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The Church's Promotion of Public Health in the Southern Part of the Nineteenth-Century Austro-Hungarian Empire
Published online by Cambridge University Press: 08 June 2022
Abstract
Then part of the Austro-Hungarian Empire, the kingdom of Slavonia was characterized in the nineteenth century by constant political and administrative changes. After its liberation from Ottoman conquests, the rural area of the kingdom, already underpopulated, was left with damaged and poor infrastructure. In such circumstances, and as the most educated figures within their communities, Catholic bishops from the diocese of Đakovo and Srijem oversaw the reorganization and reform of local society, providing the foundations for further social development. They renewed and modernized local infrastructure and the production of basic goods, while also providing access to clean water and introducing hygiene measures in cemeteries to prevent the spread of infectious diseases. In addition, they played a crucial role in the opening of hospitals and schools in the region. In such work, one can detect elements of the approach later known as public health.
- Type
- Research Article
- Information
- Studies in Church History , Volume 58: THE CHURCH IN SICKNESS AND IN HEALTH , June 2022 , pp. 284 - 305
- Copyright
- Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of Ecclesiastical History Society
Footnotes
We wish to thank Ankica Landeka from the Central Archdiocesan and Faculty Library of the Catholic Theological Faculty in Đakovo and Vlatko Dolančić from the Archdiocesan Archive of the Đakovo-Osijek Archdiocese, who supported us in gathering sources and materials for this article.
References
1 Ladurner, Joy et al. , eds, Public Health in Austria: An Analysis of the Status of Public Health (Copenhagen, 2011), 1–3Google Scholar.
2 This phrase was used by one of the fathers of public health, Winslow, Charles-Edward A., in 1923: Institute of Medicine, The Future of Public Health (Washington DC, 1988), 58Google Scholar.
3 The term is applied to the set of policies implemented in Europe in the last third of the nineteenth century after discovering that polluted water and food could transmit cholera and several other infectious diseases. The provision of safe drinking water and better hygiene measures led to a decline in deaths from diarrheal diseases: ‘Sanitary Revolution’, Oxford Reference, online at: <https://www.oxfordreference.com/view/10.1093/oi/authority.20110803100440898>, accessed 5 July 2021.
4 Institute of Medicine, Future of Public Health, 58.
5 Ibid.
6 Tulchinsky, Theodore H. and Varavikova, Elena A., The New Public Health (Oxford, 2009), 1Google Scholar.
7 In this article, the term ‘healthcare’ is used to designate systems of healthcare provision; while ‘health care’ is used to describe those actions oriented toward improving health and caring for people or populations.
8 Antun Lešić, ‘Stranovništvo Slavonije krajem 17. i početkom 18. stoljeća’ [‘The Population of Slavonia at the End of the Seventeenth and Beginning of the Eighteenth Centuries’], Essehist 6 (2004), 84–94. All translations from Croatian into English are the authors’ own.
9 Robert Skenderović, ‘Ekološko–geografska determiniranost koloniziranja Slavonije u 18. stoljeću’ [‘Ecological-Geographical Determinism of the Colonization of Slavonia in the Eighteenth Century’], Radovi – Zavod za hrvatsku povijest [Transactions of the Institute of Croatian History] 51 (2019), 181–99; Anđelko Vlašić, ‘Iskorištavanje šuma u Slavoniji u Osmanskom razdoblju (1526–1691)’ [‘Forest Exploitation in Slavonia in the Ottoman Period (1526–1691)’], Scrinia Slavonica 16 (2016), 71–90.
10 Stjepan Sršan, ‘Katoličke župe u đakovštini početkom 18. stoljeća’ [‘Catholic Parishes in Đakovo at the Beginning of the Eighteenth Century’], Zbornik Muzeja Đakovštine [Proceedings of the Museum of the Đakovo Region] 4 (1997), 83–99.
11 Mato Cepelić and Milko Pavić, Josip Juraj Strossmayer, biskup bosansko–đakovački i srijemski, god. 1850–1900 [Josip Juraj Strossmayer, Bishop of Bosnia-Đakovo and Srijem, 1850–1900] (Đakovo, 2013), 4.
12 Its Latin name is Bosniensisseu Diacovensis et Sirmiensis. Hereafter we will refer to this diocese by the abbreviated name of Đakovo and Srijem.
13 Lešić, ‘Stranovništvo Slavonije’ [‘Population of Slavonia’]; Skenderović, ‘Ekološko–geografska determiniranost’ [‘Ecological-Geographical Determinism’].
