| |
|
|
INTRODUCTION
Dr. Hunter's work, according to medical historians, in combating
the epidemic was generally unsuccessful. The same historians
examined the work of the Serbian sanitary service [1]. Evaluations
made in 1915 and 1925 were also reviewed. After the discovery of the
causative agent of plague and Nikola's Nobel Prize, earlier
uncertainties needed resolution. Dr. Vuksic noted in 1989 that Dr.
Hunter played an impressive role as a leader in combating the plague
in Serbia. He pointed out the contribution of Dr. Hunter and his
team [2]. This alone indicates the unsustainability of denying the
success of 1915. At that time, no significant action by the Serbian
sanitary service was noted; instead, it was considered to be within
the scope of Dr. Hunter's and other foreign missions' activities.
Chief Sanitary Officer Dr. Genchic insisted to the Serbian
government on January 15, 1915, that "the profession needed to be
strengthened." The government adopted the proposal, resulting in
success. Regarding Dr. Genchic's address on January 15 in his new
methodological approach to studying the Great War through archival
material, Dr. Nedok states: "This report concludes the reporting of
the Chief Sanitary Officer Dr. Genchic to the Chief of Staff of the
Supreme Command, Vojvoda Putnik..." after which "the epidemic
waned... By the end of May 1915, a period of respite and recovery
will occur..." Dr. Nedok concludes his evaluations with biographical
data on Dr. Genchic, who is "criticized" [3].
In his discussion (attached to Dr. Subbotic's presentation), Dr. J.
Berry (James Berry) emphasizes the possibility of uncertainty
regarding the success of epidemic control. The success of control
after the plague epidemic gained momentum is also questioned, i.e.,
that it is not the same as control that was "timely initiated"
[4:38]. No answer is given as to why the epidemic gained momentum..
Measures in combating the epidemic by the Serbian sanitary service
were achieved through the implementation of administrative measures
- interruption of railway traffic. The first measure was requested
on March 10 - "it came into force on March 16 and lasted for two
weeks... it was supposed to expire on March 30."
The second measure, the suspension of other traffic, followed the
first and lasted until April 16 (according to the Gregorian
calendar). Dr. Hunter takes over a significant portion of medical
responsibilities from the Serbian sanitary service starting from
March 16, thus beginning the "English side" of combating the plague
epidemic and return [5].
Some assessments of the work of the Serbian sanitary service in 1925
were disagreed upon by contemporary Dr. Žarko Ruvidić (war sanitary
general). The criticisms he pointed out in 1947 were primarily
methodological. Due to insufficient argumentation, he disagreed with
the given assessments of former chiefs [6]. It has already been
shown that Dr. M. Pecic, who combated the epidemic, successfully
ended it in its epicenter, in Valjevo [7]. Dr. Pecic and Dr. Ruvidić
were awarded in 1915. This was a new reason to doubt the correctness
of the negative assessments pronounced in 1925 regarding the work of
the Serbian sanitary service. Re-examining the defeatism of the
actors [10], assessments of the outbreak of the epidemic are
primarily the result of the impotence of medicine exacerbated by
war, i.e., "war typhus," and plague.
A way to combat it was sought, and incidentally, the main reason for
the outbreak was implicitly found. It was the initial contribution
of Dr. Subbotić, i.e., his "buried furnace" [8,9]. Who supported the
Serbian sanitary service? How can this be proven today? The
hypothesis is that those who were awarded in 1915 contributed to it.
Negative assessments of the work of the sanitary service expressed
in 1925 call into question the honor of the awarded doctors. A
retrospective analysis of the success of the awarded officers of the
Serbian sanitary service will be made. Historians' conclusions about
medicine are subject to scientific verification. The assessment by
the strength of arguments can be confirmed, modified, or rejected.
Are general measures sufficient? Why were they not properly
implemented? The increase in the epidemic led to unrest. Fear of
failure had already gripped the doctors of Serbia since January and
February, hence the request for assistance from the allies. As the
response was uncertain, Serbia contemplated the epidemic that had
befallen them. They did not give up. Isolating the sick alone needed
to be reconsidered as a strategy.
