Erwin Deutsch, the Eppinger Clinic and the legacy of the Second Vienna School of Medicine-Continuities of a career

Erwin Deutsch (1917-1992) was an outstanding representative of Austrian internal medicine after World War II. Little is known about his early biography. Considered a "Jewish half-breed" under Nazi racial laws, he was subjected to harassment during his training. Nevertheless, he can be regarded as scientific heir of Hans Eppinger (1879-1946), who enjoyed a worldwide reputation as internist despite his controversial involvement in medical experiments in the Dachau concentration camp.Already declining after World War I, the Viennese Medical Faculty largely lost its international scientific importance with the expulsion of over half its faculty members from 1938, the end of the Second Vienna School of Medicine. Erwin Deutsch significantly contributed to continuity by vehemently calling for the unity of internal medicine after 1945, as it had been practiced in Vienna since the nineteenth century. Discrimination as a "Jewish half-breed" played a paradoxical role in this context-it delayed the start of his independent academic activity and increased his personal dependence on Eppinger; at the same time it spared him military service and enabled him to start his career after 1945 unaffected by denazification measures.Based on unpublished archival material, interviews with contemporary witnesses, and Deutsch's medical publications, this article is the first to offer an account of his early career, from his graduation in 1940, his time at the Eppinger Clinic, compulsory service in Germany during the war and the beginning of his scientific work to his appointment as Ernst Lauda's successor as director of the 1st Medical Clinic in Vienna.

Reflections on internal medicine in Poland on the occasion of the 100th anniversary of Polish Archives of Internal Medicine

Dynamic development of medicine in the 20th and 21st centuries has only been possible due to its split into narrow specialties. The increasingly complicated and costly technologies used in clinical practice can only be mastered by small groups of highly‑ qualified specialists; however, diagnosis and treatment are not about matching a patient with the latest and most sophisticated technologies but about finding an optimal patient‑ oriented solution, as it is the human being as a whole that needs help. To achieve this goal, a close collaboration of different specialists is required, but the key role rests with a physician with good general internal medicine skills and the right motivation to act. Management of patients presenting to internal medicine departments requires not only the skill of appropriate pathophysiological reasoning based on extensive knowledge and acquired experience, but many times also the civil courage of the physician. The task is further complicated by chronic underfunding of these wards. The aim of the present review is to reflect on the current state and prospects of Polish internal medicine as well as to attempt a definition of an internist and their role in the integration of different medical specialties. It also stresses the importance of a master in the teaching and practice of medicine and presents profiles of 4 eminent Polish internists.

A journal as a mirror of continued progress in internal medicine. A century of Polish Archives of Internal Medicine

Internal medicine emerged as a new medical specialty in the second half of the 19th century. It was based on a novel diagnostic and therapeutic paradigm, and included pathophysiologic interpretation of physical examination, laboratory tests, and imaging techniques, in contrast with previous descriptive approach to clinical problems. Professor Edward J. Sas-Korczyński in 1891 proposed to organize Polish meetings on internal medicine. The proposal was implemented only in 1906 by Antoni W. Gluziński, a famous Polish internist. Despite obstacles set by the partitioning powers, the Society of Internists of the Polish Lands was founded. The name of the association was changed to the Polish Society of Internal Medicine during the congress held in Vilna (now Vilnius) in 1923, the first one organized in the independent Poland. The journal of the Society, Polish Archives of Internal Medicine, was founded and Antoni W. Gluziński was its first editor-in-chief. Later, the journal was edited by Władysław Janowski, Witold E. Orłowski, Andrzej Biernacki, Tadeusz Orłowski, Artur Czyżyk, and Anetta Undas. Witold E. Orłowski was a father of modern Polish internal medicine, and contributed to the development of its subspecialties and their societies. Most of them had roots in the specialist sections of the Polish Society of Internal Medicine. The journal supported the newly founded societies by publication of issues focused on selected subspecialties. Despite the development of subspecialties, the role of internal medicine as a holistic discipline covering the diagnosis and therapy of many organs does not decrease.

