??af??e?a 1

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?e???a?d?????t?s?
? ?st???a ?a? ? te????? µ?a? s?t???a? ep?µßas??
aµ.ep. ?a????t?? ??a??s??? ??aµa?t?p?????, MD,
Ph.D, ?ef???????-???a??????? ??e????t??
?ef????????? ???????? ?e??fe????? ??s???µe???
????? ??d??a? ?at??? ???ed??? t?? ??e?????
?ta??e?a? ?st???a? t?? ?at????? (ISHM)
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A Dictionary of the History of Medicine

• Pericardiocentesis... Performed successfully by
  Francisco Romero ... in 1815 Pericardial
  Effusion ... Mentioned by Galen after finding it
  during dissection of a monkey Pericarditis
  ...Described by Avenzoar (1092-1162)

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a) Annals of Surgery b) Archives of Surgery

• a) Drainage of the pericardial sac was first
  recommended by Riolan in 1648 ...

b) It is said that Galen removed the sternum
and anterior wall of the pericardium from a
soldier in whom a neglected wound ... and by this
means obtained a cure.
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American. J. Cardiology

• Galen described a young boys illness, which we
  would consider to be chronic purulent, possibly
  tuberculous, pericarditis ..

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?? ??????G?????S ??F??S??S (1)

• ????ta???? ????da??a ap? e?e? ?ata??ta? ?
  ???st?µ????, ? µ??a? st?at????. ?? ?a?eda?µ?????
  t?? ??a?a? ?e?????a ?a? ß???a? t?
  ?a?d?? t?? t????t?

?s????? ? ??µ?????? ? ??t??a? a?et?µ? µet? t??
???at? t?? ?a? ?a?d?? t?? ß?????e t????t? ?a?
p??? µe?a??te?? ap? e??a? f?s??? ??a t???
a????p???.
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?? ??????G?????S ??F??S??S (2)

• Habbakuk 216 ? ?e??a? p?? pe?pat??se st??
  ?d??? t?? µ????, t?? ?p???? ? a??p?????a ?ta?
  µe?a??te?? ap? t?? d??a t??, epe?d? de? e??e
  ?p?ste? pe??t?µ? t?? ??t???? t?? ?a?d?a?

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?? ??T?S ????????S ?O? ??????G????O? ??F??S?O?

• ??st????? ?? ?t? t? st???? t?? ??????a ?ta?
  s?epasµ??? µe p???? t????µa ?p?? ???eta? e??a?
  p??fa???, ef ?s?? p????? ?e?µ?a?µ?? ??d?e? ?????
  p???? t????µa, ??e? ?ta? t? st???? e??a?
  t????t? ?? ap?f?se?? p?? ?????ta? ap? t?? ?a?d??
  ap? ??t? e??a? t????t??, p?? s?µa??e? p?????
• ??t?????? ???e? ??? ??????a ? t????t? ?a?d??.
  ??? p?? ? ?a?d?? e??e a?a??ast??? t???e?

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?? ??T?S ????????S ?O? ??????G????O? ??F??S?O?

• ?e?? t?? ????? t?? ?t??eµa??? ?a? ?a???
  p??eµ??se µe t?? af??t? t??, µet? p?? s??t????e
  e?e???t?µ??? ?a? ß?????e ?a ??e? t????t? ?a?d??
  ?a? ?ta? (??tsa?) µ?st?f ?a? ???µa??ta? ???????

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?? ??T?S ????????S ?O? ??????G????O? ??F??S?O?

• ???st?t????

??t?? µe ta p???? µa???? ?a? ta das?t???a ?a?
e???a st???a ep???µ??? pe??ss?te?? t? s????s?a
a?t?? µe a?a?? t????µa ?a? ste?? st???a
ta?a?p?????ta? e????a µe t? s????s?a
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???F???S ??? G??????

• ?µped????? a?µa ?a? a????p??? pe?????d??? est?
  ???µa ?t? t? ??µ???? e??a? ? ß?asµ?? t??
  pe???a?d??? a?µat??
• ?pp????t?? ? ?a?d?a ??e? µe? s??µa
  p??aµ?d?e?d?? ?a? ???µa f??????e?d??. ?a?
  pe??ß???eta? ap? ??t??a ?e??? ?a? ?p???e? e?t??
  a?t?? µ???? p?s?t?? ?????, pa??µ???? µe t? ?????