If the actors after the Great War were correct in seeking the
reorganization of military and civilian sanitation, it does not mean
they pinpointed the correct cause of the high mortality rate in the
epidemic. The cause was not the organizational weakness of Chief Dr.
Genchic. He contributed to the special epidemiology of typhus by
combating the lice infestation [3,12]. The problem was how to solve
the advancing epidemic, as seen by Dr. Berry while working with his
wife in Vrnjačka Banja. The uncertainty of success in combating the
epidemic emphasized by Dr. Berry in the conditions of epidemic
spread raises the question: were there conditions for timely
suppression? Did the English mission and Serbian sanitation reflect
on the same?
It is noticeable that there are differences in the activities of the
Serbian sanitation during the epidemic and what Colonel Dr. Subbotić
wrote about it in his presentations in Paris and London [4]. There
is an inconsistency in interpreting the same events. It's as if one
truth applied to foreign countries, where Dr. Subbotić was
presenting, and another in the homeland. Therefore, despite the
dominance of memories in 1925, the published literature dealing with
the issue of epidemics in Serbia during the Great War, such as the
works of Strong, Hunter, Subbotić, etc., is not utilized. Despite
these weaknesses, the chief of sanitation is attributed with the
following: "Dr. Genchic was a participant in liberation wars and a
member of the Supreme Command. His work was criticized due to
untimely and inadequate measures against the epidemics of typhus and
dysentery, resulting in massive losses in the army and among the
people." [12;13:190]. By automatism, the writer-doctors, as actors,
have also assessed themselves. If so, because of the plague (and
that was a criticism), the question is whether the doctors deserved
the awards given in 1915.
Engagement of the Royal Mission's sanitation in combating the
epidemics. Dr. Hunter found an advanced epidemic upon arrival, as
indicated by the number of hospitalized patients. The peak was
reached one month after his mission's arrival. This corresponds to
Dr. Berry's observations.
The untimely activity of the Serbian sanitation - The consequence of
the untimely implementation of measures is registered by Dr. Hunter
in his book. He was familiar with the period preceding the arrival
of the mission. Several facts will be presented as he noted them:
"There were two types of problems - a clinical problem concerning
the improvement of accommodation. The other... a preventive problem
to stop further spread of infection to the healthy." [5:108]. Hunter
believes that "seeking help from doctors from our government and
others, it is undoubtedly, in my opinion, that the guiding thought
of the Serbian authorities was to obtain as much of the much-needed
clinical help as possible" [5:237-8]. The basis was seen: "Hospital
conditions were indescribably poor; overcrowded, without any
sanitation plan; without disinfection measures..." The urgent need
was for beds, mattresses, bedding, pajamas, clothing for a mass of
15,000 infectious patients [5:99]. The summary would be: "The state
in hospitals was overcrowded and shockingly unhygienic" [5:238].
Other reasons were present: poverty, untimely provision of money,
total war, etc.
The English Royal Sanitation Mission of Dr. Hunter proposed measures
in nine points, including the use of the "improvised autoclave": a
wooden chamber placed above a boiler. A stationary fire heats the
water (principle of moist hot air) - (Figure 1) [12]. Then they
supplemented them with a new proposal for the interruption of
passenger railway traffic [5:113,119,121].
Protich believed that Stamer's improvisation was applied in the
Russo-Japanese War of 1905 [14]. Dr. Genchic appointed him as the
representative of the Serbian sanitation during the testing of
Stamer's improvisation. An order was issued for the production of
these chambers at the Military-Technical Institute (VTZ) in
Kragujevac [5:219]. The next change was proposed by Stamer: a metal
barrel was used instead of a wooden crate, so this was the
definitive variant of the improvisation made by VTZ, known as the
"Serbian barrel" [12].
Image 1. Left: The furnace used in Japan in 1905
(found according to Dr. Đ. Protić's references) [12:104]; Right:
Sketched prototype of Stamer's proposal for an improvised autoclave
made of wood: a) box (drawn) and b) "barrel" (notated) [12:101
Upon arrival, Dr. Hunter was briefed on the preceding events of
the epidemic. As these activities in 1919 are partially depicted,
predominating are the pieces of information about the epidemic's
growth, while activities of the Serbian sanitation to resist the
infection are unknown to him.
