Heritage of Stanisław Ostrowski - the only one medical doctor who became state Polish President - Patriae Semper Fidelis.

AIM: Our purpose was to write a biography of Stanisław Ostrowski that would address in the first place the medical aspect of his professional life, with a comprehensive approach of others fields of his activity.
METHODS: We essentially grounded the paper on primary resources that were papers authored by Ostrowski including his scientific publications, memories, speeches as well as contemporaneous official documents that referred to Ostrowski. Second resources were also used to double check some data from primary resources and to place the biography of Stanisław Ostrowski in a proper background with special care to social, professional and political context. In this study, second resources comprised papers, that were prepared after the death of Stanisław Ostrowski.
RESULTS: Stanisław Ostrowski, MD was a meticulous military medical doctor with an academic engagement at the King John Casimir University of Lvov. In addition, he was an excellent organizer, who soon got involved in politics to serve the local community with essential projects in public health particularly anti-tuberculosis campaigns in Lvov district. His quiet and proficient nature made him an ideal statesman with incredible skills to reconcile social, national and political enemies. Ostrowski was elected a member of parliament three times. He also held the position of President of the city of Lvov until World War Two. During the war, he was imprisoned and deported to Siberia, Soviet Union, in years 1939-1941. Subsequently he fought against Nazi Germans in the Polish II Corps. Ostrowski survived the war providing medical service in the various military units. Afterwards, he ran his medical practice in the UK. Stanisław Ostrowski was the only dermatologist who became a state president. He held an office of state president of the Polish Republic on exile in London. DISCUSSION AND
CONCLUSION: His life is not a simple story, but a great lesson that provides clear guidelines how to find a stable ground for lifetime being a medical doctor in the turbulent times of the 20th century even during wartime.

Background and aims

Professor of medicine, an outstanding dermatologist and venereologist, a very popular MP elected for three consecutive terms, and the municipal president of Lvov, but also a political prisoner forced into slave labor, a soldier of two world wars, Stanisław Ostrowski was the only one medical doctor in the modern era who became a head of state. This paper is not just a simple collection of personal data of the past, but a story of didactic example to be a lesson of life which could be addressed to everyone, in particular to medical professionals. Therefore it is designed to work in the readers’ minds as an evangelist’s pericope or biblical midras. This story now belongs to the past, but of great values - we hope - for present readership of this paper, as this history is a true teacher of life strictly adhering to Latin function that defines history (historia magistra vitae est).

Methods

We have used numerous databases of varied sources covering both archival materials, library resources, museum resources and to a small extent in situ sources (mainly reports of witnesses of that time). They are presented in an order corresponding to categorization of sources (whose history is deeply grounded in auxiliary sciences in Poland), which somehow bypass the division into primary and secondary sources as regarded as less useful for analyses, which are related to the history of the twentieth century [1,2,3]. At the end of this section classification to primary and secondary sources is given.

First of all, invaluable information was derived from archival sources. The first to mention are materials documenting the military career of President Stanisław Ostrowski: including lists of annual qualification, course of military service in the Polish Armed Forces in the USSR, promotions and awards, superiors’ opinions and a military register of records. These documents were obtained mainly from the archives of the President Ostrowski’s Family (thanks to the courtesy of Jan Ostrowski, the son of Adam Ostrowski, the nephew of President Stanisław Ostrowski). Some of them were found in the The Central Archives of Modern Records (Archiwum Akt Nowych w Warszawie) and in the Military Historical Bureau in Warsaw. These documents have not yet been used in the short biographical notes of the President, and they help clear gaps and dispel doubts. The authors also gained access to documentation on the organization of studies and lists of teachers and students of the King John Casimir University in Lvov as well as documents generated by the Lvov Magistrate and the Polish authorities on emigration. Adequate, stenographic reports (Polish: Sprawozdania stenograficzne z obrad Sejmu) and the diaries were indispensible to highlight Ostrowski’s political activity as a Member of Lower Chamber of Polish Parliament (Polish: Sejm) of the Third, Fourth and Fifth terms (1930–1939). For the full reconstruction of the social and political background of Stanisław Ostrowski’s activity, we used the documentation found in the Special Collections of the Library of the The Silesian Piasts’ Medical University in Wroclaw (Polish: Uniwersystet Medyczny Piastów Śląskich we Wrocławiu), the Section of Manuscripts of the National Library of Ossolineum in Wroclaw, the Archives of the Medical University of Wroclaw, Library of the Sejm, The Central Archives of Modern Records (Archiwum Akt Nowych w Warszawie) in Warsaw, the National Digital Archives in Warsaw (Narodowe Archiwum Cyfrowe), the Polish Military Historical Bureau, the Regional Archives of Lvov, the private professional historical archive of Professor and Archivist Andrzej Woltanowski and sources of Leopolis Collection.

