Introduction

Child abuse may be defined as any non-accidental trauma, neglect, failure to meet basic needs or abuse inflicted upon a child by a caretaker that is beyond the acceptable norm of childcare in our culture. ₁ Abused children found in all economic, social, ethnic and cultural backgrounds and considered to be a worldwide phenomenon. Child abuse found to be the second etiological factor in SIDS (Sudden Infant Death Syndrome) which was the leading cause of death in children less than one year of age, while in older children it followed the accidents. ₂ The incidences of child abuse and neglect could be universally reportable forms of family violence.

One aspect of Forensic Dentistry was its involvement with child abuse cases. ₃,₄ Dentist is a professional who work with children and families and he can find himself in a position to help or protect children from harm. Dental professionals were more likely than other healthcare professionals to observe evidence of physical abuse. In U.S.A orofacial trauma was present in approximately 50% to 75% of all reported cases of child abuse and neglect. ₁,₂

Thus, the forensic dentist and the general dentist should be able to recognize the signs and symptoms of child abuse and neglect (intraoral and extraoral injuries, behavioral and psychological changes) and be familiar with the reporting laws of their country. Nowadays it is easier to find information about child abuse and neglect and the role of the dentist, since a number of books, articles, seminars and courses are easily available to everyone.

On 1860 the forensic odontologist Ambroise Tardieu, referring to 32 cases, made a connection between subdural haematoma and abuse. In 1874 a church group in New York City took a child named Mary-Helen from home in which she was being abused. Her case was sent to court with the help of the Society for the Prevention of the Cruelty to Animals (SPCA), the court allowed the child to be removed from home on the grounds she was a member of the animal kingdom and should be allowed the same protection afforded animals. ₁

In 1877 the American Human Organization and the first Juvenile Court were founded, while in Great Britain, the Society for the Prevention of Cruelty to Children was founded in 1884. ₄ However, the medical profession's first involvement in child abuse historically begun in 1946 with Caffey, a pediatric radiologist, who observed that children with subdural haematoma sometimes also exhibited abnormal changes in long bones, indicative of previous trauma. ₅,₆

In 1955, Wooley wrote on the significance of skeletal lesions of traumatic origin in infants. He showed that long bone trauma was inflicted wilfully by parents or siblings. ₇ In 1962, Kempe coined the term “Battered Child Syndrome”, a clinical condition in which fracture of any bone, subdural haematoma, failure to thrive, swellings, bruises, and/or sudden death was at variance with the reported history. ₈ Several initiatives in recent years have helped dentistry deal with child abuse and neglect.

A notable program was the Prevent Abuse and Neglect through Dental Awareness (PANDA) Coalition. This foundation begun with the model program in Missouri in 1992, is currently located in 34 states in the United States, the territory of Guam, and has two coalitions in Romania. Four years after the PANDA program was found, the reporting rate by dentists has risen by 160%. ₉

Unfortunately, child abuse was an old story. In ancient Greece and Rome the law allowed deformed children and unwanted female infants to be exposed and die. Some of the most ancient cases of child abuse were found in the Mythology of different nations. Mythology is the science, which treats of the early traditions (myths) relating to the religion of the ancients, and includes, besides a full account of the origin of their gods, their lives, the heroes and their theory concerning the beginning of the world. ₁₀,₁₁ People believed so strongly in these myths that they replaced reality that later would turn to be descriptions of historical facts or allegories. ₁₂

Ancient Greek Mythology is very rich in myths and in some of them we can find child abuse cases. They can be divided into three broad categories:

Child Abuse I) From Gods against Gods II) From Gods against humans and III) From humans against humans.

The reasons were different: social reasons (jealousy, revenge, unwanted children due to their gender, children victims of domestic violence), financial and political reasons (to keep the reign or save the country from destruction, children captives of war), religious reasons (punishment for insulting the gods, human sacrifices to the gods), sexual abuse cases, medical reasons (unwanted malformed-handicapped children or due to mental abnormalities-psychological problems of the parents), self defense reasons. Sometimes the violence was against pregnant women (unborn children).

Some of the most popular myths are given in this article.

