From the "pest-house" to the Charité
In 1709 and 1710 a devastating Plague raged through northeastern Europe. It reached East Prussia and Pomerania posing a threat to the Royal Prussian residence in Berlin.
A special law, the "Pest-ruling" passed in 1709, laid down that at times of increasing epidemic danger a pest-house should be built outside the town. It was in 1710 when the epidemic had already reached Prenzlau that such a house was built near the "Spandauisches Thor" (the Spandau gate), serving as a quarantine ward and a military hospital. Berlin was spared the Plague, and the "pest-house", - a simple two-storey timberframed building, - was for the time being used as a "hospital for poor, sick and elderly people, and also as a workhouse for healthy and able beggars."
In 1713 the Prussian capital gained a Theatrum Anatomicum, which belonged to the "Societät der Wissenschaften" (Society of Sciences), founded in 1700. It was mainly used for the education of medical officers, but also for civilian doctors, midwives and other practicioners of medical professions. In accordance with the customs of the time, "persons of distinction" were admitted to anatomical presentations. In this theaterlike hall, in the society's building in the Dorotheenstrasse, a professor of anatomy demonstrated the structure and location of the inner organs in human corpses.
The anatomy lectures were soon extended to other medical subjects such as pathology, physiology, pharmacology, and botany. With that the Anatomical Theatre had developed in the course of time into an institution of medical education which orientated itself to practical necessities.
With the foundation of the Collegium Medico-chirurgicum in 1724 in Berlin, medical education received a regular structure. The Collegium offered excellent educational facilities for medical officers and military surgeons. What was still lacking, however, was a facility for clinical education.
In the autumn of 1726, Frederic William I. ordered the former pest-house to be converted into a military garrison hospital. The city surgeon of Berlin, Christian Gottfried Habermas, had already in September 1726 made a proposal to open the planned military hospital for indigent civilians as well.
Since Eller, the private physician of the King, and the general surgeon Holtzendorf supported the proposal, the King approved of the plan with a cabinet order on November 18, 1726. The building was extended and the medical management was taken over by a physician and a surgeon. A chief inspector was in the charge of the administration. Soon a private house in the courtyard of the former pest-house was built for him. Habermaass became the first chief inspector. Several other buildings, such as a kitchen, a refectory, a brew house and stables where built. The state provided respectable fonds to the amount of 100.000 Talers. The military and the civil hospital together were equipped with approximately 400 beds, 300 of which alone were occupied by the "Hospitaliten", people in need of care.
On January 14, 1727 the king wrote a remark in the margin of an administrational petition requesting tax-free supply of rye for the patient's provisions from the Berlin city magazine:
"the house shall be named Charité"
This hospital, that later was to become the largest and most famous hospital in Berlin, has kept the name Charité up to this day. At present, it is the world famous University Clinic Charité.
During the first eight years Johann Theodore Eller (1689-1760) was the chief medical doctor. At his side stood Gabriel Senff (d. 1738) as the Charité-surgeon. Both were also professors at the Collegium Medico-chirurgicum.
According to the medicinal edict of 1725, which was to form the basis of the Prussian public health administration for almost a hundred years, all medical officers, who wanted to settle in Berlin or other larger cities, had to pass a exam at the Berlin "Obermedicinalcollegium" (chief medical commission) and in anatomy
. The interest in further education was considerable. For prospective military surgeons who were also allowed to treat internal diseases, an additional exam on the treatment of internal diseases was offered by the Collegium Medico-chirurgicum. Medical doctors who had graduated from universities did not receive a license to practice medicine until they had described in writing a real case- history, and had passed an exam in anatomy and another at the "oberste Medicinalbehörde" (chief medical board). Frequently, non-Prussian military surgeons came to Berlin as well, using the facilities offered here to add a theoretical foundation to their skills and to widen their practical knowledge. Foreign medical students and graduate doctors, however, came to complete their mainly theoretical knowledge from university through practice on patients. Thus, the Berlin Charité became a model for a practice-oriented medical education in Prussia and beyond.
back to table of contents
Along with the increase in population in Berlin (1680:9,800; 1730:70,000; 1800:170,000 inhabitants, of which 13,000 were military personnel) the number of indigent patients grew steadily; therefore, by mid-18th century the Charité was in need of more space.
Since1751 the Charité had a midwife school attached to the midwifery department. At last, between 1785 and 1800 a long planned new building was erected. The original Charité building had to make way for this first genuine hospital building. Experience gained in hospital construction in Paris and Vienna was applied. It was larger and better ventilated. However, the installation of water pipes and bathrooms was not possible for financial reasons. The number of beds had thereby increased to 680.
