EditorialSeite 8
I. Zur Sozialgeschichte der MedizinThemenschwerpunkt: Pflegegeschichte
Stuart Wildman „Docile bodies“ or „impudent“ women Conflicts between nurses and their employers, in England, 1880–1914 --- „Gelehrige Körper“ oder „dreiste“ Frauen Auseinandersetzungen zwischen Krankenschwestern und ihren Arbeitgebern in England, 1880 bis 1914 Seite 9–20
ZusammenfassungWenn Historiker über Konflikte in der Krankenpflege im England des 19. Jahrhunderts schreiben, konzentrieren sie sich auf die großen Auseinandersetzungen, die in London zwischen Ärzten oder Schwesternschaften und Krankenhausgremien ausgetragen wurden. Im frühen 20. Jahrhundert richtete sich das Interesse an Konflikten oft auf die aufkommenden Gewerkschaften bei den Angestellten der Nervenanstalten und die Einführung von Streiks als Mittel zum Erzwingen besserer Arbeitsbedingungen. Das Interesse an Auseinandersetzungen, die sich auf die alltägliche Routine im Krankenhaus zur damaligen Zeit bezogen, hält sich dagegen in Grenzen. Krankenschwestern wurden von Organisationen ausgebildet und angestellt, die über strenge Vorschriften verfügten, lange Arbeitszeiten, Arbeitspläne und pflegerische Tätigkeiten rund um die Uhr diktierten und absoluten Gehorsam verlangten. Im späten 19. Jahrhundert konnte man von Krankenschwestern tatsächlich im Foucaultschen Sinne als „gelehrigen Körpern“ sprechen. Von den überlieferten Aufzeichnungen beziehen sich viele auf Disziplinierungsmaßnahmen, aber wenige davon betrafen Krankenschwestern – besonders als Gruppen, die Beschwerden vorbrachten oder Entscheidungen der Obrigkeit in Frage stellten. Es gab Auseinandersetzungen, aber sie wurden gewöhnlich nicht systematisch dokumentiert. Die Fälle, die in den Akten von Einrichtungen festgehalten wurden oder sogar in die fachliche oder allgemeine Presse vordrangen, beziehen sich auf Gruppen von Krankenschwestern, die sich der Obrigkeit widersetzten und gegen Entscheidungen, Misshandlung, Diskriminierung oder unzumutbare Arbeits- oder Lebensbedingungen protestierten. Basierend auf den Aufzeichnungen mehrerer Organisationen und auf Berichten in Fachzeitschriften und Zeitungen untersucht der Beitrag die Zeit bis zum Ersten Weltkrieg. Dabei identifiziert er eine Reihe von Konflikten und analysiert die Vorgehensweise der Krankenschwestern sowie die Reaktionen ihrer Arbeitgeber. Vergleiche zwischen Krankenschwestern und anderen weiblichen Arbeitskräften werden diskutiert. Zum Teil können diese kleineren Auseinandersetzungen als Wegbereiter der Gewerkschaften und Arbeitskampfmaßnahmen gesehen werden, die in den 1920er Jahren aufkamen. Insgesamt zeigen diese Konflikte, dass es Krankenschwestern gab, die es – anstatt passiv zu bleiben – in Kauf nahmen, als „dreist“ abgestempelt zu werden, weil sie ihrer Unzufriedenheit Ausdruck verliehen und sich für bessere Bedingungen einsetzten.
Annelies van Heijst Conflicting chains of command in Dutch Catholic nursing (1839–1966) --- Konflikte in den Befehlsketten der katholischen Krankenpflege in Holland (1839–1966) Seite 21–34
Zusammenfassung
Protestantische Laienschwestern spielen eine besondere Rolle in der Geschichte der professionellen Krankenpflege in Holland. Die katholischen Nonnen, die in vielen Krankenhäusern als Schwestern tätig waren, werden hingegen als unprofessionell angesehen. Die Krankenpflege begann als eine Frauentätigkeit unter dem Regime einer religiösen Obrigkeit. Seit dem Mittelalter hatten die Nonnen traditionelles „stilles Wissen“ angesammelt. Obgleich zunächst noch nicht theoretisch formuliert, wurde die Pflege von einem „Team“ von Nonnen und ihren Mitarbeitern in organisierter Form durchgeführt. Als Ärzte in den 1870er Jahren begannen, Pflege-Ausbildungen einzuführen, wurde die konfessionelle Pflegetradition „vor der Geschichte versteckt“. Mit der weiteren Entwicklung von der konfessionellen zur professionellen Pflege kamen die Nonnen öffentlich in Verruf. Dafür gab es zwei Gründe. Die Nonnen begannen relativ spät mit der Ausbildung, behielten aber ihre Führungspositionen. Dazu kamen Schwierigkeiten bei Befehlsketten in katholischen Spitälern. In den 1960er Jahren wurden religiöse Befehlsketten von solchen abgelöst, die der Logik professioneller Krankenpflege folgten.
