Rheumatology as a medical specialty emerged at the borderline of physical medicine, balneology, and internal medicine in the first decades of the 20th century. It was largely thanks to Jan Van Breemen, who initiated international cooperation between doctors interested in musculoskeletal diseases. The current year marks the 150th anniversary of the birth of Jan van Breemen, who can undoubtedly be called the “father of world cooperation of rheumatologists”. Unfortunately, there is little biographical material available on Jan van Breemen. The aim of the presented Letter to the Editor is to recall the profile of this great pioneer of European rheumatology based on a Dutch Biographical Dictionary [1] and other fragmentary biographical sketches.
Jan Frans Leonard van Breemen was born on the 11th of May, 1874, in Amsterdam. He was the son of the merchant Jan Henri van Breemen and his wife, Hendrika Klazina Tuk. He completed his primary schooling in his hometown. In Amsterdam, he continued his education at the Barlaeus Gymnasium. However, he interrupted his studies due to conflicts with his teachers. He tried to get into a seamen’s school but was rejected due to poor eyesight. He passed the state examination, proving that he had graduated from high school and went on to study medicine at the University of Amsterdam. He graduated with the medical doctor diploma on June 8, 1901.
Still as a student, Jan van Breemen was interested in physiotherapy. At the time, this discipline in the Netherlands and most other countries was left in the hands of medically unqualified people, who rarely even had training as massage therapists. Professor Barend Joseph Stokvis (1834–1902), who taught physiology and pharmacology, was the only university teacher of van Breeman who showed an interest in physiotherapy. The young medical graduate turned down an offer from Cornelis Winkler (1855–1941) to get the post of assistant at the Department of Neurology and Psychiatry. He started working as a general practitioner in Amsterdam, further pursuing his interest in physiotherapy. In 1902, he became a doctor for several poorhouses run by the city. During this time, he undertook a training trip, acquainting himself with physical therapy methods in Austria, Germany, Sweden, Denmark, and France. He was particularly interested in electrotherapy. Back in his home city, he founded the Physiotherapy Association (Vereeniging voor Physische Therapie), which was established on February 14, 1903. The Physiotherapy Association purchased the Keizersgracht 489 building and converted it into a modern physiotherapy facility. There, the Physiotherapy Institute (Instituut voor Physische Therapie) was established as a foundation. The Physiotherapy Institute was opened on June 15, 1905. Jan van Breemen became its medical director.
Jan van Breeman drew attention to many patients suffering from rheumatic diseases. He was aware of the very limited therapeutic options in these patients. The 4th International Congress for Physiotherapy (IV. Internationaler Kongress für Physiotherapie) was held in Berlin from the 26th to 30th of March, 1913. At this congress, Jan van Breemen presented a project for the foundation of an international organisation for the fight against rheumatic diseases. The outbreak of World War I delayed the implementation of the project. It was not until 1919 that the International Organisation for the Investigation of Rheumatism (Comité International pour le Rhumatisme) was founded. Its first president was the Englishman Robert Fortescue Fox (1858–1940), and its secretary was Jan van Breeman [2, 3].
At the Congress of the International Society of Medical Hydrology (International Society of Medical Hydrology, Société Internationale d’Hydrologie Médicale, Internationale Gesellschaft für Wissenschaftliche Bäderkunde) in Paris in April 1925, also at the proposal of Jan van Breeman, the International Organisation for the Study of Rheumatism was transformed into the International League Against Rheumatism (La Ligue Internationale Contre le Rhumatisme). The organisation brought together individual countries represented by National Committees. From the last months of 1928, the newly founded Polish Committee for the Control of Rheumatism has been representing Polish rheumatologists [4]. Initially, the League interacted with the International Society of Medical Hydrology, primarily using the pages of its journal (Archives of Medical Hydrology). In 1929, Jan van Breemen established the League’s journal. It was initially entitled Acta Rheumatica; after a short time, the title was changed to Acta Rheumatologica [5]. Six international rheumatology congresses were organised until the outbreak of World War II. These included congresses in Budapest (1929), Liége (1930), Paris (1932), Moscow (1934), Lund (1936) and London and Oxford (1938). After the organization’s foundation in Paris in 1925, the authorities and delegates from each country met annually or more frequently. This is why the year 1928 and the city of Bath appeared in some historical lists as the venue of the First International Congress of Rheumatology. However, it seems that the Budapest meeting should be considered the first congress, as indicated by the extensive reports from the congress published in Acta Rheumatologica. An international textbook on rheumatology was prepared, and its publication in print was interrupted by the outbreak of World War II. The editors of the textbook were William Sidney Charles Copeman (1900–1970), the British rheumatologist, editor of rheumatological publications and historian of rheumatology, and Philip Showalter Hench (1896–1965), the American rheumatologist, Nobel Prize winner for the introduction of glucocorticosteroids into the therapy of rheumatic diseases. It should be mentioned that one of the co-authors of the textbook was to be Eleonora Reicher from Poland [4]. After the war, the first congress was held in New York in 1947, where Jan van Breemen’s significant contribution to the organisation of the international fight against rheumatism was honoured [6].
Mention should be made of Jan van Breemen’s participation in the formation of an organization of Dutch rheumatologists. He was the initiator of the Dutch Society for Rheumatism (now Nederlandse Vereninging voor Reumatologie - Dutch Society for Rheumatology); the organization was founded on October 23, 1926. His most outstanding achievement, however, is the establishment of the Institute of Physiotherapy, which was renamed the Amsterdam Center for Rheumatic Diseases and transformed into the Jan van Breemen Institute. In 2010, the Amsterdam Rehabilitation Center merged with the Jan van Breemen Institute to found the Reade Center, which offers care for rheumatology patients and rehabilitation care. Reade has close to a thousand employees, working in the main department at Breemenestraat (former home of the Jan van Breemen Institute) and the Overtoom clinic (former home of the Amsterdam Rehabilitation Center), as well as collaborating with the Vrije Universiteit Medical Center (Vrije Universiteit Medisch Centrum) and Slotervaart Hospital (Slotervaartziekenhuis) [1].
Jan van Breemen’s work for international cooperation among rheumatologists was recognized. In 1947, he received an honorary doctorate from Charles University in Prague. He was an honorary member of the Polish Society of Rheumatology.
Jan van Breemen lived all his life in Amsterdam. In 1901, he married Ignatia Henrietta Wilhelmina Maria Deutmann. Ignatia and Jan Breemen had four children. The marriage ended in divorce in 1925. Jan van Breemen’s second wife was the well-known violinist Elisabeth Anna Maria Schrik. Elisabeth and Jan had no children together. Jan van Breemen died in Amsterdam on February 7, 1961 [1].
Participating today in various forms of international cooperation of rheumatologists, we should remember the great contribution of Jan van Breemen’s work in initiating cooperation between rheumatologists of different countries.
