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Doctors and their patients in the seventeenth to the nineteenth centuries

Publikationsart Peer-reviewed
Publikationsform Originalbeitrag (peer-reviewed)
Publikationsdatum 2016
Autor/in Baschin Marion, Dietrich-Daum Elisabeth, Ritzmann Iris,
Projekt Ein Auslaufmodell: Medizinische Praxis und Lebenswelt eines Laienheilers in der ersten Hälfte des 19. Jahrhunderts
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Originalbeitrag (peer-reviewed)

Zeitschrift Clio Medica
Volume (Issue) 96
Seite(n) 39 - 70
Titel der Proceedings Clio Medica

Abstract

Analysis has revealed firstly that, depending on the chosen period, the socio-geographical situation and the profile of the individual doctor’s surgery, the clientele varied widely in terms of gender, age and social rank. The consultation behaviour of men and women changed noticeably. Findings overall suggest that, up until 1800, the gender distribution varied in the individual practices. There was a trend for women to be overrepresented in urban surgeries during the earlier period. But, from the mid-19th century, they predominated in general – both in towns and in the country, in allopathic as well as homeopathic surgeries. The absence of children, which was bemoaned by many physicians, did not apply to the surgeries under investigation. On the contrary: the percentage is consistently high while older patients remained underrepresented, right up until the end of the period under investigation, even though their proportion increased in the individual surgeries during the course of the 19th century. In each of the 19th century surgeries investigated – and increasingly among the lower and middle classes – the physicians’ services were used by several members of the same family. We have found no evidence to support the thesis that, up until the 19th century, academic physicians were mainly consulted by aristocratic or wealthy bourgeois patients. The theory probably applies only to Early Modern urban doctors’ surgeries. In the practices examined here, from the middle of the 18th century, patients from all social strata went to consult physicians. The participation of members of the lower classes or from an artisanal, (proto)industrial or agricultural background clearly increased over time, “despite ubiquitous economic and cultural barriers”. That the annual numbers of consultations per physician increased – despite the growing number of physicians available – suggests that, also for economically disadvantaged social groups, the consultation of learned physicians became more common, in towns from the first half of the 19th century and in the country from the middle of the century. The individual results also reveal that, before the introduction of statutory health insurance for salaried persons, patients of a better social standing consulted a physician considerably more frequently in the course of the year than lower class patients did. While the patient structure clearly changed around 1800, the relationship between physician and patient continued without major changes from the 17th to the 19th century. The therapeutic encounter up until the end of the investigated period can be summarised as a negotiation process. Patients were discerning in their choice of healer and did not refrain from using rival services. They sought help for unpleasant symptoms such as indigestion, pain or fever, and only rarely in cases of emergency. Therapy was decided on after an exchange between a critical and autonomous client and the medical specialist who was generally willing to compromise.
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