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• ???f?? ? ?f?s???,1?? µ.?.
• ?e??ß???e? de t?? ?a?d?a? ??t?? ?e??µe???
  pe?????d???, ? ?p???? e??a? ?e???d?? ?a? ?ept??,
  ?a? eµfa???e? ????s? p?? µetad?deta? se a?t?? ap?
  t?? ?a?d?a

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? S?????? ??? G?????? S??S G?OS??S G??O ??? ??
?????????? (1)

• ? de pe?????d??? ???µa??µe??? ?µ?? ?a? ??t??,
  d??t? ?a? ?? d?? ???µas?e? ep?t??peta? ?a
  ???s?µ?p?????ta?, ?µ?? µ?? ???? t?? s?st?se??,
  ??t?? de ???? t?? ???se??, p??sa?t?ta? p??? t?
  st????? ?at? t?? ????f?? a?t?? ?a? ep?p????
  µ???sta µe µe???? tµ?µata e?at????e? t?? ????f??

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? S?????? ??? G?????? S??S G?OS??S G??O ??? ??
?????????? (2)

• ?a? d??t? ep? ep? t?? a?ateµ??µ???? ???? e?daµe
  p????? f???? e? t? pe???a?d?? pa?a f?s?? ?????
  pe??????ta ????? pa?ap??s??? µe ?????, ?p?? st??
  ?dat?de? ??ste?? ???a? ???p?? f?s??? ?a?
  st??? a????p??? ?a s?µßa????? a?t?

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? S?????? ??? G?????? S??S G?OS??S G??O ??? ??
?????????? (3)

• ?a? ?ts? saf?? e?daµe t?? ?a?d?a ?p?? st??
  a?at?µ?? ep? ????, epe?d? e???s??? t?? ??µ??saµe.
  ?a? t? pa?d???? ???p?? es???, sa??????t??
  ?at?p?? t?? ?µ???? t?? pe?? t? st?????, ??
  ?p???? ????a? ep??eµa t?? ?a?d?a?

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? S?????? ??? G?????? S??S G?OS??S G??O ??? ??
?????????? (4)

• ?p?? ???e? ? Ga?????, ??p??a ???a??a d?a????
  ??p???µ??se sta d?µ?s?a ???t??. ??a?et? de ??p??a
  t????? ??s?a sta ???t?? ?a? ??a a?t? e??µ??et?
  p?? ??p???µ??se. ??a??t??ta? de t?? a?t?a, ?
  Ga????? ?p?? ???eta? p???ß? se a?at?µ? ?a? ß???e
  st?? ?????e? t?? ?a?d?a? ??t??a p???? d?s?d???
  ?????, t? ?p???? a???ß?? ???? t?? t?????t?t?? t??
  ?at?t???e t?? ??t???? d???µe?? ?a? p???a???se t??
  ??p???µ?e?. ?pe?d? ????e fa?e?? t? ?e?es??????
  a?t?? ? ???a??a de? ?pa?e ?a??

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?? ???F???S ???? ??? G?????

• ??e?ß?s???, 332-363 µ?
• ??t???e? ?a? f??ße? pe???????ta? ap? pa?t?? se
  ????? t?? ?a?d?a. ?e???? de de? fa??eta? ?a
  d?a??ad??eta? se a?t??, ?p?? ??te st? ?pa? t???
  ?ef???? ? t?? sp???a. ????? de ?at? t? pe?????d??
  fa??eta? s??pasµa ?ept?? ?e????

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??e?ß?s???, 332-363 µ?

• ?p????eta? de st? ?a?d?a, pe???aµß???? a?t?? ?
  pe?????d??? ?µ??, ?p?? a???ß?? µ?a asfa??? ????a
  ? f??a?? ... ?f??e? de ???? ap? t?? ?a?d?a t?s?
  e???????a, ?ste ?a t?? ?p?d??eta? ??eta ?ta?
  d?ast???eta?. ???t? a? ape??e pe??ss?te?? ?a
  ?ß?apte t?? e???t?ta t?? p?e?µ???? ?a? t?? e?s?d?
  ?a? ???d? t?? a???? ?at? ta? a?ap????. ?? de
  ape??e ?????te?? ?a ste?a?????se t?? ?a?d?a ?at?
  ta? µe???a? d?ast????.

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NEO????S ???F???S

• ? Antonio Benivieny, t?? 16? a???a a?a?e??e? t??
  ?p??? pe?? "t????t?? ?a?d???"
• ? Lower (?????????, 1631 µ?) ?e??e?ta?, ?at?
  ????? pa?ad???, ? p??t?? p?? pe?????fe?
  pe???a?d?t?da se ?????p?, t??????st?? µet? t??
  ??a?????s?.
• ? Morgani (?spa??? ?at???, 1769 µ?) ??a?e t??
  p??t? a?af??? se ?a?d?a?? ep?p?µat?sµ?, a???
  p?ste?e p?? ? pa?a??te?s? ?a a????se ?a
  efa?µ?s?e?
• ? Riolan (1649 µ?, ?a????t?? a?at?µ?a? st?
  ?a??s?) p??te??e pe???a?d?????t?s? ?p?t????
  pe???a?d?????t?s?, ????e t? 1801 µ?., ap? t??
  Romero st? ?a??e????
• S?µpe?asµat???, µe ß?s? t?? ?e?te?? ß?ß?????af?a
  ? Romero ?a? ? Larrey a?a?????st??a? ?? ??
  p??te???te? t?? pa????te?s?? t?? pe???a?d???.

