As 2025 draws to a close, we are pleased to share with you the fourteenth edition of our Bulletin — a special issue that not only wraps up the past year, but also opens a new chapter filled with fresh ideas, reflections, and challenges. This moment, when we close some stories and chart the course for the months ahead, invites both reflection and the courage to take on new initiatives. In this edition, we have gathered several pieces that we hope will energise you, spark curiosity, and offer new perspectives on familiar topics. You will find summaries of the past year as well as glimpses of what is coming next: trends worth watching, people who inspire, and ideas that can make a difference — even on a small scale. I encourage close and more frequent collaboration with our editorial team, which can help raise the quality of the publication. To all our readers and friends of our society, I wish that the coming year brings wise decisions, perseverance, and real satisfaction in everything you pursue. Thank you for being with us — your presence gives purpose to every new issue we publish. Enjoy the read! Happy New Year Warm regards, Janusz Ostrowski Editor-in-Chief

Artificial intelligence (AI) is often generating overwhelming enthusiasm, framed as a revolutionary force in modern society, but also deep doubts that the huge investments in these platforms are generating a frightening speculative bubble. Though the economical aspects are far from the short analysis here presented, one wonders whether its introduction in the humanities is happening too soon and with excessive expectations. I argue that AI introduces novel methods for analyzing medical history, with three limitations: deep contextual interpretation, critical source engagement, and ethical vigilance. We must examine also the epistemological tensions AI introduces. The Turing Test (1950), introduced to test if a machine is intelligent, prioritizes superficial mimicry. Translated in the history field, a Turing test on AI would aim at verifying if a machine has depth of understanding and knowledge that historical interpretation requires. The first AI device, the perceptron, was theoretically described few years later by Rosenblatt (1957), and was inspired by neurons, with a reduction of biological complexity to binary.

Figure 1. Rosenblatt's “The Design of an Intelligent Automaton,” (1958), describing the perceptron (taken from https://news.cornell.edu/stories/2019/09/professors- perceptron-paved-way-ai-60-years-too-soon )

Figure 1. Prof. Bolesław Rutkowski (photo Janusz Ostrowski)

Figure 2. Scientific session. From left: prof. Bogdan Biedunkiewicz (Gdańsk), prof. Janusz Ostrowski, prof. Marcin Renke (Gdańsk) (phot. Maria Ostrowska)

Janusz Ostrowski INTRODUCTION Davide Viggiano Artificial Intelligence in the History of Nephrology: Challenges, Limitations, and Criticism Davide Viggiano IAHN Activities through its Bulletin and Congresses: A Chronicle from 2008 to 2024 Janusz Ostrowski Polish Nephrology in 2025: Key Events and Contributions of IAHN Members Davide Viggiano Books in History of Medicine worth having a look Histoire de la médecine (2020) — Jean Starobinski

The simplification of complex biological phenomena in binary codes is a persistent issue in AI applied to the history of nephrology: flattening context-rich human phenomena into computable data. This stems at the heart of a strong resistance to the use of AI in historical work: the neophobia that AI might produce convincing but hollow narratives in medical history seems to resurrect age-old dilemmas about artifice and authenticity. However, several criticalities in AI can be identified: 1 . Machine learning models, including transformers like BERT or GPT, excel at identifying statistical patterns, correlations in text but lack a model of historical reality or a world model. For instance, an NLP tool might associate “humoral imbalance” with “treatment” across a corpus of 17th-century texts, but it cannot access the embodied experience, beliefs, or social hierarchies that gave those terms meaning. The algorithm could not discern metaphor from clinical description. This is not a mere data problem but an ontological one. 2 . AI can systemically exacerbate the issue of biased sources. Models trained on digitized collections will overrepresent the published works of elite, male, Western physicians. Therefore, an AI might systematically overlook the lay knowledge and patient experiences, which are less frequently digitized. 3 . The “black box” problem (nobody can tell how an AI has produced the results) is particularly acute for historiography, which relies on transparent argumentation. The use of AI thus risks creating a new form of scholarly authority that is inherently unverifiable. 4 . The ethical landscape: medical records, even historical ones, contain sensitive information. AI-driven linkage of disparate archives could reconstruct intimate health details of identifiable individuals from centuries past, raising questions about posthumous privacy and the ethics of digital resurrection. 5 . Generative AI poses a unique threat: the fabrication of plausible but false historical data. 6 . Proprietary AI models (like those of Google or OpenAI) are often trained on publicly funded digitization projects, yet their outputs remain commercial. In summary, the historian skepticism towards AI is based on valid epistemological concerns. It remains to be ascertained if an AI, overall, is really worse than all expert human beings concerning methodological rigor, openness to ambiguity, contradiction, and source criticism. I believe that the true value of AI for the history of nephrology does not lie in the unmet promise to solve any as yet unsolvable historical mystery, but in its help in giving support to reasoning and analysis: AI as a companion rather than a substitution for a skilled historian.

