Alexander I. Ignatowski

Abstract

In 1908, Alexander I. Ignatowski (1875–1955) published his pioneering work that first revealed a relationship between cholesterol-rich food and experimental atherosclerosis. This early experimental work paved a way to the metabolic study of the mechanism of atherosclerosis. Herein, we present a brief account of Ignatowski's work and life.

The understanding of the pathogenesis of atherosclerosis is often called one of the greatest discoveries of the 20th century.^1,2 Research into the causes of atherosclerosis began in 1907, when Alexander Ignatowski began to feed rabbits a diet of full-fat milk, eggs, and meat. Rabbits fed with animal proteins soon developed pronounced atherosclerosis of the aorta.^3–7

These pioneering experiments began an era of metabolic studies into the mechanism of atherosclerosis.^8,9 In 1912, using Dr. Ignatowski's experimental protocols, Theodor Fahr produced early atherosclerosis in 5 to 8 months and severe atherosclerotic damage to the aorta, with elevated blood pressure, in 9 to 10 months.⁹ The same year, Nikolai Anichkov and Semen Chalatov reproduced Ignatowski's experiments and showed that atherosclerosis can be caused by cholesterol.^10,11 Since 1912, extensive research has been conducted on the mechanism of atherosclerosis. Ignatowski's pioneering experiments became classic and were reproduced by many research scientists all over the world, which ultimately led to our current understanding of the atherosclerotic process. Although his work is cited in almost all historical reviews of studies into the mechanisms of atherosclerosis, little is known about Ignatowski's life and the conditions under which he worked. A century has passed since his pioneering effort. It is hoped that these biographical notes will preserve at least a fragment of his life and thereby pay homage to his work.

Biography

Alexander Iosifovich Ignatowski (1875–1955) (Fig. 1) was born in Smolensk, Russia, on 18 March 1875. He finished Novgorod Gymnasium and graduated “eximia cum laude” from the Imperial Military Medical Academy in St. Petersburg in 1899. After graduation, Dr. Ignatowski got involved in experimental work in the laboratory of the Nobel Prize-winning physiologist Ivan P. Pavlov (1849–1936) in St. Petersburg. Upon Pavlov's recommendation, he was sent for further postgraduate studies with Wilhelm H. Erb (1840–1921) in Heidelberg and Friedrich von Müller (1858–1941) in Munich. In 1905, Ignatowski returned to St. Petersburg and obtained an appointment as docent at the department of internal medicine of his alma mater, the Imperial Military Medical Academy, headed by Prof. Mikhail V. Yanovski (1854–1927).¹²

Fig. 1 Alexander I. Ignatowski as Professor of Internal Medicine and Dean of the Medical School of the University of Belgrade, ca. 1930. This photograph, taken by Dr. Gradimir Jankovic in 2011, duplicates the portrait on Dr. Ignatowski's gravestone.

In 1908, Ignatowski was elected to the post of ordinary Professor of Internal Medicine at the Medical Faculty in Odessa. In 1911, he moved to Poland to become a full Professor of Internal Medicine at the University Clinic in Warsaw. It appears that his focus switched at that time from the laboratory to clinical practice and to the teaching of internal medicine. During World War I, he served at the Division for Infective Diseases in the army of General Vasili I. Gurko (1864–1937). After the Bolshevik revolution of 1917, Dr. Ignatowski remained at his post at Warsaw University, then was transferred to Rostov-on-Don.

Approximately 50,000 Russian refugees moved to Yugoslavia after the 1917 revolution. The emigration of Russians to Yugoslavia in the 1920s is sometimes referred to as “professorial.” Seldom in history has there been such an exodus of highly educated people as the one that occurred after the fall of the Russian Empire in 1917. In 1922, 12% of the Russian refugees in Yugoslavia had a university education, 61% had a high school education, and only 3% were illiterate, which is remarkable when one considers that 50% of the Yugoslavian population older than 12 years of age was found to be illiterate in 1921.¹³ In the 1920s, 15 Russian professors were elected to the Serbian Academy of Sciences and Arts.

During the reign (1921–1934) of King Alexander I of Yugoslavia (1888–1934), education flourished in that country. Alexander, who had been educated in the Imperial Page Corps in St. Petersburg, wisely understood the educational and economic benefits brought to his country by highly educated Russian refugees. The state allocated generous funds to education, and well-equipped facilities were built.

In 1920, Dr. Ignatowski emigrated to Serbia and became Professor of Internal Medicine at the newly founded Medical School of the University of Belgrade. Ignatowski put all his energy into teaching medical students and establishing a new faculty. He became the Dean of the Faculty of Medicine in Belgrade from 1920 through 1924 and subsequently served a second term from 1929 through 1930. In 1925, the first class of students graduated from the University (Fig. 2). Enrollment in the Medical School increased rapidly, and by the end of the 1920s students were learning their skills in very well-equipped modern classrooms (Fig. 3). On 16 September 1928, the new Russian Institute of Sciences—funded entirely by the state—was chaired by Prof. Eugene V. Spektorski (1875–1951), former dean of the University of Kiev. Prof. Ignatowski became the dean of the Institute's Medical Faculty. In that same year, a monumental building was erected for the Internal Medicine Clinic in Belgrade (Fig. 4), in accordance with the architectural blueprint of Dr. Ignatowski's old Warsaw clinic. Ignatowski dedicated most of his time to teaching and writing; his textbooks on internal medicine were used by many generations of students.¹⁴ His wife, Anastasia, died on 7 December 1934.

Fig. 2 Professor Ignatowski with the first graduates of the Medical School of the University of Belgrade. Taken at his Clinic of Internal Medicine in Belgrade, March 1925. From the archives of the Faculty of Medicine, University Clinical Center of Serbia.

Fig. 3 Students in the histology laboratory at the Medical School of the University of Belgrade in 1928. From the archives of the Faculty of Medicine, University Clinical Center of Serbia.

Fig. 4 The newly built Clinic of Internal Medicine in Belgrade, 1928. From the archives of the Faculty of Medicine, University Clinical Center of Serbia.

Upon the Nazi occupation of the Kingdom of Yugoslavia in 1941, the occupational government ordered the vacation of Ignatowski's hospital within 24 hours, in order that it might be converted into a military hospital (Fig. 5). Prof. Ignatowski resigned. After the liberation of Yugoslavia in 1944, he was reinstated to his former positions at the Faculty of Medicine and the Department of Internal Medicine. He retired in 1946, but shortly thereafter, at the request of the newly organized University of Skopje, Dr. Ignatowski accepted a full professorship of internal medicine there. He died on 18 August 1955 in Jesenice, Slovenia; in accordance with his wishes, he was buried in the Russian Cemetery in Belgrade (Fig. 6) next to his wife. Besides his contributions to science and education, his obituary mentioned that “Prof. Ignatowski had a particularly endearing trait—his selfless love for his students and associates, whom he supported in their work and clinical research. He was an exceptionally modest man and never spoke of himself.”¹⁴

Fig. 5 Professor Ignatowski's Clinic of Internal Medicine, turned into a German military hospital in 1941. From the archives of the Faculty of Medicine, University Clinical Center of Serbia.

Fig. 6 The grave of Alexander I. Ignatowski and his wife, Anastasia, in the Russian Cemetery, Belgrade. This photograph was taken by Dr. Gradimir Jankovic in 2011.