Making Sense of Madness: Mental Disorders and the Practices of Case History Writing in the Early Nineteenth Century

Janka Kovács
Eötvös Loránd University
This email address is being protected from spambots. You need JavaScript enabled to view it.

Hungarian Historical Review Volume 10 Issue 2  (2021): 211-242 DOI 10.38145/2021.2.211

The article focuses on interpretations of madness in early nineteenth-century Hungary medical practice from a comparative perspective. By relying on the methodological approach of the anthropology of writing and the analytical considerations offered by Michel Foucault’s 1973–1974 lectures on Psychiatric Power, the article discusses the formalized and standardized practices of case history writing. It draws on sources from the teaching clinics at the universities of Pest and Edinburgh, as well as the largest mental asylums in the Habsburg Monarchy in Vienna (est. 1784) and Prague (est. 1790), and the ideal type of mental asylums at the turn of the eighteenth and nineteenth centuries, the York Retreat (est. 1796). In doing so, an attempt is made to reconstruct both the physicians’ gaze and (to a certain extent) the patients’ view, and by examining the therapeutical regime of each hospital and its correlations with the institutional background, uncover whether madness was perceived as a pathological somatic or psychological state in the medical practice of these institutions. This is in and of itself a fundamental question if we seek to understand changing attitudes towards the mad and their curability in a period of transition from a “world without psychiatry” to a “world of psychiatry,” when specialized care was still not an option for many, especially in the East Central European region.

Keywords: history of psychiatry, case history, medical gaze, clinical practice, medical writing

On July 20, 1812, Anna Maria Navratil, a 50-year-old female patient afflicted with a serious illness, was taken to the teaching clinic of the Medical Faculty at the University of Pest. Upon admission, she was diagnosed with an enigmatic disease, hysteria, the interpretation of which requires caution.1 She was undernourished and had a weak bodily posture, and she presented the following symptoms: heavy palpitation and pulse, stiffness in the neck, slow metabolism, hard stool, plentiful but watery urine, and globus hystericus, the suffocating feeling of a lump in the throat, typical of hysteric patients. She was also melancholic, sad, and sensitive, and her face mirrored desperation. The woman’s road to recovery (or at least an asymptomatic state) was followed closely by the medical students completing their clinical practice in the wards, as was done in the cases of hundreds of patients treated at the clinic. These day-to-day observations were recorded in case histories, the length and detailedness of which varied according to the personal habits and preferences of each student. The structurally strict and tight narratives consisted of the following standard elements: the day of admission and basic personal data (age, sex, occupation, religion), the anamnesis encompassing the patients’ family history and life events pertaining to illness, the diagnosis and etiology of the disease, the progress of the disease, and the day of death or discharge. In case of discharge, the patient’s current condition was also recorded (perfectus or imperfectus).

Observation as the practice of collecting and interpreting data is age-old. In medicine, however, the epistemic method of writing, the aim of which is the accumulation, recording, and structuring of information, became common only in the sixteenth century, and in medical education it was introduced as a formalized practice as late as the eighteenth century.2 Compulsory case history writing was introduced at the teaching clinic at the University of Pest in 17843 in order to counterbalance the dominance of “bookish knowledge” in dissertation writing, and it remained a prerequisite for a medical degree until the 1840s. Beginning in the 1810s, mentally ill patients, among them hysteric or melancholic individuals, were admitted to the clinic in increasing numbers, and their progress was recorded in the standardized and prescribed observational categories of case histories. This study delves into these materials and by juxtaposing them to case histories written in diverse institutional settings, It also explores patterns and tendencies in the interpretations of “mental” disorders in an era when the early forms of mental normalization were already underway.

In the case of Hungary, the insights offered by the case histories are unique in certain respects. First, there are comparatively few hospital case histories which shed light on the day-to-day experiences of healing. Second, since Hungary had no special institution (either an asylum or a designated hospital ward) to provide at least rudimentary care for the insane until the establishment of the first wards in the Buda hospital of the Brothers of Mercy in the 1830s, the Schwartzer Private Lunatic Asylum (which opened in 1850), or the Lipótmező Royal National Asylum (which opened in 1868), municipal general hospitals, policlinics, and hospitals operated by religious orders (the Brothers of Mercy and the Sisters of Saint Elizabeth) admitted them. Therefore, however sparse the available materials are (and thus the number of mentally ill patients on which some information has survived), the diagnostic and healing practices of the Pest policlinic can be taken as representative for “mental normalization” in Hungary in the period under study.

The primarily somatic approach to mental disorders might also be a direct consequence of the way in which knowledge concerning psychology was disseminated in medical education. From the early 1800s onwards, gradually replacing the dominant approach of Hippocratic and Galenic medicine, more modern theoretical and practical approaches were introduced at the medical faculties at the universities of Vienna, Prague, and Pest. Though individual courses on psychology/psychiatry were not offered until the 1840s, when in Prague and Vienna the first proposals were sent to the Court Commission of Studies (Studienhofkommission) by the primary physicians at the Vienna and Prague asylums, increasing attention was being paid to knowledge concerning psychology. Knowledge of psychology was part of the compulsory training in philosophy (itself a prerequisite of medical education) at the two-year and three-year programs offered by colleges and the philosophy faculties of the universities, either incorporated into courses on logic or taught individually as empirical psychology. Furthermore, from the turn of the eighteenth and nineteenth centuries, basic psychological knowledge was filtered into core medical courses on physiology, pathology, therapy, medical police, and forensic medicine, with the body-soul problem and the problem of mental disorders often being explained from neurological and “social” points of view.4 The latter, gaining ground in the subsequent decades, viewed mental disorders either as diseases of civilization (for example, the consequences of an urban or scholarly lifestyle) and considered the mentally ill in their broader social contexts as individuals to be defended from and also a “danger” to society at large. This, however, as the case histories reveal, rarely surfaced in the context of hospital practice. It remained within the domain of theoretical discourses in textbooks or dissertations.

In attempting to grasp the interpretations of mental disorders recorded in case histories, I focus on the case histories’ layout, seriality, formalized structure, and the cognitive practices written into the narratives and their links with knowledge production and the interpretation of different phenomena in medical practice. The means of interpretation, however, cannot be understood without paying close attention to the correlations between the methodology of writing and the institutional background, which could shed light on whether the “mental” disorders appearing in the case histories under discussion were indeed understood, approached, and handled as mental disorders with a psychological elucidation in mind or whether they were seen and treated as first and foremost somatic diseases disguised as mental maladies. To make sense of the practices at the teaching clinic in Pest, comparative materials, among them the records of hospital administration, statistics, case histories, and patient records will be explored from different types of institutions, ranging from the teaching clinic at the Royal Infirmary of Edinburgh, which operated in a similar configuration as the Pest clinic, to the early asylums of the Habsburg Monarchy in Vienna and Prague and the model of mental asylums in the period, the York Retreat, which was founded in 1796.

In addition to drawing on the methodological approach of the anthropology of (medical) writing, the study’s inquiries are also informed and inspired by Michel Foucault’s lectures on psychiatric power held at the Collège de France between 1973 and 19745 and Roy Porter’s seminal 1985 article advocating the inclusion of a patient’s view in medical history writing,6 which has been introduced and applied in research with more or less success for the past few decades.7 Taking their argumentation as a starting point, I will focus on the following aspects: 1. the ritual of questioning and confession, and the incorporation of the physician’s gaze and the patient’s perspective into the narratives, 2. the importance of pathological anatomy and “family history” in making diagnoses, 3. the applied therapeutical regimes and the length of stays in hospitals, which could be revealing with regards to the preferences of either a psychological or a somatic approach in “mental” normalization.

Managing Mental Disorders: Approaches from Teaching Clinics to Lunatic Asylums

As the layout and structure of the case histories and patient records on the basis of which conclusions can be ventured concerning the physicians’ gaze, the patients’ progress, and the interpretations of diseases depended heavily on the given institutions’ administrative practices, the following section will provide a summary of the most significant institutional tendencies and the nature of the surviving sources.

The richest collection of case histories survives from the teaching clinic at the University of Pest, where the purpose of recording the patients’ cases was twofold. First, case histories were written in partial fulfilment of medical degrees from 1784, following the Viennese example. For his final exam, each student had to summarize the progress of two or three patients chosen from a larger pool with a wide array of diseases.8 The structure of these narratives is in most cases clear and logical, and the main points are well articulated. Second, case history writing was also a compulsory part of clinical practice for fourth-year and fifth-year medical students, as testified by a diverse group of materials on hospital administration (patient records, statistics, case histories, meteorological observations) in Ferenc Bene’s (1775–1858) collection, which was preserved in the Manuscripts Archive of the National Széchényi Library in Budapest.

The teaching clinic was led by Ferenc Bene, chief physician of Pest, dean of the medical faculty (1807–1809) and rector of the University of Pest (1810), and a propagator of smallpox vaccination in Hungary between the 1810s and the middle of the 1840s. In this period, students were required to write case histories on a monthly basis, and these histories were then handed in to him for evaluation (in many cases, the documents were signed by him). In comparison with the exam materials, these narratives are less detailed and less well-structured, but in all cases they mirror the given medical student’s individual style, preparedness, and diligence, and they also show the everyday “raw” experiences involved in working in close proximity to diseases, the students’ progress, and the physicians’ approaches to the students.9 In addition to the longer case histories, on which the second part of this study draws, shorter summaries and reports (synoptica relatio), sometimes reflecting on the same cases as the longer narratives and clinical journals encompassing hospital statistics, were also prepared, in most cases by the assistant physicians at the clinic. Depending on the habits, erudition, and individual preferences of the physicians, the clinical journals had different layouts, and they often varied in the extent to which they went into detail, but their structure remained the same, including statistics (the number of all admitted patients in the previous six months or year, as well as the number of discharged and remaining patients and deaths) and a narrative part summarizing “interesting” or “curious” cases arranged into seven categories.10

As highlighted earlier, the two types of case histories, the practice and exam materials, were similar in their structure but could mirror different everyday experiences of hospital life and the progress of individual cases, as well as the physicians’ individual approaches to health, illness, and therapy. However, both types offer a glimpse into how, sometimes breaking with the “bookish” tradition of medical education, medical students, observing their patients’ progress, documented and at the same time interpreted and approached “madness” and the most frequently described and diagnosed mental maladies in the period and the connections these interpretations had with the content of their curriculum.

From among the case histories written at the teaching clinic at Pest between 1787 and 1847, I have chosen to focus on a narrower period between 1812 and 1828. Prior to 1812, no case histories were written on mental patients, while after 1828 the approach to mental disorders altered in medical education, with changes in both quantitative and qualitative factors, as shown, for example, by the number of admissions, changes in the curriculum, and the thematic spectrum of dissertations. I chose cases for further exploration in which the diagnoses were fully or partially related to mental disorders, mostly the four most common “traveling concepts,”11 hysteria, hypochondria, melancholy, and mania, which were familiar since Antiquity but which have been reimagined and interpreted over the course of the centuries in light of newer theories, such as dualism, mechanical theories, animism, vitalism, and the findings of neurology. As revealed by the Hungarian clinical cases, these maladies were still commonly diagnosed in the early nineteenth century, even though this period saw a slow and gradual transition towards a more nuanced classification of mental disorders (at least in Western Europe and, as we will see in the discussion of diagnostic practices at the Vienna and Prague asylums, to some extent in the East Central European region too) with the work of German physician Johann Christian August Heinroth (1773–1843), the French Philippe Pinel (1745–1826), and his pupil, Jean-Étienne Dominique Esquirol (1772–1840). According to their classifications, some of the categories partly became devoid of their original meaning or were reconsidered and “fell apart.”12

In some of the cases I have selected, mental disorders were concomitant with other diseases and developed in relation to or as a consequence of either neurological (debilitating headaches, epilepsy, St. Vitus’s dance, also known as Sydenham’s chorea) or gastrointestinal diseases. However, the neurological disorders that were not identified as mental maladies and were not accompanied by mental symptoms were not considered. After taking these factors into consideration, I chose 22 longer case histories which include the standard categories of observation (anamnesis, diagnosis, etiology, prognosis, the progress of the disease, therapy).13

As the policlinic of the University of Pest mostly admitted surgical cases, pregnant women, patients with fevers, skin diseases, or inflammations that could make good teaching cases, the low number of mental patients in the statistics, clinical journals, and case histories should not come as a surprise. Furthermore, if we consider the dominance of one particular disease, hysteria (and to a lesser extent its “male counterpart,” hypochondria), the number of mental diseases approached from and diagnosed based on a psychological framework are even fewer in number. As opposed to mania or melancholy, which were primarily diagnosed based on mental and behavioral symptoms, at the time hysteria and hypochondria could easily be interpreted as somatic diseases that could yield physical therapeutics if we consider their symptomatology, even though they were more often than not accompanied by mental symptoms. The dominance of the somatic approach, thus, is pinpointed by the low proportion of mental maladies and high incidence of maladies disguised as such. From among the 22 patients, 18 were diagnosed with hysteria, one with hypochondria, one with erotomania (a disorder characterized by an individual’s delusions of another person being infatuated with them), one with melancholy, and one with delirium tremens.14 Hence, the case histories of the teaching clinic of Pest shed light on interpretations of hysteria and the practice of diagnosing and healing along the lines of somatic medicine, lacking a psychological approach which was, to some extent, already in use in the diagnostic and therapeutic practices in the first asylums of the Habsburg Monarchy or in model institutions, such as the aforementioned York Retreat.

Among the universities operating a teaching clinic in Europe at turn of the eighteenth and nineteenth centuries,15 the teaching wards at the Royal Infirmary of Edinburgh showed remarkable similarities with the policlinic in Pest. Very much like the reform measures launched by Gerard van Swieten (1700–1772) in the mid-eighteenth century in Vienna, which also had a profound impact on medical education in Hungary, the reform of the Medical Faculty of the University of Edinburgh established in 1726 was also implemented by three pupils of Herman Boerhaave (1668–1738), Alexander Monro primus (1697–1787), John Rutherford (1695–1779), and William Cullen (1710–1790). Following the Leyden model, both in Vienna (and later in Pest) and Edinburgh emphasis was put on bedside teaching and empirical observation, creating the most modern spaces of medical education in Europe.16 By this time, Edinburgh diverged from the English model still followed in Cambridge and Oxford, which relied on an outdated system of theoretical lectures and observation, eliminating clinical teaching almost completely.17 As for the practices of admission, capacity, and patient numbers, there are further similarities between the teaching wards of the Royal Infirmary and the teaching clinic of Pest: in Edinburgh, 20 to 50 patients were admitted on a monthly basis, whereas in Pest the figures were between 20 and 40.18 The clinical case histories written in Edinburgh between the 1790s and the 1810s19 reveal rather similar tendencies to what we have observed in the case of the Pest policlinic. Though medical students in Edinburgh played a somewhat more passive role in the actual treatment of patients, empirical observation, the recording of day-to-day experiences, and the practice of case history writing were at the heart of medical education from the mid-eighteenth century onwards.

The collections of case histories, however, were preserved in a different format: while in the case of Pest, student reports were edited into volumes posteriorly, in Edinburgh, each medical student kept his own books, in which they recorded (or in some cases, copied) their case histories in a different structure from what we have seen in the case of Pest. Though the standard categories of observation also prevail and govern the physicians’ gaze here, medical students in Edinburgh followed different editorial practices. They recorded their daily observations chronologically in the form of diary-like entries in volumes, which allowed them to follow the treatment of different patients simultaneously. Therefore, the case histories follow a rather fragmented structure, with cross-references and indices. This less clear-cut structure, however, allows the researcher to catch a glimpse into the cognitive practices written into the broken narratives. As for the representation of mental disorders in the casebooks, though the Royal Infirmary admitted mental patients in lesser numbers, I have found similar ratios as in the case of Pest. The notebooks of John Abercrombie (1780–1844), who later practiced medicine in Edinburgh, William Pulteney Alison (1790–1859) and Thomas Charles Hope (1766–1844), the two Presidents of the Royal College of Physicians in Edinburgh in the following decades, and David Lithgow (?–?), a practitioner in Dublin, reveal that even though neurological diseases, especially epilepsy, counted as fashionable diagnoses in Edinburgh at the turn of the eighteenth and nineteenth centuries,20 mentally ill patients were either not admitted or were not properly diagnosed in the teaching wards. Altogether, seven patients were admitted with hysteria, two with hypochondria, and one with mania.

As a counterpoint to the policlinics and their primarily somatic approach, the early mental asylums of the Habsburg Monarchy in the late eighteenth century began to use a partially psychological approach in diagnostics and healing by the first decades of the nineteenth century. As we will see, the asylums of the Monarchy occupied a middle ground between the policlinics and model asylums, such as the York Retreat, which played a pioneering role in introducing moral therapy. Furthermore, since the hospital network and the early asylums of the Habsburg Monarchy provided the most important model for the organization of Hungarian hospitals and also the first (private) psychiatric institutions later in the nineteenth century, their practices must be taken into consideration as an immediate context of the trends in Hungary.21 Though it would be ideal to compare the general wards of the Vienna General Hospital (Allgemeines Krankenhaus) to the teaching clinic of Pest, the number of available case histories written by medical students is rather low, and the number of mental patients among them is even lower. Short case histories and the summaries of therapeutic measures in the general hospital were published based on the courses of Anton de Haen (1704–1776) and Maximilian Stoll (1742–1787). These narratives, however, rarely deal with either mental or neurological diseases, and even if they do, the “case histories” often do not follow the standard categories of observation that would enable us to fully grasp the ways in which the maladies were interpreted.22

As for the two most significant mental asylums in the Monarchy, only printed case histories remained, which require a somewhat different approach than the manuscripts from the teaching clinics in Pest and Edinburgh. The first decades of the operation of the first purpose-built asylum on the continent, which was established by Joseph II (1780–1790) as part of the Viennese General Hospital in 1784, and the asylum, the establishment of which was initiated by Joseph II and opened under the reign of Leopold II (1790–1792) in 1790 in Prague, were summarized in two accounts published by Joseph Gottfried von Riedel, the secondary physician of the Prague asylum, in 1830 and by Michael von Viszánik, the Hungarian-born primary physician of the Viennese asylum, in 1845.23 The printed accounts reflecting on the spatial organization, operation, healing activities, and patient statistics of the asylums contain twelve and 13 long case histories each, following the diagnostic categories included in the seventeenth-century, eighteenth-century, and early nineteenth-century nosologies of Thomas Willis (1621–1675), the English physician who played a pioneering role in neurology, François Boissier de Sauvages (1706–1767), the professor of physiology and anatomy at the University of Montpellier, and Johann Christian August Heinroth, the first professor of psychiatry.24 By applying a diverse array of categories and subcategories to describe mental disorders, the narratives of Riedel and Viszánik reveal how early psychiatric diagnostics worked in practice and how the treatments of these ailments were approached. Though Viszánik’s account was published well into the nineteenth century, later than the other materials examined in this study, the structure and logic of his book mirror Riedel’s account, which must have been a source on which he drew. Furthermore, he had been a long-serving physician at the institution by then, with a keen eye to its development from the early years. Also, since the Narrenturm, tcontinental Europe’s first purpose-built psychiatric hospital, found in Vienna, played a central role in the developing network of asylums in the Monarchy and served as a model institution, its diagnostic and therapeutic practice are indicative of the regional approaches to “madness.”

