Medizin, Gesellschaft, und Geschichte : Jahrbuch des Instituts fur Geschichte der Medizin der Robert Bosch Stiftung最新文献

16th-century's medicine was marked by a wave of professionalization: besides scientific influences--evident by new ambitious texts on botany, anatomy, and chemiatry--functions of medical expertise for political purposes were an important factor. Based on findings made in my DFG-funded project "Arztliche Autorität in der Frühen Neuzeit" (medical authority in early modem times) is discussed how these influences altered the professional conditions for physicians. "Haushalt" (household) can be understood as a social community as well as a monetary budget in this context: physicians earned their money with a lot of different ventures beside medical practice, as commerce, farming, banking, or mining etc. Expenses for houses, gardens, interior etc. were based on needs of everyday life but could also be signs of luxury. Thus the physicians demonstrated the high social status they had acquired, and some of them thereby placed themselves at one social level with the nobility. Even scientific books can be estimated as a special case of such a conspicuous consumption for in most cases publishing made high investments without monetary benefit necessary. Thus scientific reputation was to some degree foreseeable: epoch-making books like above all Andreas Vesalius' "De humani Corporis fabrica libri septem" (Basel 1543) had to be financed out of the assets of the family (in Vesalius' case: a high-standing family in the emperor's services). Other sources show clearly that many doctors were not able to afford publishing comparable elaborated and expensive books.

The Swedish physician, Dr Jonas Gustav W. Zander (1835-1920), set himself the task of devising different contraptions around 1860. He believed that people who needed medical gymnastics could be treated better and more efficiently with the help of machines. His mechanistic approach can be understood in the context of the emerging industrialisation that rapidly took hold in Europe in this period. After very successful presentations at the World Exhibitions in Philadelphia (1876) and in Paris (1878), the Zander-method soon caught on in the medical world and many so-called Zander-Institutes (very similar to fitness-centres today) emerged in the larger cities of a number of European countries. Zander-therapy became very popular in The Netherlands during the 1890s. The first Zander-Institute opened its doors in Groningen in 1894 to be followed, within four years, by another eight Zander-Institutes in the major cities of The Netherlands. Physical education teachers, engaging in medical gymnastics, and physicians worked closely together in these institutes. This was considered to be a positive development as medical gymnastics was a heavily contested area in the field of labour in the last quarter of the nineteenth century. After a short period of success almost all of the Zander-Institutes had great difficulty in maintaining their existence in the first decade of the twentieth century. Both the rise and fall of the Zander-Institutes can be ascribed to a combination of factors of a scientific (concerning the method), social (legislation concerning the care of the crippled) and professional (concerning the different strategies of the involved professions) nature. These factors and the relationships between them are analysed in this article.

This study deals with the medical certificates (Attestata medica) for mentally disturbed or insane and mad individuals which were issued by physicians (Stadt-/Landphysici) between 1750 and 1807 to gain admission to two of the Hessen High Hospitals (Hessische Hohe Hospitäler), Haina and Merxhausen. They provide an approach to mental illness in the 18th century from two perspectives: a study of coping with sickness, especially in the countryside, and mirrored by the doctor's view. In undoubted cases of madness the physician appears merely as a representative of public health care (Medizinische Policey), who must ensure that the patient is separated from the rest of society. In other cases caution and circumspection is absolutely required in the doctors' judgements. There is a catalogue of medical criteria on which the diagnosis is based. Nevertheless the physician must refer largely to the information he obtains from the social context of family, neighbourhood, pastor and officials whilst being well aware of the difficulties and danger of being instrumentalised by extraneous interests. From the physician's view, economic and social circumstances, to a great degree, are responsible for not being able to offer a cure to the individual. This fact gives great impetus to the demands for the hospital as an institution having the same recognised official standard of medicine but, at the same time, in combination with more favourable environmental conditions. These demands that can be seen from the second half of the 18th century were to be answered by special concepts of mental homes (Irrenheilanstalten) at the beginning of the 19th century.