Assessments of the success during the war - The assessment from 1915
is "astonishingly thorough," although unofficial. Primarily, it
referred to Hunter's work in Mladenovac. The route from the war zone
of Valjevo led by narrow-gauge railway to Mladenovac. Other traffic
was not functioning. In Mladenovac, Hunter implemented a
disinfection station: quarantine and a cleansing center (bathing and
delousing), as well as treatment by bringing in mobile hospitals
(under tents). The progression of the epidemic was successfully
halted by traffic bans and finding ways to protect healthy soldiers
from typhus spreading from Valjevo, known as an "epidemic focus"
[15]. The Serbian sanitation also had its judgment about the
significance of Hunter's team's work - expressed by the chief. It
wasn't just courteous, but more than that - a substantial
assessment, which would be agreed upon today.
On May 25 (June 7), 1915, Colonel L. Genchic sent a congratulatory
letter to Dr. Hunter for leaving Serbia and embarking on a new task:
"Although you and your mission have worked only for a short time,
exceptional results have been achieved. The assistance your mission
provided us in every aspect, under your experienced leadership, will
stand at the forefront of all the foreign aid we have received in
this war... (emphasized, GC)" [5:248,251]. This assessment did not
differ from Dr. Vuksic's assessment expressed in 1989 and was not
sufficiently emphasized.
These commendatory assessments debunked the assessment from 1925
about the importance of warmer weather. Consequently, the decisive
activity of the doctors was supported, justifying the proper
awarding of honors to members of the English Royal Mission.
[16:735].
Figure 2. Decorations of Serbia awarded to members
of the Medical Mission of the Royal Army in Serbia [16:735]
The assessments of Hunter's contribution are commendable, but
domestic successes have been neglected.
Dr. Subbotić's work was published in 1918. Hunter, in 1919, does not
cite this work, although it was presented in English. In his
published presentation, he mentions his "underground stove," as well
as the use of other chambers with warm dry air and bathing
facilities. This seems inadequately emphasized, somewhat clumsily
expressed. This is not the case when he points out the advantage of
the dry chamber compared to the "Serbian barrel." He also discusses
the endemic nature of typhus and the possibility of its importation
from neighboring countries such as Albania and Bosnia. Initially,
differential diagnosis of typhus posed difficulties.
It is interesting to note the participation of the Berry couple in
the discussion, who were in Serbia during the epidemic. The use and
description of the chamber with warm dry air, similar to a dugout,
is highlighted more clearly than what Dr. Subbotić did. This was
first seen and presented in Russia. Supported is also Dr. Subbotić's
experience that a deloused patient is non-infectious to the
surroundings, and the procedure is outlined as to how this
conclusion was reached when the disease is discovered among
hospitalized patients [4:38-9]. This is significant evidence that
the human body is crucial in transmitting the causative agent of
typhus, thus supplementing Nikolay's observations based on
experiments on monkeys.
Chapter on the engagement of Serbia's sanitation in combating
epidemics will be explored through questions:
a) experience with freckles before the 1915 epidemic;
b) the importance of a mild climate, warm weather, on stopping the
epidemic;
c) the interrelationship between the actors of the writers (1925),
Hunter (1919) and Subbotić (1918).
The essence of the necessary reorganization of Serbia's sanitation
was different from the perspectives of the actors. General
preventive measures were insufficient. They had to be replaced by
"specific measures". The strategy for combating typhus was
deliberation. This insight is valuable for the future Nobel Prize
awarded to S. Nikola. Dr. Genčić personally contributed to this
direction of Serbian sanitation, as seen in his address to Vojvoda
Putnik on January 15 [3,12]. Dr. Subbotić elaborated on the reasons
why a certain number of actors did not consistently accept that lice
transmitted typhus [4:38]. They could not consider delousing useful
for either the sick or the healthy – it just needed to be proven or
accepted as having epidemiological significance. So, until then,
they were just pests to be removed like any other dirt (unhygienic
condition).
At the beginning of the epidemic, a set of facts was noticed that
contributed to the spread of typhus. The first is essential: typhus
was an unknown disease in medicine. There was a lack of tactical
means for mass use. The second fact builds on the previous one,
namely the "conditions for the development of such a massive
epidemic created by a severe war."