Marion Baschin Fighting for one‘s own health Care as a cause of illness --- Der Kampf um die eigene Gesundheit Pflege als Krankheitsursache Seite 35–49
Jahrhundertelang haben Angehörige Familienmitglieder im Krankheitsfall versorgt. Doch diese häusliche Krankenpflege hat kaum Niederschlag in schriftlichen Quellen gefunden. Die Journale von Clemens (1785–1864) und Friedrich (1828–1910) von Bönninghausen, zweier Homöopathen aus Münster in Westfalen, dokumentieren die Krankengeschichten ihrer Patienten. Einige der Einträge zeigen nicht nur die Pflegeleistungen an sich, sondern vor allem auch, welche gesundheitlichen Folgen diese Tätigkeit für die Ausübenden haben konnte. Die berühmte westfälische Dichterin Annette von Droste-Hülshoff zählte zu den ersten Patienten Clemens von Bönninghausens. Auch sie pflegte verschiedene Angehörige und erkrankte infolge dieser Tätigkeit. Mit Hilfe ihrer Briefe und Gedichte lässt sich exemplarisch zeigen, wie die private häusliche Krankenpflege motiviert war und inwieweit sie vom sozialen Umfeld erwartet wurde. Dabei zeigt sich noch viel mehr als in den Einträgen der Krankenjournale, dass die intensive Pflege nicht nur eine körperliche, sondern auch eine große psychische Belastung darstellen konnte. Die Untersuchung weiterer „Ego-Dokumente“ wäre wünschenswert, um das Feld der häuslichen Krankenpflege durch Laien weiter zu erforschen.
Elisabeth Malleier Alltag im Krankenhaus Normen und Konflikte am Beispiel des Wiener „Rothschild-Spitals“ um 1900 --- The day-to-day routine in hospitals Standards and conflicts, based on the example of the Rothschild Spital in Vienna around the year 1900 Seite 51–68
Summary
The juxtaposition of official regulations and letters of complaint from Vienna‘s Rothschild Hospital shows, beyond the rhetoric and euphemisms of hospital reports, how lively and diverse day-to-day life was in a Jewish hospital around the year 1900. The letters of complaint query the official hospital rules and show that ideal and reality did not always coincide. Often, religious questions were at the root of the critique – such as doubts as to whether kosher dietary laws were adhered to – or conflicts between the agents involved, be they individuals or groups, patients, nurses, physicians or administrative staff. As part of this process, power structures, social hierarchies, patient rights and gender issues were called into question and renegotiated.
Bettina Blessing Gemeindepflege um 1900 --- Parish nursing around the year 1900 Seite 69–92
This contribution first introduces the factors that supported the development of parish nursing before going on to explain the diverse organizational concepts involved and their development over time. It looks at the various Catholic and Protestant as well as secular institutions active in this field. The article then discusses the manifold tasks, fields of work and approaches to problem-solving that were characteristic of parish nursing. The various cultural, social and religious problems that the parish nurses had to contend with on a daily basis are also presented, including the increasing competition with other professional groups. The article concludes by looking at the standing of parish nurses in society and the advantages and disadvantages of parish nursing as opposed to hospital nursing from the point of view of the parish nurses themselves.
