A TOUCH OF VIENNA – Medical developments in the 19th century: the Vienna Clinical School

Medical developments in the 19th century: the Vienna Clinical School
by I. Percebois, France


In the 19th century, the heart of medical science beat strongest in Vienna, described by the anatomist Rudolf Virchow as “the Mecca of medicine.” Its university exerted international influence thanks to talent drawn from all corners of the Habsburg Empire. This period was the high point of the Second Vienna School, personified by Carl von Rokitansky and Josef Škoda, who drilled the imperial capital in the doctrine of “therapeutic nihilism.” Their approach sought to reinvent medical knowledge from the bottom up. It went hand in hand with a distrust of the pharmaceutical remedies available at the time, which they dismissed as ineffective. Although they attracted criticism and were accused of favoring science over their patients, Rokitansky and Škoda were the key contributors to the School’s renown, along with Theodor Billroth who laid the foundations of modern surgery in the city. But Vienna offered little welcome to certain other innovators, forcing Franz Anton Mesmer, the inventor of animal magnetism, into exile, attacking the work of Sigmund Freud, the father of psychoanalysis, and driving Ignaz Semmelweis, the founder of hospital hygiene, to an early death. Spanning the spectrum between light and darkness, Viennese medicine was also an inspiration to writers and artists, in particular to the former doctor Arthur Schnitzler, and a recurrent reference for the paintings of Gustav Klimt. Pioneering, bold, and riven by scandal, the Second School made Vienna the scientific capital of Mitteleuropa.

Medicographia. 2013;35:350-361 (see French abstract on page 361)

“Josephinum,” founded by Emperor Joseph II (1741-1790).
Built in 1783-1785.

It was the first medical-surgical academy in Vienna; today it houses the Institute of Medical History, the Medical University of Vienna, and other institutes. Engraving on copper, 1825.
© akg/Imagno.

As the capital of the Habsburg Empire, Vienna was the de facto capital of 19th-century Europe, playing host in 1814 to the monarchs and diplomats tasked with drawing up a new geopolitical order after Napoleon’s defeat. The entire world looked to this Mitteleuropa city that stood center stage in the political arena up to the First World War and the collapse of the Austro-Hungarian Empire: “For one century, more than ever, the history of Central Europe was reflected in that of this city which commanded its fate”.1(p115) The Vienna of the time exerted unprecedented influence as the embodiment not only of the artistic avant-garde, but also of scientific progress, thanks to its renowned university. Its star shone with a special brightness in medicine, to the extent that none other than the Berlin anatomist Rudolf Virchow labeled it the “Mecca of medicine.” The pagan Mecca, visited by pilgrim physicians from all over the world, played host to a succession of the most eminent practitioners of modern medicine.

“Hygieia”: detail of “Medicine,” itself one of the three
University of Vienna Ceiling Paintings by Klimt, commissioned
by the University (see page 358).

1900-1907, oil on canvas. Hygieia was the Greek goddess of health,
daughter of Asclepius, god of medicine, and Epione, goddess of soothing
of pain. © akg-images/Erich Lessing.

The “Mecca” of medicine

_ From therapeutic nihilism to major strides in morbid anatomy and surgery
Viennese medicine reached a pinnacle in the 19th century. It was the embodiment of the Habsburg Empire and drew its strength from the Empire’s multicultural base. Its leading figures— those writ large in its history—converged on the capital from the four corners of the Empire to endow the School of Medicine with international influence. Jean-Paul Bled summed up the concentration of minds in his History of Vienna: “Bohemia and Moravia contributed the pathologist Carl Rokitansky and the internist Joseph Škoda.… The obstetrician Ignaz Philipp Semmelweis came from Hungary, and Józef Dietl from Galicia.…The great surgeonTheodor Billroth arrived from Prussia one year after Sadowa; the psychiatrist Theodor Meynert, a precursor of Freud, came from Dresden.”1(pp379-380) This portrait gallery emphasizes the quality of a medical training that attracted students to Vienna from all over Europe, whether already established figures or unknowns such as the young Arthur Conan Doyle who came to improve his knowledge of ophthalmology. All flocked to the city to seek inspiration from the world’s greatest specialists and attend daring and innovative surgery. In 1841, the German physician Carl August Wunderlich reported that “there was always something to learn in Vienna; you saw things there that you would have looked for in vain elsewhere.”2 The image of Viennese excellence leapfrogged frontiers, in particular into France where the physician Théophile de Valcourt published his “Impressions of a traveling physician” in the Gazette Médicale de Paris: “Every educated Frenchman should prepare for the future by learning German and getting to know Germany; in our current circumstances, should we not be giving preference to the Vienna School and requiring French students to undertake part of their training there?”3 Although this view was somewhat one-sided, in so far as both Paris and Berlin could claim to challenge the hegemony of the Vienna School, it reflected the historic rise of the capital of Mitteleuropa that within a few decades had become a mandatory stop on every aspiring physician’s career trajectory.

