CHRONICLE OF THE "ANGLO-YUGOSLAV CHILDREN'S HOSPITAL" IN SREMSKA KAMENICA.

As a peacetime work of Katherine S. Macphail (Glasgow, 1887- St.Andrews, 1974) MB ChB (Bachelor of Medicine and Surgery), the Anglo-Serbian Children's Hospital in Belgrade was established after World War I, and the English-Yugoslav Children's Hospital for Treatment of Osteoarticular Tuberculosis was founded in Sremska Kamenica in 1934. Situated on the Fruska Gora slope, the hospital-sanatorium was a well-equipped medical institution with an operating theatre and x-ray machine providing very advanced therapy, comparable to those in Switzerland and England: aero and heliotherapy, good quality nourishment, etc. In addition, school lessons were organized as well as several types of handwork as the work-therapy. It was a privately owned hospital but almost all the children were treated free of cost. The age for admission was up to 14. During the period from 1934 to 1937, around 458 children underwent hospital treatment, most of them with successful results. During the war years the Sanatorium was closed but after the war it was reactivated. In 1948 by the act of final nationalization of all medical institutions in the communist Yugoslavia, the hospital was transformed into a ward of orthopedic surgery under the supervision of the referent departments in Belgrade and Novi Sad. Today, hospital is out of work and deprived of its humanitarian mission. The building is neglected and in ruins although it has been proclaimed the national treasure by the Regional Institute for Protection of Monuments of Culture.

Thirty years of the "Anica Bitenc Travelling Fellowship" - a tribute to Dr. Igor A.S. Bitenc.

Thirty years ago, in 1984, Dr. Igor A. S. Bitenc, M.D., F.R.C.S.(C), a retired orthopaedic surgeon from Canada, who was of Yugoslav descent, and who had always remained attached to his original homeland, founded a travelling fellowship for young orthopaedic surgeons from former Yugoslavia named the "Anica Bitenc Travelling Fellowship" after his late mother. The first Fellow visited Canada in 1985 and was followed by five Fellows from different areas of Yugoslavia in successive years. Due to the tragic war in Yugoslavia in the 90's, the Fellowship was postponed for several years. It was resumed in 1997, but only for three newly formed states of Croatia, Slovenia and Serbia. Funding of the Fellowship was provided by an endowment from Dr. Bitenc and managed by the Canadian Orthopaedic Association, which hosts one Fellow per year on the rotational basis from Slovenia, Croatia and Serbia. The Fellowship finally proved to be very successful and, owing to the benevolence of Dr. Bitenc, 24 young orthopaedic surgeons from various regions of former Yugoslavia have had the opportunity to visit the best orthopaedic centres in Canada so far. Dr. Bitenc has ensured the Fellowship will continue for many years to come by bequeathing an endowment of $ 300.000. This unforgettable act of human nobility and patriotic sensibility will be of enormous help in future to many orthopaedic surgeons and their numerous patients in the countries of South Slavs.

[Famous physicians from the past--Oribasisus from Pergamum].

INTRODUCTION: Greek physician Oribasius from Pergamum (today's Bergama in western Turkey) (c. 320-400) was one of the most important physicians and personalities of his time. THE LIFE AND CAREER: Oribasisus studied medicine at Alexandria. Although he was the personal physician and friend of the Roman emperor Julian the Apostate, and a very important political figure of that period, he has been remembered as a most important medical writer and historian of medicine. MEDICAL WRITING: His major work, written in 70 books (only 25 of these survived), was the "Collectiones Medicae" which contains massive compilation of excerpts (epitomai) from the writings of older medical writers of the ancient world. Later on, he produced the "Synopsis for Eustathius" (Synopseos ad Eustathium) for his son Eustathius, who was also a physician. Oribasius dedicated a large work to his friend, the philosopher Eunapius: "Libri ad Eunapium", a kind of medical encyclopaedia in four volumes with a collection of easily procured medicines compiled for laymen. Several more of his writings are known to have been entirely lost. The works of Oribasius were translated in Latin as early as the fifth century, and later, in the medieval times his books were published in Europe (the "Synopsis for Eustathius" was published in 1554), while the critical edition of his works translated from Greek texts was published in Germany in 1926-1933. COMMENTARY AND CONCLUSION: The special importance of the Oribasius' works is that they have preserved a number of excerpts from many medical authors of antiquity whose writings would otherwise have been lost. Besides, these extracts (epitomai) were not entirely verbatim, they were looked upon critically and sorted out in an encyclopaedic manner. Because of that Oribasius is rightly considered to be the first writer of a medical encyclopaedia in the history of medicine.