The IAHN Bulletin started in December 2018, thanks to the great work of the Editor-in-Chief Janusz Ostrowski. Since then, the Bulletin has appeared twice per year . The Bulletin of IAHN is also present on the website of the European Renal Association (ERA). Many IAHN members have contributed to the contents of the Bulletin. Being a production of the IAHN community, the themes addressed within the Bulletin represent the core of the IAHN work, together with the full length publications that have regularly appeared on international journals after every biannual IAHN meeting.

Figure 1. Top themes in IAHN Bulletin

Figure 1 reports a first analysis regarding the contents of the Bulletin. Information regarding events is likely the most present item. However, specific themes are also evident: history of urine analysis, biographies, obituaries, medicinal plants, hemodialysis, transplantation etc.

Figure 2. Themes by Issue (only three issues shown)

In Figure 2 the various themes are analyzed across different issues: it is evident that there is much heterogeneity. Since 2024 we have stably introduced a section of books. Description of biographies are certainly a constant during the activity of the IAHN. Regarding the evolution of the themes, the last issue in Dec 2024 is shown in Figure 3.

Figure 3. Themes treated in the last Bulletin 2024.

Apart the organization of events, which was already a main theme in previous issues (and will likely become a fixed section of the Bulletin), there is possibly greater attention towards history of methods/nosology compared to biographies. This evolution of themes can also be appreciated from the topics addressed in IAHN congresses.

Figure 4. Themes at IAHN congresses

Figure 4, again, stresses the changes in the major themes addressed by IAHN community of the years. Biographies/giants of nephrology remains a rather constant theme. However, pharmacology/remedies now receive greater attention maybe due to the recent introduction of many new drugs in the treatment of kidney diseases (glyfozines, HIF stabilizers, GLP-1 agonists, finerenone, and all the new monoclonal antibodies). The analysis of IAHN congress programs from 2008, 2010, and 2024 shows a clear thematic evolution. Early congresses (2008, 2010) emphasized classical historical topics such as biographies, uroscopy, and manuscripts, reflecting a strong focus on pioneers and ancient practices. By 2024, themes related to clinical nephrology, dialysis, and transplantation gained prominence, indicating a shift toward integrating historical perspectives with modern nephrology. Cultural and social history remained present but less dominant, while educational and interdisciplinary themes emerged more recently. This trend suggests that the IAHN has progressively broadened its scope to include contemporary clinical relevance and global cultural dimensions.

For years, the final issue of the IAHN Bulletin has featured an overview of the activities of our Polish members during the country’s key annual nephrology conferences. The first major event of 2025 took place just after New Year’s: the 21st Gdańsk Nephrology Review – Post-ASN Meeting, held on 10–11 January in Gdańsk. The conference aims to bring the latest nephrology insights directly from the American Society of Nephrology Congress, which takes place two months earlier in the United States. For 21 years, the meeting has been organised by our colleague and IAHN Honorary Member, one of Poland’s most distinguished nephrologists, Prof. Bolesław Rutkowski (Fig. 1). This year’s programme included five thematic sessions on the physiological and pathophysiological basis of kidney diseases, advances in clinical nephrology, new developments in dialysis therapy, various topical issues, and innovations in kidney transplantation. Prof. Rutkowski and I chaired the scientific sessions, while Prof. Andrzej Więcek — another IAHN Honorary Member — delivered a lecture on iron, erythropoietic agents, and hypoxia-inducible factor inhibitors in chronic kidney disease. It was an exceptionally successful meeting (Fig. 2.). The 22nd edition is already scheduled for January 2026.

