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Vienna General and the “Narrenturm” – “Fool’s Tower” General Hospital was established in 1784 by the order of Emperor Joseph II. The conceptual design of the hospital complex was modeled after the Hôtel-Dieu de Paris in France. Adjacent to the hospital was an orphanage, a maternity ward, and the first building worldwide for accommodating mentally ill patients, the so-called “Narrenturm“, or “Fool’s Tower”, constructed by Isidore Canevale. The cylindrical building consisted of 5 floors with a total of 139 rooms for approximately 200 to 250 psychiatric patients. Each patient cell was equipped with strong lattice doors and iron rings for chaining patients. However, only 10 years after its opening, the tower was obsolete because of innovations in therapeutic concepts for the mentally ill. The round form of the building complex is derived the colloquial denomination in Viennese dialect, “Gugelhupf”, meaning a round version of Austrian cake. Over the following centuries, up until the 1960s, duty rooms for nursing staff and doctors of the Vienna General Hospital were accommodated inside the tower (presumably the chains were removed). Today, the tower is home to the Federal Pathologic-Anatomical Museum of Vienna. In 1994, a new building complex was officially opened for the Vienna General Hospital, which currently employs 1600 physicians and 4500 allied health and nursing workers and is the main teaching hospital for 11 000 students of the Medical

Michael Lichtenauer, MD, PhD University Hospital Salzburg, Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University, Salzburg,

1120 February 19, 2019 Circulation. 2019;139:1110–1120. DOI: 10.1161/CIRCULATIONAHA.118.039371