RESUMEN

ETHNOPHARMACOLOGICAL RELEVANCE: Dynameron is a Byzantine medical compendium, divided into 24 sections, the "Elements", containing 2667 recipes, most of which inherited by previous physicians of the classic ancient Greek and Hellenistic, and imperial Roman periods. AIM OF THE STUDY: In continuation to our previous study concerning the first and largest chapter of the "Element Alpha" of Nikolaos Myrepsos׳ Dynameron (Valiakos et al., 2015), this paper focuses on the plants quoted in the recipes of the eight following chapters entitled "About Salts", "About Honeypacks" and "About Spreads", all belonging to the same "Element Alpha"; "About Antitussives" and "About Suppositories" belonging to the "Element Beta"; "About women's Cathartics" belonging to the "Element Gamma"; "About Drossaton" and "About Diachrisma", both belonging to the "Element Delta". MATERIALS AND METHODS: Our main primary source material was the codex kept in the National Library of France (in Paris) under the number grec. 2243, which is the older and larger codex of Dynameron (Valiakos et al., 2015). RESULTS: The present study led us to the interpretation of 277 plants under different names, among which we recognized 57 medicinal plants listed by the European Medicines Agency, one of them with negative monograph (i.e. Chelidonium majus). In addition, there are identified taxa related to those quoted by EMA as herbal medicines. The plants appearing in the examined Elements belong to various families of which the most frequent are: Apiaceae 10.11%; Lamiaceae 7.22%; Asteraceae 6.86%; Rosaceae 6.5% and Fabaceae 6.14%. CONCLUSIONS: A total of 277 species have been catalogued, most of which are referred in our previous publication (Valiakos et al., 2015). Among them, 56 plants still play a very important role in medical practice, as they are used as traditional herbal medicines (www.ema.eu). This evidence is a proof that the use of medicinal plants remains valuable from the ancient times until today. The recipes, in contrast to older medical compendia, contain precise measurements of ingredients and dosages for every drug, which seem to reflect empirical logic.

Asunto(s)

RESUMEN

ETHNOPHARMACOLOGICAL RELEVANCE: This paper focuses on the plants quoted in the recipes of the first chapter entitled "About the Antidotes" belonging to the first and largest section "Element Alpha" of Nikolaos Myrepsos׳ Dynameron, a medieval medical manuscript. Nikolaos Myrepsos was a Byzantine physician at the court of John III Doukas Vatatzes at Nicaea (13th century). He wrote in Greek a rich collection of 2667 recipes, the richest number known in late Byzantine era, conventionally known as Dynameron and divided into 24 sections, the "Elements". The only existing translation of this work is in Latin, released in 1549 in Basel by Leonhart Fuchs. Since no other translation has ever been made in any language, this work still remains poorly known. MATERIALS AND METHODS: Our primary source material was the codex written in 1339 and kept in the National Library of France (in Paris) under the number grec. 2243. For comparison, all the other codices, which contain the entire manuscript, have also been studied, namely the codices EBE 1478 (National Library of Greece, Athens), grec. 2237 and grec. 2238 (both in Paris), Lavra Ε 192 (Mont Athos, Monastery of Megisti Lavra), Barocci 171 (Oxford) and Revilla 83 (Escorial). RESULTS: The exhaustive study of the "About the Antidotes" led us to the interpretation of 293 plant names among which we recognized 39 medicinal plants listed by the European Medicines Agency, (Herbal Medicines, www.ema.eu); the therapeutic indications of some of them provided by Myrepsos were similar or related to their current ones, as given in their monographs. The plants belong to various families of which the most frequent are: Apiaceae 10.6%; Lamiaceae 9.2%; Asteraceae 8.9%; Fabaceae 6.8% and Rosaceae 5.1%. The most frequently mentioned plants even under several different names are the following: Apium graveolens L., Crocus sativus L., Nardostachys jatamansi (D. Don) DC., Zingiber officinale Roscoe, Rosa centifolia L., Syzygium aromaticum (L.) Merr. & L.M. Perry, Papaver somniferum L., Costus sp., Petroselinum crispum (Mill.) Fuss, Anethum graveolens L., Foeniculum vulgare Mill., Daucus carota L. CONCLUSIONS: This research led us to the conclusion that the content of "About the Antidotes" is a valuable source for the study of recipes based mainly on medicinal plants, most of them inherited from classic ancient Greek and Hellenistic periods.

Asunto(s)

RESUMEN

BACKGROUND: Avoidable mortality (AM) refers to deaths from certain conditions considered avoidable given timely and effective health care. AM rates in Greece between 1980 and 2007 were examined in order to investigate the extent to which health care has contributed to the decline in mortality rates in Greece over recent decades and detect possible shortcomings in the Greek healthcare system. METHODS: Mortality data from the General Secretariat of the National Statistic Service were used. The list of avoidable conditions was the basis of the analysis in which avoidable deaths were classified into conditions amenable to medical care (treatable avoidable mortality) and conditions responsive to health policy (preventable avoidable mortality). Ischaemic heart disease (IHD) was examined separately following relevant studies. Age standardized mortality rates were calculated according to the European Community standard population. RESULTS: A steady decline of the percentage of AM over all-cause mortality was documented (1980-1984:27%; 2000- 2007:22.9%). AM rate fell by 30.5% (1980-1984:217.4/100,000 population; 2000-2007: 151.1/100,000). Treatable mortality rate fell by 48.1%, marking the largest contribution to the decline in AM (1980-1984:110.9/100,000; 2000- 2007:57.5/100,000). Ischaemic heart disease death rate fell by 13.1% (1980-1984:52.7/100,000; 2000-2007:45.8/100,000). Preventable mortality rates fell by 11%, marking a modest contribution to the decline in AM (1980-1984: 53.7/100,000; 2000-2007: 47.8/100,000). CONCLUSIONS: Trends in AM in Greece between 1980-2007 were similar to those of other European countries, with Greece performing particularly well with respect to treatable mortality. Although the decline in AM may also reflect changes in factors that influence mortality, such as disease occurrence, environment and socioeconomic conditions, they are suggestive of the health care system being an important determinant of health improvements in Greece during the recent decades. Further studies are needed in order to access the quality of care and to examine the structure and adequacy of health care in Greece.