Sylvelyn Hähner-Rombach „Die praktische Außenarbeit in der Tuberkulosefürsorge steht und fällt mit der Tuberkulosefürsorgeschwester“ Anforderungen in der ambulanten Versorgung: Das Beispiel der Tuberkulosefürsorgerinnen im ersten Drittel des 20. Jahrhunderts --- „Practical tuberculosis care outside the hospital stands and falls with the tuberculosis nurse“ Challenges in out-patient care, using the example of tuberculosis nurses in the first third of the 20th century Seite 93–110
Once it had become apparent that tuberculosis sanatoriums were unable to stop this widespread disease, out-patient tuberculosis clinics were established for patients and their relatives in the German Reich. These clinics, which started in the late nineteenth century, employed physicians and tuberculosis nurses. The nurses were generally community or parish nurses, specialized carers not being trained until later. On the one hand, their tasks included the work at these clinics, where they assisted the physician, admitted patients and carried out x-rays and lab tests. On the other hand – and this was their main task – they visited the sick and their families at home, informed them about tuberculosis, instructed them on questions of hygiene and the appropriate behaviour and made sure these instructions were adhered to. If they were able to offer material help as well, they were received more willingly – and they could only make their visits with a patient‘s consent. Due to the lack of tuberculosis medicines, the work of the tuberculosis nurses was a mainstay in the fight against this highly infectious disease. They often had to overcome the resistance of general practitioners and also of some patients and their families. But they loved doing their job because they were appreciated by the tuberculosis doctors, had a relatively high degree of freedom, authority and responsibility as health visitors and achieved visible results through personal commitment.
Kristina Matron „Sie genießen den ersten Urlaub ihres Lebens“ Entwicklung der offenen Altenhilfe von der Nachkriegszeit bis zum Beginn der 1970er Jahre --- „They are enjoying their first holiday ever“ Working with the elderly, from the post-war years up to the early 1970s Seite 111–135
While, in the post-war years and into the 1950s, the building of old people‘s and care homes and the allocation of home places in those homes was seen as the main task of municipal care institutions for the elderly in Frankfurt am Main, in the decade that followed their main task shifted towards increasing the possibilities of providing care in people‘s own homes, delaying the move into old people‘s homes and breaking through the loneliness that elderly people were presumed to experience. Supported by the state, community housing was provided with flats for elderly people and with carers to look after their needs. The „warm rooms“ of the post-war period changed into clubs, where members met and received guidance. In the late 1960s the clubs were extended into day-care centres, offering a range of consultation services, organized day trips and recreational holidays for the elderly. It was hoped that „meals-on-wheels“ in combination with age-appropriate living conditions would delay the move into a home. But these plans were not adequately developed in the 1960s and often it was not clear who would pay the bills. The same was true of outpatient medical care which had traditionally been the task of community nurses, but was now increasingly carried out by local authority carers, who also provided household assistance. This kind of care could only ever be given for a limited period of time and, while it was able to delay the move into an old people‘s home, it could not replace it.
Jürgen Schlumbohm Das „Geheime Buch“ des Dr. Friedrich Benjamin Osiander Anonyme Geburten im Göttinger Accouchierhaus 1794–1819 --- The „secret book“ of Dr Friedrich Benjamin Osiander Anonymous births in the Göttingen Accouchierhaus, 1794–1819 Seite 137–166
The problem of anonymous or confidential deliveries, a subject of current controversy, has a long history. Some maternity hospitals offered the possibility for „clandestine“ births as early as the 18th and 19th century. A recently emerged source about the maternity clinic of Göttingen University allows insight into the motives that led to keeping a birth secret and the consequences of such a clandestine birth for mother, father and child. The director of the institution, a professor of obstetrics, wrote case reports on the women, who paid a handsome sum for his help and the in-patient care they received. In return, these women could be admitted under a pseudonym, and thus falsify their child‘s birth certificate; moreover they were not used as teaching material for medical students and midwife apprentices, whereas „regular“ patients had to give their names and, in return for being treated free of charge, be available for teaching purposes. The ten cases that have been painstakingly investigated reveal that the reasons that led the women and men to opt for an anonymous birth were manifold, that they used this offer in different ways and with different consequences. All of these pregnancies were illegitimate, of course. In one case the expectant mother was married. In several cases it would be the father who was married. Most of the women who gave birth secretly seem to have given the professor their actual details and he kept quiet about them – with the exception of one case where he revealed the contents of the case report many years later in an alimony suit. Only one of the men admitted paternity openly, but many revealed their identity implicitly by registering the pregnant woman or by accompanying her to the clinic. If the birth was to be kept secret the child needed to be handed over to foster parents. By paying a lump sum that covered the usual fourteen years of parenting, one mother was able to avoid any later contact with her son. In most cases contact seems to have been limited to the payment of this boarding money. One of the couples married later and took in the twins that had been born clandestinely out of wedlock. One mother kept close contact with her son through intermediaries. All of the women who gave birth in this clandestine fashion received practical as well as financial support, often from the child‘s father or from a relative. Few of them came by themselves. In those days, only women who used the maternity hospital free of charge would have been as isolated in the difficult perinatal period as are women today who choose to deliver their babies anonymously.
