Historic review: select chapters of a history of stroke

Abstract

Background There is no shortage of books, chapters and papers on the history of stroke focusing predominantly on the last 150 years and enumerating endless “milestones”. Instead of adding another article to this body of knowledge, this essay aims at ensuring awareness for the “big picture”, the “grandes routes”, and the “striking breakes” without overloading the reader with too much detail. Results From a medical point of view, the history of stroke consists of two periods: the early era from the beginnings to 1812, and the following period from 1812 up to the present. It is argued that both periods require different methodical approaches, including disparate historiographical perspectives and varying forms of interpretation. In order to fully understand medical writings of the Greco-Roman era (Hippocratic writings, Galenic corpus) on “apoplexy”, a solid knowledge of ancient doctrines concerning health and disease is indispensable. During the Middle Ages, the spiritual perspective can be highlighted by focusing on miracle healing and patron saints. While stroke basically remained a conundrum for many doctors and patients in early modern times (ca. 1500–1800; Platter, Wepfer), the revolutionary perception and definition of the disease as a result of a lesion in the 1810s (Rochoux, Rostan) opened the door to a productive relationship of the upcoming discipline “neurology” with the natural sciences during the nineteenth century and beyond (Virchow et al.). The mostly unwritten history of stroke in the twentieth century should not only include the medical, but also the patient’s and the societal perspective. Conclusion A deeper insight into the recent and distant past will produce better educated strokologists – physicians who are able to put their own work into perspective.

Medicine in the Hippocratic and post-Hippocratic age

“…His work was continued by his sons and a son-in-law. After him, two important schools of medicine stood out: Dogmatic and Alexandrian 17 .…”

“…He practiced embryology and believed that both mother and father participated in the creation of embryos. They called him another Hippocrates 1,17 . Praxagoras was Diocles's successor.…”

“…He was the first to distinguish between arteries and veins. As Herophilos, whose teacher he was, he thought that there was air in the arteries 1,17 .…”

“…He claimed that the basis for a human being was determined by the father, and that the mother only gave what was needed for growth. In addition to the known four elements, he added the fifth, "the principle of life" 1,17 . Aristotle thought that the heart was the center of emotions and intelligence.…”

“…In his book Historia Animalium he gave the first description of the lymphatic system. He believed that some of the fibers between nerves and veins contained sanies, a colorless fluid 1,14,17 .…”