Out of the library resources, Stanisław Ostrowski’s own publications are of prime importance, demonstrating his profound scientific knowledge, confirmed by numerous citations of his scientific articles on venereal diseases and dermatology. They are written in a pleasant style with great systematic approach of the author. Original medical papers by Stanisław Ostrowski were supplied by the Section of Special Collection, Stanisław Konopka Main Medical Library Warsaw Jazdów 1A street, 00-467 Warszawa [Główna Biblioteka Lekarska im. Stanisława Konopki Dział Zbiorów Specjalnych, ul. Jazdów 1A, 00-467 Warszawa]. Online catalog of 1901–1939 publications on http://195.187.98.5/. We analyzed documents issued by the President of the Republic of Poland Stanisław Ostrowski during his term of office, his official messages to the Nation, occasional speeches and appeals appearing in the Polish press on emigration (primarily in the newspaper titled “Polish Republic” (Polish:”Rzeczpospolita Polska”). Other important, historical resources included publications and reports, printed in daily newspapers, referring to the public activities of the members of Parliament, the President of Lvov and finally the President of the Polish Republic on Exile, and the historical background of this activity. We also analyzed the memoirs of the longtime co-worker of the President of Lvov, the vice president Wiktor Chajes, published and unpublished memoirs and memoirs of the medical doctors, who worked, met or shared the fate of Stanisław Ostrowski. We also paid attention to books related to Lvov University of Medicine, which were results of mainly contemporary studies and were written mainly or exclusively by people with historical education, as opposed to the medical and legal education of the authors of this current paper. Such materials could have supplemented our main sources. Particular importance was given to the legislative acts, especially those relating to public health and the health care organization, in which the Stanisław Ostrowski was involved, the acts of local law issued with the participation of the President of Lvov Stanisław Ostrowski and the legal acts issued by the President of Polish Republic on Exile Stanisław Ostrowski.

The collection of library materials was made possible by a thorough search query in the Polish National Library, in the Section of Special Collections of the Main Medical Library, the Library of the Warsaw Medical University, Warsaw University Library, Ryszard Kaczorowski’s Cabinet in University Library in Białystok, Digital Library of Great Poland, Pomeranian Digital Library, the Gallica Digital Library - created by the National Library of France etc.

The authors have highly appreciated interviews with the people who met President Stanisław Ostrowski during the Lvov period, which was partly possible thanks to the Leopolis Collection, created in 1992 on the initiative of the Lvov Voluntary Society’s Branch as well as exhibitions devoted to Lvov in the Independence Museum in Warsaw.

Thus, we essentially grounded the paper on primary resources that were papers authored by Ostrowski including his scientific publications, memories, speeches, as well as contemporaneous official documents that referred to Ostrowski. Secondary resources were also used to double check some data from primary resources and to place the biography of Stanisław Ostrowski in a proper background with special care to social, professional and political context. Essentially, in this study, second resources comprised papers, that were prepared after the death of Stanisław Ostrowski. Thus, the paper was primarily aimed to reconstruct the biography of Stanisław Ostrowski. However, for utilitarian purposes our project went far beyond historical documentation. Thus, Stanisław Ostrowski’s primary resources were all documents authored by Stanisław Ostrowski (including Stanisław Ostrowski’s scientific articles in medical journals, symposia meetings, transcripts of meetings of Lvovian society of medical doctors, his speeches and his own memories, state documents, military official documents, records of Lvov Section of Polish Dermatological Society, cards of personal identification of persons etc. Primary resources were also memoirs written by people who were direct witnesses of Ostrowski’s activity (co-workers, patients, comrades) e.g. memories and reports of Siberian exiles. Secondary resources were mainly books which describe social and political background of Ostrowski’s biography. They included the books on the history of the king John Casimir University in Lvov, books about Polish Army in the West during World War Two, materials about Siberian prisoners in USSR. The second resources helped us double check the names e.g. of military units Ostrowski served as well as changes of his positions and professional employment through years. The secondary resources also were used to describe the background of January Uprising and The Polish government on exile etc.

Results

Early life, education and initial military service

Stanisław Ostrowski was born on 29th October, 1892, in Lvov (now Lviv), formerly Austro-Hungary, later a part of Second Polish Republic, occupied during the Second World War by the Union of Soviets and the Third Reich, after the war incorporated into the USSR, now Ukraine [4]. His father, Michał was an insurgent that was sentenced to Exile in Siberia due to his participation in January Uprising of Polish Nation against the Russian Empire in 1863–1864. His mother Maria came from the Scholtz family [4]. In 1912 after graduation from 5th comprehensive school in Lvov, Stanisław Ostrowski started studying medicine at the Medical Faculty of Lvov University, which underwent flourishing academic development in the first half of the twentieth century [5].