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??? ?? T?O??? S?? ?????

• ??a e?t?p?s?a?? ?????? a?µ???a?????
  pe???a?d?t?da? ????e t? 1846 st? Kronstadt t??
  ??s?a?. ????????sa? 60 ???at?? ?a? te???? ?
  Karawagen et??µ?se pa????te?s? t?? pe???a?d??? se
  et??µ????at? as?e??, µe ?eaµat??? ap?te??sµata.
• ?a?? ta?ta, ?, pe??f?µ?? ?e???????? Billroth
  a?af????se t? 1913 p?? pa??µ??e? e??e???se??
  ap?te???sa? ?e????????? p???e?a!

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? ???????? ??S ????????S ????????S

• G?at? de? e??a? ???da???, a?t?? p?? ??e? ta
  e??te???? ?????sµata, ??te e??a? pe??t?µ? a?t?
  p?? ???eta? e??te???? st? s???a, a??? e??a?
  ???da??? a?t?? p?? e??a? es?te???? ?a? pe??t?µ?
  e??a? a?t? t?? ?a?d???, t?? p?e?µat??, ?a? ???
  t?? ???µµat??, t?? ?p???? ? ?pa???? e??a? ap? t??
  Te? ?a? ??? ap? t??? a????p???

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S??????S???? (1)

• ?? pe?????d?? ?? a?at?µ??? ?????a ?ta? ???st? ap?
  t?? a??a??t?ta.
• ??p??e? s?s?et?se?? t?? pa??????a? t??
  pe???a?d??? µe ß?s? a?af???? se t????t??
  ?a?d??? ep?fa??? p??s?p?? t?? a??a??t?ta? e??a?,
  ?at? t?? ???µ? µa?, esfa?µ??e?.
• St?? pa???sa ?µ???a s????????µe a?a?e???µ??? t??
  ?st???a t?? pe???a?d??? ?a? t?? ??s?????a? t??
  ap? t??? a??a???? ??????? ??? ?a? t?? 19? a???a
  afa????ta? ta esfa?µ???? e?µ??e????ta st???e?a
  ?a? p??s??t??ta? ta ????.

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S??????S???? (2)

• ? Ga????? e??a? saf?? ? p??t?? p?? as???????e µe
  t? pe?????d?? ?a? t?? ??s?????a t?? ?a? ? p??t??
  p?? pe?????a?e ep?t???? t?? pa??f?s??????a t??
  ?a? t?? ?e?ape?t??? t??. ?ta? ? p??t?? p??
  p???ße? ?a? se epeµßat??? ?e?ape?t??? ?st? ?a? a?
  ??a a?t? ?p?????? e????ste? a?af????.
• ??? pe???d? t?? ?esa???a d?ad?????e ? ??a?????s?
  ?at? t?? ?p??a, ?p?? s???ß? ?a? µe p???? ???a
  ep?te??µata, ? t????? ?a?aefe??????e.

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?????G?S (1)

• ?? ????? a?t? af?e???eta? st?? ???t?ssa ?ea??
  as?e?? ?spas?a p?? ?pas?e ap? ???a?µ???
  pe???a?d?t?da ?a? e?s???? st? Te?ape?t??? ???????
  ??e???d?a t?? ?a?ep?st?µ??? ??????, t? 1973. ?
  as?e??? pa???s?ase a?f??d??? ep?p?µat?sµ? t?
  ß??d? ?a? ?ta? ??????e?t??? et??µ????at?. ?
  ?ea??? t?te - ef?µe????? ?µ???t?? apet??µ?se
  µ???? t??, ????? ???se?? ?a? eµpe???a,
  pa?a???t?s? t?? pe???a?d???, af?? e??a? ???? ??
  e?d???? t?? ???????? a????e? ?a t?? ß????s???. ?a
  ap?te??sµata ?ta? ?eaµat???. ? as?e??? a?????e
  aµ?s??, ?a? ? ße???a pa?a???t?s?? afa??????e.

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?????G?S (2)

• ??? ep?µ??? ? ???aµße?t?? ef?µe?e??? ?f??e, ?a?
  t?? µe?ep?µ??? p?? ep?st?e?e, ? ?spas?a e??e
  pe???e?. ?? ???? e??e p??? s???e?t???e? st?
  pe?????d??, ? ep?p?µat?sµ?? epa?e??f??, ?p?? ?a?
  ? ????s? ?p????d?p?te e?d???? ?at??? ?a ep?µß?.
  ???t??, d??a t? Te?, d?µ?s?e?s? e???et?!