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  • Thomas Sydenham (1624 - 1689)

    From Hippocrates, the "father of medicine", to William Osler, the "father of modern medicine", praise for physicians abounds and venerates their varied virtues (Pearce, 2020). Thomas Sydenham, the illustrious English physician, was regarded, but especially after his death, as "the English Hippocrates". In correspondence with Pearce (2020), his epitaph "noble physician of all ages" also proclaimed his great reputation. Background It is important to take into account the time of Thomas Sydenham, since, according to Iglesias (2020), until the end of the 16th and beginning of the 17th century, the old theory of humours predominated and a new conception of the concept of disease was necessary, because everything that prevailed was a consequence of this idea. At the end of the 16th century, according to Iglesias (2020), extraordinary figures emerged, such as Jan Baptista von Helmont, who transformed the concept of humoral constitution into that of individual disease, as well as the cause by a specific agent and, consequently, opened the perspective of an aetiology, pathological anatomy and diagnosis of a disease. Subsequently, the figure of Franz de le Boe, a follower of Harvey's circulation theory, the development of anatomy by the Dane Thomas Bartholin and the emergence of other concepts such as iatrochemistry and finally clinical empiricism and rationalism make themselves known in the era of Hermann Boerhaave (Iglesias, 2020). Iglesias (2020) mentions that, with these precedents in 17th century medicine came Thomas Sydenham, who introduced the concept of the modern morbid species by describing the clinic of diseases as a way of explaining the balance between experience and reason. Biography Thomas Sydenham was born on 10 September 1624 in Winford Eagle, England, into a wealthy and well-to-do Puritan family (Iglesias, 2020; Fresquet, 2000). There, health was poor and, due to climatic conditions, bone diseases such as rickets, tuberculosis, measles and other infectious diseases were prevalent (Iglesias, 2020). Also, according to Iglesias (2020), medical conditions were chaotic, and operations were performed by barbers and herbalists; the lack of medical surgeons and the lack of hygiene was the scene of the early 17th century, influenced by Paracelsus' rationalism, miasma and religious fanaticism. He fought in the English civil war for Cromwell's parliamentarians and there witnessed the treatment of his brother by Thomas Coxe (Pearce, 2020). This awakened his desire to become a doctor (Pearce, 2020). He began his studies at Oxford, which he had to interrupt due to the Civil War (Fresquet, 2000). He returned to Magdalen Hall, but in October 1647, on the advice of Thomas Coxe, he moved to Wadham College to read medicine, completing his medical degree in April 1648 (Pearce, 2020). Fresquet (2020) mentions that, according to some authors, he also seems to have studied at the University of Montpellier, where he was a student of Barbeirac. Subsequently, he practised in London, although his political views prevented him from becoming a member of the Royal College of Physicians (Fresquet, 2000). According to Iglesias (2020), in 1687, after 30 years of practising medicine, he obtained his doctorate at Cambridge University. Finally, Sydenham is known to have had attacks of clinical haematuria and gout, and his death in 1689 is thought to be related to both (Jacobson, 2017). He was buried in Westminster Abbey (Fresquet, 2000). Sydenham's fame arose after his death and, above all, thanks to the Dutchman Hermann Boerhaave, a professor at Leyden who became known as the "communis Europeae praeceptor". According to Fesquet (2000), he linked Sydenham's plans to bedside teaching and insisted on performing necropsies to look for anatomical lesions. Translated with www.DeepL.com/Translator (free version) Works Through his meticulous work, Sydenham was the first to describe scarlet fever; identify the relationship between fleas and typhus; popularise the use of quinine to treat malaria; explain a movement disorder that occurred after fever (now known as Sydenham's chorea); and introduce a liquid tincture of opium to relieve pain. Similarly, according to Jacobson (2017), his work of recorded observations, Observationes Medical, would serve as a functional textbook for the next two hundred years. Sydenham's most famous and enduring work was his treatise on gout in 1683, which took the art of clinical observation to a personal level (Jacobson, 2017). Having suffered frequent and debilitating attacks of gout from the age of thirty, he gave a descriptive, first-person account of the affliction. Although Sydenham correctly identified obesity, excessive red meat intake and alcohol as risk factors for gout, his Puritan religion also probably influenced his recommendation of temperance rather than other treatments. Jacobson (2017) mentions that, in modern medicine, gout has a known association with coronary artery disease, kidney stones and sleep apnoea. Corresponding with Jacobson (2017), ironically, colchicine, an ancient natural remedy and future pharmacological treatment for acute gout, was not used in England for over a hundred years due to the influential opposition of Thomas Sydenham. With regard to treatment, Sydenham aspired to find a specific medication that would act quickly what nature did slowly (Fresquet, 2000). In his distinction between acute and chronic diseases, he believed that in the former, the physician should quickly and precisely eliminate the causes; in chronic diseases, the disease is destroyed in kind. Therefore, according to Jacobson (2017), he prescribed bloodletting, sweating or purging for acute diseases, but recommended temperance and rebalancing of humours for chronic diseases. Translated with www.DeepL.com/Translator (free version) Legacy In addition to the eponymous "Sydenham's laudanum", according to Fresquet (2000) and Fernández & Tamaro (2004), also known today is the so-called "Sydenham's cough", which consists of hysterical spasms of the respiratory muscles; and "Sydenham's chorea", an inflammatory and degenerative disease of the central nervous system, which mainly affects children between 6 and 15 years old and causes involuntary, rapid, disordered and arrhythmic movements of the muscles of the whole body. Thomas Sydenham also made