14 For a broader historiographical context, see Alfons Labish and Reinhard Spree, eds, Einem jeden Kranken in einem Hospitale sein eigenes Bett (Frankfurt am Main and New York, 1996); George Rosen, A History of Public Health (Baltimore, MD, 2015); Michael Pammer, ‘Vom Beichtzettel zum Impfzeugnis. Beamte, Ärzte, Priester und die Einführung der Vaccination’, Österreich in Geschichte und Literatur 39 (1995), 11–29; Michel Foucault, The Birth of the Clinic (London and New York, 1973); Virginia Berridge, Martin Gorsky and Alex Mold, Public Health in History (New York, 2011).
15 Erna Lesky, ‘Die österreichische Pestfront an der k. k. Militärgrenze’, Saeculum 8 (1957), 82–106, at 86; Franciscus Xav. Linzbauer, Codex sanitario-medicinalis Hungariae, 3 vols (Budae, 1852), 1: 409; Robert Skenderović, ‘Epidemije kuge u Banskoj Hrvatskoj i Slavoniji krajem 17. i početkom 18. stoljeća kao povod za početak organiziranja javnozdravstvenoga sustava’ [‘Plague Epidemics in Banská Bystrica, Croatia and Slavonia in the late Seventeenth and early Eighteenth Centuries as the Motivation for the first Attempts to organize the Public Health System’], Povijesni Prilozi [Historical Contributions] 60 (2021), 77–96, at 83–4.
16 Franz Vaniček, Specialgeschichte der Militärgrenze aus Originalquellen und Quellenwerken geschöpft, 4 vols (Vienna, 1875), 1: 162.
17 This line of defence against the plague also existed within the monarchy. It aimed to isolate and control the flow of travellers from areas where the epidemic was present.
18 The Military Frontier in present-day Croatia had two parts. The first, the Croatian Military Frontier (Krabatische Graenitz) was the western part of the Military Frontier. In the sixteenth century, it belonged to the territory of the kingdom of Croatia. The second part, the Slavonian Military Frontier (Slawonische Graenitz, Windische Graenitz) was the part of the Military Frontier that belonged to historical Slavonia. For more on the Croatian and Slavonian Military Frontiers in the Habsburg monarchy, see Gunther Erich Rothenberg, The Austrian Military Border 1740–1881 (Chicago, IL, and London, 1966).
19 Vlatka Dugački and Krešimir Regan, ‘Povijest zdravstvene skrbi i razvoja zdravstvenih ustanova na hrvatskom prostoru’ [‘History of Healthcare and Development of Healthcare Institutions in Croatian Territory’], Studia lexicographica: časopis za leksikografiju i enciklopedistiku [Journal of Lexicography and Encyclopaedic Studies] 13 (2019), 35–74, at 46.
20 The term feldsher had been coined in the fifteenth century to refer to barber surgeons trained through apprenticeships, rather than at a university medical faculty.
21 Robert Skenderović, ‘Zdravstvene reforme Marije Terezije u slavonskom Provincijalu i Generale normativum sanitatis iz 1770’ [‘Health Reforms of Maria Theresa in the Slavonian Province and the Generale normativum sanitatis from 1770’], Scrinia Slavonica 5 (2005), 115–43, at 142.
22 Ibid. 133.
23 Tulchinski and Varavikova, New Public Health, 11; Dorothy Porter, Health, Civilization and the State (London and New York, 1999), 53. While Franck's work was very influential in Russia, and he acted as director general of the principal hospital of Vienna and was employed in the regulation of the sanitary service of the Austro-Hungarian army, the extent of his influence on the development of public health in other European countries remains unclear.
24 Dugački and Regan, ‘Povijest zdravstvene skrbi i razvoja zdravstvenih ustanova’ [‘History of Healthcare and Development of Healthcare Institutions’], 50. Four phases can be observed in the development of public health in the Habsburg monarchy. The first half of the eighteenth century was marked by a concentration on preventative measures to prevent plague epidemics. The second phase can be recognized in the building of public health institutions and of institutional networks at the local level. The third phase is seen in ensuring the availability of healthcare and increasing the number of professional staff. The fourth phase was the period after the system had already been formally developed, when public health policy focused on the general health of the population and preventative measures: see Ivana Horbec, Zdravlje naroda-bogatstvo države. Prosvijećeni apsolutizam i počeci sustava javnog zdravstva u Hrvatskoj [The Health of the People, the Wealth of the State: Enlightened Absolutism and the Beginnings of the Public Health System in Croatia] (Zagreb, 2015), 56.
25 Dugački and Regan, ‘Povijest zdravstvene skrbi i razvoja zdravstvenih ustanova’ [‘History of Healthcare and Development of Healthcare Institutions’], 51.