During his education he was an activist of the Organization of National Youth [Organizacja Młodzieży Narodowej], the Union of Active Struggle [Związek Walki Czynnej] and Riflemen’s Association [Związek Strzelecki] from September 1912 to August 1914 [6]. His nickname was “Korczak”. At the time, he cooperated closely with future general Tadeusz Piskor (1889–1951), chief of staff of the Polish Army in 1926–1931 and future general Franciszek Sikorski (1889–1940) [7]. The military and political elite of the Second Republic of Poland recruited from the Riflemen’s Association, to which Stanisław Ostrowski also belonged [8]. Like other young members of the Union of Active Struggle, he graduated from the NCOs and Officer School of the Riflemen’s Association. Thanks to this studies, he obtained military education, which helped him perform his duties during the World War One, the Polish-Ukrainian War, the Polish-Soviet War 1919–1920, and the World War Two [4,6,7]. Shortly after the outbreak of World War One, from August 1914 to April 1918 he joined Polish legions to serve as younger officer in the 1st brigade and in Military Department of Command-in-Chief National Committee [7]. After the outbreak of World War One, medical student Stanisław Ostrowski entered the first Brigade of Legions, commanded by the future charismatic head of state and the actual leader of the Second Polish Republic, Marshall Józef Piłsudski (1867–1935) [9,10]. From the 3rd of September 1914 to 10th October1914 he served in a medical and sanitarian aid in the 1st battalion of the first Regiment of Polish Legions; under the command of Marian Januszajtis (1889–1973), then Alexander Narbut-Łuczyński (1890–1977) and Albin Fleszar (1888–1916) [7]. Sergeant Stanisław Ostrowski joined the 6th Battalion and participated in Krzywopłoty Battle between the Austro-Hungarian and Russian armies from17th to18th March, 1914. Due to the importance of this struggle, this battlefield was called Thermopylae of Legions by Marshal Piłsudski to commemorate the sacrifices of legionaries during night marches in the harsh cold and rainy conditions of November 1914 [11]. Due to severe conditions of military front Stanisław Ostrowski suffered from arthritis and serious kidney malfunction [6]. After a partial recovery, Stanisław Ostrowski worked at the stations of the assembly of the legions in Vienna, Przemysl and Lvov. They were supposed to enable the “return to the ranks or society in the event of illness or wounding of legionaries” according to Stanisław Ostrowski’s own words [12]. After the signing of a protectorate treaty (German: Brotfrieden, “peace for bread”) on 9th February 1918 between the Central Powers (the German Empire and Austro-Hungary) and the Ukrainian People’s Republic in Brest-Litovsk, Grodno Governorate (now Brest, Belarus), which did not respect the Polish interests, the Polish troops refused obedience to the Austro-Hungarian command in the battle of Rarańcza from 15th to 16th February 1918. Some of the soldiers pierced the Austrian front, some were interned, some like Stanisław Ostrowski (who worked at the Legion Station in Lvov) were forced to hide [6]. Ostrowski was interned from March 1918 to April 1918, and after his release he took part in the work of independence under the direct leadership of Władysław Sikorski (1881–1943) - future general, a commander-in-chief and a prime minister during the World War Two [6].

The final collapse of the Austro-Hungarian Monarchy opened the way to independence of its nations in 1918, but the final shape of the state borders was to be defined by armed conflicts. A few days before the end of the World War One, fratricidal Polish-Ukrainian fights broke out for Lvov. Lvov, which in 1910 had 206,000 inhabitants, was a city of Polish majority: Poles were here over 105 thousands, 57 thousands were Jews and 39 thousands of lvovian Ukrainians. At the same time, 71.1% of Ukrainians, 14.4% of Poles and 12.4% of Jews lived in predominantly agricultural Eastern Galicia before the World War One [13]. Lvovian Poles were not prepared for the outbreak of the Ukrainian uprising, but were absorbed in dividing disputes over the leadership between Władysław Sikorski supporters’ and the activists of other political forces in the nation [14,15]. The Ukrainian insurgents quickly occupied key points in the city, while at the time only a small Polish military troop of 119 soldiers under the command of Zdzisław Tatar-Trześniowski (1868–1921) remained in Lvov, in comparison to Ukrainian forces of 1,500 men inside the city [14,15]. Trześniowski was joined by more than 30 volunteers – among them medical student (at the final stage of his university education before his graduation) Stanisław Ostrowski at about 10 pm on 31th October 1918 [4,14,15]. Ostrowski took a part in the defense of Lvov in a position of a medical doctor in the hospital at Technical University and later (from 23 November 1918 to July 1919) a medical doctor of the 1st riflemen’s regiment and subsequently in the 38th infantry regiment [6]. Stanisław Ostrowski was a meticulous medical doctor, that proved his loyalty, reliability and eager availability to military service, that was a true school of life for him. As early as his university years, Stanisław Ostrowski was promoted to the rank of lieutenant on 23th November 1918 for his courage as well as his zeal in his duties of providing health care and safety for his patients [7]. On 29th July 1919, he finally graduated medicine with the title of medical doctor (Latin: Medicinae Universae Doctor). In August 1919, young graduate Stanisław Ostrowski was ordained for the position medical doctor-in chief of the Military Hospital in Stryj, and served there until December 1919 [6]. In addition to provision of health care to the soldiers, the hospital was in charge of medical and sanitary services related to the prevention of typhoid, diarrhea and cholera in the civilian population [17]. During Polish-Bolshevik War, which could result in the expansion of the October Revolution to the West, he was found successful in the fight against epidemics of typhus [17,18]. He held position of medical doctor-in-chief of Lithuanian-Belarusian division from December 1919 to May 1920 [17,19], and of the 240 and the 39th infantry regiment of the Little Poland troops of the Volunteer Army [Armia Ochotnicza] from August to September 1920 [20]. On 1st May, 1922, captain Stanisław Ostrowski was transferred to the reserve [20]. His subsequent scientific work was enriched with his medical experience he acquired during that medical service [12]. His mentality and patriotic attitude was profoundly shaped by the military service with a related admiration for the Chief of State and the First Marshal of Poland, Józef Piłsudski. Stanisław Ostrowski was a recognized as a reliable supporter of Polish governmental authorities that were a loyal political background of Józef Piłsudski. Being a member of Non-partisan Bloc for Cooperation with the Government [Polish: Bezpartyjny Blok Współpracy z Rządem: BBWR], he was elected a deputy member of the Lower Chamber of the Polish Parliament (Polish: Sejm) of the 3rd term [1930-1935], the 4h term [1935-1938] and the 5th term [1938-1939] [4].

