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The Museum of the History of Health Care in Croatia, as the first such museum in the southeastern part of Europe, was established by the Croatian Medical Association in Zagreb in 1944. Beside Vladimir Ćepulić (1891 - 1964) the head of the Croatian Medical Association, epidemiologist Stanko Sielski (1891 - 1958), was one of the most prominent personalities to be credited for realizing this project. He was born in Gracanica into a family of Polish origin. After his graduation in Vienna in 1919, he worked as an epidemiologist in Konjic, Prozor, Glamoc and other places in the area of Bosnia, mostly involved in typhoid fever and variola eradication. At the beginning of the Second World War he was in Banja Luka where he was given the duty of director of the Department of Endemic Syphilis Eradication. During 1942 and 1943 his correspondence took place with Vladimir Ćepulić, which is today preserved in the Section of the History of Medicine of the Croatian Academy of Sciences and Arts in Zagreb. On the basis of this material it was possible to trace the circumstances of the foundation of the Museum of the History of Health Care, how items were collected for its first exhibition, and the role of Stanko Sielski in preserving the medical heritage and dissemination of knowledge of the history of medicine to a broader audience.

The historiography of Zagreb sanatorium Merkur, founded by Merkur Insurance Society in 1930 is presented. The research is based on archival sources kept in the State's archives as well as in the National library in Zagreb aiming to identify the opening, building and governing the hospital until 1945. The analysis of the hospital historiography allowed the insight into social insurance development on our territory as well as of Zagreb's population receptivity towards the health institution and the quality of health service in the first half of the 20th century. The paper is dedicated to the 140th anniversary of Merkur Insurance Society foundation.

The epidemic of cholera that took place in the Neretva basin in 1886 was part of the fifth pandemic wave that was spreading throughout Europe. Based on the death records, vital statistics and the newspaper articles from that period, in this paper we present the emergence and the course this epidemic. In the context of analysis and experience of the epidemic of cholera in the lower Neretva basin, the newspaper articles have been recognized as a sensitive register of the changes of behavioural patterns, the way of speaking, the mechanisms of reacting and adjusting to the spreading epidemic, but also the resistance to it. It is based on this material that we can make conclusions about the relationship between the individual and the collective in the time of danger, as well as about the particularities of historical events that have been left out in other sources. Two potential paths for cholera to enter the area of the lower Neretva basin have been identified: one from the sea and the other from land, via the neighbouring country of Bosnia and Herzegovina. Quarantine measures had been taken in order to prevent the onslaught of the epidemic, a sanitary cordon was organized, disinfection of the land was carried out and a cholera hospital organized in Metković. However, despite the undertaken measures, an inefficiency of the government organs was obvious, because their actions mainly applied to formal fulfilment of anti-epidemic measures and they quite easily handed over individual initiatives to physicians. The analysis of strategies concerning the application of anti-epidemic measures in the past can be useful for learning more about the multilayered nature of social mechanisms in the time of epidemics, which makes it convincing and valuable even in the present day.

The lower Neretva basin as a space that has undergone historical transformation into a myth of a pathological topos has been analyzed. Starting from the fact that temporality is essential for understanding of the elements that partake in conceptualization of a myth, we have analyzed the state of this area as it was during its exposure to an epidemic of cholera in 1886. There is evidence that at this time exactly a step forward was made in comprehension of the etiology of the disease, which resulted in the change of centuries-long concepts of the Neretva basin as an unhealthy area. In this paper the Neretva basin was understood and presented as a field of unfolding of all kinds of transformations, a habitat exposed to manifold social arrangements, lushly documented in newspapers and other printed material. The arguments about the natural disaster in these texts are ethically and politically coloured, which to a large extent corresponds to the vocabulary of current print media on similar occasions. Thus, the area of the Neretva basin imposes itself as a multilayered anthropological concept, a multi-semantic ecologically and socially constituted reality, within which history functions as a valuable source of knowledge pliable to contemporary usage.