A more specialized approach to mental normalization is revealed by the short case histories included in the patient register of the York Retreat kept from 1796. The Retreat was founded by the Quaker Tuke family, and it remained in their operation in the subsequent decades: the founder, William Tuke (1732–1822), was followed by his son, Henry Tuke (1755–1814), his grandson, Samuel Tuke (1784–1857), and his great-grandsons, James (1819–1822) and Daniel Tuke (1827–1895). According to the somewhat idealized accounts published by Samuel Tuke in 1813 and 1815, the institution and its practices exerted significant influence, and the Retreat served as a model institution for other asylums both in England and on the continent, especially on account of the theory and practices of moral therapy.25 As pinpointed by treatises on medical police and hospital administration, the English model and, especially, the York model had also had an impact in the Habsburg Monarchy.26 The Retreat, which devoted significant attention to religion, philanthropy, a humane approach to mental disorders, the incentive of meaningful occupation, natural environment, and conversations,27 played a vital role in introducing a psychological approach to the treatment of the insane. As for the admission, administration, diagnosing, and recording of the patients’ progress, the York Retreat with its integrated practices serves as a unique example. The rather laconic, usually one-page entries in the casebooks28 of the Retreat briefly summarize the dates of the patients’ admission, readmission, discharge, or death, and also their sex, occupation, the anamnesis, and the progress of their disease. As a sample, I have chosen 100 cases altogether from between 1796 and 1800 and 1815 and 182029 which reveal the almost complete lack of a somatic approach and the dominance of the psychological (moral) approach to diagnostics and therapy.

From Soma to Psyche: Interpreting Mental Disorders

If we seek to identify the differences between the somatic and psychological approaches to the diagnostics and the treatment of “mental” maladies recorded in the case histories, with some modifications, Michel Foucault’s thesis, introduced in his lectures on psychiatric power between 1973 and 1974, could serve as a good point of departure. In his lectures held on January 23, 1974 and January 30, 1974, Foucault called attention to the peculiarities of psychiatric diagnostics which distinguish it from other fields of medicine and medical knowledge in general. He argues that diagnostic practice in psychiatry is only seemingly based on the methodology of differential diagnostics, meaning that a diagnosis is made based on the anamnesis, the observed symptoms, and possible underlying reasons. Foucault argues that, in reality, “medical knowledge in psychiatry functions at the point of the decision between madness and non-madness.”30 Furthermore, he describes psychiatry as a field which does not focus on the body/soma, even though the development of psychiatry was dominated from the beginning by the pursuit of determining the underlying physiological causes of madness (neurological disorders, injuries). But even if psychiatric knowledge is constituted based on the medical observation of signs and symptoms, the question as to whether a patient is mad or not, whether they are simulating their symptoms or not, remain at the core of psychiatric diagnostics. And to determine this, doctors need procedures that could serve as substitutes for the techniques applied in general medicine in order to accept the individual as a patient and for the patient to accept them as doctors.31 This approach, however, disregards the fact that, from the 1820s to the 1860s, especially in the first decades, the very period Foucault discusses, we can only talk about “psychiatric power” and the success of such techniques if the people who were diagnosed with mental disorders were in fact admitted to institutions specializing in psychiatric problems, where madness was evaluated, described, and treated as, first and foremost, a psychological (mental, behavioral) problem. But what about those institutions where “mental” disorders were diagnosed without the intentions and especially the means of psychiatric normalization? How did general physicians approach the problem in the first half of the nineteenth century?

As mentally ill patients with different diagnoses, especially but not exclusively in the East Central European region, were more often than not taken into the care of policlinics, general hospitals, poor houses, and other non-specialized institutions, in short, outside the world of psychiatry, the problem of psychiatric diagnostics and the treatment of patients in need of specialized treatment brings up a set of issues and has further implications for (proto)psychiatric care and institutionalization in the region. To underpin this argument, I have chosen to focus on several factors (the naming of the disease, as well as its description and progress, the anamnesis, including the body of the “suffering family,” the point of view of the narratives, and the length of stays in hospitals) that help us determine whether the diagnostic and therapeutic practice of the different institutions pertained to a somatic and/or a psychological approach to mental disorders.

From among the five institutions examined in this study, it is, not surprisingly, the practice of the York Retreat that conformed more or less to the requirements described by Foucault, as far as one can tell on the basis of Samuel Tuke’s idealistic accounts and the casebooks. In almost all cases, the entries in the casebooks serving both as patient registers and clinical journals with short synoptic case histories contained a diagnosis. These diagnoses,32 instead of using common nosological categories and, if viewed from the Foucauldian perspective, somewhat “artificial” medical terminology, reveal a decision concerning whether the patient in question was mad or not. The patients received their diagnostic labels based on their temperament or behavioral and mental symptoms, such as derangement, deranged; insane, insanity; of the melancholiac kind; melancholic derangement, or mental anxiety.

The practice of the physicians in the early asylums of the Habsburg Monarchy, however, following the nosologies of Willis, Sauvages, and Heinroth, suggest that they relied more closely on differential diagnostics and less on the decision as to whether a given patient was mad or not. This observation on my part might of course be distorted, as both Riedel and Viszánik included model cases in their accounts, including accurate indications of which physicians’ nosologies they were following. The everyday, raw experiences of diagnostic practice are thus lost here. Among the case histories, they labelled patients with (by early nineteenth-century standards) modern categories, such as melancholic monomania (monomania melancholica) and more common and older categories, such as puerperal mania (mania puerperalis), acute mania (mania acuta), pure or simple melancholy (reine Melancholia, melancholia simplex), or mania (reine Tollheit, mania simplex).33 In case of the policlinics, where somatic medicine prevailed, almost all patients were diagnosed either with hysteria, hypochondria, or, in a few cases, delirium tremens (confusion or mania caused by the withdrawal of alcohol). The leading diagnosis, hysteria, an elusive disease which could have significant mental symptoms and was classified as a neurological or mental disorder, could also be interpreted, as underlined by the case histories, as a somatic disease with typical symptoms, such as clavus and globus hystericus, gastrointestinal, and menstrual problems.

Foucault’s other suggestion about the pre-history of patients and its correlations with diagnostic practice, however, could be relevant here with some modifications. According to Foucault, the decision between madness and non-madness (or, depending on the context and situation, the method of making differential diagnoses) required the technique of questioning or the search for signs in one’s family history to identify the moments when madness surfaced in some way or another. This, though rather fragmentarily, surfaces in the case histories, though probably requiring a slightly different interpretation than the original Foucauldian take on the problem.

Closely related to the above point, Foucault also suggests that questioning served as a substitute for the methodology of pathological anatomy in making a differential diagnosis. When it came to mental disorders, as the tools offered by pathological anatomy were not sufficient to decide between madness and non-madness, family history gained a special significance. Constituting the body of the “suffering family” by extending the scale of examination beyond the individual, a physician could discover signs and connections suggesting one’s predisposition to madness.34 Interrogating patients about their family history has been a common method in general medicine for centuries. In psychiatric diagnostics, however, as Foucault argues, it is of vital significance for the right choice between madness and non-madness. As suggested earlier, however, Foucault ignores the frequent use of labels in the 1820s and 1830s (and in Hungary, even later35), such as melancholy, mania, hypochondria, or hysteria, or simply madness, outside of specialized institutions. Even though questioning and the family history were fundamental parts of the case histories, connections between madness, the suffering family, and the patients’ status at the time are rarely revealed.36

At the university clinic of Pest, the medical history of the mentally ill patients’ parents was recorded in 17 cases.37 If we consider those patients only, whose diagnosis was, as revealed by the narratives, based on behavioral and mental symptoms, very laconic references are made to the early signs of madness described by Foucault. Sigismundus Fekete, a 26-year-old patient who suffered from erotomania, a peculiar delusional disorder, was admitted to the clinic on July 19, 1826. Johannes Slavik, a 23-year-old melancholic patient, was admitted two years later, on November 27, 1828. According to his case history, Sigismundus Fekete had healthy parents, and the only health-related event in his anamnesis was that he had received the smallpox vaccine as a child.38 Johannes Slavik, however, had a more detailed family history and anamnesis: according to the records, his father died of tuberculosis (phthisis), and ten years prior to his hospitalization he had already had a melancholic episode, and his current episode had begun ten days earlier.39 Here, the signs to which Foucault referred are clearly identifiable both in terms of the distant past and recent events. The hereditary nature of the disease surfaces in only one anamnesis: the mother of Anna Nagy, a 25-year-old hysteric patient, also suffered from hysteria (“ex mater hysterica”), however, as hysteria was approached as a primarily somatic disease in these case histories, the phenomenon described by Foucault applies to this case with restrictions.

References to the patients’ mental state in other significant, standard sections of the case histories, such as their health status upon admission (status praesens) and the progress of the disease (decursus morbi), are also relatively scarce. In early nineteenth-century medicine, which did not have modern diagnostic measures and tools, the patients’ own reflections on their conditions and symptoms were vital for making the correct diagnosis. In cases of mental disorders, getting to know the inner world of patients is all the more important, as the observable (behavioral) phenomena are insufficient to give a reliable account of their condition, its seriousness, and its curability. At this point, the patients’ or their relatives’ perspective40 often filtered into the narratives. In the case histories of the teaching clinics of Pest and Edinburgh, the patients’ complaints are often recorded in the third-person singular (accusat, complains). And even though these utterances are filtered and mediated by the physicians’ perspective and are organized into coherent narratives by them, in these instances, however rare they may be, the physician’s gaze orienting the narration and the “lived” experience of patients are juxtaposed.

In most cases, the physicians’ perspective prevails. When the hysteric or hypochondriac patients’ mental symptoms are reflected on briefly, we have characterizations like “choleric, nervous and anxious behavior and proneness to sadness” in the case of Elizabeth Szabó,41 who was admitted to the clinic on January 30, 1815, or “sadness with misanthropy” in the case of Ferenc Schober,42 admitted on December 19, 1823.43 Sometimes, however, the patients’ complaints are clearly discernible from the narratives, and though they mostly give accounts of their physical pain, they sometimes reflect on their mental state, such as Elizabeth Enzmann, a 40-year-old patient, who was admitted to the teaching clinic of Pest on November 25, 1817 with severe emesis and hysteria. Enzmann complained of anxiety (“accusat anxietates”) to the medical student examining her. As for the teaching wards of the Edinburgh Royal Infirmary, the patients complained of a wide array of symptoms, from toothaches to globus hystericus. However, their inner lives, feelings, and mental pain either remained concealed from their doctors or the doctors did not consider them important enough to record in the case histories. Whichever the case, this clearly indicates the absence of a psychological approach, and even though there are counterexamples to this tendency, by and large, the same conclusions hold for the teaching clinic of Pest.

The case histories recorded in the asylums, also in the third-person singular, allowed slightly more space for the patients’ own perspectives. In the casebooks of the York Retreat, in the synoptic summaries of the patients’ condition, complaints were rarely included, and even if they were, the entries mostly gave accounts of physical pain. Michael Viszánik and Josef Gottfried von Riedel, however, often devoted more space to the patients’ experiences of (mental) pain and recovery. These tendencies are most discernible from the anamneses and the progress sections. The anamneses not only detail the health-related events of the patients’ lives from childhood to adulthood but also reflect on the sociocultural settings from which they came. Their path to the asylums, organized into a narrative by the physicians, reveal much about the conditions, family background, and chances of (re)integration into society. Some of the experiences point towards the accidental nature of madness and its underlying reasons, such as changes in one’s personal environment. This is well illustrated by the case of an unnamed female patient admitted to the Prague asylum on January 28, 1828. Her melancholic sadness, boredom, and suicidal tendencies were induced by her husband’s alcoholism, even though she had led a happy, cheerful life before.44 On the other hand, through these narratives, we can catch a glimpse into how a patient’s attitude and mental condition changed over the course of treatment and how they gradually opened up to their caretakers. A female patient admitted to the Prague asylum in December 1829 with pure madness (reiner Wahnsinn, ecstasis simplex), completely unaware of her condition, responded well to the treatment, and on the seventh day of her stay, she shared the unknown details of her path to the asylum and began to accept her condition.45 And even if she is not heard, the narrative, the case history’s progress and therapy sessions illustrate that moral therapy and one of its most important components, conversation with patients, was known and practiced in the Prague asylum, in a setting still dominated mostly by somatic medicine.

Observation and therapy at the policlinics of Pest and Edinburgh were often influenced by the bookish knowledge which the students were expected to acquire during their theoretical courses, neither of which were specialized in the practical approaches to empirical psychology or psychiatry.46 Though mental symptoms, along with lifestyle and sociocultural dimensions, were part of the textbook definition of hysteria, in the clinical setting, these aspects were seemingly negligible and were not considered fundamental for identifying and diagnosing a certain disease. In case of both Pest and Edinburgh, there seem to have been two dominant sets of symptoms. One of these clusters included gastrointestinal symptoms, excessive stool and urine, pains, and severe cramps. Though it is not mentioned explicitly in any of the sources, this was probably understood in the context of the theory of vapors, which (it was thought), by rising from the stomach and bowels, were responsible for disturbing the mental faculties.

On the other hand, case histories point to the unyielding persistence of the gynecological interpretation of hysteria, with regular references to the disturbances of the menstrual cycle. From among the 18 hysteric patients in Pest, the date of the first period is recorded (between 11 and 17 years of age), and the changes or disorders of the cycle (excessive bleeding or the lack of periods for longer of shorter intervals) were directly linked to the appearance of hysteria and its progress. Other textbook symptoms included lockjaw or trismus, globus and clavus hystericus, and the so-called hysteric fits, the nature of which are rarely reflected on in the case histories, even though they were rather common. In Edinburgh, almost all case histories contained some reference to them.47

Therapeutic measures matched the dominant symptoms of the disease at the policlinics. As the therapy sessions in the case histories testify, the theoretical basis of healing was based on the Hippocratic and Galenic system of medicine, still dominant in the early nineteenth century, aiming to restore the balance of the four humors with bloodletting, clysters, and emetics (wild senna, ipecacuanha, asafetida). These measures were complemented with herbal remedies (valerian, chamomile, lemongrass, opium, or henbane) and chemically distilled oils (peppermint, cinnamon, and wild orange) serving as sedatives, which became widely popular in the eighteenth century with the spread of the neurological approach.

As for therapeutics, the early asylums of the Habsburg Monarchy were transitional between two poles on our scale, the two policlinics and the York Retreat, where references to the practice of moral therapy surface not only in Samuel Tuke’s accounts, but also in the case histories.48 In Viszánik’s and Riedel’s case histories, the more traditional, somatic approach is complemented by some components of moral therapy, typically those that were feasible in an urban setting. In the two asylums, in addition to the abovementioned therapeutics, cold baths were also in use as an early form of hydrotherapy.49 Since one of the cornerstones of moral therapy, the assignment of activities to the patients in a natural setting and useful occupation in, for example, gardens, was not necessarily possible in Prague or Vienna, the two physicians, especially Riedel, paid attention to conversations with patients and to the task of making the environment more bearable by, for example, furnishing and equipping the wards in a “friendlier” manner.50

As a final aspect, it is worth looking at the lengths of stays in hospitals. By the turn of the eighteenth and nineteenth centuries, most physicians realized that mental disorders could be rather persistent, and since healing (if possible) or at least subduing symptoms in general took much longer than the treatment of other (somatic) ailments, patients usually needed longer periods of hospitalization. The length of stay (LOS) is thus a good indicator of both the approaches to mental normalization and the possibilities hospitals had in offering treatments for patients inflicted with mental disorders. From the perspective of this last consideration, the average length of hospitalization underpins the tendencies observed in the respective sections of case histories, such as the anamnesis (illness-related events in one’s family or personal history), diagnosis (especially the naming of the disease), or the progress and therapy sections including the applied curatives and other measures (conversation, change in environment, etc.).

The teaching clinics of Pest and Edinburgh were on the low end of the scale: in the case of Pest, the length of hospitalization can be calculated in 19 of the 22 cases, with the average length of stay (ALOS) being 47 days (approximately 1.5 months). The shortest period of hospitalization was five days (Rosalia Hany, diagnosed with hysteria51), while it was the melancholic Johannes Slavik52 who spent the longest time in the clinic, 228 days altogether. This, at the same time, reflects on the differences between the interpretations of hysteria (primarily a somatic disease and curable as such) and melancholy (primarily a mental disorder, identifiable on the basis of mental and behavioral symptoms). Similar tendencies prevailed in Edinburgh, with the average length of stay being even lower (23 days). The shortest stay was the hysteric Elisabeth Erskine’s53 (six days), whereas the maniac John Williamson54 stayed for 50 days in the teaching ward of the Royal Infirmary.

