[MEDICINE IN OSIJEK DURING THE REIGN OF FRANZ JOSEPH I – THE ESTABLISHMENT OF THE HUTTLER-KOLHOFFER-MONSPERGER FOUNDATION HOSPITAL]

The Austrian emperor and the Croat-Hungarian king Franz Joseph I (1830/1848-1916) was the longest-serving ruler of the Habsburg dynasty. Among his properties was Osijek, which since 1809 enjoyed the status of a free royal city. In the period under review, it was the seat of the Virovitica County and the capital of the Kingdom of Slavonia until its incorporation into the Triune Kingdom of Croatia, Slavonia and Dalmatia after the Croat-Hungarian settlement of 1868. Because of this, Osijek was not only a political, economic and cultural centre but also a health care centre. At the beginning of the reign of Franz Joseph I, two hospitals were operating in it: a military one in the baroque military garrison Tvrđa and a civilian one in New Town. The most significant role in the further development of the Osijek and Slavonian health care was played by the trust established in 1806 from the legacies of innkeeper Johann Kolhoffer, tanner Josef Huttler and Jesuit Cristian Monsperger. Although originally intended for the establishment of an orphanage, due to a number of unfavourable political circumstances, the trust, until then with multiple interests attributed to the principal, came under the administration of the city of Osijek only in 1867. Along with the new orphanage opened in 1874, a new hospital was completed as well in 1868, also with the money from the trust. Huttler-Kohlhoffer-Monsperger Foundation Hospital was the largest and most modern hospital in the Triune Kingdom, and despite later constructions of various hospital wards, its building has remained the most representative building within the Clinical-Hospital Centre Osijek.

[AVICENNA’S MUSEUM IN HIS NATIVE AFSHONA]

Ibn Sina, better known to the Western medical historians by his Latin nickname Avicenna, is considered the third most important physician in medical history, along with the Greek physician Hippocrates and the Roman physician Galen. He was born around 980 in Afshona near Bukhara on the Silk Road in present-day Uzbekistan and died in 1037 in Hamadan near Tehran in present-day Iran. Among his greatest contributions to the development of medicine is his work entitled The Canon of Medicine, in which he summarized all the previous medical knowledge, which is why it has been used for centuries as a basic medical textbook. In recent times, in connection with the controversy over the naming of the medieval caliphate medicine, with the aim of formulating an inclusive term, which would not emphasize any involved group to the detriment of the others, paradoxically in the focus of the research of the in it interested historians of medicine, instead of the achievements of the individual doctors from the mentioned era, came the determination of their ethnic and religious affiliation, including Avicenna’s, all the more so because he came from the disputed area of the conflicts between different nations and opposing religions. In doing so, scientific discussions are increasingly joined by the erection of the representative architectural structures in the places related to the individual doctors, one of which is the representative Avicenna Museum in Afshona.

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Book Review/Prikaz knjige

[Protector Saints Against Plague Epidemics - Analysis of the Examples from the Sacral Patrimonies of the Cites of Rijeka and Osijek]

Plague epidemics have remained in the collective consciousness until nowadays remembered as the deadliest. Therefore, it is not surprising that the answers to them throughout history have been not only medical but also religious. The previously mentioned will be analyzed in this paper through the cults of the protector saints against the plague epidemics that have developed in two Croatian cities of comparable size, Rijeka and Osijek, but with the diametrically opposed geographical positions and, accordingly, quite different historical developments. On the one hand, a more detailed overview of the development of the cults of various saints present in the mentioned cities will be presented. On the other hand, based on their presentation in the sacral heritage of these cities, the broader context of the time and space in which they have developed will be lightened. Particular attention will be paid to their medical connotations.

[Uz 500. obljetnicu smrti Leonarda da Vincija]

This editorial is dedicated to a commemoration of the 500th anniversary of the death of Leonardo da Vinci (Vinci near Florence, April 15, 1452 ‑ Cloux Castle, France, May 2, 1519) ‑ the greatest Renaissance artist and one of the greatest artists in general. From his invaluable artistic and scientific heritage, only a small part dedicated to the exploration of the Nature was selected for this occasion. In this part, according to many, the most significant place is dedicated to his anatomical drawings as a lasting testament to his interest in anatomy and medicine in general. Much has been said and written about this topic over the past 500 years. While searching through numerous bibliographic sources, several of the most impressive drawings have been selected for this occasion, with a few short reminiscences, which bear the most impressive testimony to the brilliant mind of the great Leonardo, rightfully called uomo universale.

