Mirko Grmek
Encyclopedia
Mirko Dražen Grmek was a Croatia
n and French
historian of medicine
, writer and scientist. He was one of the pioneers and founders of the history of medicine. His entire opus promotes the historical research of medical knowledge and practices by means of contemporary scientific methods, especially the study of the formation of ideas in specific societies and periods. He put forward the theory of pathocenosis, the coexistence of all diseases in a specific time, place and society.
, Zagorje
, near Zagreb
(then in the Kingdom of Serbs, Croats and Slovenes). He went to France
and joined the French Resistance
in 1942. His underground activities took him to Italy, Switzerland and then back to France. When the war ended, he returned to Zagreb
to study medicine. After his studies, Grmek worked as a general practitioner at first. Then he became a university professor and finally dedicated all his time to scientific work. He got his Ph.D. from the University of Zagreb
. There he founded the Institute for the History of Science and edited the first local Encyclopedia of Medicine.
Graduating from the Italian Politecnico, Grmek settled in Paris
in 1963. The Collège de France
gave him the task of editing the notes of Claude Bernard
, which was a turning point of his career, since he later become an international expert in Bernard's area of research. In 1967, Grmek became a French citizen. After graduating literature in Paris, he did research in CNRS. In 1973, Grmek became the director of the research of the history of biological and medical sciences at the École pratique des hautes études. As a doctor of science and literature, he lectured at the universities of Berkeley
, Los Angeles, Geneva
, Bologna
and Lausanne
. The University of Zagreb gave him the title of emeritus
.
His editorial work included the positions of the scientific director of the International Encyclopedia of Science and Technology, as well as the editor-in-chief of the International Archive of the History of Science.
Grmek was a member of HAZU and its American counterpart. He was the president of the International Academy for the History of Science from 1981 to 1986 and the vice president of the International Union of the History of Science in 1997. He was awarded the order of Légion d'honneur
and the Sarton Medal. Grmek was also a laureate of the French Academy, the Academy of Science, the Academy of Medicine.
In the nineties, Croatia
became an independent country. Grmek spent the last years of his life building bridges between his two homelands, such as his book The Villefranche-de-Rouergue uprising, about the uprising of Croatian soldiers in the German army occupying France. Before he died, he left a large part of his library to HAZU and set up the foundations for the Croatian Cultural Center in Paris. He was buried in the Montparnasse Cemetery
.
The scientific magazine Eurêka published a large interview with Grmek in 1996. It was titled Mirko Grmek, the Physician of the Century It said: "Recognized among the scientists from all over the world, but unknown to the general public, this Croat spent his entire life vigorously defending one idea: that medicine must have a conscience and that science is nothing without humanism."
. By "facts", he meant disease
s; by "permanent elements", he meant the elements of human physiology
. The history of medicine
, however, should be primarily a historical overview of diseases in various societies and the defense strategies used by human organisms against them. Grmek followed the work of Claude Bernard
, the founder of experimental medicine and initiator of physiology as an essential medical discipline, who believed that the notion of disease covers all the phenomena that weaken the defenses of the milieu interieur
(inner space), i.e. the organism, and that disease largely depends on the environmental factors.
Of course, diseases are not concrete objects like e.g. microorganisms that cause contagion. Since a disease is a reactive process, it cannot be separated from the body where it has appeared. It seems, however, that diseases have an existence that doesn't depend on their carriers. Such independence can be seen when many people get sick: the disease becomes an event. It shows the concrete existence of diseases as phenomena that strike at entire societies.
In fact, Grmek uses the epidemiological
approach. His best known work in this area is History of AIDS, a much-translated work about the most famous disease of the 20th century, AIDS
. Looking for the causes of the disease, he analyzes in detail the disputes between French and American scientists, up to the point when Montagnier
at the Pasteur Institute
identified the HIV
retrovirus
.
But Grmek believes that the epidemiological research can't record the appearance and spread of a specific disease in a specific society if the disease in question isn't linked with all the other diseases, chronic or occasional, which appear in the relevant society. It is the basis of his theory of pathocenosis, the coexistence of all diseases in a specific time, place and society. The pathocenosis theory, which was adopted by Grmek to explain the spread of AIDS, but also to reconstruct the pathological state of the Greek world
(Diseases at the Dawn of Western Civilization), includes several hypotheses
which can all be verified with methods appropriate for the relevant period (paleopathological
data and literary texts for the ancient world; statistics
for the contemporary world). Those hypotheses can be summarized in this way:
The disease that creates a new pathocenosis largely figures as the main pathology of the age. Historically, typical pathocenoses were the tuberculosis
pathocenosis in the 19th century or the typhoid fever
pathocenosis in the imperial Russia. In the recent decades, the infamous title of the main pathocenosis has been disputed between AIDS and cancer. Still, Grmek warns that it is very difficult to determine the pathocenosis of today's world, since the constant planetary migration of large masses of people from south to north, as well as the development of communications, have turned Earth into a global village.