As for the two asylums considered “transitional” institutions, the ALOS differed significantly: in Vienna it was only 62 days (ca. 2 months) and in Prague it was twice this, 134 days (ca. 4.5 months). The highest ALOS was, as expected, in the York Retreat. However, it must be noted that the dates in the casebooks are rather unreliable due to the frequent readmissions and follow-up care provided for the patients (when it was possible, the superintendents of the asylum paid attention to their patients even after they were discharged). It is therefore in most cases impossible to work with exact numbers, and that is why I have chosen to rely only on 42 cases in which the dates of admission and discharge were given precisely (a further twelve cases ended with death, among them one suicide). Basing my calculations on the selected cases from between 1796–1800 and 1815–1820, the ALOS was 632 days (ca. 21 months), with the lowest stay being 34 days and the highest being 2,790 days (ca. 93 months).

Table 1.

Lengths of stay and average lengths of stay in the hospitals

If we consider the length of stay a good indicator of the seriousness of a disease and the efficacy of mental normalization, these numbers clearly show that, from among the institutions under discussion, it was indeed the model asylum that could fulfil its function of conducting therapy, the two asylums of the Habsburg Monarchy integrated the newest approaches and older methods (purging, bloodletting etc.), while the two policlinics only took on the responsibility of subduing (somatic) symptoms and offering a temporary asylum for those showing the symptoms of disorders classified as “mental.” As for the teaching clinic of Pest in the focus of my inquiry, both the methods of identification and therapy indicate that the medical students who were completing their practical semesters and who did not take practical courses on psychiatry could only rely on knowledge they gathered from the rather scattered material in diverse courses (introductory courses on empirical psychology focusing on the basic outlines of the cognitive faculties, physiology, pathology, therapeutics, medical police, and forensic medicine). Thus, even though psychological knowledge gradually filtered into the curricula and textbooks of the Medical Faculty of the University of Pest, in the absence of a specialized institution, a psychological approach would have been impossible to implement in practice, and this necessitated the fundamentally somatic approach to the treatment of patients labeled as mentally ill (or diagnosed with maladies disguised as such). However, it must also be underlined that the period between the end of the eighteenth century and the 1830s marks a turning point in the history of psychiatry in Hungary, and even if we can only talk about a belated introduction of the psychological approach in medical practice, the mere fact that patients with these conditions were even accepted into the policlinic after the 1810s was a great step towards reconsidering the attitudes towards their treatment, which was addressed in both theoretical approaches and practice more intensely after the 1830s.

Archival Sources

Archiv der Universität Wien (UAW)

Sonstige Archive, Josephsakademie (k. k. medizinisch-chirurgische Militärakademie) und Garnisonsspital, Wissenschaftliche Elaborate, Krankengeschichten.

Borthwick Institute for Archives, University of York

York Retreat, Casebooks, 1–3.

RET 6/5/1/1/A (Volume 1, 1796–1828)

RET 6/5/1/1/B (Volume 2, 1803–1820)

RET 6/5/1/2 (Volume, 1828–1838)

Budapest Főváros Levéltára [Budapest City Archives] (BFL)

1103.a. St. John’s General Hospital, General Administration, vols. 4–15. Patient Records (1857–1873).

Országos Széchényi Könyvtár Kézirattár [Manuscripts Archive of National Széchényi Library] (OSZK Kt.)

Quart. Lat. 2165. Historia morborum, in clinico medico... Scientiarum Universitatis ab anno scholastico 1815/1816. usque ad annum 1838/1839. tractatorum, descriptae per candidatos medicinae, Pestini.

Quart. Lat. 2166. Relationes de aegris in instituto chirurgico-practico... Universitatis Scientiarum... tractatis Pestini ab anno scholastico 1816/1817. usque ad annum 1840/1841. descriptae per assistentes ac auditores.

Quart. Lat. 2168. Conspectus synopticus in clinico medico practico Regiae Scientiarum Universitatis Hungaricae ab anno 1814. usque ad annum 1824. pertractatorum, per assistentes et auditores conscriptus, Pestini.

Quart. Lat. 2169. Synopsis observationum practicarum circa aegros in instituto medico-practico Regiae Scientiarum Universitatis Hungaricae, sub auspiciis domini professoris Joannem Pozsonyi assistentes. Pestini, 1818–1821.

Quart. Lat. 2172. Brevis eorum expositio, quae et quomodo in clinico medico Regiae Scientiarum Universitatis Hungaricae manu ducente... professore Francisco Bene acta sunt... Descripta per Josephum Krieger (1818).

Royal College of Physicians of Edinburgh Archives (RCPE)

DEP/ABJ/1–2: Men’s Cases (1800–1801)

DEP/1/1/5–9: Women’s Cases (1801)

DEP/AWP/2/1–6: Cases taken from the Clinical Journals of the Royal Infirmary of Edinburgh (1809–1811)

DEP/AWP/2/7–8: Clinical case notes (1811)

DEP/HOT/1: Clinical Casebook (1796–1797)

DEP/LID/1: Clinical Case notes (1812)

Semmelweis Egyetem Levéltára [Semmelweis University Archives] (SEL)

1/g, Annual Reports of the Clinics of the Medical Faculty, 1825–1835, Boxes 1–3.

50/a, Historiae Morborum

Bibliography

Primary sources

Heinroth, Johann Christian August. Lehrbuch der Störungen des Seelenlebens oder der Seelenstörungen und ihrer Behandlung, 1–2. Leipzig: Bei E. H. F. Hartmann, 1818.

Raimann, Johann Nepomuk von. Handbuch der speciellen medicinischen Pathologie und Therapie für akademische Vorlesungen, zweyter Band, zweyte vermehrte und verbesserte Auflage. Wien: Bey Friedrich Volke, 1826.

Riedel, Joseph Gottfried. Prag’s Irrenanstalt und ihre Leistungen in den Jahren 1827, 1828 und 1829. Prag: Calve, 1830.

Sauvages, François Boissier de. Nosologia methodica sistens morborum classes, genera et species juxta Sydenhami mentam et Botanicorum ordinem. Amsterdam: Frère des Tournes, 1763.

Stoll, Maximilian. Heilungsmethode in dem praktischen Krankenhause zu Wien. Zweyter Theil, Erster Band. Breßlau: Bey Johann Friedrich Korn, dem ältern, 1784.

Stoll, Maximilian. Heilungsmethode in dem praktischen Krankenhause zu Wien. Dritter Theil, Erster Band. Breßlau: Bey Johann Friedrich Korn, dem ältern, 1786.

Stoll, Maximilian. Heilungsmethode in dem praktischen Krankenhause zu Wien. Fünfter Theil, Erster Band. Breßlau–Hirschberg: Bey Johann Friedrich Korn, dem ältern, 1793.

Tuke, Samuel. Description of the Retreat, an Institution Near York for Insane Persons of the Society of Friends. York: Printed for W. Alexander, 1813.

Tuke, Samuel. Practical Hints on the Construction and Economy of Pauper Lunatic Asylums. York: Printed for William Alexander, 1815.

Viszánik, Michael von. Leistungen und Statistik der k. k. Irrenheilanstalt in Wien seit ihrer Gründung 1784 bis 1844. Wien: Mörschner, 1845.

Willis, Thomas. Pathologiae cerebri et nervosi generis specimen, in quo agitur de morbis convulsivis et de scorbuto. Oxford: Hall, 1667.

Secondary literature

Aaslestad, Petter. The Patient as Text: The Role of the Narrator in Psychiatric Notes, 1890–1990. Oxford: Radcliffe 2009.

Andrews, Jonathan. “Case Notes, Case Histories, and the Patient’s Experience of Insanity at Gartnavel Royal Asylum, Glasgow, in the Nineteenth Century.” Social History of Medicine 11, no. 2 (1998): 255–81.

Andrews, Jonathan and Andrew Scull. Customers and Patrons of the Mad-Trade: The Management of Lunacy in Eighteenth-Century London, With the Complete Text of John Monro’s 1766 Case Book. Berkeley, CA–Los Angeles, CA–London: University of California Press, 2002.

Bacopoulos-Viau, Alexandra and Aude Fauvel. “The Patient’s Turn. Roy Porter and Psychiatry’s Tales, Thirty Years On.” Medical History 60, no. 1 (2016): 1–18. doi: 10.1017/mdh.2015.65.

Bal, Mieke. Travelling Concepts in the Humanities: A Rough Guide, 22–55. Toronto–Buffalo–London: University of Toronto Press, 2002.

Becker, Peter and William Clark, eds. Little Tools of Knowledge: Historical Essays on Academic and Bureaucratic Practices. Ann Arbor, MI: The University of Michigan Press, 2001.

Berkenkotter, Carol. Patient Tales. Case Histories and the Uses of Narrative in Psychiatry. Columbia, SC: The University of California Press, 2008.

Blair, Ann. “Reading Strategies for Coping with Information Overload, ca. 1550–1700.” Journal of the History of Ideas 64, no. 1 (2003): 11–28. doi: 10.2307/3654293.

Chase, Ronald. The Making of Modern Psychiatry. Berlin: Logos Verlag, 2018.

Condrau, Flurin. “The Patient’s View Meets the Clinical Gaze.” Social History of Medicine 20, no. 3. (2007): 525–40. doi: 10.1093/shm/hkm076.

Craig, Stephen C. “Enquire into All the Circumstances of the Patient Narrowly”: John Rutherford’s Clinical Lectures in Edinburgh, 1749–1753.” Journal of the History of Medicine and Allied Sciences 72, no. 3 (2017): 302–27.

Daston, Lorraine. “Taking Note(s).” Isis 95, no. 3. (2004): 443–48.

Daston, Lorraine. “The Empire of Observation.” In Histories of Scientific Observation, edited by Lorraine Daston and Elizabeth Lunbeck, 82–113. Chicago, IL: The University of Chicago Press, 2011. doi: 10.7208/9780226136790-005.

Digby, Anne. Madness, Morality and Medicine: A Study of the York Retreat, 1796–1914. New York, NY: Cambridge University Press, 1985.

Michel Foucault. “23 January 1974” In Psychiatric Power: Lectures at the Collège de France, 1973–1974, edited by Jacques Lagrange, translated by Graham Burchell, 233–54. Basingstoke: Palgrave Macmillan, 2006.

Michel Foucault. “30 January 1974.” In Psychiatric Power: Lectures at the Collège de France, 1973–1974, edited by Jacques Lagrange, translated by Graham Burchell, 265–95. Basingstoke: Palgrave Macmillan, 2006.

Geyer-Kordesch, Johanna. “Comparative Difficulties: Scottish Medical Education in the European Context (c. 1690–1830).” In The History of Medical Education in Britain, edited by Vivian Nutton, and Roy Porter, 94–115. Amsterdam–Atlanta, GA: Rodopi, 1995.

Goody, Jack. The Logic of Writing and the Organisation of Society. Cambridge: Cambridge University Press, 1986.

Hess, Volker. “Formalisierte Beobachtung. Die Genese der modernen Krankenakte am Beispiel der Berliner und Pariser Medizin (1725–1830).” Medizinhistorisches Journal 45 (2010): 293–340.

Hess, Volker and Sophie Ledebur. “Taking and Keeping: A Note on the Emergence and Function of Hospital Patient Records.” Journal of the Society of Archivists 32, no. 1 (2011): 21–33. doi: 10.1080/00379816.2011.563102.

Hess, Volker and Andrew J. Mendelsohn. “Case and Series: Medical Knowledge and Paper Technology, 1600–1900.” History of Science, 48, no. 3–4 (2010): 287–314. doi: 10.1177/007327531004800302.

Hunter, Kathryn Montgomery. Doctor’s Stories: The Narrative Structure of Medical Knowledge. Princeton, NJ: Princeton University Press, 1991.

Hurwitz, Brian. “Form and Representation in Clinical Case Reports.” Literature and Medicine 25, no. 2 (2006): 216–40. doi: 10.1353/lm.2007.0006.

Ingram, Allan. The Madhouse of Language: Writing and Reading Madness in the Eighteenth Century. London: Routledge, 1991.

Kennedy, Margaret Ann. “A Curious Literature: Reading the Medical Case History from the Royal Society to Freud.” PhD Diss., Brown University, 2000.

Kovács, Janka. “Elmebetegügy a 18–19. század fordulóján: elméleti keretek, koncepciók, megoldási javaslatok.” [Mental health policy at the turn of the eighteenth and nineteenth centuries: Theoretical framework, concepts, proposals]. Korall 71 (2018): 7–26.

Kovács, Janka. “Az orvostudomány ‘legsetétebb mezeje’: Pszichológiai ismeretek a Habsburg Birodalom orvosi fakultásainak tananyagában a 18–19. század fordulóján.” [The “darkest field” of medicine: Psychological knowledge in the curricula of the medical faculties of the Habsburg Monarchy at the turn of the 18th and 19th centuries]. Gerundium Egyetemtörténeti Közlemények 11, no. 3–4 (2020): 78–103.

Krász, Lilla. “From Home Treatment to Hospitalisation: General Trends in the Development of Hungary’s Hospital Network.” In Europäisches Spitalwesen. Institutionelle Fürsorge in Mittelalter und Früher Neuzeit / Hospitals and Institutional Care in Medieval and Early Modern Europe, edited by Martin Scheutz, Andrea Sommerlechner, Herwig Weigl and Alfred Stefan Weiss, 455–73. Vienna–Munich: Böhlau, 2008.

Krász, Lilla. “Az adatoktól az információig, az információtól a tudástermelésig: Az egészségügyijelentés-írás gyakorlata(i) a XVIII. századi Magyarországon.” [From data to information, from information to knowledge production: The practice(s) of writing medical reports in 18th-century Hungary]. Századvég 70 (2013): 155–87.

Krász, Lilla. “Theoria medica és praxis medica: A tudásközvetítés változó útjai a medicinában a 18. század második felében” [Theoria medica and praxis medica: The changing methods of knowledge transfer in medicine in the second half of the 18th century]. Századok 151, no. 5 (2017): 1025–42.

Krász, Lilla. “Táblázatokba zárt tudás? Az orvosi tudásszervezés gyakorlatai a 18. századi Magyarországon” [Knowledge arranged into tables? Practices of knowledge organization in 18th-century Hungary]. Kaleidoscope 13 (2018): 223–50.

Krász, Lilla. “’Observing to describe, describing to observe’: The Epistemic Turn of Medical Writing in the 18th Century.” Hungarian Studies 33 (2019): 175–84.

Mendelsohn, Andrew J. “Empiricism in the Library.” In Science in the Archives: Pasts, Presents, Futures, edited by Lorraine Daston, 85–109. Chicago, IL: Chicago University Press, 2017.

Pomata, Gianna. “Sharing Cases: The Observationes in Early Modern Medicine.” Early Science and Medicine 15, no. 3 (2010): 193–236.

Porter, Roy. “The Patient’s View. Doing Medical History from Below.” Theory and Society 14, no. 2 (1985): 175–98.

Rédei Ildikó. Historiae morborum: Kórtörténetek a 18–19. századból [Historiae morborum: Case histories from the 18th and 19th centuries]. Budapest, Semmelweis Kiadó, 2016.

Geoffrey Reaume. “From the Perspectives of Mad People.” In The Routledge History of Mental Health, edited by Greg Eghigian, 277–96. London: Routledge, 2017.

Risse, Guenter B. Hospital Life in Enlightenment Scotland: Care and Teaching at the Royal Infirmary of Edinburgh. Cambridge: Cambridge University Press, 1986.

Risse, Guenter B. “Clinical Instruction in Hospitals: The Boerhaavian Tradition in Leyden, Edinburgh, Vienna and Pavia.” Clio Medica 21, no. 1–4 (1987): 1–19.

Scheutz, Martin and Alfred Stefan Weiss. “Spitäler im bayerischen und österreichischen Raum in der Frühen Neuzeit (bis 1800).” In Scheutz et al. eds. Europäisches Spitalwesen, 185–229.

Watzka, Carlos. Vom Hospital zum Krankenhaus: zum Umgang mit psychisch und somatisch Kranken im frühneuzeitlichen Europa. Cologne–Vienna: Böhlau, 2005.

Watzka, Carlos. Arme, Kranke, Verrückte: Hospitäler und Krankenhäuser in der Steiermark vom 16. bis zum 18. Jahrhundert und ihre Bedeutung für den Umgang mit psychisch Kranken. Graz: Steiermärkisches Landesarchiv, 2007.

Appendix

Table 2.

Cases of the York Retreat

Table 3.

Cases of the Prague Asylum

Table 4.

Cases of the Vienna Asylum

Table 5.

Cases of the Edinburgh Royal Infirmary

Table 6.

Cases of the teaching clinic of the University of Pest

Hypochondria as a Poetic Disease: Medicine and Ethics in the Case of an Early Nineteenth-Century Hungarian Poet

Gábor Vaderna
Eötvös Loránd University / Research Centre for the Humanities
This email address is being protected from spambots. You need JavaScript enabled to view it.

Hungarian Historical Review Volume 10 Issue 2  (2021): 189-210 DOI 10.38145/2021.2.189

Medical knowledge reached a wider range of social strata in the eighteenth and early nineteenth centuries. Popular medical books described diseases and how to cure them, and the press regularly addressed the topic of having a healthy body. Meanwhile, representations of the perfect body became an increasingly important problem for neoclassical art. This case study investigates how Dániel Berzsenyi (1776–1836), one of the important Hungarian poets of the early nineteenth century, thought about the human body. For him, the representation of the body was, on the one hand, an artistic problem which raised questions concerning manners of imitation and, on the other hand, an artistic problem which was associated with the display of human virtues and thus with ethical discourse. Berzsenyi gave an account of his illnesses, which can be traced back to hypochondria, in a private letter. His self-analysis has three layers. First, his private letter could be read as part of a sensible epistolary novel. I argue that Berzsenyi introduced himself as a sensible hero, who was ill because of his own uncontrollable emotions. Second, hypochondria has a medical context. Considering the continued influence, in Berzsenyi’s time, of the ancient doctrine of bodily fluids, I demonstrate that this disease may have become a mental illness associated with poets. The reason for this is that the emotions entertained by the sensible man led to the emergence of physical symptoms which were associated with the hardly definable concept of hypochondria. Third, one’s relationship to one’s body could be a moral issue. Berzsenyi attempted to assert his own moral superiority by describing his own illness. Thus, his letter also fit into a moral context of the contemporary theoretical debates in which he was involved. My paper shows how aesthetics, ethics, and medicine were interconnected and how different forms of knowledge circulated between the forums of the arts and other social forums.