The chronicler of the Berlin health care system,L. Formey, wrote about the Charité in 1796:
"The Charité building, which is the largest institution of its kind here, has a threefold application. It consists of 1.) a hospital, where sick and elderly persons are taken care of; 2.) a school for royal medical officers and for others studying at the Collegio medico-chirurgico; and 3.) a hospital and an institution, where poor, married and unmarried pregnant women are admitted some time before giving birth, are taken care of, delivered and released after a few weeks."
Despite all its excellent economical and administrational regulations and its honorable educational tasks, the Charité remained long into the 19th century what it had originally been - a hospital for the poor, whose admittance was decided for a long time, only by the "poverty-board".
The royal private physician Christoph Wilhelm Hufeland, head of the Charité since 1801, also directed the Collegium Medico-chirurgicum until its closure in 1809.
back to table of contents
1810 - Berlin becomes a university town
The Collegium Medico-chirurgicum, the Charité and the army Pépinière founded in 1795 had their merits in supplying useful technical knowledge on a comparatively high level. However, by the end of the 18th century, these educational institutions had reached their limits.
The defeat of Prussia at Jena and Auerstedt in 1806, shortly after emperor Francis II had renounced his title and thereby sealed the fate of the "Holy Roman Empire", provided the impetus for the long overdue reform work by Stein and Hardenberg. One of its results was the foundation of the Berlin University. Wilhelm von Humboldt, who worked from 1809 as head of the department for culture and education in the Prussian Ministry of the Interior, was one of the university's "spiritual founders". The physicians Hufeland and Johann Christian Reil (1759-1813) also took part in the programatic preparation of the new university. The university opened in October 1810 in the former palace of Prince Heinrich, which is today the university's main building. That day, 117 medical students enrolled, more than in the other four Prussian universities put together (Königsberg, Frankfurt/Oder, Halle and Duisburg).
The teaching staff of the Berlin Medical Faculty consisted, at first, of six full professors, one associate professor (J.Ch.Reich) and seven private lecturers. Full professors were the internist Hufeland, who became the first dean, Reil, the surgeon Carl Ferdinand von Graefe, the anatomist and physiologist Johannes Horkel and the anatomist Christoph Knape.
As early as 1810, the founding year of the university, Hufeland set up a policlinic which he directed during his lifetime It was the first institution of its kind for the indigent population of Berlin, and also served for the training of medical students.
Now, with the founding of the university, Berlin provided an academic education to medical doctors. It was at first strictly separated from the Charité, and courses were held in clinics for surgery, internal diseases and obstetrics, set up specially for the Medical Faculty. The first modest university clinics (12 beds for the internal and surgical cases) were accommodated in various apartment houses, such as in Friedrichstrasse and in Oranienburger Strasse. In 1818 the Medical Faculty was able to buy a suitable building at No 5/6 Ziegelstrasse, to accommodate the medical and surgical clinics. After the purchase of additional real estate at the same location, the buildings which at present are the I. Surgical University Clinic as well as the Eye and Ear Clinic were erected. This square reaches the Spree and has been kept till today. Until its closure in 1933, it was the place where under the direction of B.v.Langenbeck, E.v.Bergmann and A.Bier essential developments in surgery were made.
As the third clinic The Maternity Hospital, independent of the Charité, moved in 1816 under the direction of Adam Elias von Sieboldt (1775-1828) into its own building in Oranienburger Strasse. This university obstetrics clinic, which later moved to Dorotheenstrasse, was the precursor to the I. University Women´s Clinic, founded in 1822 by Carl Schröder (1838-1887) in Artilleriestrasse (today´s Tucholskystrasse).
With the foundation of the so called Pépinière, a school, which was to house the prospective military surgeons and train them in the basic subjects, another purely military educational institution had opened in 1795 alongside the Collegium Medico-chirurgicum. Since 1818 this institution was named Friedrich-Wilhelms-Institut and the Charité still remained its facility for clinical training. The Collegium Medico-chirurgicum was closed in 1809. Despite the efforts of the military, to combine the education of the military doctors with the newly founded university in Berlin did not materialise.
Thus, a Military Academy for Medicine and Surgery was founded in 1811, enabling the graduates of the Pépinière to continue their studies without leaving the army. The Charité, therefore, remained as far as administration and education were concerned, in the hands of the army. In 1895 the merger of the Friedrich-Wilhelms-Institut (Pépinière) with the Academy for Medicine and Surgery finally took place and it became the Kaiser-Wilhelm-Akademie for the education of military doctors. The most renowned scholars who graduated from this educational institution, funded by the state, were Virchow, von Helmholtz, von Behring and von Leyden.
