ABSTRACT
Formal clinical medical instruction was already several decades old in Vienna in 1780. It had been formally instituted in 1753 by Gerard van Swieten, the Empress Maria Theresa’s personal physician and a disciple of Hermann Boerhaave, whose ward round was observed by his students in Leyden’s municipal hospital from the gallery of a special ward. Hospitals were originally Christian charitable foundations for the overnight care of transients or immigrants, the local poor also lacking in the support networks that transients would have left behind, and the sick who could not pay for treatment. A system of hospital medicine founded in a holistic view of the individual patient and his or her environment gave way to a reductive clinical emphasis on diseased parts; the individual person was disregarded. Physicians’ diagnoses and their disease terminology nonetheless underlay the selection of patients for some of the more specialised hospitals. In the post-postmodern age in which people now live, globalisation is everything.
