Hippocratic Method Research Articles

Evaluation of the scapulohumeral distraction technique for anterior shoulder dislocation: a randomized controlled trial

IntroductionShoulder dislocation is a common injury presenting in emergency Department. Numerous methods have been described in the literature for glenohumeral reduction. These methods can be divided into two groups: traction maneuvers and the combination of traction with scapula manipulation techniques. In this article, we introduced a new maneuver for shoulder reduction, namely, the combination of traction with handling the scapula (scapulohumeral distraction, SHD) and compare it to the Hippocratic Method (HT). Materials and methodsThe study took place from November 2021 to September 2023. A total of 96 patients with acute anterior shoulder dislocation were enrolled in the study. Eighty-seven patients, who met all inclusion criteria, were randomly assigned to one of the two groups (SHD and HM). We evaluated each method for success rate, time to relocation, complications over a follow-up period of one month, patients’ satisfaction and pain level during the procedure. ResultsBoth methods had comparable success rates (SHD 95.3% vs. HM 93.2%, p=.833) while no complications where observed. However, SHD method required significantly less procedure time (p=.001). Moreover, patients in SHD group reported significantly less pain (p=.012) and greater satisfaction (p=.003) levels. Furthermore, when we assessed relocation time, pain and patient satisfaction as a function of recurrence, there were no statistically significant differences between the 2 techniques. Similarly, the evaluation of relocation time for both techniques as a function of BMI and age did not indicate statistically significant differences. ConclusionScapulohumeral distraction technique (SHD) represents a safe, anatomically based and simple method for shoulder reduction. It showed a statistically significant decrease in relocation time and pain, with patients mentioned higher satisfaction rates compared to the classical Hippocratic method. Nonetheless, there were no statistically significant differences between the two techniques regarding success rate.

Modified chair method: an easy and efficient reduction method without medication for anterior shoulder dislocation

BackgroundVarious maneuvers have been introduced to address anterior shoulder dislocations. Chair method allows the patient to sit comfortably and feel less pain during the reduction procedure. However, the rarity of comparative studies led to a lack of evidence to popularize. The present study aimed to introduce a modified chair (MOC) reduction method for anterior shoulder dislocation and explore its effectiveness compared with the traditional Hippocratic approach.MethodsThis is a single-center retrospective study of 257 patients with anterior shoulder dislocation from September 2020 and July 2021. Patients were divided into two groups according to the reduction method they received (either the Hippocratic method or the MOC method). Success rate, reduction time, visual analog scale (VAS) pain score, satisfaction level, and a new indicator, pain index (reduction time (s)* VAS/ 10), were compared.ResultsOne hundred sixteen patients (43 females, 73 males) underwent the Hippocratic method, and 141 (65 females, 76 males) MOC method. A significantly higher success rate was seen in the MOC group (96.5%(136/141) vs. 84.5%(98/116) in the Hippocratic group; OR 5, 95%CI 1.79 ~ 13.91; p = 0.002). Pain index of the patients in the MOC group was much lower than that in the Hippocratic group (3.20 (2.10, 4.53) vs. 36.70 (22.40, 47.25), p < 0.001). The reduction time, VAS pain score, and satisfaction level also favored the MOC method.ConclusionsThe MOC method is an easy and efficient reduction method with minimum assistance for anterior shoulder dislocations. Physicians can skillfully perform this procedure with the help of their body weight. The MOC method could be attempted for shoulder dislocations in the emergency department.

