Physicians From Italy

"Willard Fordyce, working with physician John Bonica, reconceptualized subjective ( and therefore unreachable) "pain" into observable and measurable "pain behaviors," and showed that these respond to reinforcement contingencies just like all other behaviors. Fordyce and Bonica's program at the University of Washington was the first modern, interdisciplinary, and effective pain clinic."

"John Bonica formalized the recognition of pain as a clinical entity; the work emphasized the pain syndrome's individualized consideration, as opposed to it being thought of as little more than an accompaniment of acute trauma, or an even worse myth, the miserable complaints of neurotic patients who stubbornly refuse to heal. Bonica's formal conceptualization of pain as a disease state within its own right stimulated an ever widening wave of research and clinical application culminating in the newest specialty recognized in Medicine..."

"John J. Bonica... recognized during his experience in World War II that he was unable to provide adequate pain relief for many of his patients if he utilized only the methods afforded to him by his training in anesthesiology. He realized that health care providers who had been trained in other specialties and had managed pain for their patients could add a new dimension to both the evaluation and treatment of complex pain conditions that did not respond to his particular treatment. Although perceived by some to be more complicated and more costly because of the intitial multispecialty evaluations and treatments, multidisciplinary team management of pain has proven to be more effective and less costly overall than when pain is managed by different specialists working independently."

"Dr. John Bonica and I became good friends quickly, a great benefit to me then and much more later. ...John seemed to take an interest in my having trained in the surgery of children and in two weeks taught me many basic principles of anesthesiology. Little did I know at the time how useful this information would be for me—when I became chief of anesthesia at a hospital army unit in a strange country."

"The full array of nociceptors is now deluging the nervous system with a blitz of chemical and electrical signals that the late American pain-management pioneer John Bonica called "the inflammatory soup of prostaglandins, protons, serotonin, histamine, bradykinin, pourines, cytokines, eicosanoids, and neuropeptides. Pain now echoes and amplifies itself as nociceptors form circuits and feedback loops, each link in the chain stimulating its neighbors to greater activity."

"The practice of pain rehabilitation increasingly developed during the twentieth century by evolving medical specialties of physical medicine and rehabiltitation, anesthesia, psychiatry, and occupational medicine. John Bonica, one of the fathers of pain medicine, championed a more comprehensive biopsychosocial multidisciplinary approach in the United States in 1947. This approach expanded to include a team of clinicians at the University of Washington in the 1960s. Bonica's collaboration with Wilbert Fordyce, a psychologist, incorporated operant conditioning and other behavioral approaches with more specialized, structured, and in-patient multi-week programs. In the 1980s, John Loeser formalized a more structured program at the University of Washington. This 3-week long, daily program became a model for interdisciplinary treatment."

"The challenge of managing chronic pain and suffering born of injuries to troops in WWII galvanized John Bonica and other pioneers, representing several specialties, into action. They refused to consider that their duty to these soldiers, and by extension their brethren in chronic pain of all causes, was finished once pain was controlled after an acute injury or during a surgical procedure."

"Dr. John Bonica decided that the most effective way to combat pain is to treat the person as a whole."

"It is... with perfect timing that Dr. Dermot Fitzgibbon... with the collaboration of Dr. John D. Loeser... have provided us with a comprehensive interdisciplinary, patient-centered, guide to the assessment, diagnosis, and management of cancer pain. With a combined experience of over 50 years in pain management and in the spirit of Dr. John Bonica, both Drs, Fitzgibbon and Loeser have composed a detailed treatise that covers not only pain (with a lower case p) as a symptom, but also Pain (with a capital P), as a disease, with all its physiologic, pathologic, emotional, social, and existential dimensions."