Keywords: hypochondria, sensibility, poetry, medicine

Morieris, non quia aegrotas, sed quia vivis
Seneca (Ep. 78,6)

Self-Fashioning and Psychology

“What a task it is to build a bridge between contemporary psychology and the perception of the historical world!” Wilhelm Dilthey wrote enthusiastically in 1894, though he then cautioned that this goal could only be reached step by step. We can capture the individual together with history by looking for the inner meaning that connects them.1 This approach has had a significant influence on modern literary history and theory and also on the ways in which we converse about literature in everyday life. History determines the subject, while the subject’s intellectual achievement influences history. However, what is the relationship between the historical subject’s psyche and the psyche of the person who is now thinking about him? I. A. Richards gave his Cambridge students poems to analyze without telling them anything about the origins or authors of the text. In his 1929 Practical Criticism, he claimed that thanks to the persistent work of his students who first encountered serious difficulties in text comprehension, he became able to conduct a close analysis of the poems. Richards thus distanced himself from the abuse of psychology, and he proposed that the literary text should only influence the reader’s psyche, and we should ignore the psychology of historical subjects.2 Still, can we exclude all factors that lie outside the literary text so easily? Although twentieth-century literary theory, which primarily focused on the linguistic achievements of literary works, tried to relegate the psychological contexts to the background (or at least to tame psychology), talk of history meant that elements of psychology were sneaked back into the discussion, nonetheless.

The problem thus has a dual nature. On the one hand, historical agents thought something about themselves, and they also expressed their opinions about their own essence. This is the problem of self-fashioning, research on which was initiated by New Historicism.3 According to New Historicism, historical subjects construct their identities within the constraints of their opportunities, and they fashion the social image through which others perceive them. On the other hand, pre-modern subjects are very difficult to interpret without considering modern psychological constructs. When historical agents write about themselves, it can easily tempt us to force familiar psychological clichés onto our “victims.”4

In the following, I will present a case that can be understood through the concept of modernity, but which precedes Freudian psychology and its institutionalization.

It is the year 1820, and we will peek into the private correspondence between two Central European poets. One of them was sick, and he was attempting to decipher his illness. We will see how medicine, aesthetics, and ethics were intertwined in his writings.

Sensible Self

In the discussion which follows, I introduce several nineteenth-century Hungarian poets. Hungarian literary history at the beginning of the twentieth century (Geistesgeschichte in particular) paid considerable attention to our protagonist, Dániel Berzsenyi (1776–1836), who researched the relationship between psychology and history. Berzsenyi was an ideal candidate to make this connection. We know very little about his life, and what he claimed about himself is occasionally based on verifiably false facts. He came out of nowhere, no one knew who he was or where he came from, and no one knew how or from whom he had learned to write poems. The best-known poet of the era and the other character in our story, Ferenc Kazinczy (1759–1831), published Berzsenyi’s poems, though they never met in person. Berzsenyi’s volume of poetry was published in 1813, followed by the expanded version in 1816. The poems instantly became an important part of Hungarian poetry (and continue to be so to this day). But no sooner had Berzsenyi arrived on the literary scene in Hungary than he suddenly disappeared from the prying eyes of the public. In 1817, Berzsenyi received a negative review from a young man named Ferenc Kölcsey (1790–1838) which upset him, and so he barely spoke to anyone afterwards. Kölcsey was also a poet (he later wrote the poem that became the current national anthem of Hungary). When Berzsenyi died in 1836, Kölcsey apologized to him in his eulogy.

The lack of sources concerning the details of Berzsenyi’s life became the point of departure for psychological explanations of his poetry. At the beginning of the twentieth century, Dániel Berzsenyi was popular as an author among the supporters of a thriving Geistesgeschichte (as well as among those who, although they distinguished themselves from the adherents of Geistesgeschichte, were still engaged in something very similar). I will mention only a few examples. Gábor Halász attributed the breakdown to the clash between the poet’s true nature and his principles,5 while Ferenc Fejtő attributed it to the lack of self-confidence.6 László Németh analyzed the connections between brilliance and an allegedly melancholic character.7 Mária Rónay, in her article A rejtélyes Berzsenyi Dániel – a pszichopatológia tükrében (The mysterious Dániel Berzsenyi – In the light of psychopathology), described his poetic career as the work of a man who was a sickly father who suffered from anxiety and was also stingy and, in his advanced age, anti-Semitic.8 Henriette Szirmay-Pulszky, in her monograph entitled Genie und Irsinn im Ungarischen Geistleben, classified Berzsenyi as schizoid, and concluded, on the basis of his alleged physical and spiritual characteristics, that he was a psychopath prone to melancholy and was deeply depressed.9 The list goes on and on. One almost gets the impression that Berzsenyi was looking for trouble, as if, even if unwittingly, his life goal had been to gnaw at his own soul and provide work for psychoanalysts, as if the physician and historian Sándor Puder’s following statement made in 1933 were true: “Real literature is analytical, and it was already so at the time when psychoanalysis was nowhere to be found. Even as early as at that time, [Berzsenyi] unconsciously used the method of psychoanalysis in his analytical, psychologizing literature.”10

I disagree with this. If we stick to Dilthey’s original idea, i.e., if we seek not only to define, build out of fragments, or develop the inner ingredients of subjects from an inner meaning (psychology) but also to define the comprehensive framework and meaning (Geistesgeschichte) into which the individuality fits, it does not suffice to provide a psychological portrayal of Berzsenyi. And, although the inner psychological meaning of a personality cannot be uncovered in enough depth in my opinion, no matter how hesitant we are to take the slippery route of psychologization, I will attempt to reconstruct Berzsenyi’s disease, or more specifically, one of his mental illnesses.

Berzsenyi ceased all communication with Ferenc Kazinczy in 1817, following Ferenc Kölcsey’s critical review. He simply did not write to him anymore. Kölcsey was Kazinczy’s student, and when Berzsenyi asked about him, Kazinczy defended him. Thus, the issue at hand was one of human relationships, as is documented in the correspondence until the friends stopped communicating with each other. Three years later, in the winter of 1820, an old friend of theirs notified Kazinczy that Berzsenyi was in Sopron: “We only rarely see each other. He, as he says, became sick two years ago and was mistreated; the consequence of which became one of the greatest building blocks of his hypochondria, which not even the Buda spa could improve, but only the Füred one, or rather, sour water. Now, he says he is in passable condition, but he dare not read: he spends his time in the theater and the café, and we also visit each other sometimes.”11 Possibly after having communicated with this common friend, Berzsenyi grabbed his pen and wrote one of the letters which is cited the most often in the secondary literature on Berzsenyi.

Overall, we do not know much about what Berzsenyi was doing in Sopron. We also do not know too many details about his illnesses beyond what he (and their common friend) claims, namely that he was plagued by hypochondria and that he visited the baths in Buda and Balatonfüred. The contents of the letter are startling and unexpected, and it also rhetorically expresses the state he said he was in. The letter reads as follows:

Dear Sir,

You did not visit your dying friend; and behold, his shadow shall come upon you. His shadow, I say, because the soul you once bothered with so much is no more. Yes, Dear Sir, even though I am beginning to live again, my soul has long since died, and it has been replaced by a new unknown soul, dark and cold as night, and still as the grave. The horrific disturbance that has turned my whole nature upside down could have had no other result than this half-death. And since this half-death can easily become complete, and since my headache still often tolls the bell of death in my ears, I did not want to die as your imagined enemy but wanted to let you know that whatever crime I committed against you, I did it amidst the deepest hypochondria. For the same reason, pity me or laugh at me as you please, but do not hate me, rather attribute everything to my cruel illness, which has often made me half-crazy and half-mad. The causes of my illness were a quinine-treated inflammation of my gallbladder and a dangerous fall in which my shoulder was dislocated, and my shoulder blade was fractured, and my head also suffered a large bruise, all of which caused me to be confined to bed for six months. The rude criticism [by Kölcsey] perhaps also belongs here, which provoked me into thinking in a state when I was most incapable of doing so. You can imagine what a tremendous job it was for me to aestheticize with a confused head, an angry heart, and without any books, even though I have never read aesthetics or poetry other than Rájnis’s Kalauz (Guide to poetry). Now I’m reading and smilingly reviewing my feeble attempts of the time. You should smile at this, too! This is how I have always been: I did not think I needed to study, and therefore I did not study.12

A friend of yours from Pest once told me that you would not even be capable of writing a scholarly work like Kölcsey’s critique. Now I think you could not write such a rude one. But whether you wrote it or not, it does not matter to me now. You could have had dark hours like I have, and you were free to treat me like all my friends throughout my life; you did nothing new to me. This is how I now feel about Kölcsey, whose abuse I would tolerate just as much as I have tolerated that of Mondolat, had I not written that hypochondriac countercriticism;13 but since I did write it, I must also write another, for it would be quite a ridiculous conclusion to my literary life. This is also how I feel about Thaisz, Szemere, and Vitkovics, who mocked me to my face in my miserable state,14 and who found it appropriate to trample on my ashes even in the Tudományos Gyűjtemény (Scientific collection); this is how I feel, I say, because I know very well that those who torture the pitiful with such insults will be helped by neither rhubarb, nor the sour water of Füred, nor my text.

And so, Dear Sir, I live and write again, and behold my very first letter is Yours. Accept my cold hand once again with the calm soul with which I offer it to you. I am well aware that there could be no reason, no desire, for you to fraternize with a deteriorated hypochondriac; but it is not friendship I am coming for, since, believe me, my resignation is also complete both towards you and towards the whole world, and my heart desires, knows no good but the serenity of this resignation; I just wanted to let you know that my state has improved so that you think better of me and do not consider me your enemy, and do not hate me. Be fortunate, be happier than I am, and do not experience the misery I have endured.15

We are between life and death, in a paradoxical half-death: still in this world but already beyond the death of the soul. This is a surprising transmutatio: the immortal soul is already dead, but the mortal body is still alive. And the dead soul is replaced by another, possibly death itself, with its metaphors crowding around it: shadow, darkness, cold, night, the grave, the cold hand. Very much like the protagonists of sensible epistolary novels, Berzsenyi eliminates the difference between life and death, between body and soul. On the one hand, life has become just as problematic as death through his illness; on the other, by this era, the physical and spiritual symptoms of an illness appeared as each other’s complements. It is no coincidence that the poet first lists his physical symptoms and returns to his spiritual problems in the following sentence. Much as the body does not exist without the soul, health does not exist without illness. István Mátyus, the author of a popular medical handbook of the era, a six-volume edition on dietetics, writes “people in perfect health are quite rare in this world, and if someone does manage to step up to this state for an hour or two, he cannot stay there for long, due to the miraculous structure of nature. Instead, good health starts to deteriorate, so that we have to extend health to certain limits.” From the eighteenth century on, the natural state was not the healthy one, i.e., health was not a clearly defined, enclosed whole, “there are smaller and larger illnesses, but there is also lesser and greater health.”16

Part-whole relations also disrupt narration, and metonymic story-building is disrupted in the letter, with metaphorical relations foregrounded instead. This is again a popular method of the epistolary novels of the era: frustrated and fragmented narration. The metaphorical construction of the text (text built on some image and the associations surrounding it) is also present here (through the metaphors of death); however, the train of thought is not coherent, and consecutive paragraphs are only loosely connected to each other (although there is no switch between the topics). The frequency of salutation and the deixes pointing to the addressee are of course not surprising at all, sensibility also viewed openly owning up to one’s feelings and displaying uncontrolled virtuous impulses coming from deep down as an anthropological feature, which also meant the fragmentation of the text.

At times we almost reach incomprehensibility. For example, in the break in thought between the second and third paragraphs: while in the first he dismisses his friendship with Kazinczy, among others, he begins the second by addressing Kazinczy as a friend. Immediately after the impossibility of recovery, only signaling the break in his thought by a line break, he writes about his resurrection: the notion of death alternates with the possibility of a fresh start throughout the letter. Complete death does not take place because it would also mean the end of the self-narrative, and the writer and narrator (uniquely, these two are one and the same here) do not wish that. He does not wish for his story to end with a sick hypochondriac text in front of the public, and so he first needs to write the missing ending to the novel of his life. The act of writing is thus only an excuse for self-fashioning; in other words, a kind of fictitious, imaginary life and a lived life, assumed to be real, are all mixed up here. Evoking the other also directs attention to the self in the letter. Friendship becomes the territory of absence, and the letter may make up not only for the lack of personal encounters but also for the avoidance thereof. Namely, imitating an in-person meeting quickly turns into an analysis of resignation. Resignation thus deletes notions of friendship and animosity and enters the same intermediate borderland located between body and soul, life, and death.

So far, I have listed the characteristics of the Berzsenyi letter that connect it to the popular epistolary novels of the era in terms of narrative technique. However, at the beginning of the paper, I set out to talk about Berzsenyi’s disease and mental illness, so let us thus leave the territory of aesthetics and enter dietetics.

Hypochondria

The second half of the eighteenth century was the heyday of medical anthropology, and around this time, philosophical anthropologies were also written by physicians for physicians in large quantities, thus man becomes a patient in a representative manner through anthropological nosologies and the birth of clinics. This is best illustrated by the large number of medical handbooks written for laymen in the second half of the eighteenth century, including in Hungarian.17

If we ask what hypochondria could have meant, at least roughly, in the first decades of the nineteenth century, we will not receive a clear answer. Burgeoning medicine offers so many different solutions; it describes the different symptoms in great detail (often through interesting stories), processes so many different medical ideas and provides so many seemingly sure-fire formulas that we can easily encounter problems upon evaluating a disease.

István Benedek, in his short essay on Berzsenyi’s melancholy, wrote about the difficulties of interpreting hypochondria in 1982. “Just as it will not be easy to orient oneself in the substance and interpretations of today’s schizophrenia in the next century, erstwhile hypochondria is also a large umbrella. It is related to what today lies behind psychopathy, neurasthenia, psychasthenia, neurosis, and many other, less popular expressions, it is related to apathy, melancholy, amentia, and the expression ‘dementia’, used in French-speaking areas. Instead of the many foreign expressions, it is easier to approach it through a simple-minded definition: a melancholic affliction that sinks you into inertia. It is not insanity, not a reaction to external circumstances, but an enigmatic constitutional characteristic, God’s curse.”18 Although these various types of madness may not be as blurred in early modern times as Benedek claims,19 hypochondria is quite a “large umbrella,” and accordingly, a popular topic of contemporary medical literature. A German historian of medicine, for example, counted that in the Jena Journal der praktischen Arzneykunde und Wundarzneykunst edited by Christoph Wilhelm Hufeland, one of the best-known medical professors of the time, ten percent of the literature on nosology is on hypochondria.20 This is a high ratio, and although it is equally interesting, and I do not have precise data on the Hungarian material, the four Latin-language dissertations published in Hungary that discuss hypochondria exclusively, and the chapters of the popular medical handbooks that discuss hypochondria show that the Hungarian medical-anthropological discourse was also keenly interested in the issue.

In the case of hypochondria, even the classification of the disease in terms of nosology is difficult to determine. This is because we cannot disregard the fact that initially, based on the typological classification of ancient humoral pathology, melancholy, which had enjoyed a long career in the history of European medicine and culture, also included hypochondria. Namely, Galen sees the origins of melancholy as lying in a disorder of the hypochondrium, the upper part of the abdomen, and this connection seemed logical until the beginning of the eighteenth century.21 For example, Ferenc Pápai Páriz still wrote about “Hypochondriaca Melancholia” in his popular medical handbook Pax Corporis in 1690.22 Since “in the age of Reason,” a shift of emphasis within the concept of hypochondria can be detected, i.e. “a dynamics of the corporeal space gives way to a moral theory of sensitivity,”23 we can observe how hypochondria and its related feminine disease, hysteria, replaced the pair of melancholy and mania, and how these structures operated and divided in parallel with each other. However, according to Michel Foucault, “physicians of the classical period did try to discover the qualities peculiar to hysteria and hypochondria, but they never reached the point of perceiving the particular coherence, that qualitative cohesion which gave mania and melancholy their unique identity.”24 Hypochondria cannot be defined or located, and it is difficult to specify. For example, in Immanuel Kant’s 1764 treatise Versuch über die Krankheiten des Kopfes we find the following: “The hypochondriac has a disease which, in whatever place it is chiefly located, is nevertheless likely to wander intermittently through the nervous system to all parts of the body.”25 Its seat cannot be located, and it is in constant motion and, thus, difficult to catch.