200th Anniversary of the Beginning of Clinical Application of the Laennec's Stethoscope in 1819

Although stethoscope was invented by French physician René-Théophile-Hyacinthe Laennec (1781-1826) in 1816, its wider clinical application started only after the publication of his book entitled De l'Auscultation Médiate ou Traité, du Diagnostic des Maladies des Poumons et du Coeur in 1819. Its invention coincided with the development of the 'hospital medicine' in the post-revolutionary Paris during the first quarter of the 19th century. It has enabled then contemporary physicians to explain the correlation between the patient symptoms and the clinical findings and thus has helped the shift from the humoral pathology towards the solitary pathology.

[200th birth anniversary of Ignatius Philipp Semmelweis]

Ignaz Phillip Semmelweis's significance for the history of medicine lies in his discovery of the cause of puerperal fever. He discovered it during his work at the First Obstetrics Clinic of the Vienna's Allgemeines Krankenhaus. Since the mentioned Clinic, led by the doctors, had much higher mortality rates of the child-bearing women than the Second Obstetrics Clinic, led by the midwives, he wanted to determine the causes of such a state. He came to the conclusion that puerperal sepsis was transmitted by the doctors and medical students, who after performing the anatomical sections started to perform the births with their hands beforehand washed only with soap. Semmelweis instead proposed a mandatory hand washing in a potassium-hypochlorite solution thus making the mortality at the First equivalent to the mortality at the Second Obstetrics Clinic. Despite this, his discovery was rejected by the established medical circuits.

[Holy Trinity monument in the city of Osijek]

Plague was one of the most deadly epidemic diseases of the Baroque period. Responses to it were not only medical, but religious as well. A good example of the latter is the Most Holy Trinity monument in the city of Osijek, which was in the 18th century the biggest town of the Kingdom of Slavonia and today is the regional centre in the Republic of Croatia. The monument was erected between 1729 and 1730 on the main square of the Osijek military fortress Tvrđa by the widow of the General Maksimilijan Petraš who died during the 1728 plague epidemic. Inscription on it implores the mercy of God as a protection against plague. Its foundation could be also interpreted as a part of the Catholic Revival, which was implemented by the Habsburgs in Osijek and Slavonia after their liberation from the Ottomans. But although, on the one hand, it could be interpreted as a symbol of the successful implementation of the Habsburg unifying religious policies due to its strong resemblance with the similar columns throughout the Habsburg Monarchy, on the other hand, it represented a continuation of the theurgic understanding of medicine, which could be interpreted as the failure of the Habsburg enlightened medical policies. Thus the archival documents from the Osijek State Archive together with the Osijek plague column itself were analysed with the aim of explaining the above mentioned ambiguities.

The Influence of the Age, the Years of Training, and the BMI on the Average Muscle Power in Male and Female Rowers

The aim of the study was to evaluate the influence of the age, the body mass index (BMI), and the years of training on the average muscle power in male and female rowers. The analysis of the testing results of the members of the Rowing club Iktus from Osijek in Croatia was performed. Results were obtained during the regular yearly testing on the rowing ergometer for the rowing season of 2009. Members of the Rowing club Iktus were divided into two subgroups according to their sex. The obtained results were analysed in accordance with the age, the BMI, and the years of training independently for the each of the two subgroups. The results have showed that the average muscle power is independent of all the three parameters in the male rowers, while it is dependent on the age and the years of training in the female rowers. It seems that the BMI does not play any role at all in the average muscle power. As a conclusion, it could be stated that while one can suggest to female rowers to improve their performance with prolonged training, there is a need for a further research in order to formulate a suitable advice for male rowers.

