Diabetes mellitus is a group of metabolic diseases involving carbohydrate, lipid, and protein metabolism. It is characterized by persistent hyperglycemia which results from defects in insulin secretion, or action or both. Diabetes mellitus has been known since antiquity. Descriptions have been found in the Egyptian papyri, in ancient Indian and Chinese medical literature, as well as, in the work of ancient Greek and Arab physicians. In the 2(nd) century AD Aretaeus of Cappadocia provided the first accurate description of diabetes, coining the term diabetes, while in 17(th) century Thomas Willis added the term mellitus to the disease, in an attempt to describe the extremely sweet taste of the urine. The important work of the 19(th) century French physiologist Claude Bernard, on the glycogenic action of the liver, paved the way for further progress in the study of the disease. In 1889, Oskar Minkowski and Joseph von Mering performed their famous experiment of removing the pancreas from a dog and producing severe and fatal diabetes. In 1921, Frederick Banting and Charles Best extended Minkowski's and Mering's experiment. They isolated insulin from pancreatic islets and administrated to patients suffering from type 1 diabetes, saving thus the lives of millions and inaugurating a new era in diabetes treatment.
The iconography of the doctor saints Cosmas and Damian and the artistic representations of their miracles are important sources for the history of medicine. Within the sphere of physician-saints, Cosmas and Damian have the greatest number of iconographic depictions in Byzantine and Post-Byzantine art. In most of their representations, they wear long robes as a sort of professional mantles and carry surgical instruments and boxes indicating their status as doctors. The progress of Byzantine surgery could be attested by these objects, some of them mentioned in collections of miracle stories and documented in medical sources.
Diabetic retinopathy is a microvascular complication of diabetes mellitus and is a significant cause of new-onset blindness. Diabetic macular changes in the form of yellowish spots and full or partial thickness extravasations through the retina were observed for the first time by Eduard Jäger. In 1855, he published "Beiträge zur Pathologie des Auges" where he included his fundus paintings. Jaeger's findings were controversial until 1872, when Edward Nettleship published his seminal paper on "Oedema or cystic disease of the retina", providing the first histopathological proof of "cystoid degeneration of the macula" in patients with diabetes. In 1876, Wilhelm Manz described the proliferative changes occurring in diabetic retinopathy and the importance of tractional retinal detachments and vitreous haemorrhages. However, it was not until 1943 that the work of Arthur James Ballantyne provided evidence that diabetic retinopathy represents a unique form of vascular disease. A number of multi-centred clinical trials during the last ten years have contributed substantially to the understanding of the natural history of diabetic retinopathy and have established the value of intensive glycaemic control in reducing both the risk of onset and the progression of diabetic retinopathy.
Our research on the texts of the Byzantine historians and chroniclers revealed an apparently curious phenomenon, namely, the abandonment of terminally ill emperors by their physicians when the latter realised that they could not offer any further treatment. This attitude tallies with the mentality of the ancient Greek physicians, who even in Hippocratic times thought the treatment and care of the terminally ill to be a challenge to nature and hubris to the gods. Nevertheless, it is a very curious attitude in the light of the concepts of the Christian Byzantine physicians who, according to the doctrines of the Christian religion, should have been imbued with the spirit ofphilanthropy and love for their fellowmen. The meticulous analysis of three examples of abandonment of Byzantine emperors, and especially that ofAlexius I Comnenus, by their physicians reveals that this custom,following ancient pagan ethics, in those times took on a ritualisedform without any significant or real content.(7ournal of Medical Ethics 1999;25:254-258)
Brucella abortus may have been the etiologic agent.
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