Let us instead allow Foucault to classify and meticulously analyze “figures of hypochondria”26 and examine the function this disease plays in the patient’s life. Through his disease, the hypochondriac enters the territory between body and soul, life and death, a place that cannot be detected. First, this disease makes life similar to death, which is no surprise after having read Berzsenyi’s letter. This problem is so central that the Hungarian István Mátyus, for example, illustrates the difficulties of defining life with the frequent phenomenon that happens to hypochondriac men and the hysterical women related to them: “What life is, is not as easy to determine as it seems at first glance. Namely, many died a long time ago who were thought to be alive by society; at the same time, many lived who were thought to be dead for sure. Examples of these are the many hysterical women and hypochondriac men who, having fainted […], hardly seemed to be alive, what is more, oftentimes seemingly having died completely, they were placed under the dissecting knife or in the coffin; but after some time, they came back to life on their own or with the help of some external tool, much to everyone’s surprise.”27 The comatose and the hypochondriac are closely related to each other. On the other hand, the close connection between the body and soul also surfaces in hypochondria, and in this period, probably no disease of the mind existed that would be independent of particular physical processes. The hypochondrion (in Latin: hypochondrium), as mentioned above, is the upper part of the abdomen, the right and left part of the abdominal cavity enclosed by the arches of the diaphragm. This was the part of the body where diseases of the mind had been located since Galen. It is still a widespread view in popular medicine to this day that different gastric problems, primarily stomach ulcers or irritable bowel syndrome, are consequences at least in part of an overwrought, stressful life. In his popular handbooks on dietetics, Mátyus looks for the causes of various diseases in the incorrect flow of different humors. Yet, if hypochondria is a disease that also affects spiritual life, the humors also reach the mind; in other words, the direct causes of the illness are the “frequent strong spasms in everyone’s weakened internal parts, driven by the thickened, rancid humors that have collected and settled in them, which wander around the whole body and cause a sudden multitude of changes both in the body and the mind. Its more distant causes, on the other hand, are all that weaken the stomach, thicken and sour the blood, and do not allow it to flow freely inside the internal parts.”28 The internal space of the body is freely permeable, obstacles and obstructions are created at different points, different humors slow down and decrease the speed of life functions and disturb the quality of life,29 for the sensible person pax corporis is already an unattainable ideal. Christoph Wilhelm Hufeland recounts one of the teachings of Dutch professor Herman Boerhaave from Leiden, who lived approximately one hundred years before him and remained a dominant figure in European medicine in the eighteenth century: “Boerhaave says that the blood that flows onto the brain makes people see bloody ghosts and rainbows.”30 This means that physical and mental illnesses are closely related, and we cannot separate medicine from psychology. As Christian Friedrich Richter put it very eloquently at the beginning of the eighteenth century, “The matter or the body is attracted by the soul through the union to such an extent, mixes with it so much, so to speak, as if the soul became material-like or corporeal, and as if the body became spiritual.”31

Material and spiritual things, these two good friends, alternated between tightening and loosening their friendship, and they also drifted apart from each other after a while. This is how hypochondria slowly turned from an illness of sensibility into an illness of the imagination. This change can also be detected in Hungarian popular medicine. For example, in Sámuel Köteles’s Philosophiai anthropologia (Philosophical anthropology), published posthumously in 1839 (and written some time during the 1820s), these two diseases still appear after each other, but they are already separate diseases. As he writes about hypochondria, “This disease is a fear, restlessness, and despondency resulting from some impending indeterminate harm. The hypochondriac indeed experiences some illnesses which originate from the irregularity of bodily functions, especially in the bowels. These illnesses are not such that some serious illness or even death would result from them, but the lively imagination of the hypochondriac nurtures them. Thus, hypochondria becomes the source of many diseases.32 This is how an imaginary invalid becomes a hypochondriac (Molière’s Argan is not yet a hypochondriac but merely a malade imaginaire), and by the second half of the nineteenth century, imaginary illness also became an illness of its own. The expansion of nosological literature first resulted in the appreciation of hypochondria, while soon afterwards, being unable to earn its own place within the framework of this system, it was devalued into a meta-disorder. This place for hypochondria was created by the overgrowth of the system to which it owed its existence. It is no coincidence that hypochondria, i.e., the disease that was looking for its place in the human body, appeared as some kind of civilizational, particularly urban disease.33 While Hufeland could still make fun of one of Boerhaave’s students without mentioning hypochondria, because he literally loved the Dutch professor’s teachings and was thus “an animated lesson,”34 the Viennese physician, Baron Ernst Feuchtersleben already calls hypochondriacs “the volunteers of medicine,” “who have dug themselves into the entire pathology, who write themselves prescriptions from books.”35 It was somewhere around this time when the context of Dániel Berzsenyi’s illness, to be interpreted in the discourse of sensibility, became blurred, and this is where the psychological descriptions of modernity floundered.

Constipation

Or maybe that context did not disappear completely. A common characteristic of disease and related mental illnesses, which continued for a long time, is that mental instability (the illness of the head or the heart, depending on the person) and abdominal (constipation-related) illnesses are linked. In 1830, József Horvát, a doctor of medicine and arts, translated Franz Richter’s book into Hungarian and rewrote the parts on hemorrhoids and related illnesses, including hypochondria. He discusses the abdominal consequences of madness in the chapter Az aranyérnek gerjesztő vagy távolabb okairól (On the inflicting or other causes of hemorrhoids). He thinks it is obvious that no explanations are needed: “Everyone knows the influences mental illnesses have on health in general and on the functioning of the organs of the lower body in particular so well that we should not say anything it.” According to Horvát-Richter, “people prone to anger and irritation already suffer from illnesses of the lower body anyway, or at least they are on the verge of thereof, and so they are also more or less likely to have hemorrhoids,” while the more hidden mental illnesses, the so-called “discouraging affections,” such as worry, sadness, fear, listlessness, timidity (all of these are characteristic of hypochondria), also influence processes in the lower body, even if more slowly. However, these do not cause any serious physical problems, only digestive disorders and “obstructions”: “These, weakening the circulation of blood, are particularly harmful to digestion, and they cause obstructions especially in the abdomen.”36

The obstructions disrupt the entire body. For example, in Berzsenyi’s letter to Kazinczy, he also mentions his headache: “my headache still often tolls the bell of death in my ears.” Franz Schedel (a Hungarian literary historian known as Ferenc Toldy), in his lecture notes on dietetics prepared for his medical students, still links headaches to gastrointestinal disorders in 1839: “Constipation causes wind and cramps, and if it lasts, it obstructs the unimpeded circulation of blood in the lower body and causes it to amass in some parts and causes aches, more specifically, obstructions towards the head: headaches.”37 In Sámuel Rácz’s 1776 Orvosi oktatás (Medical training), it is sadness that is linked to these physical processes, again without mentioning hypochondria: “Those who often suffer from stomach cramps are glum, sad, withdraw from merry amusements, become weak, are happy to sit, become pale and have difficulty breathing whenever they have to move: the stomach is often obstructed; the digested matter is formed into pellets.”38 A little headache, some sadness, constipation and blockages (obstructions), and occasionally unexpected wind are all not so fatal here anymore, and although nosology has changed here and there, the interfaces and contacts within the system have remained the same.

In my opinion, by emphasizing hypochondria, Berzsenyi provides Kazinczy with a key to reading his letter. He offered it not, or not only, as some weak explanation as to why he committed his crime (that he had written his Countercriticism), rather than offering a way to read his sensible epistolary novel, in which he is also a character. In illness, the border between life and death dissolves, while in the illness of hypochondria, it is the border between physical and mental illness that dissolves. It is no coincidence that Berzsenyi’s (the narrator’s, the hero’s) physical injuries (overturned car, broken bones) and mental injuries (confused head, angry heart, and ignorance) appear next to each other, even if it is somewhat unexpected. The energy of the opposites straining on each other (I live and die, write, and do not write, selfless friendship and no friendship, scholarship and amateurism, etc.) can be channeled into hypochondria. Analyzing Johann Ulrich Bilguer’s 1767 essay entitled Nachrichten an das Publikum in Absicht der Hypochondrei, László F. Földényi concludes that existence thickens around hypochondriacs, but just like in the case of all vortices, everything turns into nothing beyond a certain point.39 If Berzsenyi is heading towards something in his letter, it is the serenity of resignation. The complete dissolution and elimination of opposites.

Ethics

Berzsenyi’s letter is an unfriendly letter to an old friend: the salutation is formal (“Dear Sir”), Berzsenyi floats the idea that it was in fact Kazinczy who wrote (or at least suggested) Kölcsey’s criticism, etc. In the second paragraph, friendship is presented as a possible opposite to hypochondria. In social life, problems are dissolved, while loneliness creates a sense of absence, and in loneliness, the balance of the body and soul is disturbed. However, a disloyal friend punishes not only us but themselves as well. According to Berzsenyi, “those who torture the pitiful with such insults will be helped by neither rhubarb nor the sour water of Füred, nor my text,” i.e., the disease will catch up with them too. Namely, discarding one of the main spiritual virtues, i.e., friendship, is one of the main symptoms of hypochondria (as this is what the next paragraph is about, i.e., how he replaced Kazinczy’s friendship with resignation). And it is also probably no coincidence that he recommends the water of Füred and rhubarb to András Thaisz, Pál Szemere, and Mihály Vitkovics. Kölcsey agrees that this is no coincidence. He was familiar with the text of the letter, and this is where he sensed the biggest insult: “That he [Berzsenyi] believed that he did not have to study, that he is already studying and he wants to replace his hypochondriac Countercriticism with a better one, that he considers Thaisz, Vitkovics, and Szemere as people who mocked him to his face and who trampled on his ashes, and when talking about them, he keeps mentioning rhubarb and Füred water: these, my dear friend, are the words of deepest hypochondria. But this hypochondria comes not only from the quinine-treated inflammation of the gallbladder, or from tipping over, it is feared that its biggest lair is in the mistaken idea of the pretended invincibility of genius.”40 But why exactly are these the deepest words of hypochondria?

Rhubarb is an old medicine, and in Házi orvos szótárotska (A small dictionary of home medicine), a compilation of sixteenth-century herbaria written by the infamous Hungarian charlatan of the time, Mihály Nedliczi Váli, it is primarily recommended as a remedy for stomachache; what is more, boiled in the juice of Hungarian aszú grapes, it not only eases the dryness of the throat, but it can also be used to treat dysentery, bloating, stomachache, hiccupping, and of course, melancholy.41 And mentioning the Füred water which was considered to be a medical miracle cure in the era in question, may also be of significance.42 The different sour waters and baths often served as treatments for various illnesses of obstruction, such as constipation and the hemorrhoids related to it, as well as melancholy and hypochondria.43 The best-known of these is probably the Füred water, which Hungarian physician János La Langue’s book on waters recommends for curing the most diverse illnesses of constipation, including hypochondria: “this water has strengthening, releasing, and digestive powers, so it helps the weakness of the stomach and the abdomen, third and fourth-day chills, blockages of the liver, spleen, kidney and uterus, and hypochondria.”44

Does Kazinczy understand the language of hypochondria? In a letter written seven years later, he enthuses to an aristocrat friend of his: “Your letter would horrify me with the news that your soul has been plagued by hypochondria. But you lament about it in such a beautifully written letter that if hypochondria was capable of making one write in such a way, I would ask the Gods to release it on me as well; not even the healthiest soul can write such a letter.”45 Hypochondria is thus characterized as a condition which brings up something that had been closed off below, much as the language of Foucault’s déraison, or pain, creates an independent discourse in the era of sensibility.46 In his response to Berzsenyi dated 18 January 1821, Kazinczy rejoices over his fortunate recovery from the illness and the restoration of the balance of his mind: “Truth and time finally lift the fog, and what is clear is known as clear.”47 This is the paradox of hypochondria: the more we want to help the patient, the deeper we push them. Everything can be reversed. We may even behave ethically towards our patient in the long run; at the same time, this cannot be the method to treat the symptoms that are currently perceived.

The end of their friendship is the beginning of the disease. In Berzsenyi’s 1820 letter, we can first read how true friends (Kazinczy and his followers in Pest) betrayed Berzsenyi and pushed him into illness, and then how now there is no point in making friends with him: what is more, it is impossible to make friends with him anymore. The disloyal friends may suffer all that the one they betrayed had to suffer. Kazinczy’s response letter wants to resolve this tension, and as a good friend, he consoles him, since patients always need hope:48 “You call your state a half-death. Your letter exposes this claim as untrue, because you did not write more enthusiastic ones in your healthy days either, life and strength sparkle within. I would be inconsolable if this hope did not revive you. Nec dis amicum est, nec mihi te prius obire, my dear friend.”49 The Latin quote comes from the first strophe of Horace’s ode written to the sick Maecenas (Carm. 2,17), which has been considered the ode of intimate friendship for centuries, and in the next strophe of which Horace attributes half of his soul to his friend. In other words, Maecenas–Berzsenyi’s “half-death” would also bring death to Horatius–Kazinczy: “ibimus, ibimus, / utcumque praecedes, supremum / carpere iter comites parati.” Their friendship, their shared astrological sign (“utrumque nostrum incredibili modo / consentit astrum”) imposes responsibility on both friends, if one of them is sick, their illness is also shared (as the parallel stories of the last three strophes of the Horace ode suggest), and a shared sacrifice is necessary: “Reddere victimas / aedumque votivam memento: / nos humilem feriemus agnam.”

The end of their friendship is the beginning of the disease. The flip side of this may also be true: friendship is a balm for illness. It is literally medicine. Sir Francis Bacon writes this on friendship: “We know diseases of stoppings, and suffocations, are the most dangerous in the body; and it is not much otherwise in the mind; you may take sarza to open the liver, steel to open the spleen, flowers of sulfur for the lungs, castoreum for the brain; but no receipt openeth the heart, but a true friend; to whom you may impart griefs, joys, fears, hopes, suspicions, counsels, and whatsoever lieth upon the heart to oppress it, in a kind of civil shrift or confession.”50 The constipations and stoppages of the body orifices and the constriction of the soul happen parallel with each other, and a good friend can resolve our problems. However, the hypochondriac does not have friends. Kazinczy also knows what can be read in a popular medical book, that “sad, listless persons need to be cheered up, and we should try to take them to merry companies,” but also that “such patients […] are broody, fearful, skittish, mistrustful, and they often become quite dejected if someone contradicts their foolish opinions or does not believe them.”51 Kazinczy wishes to relieve Berzsenyi by listening to him, but an obstruction that he cannot unplug stands in his way.

***

When Berzsenyi chooses a literary form for his letter (the sensible epistolary novel), he consciously enters a medical discussion in which aesthetics and morality are interconnected. In this essay, I attempted to describe the narrator’s illness with the help of the contemporary practice of medicine and anthropology, and I eventually located its place in a moral-ethical discourse. I concluded that these three seemingly different areas are linked very closely, and those who only reconstruct Berzsenyi’s psyche can only enrich the psychological literature of their own horizon, while they will necessarily draw the wrong conclusions, since Dániel Berzsenyi himself cannot lie on the psychoanalyst’s couch. I tend to believe the cautionary note of the abovementioned Christian Friedrich Richter, who warned that those who “wish to place the body only in the jurisdiction of medicine and the soul in that of the humanities and place intellectual life in the theological faculty are wrong.”52

Bibliography

Bacon, Francis. “Of Friendship.” In The Essays or Counsels, Civil & Moral, 112–23. London: T. N., 1673.

Bacó, Verulámi Báró. “Gondolatjai külömbféle tárgyakról” [Thoughts on different subjects]. Felső Magyar-Országi Minerva 2, no. 10 (1826): 905.

Benedek, István. “Berzsenyi búskomorsága” [Berzsenyi’s melancholy]. Egészségügyi dolgozó 25, no. 10 (1982): 4.

Berzsenyi, Dániel. Levelezése [Correspondence]. Edited by Gergely Fórizs. Budapest: EditioPrinceps, 2014.

Beythe, András. Fives-könüv [Herbarium]. Vivaratt: Manlius, 1595.

Birtalan, Győző. “A felvilágosodás mentálhygiénéje külföldön és Magyarországon” [The mental health of the Enlightenment abroad and in Hungary]. Communicationes de historia artis medicinae 102–104 (1983): 45–74.

Crantz, Heinrich Johann Nepomuk von, Analyses Therm. Hercvlanarvm Daciae Traiani. Vienna: Joseph Kurzböck, 1773.

Csapó, József. Orvosló könyvetske, melly betegeskedő szegény sorsu ember számára és hasznára készűlt [Medical booklet which was created for the use and benefit of sickly and afflicted people]. Pozsony–Pest: Füskuti Landerer Mihály, 1791.

Daday, András. “A régi Balatonfüred történetéhez (1815–1818)” [On the history of old Balatonfüred, 1815–1818]. Communicationes de historia artis medicinae 44 (1968): 117–24.

Dilthey, Wilhelm. “Ideen über eine beschreibende und zergliedernde Psychologie (1894).” In Gesammelte Schriften. V. Band, Die geistige Welt. Einleitung in die Philosophie des Lebens: Erste Hälfte: Abhandlungen zur Grundlegung der Geisteswissenschaften, edited by Wilhelm Dilthey, 139–240. Stuttgart–Göttingen: B. G. Teubner–Vandenhoeck & Rupprecht, 1894.

Fejtő, Ferenc. “A ‘sinlődő álóé’: Berzsenyi Dániel halálának századik évfordulójára” [The ‘suffering aloe’: For the hundredth anniversary of Dániel Berzsenyi’s death]. Szép Szó 1 (1936): 9–18.

Feuchtersleben, Ernst Freiherr von. Die Diätetik der Seele. Wien: Carl Gerold, 1851.

Foucault, Michel. History of Madness. Edited by Jean Khalfa, translated by Jonathan Murphy, and Jean Khalfa, foreword by Ian Hacking. London: Routledge, 2006.

Földényi, László F. Melancholy. New Haven–London: Yale UP, 2015.

Frank, Lajos Fridrik. Az orvos mint Házi-Barát vagy egy orvosnak az atyák- ’s anyákhoz intézett barátságos oktatásai, minden gondoltatható nyavalyákról akármelly korban [Physician as a family friend, or the friendly teachings of a physician to fathers and mothers, on all conceivable ailments in any age]. Second, revised edition. Translated by József Horvát. Pest: Hartleben C. Ádolf, 1830.

Greenblatt, Stephen. Renaissance Self-Fashioning: From More to Shakespeare. Chicago: University of Chicago Press, 1980.

Halász, Gábor. “Berzsenyi lelkivilága” [Berzsenyi’s psyche]. Symposion 2 (1926): 77–107.

Hufeland, Christoph Wilhelm. Az ember’ élete meg-hoszszabbításának mestersége [The art of prolonging life]. Translated and expanded by Mihály Kováts. Vol. 1. Pest: Patzko Ferenc, 1799.

Kant, Immanuel. “Versuch über die Krankheiten des Kopfes.” In Kants Werke. Vorkritische Schriften II. 1757–1777. Gesammelte Schriften, vol. 2, 259–71. Berlin: Reimer, 1905.

Kazinczy, Ferenc. Levelezése [Correspondence]. Edited by János Váczy. Vol. 1–21. Budapest: Magyar Tudományos Akadémia, 1890–1911.