It existed until 1945 as Academy for Medical Officers, accommodated in a large complex of buildings at Invaliden- and Scharnhorstrasse
.
back to table of contents
Healing, Teaching and Research
A cabinet order had ensured that in 1816 also the Charité received, for purposes of medical training, a clinic for surgery and ophtalmology with two wards containing 12 beds each, an operating theater, and a room for nurses. Although the Charité´s purpose was primarily the education of prospective medical officers, it was also open for civilian students. Therefor, gradually the educational facilities of the Charité and of the university could be used by both the university students and the students of the Military Academy for Medicine and Surgery. Furthermore, the faculty and Military Academy shared several professorships.
The Medical Clinic was the first of the university clinics to be moved from Ziegelstrasse to the Charité in 1828. For the director of that time, E.D.A. Bartels (1778-1838), this was an opportunity to raise the number of beds in the clinic. The move coincided with the intentions of Johann Nepomuk Rust (1775-1840), the powerful director of surgery and ophthalmology. He was also a major general of the Medical Corps and president of the Hospital Board. Rust had tried in vain to remove the Charité from the influence of the Ministry of War and put it under the control of the Ministry of Education. It had been his intention for some time to bind the university facilities to the Charité.
The medical University Clinic and the Clinical Institute of the Charité, whose director was Eduard Wolff (1794-1878), shared rooms on the second floor of the Old Charité building. Bartels held his lectures in Latin whereas Wolff spoke German to the prospective military doctors. Therefore, the names German and Latin clinic emerged.
Surgery was particulary attractive in the Medical Faculty of that time. C.F. v. Graefe at Ziegelstrasse as well as J.F. Dieffenbach (1794-1847) - since 1829 head of the Surgical Clinic of the Charité - were masters in their field, especially in the plastic surgery. Together with the practicing physician Carl Ernst Gedicke (1797-1867), Dieffenbach planned and directed the School for Hospital Nurses, founded in 1832. He also published "Instructions for nursing".
The division of education - at the Charité for the medical personnel of the army and at the university for civilian physicians - was gradually reduced during the second half of 19th century. It could finally be overcome only with the transfer of the clinics in Ziegelstrasse to the Charité.
Between 1831 and 1835 an additional building was erected on the north of the "Old Charité" to remedy space shortage in the main building. It was called the "New Charité".
In this building the wards for the mentally sick, syphilitic patients and prisoners were accommodated. In 1836 a small-pox-house serving as isolation ward was built not far from the new hospital building.BR> In 1856 it accommodated the midwifery department and the midwife´s school. Today as the oldest preserved Charité building, it contains the Institute of Experimental Endocrinology. In 1856 the first Institute of Pathology was built for Rudolf Virchow (1821-1902) between the "Old" and the "New Charité".
Due to the quick extension of the so called Friedrich-Wilhelm-Stadt the borders of Berlin had already reached the Charité grounds.
back to table of contents
Until that time the Medizinische Klinik (internal medicine) still adhered to the 18th century methods of the terapeutics; although J.Ch. Reil, with his introduction of bedside laboratory testings, had shown the hopeful beginnings of modern clinical methods. Unfortunately he died early. In the 1840s new impulses came from Johann Lukas Schoenlein (1793-1864). In 1839, Schoenlein appointed from Zürich to Berlin, represented the type of modern clinician who considered the stethoscope, the microscope and the test-tube natural pre-requisites for efficient clinical diagnostics. The introduction of the German language in the lectures was another of his merits.
Schoenlein had won the Charité board of director´s concession to employ civilian assistans in the clinic as well. Ludwig Traube (1818-1876), a German Jew, was the first civilian colleague of Schoenlein who was employed at the Charité. He is considered to have pioneered experimental pathology. In 1849, one year after his "Habilitation", he set up a department for chest diseases, which mainly served for instruction in percussion and auscultation. In 1857, after Wolff had retired, this department gained new status as a propaedeutical clinic and extended. With this, the foundation was laid for the devision of the Medizinische Klinik lastingt till 1980. The names I. and II. Medizinische Klinik, however, were not introduced until 1885, when the Traube´s student and successor Ernst von Leyden (1832-1910) was appointed to the Propädeutische Klinik. After the death of Theodor Frerich (1819-1885), he took over the I.Medizinische Klinik. Between 1885 and 1902 Carl Gerhardt (1833-1902) became the professor of the Propädeutische Klinik, which from then on was called II.Medizinische Klinik. His successor was Friedrich Kraus (1856-1936) who worked at the Charité for the next two decades.
Together with Felix von Baerensprung (1822-1864), head of the department of syphilitic diseases at the Charité, Traube won great recognition for the introduction of measurement of temperature as a clinical examination method. A department for the mentally sick was established at the Charité after the mental asylum had burnt down in 1798 in Krausestrasse. Nearby were the department for syphilitic diseases, opened in 1825 and the department for children´s diseases, founded in 1830, at the same time the first German children´s hospital, whose director was Friedrich Baretz (1790-1856). These were further clinical institutions that existed only at the Charité for medical education.