Political and social aspects of Stanisław Ostrowski’s life in pre-war Poland, with special impact on public health

In Parliament Ostrowski focused on legislation in the field of public health with special issues on anti-tuberculosis prophylaxis, eradication of venereal diseases and social insurance policy. He supported reconciliation between Poles and Ukrainians. In general he was a defender of civil rights of national minorities. However, of all his actions in the Polish parliament in the 1930s, the most noteworthy are his postulates in the scope of financial grounds of local self-government. They are surprisingly contemporary, clearly formulated and supported by excellent arguments. That sort of his ideas was realized in law system solutions in the European Charter of Local Self-government (No. 122. European Charter of Local Self-Government. Strasbourg, 15.X.1985.), which Poland ratified in 1994, after such a long time. Stanisław Ostrowski was appointed a vice-president of Lvov in 1934 and in 1936. He was elected the president of the city of Lvov (he took the presidential oath on 24th June, 1936), which was the third largest city of Poland at the time and he held this office until his imprisonment by Soviet invaders on 23th September, 1939 [21]. Actually, Ostrowski was the statesman of public consent, as he was on good terms with the Ukrainian minority, which appreciated him, like Doctor of Law Wołodymyr Decykewycz (1865–1949) – a senator (1928–1939) and an alderman of city of Lvov (1927–1939) and Kost Levytsky (1859–1941) – a leader of the Ukrainian National Democratic Association (1925–1939) [22]) for his personal merits. Regardless of strong anti-Jewish trend at the time, a banker and a great philanthropist of Jewish origin, Wiktor (Wigder) Chajes (1875–1940) was simultaneously a vice-presidents of Lvov, while Ostrowski was the municipal president. This partially reflects Stanisław Ostrowski’s art of social and political finesse in a truly remarkable case. He was simply a master of negotiation and agreement in a dialogue with various communities. His authority was grounded also by the fact that he was a defender of Lvov and a medical doctor that virtuously provided medical aid during wartime putting his own life in danger. That is why he was given the War Order of Virtuti Militari (Latin: For Military Virtue). He was virtuous in saving of soldiers’ and civilians’ lives (he carried wounded people on his own arms from a battle fields) and in combating typhus epidemics. At the time he had an opportunity to co-operate with his university fellow, Professor Rudolph Weigl [5], a world-famous inventor of the first efficient vaccine against typhus fever. Rudolph Weigl was a member of Lvov municipal council and belonged to the Nonpartisan Bloc for Cooperation with the Government, which was the same political organization that supported Stanisław Ostrowski in his presidential election in Lvov [5]. Ostrowski greatly appreciated the scientific activity of Rudolf Weigl. Under the influence of the medical doctor-president of Lvov Stanisław Ostrowski, he was awarded the Benedykt Dybowski prize in 1936 with the amount of 2.5 thousand polish zloty [5]. Holding the office of the president of the city, he cared for organization of public health with special impact on medical departments and outpatients’ sections that dealt with pulmonary disorders particularly tuberculosis, which emerged as a main social disease at the time. In this aspect he supported the development of Brzuchowice Spa, where tuberculosis was treated [26,27]. Stanisław Ostrowski specially cared for medical treatment and prophylaxis of children and youth. For this task, a model school of Brzuchowice was inaugurated on the 3rd November, 1936. The school was located in a pine forest in a spacious modern wide-windowed building, which was an excellent site for any model anti-tuberculosis institution with its natural isolation from sources of infection. It was designed to strengthen immune defense and provide proper hygiene environmental conditions as well as an adequate nutrition for normal development. The school was equipped with spacious bathrooms and showers. Children were controlled by a medical doctor and two hygienists to assure a proper surveillance for detection of tuberculosis and a management of its eventual progression. Their task was to monitor psychomotor development of children with frequent measurements of body temperature and height. Thus, this institution followed strict rules of the combined dispensary and sanatorium of “Edinburgh Anti-tuberculosis Scheme”, being designed to implement postulates of anti-tuberculosis movement and to isolate children from sources of infection [23,28,29,30]. Thanks to patronage of president Ostrowski, it was founded with a help of financial sources from a Lvov municipal budget and was dedicated to children from low-income families [23]. A further development of school was interrupted by the outbreak of World War Two in 1939. In his actions Ostrowski generally introduced postulates of the anti-tuberculosis movement that were proclaimed in the Resolution of Section against Tuberculosis of the first State Congress of Medical Doctors in Poland [25]. The main parts of this resolution referred to fields of prophylaxis and hygiene actions, particularly addressed to children as well as development and a proper equipment of outpatients’ sections of lung diseases, provision of social benefits for diseased individuals and their families, a co-ordination of public authorities, actions of social organizations and strictly medical doctors’ organizations to fight against tuberculosis. He founded the Finsen’s Institute for Cutaneous Tuberculosis. Stanisław Ostrowski was also a propagator of broad appliance of serologic tests and X-ray examinations in anti-tuberculosis outpatient sections. He popularized specialist treatment of patients in anti-tuberculosis, pulmonary and sanatorium outpatient sections [25].