Wax anatomical model, by Clemente Michel-Angelo Susini, of Florence (1754-1814).
Emperor Joseph II commissioned a set of more than 1000 wax models, sculpted between
1781 and 1786.

They were carried by several hundred mules to Vienna and were exhibited at the Josephinum, where they
can still be seen, at the Museum of the Medical University of Vienna. © Medizinische Universität Wien.

The Viennese medicine of the 19th century excelled not only in its technical prowess and innovations, but also in its ideology, which became so characteristic of its practitioners that it served as their signature. Known as therapeutische Nihilismus (therapeutic nihilism), the method defined the Second Vienna School under the leadership of Carl von Rokitansky and Josef Škoda. The First School had laid the foundations of the method at the end of the 18th century thanks to the reforms of Gerard van Swieten and the emphasis on diagnosis. The influence of Schopenhauer’s Naturphilosophie was also visible in the deep skepticism expressed by the Viennese physicians toward the pharmacological treatments available at the time. Instead, they advocated nonintervention, trusting in Nature’s powers of recovery. This shifted the therapeutic vocation of medicine temporarily into the background, in favor of an overriding concern to first understand how the human body worked before seeking to heal it. The words of Józef Dietl, a pioneer urologist and fervent advocate of therapeutic nihilism neatly sum up the change in emphasis: “While the old school carried on therapy before engaging in research, the new school began researching in order to be able to understand therapy… Our strength lies in knowledge, not in action.”4(p122) Up until the Age of Enlightenment, diagnosis had been based mainly on Hippocratic signs and symptoms. In the 19th century, it was dethroned by the modern science of morbid anatomy that introduced radical change by shifting the physician’s gaze from the bedside to the autopsy room. Rokitansky was said to have performed around 85 000 autopsies by 1844 when a chair of morbid anatomy was established in Vienna.

Sir Arthur Conan Doyle, the Father of Sherlock Holmes, was also a physician who studied medicine in Edinburgh, did a brief stint as ship surgeon on a ship bound for the West African Coast, wrote a thesis on tabes dorsalis (syphilis), and studied ophthalmology in Vienna in 1890.

Photo taken in 1930. © akg-Imagno.

The names of Viennese physicians live on in eponymous conditions such as Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome (Müllerian agenesis) in gynecology. But at the time, they were celebrated primarily for their doctrine of therapeutic nihilism, as described by William M. Johnston in The Austrian Mind: “by 1850 skepticism toward traditional therapy had so taken root that the only medicament used in the General Hospital was cherry brandy. For fear of distorting symptoms, doctors refused to prescribe any remedies.”5(p224) It may be surprising that the most eminent specialists should have concentrated less on the patient than on building up a body of knowledge, but their approach served the purpose of medical progress as it sought to shake off the traditional remedies that had been in use for centuries with nothing but unquestioning belief in their favor: “A profusion of clinical evidence, including the rarest maladies, encouraged Vienna’s physicians to exploit observation as a tool for exploding medical myths.”5(p227) However, even in the 19th century, the proponents of therapeutic nihilism themselves came under attack, in particular from two celebrated figures: the biologist Ernst Haeckel and physiologist Hermann Helmholtz. The latter was scathing in his criticism of the cruelty of Josef Škoda, whom he accused of instrumentalizing patients for the greater good of science: “And one degraded the patient who was, after all, a human being, and disgraced him, as if he were a machine.”6(p30) Even foreign observers were taken aback by his insensitivity, as shown in the Journal de Médecine, de Chirurgie et de Pharmacologie published by the Brussels Society of Medical and Natural Sciences in 1858: “Rarely, if ever, has medicine seen as absolute or as fervent a doubter….On the 28 sick in his care— or rather on his long-suffering patients—he deploys a succession of all the most traditional and vaunted medicines, and do you know to what end?… With the sole intention of demonstrating to his students that all these medicines are in every case completely ineffective.”7(pp284,285)

Stages of gastric resection, by Christian Billroth (1829-1894)
who carried out the first successful ablation of gastric cancer in 1894.