Kovács, Janka. “Lélektudományos ismeretek közvetítése a magyar nyelvű orvosi irodalomban a 18. század második felében” [Mediation of psychological knowledge in the late eighteenth-century medical works in Hungary]. In Fenntartható tudomány. Hagyomány és újrahasznosítás a felvilágosodás előtt, edited by Ildikó Mária Bene, Annamária Molnár, Kata Ágnes Szűcs, Csilla Virág, and Márk Vrabély, 121–47. Budapest: Reciti, 2020.

Kölcsey, Ferenc. Levelezés II [Correspondence II]. Edited by Zoltán Szabó G. Budapest: Universitas, 2007.

Köteles, Sámuel. Philosophiai anthropologia [Philosophical anthropology]. Buda: Magyar Királyi Egyetem, 1839.

La Langue, János. A’ Magyar Országi Orvos Vizekről, és a’ Betegségekbenn azokkal való élésnek szabott modjairól [On the medicinal waters of Hungary and the prescribed manners of using them in diseases]. Nagy-Károly: Klemann Iósef, 1783.

Lepenies, Wolf. Melancholie und Gesellschaft. Frankfurt am Main: Suhrkamp, 1998.

Linzbauer, Franciscus Xav. Codex Sanitario-Medicinalis Hungariae. Tomus III. Sectio I. Buda: Typis Caesareo-Regiae Scientiarum Universitatis, 1853.

Magyary-Kossa, Gyula. Magyar orvosi emlékek [Hungarian medical recollections]. Vol. 1. Budapest: Eggenberger, 1929.

Mátyus, István. Diaetetica. Vol. 2. Kolozsvár: Páldi István, 1766.

Mátyus, István. Ó és új diaetetica [Old and new dietetics]. Vol. 1. Pozsony: Mihály Landerer, 1787.

McGann, Jerome. “Rethinking Romanticism.” ELH 59, no. 3 (1992): 735–54. doi: 10.2307/2873450

Melius, Peter. Herbarium Az Faknac Fvveknec nevekröl, természetekröl, és hasznairol [Herbarium: The names, nature, and uses of trees and herbs]. Colosuárat: Heltai Gáspárne, 1578.

Németh, László. Berzsenyi Dániel. Budapest: Franklin-Társulat, [1939].

Pápai Páriz, Ferenc. Pax Corporis. Edited by Ferenc Szablyár. Budapest: Magvető, 1984.

Porter, Roy. The Greatest Benefit to Mankind: A Medical History of Humanity from Antiquity to the Present. London: Fontana Press, 1999.

Puder, Sándor dr. Mit köszönhet az irodalom az orvostudománynak? Az orvostudomány és a szépirodalom. Művelődéstörténeti és irodalomtörténeti tanulmány [What has literature given medicine? Medicine and fiction. A study in the history of culture and literature]. Az Orvosi Hetilap Tudományos Közleményei. Különlenyomat. Budapest: Centrum Kiadóvállalat R.-T., 1933.

Rácz, Sámuel. Orvosi oktatás, mellyben a’ leg Gyakrabb és leg közönségesebb nyavalyáknak jelei és orvosságai röviden le-iratnak [Medical teaching, in which the signs and medications of the most frequent and common ailments are described briefly]. Vol. 1. Buda: Landerer Katalin, 1776.

Rey, Roseleyne. The History of Pain. Translated by Louise Elliott Wallace, J. A. Cadden, and S. W. Cadden. Cambridge–Massachusetts–London: Harvard University Press, 1998.

Richards, I. A. Practical Criticism: A Study of Literary Judgement. Second edition. London: Kegan Paul, Trench & Co. Ltd., 1930.

Richter, Christian Friedrich. Erkenntniss des Menschen, sonderlich nach dem Leibe und natürlichen Leben, oder ein deutlicher Unterricht von der Gesundheit und deren Erhaltung […]. Leipzig: Johann Friedrich Gleditsch, 1741.

Richter, Franz. Tanácsadó mindazokra nézve, a’ kik az aranyérben kissebb vagy nagyobb mértékben szenvednek [Guidance for all who suffer from hemorrhoids to a lesser or greater extent]. Translated and expanded by József Horvát. Pest: Hartleben K. Adolf, 1830.

Rónay, Mária. “A rejtélyes Berzsenyi Dániel – a pszichopatológia tükrében” [The mysterious Dániel Berzsenyi: In light of psychopathology]. Pesti Hírlap, February 2, 1936.

Schedel, Ferenc. Dietetica’ elemei: Hallgatói’ számára [Elements of dietetics: For students]. Buda: M. Királyi Egyetem, 1839.

Schwanitz, H. J. Die Theorie der praktischen Medizin zu Beginn des 19. Jahrhunderts. Cologne: Pahl-Rugenstein Verlag, 1979.

Störck, Anton von. Orvosi praxis [Medical practice]. Translated and expanded by Sámuel Rácz. Vol. 1. Buda: Pesti Királyi Universitas, 1801.

Szirmay-Pulszky, H. von. Genie und Irsinn im Ungarischen Geistleben. Munich: Ernst Reinhardt, 1935.

Váli, Mihály. Házi orvos szótárotska [A small dictionary of home medicine]. Győr: Streibig József, 1792.

Zacharides, Georgius. Dissertatio Inauguralis Medica de Diaeta et Regimene Hypochondriacorum. Halae Magdeburg: Joannis Christiani Hendel, 1750.

Zákonyi, Ferenc. Balatonfüred: Adalékok Balatonfüred történetéhez a kezdetketől 1945-ig [Balatonfüred: Additions to the history of Balatonfüred from the beginnings until 1945]. Veszprém, 1988.

Zay, Sámuel. Falusi orvos pap, vagy olly orvosi útmutatás, mellynél fogva leginkább a’ Falukon uralkodni szokott nyavalyák orvoslatnak [Village physician priest, or medical guidance through which diseases dominant mainly in villages are remedied]. Pozsony: Wéber Simon Péter, 1810.

Doctors into Agents: The Technologies of Medical Knowledge and Social Control in State Socialist Hungary*

Viola Lászlófi
Eötvös Loránd University / École des Hautes Études en Sciences Sociales
This email address is being protected from spambots. You need JavaScript enabled to view it.

Hungarian Historical Review Volume 10 Issue 2  (2021): 328-356 DOI 10.38145/2021.2.328

In this paper, I analyze different situations in which the doctor-patient relationship, the knowledge/information produced within this framework, and the practices of medical questioning came to the fore in the work of the state security services, one of the typical institutions of social observation and surveillance of the Hungarian socialist state. I examine work and recruitment dossiers opened from 1956 to the 1980s which document either physicians’ uses in state security observation of information which they gained about their patients during their professional (medical) activities in or in which the physician-patient relationship appears as a context of the physician’s recruitment. I discuss how physicians constructed the patient when the gaze of the state security forces was also arguably part of their medical gaze. I contend that medical knowledge and, more generally, information revealed in the professional (medical) context and used in the framework of network surveillance, taken out of their strict medical context, constituted a gray zone of power. On the one hand, this information was a useful tool with which the regime could exert some measure of effective social and political control beyond the borders of healthcare, while on the other hand, it could help physicians develop a certain degree of social resistance.

Keywords: state socialism, history of medicine, state security, doctor–patient relationship, gray zone of power

From end of the 1940s, the developing state socialist system aimed to modernize several facets of social and political life in Hungary. Building on the social and ideological objectives of the new system and conforming to international tendencies, the state engaged in a comprehensive pursuit of modernization which encompassed the provision of welfare benefits, such as universal healthcare, the development, extension and structural reorganization of which began in the early years of the state socialist regime.1 As early as the 1940s, the directive of providing more citizens with health insurance and creating a state-funded universal basic healthcare system yielded the restructuring of healthcare in many countries. This process intensified significantly after World War II.2 By 1961, with the extension of universal health insurance, almost all citizens were eligible for healthcare in Hungary, and after 1975, it became accessible essentially for free to the whole population.3

The de-privatization of the existing healthcare institutions and the establishment of new hospitals, the extension of the network of general practitioners, and the development of outpatient care enabled access to healthcare for both urban and rural populations. Healthcare providers, who previously operated private medical practices, were now employed by the state.4 By introducing these measures, the reigning party’s aims were to advance the medicalization of society and to create an institutional framework which would symbolize the provision of a high level of public care for the workers, the group favored by the state socialist system but marginalized by previous regimes.5 Consequently, medical knowledge and the doctor–patient relationship as a form of social interaction came to play a decisive role in molding socialist welfare. This process and its implications have been addressed in sociological inquiries, but historians have not yet given them adequate study or interpretation.6 However, the cases have not been examined in which doctors, who by then had come to fulfil a fundamental role in welfare provision and thus had a higher number of social contacts than they earlier had had, became the agents of state power not only on account of their medical knowledge but also as the employees of the state security forces, which was one of the key institutions of political repression, responsible for monitoring and controlling individuals in society. In this study, I focus on these rare but all the more significant instances when the state security’s gaze exerted an influence on (and arguably was part of) the medical gaze. The cases under study constitute only a small proportion of the state security files reflecting on the performance of physicians, which means that the position physicians enjoyed in society (as figures in whom trust and confidence was placed), which was clearly considered beneficial for the intelligence network, was little exploited.

As a well-definable group of people possessing specialized knowledge and the related power, physicians have already been discussed in Michel Foucault’s works. Foucault perceived power as a set of techniques, maneuvers, and functions which are distributed based on the strategical positions occupied by individuals or groups within a society. Power, furthermore, is operational, and it thus applies in social contexts and systems of relations in which both bottom-up and top-down processes are observable, and both the dominant and the dominated groups participate in developing power relationships.7 In a medical context, this power could find expression in various phenomena, from medical consultation to health education, and due to the constant presence and operation of power, individuals learn and practice required behaviors, and these processes and rituals of adaptation play a fundamental role in maintaining social order. In short, people become medicalized.8 There are, however, two aspects which weaken the force of this argument in the context of socialist Hungary. Foucault’s observations apply primarily to a capitalist context. Furthermore, he presumes that, although medical and state power are closely related, they cannot be reduced each to each other. The relationship between them should be the subject of further analyses in different social and political contexts.

Taking these arguments as my point of departure, in this study I seek to outline the different aspects and functions of medical activity (institutional, social, responsibility for the production of knowledge) which made doctors and their knowledge of interest outside of healthcare contexts or, the other way round, which impeded the use of this knowledge in new contexts. I also seek to address how the methods used primarily in medical contexts by healthcare experts were used and interpreted during their work within the network of the state security forces. Based on the available evidence, I argue that the methods and practices of the production of knowledge used during medical fieldwork within an institutional context (the development of trust in the doctor–patient relationship, the making of diagnoses) and the social control obtained through such practices produced a certain gray zone of power9 when they were adopted in the framework of state security observation. On the one hand, doctors, due to their social-institutional power, could exert significant social control, but on the other hand, this very power could enable them to put up a certain amount of resistance.

In examining this phenomenon, I explore recruitment and work dossiers, altogether 10, which center on information obtained in a medical context by doctors who had already worked as agents or who were only being pursued by state security.10 All of them were written after the 1956 Revolution in the Kádár era, but their distribution within this period varies between diverse dates. The exact dates are always indicated in the footnotes. As for the content of the dossiers, however, there are no significant differences. Through the lens of the dossiers, we catch a glimpse into a rather heterogenous medical practice, as the doctors in question had a diverse array of expertise (psychiatry, neurology, family medicine, inner medicine), came from a geographically heterogeneous background, and worked in different institutional settings (hospital, local practice, psychiatric institution). Due to the lack of documentation, in several cases it is not known why or how they were recruited by the secret police. The recruited physicians were classified into several categories, such as agents, informants, and secret emissaries.11 As these nuances of classification are unimportant in interpreting the information the doctors obtained and thus in answering my research questions, for the sake of simplicity, I refer to them as informants and/or agents. Their exact functions are summarized in Table 1 (see below).

Social Control and the Production of Knowledge

To be able to grasp how the doctors’ opportunities to become useful informants, their work for the secret police, and the usefulness of their reports were evaluated and how this related to the distinguishing characteristics of their profession, in short, whether a gray zone was indeed supervened, first, it is worth giving a brief summary of earlier research on the “success” of state security observation and the agents whose role was indispensable to this success.

As has been pointed out by a number of studies focusing on the practices of the production and interpretation of state security reports, which are fundamental to any understanding of how the system itself worked, an analysis or discussion of the observational techniques used by the secret police forces, such as the Romanian Securitate, the East German Stasi, or the Hungarian State Protection Authority, may do little to further our knowledge of the actual social realities of the time.12 Secret polices forces were created to strengthen socialist systems and to prevent disruption within society. Thus, one of the tasks entrusted to these police forces was the creation in their reports of a discourse which buttressed both the terminology and the reasoning of the state ideology. The creation of this discourse allowed the regimes to label allegedly disruptive events using terms that reinforced the state narrative (for instance, espionage or sabotage) and to identify perpetrators as culprits from this narrative (for instance, the saboteur, the bourgeois, and the kulak). In course of time, the state security forces were given new missions, and their protective functions, which purportedly were intended to advance the building of socialism through the pursuit of complete control over society and the protection of the social order, were replaced with an all-encompassing ubiquity and the wish to know and monitor every minor secret of each and every citizen.13 According to János Rainer M., in the Hungarian case, this change had been implemented by the 1960s.14 This alteration of functions, however, left the linguistic construction of reports untouched: reports still had to be written in a language interpretable (and acceptable) to both the state security force and the party.

The informants’ ability to fulfil their mission (to observe and to meet the expectations placed on them with regards to their reports) was strongly influenced by their relationships with case officers. Katherine Verdery drew on the analogies between the system of state security and educational institutions, and Sándor Horváth has compared the connection between informants and their case officers to the teacher–pupil relationship.15 Horváth argues that the individuals’ first reports within the state security system and the case officers’ criticism of their form and content could be perceived as part of a process of socialization and learning during which the informants appropriated the fundamental methods of their new “work,” such as the logic and formal requirements of report writing, as well as the perception of their own social environment based on either opposition to or conformity with the system.16 This knowledge, at the same time, could prove flexible, and it could be used by the informants to pursue their own personal goals through the secret police. Moreover, the teacher-pupil concept reflects the (limited) flexibility of this relationship. The success of gathering information and the efficiency of the relationship were determined not only by the officer’s intentions to educate and socialize the informant/pupil, but also by how successfully the two actors asserted their own will in their collaboration.

The teacher–pupil relationship as a metaphor, however, is not only relevant from the perspective of learning and socialization. It is also a great signifier of another, psychologically more sensitive interpretive process, a core element of the paternalistic, almost controlling relationship between informants and their case officers. The primary focus of this is not the report written by the informant, but his behavior, personal dilemmas, and social status. As the textbooks on operative psychology (written particularly for case officers) reveal,17 the individual’s personality and his eligibility to work within the network of state security were considered as early as recruitment plans were written, and recruits were continuously assessed from the perspective of their psychology during their operation within the network, for example, in instances when the sincerity of their reports was evaluated.18 Qualities such as intelligence, good memory, learning ability, politeness, and attentiveness were highly desired, but it was also considered valuable if the individual was ideologically trustworthy and had a wide social network on which he could rely during his work within the network.19 Though timidity or nervousness, which were seen as weaknesses since they might lead to the unmasking of secret activities, were not considered so dire as to disqualify a potential recruit, case officers were trained thoroughly to be able to motivate their informants (who had different personal values and came from diverse social backgrounds) to work efficiently. Since the informants had no insights into the operation and aims of the state security forces beyond the immediate world of their specific tasks, the case officers, taking on the role of “psychologists” and “sociologists,” had to use different tactics to secure the success of the operation. They were responsible for noticing and addressing the mental problems that could arise from stressful situations, and they had to have an extensive knowledge of the informant’s social network and its usability. This knowledge was essential if the case officers were going to give their informants.

Doctor–Patient Relationship as the Situation of Observation

The value of informants in the eyes of the state security forces thus depended not only on the content and form of their reports, but also on their psychological characteristics and social embeddedness as the preconditions of a systematic acquisition of information. Following this line of thought, first I examine the aspects of medical practice that made doctors desirable as informants in the eyes of the state security forces.

The case of “Tarkői”20 sheds light on why and how medical activity could be either the reason, the aim, or the circumstance of recruitment. In October 1957, when the 32-year-old “Tarkői” was approached by the agents of the secret police, he was working as a general practitioner in Miskolc, though he had originally been trained as surgeon.21 He was recruited because of his participation as a physician in the 1956 Revolution: he organized first aid stations in the “counterrevolutionary centers” of Miskolc.22 It was not uncommon for agents of the state security forces to approach someone because of his or her participation in the events of the revolution. In many cases, a person who had participated in the revolution would be under pressure to cooperate with the authorities simply out of fear of the potential consequences of refusal were he or she to refuse. The state security forces, furthermore, were also motivated to approach such individuals in the hopes of uncovering other “counterrevolutionaries.” The case of “Tarkői,” however, is different. The professional and political norms in this case are in stark opposition: as far as the medical explanation goes, as “Tarkői” had taken the Hippocratic Oath, he was ethically obliged to provide each sick or injured person proper medical care during the revolution.23 Thus, he was only fulfilling his professional duty. In the eyes of the state security forces, however, his medical-professional activity was understood as advancing the success of the “counterrevolution.”

