 1903 to 1905 Dr. Gomoiu 

specialised in the surgical clinique of the 

reputed professor Thoma Ionescu (1878- 

1885). Professor Ionescu studied medicine 

and law in Paris. 

He was awarded the Laborie prize of 

the Surgery Academy in Paris, and the 

silver medal for surgery, as laureate of the 

Hospitals in Paris. 

He was an anatomy agrégé between 

1892-1895 in the French capital, and in 

1895 returned to Romania. 

Thoma Ionescu pioneered anaesthetic 

surgical procedures and in 1919 published 

in Paris, at Masson et Cie Editing House, a 

momograph on «General Rachianesthesia» 

where cervical anaesthesia was described. 

[1]

140 


That is probably why the very young 

dr. Gomoiu had to share with his master 

the success of his own cervical 

sympathectomy method for angina pectoris 

pain management, a fact that seriously 

afflicted him. [6] 

More operatory procedures were given 

his name, e.g. Gomoiu-Eden method for 

the myoplastic treatment of facial 

paralysis, or the Gomoiu-Phocas method 

for the surgical management of inguinalscrotal 

hernia. [8, 10] 

In 1906, Dr. Gomoiu was member of 

the editorial board of „Spitalul” („The 

Hospital”) journal [6, 10] Along with Drs. 

Gr. Georgescu and V. S�vescu, he edited 

the shortlived publication „Le journal de 

chirurgie de Bucarest”, (“The Bucharest 

Surgical Journal”) directed by professor 

Constantin Angelescu. Only few issues of 

it appeared. [12] 

The Balkan Wars 

Dr. Gomoiu participated in the Balkan 

Wars (1912-1913). 

In October 1912, he left Bucharest, 

leading a Romanian sanitary ambulance to 

Turkey. 

One month later, with the agreement of 

the Turkish Red Crescent, he organized a 

field hospital at Dede Agath. [7, ]8] 

For his successful effort, the Turkish 

government conferred upon him the 

„Medgidia” order and „The Red Crescent” 

Medal, whereas the Romanian authorities 

awarded him the Silver Medal of the Red 

Cross and the „Bravery and Loyalty” 

Medal, I-st class. Dr. Gomoiu was also 

mobilised during the two World Wars. [7] 

After World War I he was awarded the 

Légion d`Honneur. 

Dr. Gomoiu, the benefactor 

In 1925, Dr. Gomoiu was appointed 

manager of the «Princess Elena» charity 

foundation. 

In 1925, he courageously decided to lay 

the basis a medical, social and cultural 

establishment at the periphery of 

Bucharest, in the district named “Bariera 

Vergului” (“The Verg`s Barrier”). [10] 

Vartolomei Vergu (Vergo or Virgo) had 

been a medieval merchant, civic dignitary, 

lord steward and diplomat at 

Brâncoveanu`s and Cantacuzino`s Court, 

in 1693-1697. In the XX-th century, this 

muddy zone was the land of the 

disinherited “poor and ignorant” people. 

For accomplishing his utopist dream 

with the scarce available funds, most of 

which originated in his own financial 

contribution, Dr.Gomoiu offered to assist 

patients of this hospital without any fee for 

10 years. Money was also donated by the 

«Princess Elena» charity foundation. 

Dr. Gomoiu`s idea seemed to many a 

Don Quixote’s foolish initiative and was 

harshly criticized. 

Victor Gomoiu himself adapted the 

initial architectural building plans, 

enabling more sections to be created: 

internal medicine, surgery, obstetrics and 

gynecology, pediatrics and stomatology. 

An Institute for Social and Charity Nurses 

and a public bath were included, too. 

"The Vergului barrier complex for 

medical-social assistance", the accomplishment 

of which he personally carefully 

surveyed, was comprised of 10 medical 

specialty offices, 60 beds, a pharmacy and 

two laboratories, and was cited as a model 

institution by the Sanitary Department of 

the League of Nations in Geneva. [10] 

To the hospital, a popular Athénée for 

educational programs, a cinema, a park and 

a church were added. Gomoiu and other 

outstanding intellectuals gave conferences 

there, aimed at common people emancipation 

through culture and knowledge. 

Gomoiu was awarded the „Djuvara” 

prize for his lectures. The first meetings of 

the Romanian Society for the History of 

Medicine took place equally there. 

Sanitary education held a privileged place,


and focused on the fight against 

alcoholism, tabacco dependence, tuberculosis, 

pellagra, malaria, various 

infectious or job related diseases, hypnosis. 

It aimed at a science- and ethics-based 

comprehension of the surrounding world 

and facts. 

Similar lectures were given by Gomoiu 

at the "House of Light" cultural center in 

Turnu Severin. 

The «Vergului Complex» also known 

as the «Princess Elena Establishments», 

was directed by Dr. Gomoiu until 1948, 

when it was nationalized, immediatly after 

the King`s forced abdication and leave for 

exile. 

Victor Gomoiu also founded several 

tuberculosis preventoria on the Teleajean 

Valley, at Brebu and Mâneciu-Ungureni, 

the latter bearing now his name 

(«Dr.Gomoiu» Preventorium), two others 

at Baba Runca and �an�uri, not far from 

Bra�ov, and one in Mangalia at the seaside. 

[10] 

A school was named after him at Vânju 

Mare, his birthplace and his bust by Ilie 

Berindei stands today in front of this 

college. 

Following World War II, the «Princess 

Elena» Establishments had to be renamed 

"Saint Helen" and after the «storm of 

nationalization», they became the "30 th 

December" Pediatric Hospital. [6, 7] 

The latter denomination was a token of 

the historic proclamation of the republic in 

1947. 

In 1990, after the 1989 Romanian 

Revolution, the Hospital was rebaptised in 

the name of «Dr.Victor Gomoiu». In 2004, 

it was enlarged and updated. 

It presently counts 184 beds, 

departments of pediatric internal medicine, 

neurology, otorhinolaryngology, two 

compartments of intensive therapy units 

and an external section for disabled 

children. 

Dr. Gomoiu, historian of medicine 

and sciences 

In 1929, Dr. Gomoiu founded the 

Romanian Royal Society for the History of 

Medicine, Pharmacy, Veterinary Medicine 

and Medical Folklore (RSHM), another 

visionary attempt of this true «Knight of 

the Sad Figure» of his time. 

Between 1929 and 1946, Dr. Gomoiu 

was general secretary, president and 

honorary president of the RSHM. The 

Society had also a valuable Museum, 

decommissioned after 1947. [7] 

Valeriu Bologa, a well known 

Romanian historian of medicine, too, 

confessed in his study “Wheat Grains” 

(“Boabe de grâu”) that he himself thought 

Gomoiu`s intention of creating a 

Romanian Society for the History of 

Medicine was quite unrealistic since rather 

few medical historians existed by then in 

the great academic centers of Romania: 

Bucharest, Cluj and Ia�i. 

Time instead proved that Gomoiu was 

right and his efforts paid off. Professors 

Constantin D. Severeanu (1840-1930), the 

1 st RSHM president, and Ioan Cantacuzino 

supported Gomoiu and the young RSHM. 

[6, 10] 

In 1932, the RSHM was entrusted with 

preparing the IX th Congress of the 

International Society for the History of 

Medicine (ISHM), to which it was 

affiliated. 

This first congress took place in 

Romania, in Bucharest. The renowned 

historian Nicolae Iorga (1871-1940) was 

directly involved in the manifestation as its 

vice-president. Gomoiu, as president, and 

his wife, as general secretary, were the 

main organizers of this event. Professor 

Cantacuzino (1863-1934), minister of 

health (1931-1932), was then the RSHM 

president. 

The Bucharest Faculty of Medicine 

partly tempted to boycott the RSHM and 

the Congress, but King Carol II`s support

142 


granted the final success of the meeting. 

(7) The King opened the Congress in state, 

as president of honour. [11] 

Subsequently, from 1933 to 1936, Dr. 

Gomoiu was elected vice-president, from 

1936 to 1946, president and then from 

1946 to 1960 honorary president of the 

ISHM. [1, 6, 11] 

He equally was member of about 50 

national and international scientific 

societies and academies. (6, 10) Along 

with the mathematician Petre Sergescu 

(1893-1954) and the physician Valeriu 

Bologa (1892-1971), he belonged to the 

National Group who represented Romania 

to the International Academy for the 

History of Sciences (IAHS) [2, 3, 6] 

Concurrently, he was member of the 

International Union for the History of 

Sciences (IUHS). [6] 

In 1937, Gomoiu became corresponding 

member, and in 1947 effective 

member of the IAHS. [2, 3] 

This society established by Aldo Mieli 

(1879-1950) in Paris, in 1929, numbered 

six other founder-members: Abel Rey 

(philosopher), George Sarton (chemist), 

Henry E. Sigerist (physician), Charles 

Singer (physician), Karl Sudhoff 

(physician), Lynn Thorndike (historian). 

All these three physicians were 

celebrated historians of medicine with 

whom Professor Victor Gomoiu 

collaborated. 

In 1936, the VIII-th IAHS Meeting (1- st 

IAHS extraordinary international meeting 

or «little congress») took place in 

Bucharest and Cluj, organized by the 

Romanian Group, as mentioned in the 

Academy`s journal ”Archeion” (1936, 18: 

204-226). 

The RSHM held a solemn session on 

Appril 15, 1936 in Bucharest, on this very 

occasion. In 1981, Bucharest hosted the 

XVI- th International Congress of the IAHS, 

too. [2, 3] 

A dedicated historian of medicine, Dr. 

Gomoiu was also a skilled and inventive 

surgeon and devoted anthropologist. Many 

of his papers were awarded important 

prizes. [6, 10] 

Victor Gomoiu and Petre Sergescu 

Gomoiu was particularly close to Petre 

Sergescu. 

Native of the same Mehedinti County, 

member of the Romanian Academy 

(1937), president of the IAHS (1947- 

1950), after having been its vice-president 

(1937–1947) and future executive 

secretary of the IUHS (1947–1954), 

Sergescu replaced Mieli as IAHS perpetual 

secretary in 1950. He was director of the 

collection «Travaux sur l’histoire des 

mathématiques» in Paris and chief editor 

and director of the «Archives 

Internationales d’Histoire des Sciences, la 

Nouvelle Série d’Archeion». «Archeion» 

journal, Mieli founded in 1927, continued 

his «Archivio di Storia della Scienza», first 

edited in 1919, in Rome. [2, 3] 

Sergescu exiled himself to France when 

communists ascended to power in 

Romania. His secretary, René Taton 

(1915-2004) helped him overcome 

censorship and keep in touch with Gomoiu 

and Romania. [7] 

Dr. Gomoiu and Balkan countries 

Dr.Gomoiu developed friendly 

relationships with Balkan countries and 

their representatives to the ISHM. 

He devoted medical historical studies to 

Balkan traditional medicine, since archaic 

ethnomedicine survived longer in this part 

of the world and shared related elements 

and mentality patterns. 

In 1932, during the IX-th ISHM 

Congress in Bucharest he envisaged the 

foundation of the «Centre for Medical- 

Ethnographic Studies in South-East 

Europe». 

One of Gomoiu`s supporters was Ioan


Cantacuzino, member of the Romanian 

Academy and president of the RSHM, by 

then. Gomoiu`s attitude earned him the 

titles of honorary member of the Greek 

Society for the History of Medicine 

(Athenes, 1932), honorary member of the 

Association of the Serbian, Croatian and 

Slovene Physicians (Zagreb, 1933), 

member of the «Hippocrates» Society in 

Belgrad (1939); honorary member of the 

Turkish Society for the History of 

Medicine (Istambul, 1940). [6, 10] 

Resistance and correspondence 

After 1946, Dr.Victor Gomoiu was 

marginalized by the communist regime. 

He ostentatively refused to integrate the 

new political and ideological realities of 

his country, even though he turned down 

the royal family`s proposal to accompany 

them in their exile. 

He simply tried to resist imposture and 

fight for his country and people, for his 

credo, to the end of his life, assuming the 

supreme sacrifice. [7] 

Immediately after 1945, communists 

imposed their own rigorous laws. 

Opposing psychological pressure and 

ostracization, Gomoiu maintained his 

correspondence with former friends and 

collaborators: Tricot-Royer, Giordano, 

Siegerist, Castiglioni, Diepgen, Pazzini, 

Guiart, Verhoeven, Sergescu. 

Letters were censored and details had to 

be unvoiced or subtly implied. Western 

correspondents had a faint idea about what 

was going on beyond the iron curtain. 

When addressing colleagues from the 

communist camp, e.g., Bulgaria or 

Yugoslavia, Gomoiu`s language became 

more sympathetic and even direct. [7] 

They were experiencing a similar tragedy. 

Behavioural paradigms and the 

lessons of history 

Victor Gomoiu`s memoirs reveal his 

disappointment that under the particular 

post- 

World War II circumstances, Valeriu 

Bologa had chosen a different, more 

“materialistic” way. [7] 

Bologa bowed to political pressure and 

advised Gomoiu to accept reality. But for 

Gomoiu «moral death seemed more 

serious than physical decay». 

It was unbearable for the intransigent 

Gomoiu who, to metamorphosing into a 

«new man», preferred martyrdom and the 

final «judgement of history» which gave 

him a sense of relief. Bologa, instead, 

coped with the new social order and 

political rules. 

Gomoiu exceptionally pioneered and 

sanctioned medical historical research in 

Romania; Bologa exceptionally developed 

this domain and became a reference author 

of classic writings and of the first 

handbooks. 

President of the RSHM (1949-1971) 

and vice-president of the ISHM (1964- 

1970), Bologa organized in 1970 the 

XXII nd ISHM Congress in Bucharest and 

Constantza, the second of this kind in 

Romania. 

Which was the right choice for 

intellectuals under «the terror of history»? 

This still is both a Romanian and Balkan 

dilemma, another tragic «riddle of 

history». 

References 

[1]. Bologa V. L., Br�tescu G. et al., Istoria 

medicinei române�ti, Ed. Medical�, 

Bucure�ti, 1972. 

[2]. Colan H., Petre Sergescu, historien des 

sciences ou la fascination de la 

générosité, à travers quelques 

souvenirs, Noesis, Académie 

Roumaine, 2006, 30-31: 195-204. 

[3]. Colan H., Bref historique du 

développement de l’histoire des 

sciences et des techniques en 

Roumanie. Noesis, Académie 

Roumaine, 2002, XXVII: 95–100.

144 


[4]. Constantin Gh., �erbu M., Mini�trii de 

interne (1862-2007) – mic� enciclopedie, 

Ed. Ministerului Internelor 

�i Reformei Administrative, 

Bucure�ti, 2007: 252. 

[5]. Deletant D., Memoriul unor 

intelectuali români c�tre Palat în vara 

1942, Sfera Politicii,2004,107:49-53. 

[6]. Du�escu B., Victor Gomoiu, Ed. 

Medical�, Bucure�ti, 1970, 103. 

[7]. Gomoiu V., Memorii (vol. VI), Ed. 

Sitech, Craiova, 2006-2007, 167- 

285. 

[8]. Iancu �t., Dezvoltarea �tiin�ei �i 

tehnicii în perioada interbelic�, 

Noema, 2003, II, 2: 130- 133. 

[9]. Priminescu R. M., Evolu�ia activit��ii 

institutelor de cercetare, reflectat� în 

documentele fondului arhivistic 

na�ional, Noema, 2009, III: 550-566. 

[10]. Scheau M, Olaru A, Simpozion 

Victor Gomoiu, Universitatea 

Craiova, 1972. 

[11]. Sondervorst F. A., Backward Glance 

at the International Society for the 

History of Medicine 1920-1982, 

www.bium.univparis5.fr/ishm/eng/hist 

[12]. Târcoveanu E., Ernest Juvara, J Chir, 

Iasi, 2005, 1, 4: 469-475.




THE ASPIRIN – THE FIRST DRUG 

OBTAINED BY SINTHESYS – 

FREQUENTLY USED CURRENTLY 

A. B�LESCU 1 L. NEDELCU 1 

Abstract: Hippocrates mentions the use of a bitter powder, obtained 

from willow bark to ease the pains and the fever. 

In 1828 the apothecary Henri Leroux and the chemist Raffaele Piria 

succeed to isolate under the crystalline form the salicin from the 

willow bark. The saturated water based solution has a pH of 2.4 

which gives the acidity and is known as the salicylic acid. The irritant 

effect of the salicin on the stomach is recorded in 1839. 

By replacing, in 1897, a hydroxyl group from the salicylic acid with 

an acetyl group, the negative effects on the stomach are significantly 

reduced thus the resulting acetyl salicylic acid. The acetyl salicylic 

acid (Aspirin) is the first drug obtained through synthesis in 1897, but 

of the inventor there are doubts. Officially, Felix Hoffman is 

considered the inventor of the aspirin but this right is claimed also by 

Arthur Eichengrun. 

Since many years, the aspirin is used as an analgesic, antipyretic or 

anti-inflammatory, but it was proved to be efficient as antiplatelet 

effect or in the prevention of the pancreatic cancer, the decrease of 

the relapse risk of the rectal or colonic cancers, the prevention of 

some types of cataract and the prevention of severe migraines. It has 

come into prominence that a reassessment of the current indications 

and contraindications is needed 

Key words: Aspirin, history of the discovery, role. 