important advances in the identification of diseases, for example, he differentiated scarlet fever from measles (Fernández & Tamaro, 2004). Regarding the treatment of different diseases, Fernandez & Tamaro (2004) mentioned that he promoted the use of iron for anaemia and quinine for malaria, and Sydenham's famous laudanum (opium dissolved in alcohol) for gout. Referencias Fernández, T., & Tamaro, E. (2004). Biografia de Thomas Sydenham. Biografías y Vida. Recuperado 20 de enero de 2022, de https://www.biografiasyvidas.com/biografia/s/sydenham.htm Fresquet, J. (2000). Thomas Sydenham (1624–1689). Historia de la Medicina. Recuperado 20 de enero de 2022, de https://www.historiadelamedicina.org/sydenham.html Iglesias, A. (2020). Thomas Sydenham, ¿el primer reumatólogo?. Global Rheumatology. Recuperado 20 de enero de 2022, de https://www.globalrheumpanlar.org/articulo/thomas-sydenham-el-primer-reumatologo-457 Jacobson, A. (2017). The “English Hippocrates” and the disease of kings. Hektoen International. Recuperado 20 de enero de 2022, de https://hekint.org/2017/10/11/thomas-sydenham/ Pearce, J. (2020). Thomas Sydenham, “The English Hippocrates”. Hektoen International. Recuperado 6 de abril de 2022, de https://hekint.org/2020/08/13/thomas-sydenham-the-english-hippocrates/

  • Thomas Willis (1621 - 1675)

    In the field of medical science, the eponym Willis refers to several anatomical structures, including the cerebral arterial circle (Arráez et al., 2015). In 2014, the 350th anniversary of the publication in London of the famous work by Thomas Willis, titled Cerebri Anatome , was commemorated. This text was deeply influenced by the political and cultural context of Baroque Europe, particularly 17th-century England. According to Arráez et al. (2015), this work, a product of what is now known as translational research, marked the beginning of modern neurology and laid the foundation for future investigations in the fields of clinical and comparative anatomy of the nervous system. Biography Shortly after the death of William Shakespeare and Queen Elizabeth, during a period when England still enjoyed the artistic and cultural flourishing of the Elizabethan era, Thomas Willis was born on January 27, 1621, in Great Bedwyn, Wiltshire, about 70 miles northwest of London (Arráez et al., 2015). His father, who had served several nobles, settled as a farmer in a village near Oxford. He attended Edward Sylvester's school and was admitted to the University of Oxford on March 3, 1637. Initially, he studied at Christ Church College under Dr. Thomas Isles' guidance and later moved to All Saints College. According to Arráez et al. (2015), he earned a Bachelor of Arts degree on June 12, 1639, and a Master of Arts degree on June 18, 1642, the same year his father died defending the king during the siege of Oxford. Originally inclined towards an ecclesiastical career, he learned Latin, the language of both religious authority and political power (Arráez et al., 2015). Although he did not enjoy the rigidity of theology, his mastery of Latin proved extremely beneficial in his later medical writings. During this time, he worked as a servant for Dr. Thomas Isles and Mrs. Isles, who were the canon of Christ Church College and an unofficial physician, respectively. His interest in medicine arose while assisting Mrs. Isles in preparing medical remedies, which introduced him to the growing field of alchemy. In 1642, he began his medical studies. In November of that year, King Charles I took residence at Christ Church College in Oxford, accompanied by the royal physician William Harvey. According to Arráez et al. (2015), Willis had the opportunity to learn about the main advances in medicine thanks to the lectures given by Dr. Harvey. As a royalist, Thomas Willis joined the auxiliary regiment of the Earl of Dover in the fight against the Parliamentarians (Arráez et al., 2015). On December 8, 1646, his loyalty was rewarded with a medical degree after only six months of study, allowing him to begin his medical practice before Oxford was taken by Parliamentary forces (Arráez et al., 2015). After obtaining his license, according to Campohermoso et al. (2019), Willis faced difficulties in starting his practice, not due to a lack of knowledge but because of his lack of resources to dress appropriately and his stammer, which made him appear less competent than he truly was. Despite the ban on Anglican worship during the Protectorate, he began holding religious assemblies in his home (Arráez et al., 2015). Meanwhile, at the University of Oxford, traditional teaching was replaced by new trends that turned Oxford into the center of scientific knowledge, encouraged by Puritan thought and inspired by Francis Bacon's work. In response to Puritan influence, some members of London's Invisible College founded the Oxford Experimental Philosophy Club, which Willis joined in 1649. In this club, according to Arráez et al. (2015), he interacted with figures such as Robert Boyle , the father of chemistry; William Petty , philosopher, physician, entrepreneur, and economist; Christopher Wren, professor of astronomy at Oxford and architect; Thomas Sydenham , known as the English Hippocrates; Robert Hooke , physicist and microscopist; and Thomas Millington, physician and professor of natural philosophy at Oxford. This group frequently met to discuss scientific topics and conduct experiments, promoting independent translational research in Oxford (Arráez et al., 2015). Aristotle’s natural philosophy was replaced by Pierre Gassendi’s atomism, whose ideas influenced Willis’s work, along with the iatrochemical concepts of Walter Charleton and Théodore Turquet de Mayerne. It was common for physicians to consult one another about their patients, and Willis did so with many clinicians. In fact, the Library of St. John's College, Oxford, preserves letters exchanged between Willis and Richard Higges, which are valuable for studying Willis's reasoning, which differed greatly from that of his contemporaries. According to Arráez et al. (2015), in a letter to Higges dated March 24, 1665, he provides details on treating a patient’s feet and preparing medication, demonstrating how he used his knowledge to help patients. On December 14, 1650, Willis and Petty had an unusual experience when they revived a corpse (Arráez et al., 2015). Anne Greene, accused of murdering her baby, was hanged and declared