Thanksgiving is upon us, and next to the fastidious references to pumpkin spice lattes and the like, the reference that we perpetuate and perhaps look forward to is that of the classic Thanksgiving postprandial somnolence.

Origin: Latin, post- (after) + prandium (meal)
After a meal, especially dinner

Origin: Latin, somnus (sleep)

Now, what is the soporific agent responsible for sending us on our merry way to the arms of Hypnos? Most people would tell you that copious amounts of tryptophan are responsible. Tryptophan is one of the 20 amino acids that are used to synthesize proteins in our bodies, and it is said to be abundant in turkey meat.

Tryptophan was first isolated in 1901 by Frederick Gowland Hopkins through the hydrolysis of casein; casein is one of the proteins that are abundant in milk. (Interesting aside: casein has an affinity for the molecule capsaicin, which is found in chili peppers. This is why dairy products neutralize the spice from peppers.) Hopkins conducted an animal study in which he removed tryptophan from the diets of mice. He found that tryptophan was necessary for the mice to grow, and concluded that tryptophan is one of the “essential” amino acids, i.e., it must be obtained through the diet. In 1912, he conducted another animal study in which he supplied mice with pure proteins, fats, carbohydrates, and minerals. He found that the mice did not grow, and postulated that there exist unidentified “accessory food factors” necessary for growth and survival. These “accessory food factors” are better known to us now as vitamins, and for this realization, Hopkins was awarded the Nobel Prize in Physiology or Medicine in 1929.

hopkins tryptophan

Now, regarding tryptophan: where does the word come from? Let’s start with some etymology:

Origin: Greek, trypsin (digestive enzyme) + phanein (to show)
Something that is shown when trypsinized

Thus, tryptophan is so named because it is “shown” (produced) when proteins are digested with the enzyme trypsin. The etymology behind trypsin is rather cool as well:

Origin: Greek, tribein (to rub)
So named because it was first obtained with rubbing the pancreas

Anyways, it turns out that tryptophan is not the agent responsible for the ol’ Thanksgiving food coma. It has been shown that chicken and beef contain similar quantities of the amino acid. Instead, it is the large amount of carbohydrates ingested through classic Thanksgiving dishes such as mashed potatoes, yams, stuffing, etc. I won’t bore you with the posited mechanisms behind this, but there are a number of online resources that could fill you in if you so choose. Let us part with another fun Thanksgiving etymology:

acholeus rev

The Banquet of Acholeus by Rubens (1577-1640)
(Heracles fought against Acholeus for the hand of Deianeira, and when Acholeus transformed himself into a bull, Heracles took one of his horns. Acholeus offered him the horn of the goat Amalthaea, and Heracles in turn gave it to the Naiads who transformed the horn into the cornucopia)

Origin: Latin, cornu (horn) + copia (wealth)
Horn of wealth, taken to mean horn of plenty
In classical mythology, it was an infinite source of food and drink from the goat Amalthaea

And thus I wish you all a Happy Thanksgiving, and may it be filled with a cornucopia of food, family, and fun.

I often find myself taking many modern medical advancements for granted. For instance, I can take over-the-counter medication to treat a cold or receive a vaccine to prevent the flu. We have countless specialists and medical professionals that can treat a whole host of illnesses and billions of dollars are poured into medical research each year. Truly, many of these medical achievements are miraculous, if one stops to think about them.

But consider: there was a time when the primary treatment for many diseases was a miracle. This is perhaps no where more evident than in medieval Europe, where a myriad number of saints could be invoked and relied upon to cure illness. The decline of the pagan religions of Greece and Rome was paralleled by the rise of Christianity in most of Western Europe. The god Asclepius, who was purported to cure those who slept at his temples, declined in popularity and gave rise to a pantheon of Christian saints with their own formidable healing powers. This is not to say that physicians did not exist in medieval times, but they were mostly reserved for the rich, leaving the vast majority of people reliant upon these holy persons. Let’s look at a few of these figures and examine their role in medieval and modern medicine.

Saint Anthony (251-356 AD) was an Egyptian Christian monk known for his asceticism and extreme piety. He is perhaps most remembered for his temptation in the desert, the subject of many paintings which depict this gruesome scene. In the middle ages, this saint was invoked when one was afflicted with either erysipelas [Gk. erythros (red) + pellas (skin)], a skin infection producing a bright red rash, or ergotism [Fr. argot (spur)], poisoning by the ingestion of a fungus that afflicts grains. Both conditions are known as “Saint Anthony’s Fire.” How did our friend Anthony come to be associated with these diseases? His remains were discovered and credited with the miraculous recovery of a French nobleman’s son from ergotism. In gratitude, he founded The Order of Saint Anthony in 1095 (an order which still exists today), and their monastery became famed for treating erysipelas and ergotism. It is interesting to note that ergot poisoning has been suggested as an explanation for “bewitchment” as it produces spasms, skin tingling, headaches,  and even psychosis.

temptation revThe Temptation of Saint Anthony, by Grünewald

Another Saint to have a disease named after him is Saint Vitus (died 303 AD). Vitus was a Sicilian Christian monk, known as the patron saint of dancers, actors, and comedians. This came about from the manic dancing that would take place in front of his statue during his feast day in the middle ages in order to venerate the saint. (This evokes images of the Maenads and their frenzied dancing for the god Bacchus.) With this in mind, which affliction(s) do you think Vitus was associated with? If you said epilepsy, you’d be correct. However, his name is attached to another disorder: Sydenham’s chorea [Gk. choreia (a dance)], otherwise known as St. Vitus’s Dance. This is a sign of acute rheumatic fever, a childhood infection caused by Group A streptococci. Thomas Sydenham (1624-1689), the “English Hippocrates,” first characterized the disorder. You can imagine what symptoms are produced by Sydenham’s chorea from its name alone: jerking and uncontrollable spasms of the face, hands, and feet, as if the patient were dancing manically. It is no wonder that the saint venerated by frenzied dancing should come to be associated with Sydenham’s chorea centuries before Sydenham made his observations. 