Another major event was World Kidney Day, held annually in Warsaw, with this year’s meeting taking place on 14 March, in parallel with similar initiatives worldwide. For many years, the event has been organised by Prof. Ryszard Gellert, head of the Nephrology Clinic at the Centre of Postgraduate Medical Education in Warsaw and, until recently, Poland’s National Consultant for Nephrology (Fig. 3.). Prof. Gellert presented the 2024 report on dialysis therapy in Poland, while Prof. Andrzej Więcek spoke on primary prevention in kidney diseases. I chaired a session devoted to key issues in dialysis treatment. The event concluded with a panel discussion (Fig. 4.).

Figure 3. Prof. Ryszard Gellert (Warsaw) (photo Janusz Ostrowski)

Figure 4. Panel session (photo Janusz Ostrowski)

The third noteworthy event was the 2025 Nephrocardiology Scientific and Training Conference, held on 4–5 April in Białystok. The conference has been organised for more than a dozen years — initially by Prof. Michał Myśliwiec, and more recently by Prof. Beata Naumnik, Head of the First Department of Nephrology, Transplantology and Internal Medicine with the Dialysis Centre at the Medical University of Białystok (Fig. 5). The coexistence of kidney diseases — particularly chronic kidney disease — and cardiovascular disorders is extremely common, which explains the strong interest the conference attracts among nephrologists and cardiologists alike (Fig. 6.). The programme featured lectures by many distinguished experts from across Poland. I had the honour of taking part in a debate entitled “Men are from Mars, Women are from Venus?”, which addressed, among other topics, the role of women in nephrology and the nephrological challenges in the care of female patients.

Figure 5. Prof. Beata Naumnik (Białystok) (photo Janusz Ostrowski)

Figure 6. Prof. Andrzej Januszewicz (Warsaw), cardiologist, during a lecture (photo Janusz Ostrowski)

The most important nephrology event in Poland in 2025 was the 15th Congress of the Polish Society of Nephrology, held in Katowice from 12–14 June. The Scientific Chairs of the Congress were Prof. Marcin Adamczak (Fig. 7.) and Prof. Magdalena Krajewska, President of the Society, with Prof. Andrzej Więcek serving as Honorary Chair. The Scientific Committee prepared a rich and engaging programme of lectures and workshops covering many aspects of contemporary nephrology. Among the participants were all leading figures in Polish nephrology, as well as a special guest, Prof. Peter Stenvinkel, an Honorary Member of the Society, who delivered a lecture entitled “Learning from nature to make everyone healthier – a concept of planetary health.” During the opening ceremony, I was delighted to accept the title of Honorary Member of the Polish Society of Nephrology (Fig. 8.) and to present a lecture entitled “The History of Silesian Nephrology.” One of the main items on the agenda was the election of the Society’s leadership for the 2025–2028 term. Prof. Marcin Adamczak, representing the Department of Nephrology, Transplantology and Internal Medicine at the Medical University of Silesia — and, as of this year, a member of the Council of the European Renal Association (ERA) — was elected as the new President (Fig. 9, 10).

Figure 7. Prof. Marcin Adamczak during opening ceremony (photo Janusz Ostrowski)

Figure 8. New honorary members of the Polish Society of Nephrology. From left: prof. Jan Duława (Katowice), prof. Janusz Ostrowski (photo Maria Ostrowska)

Figure 9. New Board of the Polish Society of Nephrology (photo Janusz Ostrowski)

Figure 10. From left: prof. Andrzej Więcek, prof. Marcin Adamczak (photo Janusz Ostrowski)

The final major nephrology event in 2025 was the 25th Katowice Seminar “Advances in Nephrology and Arterial Hypertension” , held from 27–29 November. The Seminar has been organised continuously since 2001 by Professor Andrzej Więcek (Fig 11.). This three-day meeting brings together specialists in nephrology, cardiology, hypertension, diabetology, and related medical fields. Over the years, nearly 250 speakers have taken part, including many on multiple occasions (Fig. 12, 13). Among them have been IAHN members such as Professors Natale De Santo, Garabed Eknoyan, and Biagio Ricciardi, as well as numerous representatives of ERA-EDTA (now ERA), including Carmine Zoccali, Francesco Locatelli, Eberhard Ritz, and Shaul Massry. I had the pleasure and honour of delivering a lecture entitled “25 Years of the Katowice Seminars – Memories of Selected Distinguished Speakers.” The Katowice Seminar remains one of the most prestigious scientific gatherings in Polish nephrology and enjoys great popularity among younger specialists (Fig. 14). We hope that, following this jubilee edition, Professor Więcek will continue this valuable initiative for many years to come.