From gods to gods

Uranus (Heaven) married Gaia (Earth) and had twelve children called Titans, six sons (Oceanus, Coeus, Crius, Hyperion, Iapetus, Cronus) and six daughters (Ilia, Rhea, Themis, Thetis, Mnemosyne, Phoebe). Their strength was such that Uranus feared them. After their birth he seized them immediately and imprisoned them with heavy chains in a dark abyss called Tartarus. Soon they were joined by their new three brothers the Cyclopes and by other three terrible creatures the Centimani (Hundred-handed). Gaia obviously dissatisfied with the treatment of her children persuaded Cronus to dethrone his father. Cronus managed to defeat Uranus with Gaia's assistance thus Uranus cursed his son and prophesized that one day he himself would be dethroned by one of his children as well. ₁₀,₁₁,₁₂,₁₃,₁₄

Zeus (Jupiter) was son of Cronus (Saturn) and Rhea. Cronus knew that one of his children would dethrone him, so he swallowed his children as soon as they were born (Fig.1). When Rhea was pregnant to Zeus she applied to Uranus and Gaia for assistance in order to save the child. They sent her to a cave in Crete. After the birth she wrapped up a stone as a child and gave it to Cronus, who swallowed it believing this was his child. Finally when Zeus came into power he forced his father to bring up alive the children he had swallowed. The stone came first and placed in Delphi while the rest of the gods followed: Hestia (Vesta), Demeter (Ceres), Hera (Juno), Hades (Pluto) and Poseidon (Neptune). ₁₀,₁₁,₁₂,₁₄

Hephaestus (Vulcanus) was son of Zeus and Hera. Homer says that Zeus hung Hera out of heaven, bound by a golden chain in one of her usual fits of jealousy. When Hephaestus was about to set her free, Zeus returned and in anger for this interference he hurled him out of mountain Olympus (Fig.2). Hephaestus's fall lasted 24 hours and he finally fell on mountain Mosychlus, in the island of Lemnos. One of his legs was injured, and the accident left him lame and deformed forever. Another tradition says that Hephaestus was born lame and weak. Hera disliked him and she threw him down from mountain Olympus. Thetis received the baby and kept him for 9 years in a grotto beneath the ocean. Then he managed to return back to Olympus. ₁₀,₁₁,₁₄

From gods to humans

Apollo and Artemis were the children of Zeus and Leto (Latona). When Leto was pregnant to them, Hera, greatly jealous she declared that if anyone, mortal or immortal, helped Leto in any way, would incur her lasting revenge. There was no place in earth for Leto to give birth. After long, painful wanderings, Poseidon sent a dolphin to carry her safely in the floating island of Delos, raised for her from the depths of the sea and that was where another two gods were born. ₁₀,₁₁,₁₄

Asclepius (Aesculapius) was son of Apollo and Coronis. A raven told Apollo that Coronis while she was pregnant in Asclepius, had a relation with another man. Apollo killed Coronis and her lover, and when her body was to be burnt, Asclepius was saved from the flames. The centaur Chiron took care of the infant who later became the most famous doctor of the ancient world, the god of Medicine. ₁₁,₁₄

Epaphus was son of Zeus and Io. Zeus transformed Io to a heifer, in order to conceal the truth from the furious Hera. Hera understood the trick and she asked the animal as a present. After many adventures she sent an enormous gadfly to torment the beast, who was driven to madness by its cruel stings, fled wildly from one country to another. She finally managed to be taken as a refuge to Egypt, where Zeus restored her to her human form and was able to give birth to her son. ₁₀,₁₄

Niobe was wife of Amphion, King of Thebes. They had fourteen children, seven boys and seven girls. She was so proud of the number of the size of her family that she boasted her self superior to Leto (mother of two children, Apollo and Artemis). The two gods decided to get revenge. First Apollo killed the seven boys with arrows. As Niobe mourned her sons Artemis start killing her daughters with arrows. The last one died in her lap tried to escape the terrible death. The gods watching the Niobe's infinite grief changed her into stone. The statue was placed on mountain Sipylus and it is said that tears continuously flowed down the marble cheeks, ever weeping for her 14 children. ₁₀,₁₁

Ganymedes was son of Tros and Callirhoe. He was the most handsome of the mortal children. Zeus in the form of an eagle or with the help of one, bore him away to mountain Olympus. He became the personal cupbearer of Zeus and his sexual companion. His father was remunerated for his loss with a pair of divine horses. Eternally young he was placed among the stars under the name of Aquarius. ₁₄

Andromeda was daughter of Cepheus and Cassiopea. Her mother declared Andromeda to be fairer than the sea-nymphs (Nereids) and in revenge Poseidon sent a sea monster to destroy the country. After an oracle, her father, in order to save his country chained her to a rock by the sea to be killed by the sea monster. She was saved by Perseus and married him. After her death she was placed among the stars. ₁₀,₁₁,₁₄

Dionysus (Bacchus) was son of Zeus and Semele. While Semele was pregnant, Hera in order to get revenge appeared to her in disguise. She persuaded her to ask Zeus to appear to her in the same form as he approached Hera. Finally Zeus appeared to her in all his divine glory and Semele, burned to death, gave premature birth to the child. Zeus sewed him up in his thigh till it was the right time for his birth. ₁₁

