The discovery of pulmonary circulation: From Imhotep to William Harvey

Leonardo Botallo (1530-1587) and his pioneering contributions to traumatology, cardiology and deontology

Leonardo Botallo (1530-c. 1587) is widely known for the eponymous "foramen Botalli" and "ductus Botalli". The first, most commonly named "foramen ovale", allows blood in the fetal heart to enter the left atrium from the right atrium. The second, named "ductus arteriosus", consists of a blood vessel in the developing fetus connecting the trunk of the pulmonary artery to the proximal descending aorta. However, Botallo was a multifaceted figure who studied many aspects of human anatomy and physiology, also making important contributions to clinical and surgical practices. Moreover, as we will see in the last section of this paper, Botallo wrote a book on medical deontology having significant features in relationship to the history of medical ethics. Botallo's multidisciplinary approach is a typical characteristic of Renaissance physicians and scientists, who contributed to making this period a fundamental prelude to the scientific revolution of the 17th century.

Milestones in Understanding Pulmonary Circulation: From Antiquity to Heart-Lung Machine

Human pulmonary circulation is as full of mysteries and surprises as is the history of attempts to uncover and understand them. The Special Issue of Diagnostics, appearing after 2020 immobilized the world, give us an opportunity, space and momentum to remind to our medical community at least the main milestones which mark the progress that was made before our times. This review’s aim is to remind about pioneers and their ideas which now are considered as if they were always with us—which is not the case…

Cardiovascular and pulmonary interactions: why Galen's misconceptions proved clinically useful for 1,300 years

The new generations of physicians are, to a large extent, unaware of the complex philosophical and biological concepts that created the bases of modern medicine. Building on the Hellenistic tradition of the four humors and their qualities, Galen (AD 129 to c. 216) provided a persuasive scheme of the structure and function of the cardiorespiratory system, which lasted, without serious contest, for 1,300 yr. Galen combined teleological concepts with careful clinical observation to defend a coherent and integrated system in which the fire-heart-flaming at the center of the body-interacts with lungs' air-pneuma to create life. Remarkably, however, he achieved these goals, despite failing to grasp the concept of systemic and pulmonary blood circulations, understand the source and destiny of venous and arterial blood, recognize the lung as the organ responsible for gas exchange, comprehend the actual events taking place in the left ventricle, and identify the source of internal heat. In this article, we outline the alternative theories Galen put forward to explain these complex phenomena. We then discuss how the final consequences of Galen's flawed anatomical and physiological conceptions do not differ substantially from those obtained if one applies modern concepts. Recognition of this state of affairs may explain why the ancient practitioner could achieve relative success, without harming the patient, to understand and treat a multitude of symptoms and illnesses.

The rich heritage of anatomical texts during Renaissance and thereafter: a lead up to Henry Gray's masterpiece

The practice of modern human anatomy was started by Vesalius in sixteenth century Europe during the Renaissance. His exploits are documented in his legendary anatomical text De humani corporis fabrica. Remarkable success of De humani encouraged noted anatomists to publish their own texts over the years. Such a cascading effect started an ongoing process of refining the text based presentation of anatomical details that eventually led to the emanation of Gray's Anatomy, the masterpiece from Henry Gray. In this review article we have tried to revisit the journey from De humani to Gray's Anatomy and have also highlighted on other anatomical texts that form important landmarks in this journey. The article attempts to focus on the rectification of Galenic errors, description of new discoveries in human anatomy, introduction of the concept of clinical anatomy, emergence of surgical anatomy and the advent of sectional anatomy. The article also put emphasis on the efforts to make anatomical illustrations used in texts more scientific and in tune with the printed matter. We noted with interest that luminary anatomists over the years have contributed in their own individual manner towards the development of text based anatomy and from cumulative perspective their visionary efforts have shaped the outlook of anatomical texts in present times.

Toward an accelerated adoption of data-driven findings in medicine : Research, skepticism, and the need to speed up public visibility of data-driven findings

To accelerate the adoption of a new method with a high potential to replace or extend an existing, presumably less accurate, medical scoring system, evaluation should begin days after the new concept is presented publicly, not years or even decades later. Metaphorically speaking, as chameleons capable of quickly changing colors to help their bodies adjust to changes in temperature or light, health-care decision makers should be capable of more quickly evaluating new data-driven insights and tools and should integrate the highest performing ones into national and international care systems. Doing so is essential, because it will truly save the lives of many individuals.

Looking for the Word "Angiogenesis" in the History of Health Sciences: From Ancient Times to the First Decades of the Twentieth Century

This review deals with the origin of the term "angiogenesis", with an attention to John Hunter who is credited with this neologism. A part of the literature refers to a Hunter's work dating 1787, and the other part claims the first use of the term "angiogenesis" in the Hunter's masterpiece published in 1794. Since we were unable to find the term "angiogenesis" in Hunter's works, this review attempts to bring a new contribution to the historical research of this important concept, moving from ancient times to the first decades of the twentieth century, when "angiogenesis" begun to appear on titles of scientific articles. The development of the knowledge on the cardiocirculatory system and the principal steps of this fascinating subject were examined, with particular regard to microvascular bed and vessel sprouting, and to the intriguing observations on blood vessel neoformation that have been also made in the premicroscopic era. In Hunter's works, the concept of angiogenesis indeed emerges, but not the term "angiogenesis". The scientific language occurring during Hunter's time was still old-fashioned, and the term "angiogenesis" was not one of those he used, rather a much later neologism that sounds too modern to appear in that context. Would the first appearance of the term "angiogenesis" occur in late nineteenth century in studies dealing with embryogenesis and organ vascularization? The present study aims to explore the scientific literature and to open a debate to better define this matter.