dead before being placed in a coffin (Molnar, 2004). Upon opening the coffin, a strange noise was heard, prompting the start of resuscitation. Anne fully recovered, married, and had three more children (Molnar, 2004). This event significantly impacted his professional career (Arráez et al., 2015). On April 7, 1657, he married Mary Fell, sister of John Fell (Campohermoso et al., 2019). In 1660, following the Restoration, Oxford was purged of Puritan elements (Arráez et al., 2015). That same year, he became a doctor of medicine and Sedleian Professor of Natural Philosophy at Oxford. Arráez et al. (2015) mentions that although this position required lectures on Aristotelian tradition, his education from members of the Invisible College contrasted with the restored scholastic tradition. Thanks to the support of his friend Gilbert Sheldon, Bishop of London, Willis was able to present his students with his theories and personal observations (Arráez et al., 2015). Among his students were John Locke , physician and philosopher, and Richard Lower, whose notes from Willis’s lectures formed the basis of Willis’s Oxford Lectures. Lower became a notable anatomist while assisting Willis in neurological studies and later conducted blood transfusion experiments presented to the Royal Society (Arráez et al., 2015). According to Campohermoso et al. (2019), in 1662, King Charles II founded the Royal Society of London, and a year later, Thomas Willis was elected a member, being admitted on October 24, 1667. In 1664, he was elected honorary fellow of the Royal College of Physicians of London (Arráez et al., 2015). In 1665, Sheldon proposed he return to London, a major center for scientists at that time. By the end of 1666, he moved to St. Martin's Lane and quickly achieved success, becoming “the most famous physician in Europe,” according to a commemorative plaque in the chapel of St. Martin in Fenny Stratford. In 1674, he bought 3,000 acres of land near Bletchley from the Duke of Buckingham. He finally died on November 11, 1675, from tuberculosis and pneumonia. According to Arráez et al. (2015), his remains rest next to those of his wife in the north transept of Westminster Abbey. Work and Publications His writings were dismissed by his contemporaries (Arráez et al., 2015). However, his work has been well documented by Hughes and Isler and in Munk’s roll. Willis's scientific output consists of seven works, organized into three stages. This reflects his interest in studying the soul from an iatrochemical perspective. During the Reformation, which promoted the use of local languages, most of his contemporaries published their works in English. In contrast, Willis chose to write in Latin, as he considered this language to be more refined and elegant. Additionally, Latin supported traditional medical education, backed by the University, the Monarchy, and the Church. Nevertheless, Willis's "Plain and Easie Method" was originally published in English, as it was a posthumous edition of a work written in 1666. According to Arráez et al. (2015), the collected editions of Willis’s works, which appeared in the 50 years following his death (nine in Latin and two in English), demonstrate his extensive influence. Willis's main contribution to medicine lies in his research on the morphology of the nervous system, including embryology, comparative anatomy, and pathological anatomy, as a foundation for understanding neurological pathology (Fresquet, 2005). In 1664, "Cerebri Anatome" was published, while René Descartes published "Traité de l’homme" (Arráez et al., 2015). Arráez et al. (2015) mentioned that both authors shared the goal of understanding the structure and function of the nervous system in their effort to comprehend the relationship between the soul and the body, although their approaches were quite different. Unlike René Descartes , Willis's ambitions were more modest (Arráez et al., 2015). He did not speculate on the relationship between the soul and the body; instead, he prioritized observing the structure as it was, without altering it to fit any theory. Willis sought to understand the normal functions of the nervous system in order to address neurological pathologies. In line with Arráez et al. (2015), for Thomas Willis, a defect or lack of nervous fluids could affect the vital spirit, an idea reflected in his work "De Anima Brutorum," where he studied the "animal" or "sensitive" soul of the human being. Although this work might seem theoretical and speculative, it made significant contributions to the comparative anatomy of the nervous system, basing his theories on animal research (Arráez et al., 2015). He held that the "animal soul" was the most subtle and fiery part of the blood and that all sensations, movements, and impulses depended on the "animal spirits." In contrast to the material nature of the "sensitive soul," the "rational soul" was immaterial and immortal; it housed the faculties of wisdom and reason and was therefore exclusive to humans. In this context, he suggested that neuropsychiatric diseases arose when both the "sensitive and rational souls" were altered. Finally, Arráez et al. (2015) indicated that Willis provided one of the earliest systematic descriptions of neuropsychiatric diseases, such as headache, sleep disorders, coma, apoplexy, vertigo, paralysis, mania, delirium, and melancholy. "Cerebri Anatome" The Body-Brain-Soul Relationship as a Starting Point for Willis' Work He began his research on the understanding of the "rational soul" and its interaction with the brain due to the need for material for his lectures (Arráez et al., 2015). In the Dedication addressed to Sheldon, he made it clear that "natural philosophy" and "Christian theology" should not be considered rivals. He also stated that anatomy could reveal the hidden places of the mind and explore the living, breathing Chapel of Deity. He concluded his dedication by asserting that after studying the brain, even the most stubborn atheist might recognize the existence of God, or else reject both religion and reason. In the Preface, his religiosity, combined with his scientific methods, led him to view the brain as a harmonious and interconnected system designed by God. Later, according to Arráez et al. (2015), when writing about the brain, he used a metaphor to express his views on the role of the king and the church, a common technique in the lectures and philosophical