Shoulder Dislocation Reduction by the Novel Prakash’s Method

1. Objectives: The aim of this study is to evaluate the effectiveness of Prakash’s Method of relocation for dislocated shoulder. 1.2. Study Design: Descriptive Study. 1.3. Setting: Sports units of Hayatabad Medical Complex, Peshawar. 1.4. Method: 30patients (30 Shoulders) were recruited for study, all patients with signs symptoms of shoulder dislocation by clinical examination were subjected to anterior/ posterior shoulder radiograph. And those diagnosed with anterior shoulder dislocations were initially enrolled in the study. Reduction was performed using Prakash's method 1.5. Results: Prakash's method had success rate of 90.0% (n=27). In 10.0% (n=3) the reductions who failed were then reduced under anesthesia using the Hippocratic method. 50.0% (n=15) patients has mild pain, 36.7% (n=11) has moderate pain, and 13.3% (n=4) has severe pain during the procedure. All patients having mild and moderate pain were reduced successfully in the first attempt. 4 patients who has severe pain out of which 1 patient was reduced successfully and 3 patients were reduced by the Hippocratic method using anesthesia. The reduction time was ranging from 180-300 seconds with a mean of 216±85 seconds. no complication occurred during the procedure. 1.6. Conclusion: Prakash Method of shoulder relocation for acutely dislocated shoulder is an effective method.

Management of Shoulder Dislocation by Prakash Method

OBJECTIVES: The objective of the study is to evaluate the effectiveness and safety of shoulder reduction developed by Prakash. METHODOLOGY: This descriptive study was carried out at Rehman Medical and Surgical Center District Buner and Naseer Teaching Hospital Peshawar from June 2017 to December 2019. All patients with a history of trauma to either shoulder were subjected to anterior-posterior shoulder radiograph. Those having shoulder dislocation were enrolled in the study. Data including age, gender, previous dislocation history, duration of dislocation and associated fracture, and fracture type were recorded in patient case sheet. Patients having recurrent dislocation, polytrauma, low GCS, fracture-dislocations, and more than a week history of dislocation were excluded from the study. RESULTS: This study was performed on 30 patients. The mean age of the patients was 36.46±11.58 years. Among them, 83.3% (n=25) were male and 16.7% (n=5) were female. While dislocation occurred on the right shoulder in 63.3% (n=19) and in 36.7% (n=11) on the left side. All the patients have dislocation for the first time. The reduction was performed using Prakash’s method. The success rate was 90% (n=27) and 10% (n=3) the reduction failed, which was then reduced under anesthesia using the Hippocratic method. CONCLUSION: The Prakash's method for reducing anterior shoulder dislocation requires minimum assistance with no anesthesia, it is safe, less time consuming, has a high success rate, less pain, and has minimal complications.

Umbelliferone (7-hydroxycoumarin): A non-toxic antidiarrheal and antiulcerogenic coumarin

Gastrointestinal diseases are very common problems; available treatments are very limited and come with a range of side effects. Coumarins are an extensive class of phenolic compounds that can be found in plants, fungi and bacteria. The 7-hydroxycoumarin, also known as umbelliferone (UMB), is a compound that comes from coumarin and has been showing biological activities in other studies. As of this scenario, the present study was designed to evaluate the acute oral toxicity, mutagenic, antidiarrheal, anti-bacterial, and antiulcerogenic effects, and antioxidant capacity of UMB. An investigation was conducted through the hippocratic screening method and through histopathological analysis in animals to evaluate the effects of acute oral administration of a dose of 50, 100 and 200 mg/kg of UMB. A micronucleus test on peripheral blood of Swiss mice, which were orally treated with three doses (50, 100 and 200 mg/kg), was conducted to evaluate mutagenic activities. The antiulcerogenic activity was accomplished through the ethanol-induced damage method. Antidiarrheal activities were tested for inducing diarrhea with castor oil and evaluating intestinal transit duration; additionally, the antimicrobial effect against some enteropathogenic bacteria was analyzed. Finally, the antioxidant capability was determined by the capacity of the UMB sample to kidnap the stable radical 2,2-diphenyl-1-picrylhydrazyl. Of the evaluated doses, signs of toxicity after acute administration of the compound were not observed. UMB presented antiulcerogenic activity (100 and 200 mg/kg), which was explained because of its antioxidant capacity. A gastro protective effect was similar to the positive control, and the UMB was able to significantly reduce intestinal transit, and also diarrheal symptoms. Furthermore, UMB had an anti-bacterial effect with minimum inhibitory concentration fluctuating between 62.5 and 1000 μg/mL. Based on these findings, we can suggest that UMB has important biological activities in vivo and in vitro and is not toxic under the evaluated circumstances, which demonstrates its large potential for pharmacological use.