"Pioneering pain researcher John J. Bonica (1990) believed that being rewarded for pain behaviors is a key factor that transforms acute pain into chronic pain. According to Bonica, people who receive attention, sympathy, relief from normal responsibilities, and disability compensation for their injuries and pain behaviors are more likely to develop chronic pain than are people who have similar injury but receive fewer rewards. Consistent with Bonica's hypothesis, headache patients report more pain behaviors and greater pain intensity when their spouses or significant others respond to pain complaints with seemingly helpful responses, such as taking over chores, turning on the television, or encouraging the patient to rest (Pence, Thorn. Jensen & Romano, 2008)"

"The practical turn in modern pain therapy is primarily traced back to American anesthesiologist John Bonica. In the early 1950s, he first tried to found the management of pain on the methods of regional anaesthesia. In 1953, he published a book... Focusing on regional anaesthesia, it was intended to list all known options for treating pain. ...regional anaesthesia alone is not the way to obtain regular therapeutic success in cases of chronic pain. However... it started a move toward detachment from the components of cultural theories that, while suitable for wordy explorations of chronic pain, only considered the statements of patients in a distanced manner, in practice leaving the patients to themselves with their pain."

"[Luigi Ferrarese] is an enlightened and philanthropic physician of Naples, who has for several years been zealously pursuing the study of Phrenology, and endeavouring to promote its application to those branches of science, morals and legislation, which he perceives it so well calculated to benefit. He has met with much persecution, but he has persevered, and it is with pleasure we perceive that there is one mind at least, in Naples, imbued with the importance of his views"

"Dottrina, che pel suo idealismo poco circospetto , non solo la fede, ma la stessa ragione offende (il sistema di KANT) : farebbe mestieri far aperto gli errori pericolosi, cosi alla Religione, come alla Morale, di quel psicologo franzese , il quale ha sedotte le menti (COUSIN), con far osservare come la di lui filosofia intraprendente ed audace sforza le barriere della sacra Teologia, ponendo innanzi ad ogn' altra autorità la propria : profana i misteri , dichiarandoli in parte vacui di senso, ed in parte riducendoli a volgari allusioni, ed a prette metafore ; costringe , come faceva osservare un dotto Critico, la rivelazione a cambiare il suo posto con quello del pensiero istintivo e dell' affermazione senza riflessione e colloca la ragione fuori della persona dell'uomo dichiarandolo un frammento di Dio, una spezie di pandeismo spirituale introducendo, assurdo per noi, ed al Supremo Ente ingiurioso, il quale reca onda grave alla libertà del medesimo, ec, ec."

"Even Italy sends forth her testimony that phrenology has reached her shores. On my return from America in June last, I found awaiting me a little work entitled' Memoirs regarding the Doctrine of Phrenology and other Sciences connected with it,' by Dr Luigi Ferrarese, Professor of Medicine in Naples, read before the Royal Academy of Sciences in that city. It was published with full permission from the royal censor of the press. The censor in his report on the work certifies that it ' is very instructive and useful, and contains nothing offensive to religion or to the rights of kings."

"I found him in circumstances which indicated much depression, both physical and mental. He spoke with interest of Phrenology, and said that he had projected a Phrenological Journal, but knew that he would be stopped by the Government. He wished to shew the importance of the science in insanity, criminal legislation, education, and social arrangements; but in Naples there was no outlet for knowledge. Altogether, I have never had an interview with any phrenologist, foreign or British, who excited so strong a feeling of sympathy and regret, mingled with respect for his intellectual acquirements, as did Dr Ferrarese."

"On 10th February 1839, he commenced a periodical, named "Il Gatto Letterato, Foglio periodico," dated in Capolago (a town in Italian Switzerland), but printed at Naples (without licence); and for a "Lettera di un Frenologo ad un Dottore degli Stati Pontifici" (" Letter from a Phrenologist to a Doctor in the Papal States"), he was called before the Santa Sede (Holy Tribunal); and afterwards, in 1840, for several other articles, he was seized and imprisoned for 28 days. He was suspended from his office of physician in ordinary to the Royal Lunatic Asylum at Aversa, and crushed to the earth by every engine of persecution which bigotry and tyranny, combined, could employ against Him."