At the beginning of Ostrowski’s self-government activity, it was very urgent to invest into infrastructure of the health care. Ostrowski modernized the Lvov ambulance service. Moreover, he invested public funds in the construction of several public baths connected to bunkers and air-raid shelters in anticipation of the inevitable outbreak of the war. He also realized ambitious plans for the development of the urban system of water supply and municipal toilets [26,27]. An absolute priority was for him as medical doctor to improve epidemiological conditions in a series of actions as follows. Firstly, a new tuberculosis outpatient section was opened for students just three months after Stanisław Ostrowski took over as a vice president of Lvov. Consequently, in March 1936, the Consulting Unit for Dermatological and Venereal diseases and the Outpatient Section of Health Care for the Lvovian high schools were opened. At the turn of 1938 and 1939, a large-scale urban hospice for women was commissioned to accommodate 200 patients [28]. The city also founded new roads that enabled quick access to city hospitals - including the Epidemiological Hospital, the Hospital of Social Insurance Fund [29,30]. Under personal impression of epidemics of dysentery 20 years before, President Ostrowski personally participated in sanitary inspections conducted in market halls, open-air markets and shops. In case of an increase in the number of new infections, so-called “epidemic barracks” were constructed to serve as a reserve hospital if necessary. They were used for such a purpose in August 1936, due to the dramatic increase of incidence of measles, scarlet fever and dysentery. Such ambitious investment plans were only possible thanks to the partial cancellation of Lvov’s debt. This was also negotiated by Stanisław Ostrowski and his administration. This partial cancellation included reduction of interest rates, amortization of overdue rates for delayed payments and additional charges with suspension of repayment of debt for a 5-year-long period. This way servicing costs of the city annual debt were able to be reduced from 3.7 million to just 2.5 million polish zloty in the city budget [31].

Academic work and activity in social organizations

His professional and scientific career developed dynamically after World War One. From May 1922 to April 1925 Stanisław Ostrowski worked as a senior assistant at the Department of Dermatology at the University of Warsaw, which was directed by the Rector of Warsaw University Professor Franciszek Krzyształowicz at the time. At the beginning of May 1925 he was employed in the Department of Dermatology at the King John Casimir University of Lvov (Uniwersytet Jana Kazimierza we Lwowie: UJK). On 28th October, 1927 Stanisław Ostrowski was appointed secretary of the Lvov Medical Society and a month later, he be-came chief of Skin and Venereal Diseases Department in the State General Public Hospital in Lvov. In 1931 he received an associate professorship in the field of medicine with specialization in skin and venereal diseases at the Faculty of Medicine of Lvov University [4]. He took part in developing the assumptions of the draft law on combating venereal diseases, which was a modern conception at that time, which after the war was used to create the Decree of 16th April, 1946. In the 1930s he presided the Association of Physicians of the Polish State and was a secretary of the Council of Hospital department heads and a secretary of the Chamber of Physicians in Lvov. In 1936–1939 he worked as an associate professor of the Department of Dermatology at the Medical Faculty of UJK. Stanisław Ostrowski was an active member and later a vice-president of the Polish Society of Dermatology [32]. In the reports of the meetings of the Society there are numerous mentions of his speeches, concerning, among others, the effect of individual resistance to development of infectious diseases and other skin diseases: psoriasis, systemic lupus erythematosus [32]. On 21st March 1937 he was elected a president of the Polish Association of Singers and Musicians [33]. He was president of the Association of Defenders of Lvov [34,35]. In 1932 he was appointed chairman of the Committee for the Care of Participants January Uprising of the year 1863–4, taking care of the veterans from Lvov region [36,37]. About 260 veterans remained from a total number of 200 thousands of insurgents of January Uprising in 1932. They were highly esteemed in the Second Republic of Poland and were officially glorified as examples to follow in patriotic education of next generations of Poles. They were particularly remembered and even venerated for their particular contribution to the struggle for Polish independence during the nearly two years (1863–1864) of the uprising against the Russian Empire, which cost the lives of tens of thousands of people [36,37]. In 1937, Stanisław Ostrowski became a board member of the Lvov section of Camp of National Unity [Obóz Zjednoczenia Narodowego] [38].

