© Borgis - New Medicine 3/2006, s. 65-67
Ewa Pomirska, Mieczysław Chmielik
History of rhinology in poland to 1939
Department of Paediatric Otorhinolaryngology, Medical University of Warsaw, Poland
Head of Department: Prof. Mieczysław Chmielik MD, PhD
Summary
Summary
We present the most important facts about the history of rhinology in Poland to 1939 based on sources.
Rhinology is one of the youngest fields in medicine. Otorhinolaryngology was separated from surgery and internal diseases in the second half of the 19th century.
Prominent representatives of this new speciality were working in Poland but we must remember that the Polish territories were annexed by other countries at that time. The most famous doctors were Przemyslaw Pieniążek, Antoni Jurasz senior, Alfred Sokolowski, Jan Sędziak and Jan Szmurlo. They contributed greatly to the separation of this clinical speciality from surgery and internal diseases.
Our doctors acquired the essentials of otorhinolaryngology abroad: in Austria, France, Germany and England. The first and most famous Otolaryngology Department was started in 1861 in Vienna. Polish specialists participated in hospital training and congresses abroad, so they did not lose touch with the achievements of Western rhinology at that time.
The first description of rhinoscopy was published in 1861 in the Warsaw weekly Tygodnik Lekarski. The article was "O laryngoskopii i rynoskopii” written by Sebastian Rosicki, a doctor in a provincial hospital in Sterdynia who had done medical training in Vienna with Johan Nepomuk Czermak.
Bronislaw Taczanowski (1840-1912) was the author of the first laryngological handbook in Polish, Diagnostyka lekarska. Laryngoskopia i rynoskopia, published 1871. Tuerck and Czermak had made laryngoscopy and rhinoscopy popular in Western Europe before 1860 and the handbook by Taczanowski, the first in Polish medicine, was based on German scientific literature.
The method of nasopharynx examination with a laryngeal mirror and the invention of the rhinoscope for anterior rhinoscopy contributed to the development of rhinology. At the beginning of the 1880s rhinoscopes were widely used. One of the rhinoscopes was invented by Antoni Jurasz senior (1847-1923). He was the first in Europe to perform natural frontal sinus catheterization in 1887. Antoni Jurasz senior also constructed rhinological instruments such as the nasopharynx forceps, forceps used to reduce nasal fracture, and perfusion cannula for a maxillary sinus washout. He improved the Adams forceps so that they could be used for septoplasty and nasal fracture reduction.
Fig. 1. Examining position for doctor and patient for anterior rhinoscopy. (J. Sędziak: Choroby nosa, jego zatok oraz jamy noso-gardzielowej, Warszawa 1897, opposite page 49).
Teodor Heryng was the first in Poland to describe the method of local anaesthesia with cocaine in 1888. He admitted, however, that Przemysław Pieniążek was the first doctor who had used cocaine in a nasal polypectomy.
We must consider that university clinics and separate otolaryngology departments have had great significance on the development of that medical field. In Cracow (in the Austrian sector of partitioned Poland) assistant professor Przemyslaw Wiktor Odrowąż Pieniążek (1850-1916) organized in 1879 the first Polish nose, throat and larynx diseases department. He was allowed to deliver lectures on laryngology and rhinology at the Jagellonian University free of charge. He had the use of ten hospital beds in the Surgery Department. In 1903 Przemyslaw Pieniążek became a full professor of rhinolaryngology.
In Lvov, Antoni Jurasz senior was in 1908 appointed to a professorship in the Otolaryngology Department. Other departments and otolaryngological clinics were organized after 1918 when Poland became an independent state again.
In Warsaw, which was under Russian control at this time, the first Laryngology Department was started in 1881 at St. Roch´s Hospital. Teodor Heryng (1847-1925) was its head for sixteen years. He delivered lectures on laryngology and rhinology. Ear diseases were not treated in Heryng´s department.