Acidum Acetylsalycilicum, the well known 

aspirin is the first drug obtained by synthesis 

while being the most used, with the longest 

lasting commercial success, being considered 

the most popular drug of the modern era. 

The oldest written accounts of the 

curative properties of the willow bark 

extract are from the Sumerian civilization. 

The therapeutic properties of the willow 

have been discovered by chance as many 

other scientific discoveries. 


Similar accounts have been found in 

Egyptian papyruses translated and published 

in 1875 by Georg Ebers who bought them in 

1869 from Edwin Smith, a passionate 

American historian and archeologist. The 

papyruses describe a number of other 

remedies and curative practices used in 

antiquity: turtle shells, snake skins, milk, 

myrtle, figs, and dates [2]. Many of these 

remedies have kept their use even when 

Egypt was part of empires.

146 


Hippocrates, the most renown and 

important Greek medical practitioners, was 

recommending the willow bark for 

diminishing the birth pains and the fever. 

In ancient Rome, Celsius was using the 

willow leaf extract for treating fever, pains, 

swallowing and inflammation. 

Pedanius Dioscorides, a Nero era 

botanist, writes about the therapeutic 

potential of the willow in the book: “De 

Materia Medica”, which was kept in the 

Arab translation. 

Claudius Galen has studied in Egypt and 

after he used to treat the gladiators in 

Greece, afterwards he uses his medical 

knowledge at the emperor’s Marcus 

Aurelius court. He was recommending the 

willow for moderate pains. 

A long period of time the medical 

knowledge as many of the initially used 

remedies were forgotten or ignored. 

There have been trialed other remedies 

and in 1763, in England, the therapeutic 

properties of the willow have been noticed 

in the fever decrease by the reverend 

Edmund Stone. He administered the 

willow bark extract to 50 feverish persons, 

observing a decrease of the fever. 

Later research discovered the active 

principle from the willow bark, the salicin. 

The Italians Brugnatelli and Fontana have 

isolated, in 1826, the impure willow bark 

extract but have failed to demonstrate the 

link between this extract and its 

pharmacologic effects. The salicin was 

isolated in its pure state, in crystalline 

form, in 1828 at the University of 

München by Johann Büchner. 

In 1829, Henri Leroux improvised a 

method to extract salicin from the willow 

bark and obtained 30 grams of salicin from 

1.5 kilograms of bark. The obtained salicin 

has adverse effects (gastric pains and 

diarrhea) which prevented it to be used 

with a therapeutic aim. 

In 1838, Raffaele Piria, Italian chemist, 

managed to separate salicin and to obtain 

the salicylic acid. The saturated water 

solution of salicin has a pH of 2.4 thus a 

high acidity and is known as salicylic acid. 

The irritative effect of salicin on the 

stomach was mentioned in 1839. 

In 1853, the French chemist born in 

Alsace Charles Frederic Gerhard managed 

to synthesize the pure salicylic acid. 

Felix Hoffman is considered the inventor 

of the aspirin, replacing a hydroxyl from 

the salicylic acid with an acetyl chain 

obtaining acetyl-salicylic acid (1897). By 

changing the chemical structure the 

negative effects on the stomach were 

significantly reduced. Felix Hoffman 

tested the antalgic and anti-inflammatory 

effects on his father. 

The acetyl-salicylic acid is considered 

the first sensitized drug. 

Arthur Eichengrün claimed the rights to 

the aspirin invention because he has 

overseeing the team work from which 

Felix Hoffman was part. 

The Eichengrün version is sustained by 

Walter Sneader, Professor at Strathclyde 

University in 1999. 

However the French consider that 

Charles Frederic Gerhard is the inventor of 

the aspirin by isolating the pure state 

salicylic acid. 

After the defeat of Germany in 1918, the 

Allies have confiscated and sold the Bayer 

facilities and the exclusivity over the 

Aspirin trade mark. The buyer was the 

American firm Sterling that makes and 

sells in the USA and Canada the acetylsalicylic 

acid under the name generic name 

of Aspirin. 

In 1950 the aspirin was included in the 

Guinness Book of records as the most 

common analgesic in the world. No other 

drug was frequently used as the aspirin. 

The prescriptions for the use of aspirin are 

well known [6]: 

• Analgesic – in the treatment of low and 

moderate pains (muscular, joint, dental 

and menstrual pains and headaches);

A. BALESCU et al: The Aspirin- The First Drug Obtained by Synthesis - Frequently Used Currently 147 

• Antipyretic; 

• Anti-inflammatory – the treatment of 

acute articular rheumatism and other 

acute inflammatory diseases; after 

1950, by discovering other drugs 

with analgesic, antipyretic and antiinflammatory 

actions the aspirin had 

major competitors; 

• As an antithrombotic agent – in the 

prophylaxis of acute myocardial 

infarction, acute angina, transitory 

acute angina and ischemic cerebrovascular 

stroke; in 1971 the pharmacist 

John Robert Vane proves the effects of 

the aspirin on prostaglandins [2] and 

the antithrombotic effect of the aspirin, 

fact that determines the use in the 

prophylaxis of cardiovascular diseases, 

this being the moment of the 

commercial revival of the aspirin; at 

the European Society of Cardiology 

Congress, in Barcelona, 2009, were 

described the results of studies done in 

Scotland on 29000 persons with ages 

between 50 and 75 followed for 8 

years; the conclusions suggest that the 

aspirin should not be prescribed to the 

general population because the healthy 

persons that take aspirin do not reduce 

their cardiac risk but increase their 

hemorrhagic risk [4]. 

• As antithrombotic agent – in the 

treatment of cardiovascular cerebrovascular 

diseases; it is ascertained 

the favorable effect in the secondary 

prevention of those diseases; but in 

the case of the primary prevention 

the benefit from administering 

aspirin are annulled by the high risk 

of cerebral hemorrhage [3]. 

Recently it was confirmed that the 

aspirin has n important role also in: 

• Pancreatic cancer prevention – the 

results of some epidemiologic 

studies suggested that aspirin can 

reduce the risk of pancreatic cancer, 

but this conclusion is not fully 

endorsed; research conducted on 

987,590 persons with a evolution 

followed for 18 years (1982-2000) 

demonstrated that the sue of aspirin 

with the purpose to reduce the 

pancreatic cancer incidence or the 

mortality caused by it does not have 

a significant effect [1]. 

• The prevention of hepatic diseases 

caused by alcohol and medication 

overdose – a study done by Yale 

University shows that daily use of 

aspirin is preventing hepatic 

diseases; for prevention a daily dose 

of aspirin is recommended and if the 

lesions are already present it is 

recommended the administering of 

immune stimulant substances; 

• Decrease of relapse risk for colon 

and rectal cancers [3]; the 

mechanism of action of the aspirin 

on tumor development is not well 

known, it is considered that some 

aspirin doses act at endothelial level, 

controlling the development of the 

blood vessels and implicit the 

development of the tumor; these test 

have been done only at a laboratory 

level and are necessary studies to 

confirm this hypothesis; 

• The prevention of some types of 

cataract – research done by the Yale 

University shows that the salicylic 

acid is capable to prevent or delay 

the onset of the cataract, acting on an 

enzyme involved in the sorbitol 

creation in the crystalline; 

• Prevention of severe migraines; 

• Prevention of obesity; 

• Effects on arterial tension – aspirin 

administered in the morning 

increases the arterial tension and in 

the evening decreases the arterial 

tension; 

• The association of aspirin with 

caffeine and ephedrine can have a 

positive influence on the

148 


development of the muscular mass 

and the reduction of the fatty tissues; 

this association has the advantage of 

lipolysis stimulation and decrease of 

protein use in the energy production 

with the disadvantage of heart rate 

increase and muscular tremor [5]. 

The efficiency and safety of aspirin 

administering in cardiovascular prevention 

has been evaluated by including in the 

study a population group with apparently 

healthy persons and persons with 

myocardial infarction or stroke. On 

patients with occlusive vascular disease the 

individual studies and randomized trials 

showed that small doses (75-162 mg/day) 

decrease the risk of serious cardiovascular 

events with 25% [3]. Studies on a group of 

95000 persons with low to medium risk 

confirm that the preventive use of aspirin 

reduces with a fifth the myocardial 

infarction risk without significantly 

influencing the stroke risk and the stroke 

mortality. 

There are studies that show the effect of 

the aspirin being dependent on age and 

sex. Research in aspirin intake for primary 

prevention significantly reduces the 

myocardial infarction risk in men without 

reducing the vascular risk. In women, the 

aspirin lowers the vascular risk but has no 

significant influence on myocardial 

infarction risk. The variations dependent 

on sex on the secondary prevention have 

not been demonstrated [3]. In general 

elderly people and women have higher 

hemorrhagic risk but this predisposition is 

not influencing alone the personal safety 

when administering aspirin. The 

association with other drugs (statins and 

anti thrombosis drugs) can decrease the 

risk of cardiovascular events. The benefits 

of associating aspirin with other drugs in 

the secondary prevention of cardiovascular 

events are ascertained [3]. 

Some studies show that associating 

aspirin with vitamin C is an efficient 

treatment against viral infections but 

administering aspirin during flu can be 

harmful. Using aspirin and other salicylate 

based drugs in treating flu can lead to Reye 

syndrome. This syndrome affects children 

between 4 and 16 years of age and when 

the flu is epidemic. 

The 20 th century was surnamed the 

aspirin century. Aspirin represented the 

subject of over 3000 scientific papers. 

The annual quantity of aspirin is 50000 

tons (20 tablets /person). 

The daily use of aspirin is 100000000 

tablets. 

References: 

[1]. Jacobs, E.J., Connel, C.J., Rodriguez, 

C. Et al: Aspirin use and pancreatic 

cancer mortality in a large United 

States cohort. In: Journal of the 

National Cancer Institute Vol. 96(7), 

2004, p. 524-8. 

[2]. Jeffryes, D.: Aspirin - The 

Extraordinary Story of a Wonder 

Drug, Bloomsbury Publishing PLC, 

2005. 

[3]. Montalescot, G.: The major risk of 

aspirin as with all NSAIDs, is 

bleeding,. In: ESC Congress 

Barcelona, 2009. 

[4]. Patrono, C.: While the benefits of 

aspirin exceed the risk/benefit ratio is 

marginal in low-risk populations. In: 

ESC Congress Barcelona, 2009. 

[5]. �erban D.: Efedrina + Cofeina + 

Aspirina = Combina�ie reu�it� în 

eliminarea masei adipoase �i în 

dezvoltarea muscular�. Available at: 

http://www.doctor.info.ro/eca.html. 

[6]. x x x- Agenda medical�. Editura Medical� 

Bucure�ti, 2007.




HIPPOCRATES’ MEMORIES OF SCYTHIA: 

STORIES AND FAIRYTALES 

�. DIAMANDOPOULOS 1 

Abstract: This presentation will deal with Hippocrates’ journey to Scythia 

and with medical and general observations on that country and its people. 

The bulk of this information is derived from his work “On airs, waters and 

places” which is generally regarded as authentic. It is a comprehensive study 

of ethno-geography, correlating the medical problems of residents with 

climate changes, the political situation and the psychological aspects of their 

personality. 

We thought that an interesting way to present this would be in the form of a 

story, both because the country itself was considered legendary, and because 

its people - men and women – that invaded Greek myths and the descriptions 

by Greek authors were reminiscent of fairytales. 

We thus see that Scythia, a faraway country, unknown and charming, had, 

long before Hippocrates’ visit, penetrated Greek thought through mythology, 

religion, commerce and art and the descriptions of contemporary travellers, 

like Herodotus. 

It should be noted here that certain historians are unconvinced that he 

travelled to Scythia and believe, instead, that he describes the impressions of 

another. His work, however, “On airs, waters and places”, is believed to be 

authentic. It begins with a description of this nation, writing that “What is 

called the Scythian desert is prairies, rich in meadows, high-lying, and well 

watered; for the rivers which carry off the water from the plains are large. 

There live those Scythians which are called Nomades, because they have no 

houses, but live in wagons. The main diseases they suffer from are infertility 

and testicular atrophy. 

The love, admiration and cultural affinity that the locals feel for the Greeks 

are still as pronounced as we suppose and hope it was when Hippocrates 

visited them to write his “On airs, waters and places” 

Key words: Hippocrates, Scythia, Herodotus, Testicular atrophy, Scythian 

legends 

Introduction 

Usually, when one speaks of 

Hippocrates, at least to his admirers, not 

dissenters, he will mention that “He was 

the first who separated medicine from 

religion and laid the foundations of 

scientific medicine. He is considered as the 

Father of Medicine” and such similar 

1 Past –President ISHM, Greece. 

laudatory statements. 

As if he was a meteorite that fell from 

the sky and illuminated the hitherto 

superstitious and obscurantist medicine. If 

the speaker is more educated on the matter, 

he will try to mention his intellectual 

ancestors, namely the Pre-Socratic 

philosophers and scientists. In a more in-

150 


dept analysis, he would comment on the 

cultural or political climate during 

Hippocrates’s era, which allowed his 

creative output. Pretty much though, we 

will experience an attempt to link the 

Father of Medicine in the Golden Age and 

its various exponents, such as Socrates and 

Plato, Pericles and Pheidias. 

This review approach is rarely extended 

beyond the Greek space. So, we thought 

that, in this open and productive event of 

the IV-th Balkan Congress of History of 

Medicine and the VII-th National Congress 

of History of Medicine we should dare 

something quite different. 

To present the political and cultural 

environment of regions we know, with 

certainty or even with some doubts that he 

visited, outside the Greek territory. 

To proceed, that is, a more international 

description of said environment. 

Material 

This presentation will deal with 

Hippocrates’ journey to Scythia and with 

medical and general observations on that 

country and its people. 

The bulk of this information is derived 

from his work “On airs, waters and 

places” which is generally regarded as 

authentic. 

It is a comprehensive study of ethnogeography, 

correlating the medical 

problems of residents with climate 

changes, the political situation and the 

psychological aspects of their personality. 

I thought that an interesting way to 

present this would be in the form of a 

story, both because the country itself was 

considered legendary, and because its 

people - men and women – that invaded 

Greek myths and the descriptions by Greek 

authors were reminiscent of fairytales. And 

even perhaps because we were often 

narrated the life and works of Hippocrates 

as a tale. 

I will not delve into the general reasons 

Hippocrates acquired a mythical dimension 

in the public mind soon after his death and, 

perhaps, even more so today. 

He competes only with Alexander the 

Great who through the century-old popular 

book Phyllada, became a favourite story in 

East and West alike. 

I will present first, only a few 

Illustrations from three beautiful medieval 

manuscripts. 

Illustration 1 

The left side of the first Illustration 

shows the delegation of Queen Saracinthe 

visiting Hippocrates’ grave somewhere in 

Greece. Saracinthe was supposed to have 

been converted to Christianity by Joseph of 

Arimathea. 

The Hippocratic shrine was decorated 

with crosses, which makes sense, as in the 

Middle Ages the Father of Medicine was 

considered more or less a Christian. I do 

not know if the finding of the actual tomb 

of Hippocrates in Greece in the early 19th 

century is any less mythical; the upper 

right side of the Illustration shows the 

same scene in another manuscript that we 

will analyse later. 

The tale culminates with the fabled 

discovery in Hippocrates’s tomb of an 

ivory box, containing the work “The Book 

of Prognostics”, which was in fact written 

seven hundred years after Hippocrates’s 

death, a predictive text on dermatological 

lesions. 

In the centre of the Illustration, we see 

an Arabic copy of the work from the 13th 

century. 


The tale becomes extravagant, when, 

the same manuscript, from the Circle of the 

“Holy Grail”, shows Hippocrates treating 

the nephew of Emperor Augustus (who 

lived half a millennium later). 

The good doctor then stayed at in 

Rome, got involved in a love affair and hid

�. DIAMANDOPOULOS: Hippocrates’ memories of Scythia: Stories and Fairytales 151 

in a hanging basket to visit his illicit lover, 

as shown on the right side of the image. 

Given that such fictitious follies on a 

fully documented historical person were 

largely credible, particularly in the West, 

we can see the room for the fantastic that 

folk tales about distant and unknown 

countries, like Scythia, allowed. 

Let us try to understand this place. 

Starting from the land, this is a fabulous 

area with dark woods, mist, dragons and 

fairies. But let us define it geographically. 

It is a huge land, north of the Black Sea. 

Scythia’s location and size varied over 

time, from the Altai Mountains where 

Mongolia, China, Russia, and Kazakhstan 

meet, along southern Ukraine to the area of 

the lower section of the Danube, Bulgaria 

and Georgia. The Chinese called the Sake 

(Asian Scythians) Sai. Scythia was noted 

for its large rivers like the Don, which 

formed its main communication routes, 

and its many high snow-capped mountains, 

which were responsible for the ever-lasting 

cold in the country. Its people, the 

Scythians were tribes of undefined origin. 