[50 years of total hip prosthesis--a tribute to Prof. Sir John Charnley].

November 2012 marked the 50th anniversary of the first implantation of a successful and long-lived hip endoprosthesis, which was performed by Prof Sir John Charnley in the "Centre for Hip Surgery" at a small country place in the north-west England. John Charnley (1911-1982) finished medical school at the Victoria University of Manchester in 1935, and than started training in orthopaedics at the Manchester Royal Infirmary, and completed it after the Second World War, in which he served as a volunteer. After that he continued working in the same hospital, and, apart from that he worked as a lecturer at the University of Manchester, and from 1949 as a visiting surgeon in the Wrightington Hospital. In 1958 Charnley decided to put his efforts into the development of hip replacement research and surgery, and initiated the foundation of the "Centre for Hip Surgery" with Biomechanical laboratory in the Wrightington Hospital in 1960, where the intesive basic and clinical research started, and becuase of that Charnley in 1962 left Manchester and moved with a full time practice at the Wrightington Hospital. That period of research time was not easy, there were many "trial and tribulations", but, owing to the tenacity and inventive mind of Charnley, in 1962 a new prosthesis consisting of a cemented metal stem with a 22 mm head articulating with a cemented polyethilene acetabular component, and with a low frictional torque was designed. The first such prosthesis, which later produced excellent long-term results, was implanted on November 22nd, 1962, and today, when we look back over a distance of fifty years, we can conclude that that day could be considered as a beginning of a modem aloarthroplastic surgery, and certainly as one of the greatest orthopaedic advance in the whole of the 20th century; and all that was initiated and promoted by Prof. Sir John Charnley.

[Dr. Elizabeth Ross: heroine and victim of the World War I in Serbia].

At the beginning of 1915, several months after the World War I started, Serbia was in an extremely difficult situation.The country was war-ravaged, full of sick and wounded soldiers, there was a desperate shortage of doctors, nurses and other medical personnel, and the epidemic of typhus fever exploded and violently attacked the entire country. At that time, however, a number of both foreign allied medical missions and individual volunteers, from various countries, mostly from Great Britain, came to Serbia to help. Among them mostly were women, and they were of enormous support to Serbia in that grave situation. It is estimated that there were more than 600 foreign women volunteers in Serbia at that time and that 22 of them died there. Dr. Elizabeth Ross was one of those brave volunteers who came to Serbia early in 1915. That noble Scottish lady doctor was born in 1878 and finished her medical studies at the University of Glasgow in 1901. After graduation she worked in various places in Great Britain until 1909, when she went to Persia (Iran), where she worked until the beginning of the so called Great War. When she heard of the urgent need in Serbia she left Persia as soon as she could and volunteered to serve in Serbia. She came to Kragujevac at the beginning of January 1915, where she worked at the First Military Reserve Hospital, which at that time was actually a typhus hospital. Working there intensively and devotedly for several weeks under shocking conditions she contracted typhus herself and died there on her 37th birthday on February 14th, 1915. She was buried in Kragujevac, next to two British ladies who also died in Serbia of typhus. Her grave was restored in 1980 when the town of Kragujevac started holding commemorations at the graveside every February 14th at noon to honor her and all other brave and noble women who lost their lives helping Serbia at that unfortunate time.