Claudia Prestel Eine „Pflicht der Humanität und Ehre der deutschen Judenheit“ Die „Schwachsinnigenfürsorge“ am Beispiel der Israelitischen Erziehungsanstalt für geistig zurückgebliebene Kinder Wilhelm-Auguste-Victoria-Stiftung in Beelitz e. V. --- A „humanitarian duty and a matter of honour for German Jewry“ „Feeble-minded“ Jewish children and the Institution in Beelitz Seite 167–205
In 1908, in collaboration with the Bnei Briss, the German Association of Israelite Communities founded an institution for intellectually disabled Jewish children in Beelitz with the aim of educating 7–14–year-olds, using therapeutic pedagogy. The institution was part of the philanthropic efforts undertaken by German Jewry in that period. It was set up in the wake of the German Kaiser‘s call to found more philanthropic institutions, and its establishment is indicative of the efforts at integration being made by German Jewry. In their fund-raising material, the German Association of Israelite Communities stressed the „loyalty and patriotism“ of German Jewry and described the establishment of the institution as „a humanitarian duty“ and „a matter of honour for German Jewry“. It was, therefore, demands from the non-Jewish world that led to the foundation of a Jewish institution; however, its establishment was also symbolic of the struggle against anti-Semitism and indicative both of German Jewry‘s dissimilation and their efforts at integration. The article investigates the struggle of Jewish parents to have their children admitted to the institution, the philosophy and teaching methods of the director Sally Bein (1881–1942) and his wife Friederike Rebeka Bein (1883–1942), the background of the students, the causes of intellectual disability, as well as the disagreements that occurred between parents, teachers and the director. The article also discusses the successes and failures of therapeutic pedagogy. The article contributes to the wider discourse on the health of German Jewry, their role in social work and their attitude towards eugenics.
Ylva Söderfeldt Jüdische Gehörlose in Deutschland 1800–1933 Blicke in die Geschichte einer doppelten Minderheit --- Deaf Jews in Germany, 1800–1933 A look at the history of a dual minority Seite 207–230
This study examines the importance of religious denomination in the German community of deaf people in the 19th century and up until 1933, focusing on the dual minority status of deaf Jews. It shows that the educational system for the deaf and the deaf movement as such were, in structure and content, informed by the Christian, primarily the Protestant, faith. This meant that deaf Jewish people were in danger of facing a conflict between their identity as Jews and their identity as deaf people. In order to resolve this dilemma, Jewish philanthropists and deaf people created a range of complementary structures: schools where deaf Jewish children received tuition tailored to their needs, religious services in sign language and a Jewish deaf association for mutual support and companionship. But being members of two stigmatized and marginalized groups made the Jewish deaf vulnerable from several sides. The discursive association of deafness, Judaism and heredity played a particular part in this. This study comes to the conclusion that deaf Jews did not want to choose between their deaf and Jewish identities but they wanted to belong to both. As a result they suffered from the negative views that some deaf people had of Jews and some Jews of deaf people – as well as from the double discrimination by the mainstream society.
II. Zur Geschichte der Homöopathie und alternativer Heilweisen
Stefanie Jahn Die Grippe-Pandemie nach dem Ersten Weltkrieg und die Homöopathie im internationalen Vergleich --- The flu epidemic after World War I and homeopathy – an international comparison Seite 231–272
The „Spanish Flu“ began in 1918 and was the most devastating pandemic in human history that had ever been, claiming more lives than World War I. The flu virus had not yet been discovered, and the usual therapy measures were merely symptomatic. In many parts of the world the pandemic was treated by homeopaths. At the time, homeopathic medical practices, out-patient clinics and hospitals existed in various countries. To this day homeopaths refer to the successful homeopathic treatment of the „Spanish Flu“. The following paper looks at what this treatment consisted in and whether it was based on a particular concept. It also examines contemporary evaluations and figures, as well as the question as to whether homeopathy experienced a rise in demand as a consequence of its success during the pandemic.