Reinhold Mueller has been the one and only historian of medicine in Germany who worked in the field of the Indian history of medicine from the 1920s to the 1960s. He influenced German, American and Indian researchers, but he was nearly forgotten soon after his death. This is the first paper about his life and work to be published. Mueller studied a wide range of topics, the history of Indian gynaecology, of psychiatry, of immunology and of general practice and his subsequent articles were published in the principal contemporary magazines. However, he did not have a perfect understanding of Sanskrit language and writing. Moreover, as he subordinated his research to the premises of National Socialism and of communism, some of his articles have to be seen as part of an Aryan-Germanic race discourse. Yet, these inadequacies and mistakes did not prevent other researchers from maintaining contact with him after 1945. Even when Anglo-American historians of medicine began to study Indian medicine in the 1980s, his publications were re-examined and analysed.

This study deals with the reform of nursing education on a day-to-day level and exemplifies the dramatic change in the image of nursing in the 1960s, when the erstwhile religious calling was transformed into a modern-day female profession. The analysis is based on interviews with two different groups of nurses who were educated between the 1930s and 1960s. The first group is composed of the deaconesses of a Protestant mother-house in Hannover (Henriettenstiftung). The second group is formed by nurses who were noted for their important role in the professionalisation of nursing in West Germany. The methodology of this study draws on the experiences of the practice of oral history which reflects the actual context of the narratives, the problem of commemoration and the relationship between individual and collective memory. Nursing education, as late as the 1950s, was based on practical experience. The nursing students were responsible for a certain number of patients from the very first day of their training. Comparison of the different narratives shows that such an experience-based training principle was bound to a specific, family-like concept of nursing which was supported by the sisterhoods. This traditional system of nursing education changed essentially in the 1960s when knowledge based on experience lost a great deal of its meaning, while a theory-based training took preference. Furthermore, the regulation and fragmentation of nursing education increased significantly. The outcome was that continuity in caring for patients decreased dramatically in the 1960s and it became much more difficult to learn how to observe the sick and to demand confidence in dealing with patients. The reform of nursing education also had far-reaching consequences for the construction of everyday life in the wards as the students had previously undertaken a major part of the work.

Research on the history of medical ethics in Germany still regards the nineteenth century as the age of medical paternalism. The authoritarian manner of German physicians is particularly emphasised by assuming that patients were normally not involved in decisions about serious therapeutic measures. This paper will analyse if and how physicians dealt with the issues of medical disclosure and of patient consent concerning surgery and other painful interventions in the first half of the nineteenth century. Physicians rarely dealt with this problem in their articles on medical ethics but reflected, instead, on the issues of disclosure and consent in descriptions of risky therapeutic interventions. They devoted considerable attention to the description of the decision making process, particularly in medical case reports on life-threatening surgery. The benefits hoped for and the risks of the surgical intervention were frequently explained in detail. It was important for them not only to legitimise their adventurous course of action by obtaining patients' consent but also to demonstrate that the seriously ill patients in reality played the active, demanding part in the decision on life-threatening surgery. It is remarkable that, even where patients from lower social classes were concerned, physicians stressed the necessity of obtaining their consent for risky surgical interventions. However, it cannot be established with certainty if the patients were comprehensively informed by the physicians about the risks involved. Nevertheless, physicians' awareness of the necessity of such disclosure, as expressed by their rhetorical "self-fashioning" in the published case reports, is beyond doubt.

The research for this paper was initiated by an Erlangen exhibition project on the history of homeopathy on the occasion of the 250th anniversary of Samuel Hahnemann's birth in 2005. The founder of homeopathic medicine received his doctor of medicine degree at the University of Erlangen in 1779. As Hahnemann spent only four months in Erlangen, homeopathic physicians, patients and apothecaries in the region from Hahnemann's time until today were investigated. The aim was to provide a concise survey of the general problems in the history of homeopathy derived from regional cases which could be illustrated by objects suitable for an exhibition. Thus, the article is not only about the history of homeopathy in Northern Bavaria (Franconia), but also about a shift in the use of media and about doing science the other way round, viz. by starting at the presentation and ending with the sources. The outcome of the project was that most of the crucial topics of the history of homeopathy could be covered on a micro-historic scale: trials, pharmacy, hospital, patients, university, National Socialism.