World War Two and postwar emigration

Stanisław Ostrowski remained in his position on his own free will, contrary to central authorities of the state, who escaped to Romania to find their rescue from the invaders on the night of 17th September, the day of Soviet invasion of Eastern Poland as Poland and Romania signed the Convention on Defensive Alliance, signed on March 3, 1921, in Bucharest for mutual help in case of Soviet invasion [39]. After the capitulation of Lvov under Soviet invasion of 22th September 1939, President Ostrowski [6] was arrested on September 23, then imprisoned for 14 months in the Lubyanka [NKVD main prison] and sentenced to eight years in a slave labor camp [22]. From the time of this first imprisonment until 1956, he was forcedly separated from his beloved wife Kamila Ostrowska [died on 1962 in UK], social activist for Lvovian Children [22]. All his vice-presidents of Lvov at the time: Wiktor Chajes, Franciszek Irzyk (1879–1940) and Jan Weryński (1897–1940) were murdered and are included in the list of victims of “Katyń crime” [22]. He was the only one to survive from the group of higher municipal authorities of Lvov. The penalty of imprisonment and Siberian deportation of Stanisław Ostrowski was executed in the transit camp at Krasnoyarsk in Siberia and later in Buryat-Mongol Autonomous Soviet Socialist Republic. Near Krasnoyarsk he worked for several weeks with other prisoners as a lumberman, and in the evenings he served as medical doctor in the camp infirmary [20,22]. The labor camp of Kraslag, in which President Ostrowski was held, was small just to keep from 600 to 1,000 prisoners and it was profiled for the logging. The most common cause of death were hunger, pelagra, dysentery and work-related accidents [40]. Later his function was limited to medical service in Buryatia. Buryatia patients of professor Ostrowski - criminals and political prisoners were exploited for slave labor at the mining of tungsten and molybdenum, road works and forestry. In consequence of the Sikorski-Maisky agreement on July 30, 1941 (the treaty between the Polish and the Soviet Union, restoring diplomatic relations between the two countries after Soviet aggression of East of Poland on September 17, 1939) he was covered by amnesty on Polish exiles, imprisoned citizens in jails or deported to concentration camps Gulag. Ostrowski was included in sanitary corpse of medical doctors at Polish Army in the USSR [22]. He served from 20 December 1941 to 20 January 1942 to disposition of sanitarian chief command of Polish Armed Forces in USSR. The formation, in which he was the chief medical doctor of the regiment was to provide communication between the command and its subordinate units, the Polish authorities in London as well as the embassy of Polish Republic in Kuybyshev and later with Tehran. From 22 January to 20th July 1942 captain Stanisław Ostrowski was main medical doctor of communications regiment [6]. On 23th July, 1942, captain Stanisław Ostrowski was appointed Chief medical doctor of the Reconnaissance Squadron “Lwów Children”, stationed at the time in Shahrisabz (Shahre Sabz: city of green: verdant city) in southern Uzbekistan (Qashqadaryo Region). Due to the deteriorating Polish-Soviet relations and the need to defend the oil fields in the Middle East, the Polish army was evacuated from the USSR. After a exhaustive four-day trip, Ostrowski arrived on 19 August 1942 on the Caspian Sea and sailed to the Iranian port of Pahlevi [4,41]. There, chief medical doctor of Reconnaissance Division “Lvov Children”, Stanisław Ostrowski was intensively involved in quarantine of Polish soldiers and refugees. On that spot it was necessary to set up a “camp of malaria” for about 1600 people. A fight against other epidemical infectious diseases (particularly against typhus fever) was continued among the Poles and local civilian population with building of numerous disinfectors. Then, his military unit was relatively quickly transported to Khanaqin, Iraq from September 3rd to 9th, 1942. Polish soldiers experienced unwelcomed conditions of very dry and hot continental climate. Namely they underwent military training in the dessert only in the morning and in the afternoon. Stanisław Ostrowski served there until 1st October, 1942. From 11th October 1942 to 18th February 1943 Ostrowski belonged to Depot of Indian Convalescents in Khanaqin [6]. His patients were mainly affected by malaria, amoebiasis, bilharosis, dysentery, shigellosis and salmonellosis. Pappataci fever (sandfly fever) was also common [42,43]. After movement of Polish army from Russia to Iran he was assigned to the Hindu House of convalescents, where together with other Polish doctors he supervised and treated former prisoners of Soviet labor camps and provided long-desired care for malnourished Polish children who escaped from Siberian winter endangered with death to warm and hospitable climate of Iran. For them Iran was a truly paradise where they could recover from various avitaminoses and to be cured from tuberculosis and rickets. Stanislaw Ostrowski went to Italy with the Second Corps of general Władysław Anders. During the Italian campaign he worked in military hospitals e.g. from 7th December 1943 to 23th November 1944 as the chief doctor in the House of Convalescents in Marina de Toranto. From July 1945 he served in 340th military hospital, which was renamed 9th military hospital on 19th November 1945 [7]. At first he was a commander of the whole hospital and later he focused on purely medical service in the position of the head of the Department of Dermatology and Venereology [7]. On 24th February 1947 he was transferred to 3rd military hospital. He was appointed head of the department of dermatology in Trani, Eastern South of Italy, where he worked until 1946, when he formed the British Isles Polish Resettlement Corpse [7]. On 1st March 1943 he was raised to the ranks of major [7]. In United Kingdom Stanisław Ostrowski served as a head of dermatology department in Polish No.3 Hospital in Penley (Welsh: Llannerch Banna, County Borough of Wrexham, Northern Wales) until 1955. The hospital was home to more than 2,000 patients and staff. The numbers began to decline due to the inevitable aging of the war veterans [44]. After the closing down of specialized clinics at the hospital, he moved to the English hospital for war invalids in Mossley Hill (Liverpool).

He was a president of the Association of Polish Doctors in exile. In 1962 Ostrowski was retired from the work at the hospital and he lived in London, but continued social, political and scientific activity. Among his undoubted talents were the ability of interpersonal mediation and the gift of winning people over. These were particularly useful in the management of 300 thousand inhabitants and branch hospital in Lvov. Then his skills were utilized to reconcile opposite fractions of Polish emigration. His effective action to re-unite Polish political emigration was a spectacular success. He ended a kind of political schism that lasted nearly 18 years. Namely, there were two bodies: Council of Three and the President of Polish Republic in exile. Both of these offices declared themselves as the legitimate continuation of the highest authority of the Second Republic of Poland. To avert this crisis Stanisław Ostrowski took the office of President of the Republic on April 9, 1972 and ended up duality of power in agreement with the Council of Three [45]. He exercised his authority to seek Polish-Ukrainian and Polish-Lithuanian reconciliation. He also supported Committee of Defense of Workers in the communist Poland. He passed the office to his follower president Edward Raczyński on April 8, 1979 [46]. Stanisław Ostrowski died on 22th November, 1982 in London [4]. On December 4, 1982 he was buried at Commonwealth and Polish War Graves, Newark-On-Trent Cemetery [4].