The first encounter between the case officer and “Tarkői” occurred in a medical context, when the officer visited him as a patient suffering from a contagious disease. The goal of his visit was to get to know the doctor and to assess his eligibility. The case officer’s two-page report portrays a professionally competent physician with a wide social network, or in other words, a suitable candidate for the role of informant. As the officer reports, “Tarkői” “received him with great politeness,” examined him thoroughly, wrote a prescription, and engaged in pleasant conversation about the local problems of healthcare and his own life and past. The “well-trained” doctor “had a good memory and good conversational skills.” He was not “verbose, but rather direct and friendly.”24 “Tarkői” was thus the ideal type of a socialist physician, and he met all the requirements that a medical professional had to meet to serve both individual patients and society properly. In the medicalization of society, the individual doctor–patient relationships were given great significance, and one of the most important components of these relationships was personal sympathy.25 Furthermore, as pinpointed by studies in the period, this confidential relationship had a substantial impact on the recovery of patients, so “Tarkői’s” behavior would have been a perfect foundation for an ideal doctor–patient relationship if he was visited by a real patient.26

This confidential conversation on “Tarkői’s” professional qualities also offered a good opportunity to evaluate his potential as a good informant: his caring and attentive nature and his proneness to “flattery” made him a trustworthy and ideal candidate in the eyes of agents of the secret police.27 Furthermore, “Tarkői’s” future case officer got a clearer idea of his social network. He concluded that “[‘Tarkői’] knows people from different [social] backgrounds well. Some of his patients have functions either in the party or the state bureaucracy.” Though the officer wished to point out “Tarkői’s” wide clientage and the value of his work for the community, the underlying logic shows the categorization of individuals according to their relationships with the state socialist system. This prefigures the potential aspects of observation.28 Consequently, the case officer’s report shows “Tarkői” as an ideal candidate due to his wide social network and trustworthy nature. His professional qualities could also easily be translated into the new context.

Confidence in the case of an ophthalmologist from Kalocsa in Southern Hungary, who worked under the code name “Siva,” and his case officer was built on an appealing doctor–patient relationship and an underlying existential vulnerability. “Siva” started working for the network in 1953, and by 1962, when his assignment was changed, he was already an experienced informant. From 1962 onwards, he was ordered to observe and report on the activities of W., one of his close acquaintances, who also happened to be his patient. The dossier reveals that W. turned to “Siva” for advice on numerous occasions and even recounted some aspects of his clerical activity that could have been seen by the authorities as seditious.29 This confidentiality in itself could have been exploited by the secret police, but the doctor–patient relationship, which was formed after they had already grown close owing to their common interest in music, added another layer to it. This new aspect made their relationship, which had been casual, in certain respects hierarchical and formal.30 The case officer, realizing this change in power relations, decided that from then on, observation should occur in a new, medical context: “The pretext of the invitation should be a follow-up examination after a previous illness. […] As his doctor, he should reassure him [W.] about his condition. He should point out that with occasional check-ups, he would recover completely. He should offer his services, help, and complete confidentiality. Thereafter, he could get to the point [investigating potential seditious activities].”31 Regular meetings necessitated by the condition of W.—[meetings] that allegedly served [W.’s] interests—secured the opportunity for further inquiries and for maintaining a confidential relationship. W. was thus observed in a delicate situation, in which the patient is both vulnerable and is expected to confide in his caretaker.32 Though vulnerability is not mentioned explicitly in the above passage, by instructing the informant to calm the patient, the case officer implicitly suggests that he expects the patient to be anxious in a situation in which the doctor’s diagnosis clearly would have consequences for his perception of his physical and mental wellbeing, short-term and long-term. And even though questioning about potential seditious activities followed the physical examination, the situation itself and the conscious reflection on the potential feelings it could induce all suggest that the doctor–patient relationship was viewed as more valuable from the point of view of observation than other, even closer relationships (close acquaintance, friendship), as it was founded on (physical) vulnerability.

“Siva’s” case officer considered the doctor–patient relationship useful because of its official, hierarchical nature and its confidentiality, which made it a rich source of information. The information obtained concerning the patients’ activities and social relations during examination and treatment, however, did not necessarily have to be used by the agents of the secret police: the protection of privacy and the prohibition of the use of information outside of the administrative context of healthcare were regulated, and under state socialism, all patients had the right to medical privacy.33 This regulation, which simultaneously served the doctors’ professional autonomy and the protection of patients, even if the extent of medical privacy was not generally agreed upon, encompassed all information (regardless of its nature) that came to light in medical contexts.34 Divergence from the principle of medical privacy because of loyalty to the system or fear of the state security forces will be discussed later. The question of whether the case officers reflected on the norm of medical privacy and its impact on the work of the secret police should be addressed here.

This phenomenon is discussed only once, in the case of a doctor who used the code name “Szentedrei,” though whatever qualms he may have had about protecting patient privacy, they do not seem to have hindered his activities as an agent. “Szentendrei” was a psychiatrist, and at the time in question, he worked as a primary physician at the Institute for Work Therapy in Pomáz. He had a rather wide social network. One of his close acquaintances was a man named György Krassó,35 who was a significant member of the opposition in the Kádár era. At Krassó’s request and with the case officer’s approval, “Szentendrei” examined Krassó’s French female friend. The woman “subjected herself to an almost one-and-a-half-hour medical examination,” the results of which were to be delivered to the French woman’s Hungarian friend, but “keeping medical privacy in mind.”36 In this case, medical privacy not only did not hinder the work of the secret police, but appears to have confirmed “Szentendrei’s” trustworthiness. “Szentendrei’s” willingness to ignore the patient’s right to privacy casts light on his work not only as a doctor, but also as an agent. He shared information with the state security forces that he did not necessarily share with someone who was close to the patient (Krassó).

In conclusion, medical activity and the doctors’ position within this context were associated in the eyes of the secret police’s agents with both social confidence and reliability, as well as exploitable vulnerability. Moreover, physicians, who conformed to the norms of modern medical practice had character traits that were perceived as desirable in their new “work environment” within the network of state security.

The Perception of Medical Knowledge within the Network

Medical diagnosis, social prognosis

So far, we have seen that doctors were considered ideal informants, but we have not touched on how the actual methods they used to diagnose and cure their patients were understood in this new context. How did the medical gaze construct its patient when the state security’s gaze was absorbed into it?37

An agent who worked under the code name “László Kaposvári” was a 45-year-old hospital physician in Sopron. In 1975, he shared the story of a young female neurology patient with his case officer. The composition of the report suggests formal and logical deliberateness. In the first part, relying on the information shared by the patient’s father, “Kaposvári” recounts the underlying reasons for hospitalization and the circumstances of the onset of her daughter’s illness: “According to the father, his daughter was hospitalized because she was recruited by two agents of the state security in Sopron. […] They even gave her money so that she could cover her expenses when she meets suspicious persons [who wish to flee the county].”38 The report then reflects on the need for hospitalization because of an “occupational disease.” Though the following sections of the anamnesis were mostly anonymized, the available details suggest that the condition of the patient was analyzed further.

If we interpret the report with the state security’s gaze in mind, the story of a de-conspired informant unfolds. However, if we consider that “Kaposvári” also used the specific methodology of medical knowledge production to construct the narrative, another possible interpretation is implied. Reliance on the father’s account could imply that the report was constructed similarly to a heteroanamnesis.39 In this, the patient’s condition is clearly interpreted as an “occupational disease.” This explanation is then mirrored in the doctor’s diagnosis. Therefore, the report highlighted the risks of the agents’ work to the individual’s health, even though the original aim of the report was to indicate possible threats to the state socialist system, for example, seditious behavior.40 This also meant that “Kaposvári” not only ignored the prescribed standards of report writing but also favored the individual’s interests as opposed to the society’s (or the regime’s). Bearing this in mind, it is rather striking that the case officer accepted his report without criticizing its form and content.

“Kaposvári” was not the only person who applied the same methodology used in medical diagnostics to interpret information reported to the secret police. A man who went by the name “Hegyi” also used this method on some occasions between the 1960s and 1970s. “Hegyi” was the primary physician41 of the Intapuszta Institute of Work Therapy, located close to the Austrian border. Owing to his position and wide social network,42 he was considered a potentially “useful” informant, and his recruitment was of great importance to the state security forces. His dossier contains two reports, the subjects of which had valuable relationships with people abroad. He characterized them as follows:

In my estimation, the onset of his lunacy was around ’54 or ’55, with the appearance of paranoid delusions. […] From a psychiatric point of view, his current condition could be evaluated as follows: he is in a balanced state, which means neither recovery nor health. Any unexpected event or trauma, in fact, any curious occurrence could induce remission. […] I do not think he could give any valuable information, as he has been hospitalized for approximately 15–16 years.43

He recounted that at work he had many conflicts because of his drinking, sometimes he showed up to work drunk. […] As we say, he suffers from chronic alcoholism. […] I would say that because of his obscure relations, he could be useful […] though not for obtaining information, rather for some other assignments, as he is an existentially unstable, unreliable person.44

The reports from which these rather expressive passages are quoted can be divided into three lengthy sections. In the first part, “Hegyi” discusses the individual’s past and his or her preceding medical conditions in detail. The wording and underlying logic of these narratives evoke the structure and content of anamneses: they detail the evolution of symptoms and the changes in the individuals’ behavior in a chronological order. The anamnesis in these cases, however, not only functions as a standard medical method of questioning, but is also fundamental to the “social prognosis” presented to the case officer. “Hegyi,” though he does not want to follow the logic of the state security forces in “reconstructing” his patients based what he was told, provides a thorough explanation for his medical observations in order to ensure that his case officer understands it properly. On the other hand, he characterizes the patients, who were potentially interesting for the secret police, in a narrative framework which was, owing to his professional, medical expertise, more “comfortable” for him than for the non-expert case officer. And although unusually an informant’s work was evaluated by his or her case officer, in these particular cases, no evaluations were made, which might suggest that this recurring method was accepted by “Hegyi’s” case officer.

It is rather difficult to determine, however, whether what these methods were part of a general tendency or were simply individual approaches to the composition of these specific narratives. Could medical knowledge play a part in procuring a more advantageous position in a situation when an informant was both an observer and someone under observation? Or did physicians who were also serving as informants simply use the routinized techniques of producing medical knowledge in another context? The doctors, logically, do not reflect on their choices of register in their reports, so a deeper analysis of the problem would require situations in which a possible change or break is detectable which then leads to the conscious use of medical knowledge tailored to new circumstances. I have only found one such case, that of “Orvos.”45

“Orvos” was a radiologist in Budapest and also an emblematic figure of the neo-avantgarde underground musical scene of the capital from the end of the 1950s. In 1960, he wrote a report on the potential spying activities of a clerical figure and employee of Orion, which was a state-owned company manufacturing telecommunications equipment. “Orvos” and the worker were introduced to each other by a friend on account of their common interest in speakers. In his report, “Orvos” described the worker as a well-prepared person in telecommunication. Born in Transylvania, he had a widespread network of friends and acquaintances abroad, and he traveled frequently to repair and sell radios. And even though his activities were suspicious in and of themselves, “Orvos” also added that his new acquaintance had several names, and his ID, which contained false information, was not valid. This report had significant relevance for the authorities, but the structure of the report was so chaotic that “Orvos,” though he had already been working as an agent for nine years, was asked to revise it. Thereafter, “Orvos” made some changes to the report and amended it with a medical evaluation missing from the previous version: “Medical opinion. […] I consider unverifiable and exclude personality change due to trauma or family and genetic inheritance. Though his interests are not monomaniac, his judgements are partly compulsive. Based on this, I consider his stories credible and true.”46 This addition suggests that after his earlier unsuccessful attempt, “Orvos” intended to use his medical knowledge to underline his opinion, assuming that medical knowledge is a socially accepted area of expertise of which he was in possession. His report suggests that the observed spy was, in fact, of sound mind and that his activities could indeed undermine the system. In this light, the value of “Orvos’s” activity as an informant was significantly more valuable. The report was eventually accepted by the case officer and assessed as operationally valuable. Although “Orvos” was a radiologist and his medical description was based on psychiatric knowledge, his report could be considered acceptable and interpretable for two main reasons. First, as I mentioned at the beginning of my article, reflecting on mental problems and the nonconformist behavior of the target person or the informant was one of the recommended methods during state security observation. Second, the information given by “Orvos” may have been acceptable to the officer because, despite the officer’s operational training, the officer presumably saw “Orvos” as having a more profound knowledge of psychology than he, the case officer, had.

Until now, I have focused on procedures and methods which are not strongly linked to the different fields of medicine but are generally true for physicians who work in an institutional context. The last three examples, however, show the significance of psychiatric and neurological expertise, since psychiatric and neurological expertise serve as the technology with which the patients are “reconstructed” in this new narrative context, outside of the medical field. This might be linked to the development of psychiatry as a discipline. Though psychiatry, especially with the broadening of neurological knowledge, was given a strongly biomedical character in the period, diagnosing “madness” required different “tests” that were meant to determine the normalcy or abnormality of the individual’s behavior from the perspective of society at large. The social character of these tests does not mean, however, that they were not medically verifiable methods. They were created precisely to attest to the medical validity of the different technologies of mental normalization.47 From among the three doctors, only “Hegyi” had a confirmed background as a psychiatrist. Still, one does not necessarily have to be a specialist in psychiatry to give an account of the social and political implications of a patients’ psychological functions, as physicians had all been required to appropriate the basics of psychiatry and neurology during their studies. Psychiatric knowledge, however, was one of the rare forms of medical expertise which was seen as enabling a physician to interpret patients’ attitudes towards the norms of socialist society. This knowledge also made these reports valuable for the authorities, but at the same time, it did not expose the patients or the doctors to the discursive and hierarchic logic characteristic of the state security.

Differences in knowledge, social prestige, and hierarchy

As we have seen, the doctors examined so far did not use the expected discursive and logical patterns, but rather recreated the techniques of medical knowledge production in a new context. This seems to have been an accepted, even recurring method, as in most cases, the doctors were not ordered to revise and resubmit their reports, and sometimes the information obtained this way had considerable operational value. But what could explain the approval of these methods? It seems plausible that regardless of the applied discursive techniques, the reports were comprehensible for the case officers. In case of “Hegyi” and “Kaposvári,” this interpretation could suffice. However, “Orvos’s” case does not seem to fit into this logic: he first provided the information, which had considerable operational value, and then he amended his report with a medical explanation, and this explanation led to the acceptance of his report. Furthermore, the content-centric explanation is weakened if we consider that expecting the informants to conform to the discursive logic prescribed by the state security also had a disciplinary aspect: the practice of ordering the informants to revise their reports was important in sustaining a hierarchical relationship. If the relationship between the case officer and the informant is understood more flexibly, taking other factors, for example, social prestige into consideration, we can find further explanations as to why medical knowledge was accepted by the officers as a methodology with which to interpret operationally valuable information.

One possible explanation is the high social prestige of doctors and medical knowledge. Doctors in state socialist societies, owing to their expertise in maintaining and restoring the health of workers, who were seen as the pillars of society, were of fundamental importance, and their positions were linked in both medical and sociological discourses to considerable social prestige.48 The first prestige analyses were carried out, however, only in the 1980s, in 1983 and 1988. The analyses underpinned the high social prestige of doctors: from among the 156 occupations under study, hospital physicians were ranked first and general practitioners fourth.49 As for the amount of expertise required to hold a certain position, hospital physicians were ranked first and general practitioners second, above all other occupations. Therefore, based on a representative sample, medical knowledge was considered the most valuable knowledge.50

A second explanation is grounded on the quality and unapproachability of medical knowledge. Due to the gradual professionalization and specialization of the different fields of medicine and the proliferation of technologies, the production of medical knowledge became more specific and impenetrable for non-experts.51 Thus, the agent-doctors based their work within the network of state security on a form of knowledge and its methods of evaluation that were largely incomprehensible for outsiders. And even though public health policy strove to incorporate some elements of the “socialist self-consciousness” into the discourse and urged the members of society (the patients) to turn to medical ethics committees,52 the task and prerogative of evaluating the complaints and possibly issuing sanctions were still in the hands of medical experts, not laymen. If we accept this explanation, it is likely that even the possibility of criticizing medical knowledge was dismissed by laymen, who, in this case, were the officers of the state security forces.

Opposition in the Wards

The adaptability of medical knowledge and the doctors’ positions, which rested on the solid foundation of the social value of their knowledge, presented something of a conundrum from the perspective of the state security forces. While their position in society was advantageous, as they could operate easily as observers in a wide social network, their expert knowledge made them unreliable, as they could manipulate the obtained information and mask potential seditious activities effortlessly. Consequently, the specific features of diagnostic and therapeutic practice and their social perceptions could enable doctors to elude the interpretive (and at the same time, disciplinary) methods dictated by the logic of the state security forces. What complicates this scheme is that applying the techniques of medical knowledge production in this new context implied the violation of professional norms and disregard for medical privacy. These explanations, however, are still insufficient to give a reassuring answer to my original research questions, because the above conclusions focus exclusively on the possibilities of obtaining information in a medical context. So far, I have not explored the phenomena strongly linked to medical activities that made the presence of doctors as the agents of state security services indispensable. Or to medicalize my inquiry: where did the blind spot of the secret police lie, a blind spot to which only doctors had access?

The secret police, as one of the fundamental networks of surveillance in the Kádár era, strove to uncover the secrets of individuals or certain groups and their attitudes towards social norms and to interpret the implications of their potentially threatening activities. Consequently, the secret police tried to infiltrate alternative spaces in society, for example, meetings among people belonging to intellectual circles or private art events that were for some reason hidden from the public eye.53 As for hospitals, the secret police was supposed to have easy access to any information, considering the public funding and extensive administrative practices of these institutions. Yet this was not always the case. Fortunately, some of the dossiers reveal exactly how permeable the walls of hospitals were and who had access to information produced within these spaces.

“Viola” worked as a physician at the First Department of Neurology of the hospital on Róbert Károly Boulevard. She was recruited because, in the hospital and especially at the neurology clinic, more people who had actively participated in the events of the 1956 Revolution were hidden. By the time “Viola” was recruited, the agents of the state security forces, who played a leading role in identifying and tracking “counterrevolutionaries” until 1963 (when a general amnesty was proclaimed), had already identified three such individuals. This could be seen as a success. However, by this time, already more than a year had passed since the revolution. Also, this particular institution played a particularly prominent role in serving the medical needs of the state socialist elite, especially the Hungarian army and the Soviet troops stationed in the country. These two facts may have cast a shadow on the efficiency of the agents’ work in identifying the potential enemies of the system. Therefore, a doctor was needed to provide an inner perspective and assist the police forces in their efforts to detect those hiding from retribution. That their reasoning in the assignment plan was sound was proven by “Viola” during their first meeting: she immediately named an individual who had successfully eluded the gaze of state security. The further analysis of the assignment plan also reveals that hospitals could serve as “asylums” for those who wanted to escape retribution.54 And as this example testifies, they sometimes hid in plain sight, but owing to the (partial) impermeability of the hospital’s walls, doctors were indispensable in assisting the agents of the state security in exposing potential enemies.