Paradoxically, advances in surgery were a direct consequence of
“therapeutic nihilism.” © Wellcome Library, London.

Although therapeutic nihilism came to be called into question in the second half of the century, it remained intimately associated with the Vienna School, characterizing the fields not only of clinical medicine and morbid anatomy, but also of surgery, whose undisputed champion was Theodor Billroth. According to the father of modern surgery, “reliance on excising a diseased part accorded with stress on pathological anatomy and skepticism toward drugs.”5(p227) Billroth was a pioneer in the history of surgical science, performing the first total laryngectomy and undertaking a number of cancer resections that had never previously been attempted, such as partial cystectomy via a suprapubic approach. His prodigies on the operating table helped push back the frontiers of human knowledge and caused the Vienna School to shine evermore brightly in the scientific firmament.

Surgeon binding up woman’s arm after bloodletting.
Oil painting (50.4×39.9 cm, on copper) by Jacob Toorenvliet (1666).

Probably the most popular form of treatment for centuries, Joseph Dietl (1804-
1878), one of the fathers of “therapeutic nihilism” waged a successful battle
against the then prevalent recourse to bloodletting as cure for pneumonia.
© The Wellcome Library, Wellcome Images.

Anton Mesmer (1734-1815) exercising his hypnotic skills (right), while patients try out the effects of his famed “tub” or “baquet” (no, it’s not a table!).

This was a oak tub containing iron filings that delivered “magnetic rays” which Mesmer claimed would cure any number of ailments. Engraving, 1780. Bibliothèque Nationale de France. © akg-images.

_ Illustrious pariahs: Mesmer, Freud, Semmelweis
While the Academy showered some physicians with honors, it cast others into the wilderness for their novel and anti-conformist ideas. The history of Viennese medicine is also that of the celebrated pariahs whose names remain as intimately associated with the imperial capital as those of their glorious colleagues, along with a strong whiff of scandal. Franz Anton Mesmer remains without doubt the most scandalous of these physicians. On his death in 1815, at the dawn of the 19th century, he left behind the foundations of a new discipline, at the interface between the science of the occult and psychology, which was to spread across the whole of Europe.

Before becoming the disruptive prophet of magnetism and the darling of Paris salons, Mesmer had made every effort to obtain the recognition of his peers. When he defended his doctoral dissertation at Vienna University’s Faculty of Medicine on 27 May 1766, he did so before a committee chaired by the celebrated Gerard van Swieten, the Dutch physician whom Empress Maria Theresa had brought in to reorganize medical education. Mesmer thus placed himself under the protection of the father of the First Vienna School, obtaining the seal of his scientific authority for the ideas expounded in De planetarum influxu in corpus humanum (On the influence of the planets on the human body). This physico-medical work on the influence of the planets heralded his subsequent research direction, but it wasn’t until the end of the century that Mesmer established the doctrine of animal magnetism, stating that “man possesses properties similar to that of mag- nets.”8(p6) This prompted his break from the Vienna School whose physicians poured scorn on his miracle cures and compared his treatments to conjuring shows. Mesmer was deeply bitter in 1777 on leaving faithless Vienna for libertarian Paris; two years later, on looking back over this painful period in his Mémoire sur ses Découvertes, he described himself as the victim of jealous colleagues: “The first cures achieved in some patients regarded as incurable aroused envy and even produced ingratitude…, such that many physicians banded together to bury or at least pour scorn on the discoveries that I made in this field: I was accused on all sides of being an impostor.”8(pp9,10) Mesmer was to spend his life trying to achieve scientific status for his doctrine, and continued to express his need for recognition by presenting himself as a “Doctor of Medicine from the Faculty of Vienna.”

Sigmund Freud offers a similar instance of the mixed attraction and repulsion aroused by the city of Vienna in someone faced with the hostility of his peers. The Austrian capital may well pride itself today on having been the birthplace of psychoanalysis, but it was not always so welcoming to Freud’s theories and showed its hostility on several levels: “in infancy, it was Vienna that dragged him away from the green paradise of Freiberg; in adolescence, it exposed him to anti-Semitic hostility; during his engagement, it kept him back from Martha in Hamburg; during his years of research, it withheld the scientific recognition he craved.”9(p199) Freud was at university in the second half of the 19th century in an era when the Medical School was personified by Škoda, Rokitansky, and Billroth. Although he too went through a period of therapeutic nihilism in his youth while training in the various departments of Vienna’s General Hospital, he was to develop his approach to the treatment of mental disorders in opposition to the prevailing orthodoxy. At a time when psychiatric patients were condemned to trepanation or to confinement in the Fools’ Tower, Freud’s preference for a talking cure over the trephine led to him being outcast by his colleagues.