Fran Gundrum (1856-1919) was a Croatian physician, encyclopedist, and an advocate of medical enlightenment and healthy lifestyle. In order to identify and analyze Gundrum's ideas about the problems of prostitution and criminality, we studied all of his books, booklets, and articles published between 1905 and 1914. We showed that Gundrum's theories of heredity, morality, and sexual hygiene incorporated many of the important discussions of his time, especially those related to the Darwinian paradigm. Gundrum's project of collecting statistics on prostitutes was the first such study published on the territory of today's Croatia. Although he rejected the notions of born prostitutes and born criminals, defended by Italian criminal anthropologist Cesare Lombroso, he still regarded eugenics as a convenient method of dealing with the ills of society. He believed that criminals were degenerate individuals representing a violent threat to the society and that it was legitimate to use radical means, such as sterilization and deportation, to deal with this problem. Organicistic view of the society prevented him from seeing the individual rights as important as that of the society to protect itself. Nevertheless, this view led to many humanistic ideas, such as the binomial illness/poverty in case of prostitution, which influenced many prominent works of social medicine movement.

Initiating licensure and medical education in Croatia was not only schooling itself, but struggle for national identity and institution of an academic setting, which, by itself, is paramount for cultural development anywhere. Throughout history, this struggle mostly ended with administrative discouragement and opposition to all such efforts of higher medical education by contemporary authorities. The paper elaborates on the first initiatives in this direction focused on the establishment of a degree of medical education in Dalmatia. Doctor Jakov Mirković (1748(?)-1824) was the first to become instrumental in the area. The aims, outlines and academic basis of those first initiatives were presented in a publication of his, leading eventually to the establishment of Split School of Medicine, University of Split, finally realized in 1997.

Based on secondary literature, a survey of particular forms of medical expertise over history is presented. The state-to-individual interaction in terms of personality and physical integrity protection, health care, etc., was observed. It was only after the 16th century that the development of anatomy was found to have become a decisive argument for convincing expertise in various trials. In Croatia, the course of medical expertise development was comparable to the close settings in the neighboring European countries. Major advances at the legislative, educational and professional levels took place in the second half of the 19th century. The subject of Forensic Medicine was introduced at Royal Academy of Jurisprudence as early as 1861; the book entitled Lecnicka izvesća (visa reperta) za prakticnu porabu lecnikov by Ivan Dezman (1841-1873) from 1868 offered the first systematic form of autopsy reports, whereas Kratka sudska medicina, a handbook in forensic medicine by Niko Selak (1861-1891) from 1889 denoted the beginnings of forensic medicine literature in Croatian language. It has been noted that medical expertise approach perceives man as a social being at the crossing of manifold impacts and influences, thus being always observed by physicians of various specialties. During centuries, medical expertise has been formed in conjunction with advances in medicine and science, and with the development of civil society. Medical expertise had gradually grown into a multidisciplinary field requiring high professionalism, ethical approach, continuous training and collaboration with various professions. This resulted in a compact and polyvalent discipline, in Croatia gradually formed as a special course in medical curriculum.

The building of the Civic Hospital in Split was an important event in the life of this city. Although it primarily served as an institution for the care of the poor, its development shows the evolution of the public health care in this territory. In spite of the recent thorough review of the older historiography on this history, incorrect data are permanently published in the literature and lately even in the content of the memorial plaque. This creates the erroneus picture and credibility of Croatian medical heritage, history and historiography.

In Zagreb, at the Surgical Department of University Hospital "Dr Ozren Novosel", today "Merkur" the first operation in hypothermia was performed on October 25th, 1957, on the patient with pulmonary valve stenosis. It allowed total circulatory interruption to do the operation in the open heart successfully, and this was the first such operation not only in Croatia but in the broader context of former Yugoslavia.

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.

