“There are two ways of spreading light: to be the candle or the mirror that reflects it.”

Edith Wharton

Internal medicine: the birth of the queen of medicine

Internal medicine emerged as a medical specialty in the second half of the 19th century. Some suggestions of dividing clinical medicine into conservative and surgical domains date back to antiquity. Homer in his Iliad mentions 2 sons of Asclepius: Podalirius or Podaleirios (Ποδαλείριος), who healed with herbs and was applying medicinal leech therapy, and Machaon (Μαχάων), who was a surgeon.1 Podalirius was even considered the ancient god of internal medicine.2 The term “internal diseases” (innerliche Krankheiten) was first used by Paracelsus (Phillippus A.T.B. von Hohenheim, 1493 or 1494–1541) in 1528.1 However, internal medicine as a medical specialty emerged many years later. It was preceded by the development of nosology, a branch of medical science that deals with the classification of diseases. The most important founder of nosology was a great English physician, Thomas Sydenham (1624–1689). He described a variety of distinct diseases based on symptoms, signs, and other clinical observations. Later, a French physician François B. de Sauvages de Lacroix (1706–1767) published the first classification of diseases based on symptomatology. These findings were expanded by descriptions of new disorders based on careful observations. In 1761 in Vienna, Leopold Auenburgger (1772–1809) introduced percussion, and in 1816 in France, René T.H. Laënnec (1781–1826) invented the stethoscope and introduced auscultation to medical practice.1 The introduction of percussion and auscultation provided for the first time the possibility of inferring pathological changes in the internal organs. This was supported by laboratory studies in the field of the newly developing clinical chemistry leading to novel functional tests.3 Advances in physiology allowed for partial understanding of the mechanisms of the internal organ work. At the same time, general and cellular pathology linked the abnormalities found during autopsy with the clinical course of the disease. All these allowed for the creation of a new paradigm of diagnostic and therapeutic approach, and the emerging internal medicine was much more than just another medical specialty. The new paradigm of internal medicine has moved away from a descriptive approach to a disease to pathophysiologic inference based on physical examination, medical history, and many additional tests, and internal medicine became the first medical specialty based on the presumed pathomechanism of a disease. In the face of centuries-old traditions of descriptive and speculative medicine, it was a huge breakthrough in medical knowledge. The discoveries of bacteriology and immunology, along with development of imaging techniques initiated by the discovery of X-rays by Wilhelm C. Röntgen (1845–1923) allowed for a rapid and progressive growth of internal medicine.4

The term internal medicine is an English equivalent of a German term “innere Medizin.” In the United Kingdom and Commonwealth countries, the term “general internal medicine” or “general medicine” or “medicine” is used.5,6 The Association of Internal Medicine was founded in Berlin on February 8, 1880 by Erns V. von Leiden (1832–1910), Paul Boerner (1845–1915), and Friedrich T. von Frierichs (1819–1885).1 The last one was elected the first president of the society. The First German Congress of Internal Medicine was organized in Wiesbaden in 1882, and was continued annually. A few Polish physicians attended most of the German Congresses of Internal Medicine.7

The International Medical Congresses have been held every 2 or 3 years since 1867. The Tenth Congress was held on August 4–9, 1890 in Berlin. During this congress, internal medicine sessions were organized for the first time. Polish physicians took part in the Congress, and Antoni W. Gluziński delivered a lecture. Unfortunately, Poles, despite many years of efforts, did not have the opportunity to participate in the congresses as a national group. Most countries had their national committees. Poles could only participate in the national committees of the partitioning countries.7-9

