Ascites historical perspective
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]
Overview
Historical Perspective
- About 20 BC, Aulus Cornelius Celsus (A.D. 30), a Roman encyclopedist explained in his book "De Medicina" three different types of fluid accumulation under the skin; which was called hydrops by Greeks. Celsus postulated that ascites is mostly secondary to quartan fever (malaria) in Rome.[1]
- Very tense belly with frequent noise of the wind movement sound - called tympanites
- Uneven swelling and rising up in the body - called leukophlegmasia or hyposarca
- The fluid gathering all together in the belly with visible movement along with the movements of body - called ascites
- In 25 BC, Philip of Epirus, promised to cure the certain friend of king Antigonus with ascites. Philip cured the patient with devouring poultices and drinking his own urine. The basis of his treatment was thirst, rest, and abstinence.[1]
Landmark Events in the Development of Treatment Strategies
- About 20 BC, Aulus Cornelius Celsus (A.D. 30), a Roman encyclopedist explained in his book "De Medicina" mentioned that ascites was relieved in slaves more easily than freemen. Because slaves can endure thirst, hunger, and other troublesome more than unserviceable freedom.
- The principles of treatment for ascites were explained as thirst, rest, and abstinence. Drinking less fluid and sweating more, not with exercise, but with heated sand, or in the sweating-room, or with a dry oven and such- like were the other alternative therapies.
- Pills composed of wormwood two parts and myrrh one part were given on an empty stomach to treat refractory types of ascites.
- Various remedies for ascites were postulated as:
- Iris root
- Spikenard
- Saffron
- Cinnamon
- Cassia
- Myrrh
- Balsam,
- Galbanum
- Ladanum
- Oenanthe
- Opopanax
- Cardamon
- Ebony
- Cypress seeds
- Taminian grape (Greeks call staphisagra)
- Southern wood
- Rose leaves
- Sweet flag root
- Bitter almonds
- Goat’s marjoram
- Styrax
- The quantity of fluid input and output had to be measured and recorded daily.
- Abdomen circumference was also measured on a daily basis.[2]
Famous Cases
- In 1827, Ludwig van Beethoven involved in ascites and underwent large volumes of paracenteses. His physician write about him as "Beethoven had almost immediate relief, and when he saw the stream of water [during paracentesis], cried out that the operation made him think of Moses, who struck the rock with his staff and made the water gush forth."
- 2 days later Beethoven died and autopsy showed cirrhosis and splenomegaly as "shrunken liver to half its normal volume…it was beset with knots the size of a bean…the spleen was double its proper size and dark colored and firm."[3]
- The cirrhotic ascites, secondary to chronic alcohol and drug use, decreased life span in jazz musicians; result in dramatic influence on the history of jazz music.[4]
- Charlie Parker died from cirrhotic ascites at 35 years of age in 1955.
- John Coltrane (inventor of avant-garde jazz) died with ascites secondary to hepatitis B and hepatocellular carcinoma at 41 years of age in 1967.
- Stan Getz in 1990 and Steve Lacy in 2004, both saxophone stylists, died from hepatocellular carcinoma.
- Bill Evans, a lyrical pianist, died of cirrhotic complications.
- The famous Four Brothers from the Woody Herman band (Stan Getz, Al Cohn, Serge Chaloff, and Zoot Sims) all died from cirrhosis complications.
References
- ↑ 1.0 1.1 Jarcho, Saul (1958). "Ascites as described by Aulus Cornelius Celsus (ca. A.D. 30)". The American Journal of Cardiology. 2 (4): 507–508. doi:10.1016/0002-9149(58)90339-4. ISSN 0002-9149.
- ↑ "CelsusDe Medicina". New England Journal of Medicine. 213 (20): 991–991. 1935. doi:10.1056/NEJM193511142132014. ISSN 0028-4793.
- ↑ Adams, Paul C. (1987). "Historical hepatology: Ludwig van Beethoven". Journal of Gastroenterology and Hepatology. 2 (4): 375–379. doi:10.1111/j.1440-1746.1987.tb00176.x. ISSN 0815-9319.
- ↑ Adams PC (2009). "The lost years: the impact of cirrhosis on the history of jazz". Can J Gastroenterol. 23 (6): 405–6. PMC 2721805. PMID 19543568.