They were first referred to in Assyrian 

codes of the 7 th century BC. 

After many adventures, they left for the 

above areas where they lived as nomads 

for centuries. 

Both men and women were excellent 

equestrians and warriors. More about these 

fearless women will be said in the body of 

speech on Hippocrates’ medical 

information. Later, the Scythians come in 

contact with the Greek colonies of the 

Black Sea; have extensive commercial, 

political and cultural contact with them and 

are partly urbanised. 

Typical cultural elements of the 

Scythian civilisation include abundant 

scattered mined tombs containing 

impressive gold jewellery. It fact, it was in 

the broader area of Scythia that the 

Argonauts found the Golden Fleece, 

where, according to Pausanias, the land 

produced vast quantities of gold, guarded 

by the mythical sphinxes, creatures with a 

female body, a lion’s head and griffin 

wings. From the 4th BC century, we can 

talk about two different groups, those who 

live in northern Scythia and continue their 

traditional lifestyles and those of the 

South, who are somehow Hellenised. 

From the culture of the first group, we 

present in the next Illustration, an 8th 

century bronze buckle and a gold Panther, 

while, from South Scythia a golden comb 

with Greek influences. 

This influence is most obvious in works 

from the Greek commercial cities of the 

North Black Sea, as shown by the 

comparison between leaden bull head from 

their religious worship centre near Olvia of 

Scythia and similar relief heads from the 

base of a marble column in the sanctuary 

of Delos. 

As time goes by, the Greek influence 

becomes more striking, as shown by A 

Scythian coin of the 1st century BC, which 

brings to mind Cavafy’s poem on 

Orophernes, son of Ariarathus. 

Before applied art however, religion 

had introduced Scythia in the cultural 

subconscious as a distant country that 

raised gods or as a place of exile imposed, 

again by the gods. 

From the time lost in the mists of myth 

it was said that the father of Uranus, that is 

the great-grandfather of Zeus, was born in 

Scythia. Uranus’ father was Acmon of 

Scythia. That was where the northernmost 

gods were born. 

The son of Hercules, Scythis, became 

king of Scythia. Prometheus was exiled to 

Scythia, where Iphigenia was also taken, in 

specific to Tauris, when the goddess 

Artemis took her in a cloud from Aulis to 

spare her from being sacrificed. 

In his tragedy “Iphigenia in Tauris”, 

Euripides beautifully describes the moment 

when Orestes recognizes his sister at the 

sanctuary: “During the preparatory ritual,

152 


Orestes started talking with Iphigenia in 

Greek; to their great joy, they quickly 

discovered who they were. 

When she learned of the purpose of his 

mission, she immediately pulled down the 

statue from its pedestal so that Orestes 

could take it... According to this version, 

the ship finally moored in Vravrona, where 

Iphigenia placed the statue and, while the 

temple was being built, followed Orestes to 

Delphi. At the sanctuary of Delphi she met 

Electra, brought her back to Athens and 

wed her to Pylades” (9). 

A similar description exists in the third 

hymn of Callimachus. 

The area was also visited by Herodotus, 

who provides us with extensive 

descriptions of its geography, inhabitants 

and diseases that complement the picture 

that emerges from the work of 

Hippocrates. 

His work is believed to have been 

written around the same time with 

Hippocrates’ “On airs, waters and places”, 

although it seems that neither of the two 

authors knew of the other’s book. 

At the end of his “Histories”, the Father 

of History attributes the self-indulgence of 

Asians to the stable climate, while, 

regarding the Scythians, he is mainly 

concerned with the relationship between 

the local geologic and climatic conditions 

and their war tactics, than with their 

ordinary diseases. 

A similar method was later used by the 

Romans to explain the martial arts of 

Germans living in similar conditions with 

the Scythians. 

An early description by Herodotus of 

the use of cannabis by the Scythians is of 

particular interest to the history of 

medicine. 

According to many linguists, the word 

cannabis itself is of Scythian origin. In 

book four of his “Histories”, Herodotus 

describes the ritual use of cannabis after a 

funeral “[...] 

The Scythians, as I said, take some of 

this hemp-seed, and, creeping under the 

felt coverings, throw it upon the red-hot 

stones; immediately it smokes, and gives 

out such a vapour as no Grecian vapourbath 

can exceed; the Scythians, delighted, 

shout for joy”. 

The History of Herodotus was 

confirmed by archaeological findings, 

when, in 1292, Professor SI Rudenko 

unearthed, in a tomb in Pazryk, in the 

Western Altai area, a device for its use and 

cannabis seeds. 

Herodotus also mentions the story of 

Anacharsis, a young noble Scythian who 

travels to many countries, including 

Greece, is impressed by its customs and 

tries, in vain, to introduce them to Scythia, 

where he is murdered. In his Panegyricus, 

Isocrates (436-338 BC) states that the 

Scythians are the most powerful and 

majestic people. (Panegyricus 67, 08 -5) 

We thus see that Scythia, a faraway 

country, unknown and charming, had, long 

before Hippocrates’ visit, penetrated Greek 

thought through mythology, religion, 

commerce and art and the descriptions of 

contemporary travellers, like Herodotus. 

Although still regarded as semibarbarous, 

contacts with Greece constantly 

increased. Therefore, it was not surprising 

that Hippocrates travel there, nor that he 

did not be feeling alienated or treated as a 

curiosity. It should be noted here that 

certain historians are unconvinced that he 

travelled to Scythia and believe, instead, 

that he describes the impressions of 

another. 

His work, however, “On airs, waters 

and places”, is believed to be authentic. It 

begins with a description of this nation, 

writing that “What is called the Scythian 

desert is prairies, rich in meadows, highlying, 

and well watered; for the rivers 

which carry off the water from the plains 

are large. There live those Scythians which 

are called Nomades, because they have no


houses, but live in wagons. […] In these 

wagons the women live, but the men are 

carried about on horses, and the sheep, 

oxen, and horses accompany them; […]. 

They eat boiled meat, and drink the milk of 

mares, and also eat hippace, which is 

cheese prepared from the milk of the mare. 

[…] the Scythian race, like the Egyptian, 

have a uniformity of resemblance, different 

from all other nations. […] The changes of 

the seasons, too, are not great nor violent, 

for, in fact, they change gradually; and 

therefore their figures resemble one 

another, […]. 

For these reasons their shapes are gross 

and fleshy, with ill-marked joints, of a 

humid temperament, […] I will give you a 

strong proof of the humidity of their 

constitutions. You will find the greater part 

of the Scythians, and all the Nomades, 

with marks of the cautery on their 

shoulders, arms, wrists, breasts, hip-joints, 

and loins, and that for no other reason but 

the humidity and flabbiness of their 

constitution, for they can neither strain 

with their bows, nor launch the javelin 

from their shoulder owing to their 

humidity and atony: […] and as to the 

women, it is amazing how flabby and 

sluggish they are. The Scythian race are 

tawny from the cold, and not from the 

intense heat of the sun, for the whiteness of 

the skin is parched by the cold, and 

becomes tawny”. 

The main diseases they suffer from are 

infertility and testicular atrophy. 

Hippocrates attributes the first to the 

years thee spend horse-riding, which 

hardens the outer genitalia and the heavy 

clothes they wear because of cold that 

prevent even the palpation of the male 

genitalia and therefore their sexual 

stimulation. 

Relating to the above is an incised 

decoration in an amber vase from the 

Kul’Oba region, now in the Hermitage 

Museum in St. Petersburg. Regarding the 

women, he assumes that their infertility is 

due to their obesity, which prevents the 

sperm from reaching the vagina 

unobstructed. Hippocrates brings as proof 

the fact that the female slaves of the 

Scythians who are thinner and more agile 

because of their constant activity, and bear 

children immediately when they come into 

contact with another man. 

However, the indigenous population 

attributes this testicular atrophy and 

accompanying eunuch-like conduct to a 

divine curse. For this reason, after they fail 

two or three times to impregnate a woman, 

they believe that their goddess cursed 

them, wear women’s clothing and engage 

in womanly occupations. 

Hippocrates however believes that the 

true cause is the phlebotomy of the 

posterior auricular vein, which they often 

perform. He believes that this vein is 

responsible for the creation of sperm. 

Hippocrates’ description of a feature 

unique to the race of the Scythians is also 

very interesting. That is, that their women 

ride and fight like men. In infancy, they 

cauterise their right breast so that they may 

be able to shoot comfortably with their 

arrows. They do not marry without first 

killing three enemies. These were the 

legendary Amazons, of we know much 

mainly through the mythological cycle of 

Theseus. 


In the third Illustrations we see first a 

scene from a vessel, with the battle 

between the Athenians under Theseus and 

the Amazons under Hippolyta, while in the 

next illustration we see a classical display 

of a wounded Amazon and, for 

comparison, a corresponding painting of 

1904, but in the next, militancy has been 

replaced by the love of Theseus for the 

Amazon Antiope. On the side however, 

Hercules continues his labours. 

Summing up the work of Hippocrates

154 


on the nosology of the Scythians, and more 

generally on the influence of climate on 

health, it should be noted that despite his 

many insightful comments, he did not 

entirely avoid ambiguities and generalities 

that raised controversy from a very early 

point. Already, his most ardent admirer, 

Galen, six centuries later, tried to reconcile 

the statements of his idol with his own 

knowledge. 

To this end, he wrote “Comments On 

airs, waters and places”, which was 

unfortunately lost. It exists only in a 

translation from Syrian by Hunayn ibn 

Ishaq (809-873 AD) 

Rather than end with the classic 

fairytale ending “they lived happily ever 

after”, I will present a brief overview of 

events after Hippocrates’ visit there and 

the exchange of cultural with Greek the 

area. In the early Christian era, it is said 

that St. Andrews visited Asia Minor, 

Byzantium and Scythia, where he preached 

Christianity in Kiev. 

From the later Byzantine period, we 

know of the wartime relations of the 

Byzantines with the Scythians. The famous 

miniature of Hippocrates donning 

Byzantine clothes, from the work of 

Ioannes Actuarius was dedicated to his 

patron, the Grand Duke Alexios 

Apokaukos, who is shown the next 

miniature. He was given this as a medical 

handbook to accompany him on his 

expedition against the Scythians. In an 

ironic twist of history, his daughter 

eventually married the brother of the 

Scythians’ ruler, Theodore. 

Being nomads and warriors, in 

subsequent centuries, the Scythians spread 

out in many directions so the effect of the 

Scythians on European civilisation is much 

more pronounced than generally believed. 

Most blue-eyed blond Europeans have, at 

some point in their history, attempted to 

prove their Scythian origin. 

This seems surprising at first, since 

these people, based mainly on reports of 

Greek and Roman historians, were 

considered synonymous with brutality. A 

book that published ten years ago attempts 

to collect all the European myths whose 

core originates from corresponding 

Scythian stories. 

In his King Lear, Shakespeare presents 

the Scythian as a cannibal who eats his 

children. Old English writers, who wanted 

to prove the superiority of their race over 

the Irish, held them as descendants of the 

Scythians based on a rumour that they 

drank human blood and were nomads. 

Not surprisingly, the other Celtic race 

of the British Isles, the Scots, also claimed 

a Scythian origin. As far back as 1320, the 

famous Declaration of Arbroath, signed by 

all the Scottish nobles and sent to the Pope, 

proudly advocates their Scythian origin, 

concluding that for this reason that they 

cannot tolerate an English king. 

Through a complex alleged genealogy 

tree, even the French kings of the 

Carolingian Dynasty proudly claimed that 

they descended from the Scythians. The 

romantic spirit of the 19th century 

identified the wild Scythian warriors with 

incorruptible democratic fighters, 

something like Cavafy’s barbarians, who 

would save mankind through the 

destruction of Rome. Tellingly, the French 

work of the Cycle of the Enlightenment 

“Voyage Du Jeune Anacharsis” written by 

Jean Jacques Barthelemy (1715-1795), 

which repeated the Scythian’s ancient 

admiration for the democratic structures of 

Classical Greece, was translated into Greek 

by Rigas Feraios. Similar claims are made 

in modern times by the Serbs, Croats and 

Lithuanians. Even the website of the the 

Australian Skopjans, who advance the idea 

of an Aegean Macedonia, features a map 

showing the supposed origin of all the 

peoples of the southeastern Balkans from 

the Scythians; the Skopjans see themselves 

are their legitimate successors. It was


natural for the Jews believe Scythians as 

their compatriots. They are supposed to 

originate from prisoners of the ten tribes of 

Israel who fled to the North Black Sea 

after the occupation of Babylon Aeschylus, 

Herodotus (Book 4, chapters 24, 46) and 

Strabo (Book 8, chapters 3, 7), and even 

Keating’s Irish history in 1723, “prove” 

that the Scythians were smart, excellent 

traders using a multitude of translators, 

honest and did not eat pork, “thus” Jews. 

Art provides objects that could be used as 

“evidence”. It is with this contribution of 

art in the understanding of the spread of 

the relationships of love and prejudice 

between Europeans and the Scythians that 

I will conclude. 


I present a series of illustrations of 

Sphinxes from various eras starting with a 

Classic Greek krater from Eretria showing 

a Sphinx and proceeding with a preclassical 

fresco from northern Iran, which 

shows a Scythian horseman behind a 

surprisingly similar Sphinx. Then a plate 

with the scene of Oedipus and the Sphinx 

and finally, we jump to the 19 th century, 

presenting, on the one hand a French gold 

and enamel buckle with the Sphinx and on 

the other a set of cast-iron railings from a 

19 th century mansion of Patras, now part of 

my personal collection. Please forgive me 

for finishing with an even more personal 

testimony: A photo of me from my visit to 

current Scythia, in Ukraine. I arrived at the 

city of Nizna, headquarters of the national 

benefactors Zosimades brothers, and, at the 

entrance of the school, I was welcomed by 

young students with Greek flags and 

evzone uniforms. The love, admiration and 

cultural affinity that the locals feel for the 

Greeks are still as pronounced as we 

suppose and hope it was when Hippocrates 

visited them to write his “On airs, waters 

and places”. 

References: 

[1]. Antiquities of the Jews, 11 .5.2, from 

The Works of Josephus, translated by 

Whiston, W., Hendrickson 

Publishers, 1987, 13th Edition. p.294 

[2]. Callimachus, Hymn 3 to Artemis 170 

ff (trans. Mair) 

[3]. Ernest Abel, 1980, Shaffer Library of 

Drugs Policy, Marihuana, the First 

12,000 Years. 

[4]. Esther Jacobson, The Art of the 

Scythians: The Interpenetration of 

Cultures at the Edge of the Hellenic 

World (Handbook of Oriental 

Studies, Vol 2. 

[5]. Euripides, Iphigenia in Tauris, 

Translation G. Ioannou, Kedros Publ. 

House, 1969, Athens 

[6]. Federico Borca, Luoghi, Corpi, 

Costumi. Determinismo ambientale 

ed etnografia antica. Roma: Edizioni 

di storia e letteratura, 2003. Pp. 161. 

ISBN 88 -84 98-1 

[7]. Galen’s Commentary on Hippocrates’ 

“On airs, waters and places”, Prof. 

Gotthard Strohmaier, 

www.manuscriptcenter.org/history/R 

esearches/Gotthard_Strohmaier.doc 

[8]. Herodotus, Histories, 4.74 

[9]. Herodotus, Histories, 9, 122, 3-4, 

[10]. Hippocrates, Law on art, “On airs, 

waters and places”, Translation: 

Pournaropoulos G., Publisher: 

Papyros, Athens 

[11]. http://www.apaclassics.org/AnnualM 

eeting/08mtg/abstracts/Romm.pdf 

[12]. Isocrates, Panegyricus, 67, 08 -5 

[13]. Karaberopoulos D., Rigas 

Velestinlis, The young Anacharsis, 

Vienna 1797 - Athens 2006, ISBN: 

960-87458 -3-7 

[14]. Scythians: From Wikipedia, the free 

encyclopaedia. 

[15]. Shakespeare, King Lear, Act One, 

Scene First. 

[16]. The New Encyclopedia Britannica,

156 


15th edition - Micropaedia on 

«Scythian», 10:576 

[17]. The Riddle of Edmund Spenser’s A 

view of the Present State of Ireland 

(c.15 96)’, in: History Ireland 

(Summer 1996). 

[18]. www.cannabisculture.com/.../jul95/s 

cythians.html




ONE OF THE FIRST ARTICLES ABOUT THE 

ROMANIAN ETHNO NATUROPATHY 

PUBLISHED IN A WESTERN SCIENCE PAPER 

WAS WRITTEN BY COLONEL DR. JAKOB 

VON CZIHAK AND DR. IOSEF SZABO 

E. G. BRODEL 1 C. IONESCU 2 

Abstract: Dr. Czihak, a highly decorated and high-ranking colonel doctor 

in the Moldavian army, originally from Germany, worked from 1827 to 1863 

in the principality of Moldavia. He earned a lot of respect there by helping 

both Moldavian society and the army to build up modern a medical 

educational system. He also was part of the early movement of writers who 

used the Romanian language in science and higher education. After his final 

return to Germany 1863, he wrote a remarkable article together with his 

friend Dr. Iosef Szabo, a pharmacist from Iasi, in the oldest and most famous 

scientific magazine of his time about the Moldavian flora. In this publication 

he gave us a deep insight into the ethnic naturopathic treatments and use of 

plants by the Moldavian and Walachian people. This was also one of the first 

publications in Western Europe where the Romanian language was used. On 

the other hand the article in the “Flora” was one of his last and largest 

publications in Western Europe referring to his work in Moldavia 

Key words: Flora, Czihak, Szabo. 