The oldest mention of an initiative to establish a society dates from July 20, 1891, and it is a proposition of Edward J. Sas-Korczyński (1844–1905) presented during the 6th Congress of Polish Physicians and Naturalists in Kraków. He suggested organization of annual conventions of Polish internists, and declared: “Medical sciences, especially internal medicine, advance so quickly that a need to organize conferences devoted to this limited field only becomes greater and greater. Such conferences organized abroad are very popular. They contribute to the development of research and discussions during the meetings, and help to find the best directions for further investigations. Polish internal medicine is at a level comparable to other countries and needs more time at conferences to present its results. It is evidenced by a number of papers on internal medicine delivered at this Congress (ie, the 6th Congress of Polish Physicians and Naturalists), but also by a number of papers which were rejected due to limited time of the sessions. Thus, I suggest organizing the annual conference of internal medicine to be held in Kraków.” For this purpose, Edward J. Sas-Korczyński proposed to create a “permanent committee of such conferences.” A preparatory committee was set up at that time.10-12 The committee consisted of Antoni W. Gluziński, Oskar Widmann (1839–1900), Franciszek Chłapowski (1846–1923), Teodor Dunin (1854–1909), Alfred Sokołowski (1849–1924), and Kazimierz Bętkowski (dates unknown). The activity of the committee remains poorly described.13 In 1900, the 9th Congress of Polish Physicians and Naturalists decided to add, from the next congress, a separate section on internal medicine. In 1906, preparations for the organization of internal medicine sessions began and this year is considered the year of founding of the Society of Internists of the Polish Lands. The authorities of the partitioning countries did not agree to the name Polish Society of Internal Medicine. The initiator and tireless animator of the Society’s work in the years 1906–1925 was Antoni W. Gluziński.14,15 The Session of Internal Diseases of the 10th Congress of Polish Physicians and Naturalists, organized in 1907 (Lwów, now Lviv, July 22–25, 1907), was considered the first de facto congress of the Society. Until 1914, 4 meetings of the Society of Internists of the Polish Lands were held. In the years 1906–1914, the Society brought together doctors of internal medicine from all Polish territories, primarily from the area of the Austrian and Russian partitions. The number of members was about 100 to 150 people. After the World War I and the Polish–Soviet war, the 5th Congress was held in Vilna on July 8–11, 1923. The name Polish Society of Internal Medicine was introduced, the statute was changed, and the publication of Polish Archives of Internal Medicine (Polskie Archiwum Medycyny Wewnętrznej) was launched. From the first issue, the journal bore the subtitle Journal of the Polish Society of Internal Medicine. In the introduction, Antoni W. Gluziński, the editor of the first volume, defined the purpose of founding the journal. It was to promote and preserve (hence the name “archive”) the best works in internal medicine.16

In the years 1923–1939, the journal was published as a quarterly. The editors-in-chief were Antoni W. Gluziński (1923–1925), Władysław Janowski (1925–1928), and Witold E. Orłowski (1928–1939). All outstanding Polish internists published in Polish Archives of Internal Medicine. For example, apart from the editors-in-chief, we can mention Jerzy Latkowski, Tadeusz Tempka, Zdzisław Górecki, Kazimierz Rzędkowski, Wincent Jezierski, Jan H. Lubieniecki, Aleksander Januszkiewicz, and Zenon Orłowski. They represented all medical faculties from Kraków, Warsaw, Lwów, Vilna, and Poznań. The outbreak of the World War II interrupted publication of the journal. The planned 13th Congress of the Polish Society of Internal Medicine in Katowice in September 1939 did not take place.

After the war, the journal publication was resumed. The editors-in-chief were Witold E. Orłowski (1948–1949), Andrzej Biernacki (1949–1963), Tadeusz Orłowski (1963–1996), Artur Czyżyk (1996–2008), and Anetta Undas (since May 2008).17,18 In the post-war period, the journal was published by the Medical Publishing Institute, which was transformed into the State Medical Publishing House. From 1993 to 2007, the journal was published by the Polish Society of Internal Medicine, and since 2007 the publisher has been Medycyna Praktyczna in Kraków.19 In 1955 the journal was published bimonthly, and since 1956 as a monthly. Since 2008, the journal has been published only in English. It was renamed Polish Archives of Internal Medicine (with English title only) in 2017.17

Two editors-in-chief of Polish Archives of Internal Medicine, Antoni W. Gluziński and Witold E. Orłowski, deserve special attention, as they were the founders of great Polish schools of internal medicine. Disciples and successors of these schools and followers in consecutive generations currently work at all medical universities in Poland and many centers abroad.

