Hausordnung und Liegekur: Vom Volkssanatorium zur Spezialklinik: 100 Jahre Zürcher Höhenklinik Wald (review)

Iris Ritzmann. Hausordnung und Liegekur: Vom Volkssanatorium zur Spezialklinik: 100 Jahre Zürcher Höhenklinik Wald. Zurich: Chronos, 1998. 216 pp. Ill. Sw. Fr. 38.00; DM 40.00.

From our perspective, as the twentieth century is coming to its close, it is quite hard to imagine to what an enormous extent tuberculosis of the lungs was epidemic in wide circles of nineteenth-century mid-European population, and how deadly a threat it was to everyone. This pulmonary epidemic was rampant in particular among young children and adolescents, so that 50 percent of the overall deaths were to be ascribed to these age-groups. From the mid-nineteenth century onward, various attempts were made to fight this infectious disease by means of sanitariums that were placed under medical observation and control, and that were situated in privileged climatic and geographical locations, such as the Alps region of Switzerland. For the population of Zurich, the lung sanitarium Wald was built on the southern slope of the mountain known as Faltiberg at a height of 900 m; when it was inaugurated in 1898, it could accommodate forty-five patients. This sanitarium grew steadily until 1930, and has developed into a large specialist clinic for pulmonary diseases, internal medicine and rehabilitation. Since 1990, it has been caring for, in particular, persons suffering from cardiac diseases, orthopedic problems, and neurologic disorders.

Iris Ritzmann closely and carefully investigates all the lines of development of this clinic and its long tradition. She analyzes social problems as well as the problems of hygiene that the medical treatment of pulmonary tuberculosis posed to the public, particularly in the first half of the twentieth century. She discusses the change in the diagnosis and treatment of pulmonary tuberculosis brought about during the course of the twentieth century, as well as against the background of the two world wars. Included in her analysis are also questions and problems related to nutrition and hygiene, the carefully structured daily schedule that was rigorously regulated by the house rules, and the development of lung surgery and radiology since 1900. The introduction of antibiotic therapy for tuberculosis, which has made this infection curable since the end of World War II, as well as the new BCG (Bacille-Calmette-Guérin) inoculation, turned out to be critical factors for the national sanitariums everywhere in Europe, since these developments resulted in a decline in the number of patients. The duration of the patients' stay quickly diminished, and the treatment of tuberculosis was no longer dependent on sanitariums in locations with a salubrious climate. Since 1967, the Wald sanitarium has therefore gradually been converted; following a generous phase of renovation from 1983 to 1990, it was entrusted with the medical tasks of a specialist clinic for cardiology, orthopedics, and neurology.

This well-structured and highly readable analysis of the Wald sanitarium provides an informative and exemplary introduction to the history of pulmonary tuberculosis and its treatment. In its development from a tuberculosis sanitarium for the poorer classes of society to a rehabilitation clinic for everyone, this Zurich welfare institution is in fact a model of clinical institutions of this kind in Europe in the twentieth century that owed their original foundation to the treatment of patients suffering from pulmonary tuberculosis.

Axel Hinrich Murken
Institut für Geschichte der Medizin und des Krankenhauswesens
Aachen, Germany

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