works of the Restoration era. He also argued that by studying anatomy, he could demonstrate the structural similarities between humans and animals, despite the differences in their higher functions (Arráez et al., 2015). This implied that humans possessed an "immortal soul" in addition to the one "shared with animals." For this reason, the work "Cerebri Anatome" is a comparative anatomy that includes numerous references and drawings comparing humans to horses and sheep. Willis realized that the functions of the nervous system were far more complex to understand than those of other organs. Consequently, he replaced Nemesius's doctrine and deduced that the ventricles contained cerebrospinal fluid, which collected the waste products from the effluvia. Likewise, according to Arráez et al. (2015), he recognized the cortex as the substrate of cognition and claimed that gyrencephaly was related to a progressive increase in cognitive complexity. In his functional scheme, he placed the origin of voluntary movements in the cerebral cortex, while involuntary movements came from the cerebellum; memory was located in the white matter; the gyri controlled memory, will, and imagination; and the striatum played a crucial role in sensation and movement (Arráez et al., 2015). Willis was an advocate of the "animal spirits," which were extracted from a cerebral distillation of blood and descended through the nerves to the organic territories to cause sensations and movements. According to Arráez et al. (2015), the nervous fluids carried by the "spiritus" were not inside the nerve fibers, as was believed at the time, but in their interstitial space. He also hypothesized about sensation and movement, involving the nerve tubules discovered in the brain by Malpighi and the membranous fibers of Baglivi (Arráez et al., 2015). Additionally, he considered the chemical process to be crucial: the substance had to reach the muscles through the nerves to bind with the "animal spirits" extracted from the blood. According to Arráez et al. (2015), this reaction triggered muscle contraction. Willis' New Technical Approaches to Study The first chapter, which is also the most extensive of his work, addresses new approaches and technologies in the field of organ preservation and the injection of colored solidifying substances (Arráez et al., 2015). In this context, he explicitly details his scientific methodology. Regarding the dissection method, he observed that previous anatomists analyzed the brain through in situ dissection, meaning that after opening the skull, they removed successive sections of the brain. This procedure allowed for a thorough study of the ventricles but complicated precise observation of the delicate structure of the brainstem. Instead, Willis opted to extract the entire brain intact, allowing him to examine a less distorted organ. According to Arráez et al. (2015), while writing "Cerebri Anatome," Willis had a large collection of anatomical plates and atlases that served as the basis for his original research. Although Willis acknowledged Galen of Pergamum (129 AD – 210 AD) and Hippocrates (460 – 377 BC) as the founders of medicine, he believed that classical anatomists not only lacked detailed anatomical knowledge but were also influenced by an incorrect belief system of pagan origin (Arráez et al., 2015). This lack of faith prevented the ancients from recognizing the true beauty of humanity, which Willis considered God's final work. Additionally, Willis was a pioneer in brain preservation techniques for later study. According to Arráez et al. (2015), to delay the rapid decomposition of the brain, Thomas Willis preserved it in pure alcohol, a method previously suggested by Boyle. Illustrations and Engravings One of his most notable achievements in his work was his ability to accurately illustrate the findings obtained during dissection (Arráez et al., 2015). Leonardo da Vinci encouraged the anatomist to abandon the idea that the structure of the human body could be fully understood through words. Beginning with the publication of "Historia de la Composición del Cuerpo Humano" by Valverde de Amusco in 1556, anatomical texts gradually began to include visual legends and higher-quality illustrations, engraved on copper plates. In fact, according to Arráez et al. (2015), the 23 figures contained in "Cerebri Anatome" were unprecedented in the history of anatomy. New Anatomical Descriptions In his work, he described in detail several brain structures, including the striatum, internal capsule, cerebellar peduncles, anterior commissure, claustrum, inferior olivary nucleus, pyramids, thalamus, terminal stria, and certain nerves (Arráez et al., 2015). He also noted that brain tissue is insensitive to painful stimuli, in contrast to the meninges, which are sensitive. Finally, according to Arráez et al. (2015), Willis provided details about the autonomic nervous system and proposed a classification that included nine cranial nerves. The Sympathetic Nerves and the Vagus Nerve The division between the sympathetic nerves and the vagus nerve is often attributed to Charles Estienne (Arráez et al., 2015). However, Eustachius and Willis were the only anatomists of the time to provide clear examples of this separation. They also asserted that the sympathetic subdivision of the autonomic nervous system had an intracranial origin. Consequently, some authors suggest that Willis knew of Eustachius's unpublished plates, while others believe that different lines of thought led to similar conclusions. The book "Cerebri Anatome" includes two clear and precise illustrations of this separation, which resemble those of Eustachius. Although Willis's images lacked the artistic refinement of Eustachius's, they stood out for their ability to show the topographical relationships between visceral organs. According to Arráez et al. (2015), Willis also posited that the vagus nerve had greater relevance for lower animals compared to the sympathetic nerves. One of his most important principles suggested that the brain influenced the cerebellum through the quadrigeminal plate and the superior cerebellar peduncles (Arráez et al., 2015). For this reason, the cerebellum coordinated the vagus and "intercostal" nerves, both involuntary. This influence commonly manifested in hysteria, causing difficulty breathing, chest pain, abdominal distension, as well as episodes of crying and