Emanuel Edward Klein's book on diseases of birds

Emanuel Edward Klein (1844 - 1925) was a British microbiologist of Croatian origin. He was born in Osijek in what is currently the Republic of Croatia and which was then part of the Habsburg Monarchy, he completed his medical studies in Vienna in 1869, and went on to spend his entire career in London. Although trained as an anatomist, embryologist and histologist, his main area of research was microbiology. Due to the fact that back then it was a new and fast developing discipline, he was able to pursue his interests in many directions and make significant discoveries, such as the identification of the 'Bacillus enteritidis sporogenes' as a cause of summer hospital diarrhoeas. Although the overwhelming majority of his researches dealt with bacteria which attacked humans, in 1892 he published a book entitled The Etiology and Pathology of Grouse Disease, Fowl Enteritis, and Some Other Diseases Affecting Birds, which revealed the results of his experiments on the bacteria which affected birds. In the context of the general development of the microbiology, this paper tries to give an objective evaluation of this until now widely neglected book.

Imbalanced concentrations of serum lipids and lichen planus

The aim of this study was to analyze possible connection between the lichen planus and imbalanced concentrations of serum lipids and to evaluate the impact of various dietary regimes (used in the regulation of imbalanced concentrations of serum lipids) on the regression of lichen planus lesions. Research was conducted as a case-control study comprised of 72 patients with Lichen Planus and 30 participants from control group, treated at the Clinic for Dermatology and Venereology of the Clinical-Hospital Centre Osijek, Eastern Croatia, during 2010 and 2011. LP cases were diagnosed with both a clinical examination conducted by a dermatovenerology consultant and by patohistological diagnostic. Serum lipid levels (total cholesterol, LDL-cholesterol, triglycerides, HDL-cholesterol) were determined by the classic laboratory diagnostics in both investigated groups (LP patients and control group). The present study has confirmed that there is a strong connection between the imbalanced concentrations of one or more serum lipids (cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides) and the occurrence of LP which is important in the therapeutic approach to patients with this disease.

Red and processed meat and cardiovascular risk factors

AIMS

The British National Diet and Nutrition 2000/1 Survey data set records on 1,724 respondents (766 males and 958 females) were analyzed in order to assess the potential influences of red and processed meat intakes on cardiovascular risk factors.

METHODS

Linear regression of the associations of the red, processed, combination of red and processed, and total meat intakes with body mass index (BMI), systolic blood pressure and plasma total cholesterol as cardiovascular risk factors was conducted, paying due attention to the subject age and sex as potential confounders.

RESULTS

Linear analyses showed the total meat intake and combined red and processed meat intake to cause a 1.03 kg/m2 rise in BMI each, while the red and processed meat intakes analyzed as separate categories caused 1.02 kg/m2 rise each. The greatest effects were observed on the systolic blood pressure with a 1.7 mm Hg rise for the total and the red and processed meat intakes, 1.5 mm Hg rise for the red meat intake, and 1.02 mm Hg rise for the processed meat intake. There were no associations between different meat intakes and plasma total cholesterol.

DISCUSSION AND CONCLUSION

Study results revealed the interquartile ranges of the mentioned meat type intakes to increase BMI by around 1 kg/m2 and systolic blood pressure by around 1.5 mm Hg, while they had no influence on plasma total cholesterol.

The impact of the vitamins A, C and E in the prevention of gastroesophageal reflux disease, Barrett's oesophagus and oesophageal adenocarcinoma

This paper aims at evaluating the impact of vitamins intake in the prevention of gastroesophageal reflux disease (GERD), Barrett's oesophagus (BE), and oesophageal adenocarcinoma (EADC). It concentrates primarily on the antioxidant vitamins A, C and E. There were 180 subjects included in the trial, 109 males and 71 females, which were divided in the four groups (70 patients with GERD, 20 patients with BE, 20 patients with EADC, and 70 healthy examinees composing a control group). Their antioxidant vitamins intake was investigated through the usage of the dietary questionnaires. Concentration of the mentioned antioxidant vitamin in serum was detected by HPLC method, and although there were no major statistical differences in their levels between four groups, there existed a correlation between the vitamin serum concentration and the rephlux disease degree. The results showed that the healthy examinees had consumed the greater quantities of the vitamins A, C and E, through both the natural (fruits and vegetables) and the supplementary (industrial vitamin additives) way, than the patients with GERD, BE and EADC. This was reflected in the higher serum levels of the mentioned vitamins in the first group in the comparison with the second group. Based on this, the intake of the vitamins A, C and E through both the natural and the supplementary ways is suggested in order to prevent the development of the GERD, BE and EADC.

