‘A civilizing mission’? Austrian medicine and the reform of medical structures in the Ottoman Empire, 1838–1850

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Abstract

During the 1840s, physicians from the Habsburg Empire played a decisive role in the reform of medical structures in the Ottoman Empire. This paper discusses different aspects of this scientific and cultural encounter. It emphasizes the importance of Austrian health care structures as a model for the work of these physicians in the Ottoman Empire and studies the role of the medical school ran by the Austrians as a means of representing, on the one hand, the reformatory efforts of the Ottoman Empire and, on the other hand, the motivations of the Habsburg monarchy for an involvement in Ottoman health care affairs, strongly bound up with its own quarantine politics towards the Ottoman Empire.

Introduction

In 1917, Max Neuburger—then professor of history of medicine in Vienna—wrote a short article on ‘Austrian physicians as pioneers of scientific medicine and hygiene in Turkey’ examining the work of Austrian physicians who had been involved in the transformation of medical structures in the Ottoman Empire in the middle of the nineteenth century.1 The First World War—during which Neuburger published his article— had turned a former foe into one of the major allies of the Habsburg Monarchy. Neuburger’s study emphasises the Habsburg Empire’s role as a partner in what was then perceived as a ‘civilizing mission’, bringing the light of science to the ‘uncivilized Orient’. The pride of the Vienna medical school in doing so is summed up by Neuburger’s introductory statement: ‘The first attempt to create a sanitary administration in Turkey and to form an educated class of physicians dates back to the civilizing work of Austria’.2 Neuburger’s emphasis on the ‘civilizing’ character of the work of the physicians is typical of his generation of historians of science, as Pyenson (1993) has shown. But it also reflects the self-conscious and ‘missionary’ approach of the new generation of Austrian physicians that was involved in medical reforms in the Ottoman Empire during the 1840s.3

This episode of Austrian influence on medical affairs in the Ottoman Empire lasted just over fifteen years, roughly between 1838 and 1854. At the beginning of the 1850s it came to a rather sudden and surprising end—especially in the light of the fact that the rapid progress of German/Austrian medicine in the second half of the nineteenth century was then just beginning.4 As we will see, the ‘export’ of medical science from Vienna to Constantinople was much more a matter of political and economic considerations, closely linked to the influence and ambitions of Habsburg diplomacy, than of scientific progress.

Much of my research on this episode in Habsburg–Ottoman relations is based on the extensive coverage of the topic in the German and Austrian medical periodicals in the mid 1840s. The intensity with which both the Austrians’ work in the medical school in Constantinople and the state of public sanitary affairs in the Ottoman Empire were discussed in Viennese medical media went beyond what could be considered pure ‘Orientalist enthusiasm’. It reflected the professional and political interest that the Habsburg Monarchy (and the individual physicians) had in the state of the sanitary conditions in the Ottoman Empire, at a time when infectious diseases such as cholera were posing a considerable threat to the European population. From the Austrian perspective, the efforts to reform medical education in the Ottoman Empire were an essential part of the Habsburg Empire’s own quarantine policy.

On the Ottoman side, the reform of medical structures is closely linked to the serious crisis the Empire experienced in the 1820s and 1830s and the subsequent reform politics. In Ottoman history, the period of reform starting with the ‘Imperial Rescript of Gülhane’ in 1839 is called tanzimat and has been one of the core subjects of modern Ottoman scholarship. European historiography has related the involvement of Europeans in the process of reforms in this period to the imperial ambitions of the ‘European powers’5 and with the influence of their respective economies.6 More recently, scholars have begun to emphasize the importance of the transfer of science and technology.7

Medicine is in many respects linked to the reformatory efforts of the tanzimat period. The introduction of new medical educational institutions, sanitary administration,8 professional associations9 and a restrictive medical legislation10 brought about a centralization and standardization of medicine and thus affected the whole Ottoman society. These reforms gradually reduced the existing ‘free market’ in health care and eventually replaced it with a more regulated, structured system both in education and in medical practice, which was in many respects modelled after European examples and, especially in the beginning, dependent on European assistance. ‘Civilizing’ here meant structuring and establishing what was perceived to be a ‘European-style’ order in health care affairs, as it would be done in the former Ottoman province of Bosnia some three decades later.11 Recent studies analyzing the development of modern medicine in other regions of the modern Middle East has shown that the establishment of such European structures and/or of medical schools has played a key role in this process.12

The formation of an ‘educated class of physicians’—as Neuburger put it—brought about with the Habsburg Monarchy’s assistance was much more than an accidental episode in the history of bilateral relations between the two Empires. This paper shows how the work of the Austrian physicians at the Imperial Medical School in Constantinople was based on Habsburg models and contributed to the change in the structures of health care and medical services in the Ottoman Empire. It furthermore argues that medicine served as a means of pursuing Austrian diplomatic and economic ambitions especially as far as international quarantine politics were concerned. Crucially, these physicians at the same time perceived themselves as agents of a ‘European civilization’.13 Based on a thorough reassessment of contemporary sources, including newspapers and files of the Haus-, Hof- und Staatsarchiv in Vienna as well as a critical review of the secondary literature, this paper sheds new light on the substantial and multifaceted Austrian part in the process of medical reform in the Ottoman Empire.

Section snippets

Medicine and the relations between the Ottoman and Habsburg empires up to the 1840s

Even though mid nineteenth-century visitors to the Ottoman Empire in their accounts stress the differences between ‘Oriental’ and ‘European’ medicine,14 there is good reason to assume that methods and concepts of health and sickness that prevailed in the Ottoman Empire were not much different from those that had been used by

‘Magnificent and well equipped’: the medical school and the staging of ‘modernity’ for the European public

At the time of the establishment of the ‘Imperial Medical School’, education in the Ottoman Empire was in the first stages of transformation towards a more differentiated system. New institutions of advanced education were introduced, among them the rüşdiyye-schools that were supposed to close the gap between primary and higher education. Military schools had been set up in Constantinople, offering specialized instruction in various fields. Guidance—and influence—in this initial impulse to

‘Pillars of civilization’: healthcare as part of a ‘civilizing mission’ for the Ottoman Empire

While struggling with the operational problems described above, the Austrian physicians gained influence in another field where their work was to leave deeper marks. Having successfully treated the Sultan Abdülmecit in 1845, Sigmund Spitzer became a friend of the Sultan, a young man in his early twenties. Spitzer was officially appointed a court physician with unlimited access to the Sultan.86 Spitzer’s close

A failed ‘mission’? The end of Austrian influence on the medical school and its consequences

In the early 1850s, the impact of physicians from the Habsburg Empire on Ottoman medical affairs came to a rather sudden end. Sigismund Spitzer, who had a strong personal influence on the Sultan and affected many decisions during the early stage of the public health system, left Constantinople for Vienna in 1850, after his life had been threatened in the course of a plot against the Sultan’s life. Some of the Austrian physicians who had held important positions in the Ottoman sanitary

Acknowledgements

This paper is based on research done for a Ph.D. thesis at the Medical University of Vienna, on Austrian physicians in the Ottoman Empire and Egypt in the nineteenth century. My thanks go to Dr Tatjana Buklijas (University of Cambridge), Univ. Doz. Dr Walter Sauer (University of Vienna), Univ. Doz. Dr Sonia Horn (Medical University of Vienna) and Dr Arın Namal (University of Istanbul) for their support. All translations are my own unless otherwise stated.

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