laughing. Thus, Willis anticipated contemporary ideas about the physiology of emotions. Willis's description of the intercostal nerves has been scarcely addressed by medical historians. However, these nerves play a fundamental role in his neurology. According to Arráez et al. (2015), Willis believed that through these nerves, which connect the brain with the heart and lower viscera, the brain regulated the passions and instincts of the lower body. The Accessory Nerve Willis was the first anatomist to describe and illustrate the accessory nerve as an independent nerve (Arráez et al., 2015). During his studies, he observed that in fish and poultry, the accessory nerve supplied the fins and wings, unlike in humans and other mammals, where this nerve is related to the neck muscles. According to Arráez et al. (2015), the temporary connection between the accessory nerve and the vagus nerve caught Thomas Willis's attention, leading him to speculate on how the brain responds to fear and other emotions that influence the muscles of the neck and arms. The Cranial Nerves Willis made important contributions to the naming and numbering of the cranial nerves (Arráez et al., 2015). From Galen until the 16th century, these nerves were referred to as "cerebral nerves." According to Arráez et al. (2015), Willis fixed the origin of these nerves inside the skull, stating that the nerve pair is born within the skull. Willis's popularity helped consolidate a new classification composed of nine cranial nerves (Arráez et al., 2015). In accordance with Arráez et al. (2015), his classification of cranial nerves was a marked improvement over its predecessors, as it included nine cranial nerves, most of which are recognized today. In Willis’s scheme, the seventh nerve comprised the facial and vestibulocochlear nerves; the eighth nerve included the glossopharyngeal and vagus nerves, along with the cranial root of the accessory nerve; and the fourth nerve consisted of the hypoglossal nerve and the spinal root of the accessory nerve (Arráez et al., 2015). This classification remained in use for the next 114 years until 1778 when Sömmering introduced the current classification of 12 cranial nerves. In fact, according to Arráez et al. (2015), Willis's work was so popular in England that some English publications continued to use his classification until the end of the 19th century. The Cerebral Arterial Circle In his work "Cerebri Anatome," the first complete illustration of the arterial anastomosis is presented, depicted as a closed circle at the base of the brain (Arráez et al., 2015). However, it should be noted that Willis never claimed to be the discoverer of this arterial circle. His immediate successors in this field did not mention him, or anyone else, as responsible for the discovery of the arterial circle, although most commented, either appreciatively or critically, on his work, particularly regarding the description of the cerebral arteries. Despite this, Willis was the first to understand the functional and pathological importance of this arterial circle. As an academic physician and pioneer in translational research, he conducted experimental surgeries to demonstrate cerebral compensation mechanisms, also identifying the blood-brain barrier. According to Arráez et al. (2015), Willis suggested that only the smallest particles, necessary for rapid nervous function, could pass from the blood to the brain. Legacy His name has endured primarily for his description of the Circle of Willis, an arterial structure at the base of the brain (Molnar, 2004). The idea of the circle arose during the autopsy of a man who died of stomach cancer when Willis was able to demonstrate its functionality by tracing the path of a post-mortem ink injection. His achievements are remarkable, especially considering that he made his observations by dissecting unfixed brains, some of which must have been in severely deteriorated conditions. During these studies, according to Molnar (2004), he redefined the cranial nerves, surpassing the classification established by Galen. In this regard, he accurately identified the first through sixth cranial nerves as they are known today (Molnar, 2004). Although he described the seventh nerve as the auditory nerve, with two branches, he identified the eighth as the vagus nerve, recognizing its branches extending to the heart. Along with Richard Lower, they demonstrated the functions of the vagus nerve through experiments on dogs. He also discovered the spinal accessory nerve, and his illustrations depicted the glossopharyngeal and hypoglossal nerves, though with different terminology than what is used today, and he highlighted the importance of the medulla oblongata in regulating the functions of the heart, lungs, and intestines. According to his observations, as referenced by Molnar (2004), nerve impulses were transmitted from the brain, and "animal spirits" were reflected in the periphery from the striated body. It is surprising that his theories on the transmission of nerve impulses anticipated the discovery of electrical currents (Molnar, 2004). Additionally, he proposed that higher cognitive functions originated in the convolutions of the cerebral cortex, an innovative idea for his time. At that time, the dominant view was Galen’s, who believed that the fluid-filled cavities in the brain contained a substance known as "animal spirits," which was considered the final product of a perfect distillation. It was believed that three cells were involved in cognitive functions: the first, the sensus communis , received sensory signals; these signals were mixed and passed to the middle ventricle, where reason, thought, and judgment were processed. Finally, memory was formed in the third ventricle. According to Molnar (2004), this paradigm was challenged when da Vinci discovered that most sensory nerves led to the third ventricle, suggesting that the sensus communis resided there. On the other hand, Willis was a pioneer in the study of disorders such as sleep, sleepwalking, insomnia, narcosis, and lethargy, linking lethargy to obstructive hydrocephalus, brain tumors, and strokes (Molnar, 2004). Additionally, as noted by Molnar (2004), by performing dissections on his own patients, he sought to correlate psychiatric symptoms, such as mania, melancholy, and hysteria, with specific brain pathologies. References Arráez, L., Navia, P., Fuentes, T., & Bueno, J. L. (2015). Thomas Willis, a pioneer in translational research in anatomy (on the 350th anniversary of Cerebri anatome) . Wiley Online Library. Recuperado 13 de enero de 2022, de https://onlinelibrary.wiley.com/doi/full/10.1111/joa.12273 Campohermoso, O. F., Solíz, R. E., Campohermoso, O., Flores, R. I., & Huallpara, V. (2019). Tomas Willis, neuroanatomista y padre de la neurología. Scielo. Recuperado 12 de enero de 2022, de http://www.scielo.org.bo/scielo.php?pid=S1652-67762019000200013&script=sci_arttext Fresquet, J. L. (2005). Thomas Willis (62-675). Historia de la Medicina. Recuperado 12 de enero de 2022, de https://www.historiadelamedicina.org/pdfs/willis.pdf Molnár, Z. (2004). Thomas Willis (1621–1675), the founder of clinical neuroscience. Research Gate. Recuperado 12 de enero de 2022, de https://www.researchgate.net/publication/8666149_Thomas_Willis_1621-1675_the_founder_of_clinical_neuroscience