Anterior dislocation of the temporomandibular joint: a simplified non-traumatic manual technique

ABSTRACT Anterior mandibular dislocation (AMD) is defined as the displacement of the condylar head out of the glenoid fossa beyond the articular eminence, and that does not reduce spontaneously to its normal position. The Hippocratic method is the usual approach for condylar repositioning at most health centers although it is perceived by the patient as an unpleasant, brusque technique and outcomes are not always favorable. Objective The aim of this work is to describe a new simplified nontraumatic manual technique and its application in a series of cases. Method A procedure based on gently and constantly guiding the patient’s mouth opening and closing movements is described in detail. Results Forty-two patients were treated with a treatment success rate of 100%, and no pain associated with the procedure. Procedure time was 1.5–7 min in 40 of the 42 treated cases. Conclusion The procedure presented here is an improvement on the original technique: it is simple, fast, effective, can be performed in any setting, and avoids use of brusque force, which is the factor that causes the patient most discomfort and fear.

Variants of temporary mmobilization in jaw fractures

In peacetime and in wartime, fractures of the bones of the facial skeleton are an important phenomenon (5-6% to 7-9% of all traumatic skeletal injuries) requiring use of rational treatment methods. The share of mandibular fractures accounts for 65-85%, of maxilla – 4-6%, of zygomatic and nasal bones – 7-9% and 4-7%, respectively. The need for immobilization is associated with the risk of development of pain and complications, such as bleeding, microbial contamination, asphyxia, injury of nerves and blood vessels. The article gives a comparative analysis of means of transport immobilization of jaws on examples of traumas received in the wartime and in emergency situations. There were chosen extraoral methods that hold jaw fragments with the help of bandage secured to the cerebral cranium, and intraoral methods with maxillomandibular ligature fixation.&#x0D; Conclusion. Standard Entin head-chin strap has certain advantages over Hippocratic cap bandage and Pomerantseva-Urbanskaya method. It is sufficiently universal and may be adjusted to any size of the head, possesses sufficient strength and provides reliable fixation of jaws. Ivy’s method was found to have advantages in comparison with other methods of maxillomandibular ligature fixation, which are strong and high-quality immobilization of the jaw fragments, possibility of use with multiple fractures, simplicity of application. All this permits to recommend Ivy’s method for use in case of indications.

„Sacra à Deo in corde discenda, natura ex natura.“ Die Observationes Johann Christian Senckenbergs als medico‐theologische Aufzeichnungspraktik

"Sacra à Deo in corde discenda, natura ex natura." Johann Christian Senckenberg's Observationes as a Medico-Theological Writing Method. In his early diaries, the pietist physician Johann Christian Senckenberg has taken down large amounts of observation data which mostly concentrated on his own body and soul. Earlier research has mistaken his diligent self-observation for hypochondria and unworldliness, especially since the author had never endeavoured to analyze and publish his work. The article shows that both his writing practice and his reluctance to process and share its results are due to his deeply religious and firmly anti-rationalist conviction. The main purpose of his journal keeping was the attainment of religious self-knowledge and professional self-perfection. Scientific publications he considered to be hypothetical and dogmatic, be it in theology or medicine; moreover, their authors were often enough driven by their self-love and desire for fame. In his eyes, the only godly way of knowledge acquisition was the humble, diligent and minute study of divine creation according to the Hippocratic method. The most immediate and reliable way of achieving true wisdom, however, was the observation of God's work within one's own body and mind, which were subject to the effects of God's grace and punishment as well as to atmospheric, environmental and dietetic circumstances.

Bilateral temporomandibular joint dislocation in a 26-month-old child: A rare emergency

Bilateral temporomandibular joint (TMJ) dislocation is very rare in children with only three cases previously reported in the literature. We report a case of a 26-month-old female child who presented to the emergency department of a tertiary care hospital with complaints of inability to close her mouth and drooling of saliva for the last two hours. Clinical examination and X-ray of the TMJ revealed bilateral TMJ dislocation. Bilateral TMJ reduction was achieved with the Hippocratic method after giving analgesia and procedural sedation. The child was able to close her mouth post-reduction, and was discharged with post-TMJ reduction instructions given to the mother and with maxillofacial clinic follow up. Our report is the first case of a child presenting to the emergency department with bilateral TMJ dislocation.