In 1890 at the International Medical Congress in Berlin Teodor Heryng presented a method of diaphanoscopy: nose and sinuses transillumination with electric light. The diaphanoscopy had as many followers as opponents. In Sędziak´s opinion the most certain way to diagnose purulent maxillary sinusitis was sinus washout with 4% boric acid.
Jan Mikulicz was in 1886 the first to describe the method of sinus maxillary puncture.
The main problems in rhinology at the turn of the 19th century were scleroma, tuberculosis, syphilis, ozaena, purulent sinusitis and their complications, neoplasms, congenital choanal atresia and acquired occlusion at the choanae in consequence of specific infections.
At Warsaw Emperor´s University there was no laryngology department but Alfred Marcin Sokołowski (1849-1924) developed that field of medicine at that time. In 1883 he opened the first laryngological day clinic in the Internal Diseases Department at Hospital Św. Duch. He lectured secretly on rhinolaryngology and he taught how to examine throat, larynx, nose and ears. He created his own "laryngological school”. Among his students were future professors of otorhinolaryngology and departmental heads in Warsaw and Vilnius: Feliks Antoni Erbrich and Jan Szmurlo, Jan Sędziak, Zdzislaw Dmochowski and many others.
In 1897 the first Polish handbook on rhinology, Choroby nosa, jego zatok oraz jamy noso-gardzielowej: podręcznik dla studentów by Jan Sędziak, was published.
The study written by Sędziak "Przewlekly zanikowy nieżyt nosa (ozena). Stadyum Kliniczne” was published in a jubilee issue of the magazine Annals of Otology, Rhinology and Laryngology. Sędziak showed in his articles in that magazine our methods and achievements, which did not lag behind those in Western Europe.
In Sędziak´s opinion chronic, atrophic, fetid rhinitis or ozaena are third place in laryngology after diphtheria and tuberculosis. Ozaena belonged to the most common laryngological diseases (5% of all laryngological patients). He used reducers to make nasal cavities narrower. Other doctors applied rubber contracting tubes. Jan Szmurlo injected solid paraffin under the mucous membrane at the floor of the nasal cavity, the anterior part of the septum and under the inferior turbinate. The method of Dionizy Hellin, who implanted pieces of a cartilage under the mucous membrane of the nasal septum, must have been seen as very modern at that time.
In those days many studies in rhinology were published and among them we find the doctor´s thesis by Zdzislaw Dmochowski "Przyczynek do etiologii i anatomii patologicznej spraw zapalnych w jamie Highmore´a” (1898), which was very significant.
The second Polish handbook of clinical rhinology, Choroby nosa i jamy nosowogardlowej. Podręcznik dla lekarzy i studentów, written by Jan Szmurlo (1867-1952), was first published in 1926. This edition contained 268 pages and 141 drawings with text. The second edition saw light in 1935. This publication was enriched (324 pages) with more drawings (214 figures and 2 coloured figs.), which were more detailed. In addition diseases of the lacrimal duct were included. Both of these publications quickly disappeared from the shelves. Jan Szmurlo received a prestigious award from the University of Poznań for his work in 1927.
In 1921 after Poland had become an independent republic again Feliks Erbrich, Jan Szmurlo and Ludwik Guranowski formed the Polish Otolaryngological Society. This society organized conferences, congresses and scientific sessions. Its members also published articles on rhinological subjects in the journal Polish Otolaryngological Review from 1924.
1923 saw the opening of another Otolaryngology Department at the University of Stefan Batory in Wilno. Jan Szmurlo became its head.
Alfred Laskiewicz (1888-1969) was the head of the Poznań Otolaryngology Department from 1923 until 1939, when he was conscripted into the Polish Army. He was a follower of Professor Antoni Jurasz senior. Laskiewicz carried out bacteriological and serological tests on ozaena and scleroma. He described conservative treatment (irrigation, inhalations, scleroma vaccines, irradiation) and operative procedures (excision, electrolysis, dilatation) and also an important part of hygiene. Research into ozaena and scleroma was continued in Poznań by Aleksander Zakrzewski (1909-1985), who defended his doctorate on rynology entitled "Wyniki leczenia ozeny w Klinice Otolaryngologicznej Uniwersytetu Poznańskiego”. The results of his research led to the use of iron in the treatment of ozaena.