  • The Concept of Death in Different Cultures

    All people understand that when someone dies, there will be a loss, followed by an emotional response, that is, grief (Ruiz, 2017). During the period of mourning, different processes take place, such as the relocation of the person who has died, adaptation to situations where the person who died is gone, the expression of pain, among others. However, in correspondence with Ruiz (2017), the way this loss is understood and elaborated is closely associated with the geographical location where the person is. For example, for Western culture, the issue of death is more complicated, since it encourages the concept of holding on and not talking about death, which makes it difficult for mourning to be carried out in a healthy way (Guerri, 2021 ). On the other hand, for other cultures, death is very present, both in rituals and in life itself, it is understood that it is part of it and is perfectly integrated. That is, according to Guerri (2021), it is normalized and accepted. China Because it is such a large country, there is a great diversity of customs and traditions, which are based on Taoism, a doctrine based on the harmony between the body and the spirit, that is, Yin and Yang (Gaviria, 2020) . These rules apply to everything, both in life and in death. Therefore, in correspondence with Gaviria (2020), death is not the end point, but rather it gives way to another existence. The Taoists are very clear about the difference between the spirit and the soul. The first belongs to the living, it is Yang energy (Gaviria, 2020). Instead, when a person dies, their spirit disappears and gives way to their soul, which is part of Yin. Therefore, they do not believe that there is a place after death, but that the soul of each individual travels to one place or another depending on how they have lived. According to Gaviria (2020), it is thanks to thei life experience that a person can decide the date of his death and the place where their soul will go. The Chinese believe in the immortality of the soul, therefore, they not only show respect towards the elderly, but also towards their deceased ancestors (Gaviria, 2020). When someone dies, a series of very elaborate rites are initiated. In the first instance, out of respect, the relatives of the deceased abstain from copious meals and great celebrations during seven days of mourning. In correspondence with Gaviria (2020), when the family member who died is very close, that is, parents, grandparents or great-grandparents, any member of the family who planned to marry must do so within a hundred days after the death, or they will have to wait one year until the ceremony can be performed. The deceased is never dressed in red, since they have the belief that they could become a ghost (Gaviria, 2020). In correspondence with Gaviria (2020), once inside the coffin, the body is covered with a light blue cloth, except for the face, since it´s covered with another yellow one. The vigil takes place inside the house if the deceased died there, otherwise, it must be done in the garden (Gaviria, 2020). The coffin is adorned with flower crowns and next to them, a photograph of the deceased should be located. It must remain open and with food in front of it, since it is a kind of offering. At the foot, there is a small altar with a lit white candle, in which incense will be burned continuously. Finally, according to Gaviria (2020), joss paper will be burned, which has false bills printed that symbolize wealth for the next life. It is a tradition that the sons and daughters-in-law of the deceased wear black, this is because it is the color with which the most respect is shown; the grandchildren must wear blue; great-grandchildren in sky blue and people outside the family wear white (Gaviria, 2020). In correspondence with Gaviria (2020), for no reason are jewelry or ornaments used, since it does not look good. After the funeral services, attendees must burn their clothes to avoid bad luck (Gaviria, 2020). In the same way, each of the family members must continue to perform a series of ceremonial rites, paying homage to the soul of the loved one on the anniversary of their death, on the day of the dead, and on other special occasions. In correspondence with Gaviria (2020), after seven years, if it has been buried, the body must be removed, a ritual performed, the bones cleaned and reburied. Cuba Cuba has had a strong influence from Santeria, which mixes Catholic beliefs with traditional Yoruba culture (Gaviria, 2019). From here, in correspondence with Gaviria (2019), many traditional ceremonies arise, such as, for example, the cult of dead ancestors, where it is a priority to do so through altars, offerings and the funeral cult, which is only for initiates in the religion called "El Ituto"; in which, among its defined rules, it is found that the deceased should not take any of their belongings to the grave and the fate of these elements is dictated by oracles and predictions. In Santeria, each saint has their own colors, rituals, paths and attributes, they can be described as personalities with characteristics as human as divine, and great respect for death is appreciated (Gaviria, 2019). According to Gaviria (2019), there are deities associated with this phenomenon, alluding to the spirits of the deceased, they have a fundamental role in all their magical-religious ceremonies. In Cuban Santeria, "Oyá", which is related to the Virgen de la Candelaria and Santa