NOTES ON THE MEDICAL HISTORY OF VIENNA By HORACE MARSHALL KORNS, M.D. IOWA CITY, IOWA PART II (Conclusion) * The first vaccination on the Euro- collection of valuable books, which was pean continent was performed in incorporated with the Hofbibliothek Vienna, on April 30, 1799, by Sani- after his death, bears witness to his deep tatsreferent Pascal Josef von Ferro, who interest in medicine and natural sci- used his own children for the experi- ence, and he was a no less diligent stu- ment. Ten days later, on May 10, 1799, dent of music and languages. Jean de Carro (1770-1857) inoculated Harrach’s patients were all indigent, his son with lymph obtained from the and, inasmuch as most of them were pustule on the arm of Ferro’s daughter. also incurables who had been given up Ferro was too much occupied with his by other physicians, his radiant per- official duties to pursue the matter fur- sonality and innumerable charities were ther, and it fell to the young and en- his most efficacious therapeutic weap- thusiastic de Carro, who reported 200 ons. K. F. Burdach, an eminent con- inoculations in his celebrated book temporary anatomist, said: (1801) , and extended his activities in I met him often, surrounded by a group behalf of vaccination throughout Aus- of incurables and grateful convalescents, tria, Germany, Turkey and India. He and saw with what admirable simplicity refused the 1000 guineas offered him for he bore himself towards these poor peo- his work in India, whereupon Jenner ple. In 1809 he devoted himself unceas- sent him a lock of his hair, and a silver ingly to the care of the French and Aus- snuffbox with the inscription, “ Jenner trian soldiers in Vienna, until he himself to Jean de Carro.” De Carro was a contracted typhus. He intrusted the man- Swiss, and a pupil of Cullen. agement of his case to a young physician Karl Borromaus Graf von Harrach (Staudenheim, later physician to the duke (1761-1829) was a physician whose of Reichstadt, son of Napoleon and Maria Louisa), and refused consultation. When humanitarianism entitles him to a he seemed about to die, he worried at the recognition which he has never been thought that his death might be blamed accorded by the historians. He entered on this young doctor, and to compensate first on a legal career, in the course of him for the possible loss of practice which which he rose to be Staatsanwalt in might ensue, willed him 10,000 florins Prague, but forsook law for medicine ($4800) . After he recovered he paid the because he thought he saw in it a better money anyhow, for then it seemed ridicu- opportunity to exercise his altruistic lous not to reward success at least as well instincts. After receiving his degree at as failure. Harrach’s unusual perception, Vienna (1803), where he was a pupil of broad education, and instinctive humani- Johann Peter Frank, he studied in tarianism enabled him to achieve a thor- France and England. From 1814 until oughly mature Weltanschauung. His in- the time of his death he served as Pri- numerable charities forced him to live marius at the Elizabethinerinnen. His very frugally. [He was paid the salary of a * Part I appeared in Anna ls of Medica l Histo ry , n.s. 9:345 (July) 1937. Primarius for his services to the Elizabeth- ■was appointed surgeon to the orphans’ inerinnen, but he always sent it back the home, where Josef 11 met him one day next day, together with an equal amount with the suggestion that he go abroad to from his own pocket.] It was one of his perfect himself in obstetrics, to which peculiarities that he never left the city. Boer readily assented. Before he went, The countess Dietrichstein, whose invita- the Kaiser persuaded him to change his tions to visit her at her summer home near cognominai Boogers to Boër, alleging Vienna he had always declined, sent word to him one day that she was dead, and that no Frenchman could pronounce asked him to come to her autopsy, think- such a barbarous name as Boogers. ing that this was an invitation which he I11 1785, provided with funds and let- surely could not refuse. ters of introduction, Boër left Vienna Richard Bright met Harrach in for Brussels and Ghent. In Paris the pro- Vienna during the great Congress of tection of Josef’s sister, Marie An- 1814, and spoke of him in glowing toinette, procured him entree to the terms. There is a little restaurant in the principal hospitals and the attention of Alserstrasse, close to the Allgemeines the great accoucheurs. His visit to Krankenhaus, which is known as the Madame Souchot. the patient on whom Gasthof zum goldenen Hirschen. This Jean René Sigault had performed his restaurant was mentioned in 1814 by much discussed symphysiotomy eight