Hercules was the son of Zeus and Alcmene. He was borned together with his mortal brother Iphicles. Hera searching for revenge had sent two colossal and poisonous serpents to kill Hercules. Little Hercules caught them by the neck with his tiny hands and strangled them, while Iphicles was crying. The parents and the servants heard the cries of Iphicles and arriving they saw in their great astonishment the first proof of Hercules future legendary strength. He was sleeping peacefully having the 2 dead snakes coiled around his hands. ₁₀,₁₄

Hesione was the only daughter of Laomedon, king of Troy. Laomedon didn't keep an agreement he had with Poseidon, and the god for revenge sent a terrible monster to devour the inhabitants and destroy the country. The Trojans consulted an oracle and agreed to feed the monster once a year, with a fair girl, chosen by lot. Finally, the lot fell upon Hesione. Laomedon trying to save his daughter, he sent heralds all over the world that the king would give a great reward to any man who would kill the monster and save his daughter. Hercules heard the proclamation and with his oaken club killed the monster just before devouring the princess. Laomedon didn't want to give the reward to Hercules (the divine horses received from Zeus as payment for Ganymedes) and in another occasion Hercules conquered Troy and Hesione was taken to Greece where she married Telamon. ₁₀,₁₁,₁₄

Iphigenia was the daughter of Agamemnon-the commander of the Greek Army and fleet to the Trojan War-and Clytaemnestra. Agamemnon killed a stag sacred to Artemis (Diana), the goddess became furious and in order to punish him she becalmed the winds of the sea and brought pestilence upon the army. The seer Calchas gave an oracle that the goddess would be satisfied only if Iphigenia was sacrificed on Artemis altar. Finally, Agamemnon being under pressure, he consented to sacrifice his daughter and he sent a message to Mycenae telling his wife to send their daughter to the camp as the future bride of Achilles. When Iphigenia, accompanied by her mother learned the truth decided to sacrifice her self in order to help the Greek Army. At the moment of the sacrifice, Artemis put a stag in her place while Iphigenia was borne in safety in Tauris, where she became priestess of the goddess. ₁₀

Laocoon was Poseidons priest in Troy. He implored in vain the Trojans left the wooden horse out of the city. While the horse was dragged into the city, Laocoon, with one of his sons on either side to assist him, prepared a sacrifice to the gods. Suddenly two huge serpents, sent by the gods came out of the sea, coiled themselves around him and his sons and crushed and bit them to death. ₁₁

Psyche, was one of the 3 daughters of a king. She was so beautiful that people worshipped her as goddess of beauty. Aphrodite (Venus) became so jealous that sent her son Eros (Cupid) to inspire her with one of his arrows love for the most contemptible of men. Eros fell in love with her and after many adventures she managed to overcome the hatred of Venous, gained her favor and together with Eros received among the Gods in heaven. ₁₀,₁₄

From humans to humans

The infant Bacchus was first entrusted to the care of his aunt Ino and her husband Athamas. Hera unable to continue persecuting the child she wreaked all her anger upon Ino. She sent the Fury Tisiphone to Athamas and made him mad. In his frenzy, he thought his wife and two children were wild beasts. He killed his son Learchus using arrows. Ino fell into the sea in order to escape having their second child in her arms. The gods in pity for her sufferings changed her into the goddess Leucothea, and her son into a sea deity called Palaemon. ₁₄

Hera in order to destroy Hercules life, as she understood that it would be difficult to kill him she drove him mad. In a fit of delirium crashed his 3 children onto the fireplace. Athena (Minerva) who made Hercules to sleep saved Megara, his wife at the last moment. ₁₀

Perseus was son of Zeus and Danae. An oracle warned Acrisius, his grandfather, that his grandson will kill him, so he shut Danae in a brazen tower. Zeus came to her in the form of a shower of gold and she became pregnant and finally gave birth to Perseus. When Acrisius discovered the child, he put mother and child in a chest and cast it in the sea. The chest was sent ashore at the island of Seriphus where Dictys, a fisherman saved them. ₁₁

Phrixus and Helle were children of Athamas and Nephele. Their stepmother Ino had intrigued to sacrifice the two children to Zeus. During the sacrifice their mother managed to save them by sending a ram with a golden fleece, which Hermes (Mercury) gave to her. While ridding away Helle fell into the sea and this was why the sea named after her, Hellespont (Sea of Helle). Phrixus managed to reach Colchis in safety. ₁₁

Pelias with his twin brother Neleus was exposed by their mother Tyro and found and reared by some countrymen. Finally, they discovered their true parentage and Pelias became king of Iolcus. He sent Jason to Colchis to obtain the Golden Fleece. ₁₀,₁₄