Antoni W. Gluziński, spiritus movens of Polish Archives of Internal Medicine

Antoni W. Gluziński (Figure 1) was one of the best known Polish physicians in the world at the turn of the 19th and 20th century. He was born on May 18, 1856 in Włocławek. He was a son of a physician Franciszek M. Gluziński (1823–1899) and Valeria Gluzińska née Szarle. Valeria Szarle was a daughter of a French military physician who stayed in Poland after the Napoleonic war. Her surname was a phonetic form of the French name “Charlais.” Antoni W. Gluziński was given the first names Władysław Antoni but he used his middle name, Antoni (with or without Władysław). After the primary school in the city of Konin, he graduated from the Saint Anne’s Secondary School in Kraków and later from the medical faculty at the Jagiellonian University. As many great internists, he combined research in clinical medicine with basic medical sciences. He carried out research at the Department of Pathophysiology. In 1885, Antoni W. Gluziński obtained habilitation in pathology and therapy of internal diseases. He was granted a title of an associate professor (1890) and then a full professor (1893). He was the head of the Department of General and Experimental Pathology at the Jagiellonian University (1893–1897). He received training in the famous bacteriological institute of Robert Koch in Berlin.

Figure 1. Antoni W. Gluziński (1856–1935): editor-in-chief in 1923–1925 (photograph courtesy of the National Digital Archives in Warsaw, Poland)

Antoni W. Gluziński moved to Lwów in 1897, and assumed a post of the head of Department of Internal Medicine. In a short time, his department became a leading center of medical sciences. He took part in the university life, was elected the dean of the medical faculty (1898–1899), and received the post of rector magnificus (1905–1906). He was considered the best Polish internist. After Poland regained its independence, Antoni W. Gluziński was invited to the Warsaw University. He moved there in 1919 and became the head of the Department of Internal Medicine. He was also the dean of the medical faculty (1923). Antoni W. Gluziński died in Warsaw on April 10, 1935.

Research achievements of Antoni W. Gluziński are enormous. His main interest was gastrology but his investigations focused on several other fields of internal medicine. He studied pathophysiology of the stomach and introduced a test known as “the Gluziński test” (1902), applied for a few decades in differential diagnostics of stomach ulcer and cancer.20,21 Antoni W. Gluziński and Walery Jaworski discovered that the digestion of proteins takes place in the intestine and not in the stomach, as it had been believed earlier.22 They found out that hydrochloric acid of the stomach does not derive from lactic acid action on chlorides.23,24 Antoni W. Gluziński published a book on fevers, and was a co-author of the first Polish handbook of internal medicine. In 1907 he, together with Marek Reichenstein published the first in the world medical literature clinical description of plasmocytic leukemia.25 This paper is cited even today in medical publications.26-28

Antoni W. Gluziński was the founder and president of the All-Slavic Congresses of Physicians. He also was the first chairman of the Committee to Investigate Rheumatism transformed later into the Polish Society for Rheumatology. Among his followers were Juliusz Marichler, Roman Rencki, Marian Franke, Włodzimierz Filiński, Zdzisław Górecki, or Jakub Węgierko.