The Debate about methodus medendi during the Second Half of the Seventeenth Century in England

Following a recent trend in the field of the history of philosophy and medicine, this paper stresses the necessity of recognizing empiricism’s patent indebtedness to the sciences of the body. While the tribute paid to the Hippocratic method of observation in the work of Thomas Sydenham is well known, it seems necessary to take into account a trend more critical of ancient medicine developed by followers of chemical medicine who considered the doctrine of elements and humours to be a typical example of the idols that hinder the improvement of medical knowledge and defend the necessity of experimentation (comparative anatomy, dissection, autopsy, chemical analysis of bodies). In light of the fact that modern discoveries (blood circulation, the lymphatic system, theory of fevers) resulted in a “new frame of human nature,” they developed a critical reading of ancient empiricism. As a consequence, we can distinguish between two distinct anti-speculative traditions in the genesis of philosophical empiricism. The first (which includes Bacon, Boyle and Willis) recommends an active investigation into nature and refers to the figure of Democritus, the ancient philosopher who devoted himself to the dissection of beasts. Defenders of this first tradition refuse point-blank to be called ‘empiricists’, a label which had a very negative meaning during the seventeenth century, when it was used to dismiss charlatans and quacks. The other tradition (including Sydenham and Locke), stressing as it does the role of description and observation, is more sceptical of the ability of dissection or anatomy to give us access to causes of diseases. This later tradition comes closer to the definition of ancient empiricism and to the figure of Hippocrates.

An early 18th-century proposal for improving medicine by tabulating and analysing practice

An early 18th-century proposal for improving medicine by tabulating and analysing practice

Reduction of Acute Anterior Dislocations: A Prospective Randomized Study Comparing a New Technique with the Hippocratic and Kocher Methods

There are several methods to reduce anterior shoulder dislocations, but few studies have compared the efficacy, safety, and reliability of the different techniques. As a result, deciding which technique to use is seldom based on objective criteria. The aim of the present study was to introduce a new method to reduce an anterior shoulder dislocation, which we have termed "FARES" (Fast, Reliable, and Safe), and to compare it with the Hippocratic and Kocher methods in terms of efficacy, safety, and the intensity of pain felt by the patient during reduction. Between September 2006 and June 2008, a total of 173 patients with an acute anterior shoulder dislocation (with or without a fracture of the greater tuberosity) were enrolled in the study. One hundred and fifty-four patients, who met all inclusion criteria, were randomly assigned to one of the three study groups (FARES, Hippocratic, and Kocher) and underwent reduction of the dislocation by first or second-year orthopaedic surgery residents. A visual analog scale was used to determine the intensity of the pain felt by the patient during reduction. Demographically, the groups were comparable in terms of age, male:female ratio, the mechanism of dislocation, and the mean time between the injury and the first attempt at reduction. Reduction was achieved with the FARES method in 88.7% of the patients, with the Hippocratic method in 72.5%, and with the Kocher method in 68%. This difference was significant, in favor of the FARES method (p = 0.033). The mean duration of the reduction maneuver was significantly shorter for the FARES method (2.36 +/- 1.24 minutes for the FARES method, 5.55 +/- 1.58 minutes for the Hippocratic method, and 4.32 +/- 2.12 minutes for the Kocher method; p < 0.001), and the mean visual analog pain score was significantly lower for the FARES method (1.57 +/- 1.43 for the FARES method, 4.88 +/- 2.17 for the Hippocratic method, and 5.44 +/- 1.92 for the Kocher method; p < 0.001). No complications were noted in any group. The FARES method is a significantly more effective, faster, and less painful method of reduction of an anterior shoulder dislocation in comparison with the Hippocratic and Kocher methods. It is easily performed by only one physician, it is applicable to anterior shoulder dislocations as well as simple fracture-dislocations, and its use is associated with no more morbidity than that associated with the other two methods.