[Professor Dr Borivoje Gradojevic--the first university professor of orthopaedic surgery].

Prof. dr Borivoje Gradojevic was one of the greatest figures of our medicine, and one of the pioneers and founders of orthopedic surgery in our country. He was the first professor of orthopedic surgery in Serbia ie. the professor of Belgrade Faculty of Medicine. Beside well education and professional skills dr Gradojevic published the numerous scientific papers and he published the first textbook of orthopedics in this country. Unfortunately, his professional career was brutally interrupted in 1945, when he was forced to retire and moved from Medical faculty, together with other professors in these times. This resulted in enormous regression--fall in academic community, and our health care system and country also.

[The gloves of love].

INTRODUCTION: Thin rubber gloves were used for the first time in the history of medicine at the end of 1889. On the occasion of the 120th anniversary of that event at the end of 2009, the great importance of that discovery for the development of surgery in general should be emphasized once again. The surgical gloves were invented and introduced by a famous American surgeon Dr. William Halsted from Johs Hopkins Hospital in Baltimore (USA). DR. WILLIAM HALSTED AND MISS CAROLINE HAMPTON: This significant innovation actually occured thanks to the romance between Dr. W. Halsted and his scrub nurse Miss Caroline Hampton, later his wife, Mrs C. Halsted. According to the antiseptic practice of that hospital the hands of the operating personnel had to be desinfected in mercuric chloride which damaged the skin of nurse Caroline who developed a bad case of dermatitis, and because of that she considered abandoning the hospital. This prompted Dr. Halsted to contract Goodyear Rubber Company to produce thin rubber gloves to protect Caroline's hands and to keep her in his vicinity. They proved to be very satisfactory and soon Dr. Halsted's assistants too began to wear sterilized rubber gloves routinely. COMMENTARY AND CONCLUSION: Although it was not until later that the importance of rubber gloves in preventing infection was realized these "gloves of love" soon entered into general surgical practice and proved to be of the greatest importance for the development of asepsis and aseptic surgical work.

[90th anniversary of founding the first children's hospital in Serbia].

The first children's hospital in Serbia, as an exclusive paediatric intitution, was founded in a deserted military barrack in Studenieka Street, near the Military Hospital, in January 1919. The founder was Dr. Katherine MacPhail, a young Scottish lady doctor, who came to Serbia for the first time in January 1915, with the first "Scottish Women's Hospital". After that, she worked as a volunteer during the First World War in France and on the Thessalonica Front. In the spring of 1919, the hospital was given an open pavilion in Topcider, which worked only during the summer months till 1924. In November 1919, the hospital was moved to a new building in Knez Milos Street, and then named The Anglo-Serbian Children's Hospital. In February 1920, a new annex, called "Villa Bravacic", was opened in Dubrovnik, which was active till 1922. In this hospital, the first Training School for Serbian Nurses was opened in 1921, and in February of that year, the hospital moved into its new permanent house in Visegradska Street, where it had 70 beds, three wards with a modern operating theatre, outpatients' department, X-ray outfit and a pharmacy. Because of much better working conditions, the Children's Surgical Department of the General State Hospital headed by Dr. Dimitrije Jovcic, later a professor of the Faculty of Medicine in Belgrade, was accommodated in this hospital from 1923 to 1931. Apart from him, in this hospital, there used to work a number of young Serbian physicians and several of them later became professors of the Belgrade Faculty of Medicine. The hospital worked till 1934, when it was closed, the building was sold and from that money Dr. MacPhail built a new Anglo-Yugoslav Children's Hospital for Tuberculosis of Bones and Joints in Sremska Kamenica.

["Serbian mother from Scotland"--Dr. Elsie Inglis (1864-1917)].