"Cardan was the most distinguished astrologer of his time, and when he settled in Rome he received a pension in order to secure his services as astrologer to the papal court. This proved fatal to him for, having foretold that he should die on a particular date, he felt obliged to commit suicide in order to keep up his reputation—so at least the story runs."

"Jerome Cardan is... the founder of the higher algebra; for, whatever he may have borrowed from others, we derive the science from his Ars Magna, published in 1545. It contains many valuable discoveries; but that which has been most celebrated is the rule for the solution of cubic equations, generally known by Cardan's name, though he had obtained it from a man of equal genius in algebraic science, Nicolas Tartaglia. The original inventor appears to have been Scipio Ferreo, who, about 1505, by some unknown process, discovered the solution of a single case; that of x3 + px = q. Ferreo imparted the secret to one Fiore, or Floridus, who challenged Tartaglia to a public trial of skill, not unusual in that age. Before he heard of this, Tartaglia, as he assures us himself, had found out the solution of two other forms of cubic equation; x3 + px2 = q, and x3 - px2 = q. When the day of trial arrived, Tartaglia was able, not only to solve the problems offered by Fiore, but to baffle him entirely by others which resulted in the forms of equation, the solution of which had been discovered by himself. This was in 1535; and, four years afterwards, Cardan obtained the secret from Tartaglia under an oath of secrecy. In his Ars Magna, he did not hesitate to violate this engagement; and, though he gave Tartaglia the credit of the discovery, revealed the process to the world."

"Every medieval and Renaissance court had a royal astrologer who advised the duke or prince he served. ...Men such as Roger Bacon, who even in the thirteenth century was a clear and outspoken champion of the experimental method in science, and Jerome Cardan, one of the foremost mathematicians and physicians of the sixteenth century, subscribed to astrology."

"It appears... from this short chapter [Ars Magna, lib x. ch. 1], that he had discovered most of the principal properties of the roots of equations, and could point out the number and nature of the roots, partly from the signs of the terms, and partly from the magnitude and relations of the co-efficients."

"You troubled mindes with tormentes loste that sighes and sobs consumes: (Who breathes and puffes from burning breast, both smothring smoke and fumes.) Come reade this booke that freelye bringes, a boxe of balme full swete, An oyle to noynt the brused partes, of everye heavye spirete. ...The lame whose lack of legges is death, unto a loftye mynde, Wyll kiss his crotche and creepe on knees,Cardanus workes to fynde."

"Cardano reasoned that the end of man is to know God and to mediate between the divine and the mortal. The is immortal and when permeated with is inseparable from God. True wisdom is gained from and by mathematics, as God has subjected the world to mathematical law."

"Although a long series of rules might be added and a long discourse given about them, we conclude our detailed consideration with the cubic, others being merely mentioned, even if generally, in passing. For as positio refers to a line, quadratum to the surface, and cubum to a solid body, it would be very foolish for us to go beyond this point. Nature does no permit it."

"Since this art surpasses all human subtelty and the perspecuity of mortal talent and is truly a celestial gift and a very clear test of the capacity of man's minds, whoever applies himself to it will believe that there is nothing that he cannot understand."

"My father, in my earliest childhood, taught me the rudiments of arithmetic, and about that time made me acquainted with the arcana; whence he had come by this learning I know not. This was about my ninth year. Shortly after, he instructed me in the elements of the astronomy of Arabia, meanwhile trying to instill in me some system of theory for memorizing, for I had been poorly endowed with the ability to remember. After I was twelve years old he taught me the first six books of Euclid, but in such a manner that he expended no effort on such parts as I was able to understand by myself. This is the knowledge I was able to acquire and learn without any elementary schooling..."

