PROFESSOR – AN EXCEPTIONAL MILITARY CAREER

Viorel Ordeanu1,2* 1Cantacuzino National Medico-Military Institute for Research and Development, , 2Titu Maiorescu University, Bucharest, Romania

ABSTRACT On the centenary of the most prestigious medical institution in Romania, today militarized and moder­ nized, we remember with all the due respect and gratitude the great forerunners who founded and developed this unique medical forum for research, education and production for the benefit of the Romanian nation. In the history of the Romanians, however, there remained a general who did not kill anyone, who on the contrary, saved the lives of many thousands of soldiers and millions of civilians. He was Brigadier General (r.) Univ. Prof. Dr. Ioan I. Cantacuzino, the founder of the Institute that bears his name, the current “Cantacuzino” National Medico-Military Institute for Research and Development, in Bucharest. During the Second Balkan War he coordinated the activity of combating the epidemics of typhoid fever and Asian cholera in the Romanian military personnel during the Bulgarian campaign. In 1913 he produced large quantities of the anti-cholera vaccine, which he administered en masse to the soldiers campaigning in Bulgaria, in an epidemic environment, the “great Romanian experience”, which reduced mortality among the Romanian Army. For his activity in the Great War he was decorated with numerous orders and medals, Romanian and the “Legion of Honor”. Professor Ioan Cantacuzino continued his prodigious activity, but in January 1934 he fell ill and died on January 14th, 1934, and will remain for eternity in the crypt of the Institute that bears his name. We hope that the Cantacuzino Institute will continue its work guarded by the spirit of the great forerunner. Keywords: Ioan Cantacuzino, Cantacuzino Institute, public health, vaccine, military medicine

REZUMAT La centenarul celei mai prestigioase instituţii medicale din România, astăzi militarizată şi modernizată, ne amintim cu respect şi recunoştinţă de marii înaintaşi care au fondat şi au dezvoltat acest for medical unic de cercetare, învăţământ şi producţie în beneficiul naţiunii române. Prezentăm această legătură intrinsecă a instituţiei medicale cu armata pentru a sublinia importanţa strategică a activităţii sale specifice, pentru securitatea naţională a României moderne. Marii generali au rămas în istorie prin victoriile lor, deci şi prin numărul mare de morţi în rândurile inamicului şi implicit şi al trupelor proprii sau chiar al populaţiei civile. Dar in istoria românilor a rămas un general care nu a omorât pe nimeni, ci dimpotrivă, a salvat vieţile multor mii de soldaţi şi milioane de civili. Este General de brigadă (r.) medic Prof. univ. Dr. Ioan Cantacuzino, fondatorul Institutului care îi poartă numele, actualul Institut Naţional de Cercetare-Dezvoltare Medico-Militară „Cantacuzino” din Bucureşti. Institutul împlineşte un secol de existenţă oficială, dar experienţa lui este de fapt de 120 de ani în serviciul naţiunii române. A produs milioane de doze: vaccinuri profilactice şi terapeutice, seruri terapeutice şi alte medicamente biologice, reagenţi in vivo şi in vitro, animale de experienţă şi materiale pentru acestea etc. dar reforma sanitară, asigurările de sănătate şi schimbările de paradigmă de la începutul acestui secol au zdruncinat din temelii tradiţiile Institutului. Sperăm ca Institutul Cantacuzino să îşi continue activitatea sa de importanţă strategică, să fie din nou ce a fost şi mai mult decât atât, să continue tradiţia şcolii cantacuziniste din toate punctele de vedere şi să se ridice iar la nivel mondial, cu deschidere către lume. Până acum semnele sunt bune şi putem fi optimişti pentru viitor. Cuvinte-cheie: Ion Cantacuzino, Institutul Cantacuzino, sănătate publică, vaccinuri, medicină militară

*Corresponding author: Viorel Ordeanu, Prof. MD PhD SR, email: [email protected]