Gjuro Armen Baglivi was one of the most famous medical authorities of the 17th century. Apart from his numerous books and publications, several extensive collections of his correspondence have been preserved and are available in libraries around the world. They provide new information about the 17th century scientific culture and place of Baglivi's work in the scientific European context. Also, they shed light on his personality more than other writings intended for the public eye. In this paper I will present the case of a theft of intellectual property, which Baglivi described in one of his letters to Jean Jacques Manget.

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.

The paper presents medical and cultural viewpoints on male circumcision throughout history. The shifts in medical perception of its indications, ranging from preventive concepts which advocated it to opposite attitudes recognizing it as a physiological, psychological and ethical disturbance of body integrity, were highlighted. Not only operative techniques play a role in its performance but also impact of cultural circumstances which influence the motivation for its performance. We argue that the awareness of the importance of all mentioned elements can contribute to better patient -- physician understanding. This review aims to stimulate further information on this subject on the territory of Croatia.

In this paper we aim to reminisce the role of the Austrian surgeon Hermann Schloffer (1868-1937) as the pioneer of a trans-sphenoidal approach to the pituitary gland. On the 16th of March 1907 he operated a patient with pituitary tumor and published his report in the Wiener Klinische Wochenschrift on 23rd May 1907. This paper is to recall the 100th anniversary of this event. Schloffer's method was spread and modified worldwide, Croatia included, a country in which the interest in trans-sphenoidal approach to pituitary tumors has not diminished or been lost, but slowly modified. Today, almost a whole century after its introduction, it is still used to operate about 95% of sellar region tumors.

We reconstructed the historical development of surgical approaches to the pituitary gland, which were used in Croatia in the first half of the 20th century, on the basis of earliest clinical case reports and descriptions of initial surgical attempts. The first published case report on surgical treatment of acromegaly was described, as well as the review of 11 patients with pituitary disease admitted to the Ophthalmology Clinic in Zagreb in the period 1925-1927. The earliest 5 reports on pituitary surgery dating from 1925 were analyzed to reveal the circumstances that led to the development of transsphenoidal approach as a method of choice in Croatia, when this technique was becoming obsolete in other parts of the world. Frequent modifications of surgical approaches to sellar region have been shown a suitable historical-medical model for analysis of changes in surgical trends.

We investigated the circumstances of building of the Civic Hospital in Split in the light of new archival evidence. The study necessitated a thorough review of the older historiography and previously unpublished archival sources kept in the State Archives in Venice and Zadar. The findings showed that construction of the hospital building finished in 1797, ie, five years later than officially cited. The topographical plan and the original project of the Split Civic Hospital were found, as well as the name of the project's author and the building supervisor. The data on the earliest efforts of Ergovac brothers to acquire land and building permission were corrected. The study revealed a recognizable pattern in the attitude of the authorities toward the establishment of a hospital at the end of 18th century.

In the present debate about academic medicine in crisis, I argue that the problem is partly the consequence of a global process of alienation and depersonalization. Technology-based medicine is one of the key players which creates unsuitable role models. In its wake and as a consequence, the profile of the academic professional must be redesigned. Academic professionals should influence more strongly not only the quality of health care but the whole mentality in our socialized world. Academia itself should also become an arena for advanced ideas, and creative power pervaded by the humanities -- a facet which has been lost.

We analyzed the beginnings of medico-legal practices in Dubrovnik, using the first eight books of criminal records series Liber de maleficiis from the early 15th century. We also looked into the mechanisms of individual and public control of the issues such as the patient-physician relationship and the control of epidemics. At that time, surgeons rather than physicians reported wounds to the court of justice and, in most cases, provided medical expertise when requested by the authorities. Cold steel weapons were the usual instruments of violent offences, and the most frequently harmed part of the body was the head. The expert testimonies formally satisfied the requirements laid down in Dubrovnik normative acts of the time, but their medical content was poor and the vocabulary was a mixture of lay and professional. Although Dubrovnik medical practitioners wrote simple expert testimonies and did not perform forensic autopsy, their involvement in the control of violence and development of the legal system corresponded to the role played by physicians and surgeons in the leading continental European centers of the period.