Figure 11. Prof. Andrzej Więcek (photo Janusz Ostrowski)

Figure 12. Prof. Michał Nowicki (Łódź) giving a lecture (photo Janusz Ostrowski)

Figure 13. Prof. Reinhold Kreutz (Berlin, Germany) during a lecture (photo Janusz Ostrowski)

Figure 14. After a lecture. From left: prof. Janusz Ostrowski, Tomasz Stompór (Olsztyn), Leszek Domański (Szczecin), Teresa Nieszporek (Katowice), Andrzej Więcek, Kazimierz Ciechanowski (Szczecin), Beata Więcek (photo Maria Ostrowska)

I hope that this brief overview provides a clear picture of the development of Polish nephrology, the contribution of nephrology’s history to that progress, and the active role played by IAHN members. In 2026, all the conferences mentioned above will take place once again, joined by the biennial Kraków Dialysis Days.

Jean Starobinski (1920–2019) has been one of the most distinguished figures in Swiss intellectual life, trained both as a physician (MD, 1945) and as a historian of ideas. A professor of French literature at the University of Geneva for more than three decades, he became internationally renowned for his studies on Jean- Jacques Rousseau, Montaigne, and the history of melancholy (see e.g. L'Encre de la melancolie, 2012). His dual formation as clinician and literary scholar gave him a unique vantage point on medical culture and its symbolic dimensions. Published posthumously, "Histoire de la médecine" (2020) grew out of a series of lectures delivered in 1999 at the invitation of his colleague Jean-Dominique Bouvier. Rather than producing a conventional chronological survey, Starobinski offers a sequence of elegant reflections on the long arc of medical development. The book is deliberately concise—barely a hundred pages—yet remarkably rich in interpretive insight. Starobinski’s central claim is that the history of medicine is not merely the story of discoveries, instruments, and therapeutic advances. It is equally—and perhaps primarily—the history of the changing figure of the physician and of the evolving relationship between healer and patient. This anthropological perspective provides the thread that binds archaic healing rites to contemporary biomedical practice. I will pick up just a few of the inspiring and original elements described in the book. Starobinski, for example, highlights the parallel sacred origins of medicine in figures such as the Egyptian Imhotep and the Greek Asclepius. He also draws attention to a striking, often neglected dimension of pre-modern therapeutics: the placebo effect, and the trust on which it depends. With characteristic irony, he recalls the persistence in Europe of a *Dreckapotheke*—a pharmacopoeia based on excrement—well into the eighteenth century. Whatever efficacy such remedies had was rooted almost entirely in belief, authority, and the dynamics of the physician–patient encounter. However, he adds that in many cases, modern drugs show greater efficacy depending on what is described in the depliant. I find also interesting his concerns about classifying diseases. Starobinski notes that once all conditions identifiable through simple observation had been catalogued, further progress could occur only through new investigative tools. The rise of microscopy, laboratory diagnostics, and physiological measurement allowed medicine to expand its catalogue of diseases and deepen its understanding of pathological processes. In this sense, the evolution of medical nosology mirrors the evolution of its instruments. Turning to the contemporary era, Starobinski reflects on the ethical and philosophical implications of modern medicine. He comments on the emergence of a “right to health,” but also poses a disquieting question: medicine has become extraordinarily adept at extending and sustaining life, yet it satisfies our desire to live without helping us understand what we ultimately seek from life itself. In just over a hundred pages, Starobinski manages to connect antiquity with modernity, technical progress with symbolic meaning, and clinical practice with existential reflection. *Histoire de la médecine* is both an accessible introduction and a subtle invitation to rethink what the medical profession represents today—a fitting capstone to a lifetime of humanistic inquiry.