Vienna school of medicine

   At the beginning of the 18th century, Western medical science still accepted the doctrine of the four humors present in human body fluids. Disease was present when one or more of the humors were out of balance; the common cures for restoring them to equilibrium were bleeding or purging. With the arrival of the Dutch physician and scholar Gerard van Swieten (1700–1772) at the court of Empress Maria Theresa in 1745, the medical faculty at the University of Vienna struck out in an altogether different direction. Van Swieten was a disciple of the great Dutch physician Hermann Boerhave, who taught in Leiden that sound medicine was based on the close observation of disease and trauma. The duty of the physician was to encourage the vast healing powers of nature rather than to prescribe treatments that he half understood. Van Swieten was also very concerned with public health. Progress was remarkably swift. In 1754, Vienna opened its first medical clinic; local physicians developed both techniques and instrumentation to improve their diagnostic capabilities. Emperor Joseph II established the Vienna General Hospital (Allgemeines Krankenhaus) in 1784, which became a center for van Swieten’s program. The Dutch obstetrician Johann Lukas Boer practiced there following the principle that parturition was a natural process, which the good physician simply allowed to take its course. His contemporary Vinzenz von Kern (1760–1829), who taught at the university from 1805 until his death, developed a revolutionary treatment for wounds. Rejecting the use of traditional ointments and pressure bandaging, he dressed traumas in loose, water-saturated cloth to maximize the healing process. This practice was widely followed in the first half of the 19th century; it was said that by 1850, the only medication prescribed in the General Hospital was brandy for those in desperate pain.

   Great diagnostic advances certainly took place. Central to the detailed understanding of the human organism so necessary for medicine was the work of Karl von Rokitansky (1804–1878). Reportedly performing more than 85,000 autopsies during his long career, he turned anatomical pathology into an effective clinical tool. Though he himself did not make much use of his findings, a successor, Josef Skoda (1805–1881), certainly did. It was Skoda who refined the technique of chest percussion, first advanced by a Graz physician, Leopold von Auenbrugger a century earlier, in the examination of patients. Surgery, the only accepted therapeutic intervention, was developed to a highly sophisticated art, culminating in the work of Theodore Billroth (1829–1894). Joining the medical faculty of the University of Vienna in 1867, he pioneered in such procedures as the resectioning of the stomach (1881) and the removal of the larynx (1874). His students joined the staffs of hospitals throughout Europe.

   Substantial though these achievements were—Vienna continued to be a medical center even after the collapse of the monarchy—its therapeutic philosophy, particularly its disdain for pharmacological or chemical intervention, had its critics even in the 19th century. The Hungarian physician Ignaz Semmelweis (1818–1865) was never able to persuade the chief of his clinic to support good sanitary practices in obstetrical clinics. An insistent man, he was dismissed for his pains. The indifference to suffering patients became legendary, as diagnosis often seemed to be favored over cure.