Witold E. Orłowski, a father of modern Polish internal medicine

Witold E. Orłowski (Figure 2) was born on January 24, 1874 in Norwidpole, the region of Borysev in the Province of Minsk. In the 19th century this area belonged to the Russian Empire. He was a son of Franciszek Orłowski, an administrator of the Polish estate Tukałły Milcz, and his wife Paulina Orłowska née Ochinimowska. The family moved to Vilna in 1891, and there Witold E. Orłowski graduated with a gold medal from the secondary school. During the school years, he worked as a private tutor. After graduation, he entered the Military Medical Academy in Saint Petersburg. It was his only opportunity to receive medical education with state scholarship. In November 1896, he graduated with honors and received the Ivanov Award. Still a student, Witold E. Orłowski authored a book of lectures on internal medicine delivered by professor Nil Ivanovich Sokolov (1844–1894). The book was prepared together with Witold’s brothers, also students of medicine, Zenon and Mścisław. Witold E. Orłowski received further medical training in bacteriology (under the supervision of professor Sergey Petrovich Botkin, 1832–1889) and physiology (under the supervision of professor Ivan Petrovich Pavlov, 1849–1936). Later, he held an unpaid position at the University Hospital of Internal Medicine in Saint Petersburg (1896–1907). He worked under professor Fedor Ignatevich Pasternatskiy (1845–1902), a famous bacteriologist. In 1900, he was granted the title of a doctor of medicine upon presentation of a thesis entitled “On the problem of bacteria-killing and uric acid solubilization of urotropine and its therapeutical application in patients with inflammation of the urinary bladder.” Since 1895, during summer months, he was working in the Caucasian health resort Yessentuki located in the shadow of the Mount Elbrus. In 1903, Witold E. Orłowski received the title of an associate professor upon presentation of a so-called habilitation thesis. His further professional carrier was associated with the Kazan University. On March 15, 1907, he was elected an associate professor of internal medicine at this university. A few years later, he became the head of the Department of Internal Medicine (April 29, 1912), and a year later, he was granted the post of a full professor.29

Figure 2. Witold E. Orłowski (1874–1966): editor-in-chief in 1928–1939 (photograph courtesy of the National Digital Archives in Warsaw, Poland)

Witold E. Orłowski was very active in the circles of Polish emigration in Russia. He was a cofounder of the Association of Polish Physicians in Saint Petersburg, and served as a scientific secretary of the association. He published a paper on the need of teaching Polish in Russian schools in the areas inhabited by Poles. The paper appeared in a progressive Russian journal Rossiya. During the World War I, he was a member of the Executive Board of the Kazan Division of the Committee for Assistance to War Victims. He protected Polish war prisoners as well as Polish schools and cultural institutions. During the 1917 revolution, he became the main manager of the Provincial Hospital for Kazan Aristocracy.30 In 1916, Witold E. Orłowski was a cofounder of Polish Medical Journal published in Kiev. In September 1918, he moved to Tomsk, and later in 1919 to Irkutsk, and he intended to organize the Faculty of Medicine and Red Cross Hospital there. While in Irkutsk, he received nomination to the post of full professor at the Jagiellonian University in Kraków. He returned to Poland and began to lecture in Kraków in January 1921. He was a founder of the Kraków Division of the Polish Society of Internal Medicine. While in Kraków, he organized 2 large physician congresses, including the First Polish Antituberculosis Congress. In January 1926, he moved to Warsaw and became the head of the department at the Saint Spirit Hospital. Two years later, Witold E. Orłowski became the head of the Second Department of Internal Medicine at the Warsaw University. He created a modern research center with a large number of pathophysiology laboratories.

During the World War II, Orłowski was involved in the underground education. The hospital was destroyed during the Warsaw Uprising, and he organized new hospitals in Brwinów and Grodzisk Mazowiecki. In 1948, he retired from his post at the university and became the head of the internal medicine ward of the Second Municipal Hospital in Warsaw. In 1956, he became the head of the Fourth Department of Internal Medicine at the Institute for Postgraduate Medical Training. He retired fully on January 1, 1961 but continued writing and editing his books. Witold E. Orłowski died in Warsaw on December 2, 1966.29-31

The achievements of Witold E. Orłowski in the field of medicine are enormous. He created a school of his followers and focused their research interest on various subspecialties of medicine. He published more than 200 papers, and his coworkers published 563 papers prepared under his supervision. His research interests involved cardiovascular and metabolic disorders as well as rheumatology. He was one of the first physicians in the world who reported a systemic nature of cardiac failure. He investigated systemic effects of acidosis. Witold E. Orłowski was an author of numerous handbooks and monographic studies. His main book was “Treatise on internal medicine”, which appeared in 8 volumes, and updated editions appeared in print to the last days of the author’s life. This was the last Polish great medical handbook on internal medicine authored by a single author.