Sigmund Freud (1856-1939) in his study in Vienna in 1935.
Doctorate of medicine in Vienna in 1881, appointed professor in
neuropathology at the University of Vienna in 1902.

Created psychoanalysis, a clinical method based on treating patients through
dialogue rather than drugs. © akg/Imagno.

Statue of Ignaz Semmelweis (1818-1865) who elucidated the
cause of puerperal (childbed) fever—doctors’ unwashed hands—
but earned only postmortem gratitude from his peers.

They ridiculed him during his lifetime, to the point that he was committed to an
insane asylum, where he died from beatings inflicted on him by the guards.
Semmelweis Memorial, marble, in Budapest, Erzsébet Square, by Alajos Stróbl
(1906). © akg-images/Gérard Degeorge.

His fate bears astonishing resemblance to that of Mesmer in that it was in Paris that he too sought refuge from the sustained hostility. In Vienna, Freud’s professor Theodor Meynert, who headed the department of psychiatry, looked down on his work, whereas in the Parisian medical world, Freud found fresh prospects beckoning. In 1885, he trained in hypnosis under Jean-Martin Charcot at the Salpêtrière Hospital and began translating his works for the benefit of his compatriots. Yet when he returned to Vienna the following year and presented a report on male hysteria to the society of physicians, he found himself once again the butt of criticism and ridicule. As a man of science, he experienced frustration on two levels: not only were his innovative theories treated with scorn, but he was kept pinned down to the post of Dozent, unable to advance higher up the university ladder. Freud also took it as evidence of the anti-Semitism rife throughout the Medical School, scathingly portrayed on stage by Arthur Schnitzler in Professor Bernhardi, and that was eventually to drive him into exile in 1938.

Freud managed to survive Vienna and his colleagues’ hostility, but not everyone in the 19th century was so lucky. Despite revolutionary discoveries that were to transform clinical practice and the history of medicine, Ignaz Semmelweis fell victim to the city. His fate was sealed in 1846 when as a young master of surgery he joined Professor Johann Klein’s department of obstetrics at the General Hospital. He was astonished to observe that the mortality of young mothers was much higher in this department than in the adjoining department of Professor Bartsch. He eventually worked out why. After various experiments, he established that it was the medical students training under Professor Klein who were passing fatal infections on to the patients: by going straight from the autopsy room to the labor ward, they were spreading the puerperal fever that caused the young mothers to flee the hospital, sometimes even to deliver in the street. By making the students wash their hands in chlorinated lime solution, Semmelweis significantly decreased the mortality rate. Yet his colleagues remained skeptical and maintained that his hand washing protocol was too restrictive in practice. But in reality, just as with Mesmer and Freud, Semmelweis was challenging the doctrine of therapeutic nihilism, thereby blocking all hope of future promotion. Even the support he received from his fellow Hungarian, Josef Škoda, proved of no avail in preventing his disgrace.

Left page: Gustav Klimt (1862-1918) was commissioned to
paint three ceiling murals—the University Paintings—for the Great
Hall of the University of Vienna:
Philosophy, Medicine, and Jurisprudence.

“Medicine” was presented in March 1901 at the Tenth Secession Exhibition.
The goddess Hygieia (middle, bottom) holds the snake of Asclepius and a cup
with water from the river Lethe in Hades. Above her, a laughing skeleton clutches
the corpse of a woman shrouded in dark muslin. A column of nude figures
extends on the right symbolizing life, while a provocatively exposed nude woman
is featured on the left, with a newborn infant at her feet. “Medicine” and the
two other ceiling paintings, judged “pornographic,” were never displayed on
the ceiling and were eventually destroyed by retreating German troops in May
1945 at Immendorf Castle, Lower Austria. 430×300 cm. Photo and ©: Archive
Leopold Museum, Vienna.

Following this bitter failure, Semmelweis left Vienna for Budapest, entrusting his colleague Professor Ferdinand von Hebra with the job of publishing his research in the Journal de la Société Impériale et Royale de Médecine, which the professor duly did, not without some errors. It was only in 1861 that Semmelweis himself put pen to paper to lay the foundation of modern aseptic technique in his book Die Aetiologie, der Begriff und die Prophylaxis des Kindbettfiebers (Etiology, concept and prophylaxis of childbed fever).10 In 1862, in an open letter to professors of obstetrics in Vienna, he gave vent to his anger and bitterness: “I would be committing a crime if I kept silent any longer and did not publish the results of my experience. I have the intimate conviction that since 1847 thousands of women and children have died who would still be alive had I not kept silent.”11 Semmelweis succumbed to depression and mental illness before dying in 1865 in an asylum close to the city of Vienna that had rejected him. Modern history books often refer to Semmelweis as a “Viennese obstetrician,” but it is important to remember that he paid for this title with his life.

