Patienten in der Chirurgischen Klinik der Universität Marburg in Friedens- und Kriegszeiten. Eine Studie anhand von Patientenakten der Jahre 1928, 1940/41 und 1944.
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Philipps-Universität Marburg
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Abstract
While the 19th century had been a period of continuous progress due to advances in anesthesia and antisepsis, the World Wars turned out to be a time marked by setbacks. Therapy had to change, medical resources ran short, and military hospitals were set up at the same time. What is more, Nazism influenced education and training as well as surgical decisions since the early 1930s.
Against this background, the thesis compares treatment of surgical patients during the pre-war years and the Second World War. For this purpose, 900 patients’ records of the Marburger Chirurgische Klinik have been evaluated, covering the years 1928, 1940/41 and 1944 with 300 records for each year. Contemporary sources have been used to complete and verify the results.
Due to an increasing acceptance of hospitals, a growing number of citizens with health insurance and better surgical conditions more and more patients sought treatment, causing the Marburger Chirurgische Klinik to expand several times. Between 1928 and 1944 Rudolf Klapp was tenured clinical professor of the faculty that was partly damaged by two air raids during the Second World War. Influenced by Nazi ideology surgical hospitals - as was the case in Marburg - forcibly sterilized men according to the Gesetz zur Verhütung erbkranken Nachwuchses (Law for the Prevention of Hereditarily Diseased Offspring). Moreover, people were asked to name any hereditary diseases such as deformities, nervous or mental diseases or alcoholism on admission to the hospital.
On the basis of the analyzed records it becomes clear that hospital care in Marburg underwent drastic changes during the war caused by a lack of doctors, nursing staff and beds as well as wartime destruction. However, primary care was always provided. In total, more men than women were treated in the period examined (percentage of women: 37,3- 45%). During war the percentage of female patients increased as a lot of men were called up for military service. Patients were mostly between 16 and 50 years old. Most of the hospitalized patients lived in the rural area around Marburg. The majority had health insurance.
Not only civilians but also forced laborers from the camps close to Marburg were admitted to hospital. Although they received the same necessary treatment, they were discharged more quickly. The surgeons took the medical history and performed a physical examination of all patients. During war patients history was quite short due to a lack of physicians. Patients’ nutritional condition and energy levels were rather good even in 1944 as there was a constant food supply in and from the Marburg area. Civilians’ clinical pictures did not change during war except for injuries caused by bombs and gunshots. However, only patients who needed urgent treatment were admitted. As expected the average stay in hospital dropped to a length of roughly three days. This was due to a lack of beds since parts of the clinic were destroyed and beds for civilians were needed for soldiers.
48,6 to 61 percent of patients were operated in the fields of visceral surgery, orthopedics or urology under local or - more often - under general anesthesia. There seemed to be no lack of typical narcotics like ether and chloroethyl ether during war. Conservative therapies included immobilization, wound care and remedial gymnastics. The latter being particularly important to Prof. Klapp who developed his own therapeutic exercises. Therapy was modern and adequate for a university hospital. Blood and urine tests as well as X-ray treatments were considered the norm. The outpatient clinic had more recall appointments as patients were discharged earlier. The mortality rate increased from the beginning of the war until the end due to severe diseases or injuries. Autopsies of the deceased were mostly performed in the Institute of Pathology.
Marburg surgeons and doctors elsewhere certainly contributed to support the war by continuously providing primary care for civilians and soldiers. Of particular note is Prof. Klapp who was Beratender Chirurg (Consulting Surgeon) in both world wars. He conducted research in the field of war surgery and the procedures he developed (e.g. wire extension) were mainly influenced and promoted by his war experience. In the 1930s, the senior physician Hans Boeminghaus tested surgical techniques for male sterilization at the Marburg hospital and then used them to forcibly sterilize “feeble-minded” men. Klapp tried to keep the doctors in Marburg for patient care, but some of them were called up for military service during the war years. Moreover, they had to support the reserve military hospital.
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Created: 2020Issued: 2020-11-10Updated: 2020-11-10
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
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DoctoralThesis
Keywords
civil population in hospitaluniversity hospital MarburgSurgerySecond World Warpatients records
DFG-subjects
Universitätsklinik MarburgChirurgiezivile BevölkerungZweiter WeltkriegPatientenakte
DDC-Numbers
610
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Serowinski, Lara Rieke: Patienten in der Chirurgischen Klinik der Universität Marburg in Friedens- und Kriegszeiten. Eine Studie anhand von Patientenakten der Jahre 1928, 1940/41 und 1944.. : Philipps-Universität Marburg 2020-11-10. DOI: https://doi.org/10.17192/z2020.0393.