ROMANIAN ARCHIVES OF MICROBIOLOGY AND IMMUNOLOGY, Vol. 79, Issue 4, pp. 295-301, October - December, 2020 295 VIOREL ORDEANU

INTRODUCTION Cantacuzène). He was award-winning, at the On the centenary of the most prestigious age of 19 he passed the baccalaureate and medical institution in Romania, today mili­ attended the Faculty of Letters and Philosophy tarized and modernized, we remember with in , which he graduated in 1885. In line respect and gratitude the great forerunners with the requirements of the time, he returned who founded and developed this unique med­ to Romania to comply with his military ical forum for research, education and produc­ obligations [1]. tion for the benefit of the Romanian nation. We On November 25th, 1885, he was present this intrinsic connection of the medical incorporated as a baccalaureate soldier institution with the army in order to emphasize (equivalent today to “short-term soldier”) in the strategic importance of its specific activity, the 1st Genius Regiment in Bucharest. On March for the national security of modern Romania. 26th, 1886, he was promoted to baccalaureate And because, as the Latins used to say, “Those corporal. On May 25th, 1886, the training who do not know must find out, and those who period ended, he was promoted to the rank know must remember with pleasure”. As for the of baccalaureate sergeant on July 10th, 1886 facts, events and personalities presented here, and after the graduation exam on August 30th, let us remember ’s exhortation: 1886, he was promoted to the rank of reserve “Learn history to know what it will come!” lieutenant in the infantry weapon according to The great generals remained in history the High Royal Decree No. 2415 of August 31th, through their victories, and therefore also 1886 (signed by King Carol I) and was assigned through the large number of dead among as a reserve officer to the 2nd Army Corps, in the enemy lines and, implicitly, also of their the 5th Dorobanți Regiment “Vlaşca”. own troops or even of the civilian population. After fulfilling his military duties, he Sometimes their own losses were much greater returned to France and in parallel he attended than those of the defeated enemy, so that King the Faculty of Natural Sciences at the Sorbonne Pyrus, after a victory over the Romans, said, University, in 1886-1891 and at the Faculty of “Another victory like this, and I am lost!” Medicine in Paris, in 1887-1894, and in 1889- In the history of the Romanians, however, 1991 he practiced in hospitals. On July 12th, there remained a general who did not kill 1894, he obtained the title of Doctor of Medicine anyone (except for a few trillion microbes), with the thesis “Research on how to destroy vibrio who, on the contrary, saved the lives of many cholerae in the body.” thousands of soldiers and millions of civilians. He returned to Romania and between 1894- He was Brigadier General (r.) Univ. Prof. Dr. 1896 he was a substitute professor (associate Ioan I. Cantacuzino, the founder of the Institute professor) of animal morphology at the Faculty that bears his name, the current Cantacuzino of Sciences in Iaşi, he worked as a doctor and National Medico-Military Institute for held geology conferences. Considering that he Research and Development, in Bucharest. was now a doctor, by the High Royal Decree The son of a Minister, grandson of a No. 3355 of July 19th, 1895, he was granted the general, descendant of the imperial family of rank of battalion doctor (equivalent today to the Cantacuzinos, he was born in Bucharest in the rank of lieutenant-doctor) and on August 1863. He used his social position to learn and 1st, 1895, he was assigned as a reserve doctor to work more than anyone else. He did not go to the 4th Army Corps [2]. school, he studied at home and was fluent in In 1896 he married and left again for Paris, Romanian, French, German, he knew Latin and where he worked until 1901 at the Pasteur Greek. He acquired a solid general culture and Institute, as an intern at the laboratory of Prof. all the knowledge of an eminent student, so at Ilya Metchnikoff (father of immunology). the age of 16 he was admitted to the “Louis- In 1901 the Faculty of Medicine in Bucharest le-Grand” High School in Paris, directly in established the Department of Experimental the third year (registered as the student Jean Medicine and on the recommendation of