Karl Ernst von Baer, the great embry- years previously, convinced him that in ologist, as a rendezvous of foreign physi- this case, at least, the operation had en- cians, and to this day it is a favorite re- tailed sorry consequences, and tended sort of Americans. One who has spent to confirm his belief that it was a pro- many happy hours there likes to think cedure to be avoided. After fifteen that Richard Bright and Graf von Har- months in Paris, he went to London. rach may have drunk each other’s health He returned by way of France and Italy across one of its tables. to Vienna, where in 1789 he became A new era in obstetrics began with chief of the obstetric clinic at the Allge- the Hollander Lukas Johann Boer meines Krankenhaus. The death of his (1751-1835), (born Boogers). After patron, Josef 11 (1790) , and his bad luck studying for a time in Wurzburg under in the case of the Archduchess Eliza- the famous surgeon Carl Caspar von beth, consort of the subsequent Kaiser Siebold, he was provided with funds by Franz, who succumbed following in- a generous patron, the bishop of Wurz- strumental delivery and manual extrac- burg, and sent to Vienna (1771) , where tion of the placenta, cost him his place he promptly squandered his substance at court and much of his popularity, but in riotous living. As soon as the bishop he continued as professor until 1822. heard of his divagations from the linear In obstetrics Boër was opposed to path of rectitude, he withdrew his sup- operative interference if it could be port. Boer then made his living by avoided. He declared that pregnancy, teaching and literary work, some of parturition and the puerperium are which was proofreading, and still found physiologic processes, and that the phy- time to study medicine. In 1778 he was sician should simply play the rôle of na- granted the degree of Master of Sur- ture’s servant. He understood and de- gery, after which he studied midwifery scribed the various rotations of the fetus for two years, and became A. J. Rech- as it passes through the pelvis; portrayed berger’s assistant at St. Marx. In 1784 he the mechanism of face presentation very graphically; and opposed version in man’s life ‘from the womb to the tomb’ breech presentations and for the second —sewerage, water supply, school hy- of twin fetuses. He disapproved of spe- giene, sexual hygiene, taxation of cial beds and stools, and simply had his bachelors, and suitable benches and patients lie on the left side during de- meals for the children, as well as the livery. In one year he lost only 5 patients ideal of a scientific ‘medical police’— in 1500. In one series of 2926 cases really left little for Pettenkofer and the (1789-92) he used forceps only nine- moderns.’’ teen times. He never did a version more In 1785 Frank succeeded Tissot at than ten times in any one year. He de- Pavia, thus becoming a colleague of scribed the clinical manifestations of Scarpa and Volta. He came to Vienna in puerperal fever in great detail, empha- 1795 to take Brambilla’s place as direc- sizing his contention that it is a disease tor of the Josephinum, but instead was sui generis. These and many other con- made director of the Allgemeines Kran- tributions entitle Boer to a place in kenhaus and the medical clinic. Under obstetrics comparable to that of de his expert management many salutary Haen, Stoll and Peter Frank in medi- changes were made in the administra- cine. tion of the hospital, and important im- The incompetence of Stoll’s succes- provements were effected in the hy- sor, Jacob von Rheinlein, quickly dis- gienic conditions of the entire city. A pelled the attractions of the Vienna good clinician, an inspiring teacher, and clinic. When it was finally brought to a man of the highest intellectual hon- the notice of the government that for- esty, Frank soon restored the prestige eign students no longer came to Vienna, of the Vienna clinic, but in spite of his Rheinlein was pensioned (1795). He sterling worth, or perhaps because of was succeeded by Johann Peter Frank it, he was continually molested by the (1745-1821), the illustrious father of preposterous Stifft, Storck’s successor as modern public hygiene. While still an generalissimo of medical affairs, and undergraduate at Heidelberg Frank finally (1804) , unable any longer to en- started the great work which was to dure Stifft’s malicious meddling, he re- make him famous, and had completed signed his position in disgust and left the first volume by 1768; however, Vienna. when the printer to whom he offered Fhe impression made by Frank’s the manuscript refused to publish it, portrait12 has been well described by Frank consigned it to the flames and Rolilfs.