History of peripheral nerve repair: may the procedure have been practiced in Hippocratic School?

Background: The literature regarding the history of the peripheral nerve repair is fairly scant. In the past, few physicians dealt with the topic and made prominent contributions. These works certainly eased the way to the modem concept of surgery of peripheral nerves. During the period between 7th and 17th centuries, Paulus Aeginatus, Avicenna, Roger of Salerno, Guglielmo da Saliceto, Guido Lanfranchi, and Gabriele Ferrara, who are universally accepted as the pioneers in this field, introduced the notion of nerve repair. The central predecessor of all these authors and as well as the founder of modem medicine, Hippocrates, also had reliable interest on peripheral nerve injuries; nevertheless, his written works do not include any section concerning peripheral nerve repair. An exciting document from Ottoman era challenges this issue by citing Hippocrates' nerve repair description. In this report, we present this account with a brief history of nerve repair. Methods: The relevant section of an early 16th century Ottoman surgical treatise was examined in detail. Results: The chapter regarding the treatments of acute wounds includes an anecdotal case report of nerve repair which is attributed to Hippocrates. Conclusions: Although attainable works of Hippocrates do not contain nerve repair procedures this Ottoman era medical book suggest that Hippocrates or his pupils may have practiced surgical treatment of nerve injury. (C) 2009 Elsevier Inc. All rights reserved.