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Metchnikoff, Dr. Cantacuzino held the the military and civilians, in the midst of the position of Professor of Experimental Medicine epidemic, the “great Romanian experience”, starting December 21st, 1901. He organized which reduced mortality among the Romanian the Laboratory of Experimental Medicine Army to only 1,611 deaths. Because in the at the “Institute of Pathological Anatomy Laboratory of the Department of Experimental and Bacteriology” created in 1887 by Victor Medicine (temporarily located at the Babeş Babeş, in the current building built in 1898. He Institute) he no longer had enough laboratory continued the research to combat the diseases glassware (10 liter flasks and 1 liter Erlenmeyer of his time: cholera, malaria, tuberculosis, glasses) to prepare an anti-cholera vaccine and scarlet fever, typhus. During 1904-1911 he there was no time to buy others, he also used organized a campaign to fight malaria among the tea samovar he had received as a gift from the civilian population and the army. In 1904 his teacher Ilya Metchnikoff when he left Paris. the General Directorate of the Sanitary Service, The samovar is kept in the small museum within the Ministry of Interior (the predecessor of the current Cantacuzino Institute, as an of the Ministry of Health) requested them exhortation for the new generations: “If you to prepare an anti-streptococcal serum, and really want to, you can!” (Fig. 1) in 1905 an antidysenteric serum. Since 1908, the Army Health Service has been sending young military doctors to the Laboratory of Experimental Medicine for epidemiological training. Between 1908-1910, Prof. Cantacuzino was the Director of the country’s Civil Health Service and had set up regional laboratories of bacteriology and hygiene (Craiova, Galaţi, Constanța, Iaşi, Sulina), tuberculosis sanatoriums (Bisericani, Bârnova, Nifon, Cărbuneşti, Filaret). He drafted the Sanitary Law of 1910 that contained modern provisions on the organization and practice of health care in our country [3], which were valid until recently. In 1910 the Directorate of the Army Health Service (led by Brig. Gen. Md. Dr. Constantin Papilian, surgeon and professor of anatomy) prompted him to prepare a vaccine against typhoid fever and applied vaccination and revitalization to all recruits, and this disease disappeared from the military. In 1911 he was elected a corresponding member of the Romanian Academy [3]. During the Second Balkan War, in 1913, Fig. 1 - Professor Cantacuzino’s Samovar he coordinated the activity of combating the epidemics of typhoid fever and Asian cholera In recognition of his merits, he was in the Romanian military personnel during the promoted by the High Royal Decree No. 5112 Bulgarian campaign. In 1913 he produced large of July 25, 1913 to the rank of MD captain in quantities of the anti-cholera vaccine, which he reserve and was assigned as a reserve sanitary applied en masse to the soldiers campaigning officer in the 2nd Army Corps, and by the in Bulgaria, in an epidemic environment. In High Royal Decree No. 7166 of December 24th, just 3 weeks, he prepared 900,000 doses of 1913 was promoted to the rank of MD major cholera vaccine, which he administered to in reserve. Prof. Cantacuzino was appointed

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Head of the Army Sanitary Service [3]. It can be and the population in the risk area, organized assumed that it is in reference to the Romanian the necessary hygienic-sanitary measures [4]. army on the Bulgarian front, because the Head After the end of the Balkan War, by of the Medical Directorate of the Ministry of Ministerial Decision No. 375 of July 16th, 2014, War was Brig. Gen. MD, Dr. Mihail Călinescu. he was moved as a reserve sanitary officer to Together with his collaborators he had the 6th (Sanitary) Directorate of the Ministry many missions on the front, including inspec­ of War. Starting with 1914 the laboratory of tions at Field Hospitals, of which a cholera Experimental Medicine prepared antidiph- hospital was financed and run by Sabina theria serum, which in 1916 exceeded 15,000 Cantacuzino, one of his sisters (Figs. 2, 3). doses. In 1915 he intervened in the epidemic of The Second Balkan War, although it typhoid fever on the Serbian front [5]. started very well for the Romanian Army, led During the period of neutrality, the to its defeat due to the incompetence of the mil­ Romanian Army self-assessed its forces itary and political leadership and the terrible and means, but the liberal government was cholera epidemic that defeated the victorious to engage Romania in war with an unpre­ army and forced it to withdraw. Marshal Otto pared army, underestimating the opponent’s von Bismark, the one who united the German response capacity and based its battle plans on states, was the first German Chancellor, had the promises of the allies [6]. The famous pol­ launched three major European wars and won itician Constantin Argetoianu, who was also a by the cost of 80,000 dead, stated: “Military doctor (he had graduated from the Faculty of regulations are the excuse for officers without ini- Medicine in Paris), left us a suggestive descrip­ tiative.” The one who saved the Romanian tion of the “sanitary line” mobilized in Carol army from disaster was Prof. Cantacuzino, Park, Bucharest: “A mess of old and new ambu- who together with his medical team applied lances, vans, requisitioned carts, smelly cars, ovens anti-epidemic measures, vaccinated the troops and field kitchens mixed with each other, left to

