Reducing fear and the risk of death in Marfan syndrome: a Chaucerian pilgrimage (original) (raw)
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Medievalism and the Medical Humanities
postmedieval, vol. 8.2, 2017
He was a verray, parfit praktisour' (Benson, 1987, 30). This is the highthough in context equivocal-praise given to the Physician, one of the pilgrims in Geoffrey Chaucer's Canterbury Tales. The endorsement is based on the Physician's knowledge of his subject: he has expertise in medicine and surgery, including the humoral system and astrology-'magyk natureel' (Benson, 1987, 30). He is deemed a successful physician for his ability to discover an origin and remedy for every illness: 'The cause yknowe, and of his harm the roote, / Anon he yaf the sike man his boote' (Benson, 1987, 30). Direct engagement with the 'sike man,' however, seems limited, and indeed, it was not until the eighteenth century that medical practice would include physical examination of a patient. In Chaucer's depiction, there is no real sense of individual diagnosis, but rather of a framework applied to 'sickness' so that a solution can be found as efficiently as possible. The Physician's main interest proves to be his fee. How influential, then, was the patient, or the individual more generally, in shaping medieval conceptions of medicine and wellbeing? What were the roles of society, economics, politics, culture, and language? What were the boundaries between illness and health, how were normal and
The Bounds of Domestic Healing: Medical Recipes, Storytelling and Surgery in Early Modern England
Social History of Medicine, 2013
This paper investigates ways in which early modern English recipe collections constructed domestic medicine as broader and more powerful than is often appreciated. It shows that their compilers frequently selected recipes that promised to allow them to address a wide range of surgical ailments, to heal serious surgical conditions medicinally, and to avoid invasive interventions. Claims of remedies' virtues and stories of their successes imagined domestic medicine not only as a ‘first port of call’, but also as a potent counterpart to the work of practitioners; a last resort when practitioners had failed; and as an alternative to the knife. Using the writings of the surgeon John Woodall, it argues that surgeons were sensitive to the attitudes and preferences that motivated this collection. In seeking to discipline surgery, Woodall invoked the stereotypical gentleness of women's and domestic medicine in an effort to inculcate greater discernment in the use of violence.
The Marfan syndrome and the cardiovascular surgeon
European Journal of Cardio-Thoracic Surgery, 1996
The authors present the current status of surgery for the cardiovascular manifestations of the Marfan syndrome. In addition, a brief review of current Marfan genetic research is presented. Data on all Marfan patients undergoing aortic root replacement at the Johns Hopkins Hospital (September 1976-June 1995) were analyzed. Survival and event-free curves were calculated and risk factors for early and late death were determined by univariate and multivariate analysis. Two hundred twelve Marfan patients underwent aortic root replacement using composite graft (202), homograft (8) or valve-sparing procedures (2). One hundred eighty-five patients underwent elective repair with no 30-day mortality. Twenty-seven patients underwent urgent surgery, primarily for acute dissection; two patients with aortic rupture died in the operating room. Actuarial survival of the 212 patients was 88% at 5 years, 78% at 10 years and 71% at 14 years. By multivariate analysis, only poor NYHA class, male gender and urgent surgery emerged as significant independent predictors of early or late mortality. Histologic examination of excised Marfan aortic leaflets by immunofluorescent staining for fibrillin showed fragmentation of elastin-associated microfibrils. These studies suggest cautious use of valve-sparing procedures in Marfan patients. Over the last 5 years significant progress has been made in identifying mutant genes that code for defective fibrillin microfibrils in Marfan patients. Attempts are underway to develop animal models of Marfan disease for study of possible gene therapy. Aortic root replacement can be performed in Marfan patients with operative risk under 5%. Long-term results are gratifying. At present, valve-sparing procedures should be used cautiously in Marfan patients because of fibrillin abnormalities in the preserved aortic valve leaflets.
Journal of Health, Medicine and Nursing, 2019
William Shakespeare's plays provide an invaluable compendium of medical terminology in the form of brief to detailed descriptions of clinical features and pathophysiology of various medical conditions. Shakespeare's ability to describe dysfunctions of the human body and mind is astounding and has remained so for almost four centuries. The afflictions appear in the characters of kings, princes' and commoners in his plays and their clinical features described in verse are more or less true even to this day. The aim of this study is to present a comprehensive compilation of medical afflictions from Shakespearean plays in alphabetical order containing verses that specifically depict clinical features, pathophysiology of medical conditions and medical ethics, and to provide short clinical explanations of relevance of passages in modern times as appropriate. Most passages do not reflect on the clinical conditions of actual patients, but deal with figurative expressions, drawn from clinical relevance in medicine during the Shakespearean era and used figuratively by the bard to illustrate those expressions through characters in the plays.
The Middle Ages Contributions to Cardiovascular Medicine
Brazilian Journal of Cardiovascular Surgery, 2016
The historical period called the Middle Ages, a long interval between the 5 th and the 15 th centuries, is still commonly known as the Dark Ages, especially in the area of health sciences. In the last decades, this "classic" view of the Middle Ages has been gradually modified with advances in historiographical studies and the history of science. During that period in Western Europe, knowledge about the human body suffered a regression in terms of anatomy and physiology, with the predominance of religious conceptions mainly about diseases and their treatments. Knowledge on the cardiovascular system and heart diseases has been classically described as a repetition of the concepts developed by Galen from the dissection of animals and his keen sense of observation. However, the Middle East, especially Persia, was the birth place of a lot of intellectuals who preserved the ancient knowledge of the Greeks while building new knowledge and practices, especially from the 8 th to the 13 th century. The invasion of the Arabs in North of Africa and the Iberian Peninsula and the eclosion of the Crusades resulted in a greater contact between the East and the West, which in turn brought on the arrival of the Arab medical knowledge, among others, to 12 th century Europe. Such fact contributed to an extremely important change in the scientific medical knowledge in the West, leading to the incorporation of different concepts and practices in the field of cardiovascular Medicine. The new way of teaching and practicing Medicine of the great Arab doctors, together with the teaching hospitals and foundations in the Koran, transformed the Medicine practiced in Europe definitely. The objective of this paper is to describe the knowledge drawn up from the Middle Ages about the cardiovascular system, its understanding and therapeutic approach to cardiologists and cardiovascular surgeons.