26 Hrvatski Sabor, Zakon od 24. siečnja 1894. o uredjenju zdravstvene službe u kraljevinah Hrvatskoj i Slavoniji [Act of 24 January 1894 regarding the Organization of the Health Service in the Kingdoms of Croatia and Slavonia] (Zagreb, 1894); Jozo Ivčević, ‘Javna uprava zdravstvom u (sjevernoj) Hrvatskoj 1868–1928. godine’ [‘Public Health Administration in (Northern) Croatia 1868–1928’], Arhivski Vjesnik [Archival Herald] 36 (1993), 117–30.
27 Dugački and Regan, ‘Povijest zdravstvene skrbi i razvoja zdravstvenih ustanova’ [‘History of Healthcare and Development of Healthcare Institutions’], 52–3. In 1919, Dr Andrija Štampar was appointed head of the Ministry of Public Health. Štampar, later the first president of the World Health Organization, devised an institutional form of primary health care in Croatia, the first of its kind in the world.
28 In early nineteenth-century France, the new Paris Health Council addressed a wide range of public health concerns, such as sanitation, food control and occupational health, and in 1848 a central national health authority was established. In Britain, a Central Board of Health was founded in 1805 with the purpose of overseeing quarantine regulations in order to prevent the spread of yellow fever and cholera; over the course of the nineteenth century, other public health provisions were also introduced, such as sanitation, lighting, iron water pipes and water filtration. 1881 was a significant year for public health in Germany: Otto von Bismarck, the chancellor, introduced legislation that provided mandatory insurance for injury and illness, and survivor benefits for industrial workers. Two years later, social insurance to fund the healthcare of workers and their families was introduced, based on mandatory payments from workers’ salaries and employer contributions. See Tulchinski and Varavikova, New Public Health, 13.
29 For more on the most influential definitions of public health, see Angus Dawson and Marcel Verweij, ‘The Meaning of “Public” in “Public Health”’, in eidem, eds, Ethics, Prevention, and Public Health (Oxford, 2007), 13–29.
30 As quoted in Tulchinski and Varavikova, New Public Health, 45 (italics ours).
31 Milan Vrbanus, ‘Ratarstvo u slavonskoj posavini krajem 17. stoljeća’ [‘Farming in the Slavonian Posavina at the End of the Seventeenth Century’], Scrinia Slavonica 2 (2002), 202–60.
32 Aleksandra Muraj, ‘Svakodnevni život u 19. stoljeću’ [‘Everyday Life in the Nineteenth Century’], in Vlasta Švoger and Jasna Turkalj, eds, Temelji moderne Hrvatske. Hrvatske zemlje u „dugom” 19. stoljeću [Foundations of modern Croatia. The Croatian Lands in the ‘long’ Nineteenth Century] (Zagreb, 2016), 309–39.
33 Cepelić and Pavić, Strossmayer, 847–99; Marin Srakić, ‘Ponovna uspostava i uređenje vlastelinstva bosansko–đakovačke biskupije (Prema dokumentima Dijecezantskog arhiva u Đakovu)’ [‘Re-establishment and Arrangement of the Manor of the Bosnian-Đakovo Diocese (According to the Documents of the Diocesan Archives in Đakovo)’], in Dušan Čalić and Đuro Berber, eds, Peti znanstveni sabor Slavonije i Baranje [Fifth Scientific Congress of Slavonia and Baranja] (Osijek, 1991), 151–61.
34 Skenderović, ‘Ekološko-geografska determiniranost’ [‘Ecological-Geographical Determinism’], 188–91.
35 Skenderović, ‘Zdravstvene reforme Marije Terezije’ [‘Health Reforms of Maria Theresa’], 122–4; idem, ‘Ekološko–geografska determiniranost’ [‘Ecological-Geographical Determinism’].
36 Skenderović, ‘Zdravstvene reforme Marije Terezije’ [‘Health Reforms of Maria Theresa’], 122–4.
37 Marin Srakić, ‘Biskup Antun Mandić – „zamišljatelj svega boljega i uzvišenijega u biskupiji”’ [‘Bishop Antun Mandić: “The Inventor of everything better and more sublime in the Diocese”’], Diacovensia 24 (2016), 229–46; Zlatko Vince, ‘Antun Mandić kao kulturni i prosvijetni radnik’ [‘Antun Mandić as a Cultural and Educational Worker’], Diacovensia 1 (1996), 155–66.