Teresa de Jesús, dominates the doors of cemeteries (Gaviria, 2019). With Yewá and Obba, she composes the trilogy of the orishas that inhabit the cemetery, and they are also known as the muerteras. In addition, according to Gaviria (2020), there is Ikú, which represents both death itself and the moment of dying. Ghana For the people who live in this region, life is considered as the prelude to the afterlife, therefore, death is the gateway to eternal life, so it is not surprising that death is a reason for celebration (Palacios, 2019). However, in Ghana it is out of control. The funeral shopping list has become a cascade of costly extravagances that bankrupt thousands of families across the country. In correspondence with Palacios (2019), funeral rituals are not carried out only to honor the deceased, but they become the symbol of the family's social status. These are social events that are advertised on road billboards and attended by hundreds of guests (Palanques, 2019). According to Palanques (2019), food, drink, music and dance are part of this celebration to accompany the family and honor the deceased. Perhaps the most extravagant part of such a joyous celebration is the coffin (Palanques, 2019). Many Ghanaians take pride in burying their dead in coffins personalized in the shape of an object representing the deceased. For example, according to Palanques (2020), a plane if they were a pilot, a fish if they were a fisherman or a bottle of soda if that was their favorite concoction. Indonesia For the people who live in this region, life is considered as the prelude to the afterlife, therefore, death is the gateway to eternal life, so it is not surprising that death is a reason for celebration (Palacios, 2019). However, in Ghana it is out of control. The funeral shopping list has become a cascade of costly extravagances that bankrupt thousands of families across the country. In correspondence with Palacios (2019), funeral rituals are not carried out only to honor the deceased, but they become the symbol of the family's social status. These are social events that are advertised on road billboards and attended by hundreds of guests (Palanques, 2019). According to Palanques (2019), food, drink, music and dance are part of this celebration to accompany the family and honor the deceased. Perhaps the most extravagant part of such a joyous celebration is the coffin (Palanques, 2019). Many Ghanaians take pride in burying their dead in coffins personalized in the shape of an object representing the deceased. For example, according to Palanques (2020), a plane if they were a pilot, a fish if they were a fisherman or a bottle of soda if that was their favorite concoction. Japan Obon is one of the most important festivals in Japan, in East Asia (Rivero, 2019). The celebration of Buddhist origin, but which also contains traits of Japanese Shintoism, takes place in summer and the dates change according to the area. In correspondence with Rivero (2019), the most common date of celebration is around August 13 and 16. That date is fundamental for a Japanese, since it is a time when he feels obliged to return to his homeland and honor his ancestors (Peñascal, 2021). During these days, the Japanese usually visit the cemeteries of their ancestors to clean their graves and place flowers (Rivero, 2019). In addition, an offering is usually made that can include different objects, such as the image of a Buddha, vegetables, incense or food. A typical Obon altar ornament is a cucumber and an aubergine, each of which is attached to four sticks. According to Rivero (2019), these figures represent a horse and a cow respectively, so that the first brings the spirit of the deceased quickly and the second takes it back slowly. The solemn side of the Obon coexists with the lively dances known as "Bon Odori", which have the purpose of giving a warm welcome to the souls that return to earth (Rivero, 2019). Bon Odori is generally performed at night and with a fine cotton kimono called a "yukata". Locals and dance enthusiasts gather around a tower with drums to dance in a circle. In correspondence with Rivero (2019), one of the most popular songs of the "bon odori" is "Soran Busshi", a Hokkaido fisherman's song. Madagascar Meeting in-laws for the first time is not an easy task (Palanques, 2019). In this region, in addition, all the deceased of the couple are added. This group celebrates the Famadihana, a funerary tradition in which people unearth their dead, take them out of the crypts, wrap them in new clothes, take them away in procession and sit them at the table to eat with the whole family (Palanques , 2019). According to Gaviria (2020), all this is a way to strengthen the internal ties between the deceased and his living relatives. In the same vein, this event helps new members of the family meet their ancestors and share memories, so that they are never forgotten (Palanques, 2019). Consequently, in correspondence with Palanques (2019), death is treated as a family issue rather than as a health problem handled by the funeral home. Mexico Since pre-Hispanic times, the indigenous people worshiped death, conceiving it as part of life and the cycle of nature (Gaviria, 2019). In correspondence with Gaviria (2019), when the conquerors arrived, this homage to death was mixed with Catholicism, giving rise to what is now known as the Day of the Dead, which is celebrated on November 1 and 2. Offerings and altars, called Altares de los Muertos, are very frequent, and this day in Mexico is celebrated in a very different way (Guerri, 2021). In this country, when the Day of the Dead is celebrated, the streets are filled with color and skeletons adorned with flowers to honor those who have left (Ruiz, 2017). In correspondence with Ruiz (2017), food, drink and music are ingredients that cannot be missing to remember the loved one at this great party. References Gaviria, A. (2020). África, culto y rituales para los muertos. Gaviria Funeraria. Recuperado 18 August 2021, a partir de https://gaviriafuneraria.com/africa-culto-y-rituales-para-los-muertos/ Gaviria, A. (2019). Cuba: Costumbres ancestrales al culto de la muerte. Gaviria Funeraria. Recuperado 18 August 2021, a partir de https://gaviriafuneraria.com/cuba-costumbres-ancestrales-al-culto-de-la-muerte/ Gaviria, A. (2019). México: Creencia de que los muertos regresan cada año y se les brinda culto.. Gaviria Funeraria. Recuperado 