Medicine in Viennese art and literature

_ Gustav Klimt and his ill-fated university mural Medicine
Vienna was without doubt one of the cultural capitals of 19thcentury Europe, standing at the forefront not only in science, but also in literature in the shape of the Jung-Wien (Young Vienna) group and the graphic arts represented by the Sezessionsstil (Vienna Secession) movement. As the bedrock of Vienna’s reputation, medical science also permeated the arts, as shown in the early work of Gustav Klimt, who epitomized art nouveau and the Vienna Secession. In 1888, Klimt started work on a portrait of Carl von Rokitansky for a painting of the Burgtheater auditorium, famous for having premiered at least three of Mozart’s operas. This was officially commissioned by the Vienna city council with a view to immortalizing the old theater before its replacement. In this painting for which he was awarded the Emperor’s Prize, Klimt portrayed the capital’s leading figures in such a striking gallery of characters that “everyone in high society fought for a place in the group portrait.”12(p16) Behind the silhouette of Rokitansky, Gustav Klimt paid tribute to Viennese medicine as a whole; by removing the anatomist from the dissection room and plunging him into a high society setting, he lifted science out of the University to share in its splendor.

Medicine was also intertwined with a key moment in Klimt’s career in so far as his early work on the Ringstrasse interior led to him being selected in 1896 to paint the ceiling of the Great Hall of the University. This commission marked the consecration of Klimt, but caused scandal within the sacrosanct Viennese institution. The history of this abortive work is that of a vision, for which only some preparatory drawings now remain, testimonies to the power of Klimt’s art in this period. The vision originated in 1900, when Klimt exhibited Philosophy, the first of the three compositions commissioned for the Great Hall. The university authorities were expecting a classical work. Instead, Klimt represented philosophy as an enigmatic female sphinx surging out of a star-lit sky. The symbolist style of this painting unsettled the general public, but the scandal only increased when Klimt delivered his second composition, entitled Medicine, at the Vienna Secession exhibition in 1901. In this painting, the Greek goddess of health Hygieia stands disdainful before the onlooker, brandishing the phallic symbol of a serpent. Reinforcing the eroticism of the scene is the presence, opposite the entwined shades of the sick and dying, of a sensuously pregnant woman whose flagrant nudity appeared profoundly shocking to the conservative professors. These reactionary forces organized an anti-Klimt cabal that recruited popular scientific periodicals such as the Medizinische Wochenschrift to exert pressure on the city authorities and have the official commission cancelled. Yet Klimt managed to capture the very essence of Viennese medicine in this painting, with its intimate juxtaposition of death and life, and its transformation of the gruesome autopsy room into a place of serious study. However, Medicine was never to find a home in the University, any more than Philosophy or Jurisprudence. In the late 1930s, all were seized from their Jewish owners and moved for protection to Immendorf Castle, which was set alight in 1945 by retreating SS, in final and uninhibited consummation of the professorial condemnation half a century earlier.

_ Arthur Schnitzler: a doctor fictionalizes Viennese medicine
In Vienna, art thus interacted with medicine. Artists regarded the men of science with an eye that was both admiring and critical, a duality particularly apparent in the writings of Arthur Schnitzler, whose approach was not dissimilar to that of the Vienna Secession master in that he too sought to “expose the erotic depths beneath Viennese Phaeaceanism.”5(p145) To understand the scientific character of this Young Vienna writer, we need to go back to his upbringing in the shadow of his father. As one of Vienna’s most celebrated laryngologists, Johann took a poor view of his son’s literary inclinations and forced him to complete his medical education. In his autobiography, Schnitzler was to complain of the stifling aridity of the medical curriculum. He described the internal conflict besetting a young student, or rather budding author, torn between pen and scalpel: “I was undecided and vacillating, and these were my feelings about medicine too. Being forced to study medicine… at times aroused in me a particularly violent repulsion towards it, while at other times drawing me to it and moving me to the very roots of my being.”13(p189) In May 1885, Schnitzler qualified as a doctor and used his talents to help his father in Vienna’s Poliklinik. When several years later he decided to give up his medical career, he found it impossible to detach himself from the medical environment that he knew so well and was to carry over into his fiction.