Grmek's approach can be described as medical Platonism
. He believes that diseases are not bodily phenomena, but ideas. Like Plato
's ideas, they can exist only together with others. In the reality of pathology, the idea becomes a concrete disease that depends on the state of the organism. Then it is related to the lifestyle, culture, as well as the way in which the disease is perceived and the tendency of societies to form systems of collective defense against diseases. In fact, Grmek took a "hard" scientific discipline such as epidemiology and turned it into the basis for a new humanism, which doesn't reject science in favor of man, but uses it as an instrument to collect facts and form ideas in order to better understand the economy, politics and culture of the "big history".
Croatia
Croatia , officially the Republic of Croatia , is a unitary democratic parliamentary republic in Europe at the crossroads of the Mitteleuropa, the Balkans, and the Mediterranean. Its capital and largest city is Zagreb. The country is divided into 20 counties and the city of Zagreb. Croatia covers ...
n and French
France
The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...
historian of medicine
History of medicine
All human societies have medical beliefs that provide explanations for birth, death, and disease. Throughout history, illness has been attributed to witchcraft, demons, astral influence, or the will of the gods...
, writer and scientist. He was one of the pioneers and founders of the history of medicine. His entire opus promotes the historical research of medical knowledge and practices by means of contemporary scientific methods, especially the study of the formation of ideas in specific societies and periods. He put forward the theory of pathocenosis, the coexistence of all diseases in a specific time, place and society.
Life and career
Grmek was born in KrapinaKrapina
Krapina is a town in northern Croatia and the administrative centre of Krapina-Zagorje County with a population of 4,482 and a total municipality population of 12,479...
, Zagorje
Hrvatsko Zagorje
Hrvatsko Zagorje is a region north of Zagreb, Croatia. It comprises the whole area north of Medvednica mountain up to Slovenia in the north and west, and up to the regions of Međimurje and Podravina in the north and east...
, near Zagreb
Zagreb
Zagreb is the capital and the largest city of the Republic of Croatia. It is in the northwest of the country, along the Sava river, at the southern slopes of the Medvednica mountain. Zagreb lies at an elevation of approximately above sea level. According to the last official census, Zagreb's city...
(then in the Kingdom of Serbs, Croats and Slovenes). He went to France
France
The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...
and joined the French Resistance
French Resistance
The French Resistance is the name used to denote the collection of French resistance movements that fought against the Nazi German occupation of France and against the collaborationist Vichy régime during World War II...
in 1942. His underground activities took him to Italy, Switzerland and then back to France. When the war ended, he returned to Zagreb
Zagreb
Zagreb is the capital and the largest city of the Republic of Croatia. It is in the northwest of the country, along the Sava river, at the southern slopes of the Medvednica mountain. Zagreb lies at an elevation of approximately above sea level. According to the last official census, Zagreb's city...
to study medicine. After his studies, Grmek worked as a general practitioner at first. Then he became a university professor and finally dedicated all his time to scientific work. He got his Ph.D. from the University of Zagreb
University of Zagreb
The University of Zagreb is the biggest Croatian university and the oldest continuously operating university in the area covering Central Europe south of Vienna and all of Southeastern Europe...
. There he founded the Institute for the History of Science and edited the first local Encyclopedia of Medicine.
Graduating from the Italian Politecnico, Grmek settled in Paris
Paris
Paris is the capital and largest city in France, situated on the river Seine, in northern France, at the heart of the Île-de-France region...
in 1963. The Collège de France
Collège de France
The Collège de France is a higher education and research establishment located in Paris, France, in the 5th arrondissement, or Latin Quarter, across the street from the historical campus of La Sorbonne at the intersection of Rue Saint-Jacques and Rue des Écoles...
gave him the task of editing the notes of Claude Bernard
Claude Bernard
Claude Bernard was a French physiologist. He was the first to define the term milieu intérieur . Historian of science I. Bernard Cohen of Harvard University called Bernard "one of the greatest of all men of science"...