[A tribute to Revista Médica de Chile on its 150th Anniversary (1872-2022)]

Revista Médica de Chile was founded in 1872 by Sociedad Médica de Santiago (currently Chilean Society of Internal Medicine) and it is one out of twenty five medical journals founded during the XIX Century that still remain active. In monthly issues it presents clinical and biomedical research articles, as well as research and position papers dealing with medical education, public health or medical ethics. Special attention receive the impact on health care given by the emergence of new private medical schools in Chile, the relevance of methodologies to assess clinical competences in graduates, the certification of specialty programs and specialists, the appropiate use of simulators in clinical training, telemedicine, organ transplants, and current issues in medical ethics, such as abortions and euthanasia. Institutional and international collaboration in medical research is clearly reflected in recent years. Articles are subjected to external peer review and ICMJE Recommendations are carefully considered throughout the review process. Most articles are published in Spanish but English abstracts are mandatory and a growing number of articles are currently published in English. An Open Access electronic version is published by SciELO. Revista Médica de Chile is indexed in the most important international data bases and it is a member of the ICMJE ruling committee. The long life and prestige of this journal can be considered a testimony of the cultural heritage and progress in Chilean medicine.

Winner's curse: The sad aftermath of the discovery of insulin

Every young researcher dreams of making a great discovery, but few achieve it. If they do, success does not guarantee happiness. There is little satisfaction in discovering something if others get the credit, and those who achieve fame must face the 'winner's curse' of living up to their reputation. Few discoveries have been more dramatic than the isolation of insulin which, as Michael Bliss said, resembled a secular miracle. And yet, as he also pointed out, this great discovery brought little happiness to those who made it. Some were sidelined, and Banting and Best were saddled with the winner's curse. Here, we look at the ways in which a great discovery can haunt its discoverers.

100 years of physiology, discrimination and wonder

There has been 100 years of research detailing the role of insulin in glucose, protein and free fatty acid metabolism. We explore the learnings though evolution and changes in management with an understanding of how it has impacted the care of people with diabetes. The discrimination endured is described and recent advances to empower and counter this are highlighted.

Rudyard Kipling's medical addresses

Rudyard Kipling was one of the most widely read writers of prose and poetry during his lifetime. His wide travels-he was born in India and lived in England and The United States and made frequent visits to South Africa-led to many encounters with physicians and medicine. His unique addresses to the medical profession reveal his knowledge of medical subjects. His three major medical addresses concern medical subjects in contrast to most laymen addressing physicians, who typically speak about their own areas of expertise. The influence of Sir William Osler on some of Kipling's stories is also examined.

The founding of neurology as a specialty: The American situation in context

With few exceptions, neurology in Europe as well as in the United States emerged from internal medicine and psychiatry, and neurology and psychiatry in particular have long remained connected in clinical practice and teaching. When the American Board of Psychiatry and Neurology (ABPN, 1934) and the American Academy of Neurology (AAN, 1948) were founded, the emancipation of neurology as an independent specialty was still evolving. During the First International Neurological Congress (Berne, Switzerland, in September 1931), a special conference was organized on the "Relation of Neurology to General Medicine and Psychiatry in Universities and Hospitals of the Various Countries," at which representatives from several countries described the situation in their countries. Their statements were made around the time of the founding of the ABPN and not long before that of the AAN. They show that neurology in most countries was still struggling to become independent and only in a few cities flowered as an independent specialty. In the second part of this article, specialist regulation (training, examination, and certification) in European countries (Germany, France, England, and The Netherlands) will be compared to that of the ABPN. It appears that Germany was among the early countries where this occurred, following the Bremen Ärztetag (physicians day) in 1924. Comparable to the American situation, it was professionally controlled, in contrast to the French state certification, which occurred later. The British specialist regulation was much later and more complicated.