"I have not lost my faith; and this I must attribute more to a miracle than to my own wisdom; more to Divine Providence than to my own virtue. Steadfastly, in fact from my earliest childhood, I have made this my prayer, "Lord God... grant me long life, and wisdom, and health of mind and body.""

"What if one should address a word to the kings of the earth and say, "Not one of you but eats lice, flies, bugs, worms, fleas—nay the very filth of your servants! With what an attitude would they listen to such statements, though they be truths? What is this complacency then but an ignoring of conditions, a pretense of not being aware of what we know exists, or a will to set aside a fact by force? And so it is with everything else foul, vain, confused and untrue in our lives."

"This I recognize as unique and outstanding among my faults—the habit...of preferring to say above all things what I know to be displeasing to the ears of my hearers. ...I keep it up wilfully, in no way ignorant of how many enemies it makes for me. ...Yet I avoid this practice in the presence of my benefactors and of my superiors. It is enough not to fawn upon these, or at least not to flatter them."

"My personal affairs are not as highly esteemed as men commonly value their own interests—vain, empty affairs like those great clouds seen in the wake of the sunset which are meaningless and soon pass away."

"I have accustomed my features always to assume an expression quite contrary to my feelings; thus I am able to feign outwardly, yet within know nothing of dissumulation. This habit is easy if compared to the practice of hoping for nothing, which I have bent my efforts toward acquiring for fifteen successive years, and have at last succeeded."

"I am able to admit two distinct trains of thought to my mind at the same time."

"I am cold of heart, warm of brain, and given to never-ending meditation; I ponder over ideas, many and weighty, and even over things which can never come to pass."

"From these beginnings, as it were, have issued bitterness, contentious obstinancy, lack of amenity, hasty judgement, anger, and an intense desire for revenge—to say nothing of headstrong will; that which many damn, by word at least, was my delight."

"Among other myseries what I pray you tá be greater than whē a man riseth frō bed in the morning, to be incertaine of his returne to rest againe. or being in bed, whether his life shall continue tyll he ryse. besydes that, what labour, what hazard & care, are men constrained to abyde with these our brittle bodies, our feeble force, and incertayne lyfe: so as no nacion I thinke a man better or more fitlye named than the Spaniard, who in their language do terme a man shadow. And sure ther is nothing to be found of lesse assurance or soner passed than the lyfe of man, no... may more rightly be resembled to a shadow."

"So shall we voyd of all craft and sail, with true reason declare how much each man erreth in life, judgement, opinion, and will. Some things there are that so wel do prove themselves, as besides nature nede no profe at all."

"And wel we see ther is none alive that in every respect may be accompted happie, yea though mortall men were free from all calamities, yet the torments & feare of death should stil attend them But b:sides them, behold, what, and how manye evilles there bee, that unlesse the cloude of error bee removed, impossible it is to see the truth, or receive allay of our earthly woes."

"Better it is to have the worst, than none at all. for example we see, that houses are nedefull, such as can not possese & stately pallaces of stone, do persuade themselves to dwell in houses of timber and clap, and wanting them, are contented to inhabite the simple cotage, yea rather than not to be housed at all refuse not the pore cabbon, and most beggerly cave. So necessarie is this gift of consolacion, as there livith no man, but that hathe cause to embrace it. for in these things better is it to have any than none at al."

"The greatest advantage in gambling lies in not playing at all."

"When Cardano's Consolation or Comforte was translated into English in 1573... one of the readers is known to have been William Shakespeare. ...Hamlet's thoughts on death and slumber are believed to have been inspired by... passages in Comforte..."

"A great number of writers on the history of medicine have indicated important observations and suggestions which made their intitial appearance with Cardano."

"Cardano was a man of universal interests, and much of his ability must have been inherited from his father, Fazio Cardano... a lawyer... but also deeply steeped in the medical sciences, mathematics, and all kinds of occult lore... he had... a high reputation as a scholar in his native town; even Leonardo da Vinci notes several times that he consulted Messer Fazio on geometric questions... he was appointed as a public lecturer in geometry."