, which was a turning point of his career, since he later become an international expert in Bernard's area of research. In 1967, Grmek became a French citizen. After graduating literature in Paris, he did research in CNRS. In 1973, Grmek became the director of the research of the history of biological and medical sciences at the École pratique des hautes études. As a doctor of science and literature, he lectured at the universities of Berkeley
University of California, Berkeley
The University of California, Berkeley , is a teaching and research university established in 1868 and located in Berkeley, California, USA...
, Los Angeles, Geneva
University of Geneva
The University of Geneva is a public research university located in Geneva, Switzerland.It was founded in 1559 by John Calvin, as a theological seminary and law school. It remained focused on theology until the 17th century, when it became a center for Enlightenment scholarship. In 1873, it...
, Bologna
University of Bologna
The Alma Mater Studiorum - University of Bologna is the oldest continually operating university in the world, the word 'universitas' being first used by this institution at its foundation. The true date of its founding is uncertain, but believed by most accounts to have been 1088...
and Lausanne
University of Lausanne
The University of Lausanne in Lausanne, Switzerland was founded in 1537 as a school of theology, before being made a university in 1890. Today about 12,000 students and 2200 researchers study and work at the university...
. The University of Zagreb gave him the title of emeritus
Emeritus
Emeritus is a post-positive adjective that is used to designate a retired professor, bishop, or other professional or as a title. The female equivalent emerita is also sometimes used.-History:...
.
His editorial work included the positions of the scientific director of the International Encyclopedia of Science and Technology, as well as the editor-in-chief of the International Archive of the History of Science.
Grmek was a member of HAZU and its American counterpart. He was the president of the International Academy for the History of Science from 1981 to 1986 and the vice president of the International Union of the History of Science in 1997. He was awarded the order of Légion d'honneur
Légion d'honneur
The Legion of Honour, or in full the National Order of the Legion of Honour is a French order established by Napoleon Bonaparte, First Consul of the Consulat which succeeded to the First Republic, on 19 May 1802...
and the Sarton Medal. Grmek was also a laureate of the French Academy, the Academy of Science, the Academy of Medicine.
In the nineties, Croatia
Croatia
Croatia , officially the Republic of Croatia , is a unitary democratic parliamentary republic in Europe at the crossroads of the Mitteleuropa, the Balkans, and the Mediterranean. Its capital and largest city is Zagreb. The country is divided into 20 counties and the city of Zagreb. Croatia covers ...
became an independent country. Grmek spent the last years of his life building bridges between his two homelands, such as his book The Villefranche-de-Rouergue uprising, about the uprising of Croatian soldiers in the German army occupying France. Before he died, he left a large part of his library to HAZU and set up the foundations for the Croatian Cultural Center in Paris. He was buried in the Montparnasse Cemetery
Montparnasse Cemetery
Montparnasse Cemetery is a cemetery in the Montparnasse quarter of Paris, part of the city's 14th arrondissement.-History:Created from three farms in 1824, the cemetery at Montparnasse was originally known as Le Cimetière du Sud. Cemeteries had been banned from Paris since the closure, owing to...
.
The scientific magazine Eurêka published a large interview with Grmek in 1996. It was titled Mirko Grmek, the Physician of the Century It said: "Recognized among the scientists from all over the world, but unknown to the general public, this Croat spent his entire life vigorously defending one idea: that medicine must have a conscience and that science is nothing without humanism."
Pathocenosis
As a historian, Grmek strongly believed that a historical reconstruction should start from a clear statement of facts and a valuation of the permanent elements of the human organismOrganism
In biology, an organism is any contiguous living system . In at least some form, all organisms are capable of response to stimuli, reproduction, growth and development, and maintenance of homoeostasis as a stable whole.An organism may either be unicellular or, as in the case of humans, comprise...
. By "facts", he meant disease
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...
s; by "permanent elements", he meant the elements of human physiology
Physiology
Physiology is the science of the function of living systems. This includes how organisms, organ systems, organs, cells, and bio-molecules carry out the chemical or physical functions that exist in a living system. The highest honor awarded in physiology is the Nobel Prize in Physiology or...
. The history of medicine
History of medicine
All human societies have medical beliefs that provide explanations for birth, death, and disease. Throughout history, illness has been attributed to witchcraft, demons, astral influence, or the will of the gods...
, however, should be primarily a historical overview of diseases in various societies and the defense strategies used by human organisms against them. Grmek followed the work of Claude Bernard
Claude Bernard
Claude Bernard was a French physiologist. He was the first to define the term milieu intérieur . Historian of science I. Bernard Cohen of Harvard University called Bernard "one of the greatest of all men of science"...