Chapter on the engagement of Serbia's sanitation in combating
epidemics will be addressed through questions:
a) Experience with typhus before the epidemic of 1915 - Borjanović
in his thesis in 1977 believes that "typhus in Serbia before the
First World War was not a health problem, as there were no endemic
foci of this disease." He declaratively states the existence of
typhus in 1836 in Kragujevac, the then capital of Serbia, without
offering arguments on how it was recognized [17:193]. Thus,
ambivalence is spoken about the endemicity, as much as it existed,
as it was not [18].
It was believed that typhus in Serbia persisted in a chain of acute
cases in specific groups. That it "... appeared only among Gypsies
without a permanent residence and in a few cases in prisons" [19].
Criticism was raised due to one-sidedness, for supporting only the
teaching that preceded the establishment of the existence of
recurrent typhus, "for which explanations had to be found," such as
permanent beds [18]. Such an approach was not taken by Dr. Kuzelj.
He was more correct as he was more biological, insisting on
similarities among people rather than differences.
The occurrence of the epidemic among guardsmen in 1836 in Kragujevac
has not been studied more studiously. Therefore, it has not been
proven which "typhus" was present; or if a type was specified,
arguments were not given for such naming [18]. The typhus that
appeared in the Topčider prison in 1906 was not even described, so
crucial judgments as experience were not drawn [20]. There was also
double reporting of the disease. Official statistics collected data
recorded by priests in death books. Until the end of the First World
War, combating infectious diseases fell within the jurisdiction of
district, county, and city doctors – physicans [21:17]. Physicians
sent their reports on the movement of infectious diseases to the
Ministry of Health, Sanitary Department. This issue was "resolved"
by wartime events. In 1913, the last annual report for 1907 and 1908
was published [22,20,23], while for 1909 and subsequent years they
were not even published..
b) Mild climate, spring, warm weather - During the Balkan Wars, the
experience was: "...During the winter of 1912/13, when our Serbian
Army units crossed Albania to the sea and reached Durrës... the
first cases of this disease appeared among them and became much more
frequent than in other units. Deaths were not lacking. At first, we
attributed them to fatigue, exhaustion, and shortages, but soon it
was noticed that we were dealing with a very characteristic disease
face to face with an enemy previously unknown to us. These were
typhus and relapsing fever, two diseases endemic in Albania. The
number of those who contracted these diseases was relatively small;
only a relatively small number of doctors knew about them. As soon
as the weather became nice, these diseases disappeared on their
own." [24:3; 4:32].
It is noted that the spread of typhus is contributed to by its
difficult detection, differential diagnosis with other diseases or
conditions. It was emphasized: fatigue, abdominal typhus, etc. This
is what doctors in contact with patients in basic units had to pay
attention to, and it is important for the entire sanitation.
Antic states how the "authorities" who did not spare us with
countless "orders" missed to inform us of one similar order,
ordering us to know that soldiers spread typhus. There is no doubt
that there was such a conviction among doctors, as well as among the
rest of the army, that the number of victims of typhus in the army
and among the people would have been significantly lower. [25:322].
Antic believed that the epidemic was stopped by the arrival of
spring, naturally; and not by the influence of measures [25:319].
Like Subbotić, Antic also points out that there were doctors who
doubted the correctness of the truth that soldiers spread typhus.
According to him, neither Dr. Hunter believed in all of this, as he
wore a handkerchief instead of a protective mask, thus showing that
the transmission of the typhus pathogen is possible through the air.
But, others also thought the same. In the article "Serbia, Land of
Death," Reid described Serbia as: "...the land of typhus -
abdominal, relapsing fever, and mysterious and cruel typhus (in
English, he is "typhus"; and "typhoid" is abdominal, G. Ch.), which
kills fifty percent of its victims and whose bacillus had not yet
been found by that time. Most doctors thought that it was spread by
white lice, but a lieutenant of the British Royal Army Medical
Corps, who traveled with us, was skeptical. I was there for three
months - he said - and I have long ceased to take any precautionary
measures except for daily bathing. And as for lice, a man gets used
to spending a pleasant evening brushing them off one by one... The
truth about typhus is this: no one knows anything about it, except
that one-sixth of the Serbian people died from it... Warm weather
and the cessation of spring rains had already begun to stop the
epidemic - and the virus weakened. Now there were a hundred thousand
sick people with typhus in the whole of Serbia and only a thousand
deaths per day - except for cases of horrible typhus gangrene."