After more than 36 years of practice as 

a physician and service in the Army of the 

principality of Moldova as a high ranking 

officer, Dr. Jacob von Czihak returned to 

his motherland Germany and birth town 

Aschaffenburg [3]. 

Dr. Czihak helped with his personal 

involvement to build up the civil and 

military medical service of the principality 

of Moldova during the years 1827 to 1863. 

He was part of the movement working 

towards modernisation and change in the 

still medieval like society of the 

principality of Moldova during the first 

part of the 19 th century. 

One of the most interesting parts of his 

activities during this time in Moldova was 

the publication of one of the first scientific 

books, which was written in the Romanian 

language: “Historia Naturalis”, Iasi, 1837. 

He was one of the first scientific writers to 

prove that it was possible to use the 

Romanian language for writing scientific 

texts [1]. 

His scientific life in the Moldavian 

principality had many other highlights, but 

these could be read in other publications. 

Even after his retirement he still could 

not stop with his enormous scientific 

engagement to part his experiences in 

1 Germany, PhD Student, University of Medicine and Pharmacy “Grigore T. Popa”, Iasi. 

2 University of Medicine and Pharmacy “Grigore T. Popa”, Iasi.

158 


Moldova with the western scientific world 

of his time. A short period after he 

returned to Aschaffenburg in the Kingdom 

of Bavaria, he contacted the oldest 

scientific botanic newspaper in the world 

in the town Regensburg to publish an 

encyclopaedia like article of the fauna of 

Moldova. It was named “Flora” or known 

as “allgemeine botanische Zeitung” 

published by the Royal Bavarian Botanic 

Dr. Jacob v. Czihak did not write this 

article alone. He had a very competent co 

writer named Dr. Iosef Szabo, a pharmacist 

from Iasi. With his help he was able to 

collect and catalogue over a 3 year period 

from 1858 to 1861, over 391 plants and 

fungi of the Moldavian flora. They both 

produced a 71 page long article that was 

published in nine parts in the “Flora” No. 

Society in Regensburg [4]. 

This science newspaper was published 

from 1818 until 1888 by the Royal 

Bavarian Botanic Society in Regensburg. 

Since 1995 this publication can be found 

digitalized by the Missouri Botanical 

Garden in the World Wide Web under the 

web address: http://www.botanicus.org/ 

title/b11691608 

Fig.no.1. Flora no.15 

10, 12, 14 to 20 of the year 1863. 

Both writers used a very modern and 

systematic way to catalogue this number of 

plants. They use the Linné - System, which 

was named after its inventor Carl von 

Linné from Sweden [5]. At first they 

identified the plant by it’s Latin name, then 

Dr. Czihak used the common German 

name of the plant, and by 391 he could use

E. G. BRODEL et al.: One of the first articles about the Romanian ethno naturopathy published 159 in 

a western science paper was written by colonel dr. Jakob von Czihak and dr. Iosef Szabo 

the Romanian name in a third position. In 

case the Romanian name was very 

different from the German one, he 

translated the Romanian words into 

German too. Dr. Cizhak was an emigrant 

from Germany when he came to Moldavia 

and so he learned the Romanian language 

at the age of 27 years. The Romanian 

language at this time was in its early stages 

of being used as a language for scientific 

purpose. So a modern day Romanian could 

easily remark that Czihak wrote the 

Romanian words like a German think 

Romanian could be written. For example at 

the plants “Pitschor Kokoschului” or 

“Tschimbrischoare” you could see these 

behaviours, but he also had a Russian 

influence in the way he wrote the 

Romanian language, for example by the 

name of the plant “Jarwa Stupului”. He 

used the Cyrillic character and translated it 

directly into German without considering 

the change of articulation in this case. In 

summary, he tried to make the Romanian 

language known in the German speaking 

scientific world of the time [6]. 

Graphic no.1 – Statistic about structure of Czikak text 

By reading Dr. Czihaks text you note 

some structure of his catalogue. In the first 

part of his text you find the normal plants, 

in the last part the fungi. The plants were 

first named, and then he described where 

they could be found in the Moldavian 

Nature, or in which regions of Moldova 

they grew if they did not grow everywhere. 

The next step was to describe how the 

Romanians used the plants. If the plant had 

a curative effect he wrote this first, 

thereafter he mentioned the possibility of 

using the plant for eating or other 

economic scope. With fungi he only 

mentioned the eatable or curative fungi. 

Poisonous mushrooms where not 

mentioned at all. 

Dr. Czihak tried to focus his article on 

the ethnic naturopathy use of the plants 

and fungi in the Romanian society. This 

aspect fills most of the information Dr. 

Czihak put in the descriptions of the plants 

and fungi. All other aspects were for him 

of secondary interest. 

One example translated into English: 

Lilium candidum L., German: “weisse

160 


Lilie” modern Romanian: “Crin” – lived in 

gardens and vineyards often. The tree oil 

was mixed with flowers to macerate. It was 

used to treat contusions and abscesses. The 

bulb was used to treat leucorrhoea. There 

are also known the subtypes: L. bulbiferum 

L., L. pyrenaicum L., L. Martagon L. [2] 

Dr. Czihak noted many common habits 

and uses of the ethno naturopathy of the 

Moldavian and Walachian people, but also 

a couple of different uses to his known 

German habits, which he mentioned in his 

article. 

Finally it is remarkable that his 71 page 

long article in the “Flora” was one of his 

longest publications in a scientific 

magazine or newspaper outside of 

Moldavia. This article was one of his last 

publications and part of a lot of other 

publications and scientific work from Dr. 

Czihak to make his beloved Moldavia and 

the Romanian language better known in 

the Western European scientific world. 

References 

[1]. Czihak Ch. I., Istoria Naturala, 

Tipografia Albinei, Iasi, 1837 

[2]. Flora Nr. 15, Regensburg 1863 

[3]. Flora Nr. 20, p. 310, Regensburg 1863 

[4]. http://www.regensburgischebotanischegesellschaft.de/geschichte.html 

[5]. http://de.wikipedia.org/wiki/Carl_von_ 

Linn%C3%A9 

[6]. Pruteanu P., Iacob Cihac, Ed. 

Stiintifica Bucuresti, 1966, 90-98; 99- 

126




ANA ASLAN, THE WOMAN WHO 

DEFEATED TIME 

L. NEICA 1 N. ALDULEA 1 

Abstract: Encyclopaedias, medical dictionaries, various speciality studies 

refer to the name of Ana Aslan briefly mentioning: Romanian doctor 

specialist in gerontology, academician since 1974, manager of The National 

Institute of Geriatrics and Gerontology (1958 - 1988). Behind all these 

biographical data there is the life of a lady who chose to devote to research 

and innovation, who, at the beginning of the XXth century, had the courage 

to propose and apply innovatory methods to bring us closer to the longcraved 

“youth without old age”. She emphasised the importance of the 

procaine in the improvement of the dystrophic troubles related to age, 

applying it at a large scale within the geriatrics clinic, under the name of 

Gerovital. Ana Aslan invented (together with the pharmacist Elena 

Polovr�geanu) the geriatric product Aslavital, breveted and industrially 

produced since 1980. 

Key words: Aslan, Gerovital, Aslavita. 

1. Biographical data. 

Ana Aslan was born on January 01 st 

1897, in Br�ila, being the youngest child of 

the fourth children of a family of 

intellectuals. The father, M�rg�rit Aslan 

wasted his fortune because of his inability 

in business and because of his passion for 

the card games. The mother, Sofia Aslan, 

20 years younger than her husband, was a 

beautiful young woman from Bucovina, 

with a special education [1]. 

She attended the courses of 

“Roma�canu” College in her hometown, 

her childhood being marked by a sad 

event, namely the death of her father 

(when she was 13 years old). After this 

event the Aslan family leaves their 

hometown and moves to Bucharest. 

In 1915, Ana Aslan graduated the 


Central School of Bucharest. There was no 

obstacle that could not be surpassed for 

Ana Aslan so that at the age of 16, she 

dreamed of becoming a pilot and even flew 

a small plane type Bristol - Coand�. 

Eventually, she decides to become a doctor 

–,”undesirable” field for the women in that 

particular time. She declares the hunger 

strike to fight her mother’s opposition and 

registers at the Faculty of Medicine, 

attending it between 1915-1922 [2]. 

2. Professional Activity and Inventions. 

Endowed with a generous spirit, during the 

First World War, she nurses the soldiers 

within the military hospitals behind the front 

of Ia�i. She returns to Bucharest where she 

works together with the well-known 

neurologist Gheorghe Marinescu (1919). 

Three years later, she graduated the Faculty 

of Medicine. She was assigned as assistant 

within Clinic II of Bucharest, managed by

162 


professor Daniel Danielopolu, who 

supervised her doctorate thesis. 

Fig. no.1. Ana Aslan – source 

www.mediafax.ro/.../ 

During 1945-1949 she carries out her 

activity as tenured teacher in the Medical 

Clinic of Timi�oara. In 1949 she becomes 

the head of the Physiology Section of the 

Institute of Endocrinology of Bucharest, 

year marking the beginning of her carrier 

of gerontologist and of the period when 

Ana Aslan would change the global 

approach for gerontology and geriatrics. 

She experiments the procaine in the 

rheumatic diseases, in the case of a student 

bedrid because of a crisis of arthritis. She 

continues the researches in an old persons 

centre and she emphasises the importance 

of procaine in the improvement of the 

dystrophic troubles related to age. She 

obtains remarkable results informed to the 

Romanian Academy, whose member she 

becomes in 1974 [3]. 

In 1952, under the management of Ana 

Aslan, the Geriatrics Institute of Bucharest 

is being incorporated, the first one of this 

kind in the world, whose organization 

manner was recommended by the World 

Health Organization (WHO) for all the 

similar institutes, creating in the same time 

a new medical specialty - gerontology and 

geriatrics - sciences that deal with the 

study of ageing process and namely the 

prevention and treatment of all the diseases 

associated with ageing. [4]. 

In the same year she prepares vitamin 

H3 (Gerovital) [5], a cream meant for 

women over 40 years old preventing and 

treating the ageing phenomenon, being 

efficient also in the old age diseases such 

as arteriosclerosis, vitiligo, sclerodermia 

etc. The product is based on the discovery 

of the regenerating property of procaine’s 

trophicity applied in the chronic treatment. 

In 1958, when she becomes the manager of 

the National Institute of Geriatrics and 

Gerontology, she begins to prepare the 

product on a large scale and to introduce it 

in the pharmaceutical circuit. She 

emphasised the importance of novocain in 

the treatment of the dystrophic age-related 

troubles. 

Fig. no.3.National Institute of Geriatrics 

source www.mediafax.ro/ 

As she was highly passionate by 

cardiology, Ana Aslan used procaine, a 

local anaesthetic that has secondary effects 

such as vasodilatation in the peripheral 

arterial diseases. The condition of the 

patients improved so much after having

L. NEICA et al.: Ana Aslan, the woman who defeated time 163 

used the substance that the doctors were 

amazed. This represented the uniqueness 

of professor Aslan who, in 1950 stated that 

ageing could be stopped and the procaine 

was a rejuvenating factor. 

Ana Aslan Geriatrics Institute becomes 

one of the most well known institutes of 

this kind in the world, offering solutions in 

ageing fighting, both from the point of 

view of the outside appearance and from 

the point of view of the inside one. Most of 

the treatments are meant for the people 

over 40 years old, age when the body starts 

losing its elasticity and tonicity. 

Fig. no.4. Gerovital H3 

The patients are assisted by a series of 

doctors in making the treatment that 

includes the re-fortification of the muscles 

of the body, by means of massages and 

gymnastics, therapy and drugs specific to 

the age. 

Gerovital H3 – the range of products 

conceived to fight the skin-ageing 

phenomenon, formula adapted to the 

various types of skin and to their specific 

problems. The component elements of the 

formula play a decisive role in the process 

of cellular regeneration, in the stimulation 

of the blood circulation and the 

normalisation of the sebum secretion. The 

genius of this formula resides in the fact 

that the distinguished researcher 

approached beauty according to health. 

The name of the product represents the 

combination of two words: “gero” coming 

from Greek and meaning “old” or 

“powerful” and “vital” that in Latin means 

“life” [6]. 

The products created by Ana Aslan are 

Gerovital H3 Deluxe and Gerovital H3 

Regular. 

In 1956 the researcher presented her 

discoveries at the European Gerontology 

Congress of Germany, where they was 

regarded with scepticism. Novocain was 

known until that time only as an 

anaesthetic used by the stomatologists. 

The specialists could not easily accept 

that this was a fountain of youth. In order 

to confirm her results, dr. Aslan organizes 

a wide research program. For two years 

blood samples were taken from over 

15.000 people, all around the country. In 

this experiment 400 doctors from 140 

clinics took part. Some of them received 

Gerovital and the other ones a placebo, but 

nobody except the doctors who were 

giving the drugs knew what he/her was 

receiving. 40% of the ones who had taken 

the drug took less sick-leave days. During 

that period an epidemic flue affected the 

communist countries. The mortality rate of 

those who had received the placebo was of 

13% and of those who had received 

Gerovital was of only 2.7%. Gerovital was 

breveted in over 30 countries, initially 

being considered a miraculous drug; it has 

an effect of balance on the vegetative 

nervous system, with visible improvement 

effects on various physical diseases. 

In 1976, the researcher is awarded the 

inventor patent for Aslavital (together with 

the pharmacist Elena Polovr�geanu) 

efficient product in the therapy of the 

nervous system and of the cardiovascular 

system. Aslavital represents the first range 

of products in the country based on clay; 

she uses an original concept of preventing 

and delaying skin aging, emphasizing the

164 


exceptional potential of clay. The concept 

of anti-aging proposes a complete program 

of sensitive skin care, having as 

ingredients clay, rice natural oil, vitamins, 

extracts of marigold and ginseng. Eight 

years later (1984), Aslavital for children 

is being homologated, being successful in 

treating nervous deficiencies. 

She creates the concept of "aging 

prophylaxis" and she is concerned with the 

elder people abandoned by their families. 

She refuses to charge the care home taxes 

for these unfortunate people, audacity 

costing her 1,500,000 lei, such money 

being imputed to her by the Party 

authorities. After seven years of court 

harassment, she is acquitted. Yet, the 

acquittal comes rather late, five months 

before becoming forever a legend. Justice 

is made far too late, taking into account 

that the outcome of her researches had 

brought incomes of 17,000,000 dollars 

annually, to the state. 

Moreover, the reputation of Ana Aslan 

products stimulates local tourism. Several 

hotels in the country offer their guests the 

possibility of undergoing treatments and 

procedures using Gerovital and Aslavital. 

These programs – generically called Ana 

Aslan Health Spa – combine the natural 

environment factors specific to mountain 

or seaside resorts (the air with intense 

ionization, the salt water and the 

saprophilous mud, plants having healing 

effects) with a multiple of classical 

procedures. The clients have access to 

hydrotherapy rooms, massage rooms, 

facial and body aesthetic care, electro and 

magnetic therapy, individual kinesitherapy 

and fitness rooms. The list of the most 

famous resorts of this type includes Eforie 

Nord - Astoria Hotel, Europa Hotel - Ana 

Aslan Health SPA, Poiana Brasov - Sport 

Hotel, Bradul Hotel, Poiana Hotel, 

Bucharest - Athenée Palace Hilton, 

CrownPlaza. 

Personalities such as Charles de Gaulle, 

Indira Gandhi, Charlie Chaplin, Salvador 

Dali, Winston Churchill or Pablo Picasso 

had had treatment with Gerovital in 

Bucharest. 

In time, the reputation of the products 

and of the treatments offered at Ana Aslan 

centers attracted numerous celebrities such 

as Ymma Sumak, Somerset Maugham, 

Salvador Dali, Charlie Chaplin, Pablo 

Neruda, Aristotel Onassis, Jacqueline 

Kennedy, Indira Gandhi, Marlene Dietrich, 

Charles de Gaulle, Lilian Gish and Tito. 

3. Personal life. 

Paradoxically, this special woman who 

perfectly spoke French, German, Italian 

who could easily have a conversation in 

English, Greek, Spanish and Polish, who 

read the greatest Russian prose writers in 

the language of Balzac, used to believe 

fortune tellers. Ana Aslan used to 

systematically receive in her house of 

Aviatorilor Boulevard a woman who was 

telling her fortune using cards or coffee. 