INTRODUCTION: 90 years ago, on November 26th, 1917, died Dr. Elsie Inglis, one of the greatest heroines of the First World War, founder and driving force of the famous "Scottish Women's Hospitals", and one of the most interesting persons in the history of medicine in general, and especially in Serbia where she and her hospitals were of the greatest help in the most difficult times. CHILDHOOD AND EDUCATION: Elsie Maud Inglis was born in India in 1864, in a Scottish family which in 1878 moved back to Scotland where Elsie studied medicine and graduated from the Edinburgh University in 1899. Medical practice and Women's Movement (1894-1914) Dr. E. Inglis worked in Edinburgh, where in 1904. She opened a small hospital for women and children called "The Hospice", which was staffed only by women. She was also very active in the Women's Movement (the so-called suffragettes), fighting for the women's rights and for the Vote. From 1906 until 1914 she was Honorary Secretary of the Scottish Federation of Women's Suffrage Societies. THE FIRST WORLD WAR-THE SCOTTISH WOMEN'S HOSPITALS: After the outbreak of the Great War in August, 1914. Dr. E. Inglis immediately organised, through her Federation, the so-called "Scottish Women's Hospitals" (SWH), on the whole 13 of them, which worked through the war in France, Belgium, Serbia, Greece (Macedonia), and Russia (Romania). SERBIA, 1915: In.January, 1915 the first Unit of the SWH arrived to Kragujevac, and.soon three more hospitals came to Serbian towns of Valjevo, Lazarevac and Mladenovac. In May 1915 Dr. E. Inglis herself came to Serbia. In October, 1915, when the great offensive of the Central Powers began, all these hospitals were evacuated to Krusevac, where they undertook the task of nursing 900 Serbian wounded at the "Csar Lazar" military hospital. Dr. Inglis and the majority of her staff refused to evacuate any further and stayed with their Serb patients. In November, 1915 they became prisoners of war, but continued to treat their patients until February, 1916 when they were repatriated. RUSSIA, 1916-1917: Back home, Dr. E. Inglis formed a new large SWH Unit, which, headed by herself sailed for Russia in August, 1916, and soon joined the so-called Yugoslav Volunteer Division, consisting mainly of Serbs, fighting on the Dobrudja front. After heavy losses and many retreats the remainder of this division, together with the SWH were evacuated back to England, to Newcastle, where Dr. E. Inglis, who was already seriously ill, died, on November 26th, 1917. She was later buried in Edinburgh, with full military honours. EPILOGUE: High honours were bestowed posthumously on Dr. E. Inglis both by Great Britain and Serbia, and now, 90 years after her death, we should remember her with deep gratitude and respect for all she did for our people in the most difficult times of its history.

[Imhotep--builder, physician, god].

INTRODUCTION: The medicine had been practiced in ancient Egypt since the earliest, prehistoric days, many millenia before Christ, and was quite developed in later periods. This is evident from the sceletal findings, surgical instruments found in tombs, wall printings, the reliefs and inscriptions, and most of all, from the sparse written material known as medical papyri. However, there were not many physicians from that time whose names had been recorded. The earliest physician in ancient Egypt known by name was Imhotep. WHO WAS IMHOTEP?: Imhotep lived and worked during the time of the 3rd Dynasty of Old Kingdom and served under the pharaoh Djoser (reigned 2667-2648 BC) as his vizier or chief minister, high priest, chief builder and carpenter. He obviously was an Egyptian polymath, a learned man and scribe and was credited with many inventions. BUILDER: As one of the highest officials of the pharaoh Djoser Imhotep is credited with designing and building of the famous Step Pyramid of Djoser at Saqqarah, near the old Egyptian capital of Memphis. Imhotep is also credited with inventing the method of stone-dressed building and using of columns in architecture and is considered to be the first architect in history known by name. PHYSICIAN: It is believed that, as the high priest, Imhotel also served as the nation's chief physician in his time. As the builder of the Step Pyramid, and as a physician, he also had to take medical care of thousands of workers engaged in that great project. He is also credited with being the founder of Egyptian medicine and with being the author of the so-called Smith papirus containing a collection of 48 specimen clinical records with detailed accurate record of the features and treatment of various injuries. As such he emerges as the first physician of ancient Egypt known by name and, at the same time, as the first physician known by name in written history of the world. GOD: As Imhotep was considered by Egyptian people as the "inventor of healing", soon after the death, he was worshiped as a demigod, and 2000 years later he was elevated to the position of a god of medicine and healing. His cult reached its zenith during Greco-Roman times when he was identified with the Greek god of medicine Asclepius. CONCLUSION: Imhotep was a real historic person from the period of the 3rd Dynasty of Old Kingdom (2686-2637 BC) and he served under the pharaoh Djoser as his vizier and high priest. Obviously, he was a very capable and many-sided man who is believed to be the designer and builder of the so-called Step Pyramid of Djoser at Saqqarah and of several other buildings. Apart from that he was believed by his people to be the "inventor of healing" and is considered to be the practicing physician at his time and the author of the famous Smith papirus. As such he is considered to be the first physician known by name in written history of the world. He was one of only two mortals ever to be accorded divining status after death.