Medea was daughter of Aetes, king of Colchis. She fell in love with Jason and helped him to gain the Golden Fleece. She left with Jason and the other companions of Argo (the Argonautae) taking as a captive her little brother Absyrtus. When the two ships came near to each other, Aetes wildly called her daughter to return together with her brother home. Medea in order to delay her father, with her own hands slew Absyrtus and cut his body into pieces. Then she dropped the remains over the side of the vessel one by one. Aetes piously collected his son's remains and in pausing to do so, lost sight of Argo. He returned to Colchis where he gave his son a solemn burial. When Jason fell in love with Glauce, Medea frantic with jealousy prepared and sent to the girl a magic robe that killed her. Still full of resentment against Jason, she slew their 2 children and fled to Athens, mounting her dragon chariot. ₁₁

Pelops, was the son of Tantalus grandson of Zeus. Tantalus was favorite of the gods. In order to see if the gods really knew all things he invited them to a feast. He killed his son, cut him in pieces, boiled him and served him to them, but the gods immediately understood the true origin of the meat and they didn't eat it. Only Demeter, in deep grief at the loss of her daughter Prosperina hastily ate a shoulder. The gods gave the order to Hermes, (Mercury) to restore him to life but a shoulder was missing. Demeter replaced it with an ivory one and his descendants were believed to have an ivory shoulder. ₁₀,₁₄

Oedipus was the son of Laius and Jocasta. One day, they had an oracle, their newborn child was being destined to kill his father, marry his mother and bring great misfortunes upon the city of Thebes. They decided that a servant should kill their child. The servant instead of killing the child hung it up by its ankles to a tree in a remote place and left it there. A shepherd found the baby and carried him to the king of Corinth who adopted it. When the queen and her maidens gave a bath to it, they noticed the swollen ankles and called the baby Oedipus (swollen-footed). ₁₀,₁₁

Paris (Alexander) was son of Priam, King of Troy and Hecuba. Before his birth Hecuba dreamed that she had brought forth a torch, which set the entire city on fire. At the same day his son and his nephew were born. Priam ordered his nephew to be killed and his son to be exposed to mountain Ida. A shepherd found Paris and brought him up. Finally, he discovered his parentage and received by Priam as his true son. He gave the golden apple to Venus and with her help carried beautiful Helen to Troy thus starting the Trojan War. ₁₀,₁₄

Astyanax (Scamandrius) was the infant son of Hector and Andromache. When Troy was captured he was hurled from the walls of the Troy. ₁₅ Atalanta from Arcadia was also exposed, as a baby on mountain Parthenium. Her father Lasius was very disappointed to see a daughter instead of the longed-for son. She was suckled by a bear, became a famous huntress and finally married to Milanion outran by him in a foot race. ₁₁

Figure 1

Figure 1: Cronus devouring one of his children, 19 century (Prado Museum, Spain).

Figure 2

Figure 2: Zeus throwing little Hephaestus from the mountain of Olympus while Hera is watching helpless (Schloss Charlottenburg- Staatliche Museum, Germany)

Discussion

It is obvious that in these stories the children were constantly in danger. Gods were against them and even their parents appeared to be their greatest enemies. The children appearing in the Greek Mythology seemed to be victims of abuse. Child abuse was performed in many different patterns; some were still in practice even in our modern societies (e.g. exposition of a child due to gender).

In contrast to the myths, we know that the children in ancient Athens and in other parts of the Greek World were carefully protected. They considered to be the citizens of tomorrow, the heirs of the land and of the family name. ₁₂,₁₅ We should not forget that the child mortality rate was high and the future was uncertain (war, infectious diseases, famine etc.).

It is very interesting that the great tragedians of the 5th century BCE in Athens avoid referring to these terrifying myths. Perhaps it was considered to be quite sophisticated for the Athenian audience.

Archaeologists, historians, philosophers and scholars still try to bring light to these ancient stories. Their interpretations differ and their conclusions and suggestions seem controversial. But it is worth mentioning that even in today's famous ferry tales like Snow-white or Cinderella child abuse still plays a prominent role.

Finally, we must spread the message that as members of the dental profession, we find ourselves in a unique position to observe symptoms of child abuse and this happens because a high proportion of abused children experience injuries to the face and head that may be readily detected in the dental office. Providing the proper training to the dentists in order to recognize and intervene in the syndrome of child abuse and neglect, we could give them the power to participate actively in a process that may help to save the lives of otherwise helpless children. Dentistry could be at the forefront of preventing family violence. Working together with other health care professionals and community groups could make a difference against this exponentially growing problem.

Correspondence to

Panagiotis Kafas Kassandrou 3 Kavala 65403 Greece e-mail: pankafas@yahoo.com