18 August 2021, a partir de https://gaviriafuneraria.com/mexico-creencia-de-que-los-muertos-regresan-cada-ano-y-se-les-brinda-culto/ Gaviria, A. (2020). Tradiciones funerarias en China. Gaviria Funeraria. Recuperado 18 August 2021, a partir de https://gaviriafuneraria.com/tradiciones-funerarias-en-china/ Guerri, M. (2021). El concepto de muerte en las diferentes culturas y religiones. PsicoActiva. Recuperado 17 August 2021, a partir de https://www.psicoactiva.com/blog/concepto-muerte-las-diferentes-culturas-religiones/ Palacios, A. (2019). Morir en Ghana: un largo, extravagante y ruinoso viaje. El País. Recuperado 18 August 2021, a partir de https://elpais.com/elpais/2018/12/29/planeta_futuro/1546099563_732788.html Palanques, S. (2019). Cinco lugares donde morir es una fiesta. El País. Recuperado 18 August 2021, a partir de https://elpais.com/elpais/2019/03/21/buenavida/1553185801_730511.html Peñascal, M. (2021). La muerte en Japón a lo largo de los años: espiritualidad y deuda moral. VOYAPON ES. Recuperado 18 August 2021, a partir de https://voyapon.com/es/la-muerte-en-japon/ Rivero, M. (2019). Ritos sobre la muerte en Asia y África. Programa Universitario de Estudios sobre Asia y África. Recuperado 18 August 2021, a partir de http://pueaa.unam.mx/en/multimedia/ritos-sobre-la-muerte-en-asia-y-africa Ruiz, R. (2017). La muerte: diferentes formas de afrontarla según la cultura. ifeel. Recuperado 18 August 2021, a partir de https://ifeelonline.com/muerte-formas-de-afrontarla-segun-cultura/

  • Importance of Educational Psychology

    Education is fundamental for human development, especially in the early stages of life. Over the years, countless strategies have been implemented to meet the needs of students in the classroom, one of which is educational psychology (Román, n.d.). The breadth, diversity, and richness of current educational content are clear evidence of the advancement of education, as well as the impact that educational psychology has on it (Beltrán & Pérez, 2011). However, according to Sanfeliciano (2018), few schools or institutions have educational psychologists, and even then, their role is often confused with that of guidance counselors or child clinical psychologists. While the training of this professional allows them to serve as counselors, the functions of educational psychologists are completely different (Sanfeliciano, 2018). These professionals are responsible for building relationships, adjustments, and academic processes between students and their environment (Florez, 2016). Similarly, according to Sanfeliciano (2018), educational psychologists are committed to the study of human behavior and cognitive processes in the context of education, as well as the applications derived from this research. Additionally, educational psychology can help minimize school failures and increase student satisfaction (Román, n.d.). In general, some students absorb knowledge more easily, while others find the process a bit more complex. Therefore, including this professional practice can ensure the application of techniques designed to detect the presence of students with disabilities, who are supervised and treated by guidance counselors or educational psychologists, as appropriate. According to Román (n.d.), the appropriate treatment of students with disabilities, combined with active participation and didactic teaching methods, promotes the growth and development of their potential. Regarding the context, educational psychology has incorporated new ecological currents and powerful tools to transform the classroom and turn it into a community that poses and solves real problems related to students' lives (Beltrán & Pérez, 2011). This tool helps teachers make decisions and creates a teaching and learning process based on the real situation of the participants (Román, n.d.). The analysis of limitations, weaknesses, threats, and strengths of each student serves as a basis for developing educational strategies that promote student-teacher interaction, incorporating the family system. According to Román (n.d.), when this relationship is maximized, the results in the short, medium, and long term are usually ideal. With this in mind, according to Beltrán & Pérez (2011), the contributions of educational psychology are such that it is inconceivable to understand current education without considering the imprint that educational psychology has left throughout its history, in which it has led the development of the educational process within the channels of the scientific model, both in research and in school practice, with successes and failures. In summary, according to Fernández (2014), thanks to educational psychologists, we have a better understanding of the different mechanisms involved in learning, such as attention, motivation, reinforcement, among others; we have a better assimilation of the specific characteristics of each developmental stage; we have a better understanding of what differences in learning and teaching styles can mean, and thus, appropriate and personalized curricular adjustments can be made, and we have more assessment and clinical and educational diagnostic tools, counseling for students, parents, teachers, and academic authorities, as well as corrective, preventive, and optimizing interventions. Referencias Beltrán, J., & Pérez, L. (2011). Más de un siglo de psicología educativa. Valoración general y perspectivas de futuro. Redalyc.org. Recuperado 5 March 2021, a partir de https://www.redalyc.org/pdf/778/77822236002.pdf Fernández, J. (2014). Importancia del psicólogo educativo en los centros educativos. Psicólogos y Logopedas en Getafe (Madrid). Recuperado 5 March 2021, a partir de https://www.psicologosylogopedas.com/2015/01/13/importancia-del-psicólogo-educativo-en-los-centros-educativos/ Florez, C. (2016). El colegio, más que docentes y estudiantes. www.elmundo.com. Recuperado 5 March 2021, a partir de https://www.elmundo.com/portal/pagina.general.impresion.php?idx=270534 Román, A. (s.f) La importancia de la psicología educativa | Flipa. Flipa. Recuperado 5 March 2021, a partir de https://www.flipa.net/importancia-psicologia-educativa/ Sanfeliciano, A. (2018). La importancia del psicólogo educativo en la escuela. La Mente es Maravillosa. Recuperado 5 March 2021, a partir de https://lamenteesmaravillosa.com/psicologo-educativo-en-la-escuela/

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