Taking the “ouch” out of temporomandibular joint reductions!

We were fascinated to read the paper by Oliphant et al 1 on relocating temporomandibular joint dislocations. In our practice we prefer the Hippocratic method of reduction …

Ethical considerations of fetal urology: summary of the Twenty-Second Biannual Meeting of the Society for Fetal Urology

T fundamental driving force in life is to do the right thing. Those who teach children or raise their own children know that children thrive on being told the right way to behave and how to excel in life. They become frustrated and lose attention if not given specific, logical instruction. Physicians, especially surgeons, know that when faced with uncertainty or incomplete information, we use principles of physiology, anatomy, biochemistry, and past experience to find a solution to a problem. But what about the case where there is little experience to guide us? How do we choose a path to follow, especially, in the words of Professor Clare Fekete, when there is only a “least worst” choice? What about our initial decision to act? What principles do we follow to guide patient care when faced with an uncertain outcome? Finally, who decides what constitutes the best outcome? Probably the most dramatic example we face as urologists is a woman carrying a fetus with bilateral hydronephrosis and megacystis and oligohydramnios. When facing that pregnant couple in the consultation room, what is our responsibility as physician to the fetal patient, to the family, to society? Is there is a decision tree to use? How do we guide ourselves and those involved through this decision tree? How do we start to prioritize our decisions? These were the questions posed before a panel of experts at the 22nd biannual meeting of the Society for Fetal Urology, in Dallas, Texas, who discussed the topic of ethics, with particular regard to fetal anomalies. Present were Bill Cromie, Professor of Surgery/Pediatrics at the University of Chicago, Clare Fekete, Professor of Pediatric Surgery at Necker-Enfants Malades in Paris, and Roy Martin, D.Min., Chaplain Emeritus, Cook Children’s Medical Center in Fort Worth, Texas. Presentations and discussions centered around practical dilemmas, and most present came to a better understanding of the problems and questions we face in the practice of fetal urology. First, we reviewed a very brief outline of how normative ethics might help to describe solutions. This was based on a number of sources and represents a conceptual line of reasoning concerning fetal ethics. Further ethical understanding and examination is needed to provide physicians with a paradigm for counseling and is beyond the scope of this paper.1 Physicians are familiar with the Hippocratic oath. The core of the oath is, of course, to do what is good for our patients, at least without harm. The ethics of the Hippocratic corpus were written over a period of time by various Greek schools of philosophy and contain obligations of beneficence, nonmaleficence, and confidentiality, as well as some prohibitions against abortion, euthanasia, surgery, and sexual relationships with patients. Throughout the years, these codes were modified with cultural, religious, and theological overtones in the Judeo-Christian society until Perceval attempted to solidify this into a written code in Britain in 1803. In 1847, the American Medical Association released its first written code of ethics. It was based on the Hippocratic method but also included information on etiquette for physicians such as proper dress, gossip, reputation, cleanliness, truth-telling, consultation with other physicians, and the physician’s education. With the 1960s came societal re-examination of traditions, including these Hippocratic principles. This came about because of a better-educated public and the spread of participatory democracy such as civil rights, feminism, and consumer action. The need to re-examine medical ethics also came about This paper was presented at the Society for Fetal Urology Conference in Dallas, Texas, May 1999. From the Division of Pediatric Urology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Reprint requests: Timothy P. Bukowski, M.D., Division of Urology, University of North Carolina School of Medicine, 427 Burnett-Womack Building, Campus Box 7235, Chapel Hill, NC 27599-7235 Submitted: July 2, 1999, accepted (with revisions): August 2, 1999 SOCIETY FOR FETAL UROLOGY UPDATE