38 Cepelić and Pavić, Strossmayer, 15.
39 Nikša Stančić, ‘Josip Juraj Strossmayer u hrvatskoj politici’ [‘Josip Juraj Strossmayer in Croatian Politics’], Rad Hrvatske akademije znanosti i umjetnosti. Razred za društvene znanosti [The Work of the Croatian Academy of Sciences and Arts. Department of Social Sciences] 535 (2018), 11–36.
40 Đakovo, Archdiocesan Archive (NAĐ), 12 Diocesan Council, books II (1874–97), IV (1824–92), V–VIII (1874–97); II–VI (1898–1926).
41 Because of his involvement in many secular spheres, Strossmayer had a good knowledge of the political, social, educational and pastoral problems of the kingdom of Slavonia, and indeed of the whole of Croatia, at that time. He was best known for his speeches at the First Vatican Council (1869–70), opposing the dogma of papal infallibility. He acknowledged the dogma, but never officially endorsed it.
42 The new brickfield provided the bricks for the new cathedral in Đakovo (1866–82).
43 Cepelić and Pavić, Strossmayer, 905–11.
44 Ibid. 186. Today, these registers are an invaluable resource for research in many areas, including public health and education.
45 Ibid. 178–9.
46 Dugački and Regan, ‘Povijest zdravstvene skrbi i razvoja zdravstvenih ustanova’ [‘History of Healthcare and Development of Healthcare Institutions’], 43–4.
47 The oldest medical book in the Croatian language was published by the Franciscans in Buda in 1768; it is a bilingual Croatian-Latin translation of the book Flos medicinae / Cvit likarije. In many areas, the Franciscans were the only doctors available: Fr Petar Dombaj Saboljević worked in Vukovar, and in Virovitica Fr Bonifacije Gerber, a trained feldsher, established a small pharmacy. Its importance is evidenced by the fact that in the entire Virovitica County, from Osijek to Koprivnica, there was no other doctor or pharmacy. This situation alone testifies to the great lack of healthcare in Slavonia: Skenderović, ‘Zdravstvene reforme Marije Terezije’ [‘Health Reforms of Maria Theresa’], 117.
48 The experience of folk healers and herbalists is preserved in books called ‘Ljekaruše’: Dugački and Regan, ‘Povijest zdravstvene skrbi i razvoja zdravstvenih ustanova’ [‘History of Healthcare and Development of Healthcare Institutions’], 43–4.
49 ‘Đakovo je tako bijedan grad, da u njemu nema ni nedjeljnog sajma, ni prikladne kuće u kojoj bi stanovali potrebni ljudi, ni liječnika, ni apoteke’: Marin Srakić, ‘Antun Mandić, biskup, realizator školskih reforma u Hrvatskoj’ [‘Antun Mandić, Bishop, Implementer of School Reforms in Croatia’], in Dragutin Tadijanović, ed., Zbornik radova o Marijanu Lanosoviću [Collected Papers relating to Marijan Lanosović], Posebna izdanja, Zavod za znanstveni rad Osijek 6 [Special Editions of the Osijek Institute for Scientific Research 6] (Osijek, 1985), 87–97, at 92.
50 Cepelić and Pavić, Strossmayer, 17; Željko Lekšić, ‘Kratka povijest ljekarništva u Đakovu do Drugog svjetskog rata’ [‘A Brief History of Pharmacy in Đakovo until the Second World War’], Zbornik muzeja đakovštine [Proceedings of Đakovo Museum] 13 (2017), 127–44.
51 This was opened in 1829 by Mandić's successor, bishop Raffay.
52 Skenderović, ‘Zdravstvene reforme Marije Terezije’ [‘Health Reforms of Maria Theresa’], 136–7.
53 Vince, ‘Antun Mandić’, 155.
54 Cepelić and Pavić, Strossmayer, 22.
55 NAĐ, 10 Diocesan Ordinariate, 371/1849; 641/1849; 136/1850; 371/1850; 1052/1850; 1070/1850, official correspondence of the military authorities with the diocese in Đakovo.
56 Estera Radičević, ‘Bolnica biskupskog vlastelinstva – bolnica Milosrdnih sestara sv. Križa u Đakovu’ [‘The Hospital of the Episcopal Estate, the Hospital of the Sisters of Mercy of the Holy Cross in Đakovo’], Zbornik muzeja đakovštine [Proceedings of Đakovo Museum] 13 (2017), 47–66.
57 Ibid. 58–61.
58 Ibid. 63.
59 Ibid. 56.
60 Two citizens of Osijek, originally from Germany, Johann Kohlhoffer and Josef Huttler, bequeathed all their possessions in 1782 to a religious foundation for neglected children. The executor of their wills, the Jesuit Cristian Monsperger, also left his property to the foundation, which was placed under the royal protection and administration of the Hungarian Council of Governors in Pest.