[26,9].
Events in the Great War were memorable and unforgettable. In a
commemorative brochure reflecting on that time, it was noted: "The
epidemic of typhus in Serbia, which during the First World War
placed us in an unfavorable position in the history of medicine,
could not be thoroughly studied or described... Today, there are few
doctors in life who served in the sanitation service of Serbia
during the First World War, but those last witnesses of the great
typhus epidemic of 1914 and 1915 still vividly remember the sudden
appearance and dramatic spread of this serious disease among the
ranks of soldiers and civilian population. The catastrophic
consequences of that epidemic left a mark in their memories as one
of the most painful events of that difficult time. Typhus was
introduced by the Austrian army and masses of enemy prisoners from
Bosnia into Serbia, where all the conditions for the development of
such a massive epidemic were created by a hard war." [20:34]. With
the departure of the actors from the world stage, Serbian doctors
were supposed to complete the description of the "typhus epidemic in
Serbia".
From the foregoing, it can be seen that in Serbia, in peacetime, the
people's activities prevented typhus from becoming a problem that
imposed itself with its special significance. At the beginning of
the epidemic, it persisted because it was difficult to diagnose. It
was believed that "typhus, as it came, would also go", spontaneously
without major casualties. Experience provided evidence that typhus
would not be a bigger problem, and those rare cases (sporadic ones)
would incapacitate by the first spring [12:19]. In the archives of
the sanitation department of the Supreme Command, evidence
supporting such thinking was not found. Contrary to this...
Memories from 1925 indicate that such expectations prevailed among
physician writers, as seen in their final conclusion explaining the
end of the 1915 epidemics: due to the upcoming warm season, they
ceased naturally, rather than through undertaken efforts to combat
them [12:29,135].
Capur is probably closest to the truth as he believes in 1875 that
the medical personnel's imperfections stem from "a lack of patience
and perseverance for deeper and more thorough immersion in certain
matters, or specific fields... This is a common occurrence among
people taking their first steps towards cultural development. They
simply don't yet have the need to be thorough scholars. Practical
knowledge, useful for their current needs, is entirely sufficient
for them at first" [11:49]. Serbian doctors were aware of these
facts. They advocated for the establishment of a medical faculty.
Poor personnel preparedness was emphasized not only in terms of
quantity but also regarding specialization. Trouble ignites a spirit
whose scope is difficult to measure accurately in wartime
conditions, with the presence of a not insignificant number of
"scientific unknowns."
Unlike the stance of the actors, Dr. Genčić, with the Infection
Control Commission at the Supreme Command, as well as the State
Committee for Infection Control, advocated for undertaking
activities that respected the body's resilience. The only question
was - how to manage them. Dr. Subbotić pointed this out in 1916
[24], which was published in 1918 [4].
c) The interaction between the actors, the writers (1925), Hunter
(1919), and Subbotić (1918), shows that Dr. Hunter acted as a
scientist, which simultaneously connected him to the history of
medical science. He commented on the scientific contribution arising
from improvisation: "The problem of providing a simple and effective
method of disinfection, accessible to everyone and for the needs of
the railway, has been solved, not only now, but for all times
(emphasized by V.H.)." [5:248]. Therefore, the "Serbian miracle"
emerged. With such actions, there were conditions that could provide
a solution, which Dr. Hunter utilized as an organizer. Dr. Subbotić
also acted in this direction, solving the impotence through
improvisation, offering his "buried stove" (for dry warm air)
[4,12]. (Figure 3)
Image 3. Distinguished doctors (left) Official
Military Gazette. (35) No. 16 dated 08.06.1915. p. 328. and (right)
Official Military Gazette. (35) No. 15 dated 04.06.1915. p. 315-6.
