ruski

Specijalizacija koja je trajala jedno stoljeće -ftizeologija u Hrvatskoj - izvornik na ruskom

In the centennial epidemics of tuberculosis Croatia has belonged to less developed part of Europe. Being rural part of the Austrian-Hungarian Monarchy the peak of the tuberculosis mortality and morbidity has been experienced later than in more developed countries of Western Europe, at the end of XIX and the beginning of the XX century. In 1880. the tuberculosis mortality in Zagreb, the capital of Croatia was 684 per 100,000 inhabitants. Slowly but steadily the concept of tuberculosis as a social disease has been accepted especially after the International Congress against tuberculosis held in Berlin 1899. M. Dežman (1873-1940) in 1903. was the first to work in the Ambulance for tuberculous workers and the members of their family. His knowledge and efforts brought the first Sanatorium against tuberculosis to be opened at Sljeme, the southern outskirts of Medvednica, very near Zagreb in 1909. Between 1899. and 1909. the total number of those reported as died from tuberculosis in Croatia was 681.016. The situation became even worse through the World War I. In 1918. tuberculosis mortality was still at 586 per 100,000 representing 20-25% of all deaths in Croatia. In 1920. more than 71% of nine-year-old children in Zagreb were infected with M. tbc. It was estimated that about 4% of Croatia rural population had tuberculosis. The health authorities had to send young doctors abroad to learn and to transfer modern concepts of the measures against the "white plague". Vladimir Ćepulić (1891-1964) was the first abroad educated phthysiologist (Brauer, Much, Krause). Returning to Zagreb in 1920. he was apppointed as the Chief of the first Government Hospital Tuberculosis Department in Zagreb and the first Anti-Tuberculosis Dispensary, established in the way of Calmette. L. Thaller (1891-1949) started also in 1920. as a Head of the Department of tuberculosis and in the same time worked in the Ambulance for the lung diseases that in those days meant mostly tuberculosis. In 1934. the Tuberculosis Department and the Tuberculosis Dispensary merged to form the Institute for Tuberculosis. V. Ćepulić became in 1928. the first lecturer in Phthysiology at the Zagreb Medical Faculty established in 1918. Therefore the next generation of Croatian phthysiologists were educated at home. They have worked within the network of Anti-Tuberculous Dispensaries, several Hospitals for tuberculous as well as Society Against Tuberculosis. Well planned and organised and meticulously performed antituberculosis service brought a decreases in tuberculosis mortality in Zagreb from 586 in 1918. to 146 per 100,000 in 1939. Next decades, especially after the introduction of potent antituberculosis drugs, brought the tuberculosis mortality in 1986. do 6,5 per 100,000. In 1955. the total number of newly registered tuberculous patients in Croatia was 20,000 and in 1990 that number was 2,000. The new era enabled the closure of many hospitals for tuberculosis in the last twenty years. Since 1993. The new healthcare structure has been adopted without Anti-tuberculosis dispensaries in it because they have been estimated as obsolete. In the same time the phthysiology has been dropped from the list as specialisation for medical doctors.With stagnant number of 44 newly discovered per 100,000 in 1990. the Republic of Croatia was still among the countries with the highest tuberculosis incidence in Europe. The burden of the liberation war 1991-1995 with large and heavy destruction and several hundred thousand displaced persons will make the fight against tuberculosis even more difficult. The end of the century that might bring the eradication of the tuberculosis in the most developed countries will bring a difficult task for physicians in Croatia. From the history of medicine we have learned how important is global approach to tuberculosis. That lesson should be neither forgotten noroverlooked.

Hrvatska; ftizeologija; povijest -izvornik na ruskom;19-20.stoljeće

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