A history of medicine program was first introduced at the University of Zagreb, Croatia, in 1927 by the internist Lujo Thaller, who became the first lecturer on this subject at Zagreb. However, the development of the program did not go smoothly and medicohistorians in Croatia were engaged in a constant struggle for proper status and a permanent place for their program within the medical school curriculum. Today a 15-hour medical history course (offered in the last semester of the 6-year curriculum) is mandatory at all four Croatian medical schools. The course draws on historical, cultural, sociological, epistemological, and bioethical aspects of medicine, with the goal of broadening students' perspectives on the practice of medicine and thereby enabling them to better meet the demands they will face as practicing physicians.

It is proposed that beauty can be external or internal or both. External or physical beauty is immediately visible. Internal or inner beauty is not always immediately visible. Ideally both types of beauty are connected and spring from one another. The opposite situation, in which only one exists while the other is suppressed, is exemplified in this paper, using a tale from 19th century Croatian literature as a model. The main character is Tena. Initially physically beautiful, she is later disfigured by smallpox. Consequently her psyche metamorphoses through illness, distress and destitution, and she discovers an inner self that allows her full personality to develop. The story of Tena illustrates how love based only on outer appearance may end in unhappiness. Perhaps true love depends more on soul than surface. Endless quests for external beauty are part of medical practice today more then ever before. Skin is the paradigm of this. The dermatologist needs many clinical skills, including an understanding of psychology, when addressing skin-related problems--appearance-related problems in particular. Sometimes the humanities (e.g. literature, poetry, etc.), may help broaden our perspective of such a complex phenomenon as beauty.

Carl von Rzehaczek was a classmate and contemporary of Ferdinand von Hebra, who founded the tradition of painter-physicians at the Vienna School of Dermatology. The following reminiscence shall bring him to the attention of the reader.

This is a story of Dusan Jakac, one of the most prominent Croatian dermatovenerologists. Born in 1906, he is also our oldest dermatovenerologist and certainly among the oldest in Europe. His life and experience constitute a treasure of information on dermatovenerology in the region, which motivated us to ask him for an interview. In his life, Jakac experienced the time when Europe saw its unrest and witnessed the shift of dreadful epidemics such as Spanish flue, syphilis, and recently AIDS. He has observed different diagnostic approaches, their benefits and failures, and practiced various therapeutic approaches, never forgetting to take care of their side effects. Jakac's career illustrates the medical and cultural times in a striking way. We met him at his apartment in Zagreb, where he lives now and where he answered promptly and enthusiastically all our queries. Thanking him warmly, we can truly state that talking to Dusan Jakac was a unique experience for both the historian of medicine and the dermatovenerologist.

Lijecnicki vjesnik, during its 125 years long existence, played important role in promotion of History of medicine on our territory. The first articles, which appeared at the end of 19th century, advanced soon to endeavours for affirmation of History of medicine to academic and research discipline. The most important in this respect are texts written by medical history founders and pioneers such as Lujo Thaller, Lavoslav Glesinger and Mirko Drazen Grmek. The topics ranged from antiquity to 20th century covering general historical, culturological, anthropological, epistemological and bioethical dimension of medicine. Professional medical historians wrote greater part of medical historical articles but also physicians of other disciplines participated. Most intensive period in publishing of medical historical articles corresponds with that of the most intensive efforts in establishing the history of medicine as scientific and scholarly discipline. Pages of Lijecnicki vjesnik have fixed not only struggle for status of this discipline but are chronology of actions aimed to include the results of History of medicine to unique knowledge fund in a context of modern medicine and science.

A votive painting in the chapel of St. Donatus in Pavlovec (northern Croatia) from the 18th century depicts St Notburga of Eben with two paupers, a shepherd and an invalid. Although generally venerated as patron-saint of peasants and maids, Notburga seems to have captured the imagination of the anonymous painter as the helper of the poor and underprivileged. The vicious circle of poverty and disease is evoked by this painting, as well as the popular belief in divine assistance by supplication to patron saints.