The role of the nutrition in the pathogenesis of gastroesophageal reflux disease, Barrett's oesophagus and oesophageal adenocarcinoma

This paper aims at evaluating the role of improper nutrition in the pathogenesis of gastroesophageal reflux disease (GERD), Barrett's oesophagus (BE), and oesophageal adenocarcinoma (EADC). It also tries to examine the influence of the alcohol, nicotine and coffee consumption in the development of the mentioned diseases. There were 180 subjects included in the trial, 109 males and 71 females, which were divided in the four groups (70 patients with GERD, 20 patients with BE, 20 patients with EADC, and 70 healthy examinees composing a control group). Their dietary habits were investigated by the usage of the dietary questionnaires. The results show that the fast eating and the insufficient mastication were present in 64.3-85.0% patients with GERD, BE, and EADC in comparison with only 15% of the examinees from the control group. Furthermore, very hot was preferred by 25.0-42.9% of the mentioned patients in comparison with only 12.9% from the control group. Similarly, 60.0-75.0% of them preferred strongly spiced food on contrary with 17.1% of the healthy examinees. Moreover, strong alcoholic beverages were consumed three or more times per week by 55.0-75.0% of the mentioned patients in comparison with only 15.7% from the control group. Finally, there were 15.7-55.0% heavy smokers among the patients with GERD, BE, and EADC contrary to 1.4% in the control group.

Emanuel Edward Klein--the father of British microbiology and the case of the animal vivisection controversy of 1875

The new Appendix A of the European Convention for the Protection of Vertebrate Animals Used for Experimental and Other Scientific Purposes, which gives guidelines for accommodation and care of animals and was approved on June 15, 2006, was the main reason the authors decided to investigate the origins of the regulations of animal experiments. Although one might assume that the regulation had its origin in the United Nations conventions, the truth is that its origins are a hundred years old. The authors present a case of the nineteenth-century vivisection controversy brought about by the publication of the Handbook for the Physiological Laboratory in 1873, in which John Burdon-Sanderson, Emanuel Edward Klein, Michael Foster, and Thomas Lauder Brunton described a series of vivisection experiments they performed on animals for research purposes. It was the first case of vivisection to be examined, processed, and condemned for inhuman behavior toward animals before an official body, leading to enactment of the Cruelty to Animals Act in 1876. The case reveals a specific ethos of science in the second half of the nineteenth century, which was characterized by a deep commitment of scientists to the scientific enterprise and their strong belief that science could solve social problems, combined with an overt insensitivity to the suffering of experimental animals. The central figure in the case was Emanuel Edward Klein, a disciple of the Central European medical tradition (Vienna Medical School) and a direct follower of the experimental school of Brücke, Stricker, Magendie, and Bernard. Because of his undisguised attitudes and opinions on the use of vivisection, Klein became a paradigm of the new scientific identity, strongly influencing the stereotypic image of a scientist, and polarizing the public opinion on vivisection in England in the nineteenth century and for some considerable time afterward.

Different roles of sex steroid hormones in the pathogenesis of vascular dysfunction and the development of cardiovascular disease in men and women

In this review an overview of current literature on the topic of the relation between sex steroid hormones and cardiovascular diseases (CVDs) is presented. The influence of the mentioned hormones on the three levels has been analyzed: their interaction with the blood vessel receptors, their modulation of the vascular function, and finally their role in the pathogenesis of CVDs. This review is focused not only on already known facts of the protective role of estrogens and the inceptive role of testosterone, but attempts to give examples of their opposite effects on vascular function and development of CVDs.

[Between barber's and hospital: the role of barber-surgeons in Osijek in the period from 1687 to 1746]

This paper presents emergence and role of medical practitioners especially surgeons and barbers in particular in Osijek in the period marked by the Christian liberation in 1687 to the pronouncement of Regulationenfür Baderen in 1746. On the bases of archival sources we have revealed their identity, origin, number and reputation, and demonstrated differences in their duties in comparison to the other towns of the Habsburg Monarchy. We argued that their presence and activities can be explained by the position of Osijek as an important military fortification at the Othoman Empire's border, as well as with deficiency of physicians. The data presented in this paper demonstrate the very beginnings of medical practitioners in Osijek and are therefore important in understanding of the further development and the organization of health on this territory.