Serbian medical services did not emphasize their scientific
contribution. Patriotic and military virtues were valued, and
military awards were received for them. Stammers was also promoted
[26,5], and Serbia honored him. (Figure 2). The great efforts of
Serbian doctors were respected, demonstrating selflessness and
dedication to the Serbian soldier (Figure 3 and 4). Improvements in
the Serbian army followed the same year.
Dr. Hunter also acted as a scientist. He published his contributions
in The Lancet and in a monograph on typhus in Serbia [12]. His
achievements were recognized by the British community, and he was
awarded an honorary doctorate.
Hunter and Subbotić mention the buried stove in their works in its
most primitive initial form, when it did not represent anything
significantly preventive [5:106; 12]. Subbotić points out the
applied teachings of Nikola in the Great War, but not in the
Balkans. They indicate that Nikola's hypothesis needed to be proven
because practice imposed misunderstandings. They sharply point out
problems that were later proven as hypotheses: that the unknown
cause of typhus "is not transmitted only by flea bites," as was then
believed, but that it can also occur through other means, such as
inhalation or contact with "dejecta and vomitus." They mention the
experience of disinfection in hospitals, which is insufficiently
emphasized in the literature about the year 1915. Disinfection was
performed using sulfurization, as was routine in Serbia before the
war, and systematically during the war in Valjevo, according to the
instructions of Hirschfeld, Pecić, and Savić [6]. They present their
observations, which are more interesting to surgeons, regarding the
frequency of typhus complications that require surgical
intervention, such as "parotitis," gangrene, etc.
The authors in 1925 were deeply influenced by emotions for a long
time. In support of this, there is a retrospective in the jubilee
memorial book of 1969, where the prevailing current rationale of the
actors is still presented. Checking the attitudes was as much in
line with major discoveries: the awarding of the Nobel Prize in
1928, or the hypothesis of the existence of late relapse of typhus
in 1934. Also significant was what was written about the same
events, especially before the publication of the memories of 1925:
Hunter's work from 1919 was not considered, nor what Subbotić and
Strongitd published.
There are assessments of the "unenviable position of the medical
service," as well as criticism of the chief's "management of the
medical service," despite Dr. Stanojević only considering it as
"unexplored." It is noted that the public debate began in 1921, and
the question was reopened in 1925 that "our medical experience,
however, remains unexplored to this day" [1:foreword]. The
unexplored nature was directed through the mortality, and therefore,
the culprit for its occurrence was sought...
In the considerations of 1989, the medical historian Dr. Vukšić
clearly expressed disagreement with Dr. V. Stanojević as the editor,
and he explained this. In evaluating Hunter's work, Vukšić did not
differ from Genčić; both emphasized - the success of Hunter's
mission was emphasized. The collaboration between Dr. Hunter and Dr.
Genčić is enough to assess the successful engagement of the Serbian
medical service. But it should be noted that Dr. Nedok proves the
existence of archival material. Based on the documentation found,
which he considered the final report of Dr. Genčić, the suppression
of the epidemic occurred. Therefore, in addition to Dr. Hunter, Dr.
Vukšić, and Dr. Nedok consider the assistance of medical teams that
came to Serbia as crucial. This leaves unaddressed the assessment of
Dr. Hirschfeld, which obviously does not refer to Dr. Subbotić's
"buried stove" because of its modest capacity but rather to the most
significant activity of the Serbian medical service, described by
the words: "Serbian doctors, with superhuman effort, without means
and assistance, began to organize, or rather to improvise devices
for dry disinfection, achieving more than all foreign missions
combined." [27].
If we accept the fair assessment of Dr. Hunter's work and consider
the contribution of the Serbian medical service in proportion to its
involvement, along with the correct attitude of Dr. Genčić as the
leader, then it becomes evident that Serbian doctors deservedly
received the mentioned honors for their patriotic and professional
actions in 1915 (Figures 3,4). This is confirmed by the studies of
Vukšić, Nedok, Zorić, Stanković, Čukić, and others.
Picture 4. Decorated doctors. Official Military
Gazette. (35) No. 15, June 4, 1915, p. 293-4.