Arthur Schnitzler (1862-1931). Physician and prolific author (plays, short stories,
novels). His father, Johann Schnitzler, was a pioneer of modern laryngology.

© akg/Imagno.

One reason why Viennese medicine is so central to Schnitzler’s work is that he was describing its golden age, even to the extent of prefiguring Freudian psychoanalysis. He drew inspiration from his experience of medicine and enjoyed blurring the frontier between autobiography and fiction by subtitling some of his early stories, such as Mein Freund Ypsilon (1887), “Pages from a doctor’s notebook.” He thus drew his readers into a tantalizing web of masks and doubles, depicting himself under a variety of fictional avatars, such as Dr Merano in Die Weissagung (1902). The stories resemble consulting rooms in which the reader eavesdrops on a series of psychological disturbances and mental illnesses. In Der Sohn (1889), for example, Schnitzler studied the origin of certain neuroses, in the person of a dying mother who attempts to explain the violent behavior of her son by admitting she had tried to kill him when he was a child: “Do we conserve blurred memories from the first hours of our lives that we have become unable to interpret but that do not disappear without leaving a trace?”14(pp219,220) His writing reflects the influence of his mentors, in particular his professor, the psychiatrist Theodor Meynert. Despite feeling a certain antipathy for the man, Schnitzler owed him his fascination with dreams and hypnosis. This also accounts for the close relationship between his writings and the work of Sigmund Freud, who had also been Meynert’s student and considered Schnitzler his Doppelgänger.

Schnitzler’s style was all about stripping his characters bare and studying their psyche. He was a master of the internal monologue which he used to expose inner conflicts to the reader’s gaze. He resorted to the same technique to handle the subjects of death and loss of a loved one. These represent a leitmotif in his work, in particular in Ein Abschied (1896) and Die Toten schweigen (1897), two complementary short stories that together form a veritable case history. However, even as he retained his physician’s eye, Schnitzler never used medical science as a pretext for long disquisitions, but only as a plot driver: “he never sought to impress with the superiority conferred upon him by his medical skills…. Almost always a simple allusion would suffice to illuminate the story, without weighing it down or inserting blunt or unprepossessing details.”15(p199) Thus, his short stories, novels, and plays were not texts of medical vulgarization, but snapshot reconstitutions of the scientific city atmosphere that reigned in 19th-century Vienna.

In the final analysis, it was in his plays that Arthur Schnitzler was most critical of medicine, as in aracelsus (1899) where he described the European fascination for the hypnotism that was ridiculed by the Vienna School. By recounting the cabal mounted against the physician Paracelsus, accused of charlatanism, Schnitzler transposed into 16th-century Basel the attacks that he himself suffered in his youth when he practiced hypnosis: “[Some] slyly put about the rumor that I staged ‘shows’ at the Poliklinik, the immediate effect of which was to stop me conducting my experiments in front of a large audience, although I continued them for a while in front of reduced numbers.”13(p319) Schnitzler adopted a more humoristic tone in Professor Bernhardi (1912), a play that immersed the reader-spectator in a hospital not dissimilar from the Poliklinik of Johann Schnitzler, featuring a medley of white-coated caricatures: “from the preposterously-named Hochroitzpointner, a heel-clicking student capable of the basest of behavior in order to get ahead, to kindly Cyprian, the honest and sententious professor, via the stubborn ’60s-style liberal protester, the unscrupulous careerist, the personification of vanity obsessed with letters after his name, and the dedicated man of science.”15(p121) Beneath its superficial levity, the play describes the disgrace of a man reproached less for his professional failings than for his religious convictions. It was Schnitzler’s way of stigmatizing the rise of anti-Semitism in the Austro- Hungarian Empire while satirizing the medical establishment that contributed to the Empire’s fame.

The legacy of the Viennese school

Throughout the 19th century, world medicine centered on Vienna and the prestige of figures such as Rokitansky, Škoda, and Billroth. Even if Vienna was sometimes fickle and failed to recognize and justly reward some of its most strikingly innovative minds, it epitomized scientific progress and was an inspiration for artists. The name of the Vienna School remains written in gold in the history of medicine and its star never ceased to shine, even after the decline of the Habsburgs and the downfall of the Empire. _

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11. Open letter to Dr J. Späth, Professor of Obstetrics at the K. K. Josefs Academy in Vienna. 1862.
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