MEDICINE IN OSIJEK DURING THE REIGN OF FRANZ JOSEPH I ­ THE ESTABLISHMENT OF THE HUTTLER-KOLHOFFER-MONSPERGER FOUNDATION HOSPITAL / MEDICINA U OSIJEKU U DOBA FRANJE JOSIPA I. ­ OSNIVANJE HUTTLER-KOLHOFFER-MONSPERGEROVE ZAKLADNE BOLNICE

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 Tvrda 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 / AVICENIN MUZEJ U NJEGOVOJ RODNOJ AFSHONI

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.

Tatjana Culina, Povijesnomedicinski i javno-zdravstveni odrazi neravnomjernog gospodarskog razvitka Rijeke i okolice u XIX. stoljecu

Book Review/Prikaz knjige

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.

[Uz 500. obljetnicu smrti Leonarda da Vincija] / 500th ANNIVERSARY OFLEONARDO DA VINCI'S DEATH

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.

[Protector Saints Against Plague Epidemics - Analysis of the Examples from the Sacral Patrimonies of the Cites of Rijeka and Osijek] / Svetci zastitnici protiv epidemija kuge ­ analiza primjera iz sakralnih bastina Rijeke i Osijeka

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.

[200th birth anniversary of Ignatius Philipp Semmelweis] / Uz 200. obljetnicu rodenja Ignaza Philippa Semmelweisa

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]. / Spomenik Presvetoga Trojstva u gradu Osijeku.

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 Tvrda by the widow of the General Maksimilijan Petras 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.

Renaissance plays as a useful source for the comparison between English and Croatian early modern medicine.

This paper evaluates the differences between English and Croatian views of early modern medicine through the respective Renaissance plays. As Renaissance made no particular distinction between arts and sciences, plays of that time provide a very common source of medical narrative. During Renaissance both languages produced high literary achievements, which makes them exemplars among their Germanic and Slavic counterparts, and justifies this comparison, regardless of their significant differences. One should bear in mind that while England was a unified kingdom, with London as the major cultural centre, Croatia's division among the neighbouring powers produced several prominent cultural centres such as Zadar, Sibenik, Split, Hvar, Korcula, and the most important one, Dubrovnik. One should also bear in mind that the golden age of Croatian Renaissance plays had finished as early as 1567 with the death of Marin DrZic, before it even started in England with the foundation of the first permanent theatrical companies in 1576. Along these lines, this paper compares their early modern attitudes toward medicine in general and men and women practitioners in particular. In this respect, it evaluates the influences of the origin, patronage, and religion of their authors. Special attention is given to William Shakespeare (1564-1616) and Marin DrZic (1508-1567) as the exemplars of English and Croatian Renaissance literature.

Differences and similarities in the regulation of medical practice between early modern Vienna and Osijek.

This paper evaluates the regulation of medical practice from the sixteenth to the eighteenth centuries in two Habsburg cities, Vienna and Osijek, in the light of the spread of medical knowledge and practice from the centre to the periphery of the Habsburg Monarchy. Although both cities were part of the Habsburg Monarchy for much of the early modern period, there were more differences than similarities between them. This may be explained by appealing to a variety of factors, including geographical position, population structure, religion, government type, and professional organisations, all of which contributed to making medical practice very different in the two cities. The divergence occurred in spite of a central agenda for ensuring uniformity of medical practice throughout the Habsburg Monarchy. Although the legislation governing medical practice was the same in both cities, it was more strictly implemented in Vienna than in Osijek. In consequence, Osijek was the setting for some unique patterns of medical practice not to be found in the Habsburg capital.

Evaluation of influences of the Viennese Anatomical School on the work of the Croatian Anatomist Jelena Krmpotic-Nemanic.