The Chief's actions were manifested in several ways as correct:
a) as a physician, he offered a correct solution consisting of
applying Nikolov's teachings, by determining a good strategy for
disinfection, for which he proposed factory-made autoclaves; b) as
the chief, i.e., the leader, he supported all those who offered
arguments that their stance was valid, including doctors (domestic:
Subbotić, Batuta, etc., foreign: Hunter, Morrison, etc.) and the
State Committee for the Suppression of Contagious Diseases, headed
by Eng. Vuković; c) he highlighted proactive individuals (e.g.,
Infantry Major Sretenović); and d) in the Supreme Command, he
founded the Commission for the Suppression of Contagious Diseases,
which made a significant contribution by publishing brochures and
numerous other activities [12]. The contribution of Serbia's medical
service in 1915 was significant for world medicine [28].
Although the list of honorees was not final, among them were: 4
sanitary generals; 12 brigade generals; 13 colonels, who could be or
were the heads of the highest rank, such as sanitary chiefs; then,
senior officers - 4; other distinguished doctors who continued their
careers in civilian life (academics, faculty professors, civilian
sanitary chiefs, ambassadors, physicists, specialists, etc.) - 12.
This group engaged in the suppression of epidemics in 1915 provides
a general assessment that the honored were successful war doctors
who overcame all the wartime trials and were the backbone of
Serbia's medical service.
Dr. Genčić, although "criticized," remained spiritually strong,
considering himself "neither guilty nor obligated" because of his
contributions, for which others were honored with exceptional
recognition [8]. The recipients of the same honor include: Tesla,
Pasteur, Batuta, voivodes. Undoubtedly deserving and recognized, Dr.
Hunter received the same honor (Figure 2), having successfully
collaborated with Dr. Genčić. The highest-ranking honor awarded to
Dr. Genčić in 1929, as the head of the medical service in 1915,
ranks him among successful citizens, about whom their homeland must
care.
CONCLUSION
• There is no foundation found for the assessment by the medical
historian - actors from 1925 that the suppression of the 1915 typhus
epidemic was generally unsuccessful and that the epidemic stopped on
its own, naturally.
• It has been proven that through the work of Dr. Hunter's mission
with the engagement of the Serbian medical service and other foreign
missions, the epidemic was suppressed. Therefore, English and
Serbian doctors rightfully received their honors in 1915.
• Dr. Genčić deserves a reevaluation of the publicly stated
assessment that his work was "criticized." Such an assessment is
scientifically unfounded. There are oversights by critics who did
not give importance to the results of the Serbian medical service,
which are of particular significance to the world of medicine.
• The existing archival material must be studied in more detail.
Whether Dr. Genčić's address to Voivode Putnik on January 15, 1915,
was his last, the reason for it, and Dr. Hirshfeld's assertion, are
separate topics.
LITERATURE:
- Stanojević V, urednik. Istorija srpskog vojnog saniteta,
Naše ratno sanitetsko iskustvo (1925, prvo izdanje), VIC,
Beograd, 1992.
- Vukšić Lj. Istorijski osvrt na prestanak pegavca (Typhus
exanthematicus) 1914-1915. godine u Srbiji, Arhiv za istoriju
zdravstvene kulture Srbije, Beograd, 1989; 1-2, 18:45-57.
- Nedok A. Tri pisma načelnika sanitetskog odelјenja Vrhovne
komande pukovnika Dr Lazara Genčića načelniku štaba iste vojvodi
Putniku o stanju, problemima i radu saniteta operativnih
jedinica i podređenih bolnica tokom ratne 1914. godine (sa
komentarima).800 srpske medicine, Zbornik radova, Beograd: SLD;
2014;13-29.
- Soubbotitch V. A Pandemic of Typhus in Serbia. Proc R Soc
Med. 1918;11(Sect Epidemiol State Med):31-9.
- Hanter V. Epidemije pegavog tifusa i povratne groznice u
Srbiji 1915. godine. (prevodilac: M. Grba), Novi Sad: Prometej;
2016.
- Čukić G. "Ocena" Dr Milana Pecića za suzbijanje epidemije
pegavca u vojnoj zoni Valјeva 1915. godine. 13. naučno-stručni
skup, Arhiv Zaječara, 2022. (Zbornik je u pripremi)
- Čukić G. Nikolovo istraživanje i naši lekari. U: Tokovi,
Berane; 2019(2):27-41.