Some people were certain that the fortune 

teller was – as many other people who 

used to come to her house – informers of 

the Security Services. In the same time, 

Ana Aslan believed in God who used to 

permanently have on her an icon of Virgin 

Mary. Ana Aslan was not only a scientist 

and a doctor, but also an extraordinary 

woman. Among her patients there were 

kings, presidents of states, heads of the 

secret services, actors and simple 

earthlings. Otherwise, she avoided doctors

L. NEICA et al.: Ana Aslan, the woman who defeated time 165 

all her life, having troubles in letting 

herself on their hands, as she was her own 

doctor. She hardly accepted being operated 

of colon cancer by professor Setlacec, at 

Elias Hospital. A surgery is performed on 

her and when they thought they made it, as 

it was incipient colon cancer, less 

aggressive in elder people, the final act 

occurred. A new surgery is proceeded 

because of an infection with Pseudomonas 

aeruginosa taken from the hospital, but the 

infection had already seized the entire 

abdomen. 

On Thursday, May 19 th 1988 Ana Aslan 

died at Elias Hospital. Elena Ceausescu 

refused to make her last wishes come true: 

funerals with a priest, together with her 

mother and brother, in Kalindero- 

Danielopolu crypt and she is buried in 

Bellu Orthodox Cemetery without a priest 

and without candles. 

On the Internet, at the address GERO 

Vital Web Site, a totally different version 

of the death of the savant is launched - in 

Portuguese. Mysterious sources assert that 

she died in suspect circumstances and that 

some historians conform that she had been 

assassinated by the Security Services. It is 

asserted that investigations have never 

been made related to this issue. 

The international fame and the numerous 

distinctions granted to her, the number and 

rank of the patients in the political, 

scientific and artistic sphere all over the 

world include Ana Aslan in the 

constellation of the most well-known 

world personalities who "moved" the 

Universe. No doubt that she was the most 

interesting medical personality living 

before 1989 in Romania. 

“Being forever young does not mean being 

20 years old. It means being optimistic, 

feeling good, having an ideal to fight for and 

reaching this ideal.” (Ana Aslan) 

4. Titles. Prizes and Distinctions. 

The geriatric researches and the 

development of Gerovital H3 formula 

brought Ana Aslan the quality of honor 

member in numerous medical societies and 

organizations, thus becoming one of the 

most important Romanian researchers. 

Consequently she was a member of several 

societies [7]: 

� Member of the Academy of Sciences, 

of New York; 

� Member of the World Union of 

Prophylactic Medicine and Social 

Hygiene; 

� Honor Member of the European 

Center of Applicative Medical 

Researches; 

� Member of the Board of Directors of 

the Gerontology International 

Association; 

� Member of the National Society of 

Gerontology of Chile; 

� President of the Romanian Society of 

Gerontology. 

� Her activity was crowned with 

numerous Prizes and distinctions: 

� "Leon Bernard" international prize 

and medal, prestigious distinction 

awarded by the World Health 

Organization, for the contribution 

brought to the development of 

gerontology and geriatrics, 1952; 

� Merito della Republica, Italia; 

� Cavalier de L’Ordre Palmas 

Academica, France ; 

� Honoris Causa Professor and Doctor 

Emeritus of Braganza Paulista 

University, of Brazil; 

� Commemorative Gold Medal, 

Nicaragua, 1971; 

� Merit Cross, Class I, Germany, 

1971; 

� Hero of the Socialist Work, Romania, 

1971; 

� "Augusto Pinaud" Medal, Venezuela, 

1972;

166 


� Knight of the New Europe, Oscar 

Prize, Italy, 1973; 

� "Eva" International Prize, Italy, 

1974; 

� Commander degree in the Order "De 

Orange Nassau", Holland, 1975; 

� "L’Ordre du Merite" in the rank of 

Grand Officer, Senegal, 1976; 

� "Dag Hamarskjoeld" Prize, 1977; 

� "Dama di Collare Del Santo Graal," 

Nice, 1978; 

� Citizen of Honor and Sciences 

Honorific Professor, Philippines, 

1978 etc. 

References 

1. http://ro.wikipedia.org/wiki/Ana_Aslan 

2. http://biografii.famouswhy.ro/ana_aslan/ 

3. Avram A., Femei celebre, Ed. All, 

2006. 

4. http://www.medicalstudent.ro/personal 

itati/profunivdr-ana-aslan.html 

5. http://www.ici.ro/romania/ro/stiinta/asl 

an.html 

6. http://www.arhimag.ro/Gerovital-H3este-redefinit-de-compania-unde-afost-produsprimaoara++ 

articles+article.aid+10334.html 

7. http://www.travelworld.ro/romanesc/m 

edicina/ana_aslan.php


Series 6: Medical Sciences - 


HISTORICAL ASPECTS OF COMPUTER 

SCIENCE IN THE EMERGENCY ROOM IN 

TRANSILVANIA UNIVERSITY OF BRA�OV 

- A STUDY CASE - 

L. SANGEORZAN 1 

Abstract: 

Health care or medical informatics, represent an intersection between 

information care, computer science and health care. In the Health Services, 

computers are being introduced not only to provide direct care for the 

patients but also to obtain some important information regarding the type of: 

assurance, diagnosis (main or secondary) etc. The paper presents some 

historical aspects of developing the applications for helping: the physician 

and the patients that are in the emergency room; the students who want to 

learn more about the evolution of the diesis using descriptive statistics. 

Several software applications designed by the team, made up of computer 

scientists, statisticians and physicians, within Transilvania University of 

Brasov are described. 

Key words: Descriptive statistics, HTML, PHP, Excel, Health Services 

1. History 

The first computer was building in 

USA 1946 named ENIAC, having a weight 

of 30 tons and a surface of 160 square 

metres. 

If in the 1950 with the medical 

informatics began to take off in the USA, 

in Romania, Acad. Prof. Grigore C. Moisil 

formed a research group whose expertise 

was the algebrical theory of automate 

mechanisms (in other terms, the first steps 

in computer science). Medical informatics 

is a interdisciplinary domain applying 

methods specific to informatics to 

medicine [1]. 

“Medical informatics includes medical 

computing, medical computer science, 

computer medicine, medical electronic data 

processing, medical automatic data 

1 Transilvania University of Bra�ov, Faculty of Mathematics and Computer Science 

processing, medical information processing, 

medical information science, medical 

software engineering, and medical computer 

technology.” [http://en.wikipedia.org/ wiki/ 

Health_informatics#Aspects_of_the_field]: 

Medical informatics provides a new 

approach of the applications in the medical 

area. In 1989 the International Medical 

Informatics Association (IMIA) was 

established, under Swiss law as an 

independent organization. This association, 

IMIA, had an important role in application 

of information science and technology in 

the fields of healthcare and research in 

medical, health and bio-informatics. Some 

of the important objectives of the 

association IMIA are to introduce in health 

care and health research the informatics 

applications. In 1976 the European

168 


Federation for Medical Informatics (EFMI) 

was established in Copenhagen in September 

1976. EFMI functions as the autonomous 

European Regional Council of IMIA. 

In our days there are a lot of types of 

medical software as: 

� software to interpret the sensor 

information and display it on a monitor; 

� devices that are programmed to 

pump some medication or other solution 

into a patient; 

� processing row data obtained by 

measured and create images that doctors 

can read and understand; 

� expert systems that indicate what 

should be done; 

� software used as an educational or 

study tool for healthcare. 

We enumerate a series of software 

products able to assist the doctor or the 

patient and are divided into categories 

according the particularity of the medical 

area or for the medical environment: 

� Public Health and Biosurveillance: 

Epi Info, EpiSPIDERE, iDART; 

� Electronic health or medical record : 

CHITS, FreeMED, GNUmed, Open 

Healthcare; 

� Medical Practice Management 

Software : Care2x, ClearHealth, 

FreeDiams ; 

� Health System Management: DHIS, 

iHRIS Suite; 

� Imaging/Visualization: 3D Slicer, 

Brain Visa, BioImageXD; 

� Telemedicine: Ipath. ZephyrOPen. 

One can say that health informatics is 

meant to include not only computers but 

also the clinical guidelines and the corresponding 

information and communication 

systems. It is applied to the areas of public 

health, (bio)medical research and also 

eLearning in medicine. Software and 

platforms already designed are extremely 

useful, instead, the medical staff working 

in this domain should be taught and trained 

as to use efficiently and in a correct way 

this new equipment. This is the reason that 

has led to the development of small 

applications meant to solve urgent 

problems related to the recording of the ill 

persons or of the diseases, as well as 

statistic processing. These applications do 

not require an up-to-date infrastructure. 

We shall show some of these 

applications designed by a mix team of 

researchers of Transilvania University of 

Bra�ov. 

2. Online application 

On line applications in the medical area 

have been designed and developed since 

2004, in Transilvania University of 

Brasov. These applications were the 

products of a research team comprising 

computer scientists, statisticians and 

physicians, and were presented on the 

occasion of the international conferences. 

At present, this team is at the final stage of 

designing these applications as to be 

implemented in the emergency room and 

to be used as didactic material for the 

classes of computer science within the 

Faculty of Medicine. The development of 

this software has been possible, due to the 

fact that the author of this paper dedicated 

her research work to the web technology 

and the on-line applications. At the same 

time, the curriculum of computer science 

for the students in the Faculty of Medicine 

has been improved, the main goal being 

the students’ training in using the on-line 

informatics products. 

Biostatistics tackles with the analysis of 

biological and medical data. 

Statistics is important not only in 

analyzing the health status of patients but 

also for analyzing the administrative work 

in a clinic and developing modalities for 

improving these types of activities. 

Important information one can obtain from 

the patient record that must be field, when

L. SANGEORZAN: Historical aspects of computer science in the emergency room in Transilvania 169 

university of Bra�ov - a study case - 

the patient is coming in the emergency 

room. It is important to improve the quality 

of healthcare and this is possible if one can 

collect in real time, data about patients. 

This entire one can do with statistical 

methods using IT tools and with specific 

online software. 

There are two types of on-line 

applications designed by the mix team, 

made up of computer scientists, statisticcians 

and physicians, within Transilvania 

University, such as: 

� Application of recording the patient 

for emergency cases [4]. 

This patient record can be stored on 

the computers with the application called 

OnLine_Patient_Record. Each user will 

introduce the information in an Excel file 

and this can be printed out and/or one can 

see also statistical result. 

� On-line statistic processing of data 

related to the patients or the diseases. This 

information can be processed on-line with 

the application “e-Statistics“ and it support 

the training of medical students and 

nursing students with the aim of becoming 

familiar with elements of statistics and the 

use of Excel files in on-line processing of 

statistic data [3]. 

2.1 Theoretical aspects 

The written applications called uses at 

implementation level the PHP server 

scripting language. The language PHP has 

a special flexibility which permits to be 

used with other technologies. These 

languages/technologies make possible to 

obtain remarkable results. WEB 2.0 is a 

term describing the trend in the use of 

word wide Web technology and Web 

design that aims at enhancing creativity, 

information sharing and communication 

among users [4]. The input data stored in 

the created database are processed by using 

elements of mathematical statistics. In 

order to investigate the character of a 

distribution, it is useful to have various 

measurements for describing the 

distribution, to draw pictures (histograms, 

polygons, etc.) of the distributions and to 

use certain measurements which are most 

commonly used to describe a distribution. 

2.2. OnLine_Patient_Record - 

Problem Formulation 

OnLine_Patient_Record is an online 

informatics system, dedicated to the patient 

care in an emergency room in a hospital 

and comprises several applications 

designed to reach the following aims: 

- to get important information regarding 

the patient 

- to get summary statistics and the chart 

type for the selected variables ; 

- to support students in health sciences 

to improve their research during their 

medical training and university 

studies. 

Following the fields enclosed in the 

Hospital patient record (Fi�a de observa�ie 

clinic� general�) (Fig.1) we build the web 

application. The model is realized in such 

way that the access to the application is 

granted for two categories of users: the 

administrator and the user. 

The administrator - is the person which 

has access to all parts of the application 

allowing him to manage the database 

information. 

The user - is an employee of the 

hospital -doctor or nurse - which has 

access to certain parts of the application, 

after authentication. 

The software system OnLine_Patient_Record 

allow to display or print the information 

stored in the current Excel file, the 

database that is an Excel list. The menu bar 

(Fig.2) contains the following applications: 

� Hospital patient general record (Fi�a 

de observa�ie clinic� general�) allow, after 

authentication, the introducing of patient 

data in the Excel files ; 

� e_Statistics – allow to generate the

170 


summary statistic and the chart type for the 

selected variable (Fig.3) after 

authentication and also the visualization of 

the corresponding chart (Fig.4); 

The application OnLine_Patient_Record 

is software based on Web technologies and 

Open Source products. 

Fig.1. Hospital patient record 

Fig.2. The main Interface of Online 

Patient Record 

Fig.3. Selecting a variable for generating 

the summery 

Fig.4. Summery statistics for sex 

variable and chart statistic and the type of 

chart 

The application e_Statistics can be used 

as independent software by any user, at 

any time without restriction. The steps to 

be followed in running the application are: 

a. Create an Excel formatted file taking 

into account the following rules: 

� In the first sheet, named 

data_sheet, must be stored the data to be 

analyzed. The first row must contain the 

names of the variables and the following 

the measured values (Fig.5). All the values 

of the variables that we want to study must 

be numerical.

L. SANGEORZAN: Historical aspects of computer science in the emergency room in Transilvania 171 

university of Bra�ov - a study case - 

� In the next sheets, for each 

variable with text values, we must give 

them a number, a codification. For 

Fig.5. Data Base for Online Patient Record 

Fig.6. Codification for variable Sex 

example for the Sex variable we give 1 for 

male and 2 for female (fig.6).


Series 6: Medical Sciences - 


b. Using a Browser we start the 

application from the Web Server after 

authentication 

c. On the Server we store all the 

uploaded data for later use. The data is 

made accessible for other authenticated 

users for viewing and analyzing. 

3. Conclusion 

This software application has been 

created as to be easily scalable and 

adaptable (on request) to other emergency 

room and also for eLearning for students 

studying medicine or nursing. The 

application uses PHP server side scripting 

language, Excel list as database, all of 

these technologies are open source, and 

allow easy implementation on any server 

with any operating system. The application 

is very dynamic; it allows storing the 

information in the emergency room in real 

time. 

References 

[1]. Mocanu N.-M. T., Informatica 

medical� - Ed. Transilvania Brasov, 

1996. 

[2]. O’Reilly T., Web 2.0 Compact 

Definition: Trying Again. 2006–12– 

10, Retrieved on 2007. 

[3]. Sângeorzan L., Florin T., Rogozea L., 

Micl�u� R., Summary statistics for 

Training Medical Students, 29 th 

International Conference of the 

Romanian Medical Informatics 

Society, MEDINF 2007, e_Health 

Days in Sibiu, pg. 299-304, 8-11 Nov. 

2007, ISSN 1843-651X. 

[4]. Sangeorzan L., Nedelcu A., Mazgaciu 

C., Rogozea L., Podoasca C., Online 

Patient Record in an Emergency Room 

Based on WEB 2.0 Technologies, 

Mathematical Methods and Applied 

Computing, Vouliagmeni, Athens, 

Greece, September 28-30, 2009, 

Proceeding of the ACC’09, pg.622- 

626, ISBN: 978-960-474-124-3, ISSN: 

1790-2769




ANALYSIS OF THE IMPACT OF HISTORY 

OF MEDICINE’S PUBLICATIONS 

A. REPANOVICI 1 , L. ROGOZEA 2 , R. MICLAUS 2 

Abstract: The impact of publications is an indicator of quality. For 

measuring the impact of publications usually are used scientometric 

indicators, and the most common way is to use the internet and the 

scientometric database Google Scholar. We use a soft-wear Publish and 

PERISH who can calculate the index for authors. The article is a study about 

the impact of published books on the history of medicine and analyzed the 

impact of authors 

Key words: history of medicine, Hirsh index, Google Scholar, 

scientometric indicators. 

1. The resources to analyse the 

quotes and to measure the impact factor 

of publications 

Publish or Perish – is a soft designed to 

analyse the quote in the aim of helping 

scientists in increasing the impact of their 

research. 

This software is available no charge on 

the web page of Prof. Anne Wil 

HARZING, International Management 

Specialist in University of Melbourne, 

Australia (Harzing A.-W., 1997-2009). 

Willing to reveal the researches 

influences of the publications not quoted in 

ISI Journals the best recommendation is 

the soft Publish and Perish designed to 

process and analyse the quotes .The soft is 

using Google Scholar to find the 

references, quote sources and then analyse 

them leading to statistics based on the 

following parameters: 

� Total number of papers 

� Total number of quotes 

� Average number of quotes for one author 

� Average number of quotes for one 

publication 

1 Faculty of Mechanics, Transilvania University of Bra�ov. 


� Average number of papers for one author 

� Average number of quotes in one year 

� Hirsch Index and linking parameters 

� Egghe g Index (EGGHE L., 2006 ) 

� h contemporaneous Index 

� Age Importance in quote rate 

� Two variations of individual h index 

� Analysis of the number of authors for 

one paper 

Publish or Perish is designed to 

individual empower scientists to present their 

personal experience of researches’ impact in 

the most advantageous way. Is not 

recommending being mechanical in 

academic evaluation. It is highly recommended 

to consider the following aspects: 

a) If a teacher has good performance 

based on publications’ quotes is 

obvious he has a significant impact in 

that field of science. The backhand is 

not valid every time. 

b) If a teacher has not very good results 

in his publications’ quotes, one cause 

can be the lack of impact of his 

domain of research. Another causes 

might be linked with a small domain

174 


he is working in or his publications are 

in a different language then English 

(LOTE- Languages Other Than 

English) or his publications are only 

books or papers in books. 

