Századok – 2005
TANULMÁNYOK - Krász Lilla: „A mesterség szolgálatában" Felvilágosodás és „orvosi tudományok" a 18. századi Magyarországon 1065
1104 KRÁSZ LILLA ,ΙΝ THE SERVICE OF CRAFTMANSHIP". ENLIGHTMENT AND „MEDICAL SCIENCES' IN 18TH-CENTURY HUNGARY by Lilla Krász Summary In he second half of the 18t h century — almost simultaneously — in those new type of „welfare states" propagating more or less enlightened reforms, that ranged from England over France to the Habsburg Monarchy, began within a conceptually well-considered centralized health policy framework on state level the medicalization of society. This incentive was further supported by centralized controlling measures, normative regulations and the introduction of professionalism. This process in terms of its practical realization meant that the professional physician as one important layer of the newly forming university educated intellectual elite was put to the foreground. The central authorities supported by the academic physicians, while emphasizing the common good, firstly questioned the methods and procedures of folk healing, then by issuing ordinances simply ripped the non-educated healers, who were relying mainly on their own experience, of their licenses. By investigating the newly established centralized health administrative branches, the conceptual bases of health policy, and the regularly issued normative directives on the territory of the Monarchy, and thus in Hungary as well, the growing influences of the state on the forming of society can be traced easily - be it positive or negative. It can not be questioned that at this time the number of educated physicians having obtained a university degree as compared to earlier centuries grew considerably, and a growing number of people from different layers of society turned to them and relied on their services. The source materials — official documents, medical reports, royal ordinances, private correspondence — even at the end of the 18th century give vivid testimony of the chronic lack of physicians at certain places, the quakery of non-educated healers, of ill-treated men, women, and children, the lack of the culture of health. A the same time these sources exemplify the newly evolving needs and demands of different layers of society, the openness towards modern health incentives and therapeutical treatments. In the field of health care this era witnesses the constant fore and back arguing, or more exactly the invigorating dialogue and reciprocal interaction between the educated physician and the empirical healer, between the thoroughly structured written royal ordinances and the non-professional, experience-based 'pagant' treatments, between 'scientia medica" and the „ars medica". What exactly is the nature of medical science that was exercised by the academics? What is the reason for their growing acceptance and appreciation by society, for their success? What kind of newly established administrative authorities served as a forum for the endorsement of the interests of physicians on individual and group level that contributed to their professional and social uplifting? To what extent did they play a role in the design and execution of the conceptual framework of health policy measures undertaken on highest levels of authority? Did they serve as instruments of the highest authorities, or were they good-willed, skilful mediators in the process of the modernization of health care? A new phenomenon of the era around the middle of the 18t h century is the 'birth' of the bureaucratic physician, who is performing written reports for the centralized administrative authority - the first and most influential Lieutenant Council. The bureaucratic physician is actively involved in the shaping and execution of the conceptual framework of health policy designed on highest levels of authority. As integral and actively contributing parts of the newly established centralized bureaucratic authorities in the 18th century these physicians 'produced' enormous numbers of official documents, figures, reports, trial documents that covered more or less objectively the actions and procedures of official and non-official healers performing on different levels, and collected data on conditions of health and illness of the population. They acquired the necessary knowledge and skill for the proper handling of statistical data that corresponded to the newly evolving bureaucratic needs of the state at the newly formed universities abroad, and from 1770 onwards at the universities of Nagyszombat, later Buda and Pest. By the last decades of the century the social stratification of the physicians with respect to rank and position became apparent. A relatively small proportion of physicians being employed as county or royal city physicians enjoyed the benefits of a high position and rank. Most physicians however settled in district or county centres as practitioners. Only a tiny proportion could practice at the royal court or was employed by counts or princes.