Leonardo da Vinci: The Anatomy of Man

This volume consists of reproductions of 23 sheets of the anatomical drawings of Leonardo da Vinci (1452-1519) together with explanatory discussions of their content and significance. These were selected from the extensive collection of his anatomical works in the Royal Library at Windsor Castle. They formed the basis for an exhibition that was organized in 1992. Leonardo conducted extensive anatomical dissections in humans. Most of his written records are lost, but several hundred heavily annotated drawings have been preserved. The majority came into the possession of the British monarchy in the early 17th century. Their significance was not recognized until well into the 19th century. The contributions of Andrei Vesalius (1514-1564) had been recognized long before those of Leonardo were acknowledged. Leonardo's anatomical studies began as a companion to his work as an artist. His insatiable curiosity and demand for the primacy of direct observation (the Aristotelian and Hippocratic method)

Anterior dislocation of the shoulder, a simple and effective method of reduction.

The reduction of anterior dislocation of the shoulder is frequently regarded as a hospital procedure requiring general anesthesia and some type of manipulation. It is our purpose to call attention to a simple, effective, atraumatic method of reduction of anterior dislocation of the shoulder without the necessity of general anesthesia. The two most widely employed methods described in current textbooks 1 are the Kocher maneuver and the Hippocratic method. Both frequently require general anesthesia, which may invite vigorous manipulation. The latter has been known to cause fracture of the neck of an osteoporotic humerus and trauma to the brachial plexus. Technique In 1899, 2 Stimson first utilized a procedure for reduction of anterior shoulder dislocations that required neither a general anesthetic nor active manipulation. The patient was placed on a specially constructed canvas cot, and the involved arm was allowed to hang through a hole cut in one end of

Plato, Hippocrates, and the Menon Papyrus

Previous articleNext article No AccessPlato, Hippocrates, and the Menon PapyrusFritz SteckerlFritz Steckerl Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Classical Philology Volume 40, Number 3Jul., 1945 Article DOIhttps://doi.org/10.1086/362889 Views: 1Total views on this site Citations: 3Citations are reported from Crossref PDF download Crossref reports the following articles citing this article:Elizabeth Jelinek, Nickolas Pappas HIPPOCRATES AT PHAEDRUS 270C, Pacific Philosophical Quarterly 4 (Jul 2020).https://doi.org/10.1111/papq.12315Jordi Crespo Saumell Who Are ‘the Ancients’?, Méthodos , no.1818 (Jan 2018).https://doi.org/10.4000/methodos.5089G. E. R. Lloyd The Hippogratic Question, The Classical Quarterly 25, no.22 (Feb 2009): 171–192.https://doi.org/10.1017/S0009838800030032

Hippocratic Medicine, Its Spirit and Method

Hippocratic Medicine, Its Spirit and Method

The Advance of Medicine

THE Romanes Lecture entitled “The Advance of Medicine” delivered at Oxford on June 1 by Lord Moynihan, president of the Royal College of Surgeons, who received the honorary degree of D.C.L. on that occasion, has been published by the Clarendon Press (2s. 6d. net). After an historical introduction in which he briefly reviews the work of Hippocrates, Galen, Vesalius, the Italian anatomists, Harvey, Mor-gagni, and John Hunter, Lord Moynihan passes on to Lister, whom he describes as the greatest material benefactor of mankind the world has ever known. He attributes Lister's genius to the fact that he was master both of the Hippocratic method of induction and the Galenic method of deduction, and combined the qualities of a physiologist and clinician. Lord Moynihan deplores the fact that physiology is now losing the close relationship it formerly had with clinical medicine, and urges that physiologists and surgeons should make a common attack upon “the innumerable mysteries of disease”. On the other hand, he maintains that though the aid given by physics, chemistry, and physiology is indispensable, these sciences are merely ancillary to medicine, which is a science as well as an art in itself. In view of the fact that laboratory aid, though sometimes decisive or at least helpful, is not seldom negligible, the clinician must maintain his sovereignty. In conclusion, Lord Moynihan exemplifies the humanism of medicine by the work of Harvey, John Hunter, Hillman, who discovered anaesthesia, and Lister. Three appendices to the lecture deal respectively with the ideal training of the surgeon, experiments on animals, and the relation of physics and chemistry to medicine.