Witold E. Orłowski was a supervisor of 33 habilitations (theses presented to obtain the title of an associate professor). Among his associates and followers were such famous Polish internists as Dymitr Aleksandrowicz, Andrzej Biernacki, Walenty Hartwig, Józef Markert, Janina Misiewicz, Tadeusz Orłowski (the son),18 Eleonora Reicher,32 Jan Roguski,33 Edward Rużyłło, Józef Rydygier, Edward Szczeklik,34 or Tadeusz Tempka.

The journal: from yesterday to tomorrow

The 20th century was the age of intense development of internal medicine. From a new specialty, internal medicine became the leading specialty and “the queen of medicine.”35,36 This resulted from progress in diagnostics and then development of disease-specific therapies. The amount of knowledge required to practice internal medicine was growing rapidly, and the specialty was soon divided into a number of subspecialties.37-40 Despite its dynamic growth and development of individual specialties, the role of internal medicine as a holistic discipline covering the diagnosis and therapy of many organs does not decrease. This is important, because a physician should always treat a patient, not a disease.

Development of subspecialties that emerged from internal medicine was associated with the foundation of new scientific societies. Most of them had roots in the specialist sections of the Polish Society of Internal Medicine. For example, the Polish Cardiac Society was initially the Section of Cardiology of the Polish Society of Internal Medicine (1950), which was in 1954 transformed into an independent society.41-43 Polish Archives of Internal Medicine supported the newly founded subspecialty societies by publication of issues focused on certain subspecialties only. A number of issues devoted to rheumatology, cardiology, nephrology, hematology, and other subspecialties were released.44-45 Additionally, proceedings of the congresses of the Polish Society of Internal Medicine were published (1925–1937, 1986–2004). Several conferences of internal medicine published their proceedings in the journal, often as special issues. Special articles on anniversaries of leading Polish internists, as well as memories of those who passed away were published in commemorative issues of the journal.

In 1973, on the occasion of 50 years of Polish Archives of Internal Medicine existence, Roman Dzierżanowski reported that in the years 1923–1972, as many as 3754 scientific papers were published in the journal.13 This number has increased significantly over the next 50 years and now it is estimated at 9400 scientific papers published between 1923 and 2022. All significant Polish internists published in our journal. The input of foreign authors is also increasing. Although most of the subspecialties derived from internal medicine already have their own journals, Polish Archives of Internal Medicine still publishes articles from all areas of internal medicine. There is also a place for publication of papers devoted to interdisciplinary topics.

Browsing the papers published years ago in Polish Archives of Internal Medicine, one can see how much the scientific tools have changed, how the style of research reports has evolved, and how significant the efforts to objectively evaluate the results are. The works from the old volumes, however, are delightfully accurate in the clinical descriptions and contain more personal impressions of the physicians examining their patients who were the subjects of scientific analysis as compared with more standardized modern manuscripts. On the one hand, Polish Archives of Internal Medicine is a common space for the presentation of the most valuable research in internal medicine. On the other hand, through the system of evaluation of submitted manuscripts and partially unnoticeable, dedicated work of editors and reviewers, it affects the scope and style of the published papers. Thus, the journal is not only the mirror but also the creator of new roads of light.

The basic concept of internal medicine, underlying the establishment of the Polish Society of Internal Medicine and its journal, has not changed since its foundation, and is continued and reinforced, even though the research methods, therapeutical strategies, and understanding of the nature of diseases have undergone huge transformations, and despite great changes in the systems of distributing scientific information.

Many thanks to all the people who have made Polish Archives of Internal Medicine successful for over 100 years, particularly the editors-in-chief, editors, reviewers, authors, and all the internists contributing to the development of our journal for their dedication and cooperation. We believe that with the zeal and high spirits carried out from the times of the founders and pioneers of Polish Archives of Internal Medicine, we will be able to conquer any problems which are today difficult to anticipate. This attitude gives us hope that the future of the journal should be bright.