The department for syphilitic diseases and the department for scabies and smallpox were finally mergel and became the skin clinic. Here, Baerensprung´s studies on the pathogenesis of the herpes zoster were written here after 1860.
A gynecology department was added to the maternityl unit.
The successor of Schoenlein at the Medizinische Klinik was Theodor Frerich (1819-1885). Under his direction, the clinic gained a small chemical laboratory, where Frerich´s assistant Paul Ehrlich (1854-1915) carried out his fundamental research on the morphology of blood. Later Ehrlich worked under the direction of Robert Koch at the Institute of Infectious Diseases and was finally, as director of the Institute for Experimental Therapeutics in Frankfurt (Main), awarded the Nobel Prize in 1909 for his studies on immunology. With his antisyphilis drug Salvarsan the era of chemotherapy began.
The Medizinische Poliklinik, which in 1850 had moved into the hospital at Ziegelstrasse, was until 1856 directed by the internist and neurologist Moritz Heinrich Romberg (1795-1873). His greatest achievements were in the field of neuropathology. He was succeeded by Wilhelm Griesinger (1817-1868) who had come from Zurich and who took charge of the psychiatric clinic as well. He was the founder of a somatic-empirical direction in psychiatrics, which saw the cause of psychic diseases in pathological changes of the brain. Griesingers credo was: "Mental diseases are illnesses of the brain.".
The Chirurgische Universitätsklinik (surgical university clinic) on Ziegelstrasse enjoyed great esteem. Bernard von Langenbeck (1810-1887), a famous military surgeon, worked here. He attracted doctors and students with his new surgical techniques. His successors Ernst von Bergmann (1836-1870) and August Bier (1861-1949) were also able to surpass their colleagues in the Charité. E.v.Bergman gained wide recognition through his achievements in aseptics.
Between 1828 and 1868 the Ophtalmological Clinic also belonged to the Surgical Clinic. Unfortunately the faculty had in time neglected the appointment of Albrecht von Graefe (1828-1870) as professor. Berlin had already,through him, become a focal point in ophtalmology at that time. Since the appointment did not materialize, A.v.Graefe was for 18 years dependent on his private clinic. He received a full professorship for ophtalmology only in 1868, which he held for only two years. In 1882 a monument, which remains as one of the most beautiful on the Charité grounds was erected in his honour. It is located on the corner of Luisen- and Schumannstrasse.
The expansive development of medicine during the 19th century with its increasing specialization and the extension of specialized clinics, had brought the university clinic as well as the Charité to their limits. Therefore, in 1878, the reconstruction of the university clinic on Ziegelstrasse started in order to establish a new surgical and ophtalmology clinic. At the same time in the neighbouring Artilleriestrasse a modern I. Universitätsfrauenklinik (women´s clinic) was built. The midwifery department, the midwife´s school and the gynecology department of the Charité were merged and became the II. Universitätsfrauenklinik and existed until 1952.
Since the foundation of the university anatomy and physiology had been taught by Karl Asmund Rudolphi (1771-1832). After his death, Johannes Müller (1801-1858) received the professorship for anatomy and physiology. He was not only a great anatomist and zoologist, but also a pathologist and physiologist, and is considered to be one of the founders of comparative anatomy. The institute in 1827 was located in a gloomy building in the inner city. It had an extensive anatomical-zoological museum, which was accommodated in the western wing of the university. Müller contributed greatly to the separation of medical science from philosophical speculations. His and his followers´´ results in the fields of normal, comparative and pathological anatomy had a substantial influence on medical science of that time. Müller´s manual of physiology, which was published between 1834 and 1840 had a great impact on the process of scientification of therapeutics.
Among Müller´s students were the pioneers of cellular research and natural science oriented physiology, Jakob Henle (1809-1885), Theodor Schwann (1810-1882), Rudolf Virchow (1821-1902), Emil Du Bois-Reymond (1818-1896), Hermann Helmholtz (1821-1894), Ernst Wilhelm Brücke (1819-1892) and Carl Bogislaus Reichert (1810-1883).
Müller died in 1858, and Schoenlein resigned. They left a faculty which, in the course of a generation, had risen from an institution of merely provincial significance to one that had gained worlwide recognition.
The steady increase in knowledge made further specializations in medicine necessary. This was connected with a reorganization of space and institutions. three professorships were made out of the subjects taught by Johannsa Müller alone. These were given to his students R.Virchow (pathology), C.B.Reichert (anatomy) and E. Du Bois-Reymond (physiology).
back to table of contents
URL: http://www.rz.charite.hu-berlin.de/ch/presse/chronik/chrengl1.html
Letzte Änderung:07.01.1997 13:22:29