61 The orphanage housed sixty children, male and female. In 1899, its management was entrusted to the Styrian province of the Merciful Sisters of St Vinko Pavlov. Children could train in craft schools, while gifted students were provided with further education: Cepelić and Pavić, Strossmayer, 254–5.
62 Georg Ritter is the first surgeon mentioned in the historical accounts of the institution: Željko Vranješ and Krešimir Glavina, ‘Od Zakladne bolnice do Kliničkog bolničkog centra u Osijeku’ [‘From the Foundation Hospital to the Clinical Hospital Centre in Osijek’], Medicinski vjesnik [Medical Journal] 41 (2009), 27–40; Zlata Živaković–Kreže, ‘Razvoj zaštite zdravlja u Slavoniji, posebni osvrt na Osijek’ [‘The Development of Healthcare in Slavonia, a Special Review of Osijek’], Hrvatski časopis za javno zdravstvo [Croatian Journal of Public Health] 1 (2008), 14–18.
63 Kamilo Firinger and Vladimir Utvić, Povijest bolničkih ustanova u Osijeku od 1739 do 1930 [History of Hospital Institutions in Osijek from 1739 to 1930] (Osijek, 1970); Vladimir Utvić, Povijest bolničkih ustanova u Osijeku od 1874 do 1974: II dio [History of Hospitals in Osijek from 1874 to 1974: Part 2] (Osijek, 1974); Aleksandar Včev, ‘Prva klinika Kliničkog bolničkog centra u Osijeku’ [‘The First Clinic of the Clinical Hospital Centre in Osijek’], Medicinski Vjesnik [Medical Journal] 41 (2009), 41–6.
64 Cepelić and Pavić, Strossmayer, 245–55.
65 Ibid. 188.
66 Josip Juraj Strossmayer, ‘Okružnica’ [‘Circular’] and ‘Naredba’ [‘Order’], Glasnik biskupija Bosanske i Srijemske [Bulletin of the Dioceses of Bosnia and Srijem] 9 (1881), 173–4.
67 NAĐ, 10 Diocesan Ordinariate, 379/1880.
68 NAĐ, 10 Diocesan Ordinariate, 1890/1893: the bishop recommends the clergy pray to God so that they do not become infected with cholera.
69 Josip Juraj Strossmayer, ‘Okružnica’ [‘Circular’], Glasnik biskupija Bosanske i Srijemske [Bulletin of the Dioceses of Bosnia and Srijem] 21 (1893), 18–19.
70 N. N., ‘Preventivna sredstva proti koleri i vladanje za vrieme iste’ [‘Cholera Prevention Measures and Behaviour during a Cholera Epidemic’], Glasnik biskupija Bosanske i Srijemske [Bulletin of the Dioceses of Bosnia and Srijem] 11 (1883), 183–4.
71 Basch, Charles E., ‘Healthier Students are Better Learners: A Missing Link in School Reforms to close the Achievement Gap’, Journal of School Health 81 (2011), 593–8CrossRefGoogle ScholarPubMed.
72 Peter, Louk W. H. et al. , ‘Effective Elements of School Health Promotion across Behavioral Domains: A Systematic Review of Reviews’, BMC Public Health 9 (2009), 182–95CrossRefGoogle Scholar.
73 Hahn, Robert A. and Truman, Benedict I., ‘Education improves Public Health and promotes Health Equity’, International Journal of Health Services 45 (2015), 657–78CrossRefGoogle ScholarPubMed.
74 Cepelić and Pavić, Strossmayer, 15.
75 Ibid. 15, 239. Except in the military district, where schools came under military administration, the vast majority of schools in the diocese were overseen by the church.
76 ‘Ban’ was a noble title used in several states in central and south-eastern Europe between the tenth and twentieth centuries, primarily in the territory of Croatia. From the eighteenth century, a ban presided over the Croatian parliament and headed the executive branch. He was directly subordinate to the king, enforcing the ruler's orders: Leksikografski zavod Miroslav Krleža, Hrvatska enciklopedija, mrežno izdanje [Miroslav Krleža Lexicographic Institute], Croatian Encyclopedia, online edition, at: <https://enciklopedija.hr/natuknica.aspx?ID=5627>, accessed 23 May 2021.
77 NAĐ, 10 Diocesan Ordinariate, 852/1852, official letter about the Croatian ban to the diocesan administration, 23 August 1852; Cepelić and Pavić, Strossmayer, 240.