Fig. 2 - Infirmary unit on the Balkan front

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Fig. 3 - The staff of a field hospital on the Balkan front, in the center is the major doctor Ion Cantacuzino fate. A bustle of officers, high-ranked, and civilians, Experimental Medicine had staff, facilities shouting and cursing hierarchically, all cursing the and high-performance materials, with which “organization” (or even better said the “disorgan- it prepared sera and vaccines for the civilian ization”), making things even worse, as if on pur- population and the army, and some staff were pose, what had already been so messy in the pre- assigned to hospitals of contagious diseases vious days”. General Henry Berthelot, the head and in field laboratories. [7] At the beginning of the French Military Mission, an officer with of the mobilization of the Romanian Army, extensive war experience, summed up the situ­ on August 15th, 1916, Prof. Cantacuzino was ation correctly when he said: “You are admirably employed as MD chief hygienist in the Sanitary disorganized!” [6]. Service of the Great General Headquarters. He The poet George Toparceanu, who had developed the Guidelines for the preventive been mobilized as an artillery sergeant, and curative treatment of tetanus, to counteract recounts how in 1916 the military carts that complications in the wounded. On November brought bread to the front line in Bulgaria left 1st, 1916, he was promoted to MD lieutenant- with the cholera and typhoid fever patients colonel in reserve and in 1917 he was appointed and returned with bread. The doctor of the unit General Director of Military and Civil Public reported this to the colonel but was told that he Health. During the period 1916-1917, when the did not know the regulations. Obviously, the Romanian troops were retreating to Moldova, a epidemics spread explosively and the combat terrible epidemic of typhoid fever (triggered in force of the Romanian Army was considerably January 1917, peak in March, eradicated in June) reduced and the retreat beyond the Danube and recurrent fever broke out. The treatment, followed. carried out in cooperation with military It is commendable that at Romania’s entry doctors from the French military mission, was into the First World War, the laboratory of completed with mandatory hospitalization of

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Fig. 4 - Withdrawal of the front in Moldova, pictured: Romanian Queen Maria, General Berthelot, MD Colonel Ioan Cantacuzino and Romanian, French and Russian officers all patients, the establishment of quarantine From June 1918 Prof. Cantacuzino was a areas, severe control of the civilian population member of the National Council of Romanian and localities, disinfestation and hygiene. Unity in Paris; from 1919 he was delegated to By the High Royal Decree no. 465 of May 23, the Paris Peace Conference, being one of the 1917, he was appointed President of the Army signatories of the Treaty of Trianon in 1920, Sanitary Advisory Committee, which had been which entered into force only on July 26th, 1921, abolished at the beginning of the mobilization, marking the official end of the First World War and on September 1st, 1917, he was promoted and confirming the existence of Great Romania. to the rank of MD colonel in reserve [2] (Figs. Between December 1st, 1919 - March 13th, 4, 5). 1920, Prof. Cantacuzino was also the Minister of Health; he continued the work of modernizing the Romanian medical system, the didactic, medical, scientific and organizational activity. In 1921, by special law, takes form the Institute of Serums and Vaccines “Dr. Ion Cantacuzino” near the Ministry of Interior (at the General Directorate of the Sanitary Service) and by Decree signed by King Ferdinand it was decided that the director of the institute should be Prof. Cantacuzino, from Experimental Medicine at the Faculty of Medicine in Bucharest, as a supreme recognition of his merits. It should be mentioned that the Minister of Interior was the MD Dr. Constantin Argetoianu. Prof. Fig. 5 - Portrait of the MD colonel Ioan Cantacuzino, Cantacuzino started his activity at the new decorated with the Legion of Honor institute, received the title of Doctor honoris