Stanislaw Ostrowski’s scientific output

One of the first clinical articles by Ostrowski, who was a student of Franciszek Krzyształowicz at the time, is a diligent description of the case report of bed sores of a woman poisoned with gas [47]. Ostrowski conducted extensive research on cutaneous tuberculosis [48]. In his scientific work he studied the impact of sympathetic and parasympathetic systems on the development of various dermatoses - mainly tuberculosis of skin and syphilis [49,50]. He studied a large number of patients to interpret the enhancement of the cardio-ocular reflex in the context of infectious illnesses, body poisoning by toxins and drugs, endocrine disorders and alterations of metabolism [51]. He also was interested in the impact of sympathetic and parasympathetic systems on blood homeostasis of patients with syphilis and cutaneous tuberculosis. He assumed that the vegetative system is involved in the metabolism and particularly in maintaining the ion balance of the body. He investigated 61 patients with tuberculosis and 153 syphilitic patients split into groups of various age, gender or with essential difference of length of the disease. He found that anti-tuberculosis ultraviolet light treatment causes transient increase in reserve of body bases, while syphilis does not affect base-acid balance. The sympathetic and parasympathetic endocrine disorders affect the acid base balance [32]. He also focused on the functioning of autonomic nervous system in endocrine disorders in the context of structure of the sympathetic and parasympathectic nervous systems [52]. He recorded biological reactions of substantially large number of mainly syphilitic patients to the mediators of the sympathetic and parasympathetic systems. He administrated adrenaline, nicotine, muscarine, pilocarpine, physostigmine and atropine and he observed subsequent sympathetic and parasympathetic reflexes. His other studies referred to the digestive system, cardiovascular system, urinary, ocular, and sweat glands in patients with syphilis in various stages [52]. His extensive knowledge was used in the treatment of various forms of cutaneous tuberculosis of the skin. As an associate professor of the Department of Dermatology at the Lvov Medical Faculty, he tried to be innovative by introducing novel treatments with appliance of compresses with tuberculin solution, just to stimulate immune system and enhance resistance of patients [53]. It was quite an extraordinary and reasonable approach in the contemporary state of knowledge of tuberculosis serology and immune responses [54]. He thought that effective tuberculosis fight could be executed with the massive use of tuberculin tests and anti-tuberculosis vaccination of children. He applied tuberculin into dermis, subcutaneous region and on the surface of the skin and he propagated usage of Mantoux and Nathan tests in this way [55]. His clinical experience dated since 1924 in the field of Mantoux Moro Pirquet Nathan tests. Meetings of Lvov Medical Society were ground for him to propagate ideas of compulsory children’s vaccination and surveillance with periodical control of the whole given population with tuberculin testing. However, such ideas were completely put into practice with universal BCG vaccination only later, in postwar time [56]. Ostrowski returned to Mantoux reaction in tuberculosis skin disease and systemic tuberculosis in the 1930s, developing many themes based on further research [57]. In 1932 Stanisław Ostrowski and professor of microbiology Stanisław Legeźynski (1895–1970) published an article devoted to the diagnosis of tuberculosis in the 111th volume of the Parisian “Comptes rendus des séances de la Société de biologie et de ses filiales Société de biologie” [58]. Ostrowski extensively observed the impact of arsenobenzole in the management of skin diseases with special attention to arsenobenzole side effects [59,60]. He also examined the use novarsenobenzole in treatment of syphilis [61]. Ostrowski, who conducted lectures at the King John Casimir University on gonorrhea, examined and treated the entire year populations of university students in the field of venereal diseases [62]. Moreover, he published a very important article on the treatment of urinary tract infections with acridine derivatives [62]. Clinical experience has also allowed Ostrowski to write a very interesting article on the fight against chancroid (ulcus molle) with appliance of the Dmelcos vaccine [63]. He often initiated discussion on the differences and similarities in the clinic and histopathological appearance of the cutaneous and systemic scleroderma in comparison to skin atrophy at meetings of the Lvov Medical Association [64,65]. He applied sensitizing patients to light by acridine derivatives in management of psoriasis [66]. He also gave a profound characteristics of sebaceous nevus in Polish and German publications e.g. in Stockholm journal “Acta Dermato-Venereologica [67,68]. He published also (1901–1977), a paper devoted to Fox-Fordyce with Tadeusz Chorążak in the same journal [69]. Ostrowski published an article on mediators of the vegetative system in connection with structure of this system, too [70]. Ostrowski described a practical way to prevent the side effects after treatment with arsenobensole in Acta Dermato-Venereologica as well [71]. He also studied the therapeutic properties of gold salts in rheumatologic arthritis, cutaneous tuberculosis and other skin diseases like inflammation of the serous membranes, lupus erythematosus to give reports to Lvov Medical Society [72,73]. Secher’s remarks were starting points for Ostrowski to develop his own considerations on dermatological symptoms after use of gold salts, as well as after the treatment of syphilis with salvarsan. He was quite a meticulous propagator of up-dated approach to cutaneous tuberculosis and skin manifestations of other particularly systemic and venereal diseases. It is clearly evidenced in reports of meetings of the Lvov Medical Society during the period when he was a secretary there. After the World War Two, he continued his scientific surveys in exile in UK, but already in a somewhat narrower scope. Instead, he devoted himself primarily to social activity and political organization of Polish emigration. In one of his few postwar articles in 1950 he documented his experience of a military doctor entitled: “Progressive gangrene-infectious skin necrosis and gangrene-hospital (with a report of an epidemic of hospital gangrene)” [74]. While being censored to publish medical papers in Poland after World War Two, Ostrowski wrote several following articles in the Polish Yearbook of the Polish Society of Arts and Sciences Abroad: “The importance of the use of penicillin in syphilis in experimental and clinical aspect” [75] and “Comparative skin patch tests after exposition to antibiotics “ [76].

