Nolte Karen
Institut für Geschichte der Medizin, Julius-Maximilians-Universität Würzburg.
Wurzbg Medizinhist Mitt. 2010;29:131-57.
Around 1800 there arose a need in German university towns for patients to serve as subjects during the practical instruction of academic physicians. Since the early university hospitals could not provide enough patients for the practical training, the Poliklinische Institut (outpatient departments) whose doctors and nurses visited the patients in their home offered an economical alternative to the in-patient therapies. Patients from the lower social classes who could not pay for medical care had to offer themselves as "teaching objects" in return for receiving free treatment. Simultaneously, since the end of the 18th century physicians had been emphasizing both the causal connection between disease and poverty and their own significant role in fighting and preventing poverty. In addition to learning about diagnosing methods and therapies, the practical training also provided a lesson in dealing with patients from a lower-bourgeois background. Utilizing the example of the university city of Göttingen, the current article will reconstruct the discussion about the opportunities academic training with poor patients provided. I will analyse the medical care the poor received and the negotiation processes involved between the university and the city council's department for the poor.
19世纪初,德国大学城出现了一种需求,即在学术医生的实践教学中需要患者作为受试者。由于早期的大学医院无法为实践培训提供足够的患者,波利克林诊所(门诊部)的医生和护士会上门探访患者,这为住院治疗提供了一种经济实惠的替代方案。来自社会底层、无力支付医疗费用的患者不得不主动成为“教学对象”,以换取免费治疗。同时,自18世纪末以来,医生们一直强调疾病与贫困之间的因果关系以及他们自身在消除和预防贫困方面的重要作用。除了学习诊断方法和治疗方法外,实践培训还提供了与来自中下层背景患者打交道的经验教训。本文将以哥廷根大学城为例,重建关于利用贫困患者进行学术培训机会的讨论。我将分析穷人所接受的医疗护理以及大学与市议会贫困部门之间的谈判过程。