Italy And The Valsalva Manouevre

Antonio Maria Valsalva (1666-1723) was an Italian anatomist, physician and surgeon whose name is familiar to cardiologists for two reasons. First, he described what are now termed the sinuses of Valsalva, the three areas of dilatation in the proximal portion of the aorta just outside the opening of the aortic valve.

Second, in his textbook on the ear, De aure humana tractatus, published in 1704 in Bologna, he showed an original method of inflating the middle ear (now called Valsalva’s manoeuvre) in order to expel pus. A variation of this classic Valsalva maneuver is used frequently in cardiology for diagnostic and therapeutic purposes.

The skeptical cardiologist and his newly-minted bride, will be jetting off to Italy in a few weeks but, alas, we are not visiting Bologna. Hopefully we won’t need to utilize the original Valsalva manouevre to equalize the pressure between our middle ears and the cabin atmosphere in order to prevent otic barotrauma as we descend.

I don’t feel so bad about the rock because the wikipedia caption reads as follows:Sections of Hadrian’s Wall remain along the route, though much has been dismantled over the years to use the stones for various nearby construction projects.

I’ve been fascinated by the Roman Empire since I took Latin in high school. I was so obsessed with all things Roman that when my family traveled back to England to visit relatives and such, I insisted on us visiting Hadrian’s Wall. Don’t tell the authorities, but I still possess a rock I took from said wall.

The only time I’ve been to Italy was 30 years ago after presenting at the European Society of Cardiology meeting in Nice, France. I foolishly rented a car and drove north to Lago Maggiore. It was one of the most harrowing experiences of my life.

The Italian Itinerary

This time we are flying into Rome and then taking a train to Florence.

From Florence I’m planning to rent a car (having failed to learn my lesson) to drive to La Foce, an historic estate, which lies on the hills overlooking the Val d’Orcia.

La Foce

We’ll spend two nights in the B&B portion of this place, which sounds amazing:

Midway between Florence and Rome, it is also within easy reach of Siena, Arezzo, Perugia, Assisi, Orvieto. Renaissance and medieval gems such as Pienza, Montepulciano, Monticchiello and Montalcino are only a few miles away. The countryside abounds in lovely walks among woods and the characteristic crete senesi (clay hills); the food is among the best in Tuscany and famous wines such as the Vino Nobile and Brunello can be tasted in the local cellars. The Val d’Orcia has recently been included among the World Heritage sites of UNESCO.

From the heart of Tuscany, we then drive to the coast of northern Tuscany to meet up with the in-laws in Viareggio.

Manarola

 

After a few nights in Viareggio with Geo (the man on the statin fence) and Wendy, we will all take a ferry to the Cinque Terra, staying in Manarola.

Lastly, we will travel to Milan, and then fly home.

I’ve got a good idea of what the top tourist destinations are in these cities from reading Rick Steves’ book on Italy and from discussions with friends who have been there.

However, we typically prefer wandering semi-aimlessly in great cities, rather than dealing with large tourist herds at the must-see attractions.

I’m actually more interested in La Specola in Florence than I am in seeing Michaelangelo’s David. La Specola:

spans 34 rooms and contains not only zoological subjects, such as a stuffed hippopotamus(a 17th-century Medici pet, which once lived in the Boboli Gardens), but also a collection of anatomical waxes (including those by Gaetano Giulio Zumbo and Clemente Susini), an art developed in Florence in the 17th century for the purpose of teaching medicine. This collection is very famous worldwide for the incredible accuracy and realism of the details, copied from real corpses. Also in La Specola on display are scientific and medical instruments. Parts of the museum are decorated with frescoes and pietra dura representing some of the principal Italian scientific achievements from the Renaissance to the late 18th century.

I tend to rely on Rick Steves’ books for European travel, but if any readers have experience in these Italian areas please feel free to add them to the comments section or send me an email at dr._pearson@icloud.com. I would be especially interested in “off-the-beaten path” things of interest (especially if they have a literary, medical or scientific connection) and restaurant recommendations.

 

To all my patients, please accept my apologies for any rescheduling this may have caused.

In my absence you will be in good hands as my partners, primarily Brian Kaebnick, will be covering for me.

Arrivederci!

-ACP

7 thoughts on “Italy And The Valsalva Manouevre”

  1. My first trip abroad was to Italy for our honeymoon. My husband handed me a Berlitz Italian Book and said “Here, learn Italian.”
    Our only reservations were into Rome and then three weeks later, fly out of Milan. Hubby was a lawyer that could not speak anything but English with no facility for foreign languages.
    Myself, an Irish girl from Baden, St. Louis, just had to talk to everyone. I had 4 years of Spanish from Nerinx Hall and got us reservations, transportation tickets and interpretations of the menus.
    If he annoyed me, and if I was tired of all the translations and such, he ate liver and other unfamiliar to him foods.
    Hey, no one ever kept him from the Berlitz book…
    It was wonderful. Italy is where you travel just brushing crumbs off your lap because of all the wonderful food.
    You also have to realize that its country that is either on strike, on vacation, or sites are in restoro. Just relax and appreciate the vibe.
    Go get a good meal or coffee and accept this as a momento of your vacation.

    1. Maureen,
      Thanks for the great advice! I shall do my best to savor the vibe. Thus far without the Berlitz Book I’ve learned Buon giorno, parla inglese, Si/No, Per favor and grazie and arrivederci. I figure I can make do with those plus an iPhone but I suspect I’ll end up eating liver.

  2. Be grateful you’re not driving in the UK. We just came back from Scotland, where we rented a car and drove ON THE WRONG SIDE OF THE ROAD! Talk about harrowing. These people have no sense of propriety. They will honk at you if you dare get back on the CORRECT side of the road.

    People. Whaddya gonna do?

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