Keywords:
history of medicine - mythology - syringomyelia
Palavras-chave:
historia de la medicina - mitología - siringomielia
In Greek mythology, the god Pan represents the vital principle of both conservation
and reproduction[1].
He is depicted as having a man's body down to the waist, and goat's legs and hooved
feet. He also has horns, pointy ears, a beard and a tail[1]. When he was born, his mother thought he was so grotesque that she abandoned him
on a mountain. Hermes (Mercury to the Romans), his father, took him to Olympus to
entertain Zeus and his heavenly court[2].
Pan lived in Arcadia looking after sheep herds, helping the hunters, enjoying parties
and encounters in which he drank a lot of wine and chased mortals and nymphs alike,
in order to have intercourse with them. He enjoyed napping, something he did daily.
What he did not forgive for any reason, was to be disturbed while he slept. Anyone
who dared to wake him became prey to his dreaded persecution with tremendous cries
that caused true horror and fear in the victim[1],[2].
Among the numerous women he courted were mortals, gods and nymphs. The moon goddess
Selene, the nymphs Echo, Eupheme and Pitys were only some of the satyr's conquests.
However, we will focus on one of his most-remembered paramours, a wood nymph called
Syrinx. Pan felt instantly and tremendously attracted to Syrinx, so much so that he
fell in love. Pan pursued Syrinx all over including, one day, to the bank of the Ladon
river.
When he was just about to throw himself at her, the nymph transformed herself into
hollow water reeds. The transformation rendered Pan unable to distinguish her from
the other river plants. Full of woe and melancholy, the satyr cut several of the reeds
he found, tied them together with wax and threads, and constructed a flute, known
from that day forward as the pipes of Syrinx or a Pan flute ([Figure]).
Figure Pan and Syrinx, by Henry d'Arles.
The tragedy of Pan and Syrinx was one of the stories that Hermes, messenger of the
gods, told on his journey to rescue one of the many mortal and very beautiful lovers
of Zeus, Io. Io was kidnapped by Hera, Zeus's very resentful wife. Hera kept her under
the protection of Argos, the guardian with one thousand eyes. Argos, always vigilant,
was instructed by Hera not to let Zeus anywhere near Io. The king of the gods, entrusted
his son Hermes with the task of rescuing his darling Io. Gently playing a Pan flute,
Hermes approached Argos to tell him stories. When he told the guardian the story of
the poor nymph, Syrinx, Argos closed his one thousand eyes, fell asleep and was killed
by the cunning young god, which allowed the latter to rescue Io and return her to
his father. The eyes of the fallen Argos were kept by Hera, and transferred onto the
tail feathers of the peacock, the goddess's favorite animal[3].
The tale of Syrinx's desperate escape and her eternal persecutor, have resulted in
a number of cultural consequences. As usual, the characteristics bestowed upon the
gods and creatures of myths derive from the same virtues, or defects, that the Greeks
saw in themselves, as well as from their eagerness to explain the world. Pan was held
responsible for the terrifying sounds of forests, and that is where the word “panic”
comes from[4].
In relation to Syrinx and her modern link to neuroanatomy, the ependymal canal or
medullary central canal is also called a syrinx, and syringomyelia is a condition
in which a cyst or a tubular cavity forms within the spinal cord[5].
The first description of this medullary cavitation occurred in 1546 by French anatomist
Charles Estienne (1504-1564) and was published in the book of his authorship, De dissectione partium corporis humani libri tres. The clinical manifestations of this condition were published in 1804 by French physician
Antoine Portal (1742-1832) and in 1824, Olliver d'Angers first used the term “syringomyelia”
in his Traité de la moelle epinière et ses maladies
[5].
This tubular cavity in the spinal cord arises from an obstruction of normal CSF transit
through subarachnoid space - as explained in the intramedullary pulse pressure theory
proposed by Greitz. Chiari type I malformation occurs in 50% of the cases, 0.5-4.5%
in spinal cord trauma, infections such as meningitis due to tuberculosis and listeria.
Clinical manifestations are various, with sensory loss (93%), pyramidal signs (82%),
and muscular atrophy (60%) among the most common. It is known that complete spinal
cord injury doubles the risk of developing clinical syringomyelia, as well as increasing
canal stenosis by 25%, and post-traumatic kyphosis. The diagnosis is confirmed with
magnetic resonance imaging (MRI) and complemented with cine-MRI[6].
In addition to syringomyelia, other semiological terms are derived from the etymology
of the word “syrinx”, such as syringomas, small cutaneous tumors of benign behavior.
In the same way, an object of daily use in any hospital, such as a syringe, gets its
name from the same word[4],[6].
Who could imagine the etymological origin of the words syrinx, syringomyelia, panic
and syringe is built on very colorful characters in Greek mythology, with more than
two thousand years of history, as well as the fact that it remains in use thanks to
the recognition that great doctors have given it by naming anatomical structures,
emotional conditions and even medical ware after it.
