Letter to editor
SARS in Classical Greece? A glimpse in history
Gregory Tsoucalas
Dear Editor,
Mystery in ancient Hellenic civilization represents a huge part of
its history. Greek medico-philosophers tried through experience
and in many occasions torturous observation to explain all about
human physiology and medicine in its consummation. The Hippocratic
School of Medicine marked the era by summarizing all available
medical knowledge of the known world, as travel and medical
review were among the fundamental methods to gain expertise.
To propose a hypothesis that a case of a severe acute respiratory
syndrome (SARS) was noted by Hippocrates and his followers is
not far from possible.
(Figure 1)
However, to add a virus from the family of Coronaviridae is
something else. Nonetheless, some historical clues may allow such
a narrative investigation. Caronaviruses were named after the
Latin tern "corona" which means "crown",
deriving from the ancient Greek verb "coroniao" (Greek:
κορωνιάω) which describes the bending neck (flexion) movement,
while "coronis" (Greek: κορωνίς) means the oval edge of
something and in the case of humans the epicranium.1
A single crown-like virion was directly visualized under the atomic
force microscopy, specifying the family name.2 There are still
significant knowledge gaps in their epidemiology and transmission
dynamics, while the spectrum of clinical features varies,
presenting a heterogeneous cluster of symptoms, from mild to
severe life threatening disease.
Since 2003 coronavirus SARS is identified, prompting a quest for
novel types. The family was recognized in a diverse array in
humans, domesticated animals and wildlife, especially in bat and
bird species, which are believed to act as natural hosts. Bats
were accused for the SARS- Cov-2 pandemic during 2019-2021. Recent
molecular analyses demonstrated that coronaviruses are orders of
magnitude older than previously suggested, exhibiting a past
ancestor, common for all types of the family, who is likely far
greater (millions of years) than it was believed.3
In ancient Greece the ceremonial religious sacrifice of cattle or
sheep demanded the advent of bats for them to drink the animal's
blood before the believers’ practise “spondi” (Greek: σπονδή,
an act of pouring a liquid as a sacrifice, or drinkin it in
frenzy or ecstasy).
Figure 1: Hippocrates of Kos, Pieter Serwouters, Bonaventura
Elzevier, Abraham Elzevier, 1628.
Is there the possibility for a "miasmatic" cattle blood,
which was infected by a bat virus? Looks like a fade case, but on
the other hand all is possible.
Inside Corpus Hippocraticum various viral induced infections
of the lower respiratory tract were noted, like bronchiolitis
and bronchitis, usually presenting with cough accompanied
by gastrointestinal disorders. In the report of the
"cough of Perinthos", a winter epidemic presented by the
Hippocratics, dry or productive cough, rich in sputum production
could be combined with pleurodynia, severe respiratory distress,
orthopnoea, gastrointestinal disorders, arthralgia, voice
irregularities and high fever waves, usually ending with
pneumonia. Furthermore, an uncommon angina was described,
characterized by intense respiratory distress with acute
breathlessness and the felling of choking with peculiar rapid
progression. The infected could pass away within the first day, or
soon enough after the pathology's outset, "the sore throat
angina, when not exhibit any event neither to the neck, not to the
throat, but cause severe choking and wheezing, cause death the
same day or the third day".5
Speculating for a Hippocratic SARS we only present a hypothesis
with no firm strong clues. Exactly the same thing they all do when
they exam the mysteries of the Hellenic antiquity!
References
1. Liddell GH, Jones HS, Scott R. A Greek-English lexicon. Clarendon
Press, Oxford, 2006.
2. Lin S, Lee CK, Kao CL, Lin CW, Wan AB, Hsu SM, Huang LS. Surface
ultrastructure of SARS coronavirus revealed by atomic force
microscopy. Cell Microbiol 2005;7(12): 1763-1770. doi:
10.1111/j.1462-5822.2005.00593.x
3. Wertheim JO, Chu DK, Peiris JS, Kosakovsky Pond SL, Poon LL. A
case for the ancient origin of coronaviruses. J Virol
2013;87(12): 7039-7045. doi: 10.1128/JVI.03273-12
4. Aristophanes. Birds. Henry Francis Cary
(trans.). Taylor and Hessey, London, 1824.
5. Hippocrates. Coa praesagia, vol. 5 & De morbis popularibus
& De fistulis & De humidorum usu & De ulceribus & De
medico, ed. É. Littré, Oeuvres Complètes d’Hippocrate, vol. 6.
Baillière, Paris, 1846-1849.
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