Ultimately—after van Swieten’s death—Anton Stoerck became the leading spirit in the affairs of the Vienna medical world. The instruction in medicine was graded by him, with the Emperor’s consent, in the following manner: The medical students, before they were permitted to begin the course of instruction, were obliged to furnish satisfactory evidence of possessing adequate general scientific knowledge and of having previously attended lectures in natural history and experimental physics. In the next place, they were further obliged to attend the lectures on botany, chemistry, anatomy and physiology, and to pass a satisfactory examination in these branches before they were permitted to take up the study of pathology and materia medica. It was only after having passed a satisfactory examination in these subjects that they were allowed to receive clinical instruction. At the final examination they were called upon to make a report on a few cases of actual disease and to set forth especially the details of the treatment adopted; to write a certain number of prescriptions; and, finally, to defend publicly, in the presence of the Rector and the Chancellor of the University, the Deans of the four Faculties, and one Professor of the Medical School, a thesis on some medical doctrine. After which the formal ceremonial of conferring the degree was carried out in the presence of the same university officials. And here again, the Emperor effected a most marked reformation; he abolished all those religious ceremonies which it had been customary to observe in connection with the bestowal of the degree of M.D. and the right to practice medicine. He also adopted measures for enlarging the equipment of the University libraries, and among other things he abolished a large number of monasteries and turned over their collections of books to the libraries of the university. Recognizing, as he did, the fact that the proper training of medical men who intended to follow the career of surgeons was at that time lamentably inadequate, he instituted, at the earliest moment practicable, such changes in the teaching, in the duration of the course, in the requirements for graduation, etc., that the surgeons would thereafter be on the same level, with regard to education and practical training, as the physicians.
At first (1780), the Faculty consisted of nine professors, who gave instruction in the following branches: anatomy, physiology, natural history, chemistry and botany, general pathology and therapeutics (including pharmaceutics), internal medicine and clinical instruction, theoretical surgery, clinical surgery, and obstetrics. In addition to these there were several assistants and a prosector (demonstrator of anatomy). The Emperor Joseph II., after expressing serious doubts with regard to the “possibility of teaching the theory of surgery, bandaging and the various surgical operations in six months,” gave orders that the following scheme should be adopted:—
First Year: Anatomy and physiology, together with chemistry and botany (for physicians only) and operative work, bandaging and obstetrics (for surgeons only).
Second Year: (For physicians) Materia medica, pathology and clinical medicine.
(For surgeons) Clinical medicine, clinical surgery, and obstetrics.
Third Year: Entirely given up to practical work at the hospital and the Clinic.
At a later date the course was extended to four years; and from that time forward, according to Puschmann, surgeons were looked upon with consideration.
Hirsch, speaking of the majority of physicians of that period, says that they sought to quiet the demands of the public for satisfactory information about their maladies by employing, in their responses, the meaningless terms of Graeco-Latin terminology; and he quotes Immanuel Kant, the famous Prussian metaphysician, as having expressed the same idea when he said: “These men thought they were rendering their patients a great service when they gave them a name for their disease.”
As regards the therapeutic measures which these so-called physicians employed, Hirsch adds: “they generally consisted of pills and plasters, drugs of various kinds, clysters and repeated blood-lettings which at times produced such a degree of exhaustion that only patients with a strong constitution were able to rally from the effects of this loss of blood.... The title ‘Doctor of Medicine’ afforded no guarantee that the individual who bore it possessed the requisite degree of medical knowledge.” Fortunately for the public there were at that time in almost every community a few men to whom the description given above does not in the slightest degree apply. I have already mentioned the names of several physicians of this higher stamp, and the number of such honorable representatives of our profession rapidly increases as we approach the nineteenth century.