The development of dermatovenerology in Croatia parallelled more or less this process in other parts of the Austro-Hungarian Monarchy throughout the 19th century. The foundation of the first specialized hospitals as well as the establishment of dermatovenerological units and their transformation into academic departments and chairs in the early 20th century was a slow growth provoked by the spread of syphilis and Skrljevo disease. A group of Zagreb physicians were instrumental in this regard. Based on archival sources, this paper illustrates the chronology and circumstances of the foundation of the first chair, on the occasion of its 80th anniversary.

We explored the notions of life and death as perceived and presented in a 15th century Croatian literary text, Slovo Mestra Polikarpa, in which master Polikarp, a well-learned man of medieval times, engages in a lengthy dialogue with Death itself. This contrast/debate is a rare piece of medieval literature, not only by its Old Croatian language, but also by the angular Glagolitic script in which it was written. As a part of Croatian cultural heritage, it is deeply rooted in and clearly belongs to the common context of Western European medieval views on life, health, ailing, and death. A medieval perspective on such issues might be interesting to broad readership and, in many aspects, to medical professionals, whose everyday practice necessarily involves not only practical and scientific, but also moral, philosophical, and religious deliberations about life and death.

The development of Japanese dermatology is reviewed from the times of the founding fathers and Keizo Dohi to today. Tribute is paid to the heroes of the first hour. Thereafter, an evaluation of Japanese-authored papers in the leading journal of the field (JID) over four decades is presented, taking a triennial slot in each. The contribution of Japanese- authored papers has increased substantially over this period.

Although the Hippocratic natural theory of epilepsy as a brain disorder originated around 400 bc , it did not begin to take root until the 18th and 19th centuries, leaving the intervening centuries dominated by mostly supernatural concepts. This article provides historical insight into human behavior when afflicted with disease: supplication to a patron saint, Saint Valentine, a cult that spread throughout Europe.

Luca Stulli of Dubrovnik (Ragusa), 1772-1828, was one of the first to make epidemiologic studies of heritable skin disorders. His treatise of what became the 'mal de Meleda' on the Adriatic island of Mljet (Meleda) is a classic in the dermatologic literature. The present study documents his life, his birth record, his portrait and recalls his original publication (in Italian)., (Copyright 2001 S. Karger AG, Basel)

A review is presented calling attention to the first naming and publication of the term 'lupus erythematosus' and to the dermatologist (M. Kaposi) who first detected the systemic nature of this disease., (Copyright 2001 S. Karger AG, Basel)

In Croatian archives a rich collection of registers is preserved. Among the oldest and best-conserved collections of such valuable sources in Europe, are those from the territory of Istria. Investigating these sources we focused our attention on three recipes for treatment of calculi and cuts found on pages of Kastel baptismal's record (1749-1815) in Istria. Similar to other recipes found in various other recipe collections they mirror interlace of folk experience and theurgical views of healing which was detected unexpectedly sometimes on unconventional places, have survived on Croatian territory throughout centuries.

Giovanni Alessandro Brambilia (1728-1800) was the Chief Surgeon of the Imperial Austrian Army and the first director of the newly founded medico-surgical academy in Vienna (1785). He died in Padua in late July 1800 (29th?), en route from his estate in Lombardy to Vienna, and the chiostro della magnolia in the Santo displays a memorial plaque commemorating his demise. On account of his merits for the education of (military) surgeons and the development of surgery in Austria, this short article shall serve to briefly recall his life and related facts.

Professor Mirko Drazen Grmek (Krapina 1924--Paris 2000) was one of the most prominent Croatian scientists. Work in history of science directed him to the crossroads of various fields placing his approach in anthropological perspective. Two models will serve as illustrations of his main theories. The historical reconstruction of scientific discovery (mostly on examples of 17th century) will be presented as well as Grmek's ideas on a concept of disease. The introduction of the term "memoricide" within his activities during aggression on Croatia is mentioned.