Although from this point of view, 

Google Scholar has better performance 

than Web of Science it has no performance 

in taking quoting from books or books’ 

chapters. 

Measuring the quoting in Social 

Sciences and Humanist Sciences they are 

underestimated because they are published 

in LOTE - Language Other Then English 

and in books’ chapters more than Precise 

Sciences. 

Google Scholar provides more quotes 

than ISI but not in all domains. Both soft 

are covered Social, Humanist and 

Engineering sciences with quotes in books, 

proceedings of conferences and a large 

amount of journals. Natural Sciences and 

Health Sciences are well represented in ISI 

and subsequently Google Scholar cannot 

provide more quotes. In addition, journals 

are not generally covering Google Scholar. 

This is the reason way quoting in this 

domains can be smaller then in ISI 

(Harzing A.-W., 2008). 

As recommendation, Google Scholar 

can be preferable in the following 

domains: 

a) Business, Administration, Finance & 

Economics; 

b) Engineering, Computer Science & 

Mathematics; 

c) Social Sciences, Arts & Humanities. 

Better, is recommended to processed 

this analysis in parallel and comparative 

with Scopus and Web of Science. 

Hirsh (Hirsch, 2005) suggests h Index 

as a criterion to quantify the scientific 

impact of an author as following: a 

researcher has h Index for his Np 

publications if he has at least h quotes for 

each one and no more than h quotes for 

each one of the others (Np - h) papers. This 

new indicator for measuring personal 

scientific results was quickly considered 

by informatics’ specialists and 

bibliometrics’ researchers. 

In the specific literature (Borgman, 

1990) the specialists found approximate 30 

publications referral to h Index in one year 

after Hirsh paper. Also, there were a lot of 

comments, critics and an evaluation 

regarding h index and was revealed that H 

index is less sensitive in the most quoted 

references in a publications and is 

dependent of the domain of science. 

Different variants of Index were 

designed in the aim to eliminate the 

disadvantages: m coefficient, h index 

(Hirsch, 2005), g index (Egghe L., 2006), h 

index (2) (Kosmulski, 2006), A index (Jin, 

2006), R index (Jin B., 2006), AR index 

(Jin B. L., 2007) and hw index (Egghe L. 

R., An h-index weighted by citation 

impact, in press). The most representative 

and productive score of researchers’ 

impact is weighted by h index and g index 

and the papers’ impact is weighted by R 

index and AR index. 

To optimise the presented indexes was 

suggested b index as indicator with two 

values (suggesting to enclose or to disclose 

the publications in weighted the author’s 

productivity) and result of the researcher’s 

characteristics. B index is based on value 

comparing of researchers’ indexes. 

2. The research in Google Scholar 

scientometric database. The analyze of 

history of medicine’s publications 

A simple request for searching “History 

of medicine” will arise 2810000 results. 

The most quoted book is FH Garrison 

: An introduction to 

the history of medicine, 1914. This book 

has 814 quotes.

A. REPANOVICI et al: Analysis of the impact of publications in the history of medicine 175 

Figure no. 1: Image from scientometric 

database Google Scholar 

Analysing h index for the most quoted 

authors for published books give the next 

results: 

Figure no. 2: Analyse of the search impact 

for author FH Garrison 

FH Garrison wrote 330 papers in the 

field of history of medicine, written 

between 1914-1921 and has an h index 

equal to 20. The higher quoted .have the 

following publications: “An introduction 

on history medicine”-800 quotes, “History 

of medicine”-206 quotes and “Garrison’s 

history of neurology”-158 quotes. 

Figure no. 3: Analyse of the search 

impact for author CC Metler 

FH Metler wrote 45 papers in the 

domain of history of medicine, written 

between 1935-1979 and has a 10 h index. 

The higher quoted .have the following 

publications: “History of medicine”, 248 

quotes. 

Conclusions 

The most important application of 

scientometry is the performance evaluation 

of scientific research. Hirsch index is a 

new instrument of measuring the research 

performances.

176 


Quoting is an intellectual transaction or 

an intellectual responsibility to other 

people work. H index depends as well on 

the number of publication as on the impact 

on the users. 

Publish and Perish Soft represents an 

instrument very easy to use in analysing 

the researches’ impact. It is free of charge 

and evaluates the research’s impact and his 

visibility on the internet through Google 

Scholar. 

ISI Web of Science is a very expensive 

database and a very low number of 

institutions have access to this database. It 

is recommended to consider the domain of 

research, when academic evaluation 

because the results are different from one 

domain to another. 

References: 

[1]. Egghe, L. „An improvement of the hindex: 

the g-index.” ISSI Newsletter 

(2006): 2(1): 8-9. 

[2]. Egghe, L., Rousseau, R. „An h-index 

weighted by citation impact.” 

Information Processing & 

Management (in press): in press. 

[3]. Harzing, Ane-Wil. HARZING HOME. 

1997-2009. 13 August 2009, 

http://www.harzing.com/index.htm. 

[4]. Harzing, Anne-Wil. Google Scholar - a 

new data source for citation analysis. 

20 December 2008. 13 August 2009, 

http://www.harzing.com/pop_gs.htm. 

[5]. Hirsch, J. E. „An index to quantify an 

individual's scientific research 

output.” Proceedings of the National 

Academy of Sciences of the United 

States of America. Washington: 

National Academy of Sciences of the 

United States of America, 2005. 102 

(46): 16569-16572. 

[6]. Repanovici, A. Managementul resurselor 

informa�ionale în cercetarea �tiin- 

�ific�. Bra�ov: Editura Universit��ii 

TRANSILVANIA din Bra�ov, 2008. 

[7]. Repanovici, A. „Marketing Research 

about Attitudes, Difficulties and 

Interest of Academic Community 

about Institutional Repository, 

PLENARY LECTURE.” Advances 

in Marketing, Management and Finances, 

Proceedings of the 3rd International 

Conference in Management, 

Marketing and Finances, (MMF’09), 

Houston, USA, April 30-May 2, 

2009, ISSN 1790-2769, ISBN 978- 

960-474-073-4, pag.88-95. Houston, 

USA: WSEAS, 2009. 88-95..




„MEDICAL HYDROTHERAPY” OF 

GEORGE BAIULESCU – AN HISTORICAL 

PERSPECTIVE 

R. MICL�U� 1 , L. ROGOZEA 1 , G. SECHEL 1 , 

A. FLEANCU 1 , L. CRISTEA 2 , M. BARITZ 2 

Abstract: The “Medical Hydrotherapy” was published in 1904 in 

Bucharest, at Minerva Publishing House and is kept in the County Library of 

Brasov next to other very valuable books. 

In 698 pages George Baiulescu MD, head of Hydrotherapy Department and 

professor of hygiene at Romanian Gymnasium in Brasov, included 53 

photographs. The book is written in the Romanian language of the beginning 

of the 20th century and is structured in one Introduction and 2 parts: „The 

physiologic action of Hydrotherapy” and „The Reaction”. The first part has 

two chapters „The Technique of Hydrotherapy”, „The Hydrotherapic 

applications for sudation”, „The Compresses”, „The Irrigations”, „The 

Drinking Water”. There are pictures of procedures done into the hospitals: 

foot shower, ascending shower, massage shower, wet package, bath of light, 

steaming bath with warm air. There are also are presented warm and cold 

applications and the therapy with ice. 

The author clearly underlined that the watery therapy is depending of many 

factors as water’s temperature, time of application, individuality of the 

patient, skin’s sensibility, nervous activity and reaction, peripheral 

circulation, patient’s reactivity and type of pathology and others. 

The book included the actions of hydrotherapy on Central Nervous System, 

blood circulation, „morphology” of the blood, „organic exchanges”, 

breathing, muscle strength, temperature, secretion and excretion and is 

giving details about these actions. 

It is a proof that the doctors of that time tried to reach above their condition 

of practitioners, becoming theorists in the same time. 

Key words: Medical Hydrotherapy, history of medicine, book. 

Among a sum of cultural treasures hosted 

inside the old walls of Brasov County 

Library, “Medical Hydrotherapy” is one of 

the rare books useful to understand the old 

times, époques and the Romanian culture 

evolution. A part of these books were the 

property of the physician Emil Bologa, local 

doctor and very well known for his research 


2 Faculty of Mechanics, Transilvania University of Bra�ov 

in the field of history of medicine in Brasov 

and Romania. 

The “Medical Hydrotherapy” was 

published in 1904 in Bucharest, at Minerva 

Publishing House, Institute of Graphic Arts. 

The rare sample of the book has the owner’ 

autograph fromApril 18, 1938 and an “exlibris 

Dr. Emil I. Bologa” representing a a

178 


skull, a snake, a book and contained the 

Latin expression „mulla dies sine linea”. 

Fig no 1: First page of the book 

Head of Hydrotherapy Department and 

Professor of Hygiene at Romanian 

Gymnasium in Brasov at the dawn of 20 th 

century, George Baiulescu MD wrote this 

book in the aim to help the students, doctors 

and specialists to understand, learn and practice 

hydrotherapy in their medical practice. 

Written in the beautiful and authentic 

old Romanian language of the beginning of 

the 20 th , full of neologisms century the 

book is structured in one Introduction and 

two parts, collecting in 698 pages 53 

photographs and a lot of medical 

information very new for the beginning of 

the 20 th century. 

The first part has two big chapters „The 

physiologic action of Hydrotherapy” and 

„The Reaction” and the second part is 

structured on five chapters: „The Technique 

of Hydrotherapy”, „The Hydrotherapic applications 

for sudation”, „The Compresses”, 

„The Irrigations”, „The Drinking Water”. 

The book shows pictures of the cure 

rooms of Brasov hydrotherapic department, 

one for men, one for women and the 

technical conditions and electrical 

machineries necessary to provide the 

hydrotherapic treatment: lifting tank for 

water - Carré system, pressure accumulator 

tank - Henry System, showers’ plumbing. 

In addition, the book describes the technical 

details of hydrotherapic procedures 

provide into the hospitals: foot shower, 

ascending shower, massage shower, wet 

package, bath of light, steaming bath with 

warm air (general warm air bath and local 

warm air bath and steam). There are also 

presented warm and cold applications and 

the therapy with ice: wet sheet friction, 

refrigerating bag, coil rubber tubes, ice 

bag, and rectal refrigerating bag. 

Fig. no 2 Illustration from book 

In the chapter “Introduction” doctor 

Baiulescu underlined the factors that 

physiotherapy and watery application 

depends on the: 1. water’s temperature; 2. 

time of application; 3. individuality of the 

patient; 4. skin’s sensibility; 5. nervous 

activity and reaction; 6. peripheral circulation; 

6. patient’s reactivity; 7. type of 

pathology and others. Additionally, the 

author showed that „there is a big differrence 

in practicing hydrotherapy’s applications” 

in France where the main 

procedure were showers comparing with 

Germany and Switzerland where are used 

more often Priessnitz procedures like half 

bath, frictions with wet and cold sheet, wet 

or dry packages, perineum bath. 

The physiological effects of hydrotherapy

R. MICL�U� et al.: George Baiulescu – an historical perspective 179 

are very well described. First, Baiulescu 

postulated: „all applications not included in 

33-36 C are excitants for a body and induce 

physiological changes”. The book included 

detailed actions of hydrotherapy on central 

nervous system, blood circulation, 

„morphology” of the blood, „organic 

exchanges”, breathing, muscle strength, 

temperature, secretion and excretion. 

In addition, the cardiovascular effects 

depend on the temperature and on the time of 

application. There are precisely described the 

effect of warm application in intensive or nonintensive 

application. Considering that the 

effects of hydrotherapy influence the central 

nervous system, the circulation, the 

“morphologic condition of blood”, the 

“organic exchange”, the breathing, the 

muscles strength, the temperature, the secretion 

and excretion, doctor Baiulescu is detailing 

these domains further. Concerning the 

hydrotherapic effects on central nervous 

system Baiulescu considered that hydrotherapy 

influences as well locally as at 

distance thus “a cold application on feet has a 

reflex influence of brain and meninx’s 

vessels. A hot bath of hands influences on 

respiratory organs.” 

Based on the assertion of reflex points 

and their stimulation techniques Baiulescu 

described the tonic or relaxing effects of 

massage and as well physical effects as 

psychic influences of hydrotherapy. 

Baiulescu wrote the conclusions related 

to the effects of intensive warm application 

vs. cold applications: „through local cold 

and warm applications and depending on 

the intensity of thermal excitation will be 

induced a primary vascular constriction 

followed sooner or later by a vasodilatation 

inducing a skin hyperemia”. 

Concerning the influence of hydrotherapic 

applications on „the morphology” 

of the blood there are remind the publiccations 

of Winternitz, Rovighi sau Thayer. 

Thus, the author remembered „Wintermitz 

found a maximal increase of 1860 

thousands red blood cells/cube mm and the 

number of white blood cells is three times 

higher and haemoglobin is 14% higher 

than before the applications. 

On muscles, “cold applications increase 

the muscles’ capacity and labor and warm 

applications decrease the muscles labor and 

effort capability if not combined with 

mechanic action”. 

In the chapter „The Reaction” is a 

description of hydrotherapic effects and a 

classification of these effects in primary and 

secondary. Also, “each technique of 

applications has to specify tree periods: 1. 

action period; 2. reaction period and 3. 

equilibrium seting”. 

The book presented a very modern 

concept related to the medical management: 

1. The patient admission is mandatory to 

assure the continuity and regularity of 

hydrotherapic applications. 2. The favorable 

effect of the cure mostly depends of the 

“hospital management meaning the doctors’ 

experience and the pluming and technical 

installations (modern machines able to 

mathematically control in short time the 

water temperature and pressure)” 

Convinced of the medical effect and 

importance of hydrotherapy, George 

Baiulescu sustained in 1904 that 

„hydrotherapy is recognized today from the 

majority of physicians as an excellent 

“medication” not only in chronically 

diseases but in acute pathology, too, 

especially in typhus fever”. „The patients 

won a strong confidence in watery therapy 

beyond doubt. The proof is the high 

addressability of patients in all hospitals 

appropriate equipped with good techniques, 

plumbing and a run with good 

management”. “Still, there are many 

reasons that hydrotherapy is not enough 

valued, known and practiced”. Baiulescu 

explained that the procedures are not 

enough known because hydrotherapy was 

practiced for many centuries by false 

“therapists” being completely compro-

180 


mised, also because “physicians considers 

hydrotherapic practice as a “humiliation” 

and not practicing is a vicious circle 

leading to a deep lack of skills” and because 

“hydrotherapic techniques are considered 

as “inconvenience”, not cozy and 

completely neglected”. 

Fig. no 3 Ex libris Dr. Emil I. Bologa 

Another author’s concerns are that 

hydrotherapy “is not included as compulsory 

into Medical Universities’ curricula and this is 

the reason why young doctors’ medical 

education is not complete”. In some 

universities abroad the students are able to 

attend courses about the hydrotherapic theory 

but they cannot have a solid preparation, hold 

the technique and observe the therapeutic 

effects of hydrotherapy” 

Further, doctor Baiulescu insisted on 

the mandatory of doctors’ theoretical 

knowledge to be complete with practical 

skills on the manner of applying the 

hydrotherapic techniques.” If the doctor 

has not enough skills and experience in 

handling the apparatus and tools used to 

apply hydrotherapy, he will be fallible and 

the benefit effects of the applications can 

be compromised”. 

Each doctor should be able to apply all 

the procedures but if this is not possible is 

compulsory at least to supervise the 

applications he prescribed” 

Finally, the importance and value of 

“Medical Hydrotherapy” is non contestable 

as a very bold publication about a new field 

of medical practice, more practical then 

others and which needed advertising and 

motivation to be operable. 

Even the book received objections from 

Cr�iniceanu as not being a valuable book as 

medical literature, the initiative to write a 

useful book for doctors is remarkable. This 

book encouraged all doctors to learn and 

practice hydrotherapy and finally is a proof 

that the doctors of that time tried to reach 

above their condition of practitioners, 

becoming theorists in the same time. 

Reference: 

[1]. Baiulescu G. - Idroterapia medical�, 

Minerva, Institutul de Arte grafice, 

Bucure�ti, 698 de pagini, 1904 

[2]. Bologa V.L. – Contribu�ii la istoria 

medicinii în Ardeal, Tipografia 

Ardealul, Cluj, 1927 

[3]. Bologa V.L. �i colab. – Istoria 

Medicinii Române�ti, Ed. Medical�, 

Bucure�ti, 1970, 

[4]. Br�tescu Gh. – Dic�ionar cronologic 

de medicin� �i farmacie, Ed. �tiin�ific� 

�i enciclopedic�, Bucure�ti, 1975 

[5]. Huttmann A., Barbu G. – Medicina în 

ora�ul Bra�ov ieri �i ast�zi, Ed. 