, the founder of experimental medicine and initiator of physiology as an essential medical discipline, who believed that the notion of disease covers all the phenomena that weaken the defenses of the milieu interieur
Milieu interieur
Milieu intérieur or interior milieu, from the French, milieu intérieur, is a term coined by Claude Bernard to refer to the extra-cellular fluid environment, and its physiological capacity to ensure protective stability for the tissues and organs of multicellular living organisms.-Origin:Claude...
(inner space), i.e. the organism, and that disease largely depends on the environmental factors.
Of course, diseases are not concrete objects like e.g. microorganisms that cause contagion. Since a disease is a reactive process, it cannot be separated from the body where it has appeared. It seems, however, that diseases have an existence that doesn't depend on their carriers. Such independence can be seen when many people get sick: the disease becomes an event. It shows the concrete existence of diseases as phenomena that strike at entire societies.
In fact, Grmek uses the epidemiological
Epidemiology
Epidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...
approach. His best known work in this area is History of AIDS, a much-translated work about the most famous disease of the 20th century, AIDS
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...
. Looking for the causes of the disease, he analyzes in detail the disputes between French and American scientists, up to the point when Montagnier
Luc Montagnier
Luc Antoine Montagnier is a French virologist and joint recipient with Françoise Barré-Sinoussi and Harald zur Hausen of the 2008 Nobel Prize in Physiology or Medicine, for his discovery of the human immunodeficiency virus...
at the Pasteur Institute
Pasteur Institute
The Pasteur Institute is a French non-profit private foundation dedicated to the study of biology, micro-organisms, diseases, and vaccines. It is named after Louis Pasteur, who made some of the greatest breakthroughs in modern medicine at the time, including pasteurization and vaccines for anthrax...
identified the HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...
retrovirus
Retrovirus
A retrovirus is an RNA virus that is duplicated in a host cell using the reverse transcriptase enzyme to produce DNA from its RNA genome. The DNA is then incorporated into the host's genome by an integrase enzyme. The virus thereafter replicates as part of the host cell's DNA...
.
But Grmek believes that the epidemiological research can't record the appearance and spread of a specific disease in a specific society if the disease in question isn't linked with all the other diseases, chronic or occasional, which appear in the relevant society. It is the basis of his theory of pathocenosis, the coexistence of all diseases in a specific time, place and society. The pathocenosis theory, which was adopted by Grmek to explain the spread of AIDS, but also to reconstruct the pathological state of the Greek world
Ancient Greece
Ancient Greece is a civilization belonging to a period of Greek history that lasted from the Archaic period of the 8th to 6th centuries BC to the end of antiquity. Immediately following this period was the beginning of the Early Middle Ages and the Byzantine era. Included in Ancient Greece is the...
(Diseases at the Dawn of Western Civilization), includes several hypotheses
Hypothesis
A hypothesis is a proposed explanation for a phenomenon. The term derives from the Greek, ὑποτιθέναι – hypotithenai meaning "to put under" or "to suppose". For a hypothesis to be put forward as a scientific hypothesis, the scientific method requires that one can test it...
which can all be verified with methods appropriate for the relevant period (paleopathological
Paleopathology
Paleopathology, also spelled palaeopathology, is the study of ancient diseases. It is useful in understanding the past history of diseases, and uses this understanding to predict its course in the future.- History of paleopathology :...
data and literary texts for the ancient world; statistics
Statistics
Statistics is the study of the collection, organization, analysis, and interpretation of data. It deals with all aspects of this, including the planning of data collection in terms of the design of surveys and experiments....
for the contemporary world). Those hypotheses can be summarized in this way:
- a single disease, either infectiousInfectious diseaseInfectious diseases, also known as communicable diseases, contagious diseases or transmissible diseases comprise clinically evident illness resulting from the infection, presence and growth of pathogenic biological agents in an individual host organism...
or degenerativeDegenerative diseaseA degenerative disease, also called neurodegenerative disease, is a disease in which the function or structure of the affected tissues or organs will progressively deteriorate over time, whether due to normal bodily wear or lifestyle choices such as exercise or eating habits...
, can be considered only in relation to all the other diseases in a particular society; - the existence and spread of a disease depends on the existence and spread of all the other diseases in that society;
- environmental and cultural factors determine the precise pathocenosis, i.e. the tendency of certain diseases to have a stable presence in a society (in the ancient West, for example, those were the syndromes of flu in winter, related to the syndromes of digestive diseases in summer);
- the appearance of a new environmental or cultural factor can usher the dominance of a disease (e.g. cancer in the industrialized countries), where one pathocenosis is replaced by another.
