Medical history in German medical education.

BEFORE discussing the present position of medical history in the German medical curriculum I should like to make some historical remarks. The paper begins therefore with the part played by the history of medicine in Germany during the nineteenth century up to the first world war. Thereafter it will deal with the time between Sudhoff's foundation of the Institute of History of Medicine at the University of Leipzig and the second world war. The main topic will be the period after 1945 when nearly every German medical school established a chair and an institute or department of history of medicine. A short survey of the research that is done in these institutes will follow, and finally we shall glance at the teaching programme of the German medico-historical institutes. In the beginning of the nineteenth century German medical schools already offered lectures and courses in the history of medicine, like many medical schools in other European countries. But the aim of the instruction was not the same as today. Today a course in the history of medicine is intended to demonstrate to students that medicine is not an isolated phenomenon, but depends on cultural, religious, economic and social factors, and that the actions and thought of the modern physician have been shaped by the theories, doctrines, findings and errors of countless generations of physicians before them. In the first decades of the last century the medical student had to study classical medical authors in order to learn from them how to practise as a good doctor. Kuhn's Greek-Latin edition of Galen, published in twenty-two volumes at Leipzig from 1821 to 1833, applied to the physician, not to the philologist. This pragmatic conception of the history of medicine was given up about the middle of the century. The leading medical men realized that progress in medicine could not be achieved by persisting in traditional theories or the study of historical texts, but from the scientific approach to disease. The systematic application of physical and chemical methods to the phenomena of life characterized German medical research from the time of Theodor Schwann, Carl Ludwig, and Hermann Helmholtz. There remained no place for the history of medicine: medico-historical lectures disappeared from the curriculum or found no audience. Although the history of medicine did not enjoy great standing as an academic discipline, the University of Berlin had a chair in medical history. Until 1850 it was occupied by Karl Hecker, the founder of historical epidemiology, and later by August Hirsch, known as the author of the Handbook of Geographical and Historical Pathology. The immense development of the science of general history and the formation of a critical method for historical research from the middle of the nineteenth century encouraged studies in the history of medicine, and particularly original research work in archives and libraries. After the death of August Hirsch, Bismarck passed the chair of history of medicine to his personal physician Ernst Schweninger, who had no knowledge of the subject and never gave a lecture on the history of medicine. Julius Pagel, who was well known in this field, received only the title of professor. This shows how little attention was being paid to the history of medicine by local governments-and medical faculties too. In 1904 the University of Leipzig received a bequest of 500,000 Marks for the