In the history of rhinology some methods of diagnostics and treatment have been abandoned over the years. For example electrolysis was eliminated as a method of therapy because of complications. Doctors started to use antiseptics and chemotherapeutics which had been discovered. These medicaments made treatment easier, slowly eliminated some diseases such as syphilis, scleroma and tuberculosis, and excluded less effective methods.
We should stress that Polish doctors did not avoid critical judgement about medical novelties from abroad, and their own experience, practice and scientific reflections have become part of the world´s medical achievements. The activities of Polish doctors have contributed to the development of rhinology not only in Poland.
Piśmiennictwo
1. Dmochowski Z.: Przyczynek do etyologii i anatomii patologicznej spraw zapalnych w jamie Highmora, Pam. Tow. Lek. Warsz. 1894; 90(3). 2.Heryng T.: Utrudnione oddychanie nosem i jego fatalne następstwa dla fizycznego i intelektualnego rozwoju młodzieży (wyrośla adenoidalne), Wyd. M. ARCTA, Warszawa 1917. 3.Jankowski W.: Rozwój jamy nosowej i jej stosunek do sąsiednich części mózgu i twarzoczaszki. Pol. Przegl. Otorynolaryngol., 1938, 15: 282-321. 4.Kierzek A.: Rozwój warszawskiej myśli otolaryngologicznej w XIX wieku. Wydawnictwo Arboretum, Wrocław, 1997. 5.Kierzek A.: Otolaryngolodzy warszawscy w XIX wieku. Wydawnictwo Arboretum, Wrocław 1998. 6.Kosiński J.: Album zasłużonych lekarzy polskich. Warszawa, 1925. 7.Rosicki S.: O laryngoskopii i rynoskopii, Tygodnik Lekarski, Warszawa 1861; 15(17). 8.Sędziak J.: Nowotwory złośliwe w górnych drogach oddechowych oraz w uszach. Stadyum Kliniczno-historyczne. Gazeta Lekarska 1913, 58(45): 1358-1379. 9.Sędziak J.: Przewlekły zanikowy nieżyt nosa (ozena). Stadyum Kliniczne. Odb. z "Kroniki Lekarskiej", Warszawa 1906. 10.Sędziak J.: Choroby nosa, jego zatok oraz jamy noso-gardzielowej: podręcznik dla lekarzy i studentów, Warszawa 1897. 11.Sędziak J: O zboczeniach przegrody nosa., Odb. z Przeglądu Lekarskiego, Kraków 1891. 12.Szlenk Z.: Początki rynologii w Polsce in: Krzeski A. Janczewski G.: Choroby nosa i zatok przynosowych. Wyd. Sanmedia, Warszawa 1997, 13-14. 13.Szmurło J.: Gruźlica krtani, gardła i nosa w świetle własnych spostrzeżeń (stadyum kliniczne); in: Odczyty kliniczne, Nakładem Gazety Lekarskiej, Warszawa 1918; 4, 5, 6. 14.Szmurło J.: Sposoby badania nosa i jamy nosowogardłowej; in: Szmurło J.: Metody badania narządu oddechowego. Warszawa 1920. 15.Szmurło J.: Choroby nosa i jamy nosowogardłowej. Podręcznik dla lekarzy i studentów. Tow. Wyd. "Pogoń", Wilno 1926. 16.Taczanowski B.: Diagnostyka lekarska. Laryngoskopia i rynoskopia. Biblioteka Umiejętności Lekarskich, Wyd. Red. Gaz. Lek. Warszawa 1871. 17.Zuberbier D.: Choroby nosa, gardła, krtani i ucha w zarysie. Warszawa 1938.