Medical�, Bucure�ti, 1959, 162 p. 

[6]. Ivan N., Cr�ciun I., Lotreanu C. – 

Istoria Medicinei, Ed. Universit��ii 

Lucian Blaga din Sibiu, 1998 

[7]. Izsak S. – Aspecte din trecutul 

medicinii române�ti, Ed. Medical�, 

Bucure�ti, 1970, 902p. 

[8]. Izsak S. – Farmacia de-a lungul 

secolelor, Ed. �tiin�ific� �i 

Enciclopedic�, Buc, 1979 

[9]. Rogozea Liliana - Farmacognozia în 

preg�tirea studen�ilor medicini�ti din 

România, de-a lungul timpului, Ed. 

Universit��ii Transilvania, 2002 

[10]. * * * – Gazeta de Transilvania, 1850- 

1945.




THE LION’S REPUBLIC FIGHT AGAINST 

THE PLAGUE ORIGINATING FROM THE 

LEVANTE VENETO 

G. ZANCHIN 1 

Abstract: Until its end the Serenissima constantly supported the 

contagionist hypothesis, playing for all the span of its history the role of 

pioneer and model for the measures adopted to prevent the diffusion of 

epidemics. The sanitary preoccupations of the Republic were particularly 

directed upon people and goods arriving from the territories of the Ottoman 

Empire from where periodic bouts of plague originated. The examination of 

the written and iconographic primary sources here considered puts in 

evidence relevant aspects of the Venetian fight against the plague 

Key words: Republic of Venice, plague, epidemics, lazaret, quarantine, 

osella. 

The experience made during the 

epidemics of the XIV th century contributed 

to the affirmation of the contagionist 

hypothesis of which Venice remained 

vigorous supporter for the entire period of 

its history [5] 

This theory maintained that the cause of 

the plague, identified with the so called 

“miasma”, corrupting the air and decomposing 

the bodies, could attach from an 

individual to another, or even adhere itself 

to clothing or to objects, thereafter passing 

to whoever touched them. 

Accordingly, systematic measures of 

isolation, such as sanitary cordons, quarantine 

and disinfection were taken [1] 

In 1423, the Senate ruled out to assign 

the monastery of Saint Mary of Nazareth 

to the isolation of people affected by the 

plague. This was thus transformed into the 

1 Department of Neurological Sciences, University of Padua Medical School. 

“tainted” pesthouse, to become later the 

“old” lazaret (Fig. 1), the first institution to 

be established for this purpose. 

In this last case, according to the 

habitual formula, the location was decreed 

as “healthy (thanks to God) and free from 

any doubt of contagious illness”: a “fede di 

sanità” that is a specific written licence 

bearing this statement, was released in 

such a condition by the local sanitary 

officers. 

Otherwise, only when the prescribed 

period of the quarantine was terminated 

without evidence of the plague the “libera 

prattica” (that is free entrance) was 

granted. Even today in the “new” lazaret 

are still visible the “graffiti” done mostly 

during the sixteen century by people kept 

in isolation for such a long time.

182 


Fig. 1. The Old Lazaret “Lazzaretto Vecchio”. 

Established into the Venetian lagoon in 1423, it was the first institution to be devoted to the 

isolation of people affected by plague. 

The sanitary preoccupations of the 

Republic were particularly directed upon 

people and goods originating from the 

territories of the Ottoman Empire, with 

which Venice maintained commercial ties 

of utmost relevance and where the plague 

was constitutive. 

On the terrestrial side, at the border 

between Dalmatia and the Ottoman 

Empire, a pesthouse at Cattaro was 

constructed and other pesthouses were 

built in the Venetian possessions in the 

“Levante” (the Venetian word for the 

territories facing the oriental Mediterranean 

sea), to control the busy traffic 

with the Turkish domains, from where 

periodic bouts of epidemics originated. 

The measures of prevention against the 

importation of the contagion included the 

disinfection of objects. The treatments 

varied according to the quality and value of 

the merchandise, but from a sanitary 

standpoint two large groups were distinguished: 

“susceptible” and “not susceptible”. 

Under the name of “susceptible” goods were 

encompassed those items that were 

considered to be able to transmit the 

contagion; to the contrary, “not susceptible” 

were those incapable of such a transmission. 

These included materials that by their 

nature seemed to retain more easily the 

“contagious miasma” such as wool, 

clothes, rags, skins, feathers, rope; 

whereas, within the first group, were listed 

(quotation from a XVI th century Venetian 

document) “all of the lumber, wines, oils, 

cured and fresh meats, cheeses, metals, 

jewellery, money”, and further on 

“animals, without leash and harness, 

however; except dog, cat, sheep, mutton 

because these sorts of animals are able to 

propagate contagion”.

G. ZANCHIN: The Lion’s Republic fight against the plague originating from the Levante Veneto 183 

Disinfection of the goods took place 

with the “sborro”, that is the exposure to 

air and sun; or with heating, immersion in 

sea water, spraying with vinegar, “perfuming” 

that is with fumigation which aimed 

at neutralizing the miasma substituting it 

with the “fumes” of aromatic woods. 

The finding of a manuscript notebook of 

the end of XVIII th century of medical content 

allowed us the examination of an 

unpublished report contained within, that 

treats the problem of the propagation of 

contagion, in relation with the closely 

attached problem regarding “susceptible” 

and “not susceptible” goods (Fig. 2). Such a 

distinction, obviously with reference to the 

pre-Pasteurian era, possessed remarkable 

importance. Indeed, in the case a good was 

classified as susceptible, it became necessary 

to adopt the above mentioned measures, all 

of which had noteworthy direct and indirect 

costs. From the verbatim citations, the author 

is clearly identifiable as Ignazio Lotti, head 

physician of the Venetian Magistrate of 

Maritime Health, known for his endeavours 

at diffusing the practice of variolization in 

the domains of the Serenissima Republic [2]. 

Fig.2. Front cover of De multis rebus et de 

quibusdam aliis (1812), unpublished 

manuscript by Ignazio Lotti, Protomedico del 

Magistrato di Sanità Marittima di Venezia. 

Private collection. 

A second important document, 

preserved in the State Archive of Venice, 

will be also examined in this context. It is a 

detailed report by the “Avvocato fiscale” 

(Public Attorney) Lorenzo Alugara on the 

successful containment of the plague 

which reached the lagoon on an Ottoman 

ship in 1793 [6]. 

The way we found it is rather curious. 

Since the year 1521, the Venetian Doge 

used to have coined every year a special 

silver medal, called “osella”, commemorating 

the most relevant events of the 

Serenissima Republic [3]. 

Being interested on the impact of the 

plague on the Venetian traditions, our 

research brought us to identify, among the 

275 osellas coined until the end of the 

Venetian State, five occasions in which the 

coins were referring to the plague [4]. 

Fig.3. Coined in 1793 under the Doge 

Ludovico Manin (first), this “osella” 

commemorates the successful prevention of 

plague epidemics in the port of Venice. On the 

second, in the forefront we see the Vierge, 

encircled by the inscription Nec nuper defeci 

(Even in this distress I did not abandon you). In 

the background, the little church identifying the 

island of Poveglia is well reconignizable, as 

well as a ship put in quarantine.

184 


This rather unknown iconography appeared 

indeed as a relevant document of the popular 

faith, since in most instances a religious symbollism 

is prominent. However, the picture of the last 

osella “of the plague series” (Fig. 3), struck in 

1793, makes a reference not only to the Virgin 

protection, but also to factual measures of isolation, 

clearly quoting a very interesting episode of 

a successful fight against the plague, the detailed 

report of which we were then able to identify in 

the State Archives of the Republic in Venice. 

On a “Tartanella”, a little commercial 

ship, with Ottoman flag and a crew of 

thirty people, a case of bubonic plague 

developed with “petacchie nere, antraci, 

buboni”. 

Strict preventive measure were 

immediately taken “to stop the infection in 

the same place” in the Poveglia’s canal, 

that for this purpose was get rid of any 

other ship. The crew, put ashore, was 

divided in affected and in suspect groups, 

which were held in separate locations. An 

internal ward of soldiers was established 

on the island; around it an external circle 

of armed ships was put. As a whole, 

internal and external wards were formed 

by one hundred forty individuals, plus nine 

ships and two boats. Everything -food, 

water, garments- that was necessary for the 

well-being of the crew was brought ashore 

and continuous fires were kept alive to 

purify the air from the contagious miasma. 

At the end, twenty crew members 

survived and the plague was successfully 

contained within the island. The feelings of 

gratitude for the Republic are well 

documented by a letter wrote to the Venice 

health officers by the captain and the 

surviving crew. 

The examination of the above 

mentioned primary sources put in evidence 

relevant aspects of the Venetian fight 

against the plague. Indeed, until its end the 

Serenissima constantly supported the 

contagionist hypothesis as witnessed by 

the establishment in its lagoon of the first 

lazaret since 1423, playing for all the span 

of its history the role of pioneer and model 

for the measures adopted to prevent the 

diffusion of epidemics. 

References 

[1]. Bergdolt K., La peste nera e la fine del 

medioevo. Edizioni Piemme, Casale 

Monferrato 1997. 

[2]. Lotti I., De multis rebus et de 

quibusdam aliis. Unpublished 

manuscript (Private collection) 1812. 

[3]. Paolucci R., La zecca di Venezia. 

Paolucci editore, Padova 1991. 

[4]. Zanchin G, Mainardi F, Dainese F, 

Maggioni F. La pestilenza nelle 

“oselle”, monetazione celebrativa della 

Repubblica di Venezia. Atti del XLI 

Congresso Nazionale della Società 

Italiana di Storia della Medicina. 

Mesagne (Br) 2002, p. 145-154. 

[5]. Zanchin G. Health and disease in the 

relationships between Venice and 

Istanbul. Proceedings of the 38th 

International Congress on the History 

of Medicine. Istanbul 2002, p. 285 

[6]. Archivio di Stato di Venezia, 

Provveditori alla Sanità, filza 251.




GUILLAUME-BENJAMIN-AMAND 

DUCHENNE - BETWEEN MEDICINE AND ART 

A. VADANUTA PLOTOGEA 1 , A. KERESZTES 2 , 

M. MOARCAS 1 

Abstract: Guillaume-Benjamin-Amand Duchenne was one of the most 

ingenious minds of the 19th century. By combining physics and a thorough 

knowledge of medicine, he described several neuromuscular disorders; his 

work also developed physiology of human facial expression and psychology. 

Born in 1806 in Boulogne-sur-Mer, he studied medicine in Paris and became 

a physician in 1831. Duchenne conducted many experiments using electricity 

as therapeutical and diagnostic tool. In 1850, he published his first results 

regarding the connection between facial expression and electrical 

stimulation of muscles. Duchenne studied paralysis and several myopathies. 

He created a harpoon that could be used to extract sample of muscle tissue 

and this instrument was a predecessor of modern biopsies. Duchenne wrote 

three major books summarizing his research: "De l'électrisation localisée", 

"Mecanisme de la physionomie humaine" and "Physiologie des 

mouvements". Duchenne died in 1875 without having yet obtained respect of 

the medical community; later, his reputation arouse evidently. 

Key words: Duchenne, myopathy, human facial expression. 

Introduction 

The eponyme Duchenne is well known 

in relation with the most common form of 

childhood muscular distrophy, even though 

Duchenne was not the first to describe this 

disease, but the one to clarify both clinical 

manifestations and microscopically characteristics 

based on muscular biopsy studies. [5] 

Guillaume-Benjamin-Amand Duchenne 

was a French neurologist of the XIX th 

century, a pioneer of muscular electrophysiology 

based on Galvani’s research. 

Although the father of modern neurology 

is thought to be Charcot, he truly 

appreciated Duchenne’s work and called 

him „my master”. 

Duchenne chose „de Boulogne” as a 

post-nom in order not to be mistaken for 

1 Bra�ov. 

2 Faculty of Medicine, Transilvania University of Brasov. 

Edouard Adolphe Duchesne (1794-1869) 

from Paris, a respected doctor of the local 

salons at the time. [6] 

Duchenne’s life 

Duchenne (1806-1875) was born on the 

17th of September 1806, in Boulogne-sur- 

Mer (Pas-de-Calais, France), the place 

where his family had lived since the 

middle of the XVIII century. His father 

was marine captain during Napoleon 

Bonaparte’s wars. He was affectively 

connected to his birth places for his whole 

life. Both his personality – active, ambitious, 

yet very calm and his accent and his 

look prove his Boulogne origins. [9] 

Although his family’s tradition was related 

to sea and his father had hoped Duchenne

186 


would follow his steps, love for science 

was stronger. 

Duchenne went to local school, than to 

highschool in Douai and he was 19 years 

old when he got his Bachelor diploma, 

along with his colleague and firned dr. C. 

Gros. Next, he tudied Medicine at Paris 

which he graduated in 1831, with a licence 

thesis about burns called „Essai sur la 

brillure”, having probably been influenced 

in choosing the theme by Dupuytren. 

As a doctor, he returned to his birth city 

where he activated as a general practitioner 

for 10 years. He got married in 1831, but, 

after about 2 years, his wife died of puerperal 

sepsis. Duchenne’s mother in law 

spread many rumours regarding the fact 

that, as a sole witness of his wife’s labor, 

he was responsible for her death; this lead 

to the separation of his only son.[12] 

In 1833, along with dr Gors, Duchenne 

made the first experiments of electropuncture, 

a new technique, invented by 

Magendie and Saralndiere. Thus was the 

beggining of his neuroelectrophysiology 

research. In 1842, Duchenne moved to 

Paris for research that could not be done in 

Boulogne. He was viewed reticently and he 

never received an academic post; at first, he 

worked in charity hospitals and earned his 

existence from private practice. He worked 

for more than 30 years; daily visiting 

hospitals form Paris in the quest of particular 

cases he could research, devoting his entire 

life and passion to medicine and his patients. 

Lonely spirit, he showed an admirable 

ambition, in spite of the fact that his merits 

were appreciated only after death. Duchenne 

died in the 15th of September 1875, 2 days 

before his 69th anniversary, following a 

cerebral haemorrhage. 

Duchenne’s activity and work 

More than his fellow clinicians of the 

time, Duchenne emphasized the 

importance of neurology examination and 

electrophysiological studies. 

Along the description of diseases named 

after him, Duchenne also contributed to 

differentiation of facial nerve paralysis 

caused by central and peripheral neuron; he 

described the cog wheel sign in Parkinson 

disease, the characteristics of Lead intoxications 

and the epigastric respiratory 

depression of frenic paralysis is called 

Duchenne sign. [12] 

In „De l'électrisation localisée et de son 

application à la physiologie, à la pathologie 

et à la thérapeutique” published in 

1955, Duchenne describes the advantages 

and disadvantages of static and dinamic 

electric power use in therapy and 

diagnosis. He presents the influence of 

electricity on skin and the relationship 

between intensity and other characteristics 

of electricity and penetrability in order to 

obtain a biological effect – muscular 

contraction and resistance of living 

structures to electricity, for example. In the 

same book, there is described also the 

machine built by Duchenne for nerve and 

muscle stimulation. There are presented 

the indications of faradisation, the 

treatment technique using electricity: 

profound coetaneous anaesthesia of hands 

or feet, the method seamed to be the only 

way to obtain sensation of various degrees, 

depen-ding on the electrodes and the 

particularities of the subject; also, 

electrical stimulation determines focal 

contraction of the muscles of the face. 

Duchenne believed there was no other 

therapeutically agent as efficient as 

faradisation. The use of the method in 

various types of muscular dystrophies, 

atrophies and paralysis are described. 

Faradisation using wet electrodes was 

proven to be effective in preventing tisular 

necrosis. [2] 

Using faradisation as a diagnostic tool, with 

emphasis on contractility, Duchenne 

discovered the aetiology of poliomyelitis, 

suggesting that the lesion was in the spinal 

cord. [8]

A.V.Plotogea et al.: Guillaume-Benjamin-Amand Duchenne - between medicine and art 

One of Duchenne’s innovations that 

brought precision to diagnosis of muscular 

diseases was a harpoon that allowed the 

percutaneous prelevation of muscle tissue. 

The instrument is thought to be a predecessor 

of modern biopsy. Duchenne used it for the 

diagnosis of progressive muscular atrophy 

and pseudohypertrophic paralysis that is 

nowadays named after him. [8] 

Duchenne was the first to describe 

syphilitic ataxia and chronic progressive 

bulbar paralysis. 