- Čukić G. Rotacija u srpskom sanitetu 1916. godine. Arhivsko
nasleđe. Arhiv Zaječar. XV (15):89-112.
- ČukićG. Golgotaimedicinskaepopeja 1914/1915. godine ("Specijalnaepidemiologijapegavca"
između 1909. i 1919. godine). Timočki medicinski glasnik. 2007;
4 (32):194-204.
- Čukić G. Defetizam u epidemiji pegavca 1915. godine i
njegovo rušenje. U: 800 godina srpske medicine, Novopazarski
zbornik 2019. Beograd; 2020;581-604.
- Kaper S. O Crnoj Gori. Podgorica; 1999.
- Čukić G. Srpska prevencija pegavca 1915. godine. Zaječar
2018.
- Srpsko lekarsko društvo, Spomenica 1872-1972, Beograd :
Srpsko lekarsko društvo. 1972.
- Protić Đ. „Srpsko bure“. Vojno-sanitetski glasnik.
1933;(4):198-205.
- Grba M. Nastanak, širenje i suzbijanje epidemija tifusa u
Srbiji 1914-1915. U: Hanter V. Epidemije pegavog tifusa i
povratne groznice u Srbiji 1915. godine. (prevodilac: M. Grba),
Novi Sad: Prometej. 2016;11-79.
- Serbian Orders of the Royal Army Medical Corps Mission to
Serbia. The Order of St. Sava, British Medical Journal, War
notes, May 20, 1916.
- Borjanović S. Epidemiološka studija pegavca u Srbiji i
mogućnost njegove eradikacije (doktorska disertacija). Beograd:
Medicinski fakultet. 1977.
- Čukić G. Čemu nas uči prošlost pegavog tifusa. Berane:
Centar za kulturu Berana; 2016.
- Todorović K, Žarković B. Akutne infektivne bolesti sa
epidemiologijom. Beograd: Institut za stručno usavršavanje i
specijalizaciju zdravstvenih radnika, 6. izdanje. Beograd; 1972.
- Čukić G. Epidemija pegavog tifusa u Topčiderskom kaznenom
zavodu 1906/7. godine. U: Zbornik radova sa XII naučno-stručnog
skupa Istorija medicine, farmacije, veterine i narodna
zdravstvena kultura, održanog 2021. Knj. 11. Zaječar;
2022;45-66.
- Spomen knjiga Zavoda za zdravstvenu zaštitu SR Srbije. 50
godina higijenske službe i socilanomedicinske službe i 120
godina preventine medicine u Srbiji, Beograd: Zavod za
zdravstvenu zaštitu SR Srbije; 1969.
- Uprava državne statistike. Statistički godišnjak Kralјevine
Srbije, 1907., 1908. Beograd, 1913.
- Čukić G. Narodni nazivi za tifuse na području Toplice (Imenovanje
– „tifusa“). U: Zbornik radova sa XI naučno-stručnog skupa
Istorija medicine, farmacije, veterine i narodna zdravstvena
kultura, održanog 2019. Knj. 10. Zaječar; 2021;191-217.
- Subbotić V. O pegavom tifusu u Srbiji. Međusaveznička
sanitarna konferencija u Parizu 15.03.1916. Muzej nauke i
tehnike, Zbirka Muzeja srpske medicine Srpskog lekarskog društva,
(MNT.T:11.7.1546) Ministarstvo vojno, Sanitetsko odelјenje, Pov.
br. 1625, 25.04 1916., Krf, Muzej SLD, Beograd.
- Antić D. Pegavi tifus u kragujevačkoj Prvoj rezervnoj vojnoj
bolnici. U: Stanojević V. Istorija srpskog vojnog saniteta, Naše
ratno sanitetsko iskustvo (original 1925). Beograd: VIC. 1992;
314-28.
- Rid Dž. Rat u Srbiji 1915. Cetinje; 1975.
- Hiršfeld L. Istorija jednog života. Beograd: Srpska
književna zadruga (knj. 377). 1962;56-7.
- Čukić G. Doprinos srpskog saniteta medicini sveta 1914/15.
godine. Glasnik javnog zdravlјa. 2023;97(2):233-49.
|
|
|
|