OBJECTIVE: This paper tries to evaluate the connections between the Viennese Anatomical School and the Croatian Anatomist Jelena Krmpotic-Nemanic. MATERIALS AND METHODS: 17 papers written by Professor Jelena Krmpotic-Nemanic in the last decade of her life were chosen for analyses. According to their themes they could be divided into three groups: ones which evaluate the anatomical terminology, ones which research the development of anatomical structures, and ones which describe the anatomical variations. Mentioned papers were analysed through their topics, methods of research and cited references. RESULTS: Analyses of the mentioned papers revealed the indirect link between the Viennese Anatomical School and the Professor Jelena Krmpotic-Nemanic, through her mentor Professor Drago Perovic, regarding the themes and the methods of her anatomical researches. It has also showed her preference for Austrian and German anatomical textbooks and atlases, primarily ones published in Vienna and Jena, rather than English and American ones. Finally, her direct connections with the Viennese Institute for the History of Medicine and the Viennese Josephinum Wax Models Museum were emphasized. DISCUSSION AND CONCLUSION: Mentioned indirect and direct influences of the Viennese Anatomical School on the work of Professor Jelena Krmpotic-Nemanic were critically appraised.

Sexual behaviour of Croatian blood donors as a threat to the health of blood recipients.

BACKGROUND: In this cross-sectional study we assessed the prevalence of the various blood safety sexual risk behaviours among blood donors from East Croatia and the possibilities for improving the present blood donor screening procedure. MATERIALS AND METHODS: The study included 423 blood donors of both sexes who completed a specially designed anonymous questionnaire immediately after their blood donations. The questionnaire contained questions on demographic data, sexual preferences, and possible sexual risk behaviours in the period before the blood donation. RESULTS: The study revealed that the most common forms of sexual risk behaviour among Croatian blood donors had been irregular condom use during sexual contacts with new partners (294/423; 69.5%) and five or more sexual partners during the lifetime (213/423; 50.4%). More male than female subjects had had five or more sexual partners during their lifetime (p<0.0001). Compared to married donors, single subjects more frequently reported sexual contacts without using a condom with their new partners in the period from the last blood donation (p<0.0001) and also in the period of 1 month before current blood donation (p=0.0060). A larger number of younger than older subjects had practiced different types of sexual intercourses during the lifetime (p=0.0002) but more older than younger subjects reported irregular use of condom on sexual contacts with a new partner during their lifetime (p=0.0231). CONCLUSION: Blood donors who were involved in various forms of sexual risk behaviour represent a serious threat to the health of blood recipients. In this respect a new approach to blood donor screening procedure with additional questions on sexual behaviour in anonymous donor questionnaires would improve the safety of transfusion treatment in East Croatia.

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, a diligent and industrious plodder or the father of British microbiology.

Emanuel Edward Klein (Osijek, 1844 - Hove, 1925) was a British microbiologist of Croatian origin. He completed his medical studies in Vienna in 1869. In 1869 he was sent to England to determine terms for the translation of Samuel Stricker's manual Handbuch von den Geweben des Menchen und der Tiere. During his visit he made a good impression on John Burdon Sanderson and John Simon, which was the main reason why he was invited to London in 1871 to conduct investigations under their guidance. In 1873 Klein began his collaboration with the Saint Bartholomew's Hospital, where he was appointed as a Joint Professor of General Anatomy and Physiology. His researches were in the fields of anatomy, histology, pathology, embryology, physiology, and especially microbiology. He did a great deal to its development in Britain. He has written about 260 scientific papers on a broad range of different topics. Despite all the aforementioned facts, his work was never properly studied, and he is almost unknown outside academic circles. For that reason, attitudes towards him still range between the extremes of calling him the father of British microbiology on one side, and attributing him as a diligent and industrious plodder on the other. In this paper we will try to prove the first attitude. We will put his researches in a general context. Finally we will highlight his original achievements in the isolation of new microbes.

1885 Cholera Controversy: Klein versus Koch.

This paper will try to give new insight into the Cholera Controversy, which occurred 125 years ago. The majority of papers already written on the topic have emphasised the role of Robert Koch who described the comma bacillus as the cause of cholera epidemics. At the same time they have marginalised the role of Emanuel Edward Klein by stating that he was wrong when he objected to Robert Koch's statement, because as an employee of the British government he was politically motivated. Moreover, they have paid barely any attention to Klein's writings on the subject. In this paper I will try to approach his attitudes from the scientific, not political, perspective and try to explain the reasons why he challenged Koch.