300 Professor Ioan Cantacuzino – an exceptional military career causa from several European universities, and Professor Ion Cantacuzino continued his in 1925 he was elected a full member of the prodigious activity [7-8], but in January 1934 Romanian Academy [1, 3]. he fell ill with pneumonia and died at work, on By the High Royal Decree no. 1345 of May January 14th, 1934, and will remain for eternity 12th, 1928, he was granted the rank of MD in the crypt of the Institute that bears his name. brigadier general in reserve, so he went through As a tribute, in front of the main entrance is his all military ranks, from soldier to general; and white stone bust, a bronze bust is in the amphi­ by the High Royal Decree No. 1829 of June 11th, theater and another in the small Cantacuzino 1929, the MD brigadier general in reserve Ion I. Museum in the Institute. We hope that the Cantacuzino was retired due to old age, at 66 Cantacuzino Institute will continue its work years old [2]. through the new Cantacuzinos, guarded by the He continued the scientific, didactic spirit of the great forerunner. and management activity of the Institute, elaborated the Sanitary and Protection REFERENCES Law no. 236/July 14th 1930, known as the 1. Ionescu-Mihăești C. În amintirea profesorului “Cantacuzino Law” whose principles were Ioan Cantacuzino. M.O. Imprimeria Naţională, valid until recently regardless of the political Bucureşti, martie 1934. regime. In 1931 he was elected to the Romanian 2. Spătaru ED. Medicul general de brigadă în Senate, in 1931-1932 he was Minister of Labor, rezervă Ioan Cantacuzino. Revista Misiunea. 2019;1(6):80-83. Health and Social Welfare in the government 3. Ilea T, Ghelerter I, Duțescu B. Învăţământul of Nicolae Iorga, etc. In 1933 he was the first medical şi farmaceutic din Bucureşti. IMF Romanian nominated for the Nobel Prize for București. 1963. his work: “Contributions to study immunity 4. Ciufecu C, Neguț M. Profesorul Cantacuzino – from invertebrates and contact immunity”. personalitate de excepţie în conştiinţa poporu­ For his activity he was decorated with lui român. Total Publishing, Bucureşti, 2013. numerous orders and medals, Romanian 5. Alexandrescu V. Profesorul Ioan Cantacuzino – and foreign, of which we mention: “Military Centenarul Marii Uniri 1918-2018. Ed. Medicală. Virtue” of war, gold, in 1913, “Star of Romania” Bucureşti, 2018. 6. Constantiniu F. O istorie sinceră a poporului in the rank of Knight, in 1921, “Sanitary Merit” Român. Univers Enciclopedic Gold. Bucureşti, class I and the “Legion of Honor” in the rank 2011. of Commander, in 1918, the Gold Medal of 7. Ionescu-Mihăești C, Ciucă M. Handbook of “French Gratitude” in 1919, etc. Infectious Diseases with notes on prophylaxis, On the occasion of his 70th birthday, he serum treatment and vaccination. League of was decorated by the French Republic with Nations Publications, Geneva, 1945. the “Legion of Honor” in the rank of Grand 8. Mesrobeanu I. Opere alese. Ed. Academiei RPR, Knight, which is equivalent to a title of nobility; 1965. he received this special distinction the year of his death.

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