Professors of internal diseases at Polish universities in 1918-1939

The article outlines the achievements of Polish professors who specialized in the treatment of internal diseases. The analysis concerns the scientists who held professorial chairs between 1918 and 1939. The findings were presented in the context of university medical departments. In Poland, in the interwar period, a total of 13 professors held chairs of internal medicine: Zdzisław Gorecki, Władysław Antoni Gluziński, Aleksander Januszkiewicz, Walery Jaworski, Wincenty Jezierski, Jerzy Latkowski, Jan Henryk Lubieniecki, Witold Orłowski, Zenon Orłowski, Roman Rencki, Kazimierz Rzętkowski, Tadeusz Tempka, and Edward Żebrowski. Some of them had been awarded their chairs before 1918. Most of them were successful researchers. Professors Antoni Gluziński and Witold Orłowski were particularly recognized in the scientific world. Gluziński held chairs at Jagiellonian University and then at the University of Warsaw. Orłowski worked at Jan Kazimierz University in Lviv and then moved to the University of Warsaw. In the interwar period, Polish departments of medicine were one of the largest when compared with other departments. Consequently, internal medicine units (assigned to such chairs) were the largest within the departments of medicine in terms of the staff employed. For this reason, most universities decided to divide such units into 2 independent ones. In the years 1918-1939, the field of internal medicine had flourished in Warsaw, Kraków, Poznań, Lviv, and Vilnius; however, the outbreak of World War II would change this forever. After 1945, Lviv and Vilnius were no longer within the territory of Poland, and Polish professors based in those cities moved to join professorial staff at Polish universities.

A return to humane medicine: Osler's legacy

Sir William Osler is celebrated today not only for his contributions to the advancement of medical education, but also for the humanism he brought to the practice of medicine. He was a doctor whose bedside skills and manners were emulated, and can legitimately be called an infectious diseases specialist. Nonetheless, he was also a humanist in the broader sense of the term, a student of human affairs and human nature, who emphasised compassion for the individual. To what extent, if any, are today's challenges influenced by departures from the paradigms created by Osler? In this paper we sought to ascertain whether such a tradition is still relevant to current practice and may foster a new perspective. We analysed two features of Osler's legacy that may be useful to clinicians: the first is his vision of the patient-physician relationship; the second is his approach to humanities. William Osler saw medicine in its wider scope, with the right and duty to be concerned with the human condition as a whole. Indeed, his rounded concept of the medical profession as being engaged in helping and caring for the whole human being could help physicians build a more humanised medicine. Adopted in the age of evidence-based medicine, the Oslerian approach can enhance the relationship with patients and give physicians a role based on trust and authoritativeness rather than on authority.

[Attempting a Great Integration : Paul Martini and the First Post-War Conference of the German Society for Internal Medicine]

The long established German Society for Internal Medicine (DGIM) profoundly incriminated itself through its actions and positions during the National Socialist era. The German clinical physician Paul Martini assumed the part of reorganizing the DGIM prior to its first post-war convention in 1948 in Karlsruhe. Martini, who himself had opposed the Nazi regime, adopted a course of comprehensive integration. He strived to incorporate both physicians who had been persecuted by the Nazi Regime as well as former moderate National Socialists into the DGIM. At the same time he campaigned to preserve the pan-German nature of the conferences and aimed rapidly to make the DGIM re-compatible with international research. However, this path led to an allegedly apolitical focus on science and decades of largely failing to confront its Nazi past.

Władysław Biegański, MD (1857-1917)

Dr W. Biegański was an eminent doctor of internal medicine mostly the acute infectious diseases and tuberculosis, he was scientist doing the research on the origin of the diseases and on the medical ethics, but more he was also a social activist taking care on the public health of the society in his time still living under the Russian rule. W. Biegański living on the XIX/XX century in small provincial town, grace to his knowledge, self education and energy created the important scientific center in the municipal small hospital. His philosophic works and especially knowledge published under the shape of aphorisms on the medical ethics were several time published still after his death. The century of the death of Dr W. Biegański the Senat of RP, the Higher Chamber of the Polish Parliament, celebrated by nominating him as one of the eminent persons for the year 2017. This publication was prepared to memorize the achievements of a medical doctor, scientists and social Dr W. Biegański activists, that can be jugged as the precursor of the public health activist, and whose philosophical findings are still worth to be remember.

Internal medicine in the United States and Germany: mutual influences from 1870 to today

Over the past 140 years, the close academic and clinical interactions in Internal Medicine between German-speaking countries and the United States have been through three distinct stages. From 1870 until the First World War, German medical research, teaching, and university organization served as a model for U.S. medical schools and practice. However, after World War I, medical education reforms were implemented in the U.S., and due also to radical economic and political changes at home, German medicine lost its pioneering role. Furthermore, many scientists and clinicians were forced to emigrate in the face of racial and political persecution in Germany and Austria. Since the Second World War, American medicine has grown further to become the world leader in research, training, and clinical practice. The earlier trend of American physicians studying abroad was thus reversed, with many of today's foremost German physicians completing clinical and research training in the United States.