The disease that creates a new pathocenosis largely figures as the main pathology of the age. Historically, typical pathocenoses were the tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
pathocenosis in the 19th century or the typhoid fever
Typhoid fever
Typhoid fever, also known as Typhoid, is a common worldwide bacterial disease, transmitted by the ingestion of food or water contaminated with the feces of an infected person, which contain the bacterium Salmonella enterica, serovar Typhi...
pathocenosis in the imperial Russia. In the recent decades, the infamous title of the main pathocenosis has been disputed between AIDS and cancer. Still, Grmek warns that it is very difficult to determine the pathocenosis of today's world, since the constant planetary migration of large masses of people from south to north, as well as the development of communications, have turned Earth into a global village.
Grmek's approach can be described as medical Platonism
Platonism
Platonism is the philosophy of Plato or the name of other philosophical systems considered closely derived from it. In a narrower sense the term might indicate the doctrine of Platonic realism...
. He believes that diseases are not bodily phenomena, but ideas. Like Plato
Plato
Plato , was a Classical Greek philosopher, mathematician, student of Socrates, writer of philosophical dialogues, and founder of the Academy in Athens, the first institution of higher learning in the Western world. Along with his mentor, Socrates, and his student, Aristotle, Plato helped to lay the...
's ideas, they can exist only together with others. In the reality of pathology, the idea becomes a concrete disease that depends on the state of the organism. Then it is related to the lifestyle, culture, as well as the way in which the disease is perceived and the tendency of societies to form systems of collective defense against diseases. In fact, Grmek took a "hard" scientific discipline such as epidemiology and turned it into the basis for a new humanism, which doesn't reject science in favor of man, but uses it as an instrument to collect facts and form ideas in order to better understand the economy, politics and culture of the "big history".
Select bibliography
- Uvod u medicinu (An Introduction to Medicine), 1961, 1996
- Léonard de Vinci, dessins scientifiques et techniques (Leonardo da VinciLeonardo da VinciLeonardo di ser Piero da Vinci was an Italian Renaissance polymath: painter, sculptor, architect, musician, scientist, mathematician, engineer, inventor, anatomist, geologist, cartographer, botanist and writer whose genius, perhaps more than that of any other figure, epitomized the Renaissance...
, Scientific and Technical Drawings), 1962 - Mille ans de chirurgie en Occident (A Thousand Years of Western SurgerySurgerySurgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
, 1966. - U borbi za narodno zdravlje, 1966
- Catalogue des manuscrits de Claude Bernard (Catalog of the manuscripts of Claude BernardClaude BernardClaude Bernard was a French physiologist. He was the first to define the term milieu intérieur . Historian of science I. Bernard Cohen of Harvard University called Bernard "one of the greatest of all men of science"...
), 1968 - Raisonnement expérimental et recherches toxicologiques chez Claude Bernard (Experiments and toxicologicalToxicologyToxicology is a branch of biology, chemistry, and medicine concerned with the study of the adverse effects of chemicals on living organisms...
research of Claude Bernard), 1973 - Les Maladies à l’aube de la civilisation occidentale (DiseaseDiseaseA disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...
s at the Dawn of Western Civilization), 1983 - Histoire du sida (History of AIDSAIDSAcquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...
), 1989 - la Première révolution biologique (The First Biological Revolution), 1990
- le Nettoyage ethnique (Ethnic Cleansing), co-author, 1993
- Mistika riječi (Mysticism of Words), a collection of poetry, 2000
- Histoire de la pensée médicale en Occident (History of Medical Thought in the West), 3 volumes, 1995-99
- le Legs de Claude Bernard (The Heritage of Claude Bernard), 1997
- les Révoltés de Villefranche (The Villefranche-de-Rouergue uprising), co-author, 1998
- les Maladies dans l’art antique (Diseases in Ancient Art), co-author, 1998
- La Vie, les maladies et l'histoire (Life, Diseases and History), 2000
- La Guerre comme maladie sociale (War as Social Disease), 2000
- Le chaudron de Medee (MedeaMedeaMedea is a woman in Greek mythology. She was the daughter of King Aeëtes of Colchis, niece of Circe, granddaughter of the sun god Helios, and later wife to the hero Jason, with whom she had two children, Mermeros and Pheres. In Euripides's play Medea, Jason leaves Medea when Creon, king of...
's Cauldron), 2004