In spite of the fact that pseudohypertrophic 

paralysis of childhood is Duchenne’s 

myopathy nowadays, he was not the firstt o 

describe it, the controversy between him 

and Meryon being well known. Duchenne 

prefer not to read the new scientific 

discoveries in order not to be influenced by 

them. [1] Edward had described the 

condition ever since 1851, mentioning the 

male predominance, the necrotic aspect of 

granular degradation. According to 

Gowers, the first to describe the disease 

was Charles Bell, in 1831. [7] 

Duchenne described the pesudohypertrophic 

paralysis in 1868, using also his 

harpoon for the studies Duchenne characterises 

the muscle weakness that first appears 

in the lower limbs and lumbar region, 

followed by progression to upper limbs, the 

increase in muscle mass due to dvelopment 

of interstitial connective tissue and overporduction 

of fibroses and adipose tissue in more 

advanced stages. He thought that the term 

myo-sclerotic paralysis was more appropiate 

based on histopathologic aspect. [10] 

His first studies about muscular 

dystrophies date from 1850. In 1849, based 

on his research, François Amilcar Aran 

presented a case of progressive muscular 

atrophy that began in the hands and 

forearms and arms. In 1870, Duchenne 

published the description of the 

aforementioned condition, mentioning the 

vermicular fibrilar movements of limbs 

and the fact that the upper limbs were more 

187 

affected in a northerly fashion. The 

characteristic positions of hands were also 

reported: if the abductor policis was 

affected, the first metacarpal muscle is 

closer to the second than it is normally; 

whereas, if the interossei muscles are 

affected the claw hand appears. The 

muscles of the lower limbs are later and 

inconstantly affected and control of 

sphincters is preserved. Duchenne emphasized 

that the contractility is normal, based 

on electrophysiological studies. Histopathological 

studies revealed the loss of 

muscle fibers striations due to replacement 

with granular material and adypocites. [8] 

One of Duchenne;s masterpieces is 

„Mecanisme de la physionomie Humaine” 

published in 1862. The book combines 

contraction electrophysiology studies, 

photography and the study of human 

reactions and emotions. He was influenced 

by physiognomy, a conception that the 

personality and emotions externalize as 

physical characteristics, especially of the 

face. Moreover, he thought of the face as a 

map of spiritual feeling, that divinity had 

not created face muscles only for 

mechanical purposes. 

By isolated, followed by combined 

muscle stimulation, he described the role of 

each muscle of the face: the frontal muscle is 

for attention, the superior part of orbicularis 

is for reflection, the great zygomaticus is for 

joy. The description of Duchenne’s smile 

remains classical – there can be 

differentiated a fake from a sincere smile, as 

the second involves both the contraction of 

great zygomaticus and inferior part of 

orbicularis, while the first is the simple 

contraction of the great zygomaticus. [3] 

In his studies, Duchenne used subjects 

that suffer form a minor mental retard. The 

most famous one is an old man who suffered 

from near complete facial anaesthesia that 

was useful for Duchenne, because the 

electrodes determine an unpleasant feeling in 

a person with intact facial sensibility.

188 


Duchenne believed that the reactions of his 

subjects were common to any individual. In 

this work, there are also photographs he did 

in cooperation with Adrien Tournachon. 

Some of the photographs are compared to 

classical art masterpiece to show how art 

does not always reflect the true feelings. 

(Fig. 1) One of the critics of his time 

reproached him that he takes away from art 

its idealism, reducing it to an anatomical 

realism. [11] 

Fig 1. – Stimulation of eye lids, mandibula 

and frontal reion simulate terror. [11] 

Conclusions 

Duchenne remains a remarkable figure 

of neurology, which he inovated both as 

diagnosis and therapy. As an open minded 

brilliant researcher, he had his work 

recognized only after death, but nowaday, 

he is considered one of the greatest minds 

of the XIX century. He was a complex 

personality, deoting his mind to medicine, 

but also art, technique and photography. 

References 

[1]. Bach, J. R., The Duchenne de Boulogne- 

Meryon Controversy and 

Pseudohypertrophic Muscular Dystrophy, 

Journal of the History of 

Medicine and Allied Sciences, Oxford 

University Press, Oxford, Volum 55, 

Numarul 2, 2000, pag. 158-178 

[2]. Duchenne, G., De l'électrisation 

localisée et de son application à la 

physiologie, à la pathologie et à la 

thérapeutique: et de son application a 

la physiologie, a la pathologie et a la 

thérapeutique, Chez J.-B. Baillière, 

Paris, 1855, pag 5-35 

[3]. Duchenne, G. B., Cuthbertson, A., The 

mechanism of human facial expression, 

Cambridge University Press, 

Cambridge, 1990, pag 129-226 

[4]. Eisen, A, Shaw, P., Aminoff, M. J., 

Motor neuron disorders and related 

diseases, Elsevier Health Sciences, 

New York, 2007, pag 8 

[5]. Jay, V, On a Historical Note: 

Duchenne of Boulogne, Pediatric and 

Developmental Pathology, Springer 

New York, nr. 3, 1998, pag 254–255 

[6]. Koehler, P. J., Bruyn, G., Pearce, J., 

Neurological eponyms, Oxford University 

Press, New York, 2000, pag 301 

[7]. Pearce, J.M.S., Early Observations on 

Duchenne-Meryon Muscular Dystrophy, 

Eur Neurol, Karger Publishers, 

Basel, Numarul 54, 2005, pag 46–48 

[8]. Pearce, J. M. S., Some contributions of 

Duchenne de Boulogne, Journal of 

Neurology, Neurosurgery, and 

Psychiatry, BMJ Publishing Group, 

Londra, 1999; nr. 67, pag 322 

[9]. Poore, G.V., Selections from the 

clinical works of Dr. Duchenne de 

Boulogne, The New Sydenham 

Society, London, 1884, pag 95. 

[10]. 10.Reincke, H., Nelson, K. R., 

Duchenne de boulogne: Electrodiagnosis 

of poliomyelitis, Muscle & 

Nerve, Wiley Interscience, Oxford, 

Volum 13, 2004, Pages 56 – 62 

[11]. 11.Warner Marien, M., Photography: 

A Cultural History, Laurence King 

Publishing, Londra, 2006, pag 148-149 

[12]. 12. Williams, M., Geryatric physical 

diagnosis: a guide to observation and 

assessment, McFarland, Jefferson, 

2007, pag 147 

.

Bulletin of the Transilvania University of Brasov • Vol. 2 (51) - 2009 


Supplement – Proceeding of The IVth Balkan Congress of History of Medicine 

DISEASE AND DEATH IN THE WORK OF 

EUGENE IONESCO 

A-J. FABRE 1 

Abstract: Ten years after his death, Eugen Ionesco is still the most 

celebrated playwright in France. In most great pieces of art, comedy and 

tragedy live side by side, and this confirmed in Exit the King, written while 

Ionesco was ill and frightened of death The play holds a narrow link between 

comedy and tragedy : disease is seen by Ionesco as a disgrace to the intrinsic 

existence, medicine as burlesque distraction in the fate of human beings and 

physicians as grotesque personages anxious to assert their authority on 

patients. The Théatre de l'Absurde had a deep impact in France but very 

powerful links have always existed in French cultural life between France 

and Romania, among many other examples : Stephane Lupasco, Tristan 

Tzara, Emil Cioran, Paul Celan and Martha Lahovary, better known as 

Princess Bibesco 

Key words: Ionesco, Exit the King, Romania, Theatre of Absurd 

Ten years after his death, Eugen Ionesco 

is still the most celebrated playwright in 

France. 

His life was shared between France and 

Romania : Ionesco was born in 1909 in 

Slatina near Bucharest, but, soon after, was 

brought by his family to Paris but, in 1922 

Ionesco returned to Romania together with 

his sister. There; he learnt Romanian and 

attended the college Sfântul Sava in 

Bucharest and passed the baccalaureate at 

the secondary school in Craiova in 1928. 

In 1938, Ionesco comes back to Paris 

after having obtained a state grant to write 

a thesis (which he never finished…) on 

"Topics of sin and topics of death in 

French poetry since Baudelaire". 

However, when the 2nd World War was 

declared, he decided to return home to 

work there as French teacher at Sfântul 

Sava. 

1 International Société for Hstory of Medicine, France 

Now the situation in Romania was so 

bad that Ionesco, in May 1942 , had no 

other choice than return to France with his 

wife Rodica Burileanu. 

A long difficult period began for Ionesco 

until the fifties and the premiere of his 

play, "The Bald Soprano" still performed 

at the Théatre de la Huchette in Paris : the 

15000th representation was recently 

celebrated ! 

Ionesco gained gradually fame in the 

sixties as founder of the Theatre of Absurd, 

capturing, alongside Samuel Beckett, Jean 

Genet, and Arthur Adamov, all the 

meaninglessness of existence. 

Celebrated everywhere in the world, 

Ionesco, suffering since long time of a 

severe form of diabetes, died in Paris in 

1994 

In most great pieces of art, comedy and 

tragedy live side by side, and this is the 

case with Eugene Ionesco’s Exit the King,

190 


the most emblematic play of Ionesco 

created by Jacques Mauclair in 1962 at the 

Théatre de l'Alliance in Paris. 

In the play, a parodic patriarch is ruling 

over less than a thousand prematurely-aged 

subjects : now he feels that death will 

come soon and howls against his fate, 

moving from denial to terror towards a 

final, moving, acceptance 

Around the King, two rival queens, 

Marie who tries to make Berenger face the 

reality of his impending death and the 

sweet Marguerite, attempting to keep the 

King from knowing that end is imminent. 

There is also a domestic help, Juliette, 

the wide-eyed servant, a Guard always 

prone to commemorate the Past and the 

Doctor, central symbol of authority 

proclaimed: both executioner physician, 

astrologer and bacteriologist 

Ionesco in this play views medicine as 

mere distraction to help humans forget 

their fate, disease as a disgrace to intrinsic 

existence and physicians as grotesque 

personages only anxious to assert full 

authority on their patients. 

References 

1. Béhar H.: Le théâtre dada et 

surréaliste. Gallimard, Paris, 1979 

2. Bonnefoy Cl.. "Entretiens avec Eugène 

Ionesco". "Entre la vie et la rêve". Pierre 

Belfond. Gallimard, Paris, 1966. 

3. Cleynen-Serghiev E.: La jeunesse 

littéraire d'Eugène Ionesco. Paris : 

Presses universitaires de France, 1993 

4. sselin M.. The Théâtre of the absurde. 

Doubleday, New York. 1961 

5. Hamdan A.. Ionescu avant Ionesco : 

portrait de l'artiste en jeune homme. P. 

Lang, Berne, 1993 

6. Ionesco E.. Littérature roumaine suivi 

de Grosse chaleur. Fata Morgana, 

Saint-Clément-la-Rivière, 1998 

7. Ionescu G.. Les Débuts littéraires 

roumains d'Eugène Ionesco. 1926- 

1940. C. Winter, Heidelberg, 1989 

8. Jacquart E.. Le théâtre de dérision. 

Gallimard, Paris, 1974 

9. Plazy G.. Eugène Ionesco : le rire et 

l'espérance : une biographie. Julliard, 

Paris, 1994 

10. Stolojan S.. Au balcon de l'exil roumain à 

Paris : avec Cioran. Eugène Ionesco. 

Mircea Eliade. Vintila Horia l'Harmattan, 

Paris Montréal (Québec) 1999

CONTENT 

Erdemir, A.D.: Laws on Medical Ethics in Turkey from the Past to Nowadays and 

Comments............................................................................................................................... 5 

Bogdan, C.: Historic Highlights and Perspectives of Bioethics in Romania ....................... .9 

Rogozea, L.; Leasu, F.; Nedelcu, L.; Bălescu, A.; Nemet, C.; Marcu, N.: Three 

Personalities of Medicine – Representative for Medical Ethics within 

Romania ...................................................................................................................... 15 

Yaprak, M.; Gökçe, N.: One Writing from ðbrahim Temo about Thermal 

Springs of Bursa and Romania ................................................................................... 21 

Lucasciuc, A.; Suliman, M.-G.; Elefteriu, O.; Grecu, C.: The Greek Pharmacist 

Gherasimos Zervos (1842-1901) and his Successors, the Zervos 

Physicians from Romania ........................................................................................... 25 

Lucasciuc, A.; Suliman, M.-G.; Elefteriu, O.; Grecu, C.: Greek Physicians and 

Pharmacists Graduated in Athens Practicing in Romania ........................................ 29 

Besciu, M.: The Byzantine Physicians .................................................................................. 33 

Baran, D.: Greek Physicians and Medical Emancipation of the Romanian Lands............... 39 

Diaconescu, D.; Toma, S.; Diaconescu, R.-S.: The Importance of Studying 

Greek Philosophers and Physicians (5th – 3rd Century B.C.): 

Contribution to the Development of Neuroscience in Medical Schools ..................... 47 

Tartau, L.; Lupusoru, R.V.; Lupusoru, C. E.; Andritoiu, C.; Duma, O.: Doctor- 

Patient Relationship in Neuropathic Pain: A Comparative Study between 

Urban and Rural Zone................................................................................................ 53 

Rogozea, L.; Dragoman, M.; F. Leasu, F.; łurcanu, M.; R. Miclăus, R.; Cardis, 

M.: A Reference Analysis about the Human Soul ....................................................... 59 

Erdemir, A.D.; Erer, S.: Prof. Dr. Hulusi Behcet (A Famous Turkish Physician) 

(1889-1948) and his Book on Cutaneous Leishmaniasis (Oriental Sore) ................. 67 

Bakir, B.; Basağaoğlu, I.: The Effects of the Medical Functions on Architecture 

in Süleymaniye Dar’us Sifa of the Ottoman Dar’us Sifas .......................................... 71 

Gökçe, N.; Yaprak, M.: Summary of the History of the Thrace Fighting Malaria 

Organization............................................................................................................... 81 

Albou, P.: Ambroise Paré’s Broken Left Leg in 1555........................................................... 85 

Vasylyev, Y.K.: Significance of Physicians’ Society in Odessa in Generation 

and Formation of Phagocytal (I.I. Mechnikov’s) Theory (Dedicated to 

Centenary of I.I. Mechnikov’s Nobel Prise Awarding)............................................... 89 

Atici, E.; Atici, T.: Milestones Physicians and their Contributions in Turkish 

Orthopedics and Traumatology.................................................................................. 93 

Fulga, M.; Andreescu, V.; Lupulescu, D.: Silicosis Disease History in 

Exploitation of Coal in Jiu Valley............................................................................... 101 

Găbrean, S.: Some Contributions of Romanian Medical School in the Treatment 

of Neurosyphilis before the Discovery of Antibiotics ................................................. 105 

Musajo Somma, A.; Musajo Somma, L.: Lazzaro Spallanzani, in Transylvania 

Drive ........................................................................................................................... 109 

Tricot, J.P.: Victor Gomoiu and the Cantacuzène-Commission ........................................... 115

Bulletin of the Transilvania University of Brasov • Vol. 6 (51) – 2009 • Series VI 

Muresan, O.; Safta, L.: Medical and Toxicological Aspects in Arthur Conan 

Doyle’s Writings ........................................................................................................ 121 

Ertin, H.; Usmanbas, O.; Basagaoglu, I.: Ord. Prof. Dr. Cemil Topuzlu (1866- 

1958) and his Contributions to Turkish Surgery ........................................................ 125 

Awojoodu, O.; Baran, D.: Traditional Yoruba Medicine in Nigeria: A 

Comparative Approach............................................................................................... 129 

Baran, D.: Dr. Victor Gomoiu, Balkan Paradigms and Lessons of a Lifetime .................... 137 

Balescu, A.; Nedelcu, L.: The Aspirin – The First Drug Obtained by Sinthesys – 

Frequently Used Currently ......................................................................................... 145 

Diamandopoulos , A.: Hippocrates’ Memories of Scythia: Stories and 

Fairytales ................................................................................................................... 149 

Brodel, E.G.; Ionescu, C.: One of the First Articles about the Romanian Ethno 

Naturopathy Published in a Western Science Paper Was Written by 

Colonel Dr. Jakob Von Czihak and Dr. Iosef Szabo 157 

Neica, L.; Aldulea, N.: Ana Aslan, the Woman who Defeated Time..................................... 161 

Sangeorzan, L.: Historical aspects of Computer Science in the Emergency 

Room in Transilvania University of Brasov - A Study Case - .................................... 167 

Repanovici, A.; Rogozea, L.; Miclăus, R.: Analysis of the impact of History of 

Medicine’s Publications ............................................................................................ 173 

Miclăus, R.; Rogozea, L.; Sechel, G.; Fleancu, A.; Cristea, L.; Baritz, M.: 

„Medical Hydrotherapy” of George Baiulescu – an Historical 

Perspective ................................................................................................................. 177 

Zanchin, G.: The Lion’s Republic Fight against the Plague Originating from the 

Levante Veneto............................................................................................................ 181 

Vadanuta-Plotogea, A.; Keresztes, A.; Moarcas, M.: Guillaume-Benjamin- 

Amand Duchenne - between Medicine and Art........................................................... 185 

Fabre, A-J. : Disease and Death in the Work of Eugene Ionesco ......................................... 189

BULLETIN OF THE 


OF BRASOV 

Vol. 2 (51) – 2009 

Series VI 


– SUPPLEMENT – 

PROCEEDING OF THE IV TH BALKAN 

CONGRESS OF 


ISSN IS N 2065-2224 2065 2224

Series VI: Medical Sciences – SUPPLEMENT ... - Krongres

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