Scottish Women's Hospitals--the 90th anniversary of their work in Serbia.

The Scottish Women's Hospitals (SWH), a unique health institution in the history of medicine, staffed entirely by women, was founded soon after the outbreak of the First World War, August 12, 1914 in Edinburgh, by the National Union of Women's Suffrage Societies. The founder and the main driving force behind this organisation was Dr. Elsie Inglis (1864-1917). Although her proposition to the British War Office had been rejected, she offered her services to the Allies (France, Belgium, Russia and Serbia). The first 200 bed SWH unit was sent to France in November 1914, and soon after followed other units, so at the end there were 13 very well equipped SWH units working in the various theatres of war in Belgium, Serbia, Russia, Rumania and Greece. The first unit of SWH came to Serbia in early January 1915, and was located at Kragujevac. Soon after, three other SWH units arrived to Serbia and were stationed at Mladenovac, Valjevo and Lazarevac. It was an enormous help to Serbia, full of wounded and sick people, due to the dreadful typhus epidemic which was devastating the country. A large SWH unit, attached to the Southern Slav Volunteer Division, had worked on the Dobrudja front, and there were three hospitals and a special transport unit on the Salonika Front, which were all engaged in the treatment of Serbian wounded soldiers until the end of the First World War. Two other SWH units, located in France, were treating the Serbian refugees. Serving bravely and honorably on the various theatres of war, the legendary Scottish Women's Hospitals made enormous contributions to the allied war efforts, and helped Serbian people a great deal.

[70 years of English-Yugoslav Children's Hospital for osteoarticular tuberculosis in Sremska Kamenica]. / Sedamdeset godina od osnivanja Englesko-jugoslovenske decje bolnice za lecenje tuberkuloze kostiju i zglobova u Sremskoj Kamenici.

The development of orthopedic surgery in Novi Sad and Voivodina is related to the name of Dr. Katherine MacPhail, a Scottish physician, who came to Serbia during the World War I, where she worked with her mission in Belgrade and Kragujevac. After the war, she remained in Serbia and, in 1921, founded the first children's, co-called English-Serbian Hospital; then, in 1934, established English-Yugoslav Children's Hospital for Treatment of Osteoarticular Tuberculosis in Sremska Kamenica, which was open until 1941. After the end of World War II, as early as in 1947, Dr. MacPhail returned to Sremska Kamenica, where she reactivated the hospital. After the nationalization of the hospital, she left for Scotland, but the hospital kept working, first under the supervision of the Belgrade Clinic for Orthopedic Surgery and Traumatology, and then as a ward of the Clinic for Orthopedic Surgery and Traumatology of the Novi Sad School of Medicine, until 1992, when it was closed.