"Most important for the history of science is the fact that Liber de Ludo Aleae, "The Book of Games of Chance," contains the first study of the principles of probability. ...it would seem much more just to date the beginnings of probability theory from Cardano's treatise rather than the customary reckoning from Pascal's discussions with his friend de Méré and the ensuing correspondence with Fermat... at least a century after Cardano..."

"Cardano's entertaining books on science and curiosities were among the best read and most pirated works in the sixteenth century. ...his work on the "Great Art" has been characterized as the first that goes decisively beyond the attainments of classical Greek mathematics."

"The application of the theory [of probability] to mortality tables in any large way may be said to have started with John Graunt... The first tables of great importance, however, were those of Edmund Halley... however... Cardan seems to have been the first to have been the first to consider the problem in a printed work, although his treatment is very fanciful. He gives a brief table in his proposition "Spatium vitae naturalis per spatium vitae fortuitum declarare," this appearing in the De Proportionibus Libri V..."

"The law which asserts that the equation X = 0, complete or incomplete, can have no more real positive roots than it has changes of sign, and no more real negative roots than it has permanences of sign, was apparently known to Cardan; but a satisfactory statement is possibly due to Harriot (died 1621) and certainly to Descartes."

"The problem of the biquadratic equation was laid prominently before Italian mathematicians by Zuanne de Tonini da Coi, who in 1540 proposed the problem, "Divide 10 parts into three parts such that they shall be continued in proportion and that the product of the first two shall be 6." He gave this to Cardan with the statement that it could not be solved, but Cardan denied the assertion, although himself unable to solve it. He gave it to Ferrari, his pupil, and the latter, although then a mere youth, succeeded where the master had failed. ...This method soon became known to algebraists through Cardan's Ars Magna, and in 1567 we find it used by Nicolas Petri [of Deventer]."

"He... gave thirteen forms of the cubic which have positive roots, these having already been given by Omar Kayyam."

"He states that the root of x^3 + 6x = 20 is{{center|1=x = \sqrt[3]{\sqrt{108} + 10} - \sqrt[3]{\sqrt{108} - 10}.}}"

"Cardan's originality in the matter seems to have been shown chiefly in four respects. First, he reduced the general equation to the type x^3 + bx = c; second, in a letter written August 4, 1539, he discussed the question of the irreducible case; third, he had the idea of the number of roots to be expected in the cubic; and, fourth, he made a beginning in the theory of symmetric functions. ...With respect to the irreducible case... we have the cube root of a complex number, thus reaching an expression that is irreducible even though all three values of x turn out to be real. With respect to the number of roots to be expected in the cubic... before this time only two roots were ever found, negative roots being rejected. As to the question of symmetric functions, he stated that the sum of the roots is minus the coefficient of x2"

"[Zuanne de Tonini] da Coi... impuned Tartaglia to publish his method, but the latter declined to do so. In 1539 Cardan wrote to Tartaglia, and a meeting was arranged at which, Tartaglia says, having pledged Cardan to secrecy, he revealed the method in cryptic verse and later with a full explanation. Cardan admits that he received the solution from Tartaglia, but... without any explanation. At any rate, the two cubics x^3 + ax^2 = c and x^3 + bx = c could now be solved. The reduction of the general cubic x^3 + ax^2 + bx = c to the second of these forms does not seem to have been considered by Tartaglia at the time of the controversy. When Cardan published his Ars Magna however, he transformed the types x^3 = ax^2 + c and x^3 + ax^2 = c by substituting x = y + \frac{1}{3}a and x = y - \frac{1}{3}a respectively, and transformed the type x^3 + c = ax^2 by the substitution x = \sqrt[3]{c^2/y}, thus freeing the equations of the term x^2. This completed the general solution, and he applied the method to the complete cubic in his later problems."