strep pyo and vitus

Left: S. pyogenes, the causative agent of acute rheumatic fever; right: the man himself, Saint Vitus

Let’s end with a look at the brother saints, Cosmas and Damian (died 287 AD). The brothers were born in Cilicia (Asia Minor) and their chief miracle is truly fascinating: they hold the distinction of successfully completing the first transplant surgery. The story goes that they amputated the gangrenous leg of a patient, which in those times was the best one could hope for. However, being imbued with divine power, the brothers were said to have taken the leg from a dead Moor (in some versions of the story, an Ethiopian) and miraculously transplanted it to the amputee. This predates the first modern organ transplants by centuries, and it is quite a tall tale. The fact remains that human beings were considering organ transplants long before they were feasible. What did the brothers get in return for their miraculous healing powers? Unfortunately, they lived during a time of great persecution against Christians by the Roman emperor Diocletian, and were thus incarcerated, pelted with stones, burned at the stake, shot full of arrows, sawn in half, and decapitated. But their legacy lived on, and the brothers became the patron saints of medicine during the middle ages. Christiaan Barnard, eat your heart out!

cosmos and damian

Left: Saints Cosmas and Damian at work with angelic assistants; right: how the pair met its end

You may be asking yourself, how were these saints invoked? How exactly did the masses interact with these larger-than-life figures? Many were venerated in monasteries and churches and could be prayed to in times of need. Priests and monks could give advisement on how and when to pray, and in many cases, acted like middlemen between the holy and the sick. Perhaps the most common way to interact with a saint was through relics. The importance of these objects cannot be understated. Relics could be articles of clothing, pieces of wood purported to be from the cross, and even body parts such as bones and blood. These objects were housed in healing shrines and places of worship—being in their mere presence could ensure health and recovery.

These are but a few of the many, many saints associated with their own diseases, each fascinating in their own right. Hopefully I’ve shed a bit of light on the medical practices and beliefs of our medieval forebears!

At some point in our lives, we inevitably fall into some form of ill health. This usually necessitates a visit to a local physician or the hospital, and it may sometimes necessitate a visit from emergency medical services. Thus, it is not unreasonable to assume that most of us have seen the symbol of medicine in one of these settings as a logo of sorts. Except there is a slight problem: there are two snakes on that staff. That staff is, in fact, not the symbol of medicine. It is instead the caduceus, the staff of Hermes. The caduceus was the symbol of commerce, for Hermes is the god of commerce (and thieves…). The U.S. military adopted the caduceus as its symbol of medicine in the 1850s, and it erroneously stuck. The real symbol of medicine is the rod of Ascelpius (Gk. Asklepios).

rod vs caduceusAsclepius was a son of Apollo, and Asclepius took on Apollo’s role as the god of healing in the Greco-Roman pantheon. The etymology behind his name is contested, so I unfortunately have no insights on that matter. There are multiple versions of the story regarding how Asclepius acquired his legendary abilities, and one of the more common ones is this: Asclepius was once asked to cure a man named Glaucus. While doing so, a snake slithered up his staff, and Asclepius promptly killed it. Another snake slithered by with an herb in its mouth and Asclepius placed the herb in the dead snake’s mouth. Sure enough, the dead snake returned to life! Regardless of his “origin story,” long story short, he learned how to raise the dead. Using a snake as a symbol of healing is somewhat paradoxical, since in those days, a snake bite was a death sentence. But Asclepius, utilizing his newfound knowledge, could cure even snake bites—and was thus eventually deified as the god of medicine.

asclepius vs zeus

Asclepius (left) and Zeus (right) share many facial features in classical sculptures

Asclepius was so skilled in medicine that he was asked by Artemis to revive Hippolytus, the son of Theseus and Hippolyta. He was able to do so successfully, and when Hades got word of this, he complained to Zeus that Asclepius was robbing him of his souls. Zeus struck Asclepius down with a thunderbolt to end this traveshamockery (travesty + sham + mockery). Apollo was so enraged that he killed the Cyclopes (singular: Cyclops), who fashioned Zeus’s thunderbolts. Outraged in turn, Zeus forced Apollo to be a servant to King Admetus of Thessay for one year. When Apollo returned to Olympus, Zeus revived the Cyclopes and resurrected Asclepius, turning him into a god.

Outside of the myth, why a snake coiled around a stick? One theory is that the symbol represents the painful process of treating dracunculiasis, better known as Guinea worm disease.

Origin: Neo-Latin, draco (dragon) + -cule (diminutive) + -iasis (condition of)
Condition of small dragons/serpents

Perhaps a picture would illustrate why this makes sense:

guinea worms rev

As a side note, former president Jimmy Carter has been monumental in the global effort to eradicate the Guinea worm, for dracunculiasis is a truly wretched condition. He was recently interviewed and said “I would like the last Guinea worm to die before I do.” (Jimmy Carter was recently diagnosed with melanoma with metastases to the brain and liver.)

Back to our story: many temples were built throughout Greece dedicated to Asclepius. Those who were sick would come and spend a night at the Asclepion, and Asclepius would visit the patient in his or her dreams and relay to them the cure to their disease. One other interesting tidbit is that there were hordes of nonvenomous snakes, colloquially called Aesculapian snakes (Zamenis longissima), that would slither around the temples to promote healing!