["On a strictly scientific basis.” German constitutional medicine establishing itself, 1911–1921]

In the years between 1911 and 1921, modern constitutional medicine established itself as an interdisciplinary research program in German-speaking countries. Untouched by later holistic interpretations and still far from the ,,crisis of medicine“ of the late 1920s early constitutional medicine was very attractive due to its scientific self-characterisation. Thus, it became influential across the medical disciplines. This paper examines history and subject matter of German modern constitutional medicine in its first decade, starting in 1911, the year constitutional medicine was first publicly discussed by the Wiesbaden congress for internal medicine, including its development during World War I and closing with the first textbooks for medical students in 1921.

[History of the 4th Department of Internal Medicine of the First Faculty of Medicine at Charles University and the General University Hospital in Prague]

In 2015, the doctors and nurses of the 4th Department of Internal Medicine of the First Faculty of Medicine, Charles University and the General University Hospital in Prague celebrated the 70th anniversary of its founding. The article summarizes the clinics contribution to the field of internal medicine, and particularly to angiology, hepatogastroenterology and lipidology. It comments the clinics current activities and the possibilities of its further development. Attention is also paid to the tradition of high ethical and professional standards of medical care in accordance with the norms established by the clinic's founder, prof. MUDr. Bohumil Prusík.

John H. Laragh MD: The Man

John has been variously described as an inspiration, mentor, teacher, friend (fiend--a typo?), charming, warm, enthusiastic, visionary scientist, pioneer, innovator, egalitarian, and golfer. At other times he was called street fighter, competitor, and some unprintables. I believe he was all of these, and more. Join us in celebrating the life of Dr. John Laragh.

[Medical anthropology in academies: on the criticism of natural science medicine exemplified by Viktor von Weizsäcker]

Viktor von Weizsäcker (1886-1957) founded his concept of medical anthropology as a clinician educated in internal medicine and neurology. He tried to broaden natural scientific medicine psychosomatically focussing on the "sick human". The natural scientific approach would exclude subjectivity, and therefore he propagated the "introduction of the subject' (Einführung des Subjekts) into the life sciences. His own sensory physiological experiments and Sigmund Freud's psychoanalysis inspired him essentially since the 1920s. In his main work Der Gestaltkreis (gestalt circle) published in 1940 he stressed the "entity of perceiving and moving" (Einheit von Wahrnehmen und Bewegen) in regard to relevant aspects of medicine. In 1932, Weizsäcker became a member of the Heidelberg Academy of Sciences, whose president he was from 1947 till 1949; 1942 he became a member of the Leopoldina. Primarily his merits as a neurologist were highly appreciated. His medical anthropology was not relevant for his election by the two academies. Nevertheless, there was a certain repudiation against the objectivistic and materialistic Weltanschauung within the scientific community. So, Paracelsus and Goethe were highly estimated as natural philosophical guides for own conceptions. This was especially evident for the circle around Wilhelm Troll and Karl Lothar Wolf in Halle, both members of the Leopoldina, who were fascinated by Goethe's concept of "Gestalt". Weizsäcker's lecture on "Gestalt und Zeit" in Halle in 1942 fitted in the concept of those natural scientists.

[A reading of Foucault's "The Birth of the Clinic"]

The starting point for Foucault's book was his wide reading of French medical literature from late 18th and early 19th centuries. He showed how the concept of disease changed profoundly during that period of great societal changes. Foucault's protagonists in the book were the French doctors Pinel, Bichat, Laënnec and Broussais. Here, short biographies and summaries of their works will be presented in the medical and historical context and together with extracts of Foucault's text.

[YESTERDAY'S CLINICIANS: JUDGEMENTS AND REQUESTS IN THREE LETTERS OF NIGRISOLI, MURRI, AND GALDI]

We present here three interesting documents which allow us to have a quick look at some aspects of the professional life of Italian teachers of internal medicine at the end of XIX century. A typewritten copy of a letter sent, on 23 February 1877, by Augusto Murri, professor of internal medicine at the University of Bologna, to Francesco Crispi, Speaker of the Italian Parliament. This document was enclosed in a letter dated 6 March 1937 from Bartolo Nigrisoli, a distingued surgeon of Bologna, to Francesco Galdi, clinician of the University of Pisa. The third document is a handwritten reply from Galdi to Nigrisoli. Relevant information in all three documents are commented upon.