Discussion

Stanisław Ostrowski’s principles as president and medical doctor perfectly fit to rules of conduct developed by Thomas Jefferson (1743 – 1826), American Founding Father, main author of the Declaration of Independence and the third President of the United States) [4,77]. Thomas Jefferson addressed these rules in the first place to himself and his relatives for improvement of personal behavior. According to Jefferson’s first canon, Ostrowski “never put off to the next day what he could do today” [77]. His deep sense of duty was cultivated in patriotic education and culminated in medical military service [4,22]. He “never troubled another with what he was able to do by himself” [77]. For example, being a medical professional he cared directly for public health affairs while holding an office of municipal president of Lvov. Ostrowski “never spent his money before he had it”. Indeed he never lived on credit and in the most severe conditions of his life he was able to survive due to his service as medical doctor. Thanks to his medical profession he was self-sufficient but always humble through his life on private financial ground [22,77]. He “had never bought a thing he did not want, because it was cheap” but his motivation was always pragmatic. He “took care of his cents: dollars had taken care of themselves” in his life. Indeed he was careful about little things and paid a great attention to details, so he finally succeeded in performing his functions for the society with great financial scrutiny [22,77,78]. He had a hard life but he managed to get along with most of terms as he worked as a medical doctor everywhere. He was aware of the fact that “pride costs us more than hunger, thirst and cold” [76]. All his life he remained a humble silent person, but he managed to preserve his dignity and strength in spite of the fact of his exposure to Siberian hunger and cold [22]. Thus, he “never repented of having eaten too little while at last enjoying comfort as medical doctor in UK. He never forgot that “nothing is troublesome that one does willingly” [77]. Thus he always tried to think carefully and act with deep common sense as even gestures could cost him a life in very dangerous times. He tried not to worry in advance despite horrible experiences, because it would be unreasonable to add himself additional sorrows [22,78]. He simply knew “how much pain had cost us the evils, which had never happened!” [22,77]. He tried to be subtle and gentle in handling fragile public and medical affairs as he followed the advice of Jefferson “to take things always by their smooth handle” [22,77]. He was the supreme leader for a government of Polish Republic in Exile in London that was legal, the Polish government on emigration while Polish land was ruled by communists after World War Two. He had such a calm nature which was perfectly balanced emotionally, speaking quietly in a calm voice as probably he knew that emotions did not solve problems [4,22,77]. He probably knew that “when angry, he should count to 10 before he spoke; if very angry, 100” [77]. He never used a language as instrument of fight as it is used in political debates, but his voice was a tool of therapy through reasonable dialogue. His speeches make him excellent president of Lvov. He was able to communicate with everybody and everywhere he had friends. His authority, great social esteem and respect were early and strongly grounded by his sanitary service during wartime [22,77]. Thus, as a politician, he was the youngest member of Parliament. He was able to unite all and was well liked by all [22,77]. If there is a need of a great statesmen, let us look for a person who resembles Stanisław Ostrowski and such an individual will certainly be a healer of our problems on social grounds in a truly therapeutic aspect. Communist regime formed new societies under the same rules as in the entire Soviet block. One of these rules was the destruction of prewar intellectual elite of nations and states under Soviet hegemony. Following this pattern of action, Stanisław Ostrowski was destined to persecution under Soviet rule similarly to the Romanian pioneer of medical biochemistry, Professor Ion Manta (1900–1979) [79]. Although Stanisław Ostrowski and Ion Manta were great academic teachers, it was a great luck for both of them to save their own lives under communist regime [79]. As shown in the discussion, due to a great life story of Stanisław Ostrowski, the professional biography of Stanisław Ostrowski has been worth profound biographical studies for a number of reasons. Our current original historical paper presents so far the most complete, grounded on primary resources, thoroughly checked within secondary resources, biographical study on Stanisław Ostrowski. The authors of the paper aimed to provide a medico-historical analysis of the life of Stanisław Ostrowski in ethical, socio-economic and cultural aspects, as these perspectives are always pivotal in an academic approach of the history of medicine [80].

Conclusion

Stanisław Ostrowski was the undisputed leader of millions of the Polish emigrants in the West. Putting aside his political involvement he was a non conformist and independent person who managed to earn a living by performing his medical profession no matter if it was in Siberia, war front or the UK. This biographical study shows the life of Stanisław Ostrowski as a great lesson how to find a stable ground as medical doctor for personal maintenance among poverty of war, how to survive in a constant danger of life and how to emerge as a unifying statesman of Polish emigration in Great Britain torn by internal conflicts at last. Stanisław Ostrowski’s fight against tuberculosis and syphilis was his main activity in public health, that he exercised with great executive power as president of Royal City of Lvov. A story of Stanisław Ostrowski is a great lesson about how to cure such a conditions holding a high authority office.