The recruitment of “Viola” in 1958 could be explained either as a consequence of the relative closeness of the revolution in time or the efforts of the authorities to expose the enemies of the system. However, even when these circumstances did not hold, hospitals remained places of interest for the agents of the secret police, as the cases of “Kaposvári” and “Marossi Pál,” a physician at the Second Department of Internal Medicine of the Medical University of Pécs, show.

“Marossi” was first asked to report on a patient in 1960. The patient, K. L., who had been at the clinic for months, was a religious person and had numerous visitors. Though “he was not visited by the priests of the Church of the Order of Mercy, he often called priests for fellow patients and strove to persuade others to follow his example. The directors of the clinic, however, prohibited him from continuing with such activities.”55 K. L.’s religiosity is emphasized throughout the report, and this explains why he was under surveillance. However, “Marossi” tried to divert the attention of the case officer from K. L.’s religiosity by making it seem as if it remained merely a private matter and did not influence the other patients.

Like “Marossi,” “Kaposvári” also gave an account of his patients’ behavior in the wards. He reported that “Mrs. H. A., a teacher from Sopron, listens to Radio Free Europe daily, though she does not share what she has heard with the others.” Upon evaluation, “Kaposvári” added the following: “Mrs. H. A. listens to Radio Free Europe again. However, her roommate is hard of hearing, and thus she does not know which frequency her roommate listens to.”56 According to a 1953 court decision, listening to RFE was not prohibited as long as it was not done in public. “Kaposvári,” who presumably was familiar with the court decision, by referring to the hearing loss of Mrs. H. A.’s roommate, tailored his report to the norms and expectations of socialism, and he used a medical explanation to minimize the possibility of any drastic measures being taken by the police. Although the informants never knew what the State Security Service would do with the information obtained through them and or what consequences their contributions to the system would have for the individuals “denounced,” according to the report issued by “Kaposvári,” the patient had not violated any rules, so the report qualified as operationally valuable, and the agents of the state security remained alert.

The cases of “Kaposvári” and “Marossi” reveal that the individuals under surveillance were already known by the secret police, and their stay in the hospital was seen as a period that could be instrumental in uncovering their potential seditious activities. It was therefore particularly important, from the perspective of the authorities, to keep them under observation on account of their potentially threatening activities and the ideological influence they could exert on other patients. As both cases illustrate, the social space of hospitals was seen as a milieu in which listening to the RFE or engaging in religious activities that were tolerated if done in private could become subversive because of the impact they could have on other individuals. This is something that authorities could not turn a blind eye to. Furthermore, reports on the visitors who came to see these patients could shed light on the patients’ social networks, which in turn could assist the authorities in tracking other potentially dangerous individuals.

Observing the behavior of patients was only one possible reason for the active presence of the secret police in medical institutions. As the cases of “Lénárd Pál” and “Angyalföldi” illustrate, other, more complex problems of socialist healthcare could come to the surface, which, in addition, could shed light on the common violation of norms by either doctors or their patients.57 While “Angyalföldi” reported on the practice of prioritizing Yugoslavian patients, who paid in foreign currency for medical services, to the detriment of insured Hungarian patients, “Lénárd Pál,” a neurologist at the Székesfehérvár hospital, wanted to declare a patient who had already suffered of ill health an invalid. However, in doing so, encouraged by his case officer, “Lénárd” did not follow the usual, official route, but rather bribed other physicians, a seemingly common method for declaring healthy individuals invalids. Though the two situations differ, the aim in both cases was to uncover activities that had already been known broadly, but the authorities were in need of more information (names, venues, dates) to move forward. These were significant details that non-medical personae would not have been able to unearth. The above situations also demonstrate that hospitals, even though they were intended, in principle, to serve the wellbeing of society, could function as institutions in which the evasion of norms was rather frequent.

The last five cases prove that hospitals and wards enabled subversion and could serve as hiding places for enemies of the state and at the same time could effectively conceal these activities. The impermeability of the hospital’s walls is due to its function as a total institution. As Erving Goffman points out, hospitals and similar institutions, such as prisons, monasteries, and schools, have a special, socializing function either to habituate individuals to follow norms or to correct their behavior. If these institutions are going to perform this function successfully, any passage between the inner world of the institutions and the “real” world outside must be severely restricted. The physical and mental separation of the two spaces could mean reformulating the rules and norms of the outside world, all the while creating a new order within the walls of the institutions.58 The agent-doctors, therefore, could offer a glimpse into a segment of social space that would have been impenetrable without their cooperation. At the same time, this impermeability meant that they had some autonomy in selecting the information to be shared or concealed.59

Conclusion

In this study, I have offered several concrete cases illustrating ways in which doctors maneuvered within the network of the state security forces, one of the most significant institutions of state socialist societies responsible for the surveillance and control of individuals. A physician’s adherence to professional norms, expertise, and institutional position made him or her a potentially valuable asset in the eyes of the authorities. It was not as simple to exploit this potential, however, as it may have seemed initially. Though on many occasions, the doctors’ performance as agents was assessed positively by their case officers, the doctors often failed to follow the prescribed norms of construing the enemy. The gray zone between the standard practices of the state security forces and medical activities denotes social spaces which the authorities would have been unable to permeate without the assistance of medical practitioners. At the same time, this points at a specific quality of medical knowledge that made these spaces inaccessible for outsiders, thus facilitating social resistance, at least to some extent.

I have also attempted to underline that, following Foucault’s argument, the affiliation between doctors and their case officers exerted an influence through relationships and institutions. In the framework of the strongly hierarchical operations of the state security forces, the social position of physicians also came into prominence, and in this context, this social position gave physicians a certain amount of autonomy. In the future, this aspect should be explored in further detail, using a wider array of sources which could shed light on the extent to which the publicly funded healthcare system and its publicly financed employees could realize their autonomy from the state in other respects, such as medical education and primary care.

Appendix

Table 1.

Archival Sources

Állambiztonsági Szolgálatok Történeti Levéltára [Historical Archives of the Hungarian State Security] (ÁBTL)

2.8.1. BM Vas Megyei RFK személyi gyűjtők [Ministry of the Interior, Vas County Police Headquarters, Personal dossiers]

3.1.1. B-84186 “Viola”

3.1.1. B-92993 “Tarkői”

3.1.2 M-17361 “Marossi Pál”

3.1.2. M-17764/1 “Orvos”

3.1.2. M-18864/1 “Siva”

3.1.2. M-31222 “Szentendrei”

3.1.2. M-33556 “Hegyi”

3.1.2. M-37256 “Kaposvári László”

3.1.2. M-39489 “Angyalföldi”

3.1.2. M-39640 “Lénárd Pál”

4.1 A-3120. Ivanin, G. I. Az operatív pszichológia néhány kérdése [Some questions of operative psychology]. Moscow, 1973.

4.1. A-3121. Láng György. Operatív pszichológia III. A hírszerzés hálózata vezetésének és nevelésének szociálpszichológiai kérdései [Operative psychology III. Some questions of social psychology on leading and training the members of intelligence services].

4.1 A-4510. Horváth István. A pszichológia és szociálpszichológia felhasználása hálózati munkában [Using psychology and social psychology in the work of intelligence services]. Thesis.

Decree No. 8. Medical Regulation, 1959.

11/1972. (30. VI.), Regulation of medical workers, issued by the Ministry of Health.

Bibliography

Balint, Michael. “The Doctor, the Patient and the Illness.” The Lancet, 265, no. 6866 (1955): 683–88.

Bates, Vicoria. “Yesterday’s Doctors: The Human Aspects of Medical Education in Britain, 1957–93.” Medical History 61, no. 1 (2017): 48–65. doi: 10.1017/mdh.2016.100.

Benedek, István. The Gilded Cage. Budapest: Corvina Press, 1965.

Bernstein, Frances L. “Behind the Closed Door: VD and Medical Secrecy in Early Soviet Medicine.” In Soviet Medicine: Culture, Practice and Science, edited by Bernstein, Francis L., Burton, Christopher, Healey Dan, 92–110. Dekalb: Northern Illinois University Press, 2010.

Betts, Paul. Within Walls: Private Life in the German Democratic Republic. Oxford: Oxford University Press, 2010.

Blum, Alan. The Grey Zone of Health and Illness. Bristol–Chicago: Intellect, 2011.

Bolgár, Dániel. “A hatalom mindennapjai: Azonosítási játék az államvédelemnél” [The everyday life of power: A game of identification at the state security]. 2000 23, no. 11 (2011): 3–13.

Borhi, László. Hungary in the Cold War, 1945–1956: Between the United States and the Soviet Union. Budapest: Central European University Press, 2004.

Csikós, Gábor. “Countryside Modernized or Traumatized? Rural Mental Health in Hungary after the Collectivization of Agriculture.” Hiperboreea 7, no. 1 (2020): 74–98. doi: 10.5325/hiperboreea.7.1.0074.

Deleuze, Gilles. Foucault. Paris: Les Editions de Minuit, 2004.

Farádi, László. “Dialektikus materializmus a gyakorló orvosi tevékenységben” [Dialectic materialism in medical practice]. Katonaorvosi Szemle 5, no. 9 (1953): 817–22.

Foucault, Michel. Discipline and Punish. The Birth of Prison. New York: Vintage Books, 1977.

Foucault, Michel. “The eye of power.” In Power/Knowledge: Selected Interviews and Other Writings, 1972–1977, edited by C. Gordon, 146–65. New York: Vintage Books, 1980.

Foucault, Michel. The Birth of the Clinic: An Archaeology of Medical Perception. New York: Vintage Books, 1994

Foucault, Michel. Le pouvoir psychiatrique: Cours au Collège de France, 1973–1974. Paris: Gallimard Seuil, 2001.

Fulbrook, Mary. “The Concept of ‘Normalization’ and the GDR in Comparative Perspective.” In Power and Society in the GDR, 1961–1979: The “Normalisation of Rules”?, edited by Mary Fulbrook, 1–30. New York: Berghan Books, 2009.

Fülöp, Tamás. Néhány tőkés ország egészségügyének szervezete: Az egészségügy nemzetközi szervei [The healthcare system of some capitalist countries: The international organizations of healthcare.] Budapest, 1962.

Goffman, Erving. Asylums: Essays on the Social Situation of Mental Patients and Other Inmates. New York: Anchor Books, 1961.

Gyarmati, György, and Tibor Valuch. Hungary under Soviet Domination. New York: Columbia University Press, 2009.

Hancock, Black Hawk. “Michel Foucault and the Problematics of Power: Theorizing DTCA and Medicalized Subjectivity.” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 43, no. 4 (2018): 439–68. doi: 10.1093/jmp/jhy010.

Harmat, Pál. “Az orvosi tekintély változása korunkban” [The transformation of the medical profession’s prestige in our age]. Orvosi Hetilap 119, no. 11 (1978): 32–35.

Horváth, Sándor. “Life of an Agent: Re-Energizing Stalinism and Learning the Language of Collaboration after 1956 in Hungary.” Hungarian Historical Review 4, no. 1 (2015): 56–81.

Horváth, Sándor. “A helytörténetírás mint ‘szürke zóna’ és kulturális ellenállás a szocialista korszakban” [Local history as a “gray zone” and cultural opposition in the socialist era]. In Az ember helye – a hely embere: A helytörténetírás módszertani kérdései [The place of man – the man of the place: The methodological questions of writing local history], edited by István Lengvári, Mónika Pilkhoffer, József Vonyó, 88–99. Budapest–Pécs: Magyar Történelmi Társulat–Kronosz–MTA Pécsi területi Bizottsága, 2019.

Horváth, Attila. “Orvosok – pedagógusok” [Doctors – teachers]. Valóság 29, no.4 (1986): 59–67.

Hosking, Geoffrey. “Trust and Distrust in the USSR: An Overview.” The Slavonic and East European Review 91, no. 1 (2013): 1–25. doi: 10.5699/slaveasteurorev2.91.1.0001.

Koltai, Gábor. Akik a “Párt” ellen vétkeztek [Those who wronged the “Party”]. Budapest: Korall, 2019.

Kovai, Melinda. “‘Számlálatlan forró csókkal’ – Állambiztonsági megfigyelés a Kádár-korszak pszichiátriai kórrajzain” [“With countless fervent kisses” – State security observation on the psychiatric case histories of the Kádár era]. Forrás 43, 7–8 (2011): 159–76.

Kulcsár, Rózsa. Foglalkozások presztízse [The prestige of occupations]. Budapest: KSH, 1990.

Kürti, Emese. Glissando és húrtépés: Kortárs zene és neoavantgard művészet az underground magánterekben, 1958–1970 [Glissando and string tearing: Contemporary music and neo-avantgarde art in underground private spaces, 1958–1970]. Budapest: L’Harmattan, 2018.

Le Bonhomme, Fanny. “‘Le Mur lui est monté à la tête’: Construction du mur de Berlin et basculement dans la maladie (Berlin-Est, 1961–1968).” Le mouvement social 253, no. 4 (2015): 31–47. doi: 10.3917/lms.253.0031.

Light, Donald W. “Universal Health Care: Lessons from the British Experience.” American Journal of Public Health 93, no. 1 (2003): 25–30. doi: 10.2105/ajph.93.1.25.

Losonczi, Ágens. A kiszolgáltatottság anatómiája az egészségügyben [The anatomy of vulnerability in healthcare]. Budapest: Magvető, 1986.

Lukáts Jenő. “Strukturális vizsgálódások a magyar orvostársadalomban: Az orvosi réteg helye, szerepe a társadalomban” [Structural examinations in the Hungarian medical society: The place and role of medical professionals in society]. Politika-tudomány 1, no. 1–2 (1971): 73–110.

Peerson, Anita. “Foucault and the Modern Medicine.” Nursing Inquiry 2, no. 2 (1995): 106–14. doi: 10.1111/j.1440-1800.1995.tb00073.x.

Rainer M., János. Jelentések hálójában: Antall József és az állambiztonság emberei 1957–1989 [In the web of reports: József Antall and the personnel of state security, 1957–1989]. Budapest: 1956-os Intézet, 2008.

Szabó Ferenc. Orvosetikai kérdésekről [On some questions of medical ethics]. Budapest: Medicina, 1973.

Szalai, Júlia. Az egészségügy betegségei [The maladies of healthcare]. Budapest: Közgazdasági és Jogi Könyvkiadó, 1986.

Takács, Tibor. “Az ügynökhálózat társadalomtörténeti kutatása” [Social historical research of the agent network]. In Az ügynök arcai: Minennapi kollaboráció és az ügynökkérdés [The faces of the agent: Everyday collaboration and the question of secret police agents], edited by Sándor Horváth, 107–30. Budapest: Libri, 2014.

Van Dijk, Wieteke, Marjan J. Meinders, Tanke, Marit A.C., Westert, Gert P., Jeurissen, Patrick P.T. “Medicalization Defined in Empirical Contexts – A Scoping Review.” International Journal of Health Policy Management 9, no. 8 (2020): 34. doi: 10.15171/IJHPM.2019.101.

Vatulescu, Cristina. Police Aesthetics: Literature, Film and the Secret Police in Soviet Time. Stanford: Stanford University Press, 2010.

Verdery, Katherine. Secrets and Truths: Ethnography in the Archive of Romania’s Secret Police. Budapest: CEU Press, 2014.

Weil, Francesca. Zielgruppe Ärzteschaft: Ärzte als inoffizielle Mitarbeiter des Ministeriums für Staatssicherheit. Berichte und Studien 54. Hannah Arendt Institut für Totalitarismusforschung 5. Göttingen: Vandenhoeck & Ruprecht Unipress, 2008.

TEKA: A Transnational Network of Esperanto-Speaking Physicians

Marcel Koschek
University of St Andrews
This email address is being protected from spambots. You need JavaScript enabled to view it.

Hungarian Historical Review Volume 10 Issue 2  (2021): 243-266 DOI 10.38145/2021.2.243

The Tutmonda Esperanta Kuracista Asocio (Worldwide Esperanto Medical Association, TEKA) was founded in 1908 at the Fourth International Esperanto Congress in Dresden and was the international medical association of the Esperanto movement. The aim was to “facilitate practical relations between Esperanto-speaking doctors of all countries.” The interest within the Esperanto movement was immense: after one year, TEKA had more than 400 members all over the world with a focus on Europe; one year later, there were more than 600 members with official representatives in about 100 cities. In Europe, a medical press in Esperanto had already been established. The approach of these journals was both simple and brilliant: the doctors presented the latest medical findings from their home countries in a peer review system and critically examined the articles in their vernacular. This made each issue a compendium of the most important and pioneering findings of national research. The numerous experts also had many other connections with, for example, the Red Cross and similar organizations. Thus, after a short period of time, TEKA brought together the expertise of countless physicians. This paper examines TEKA as a transnational network of experts before World War I. The history of the association and the role of Medicine within the Esperanto movement are briefly discussed. The focus is then on the various association journals and the circulation of knowledge. Finally, the essay offers a look at TEKA’s cooperative endeavors with the Red Cross. It works from a transnational perspective and takes a close view of the actors and their personal backgrounds at appropriate points. Furthermore, lists of members and journal subscribers are provided in map form to make the global spread of the movement within medicine visible.

Keywords: Esperanto, transnationalism, internationalism, network of physicians

Introduction

The end of the long nineteenth century was a dynamic time during which groundbreaking changes were taking place in all areas of life. The decades before World War I were characterized by networking and internationalization as well as inventions and technical progress.1 Even in medicine, the peak of internationalism did not pass without leaving its mark. In 1863, the Red Cross was founded, and in 1881, medical assembly began with the first International Medical Congress in London. At the time, Ludwik Lejzer Zamenhof, an ophthalmologist in Warsaw, also had thoughts on medicine, internationalization, and networking. In 1887, he published a brochure entitled International Language.2 This booklet, which he published under the pseudonym Dr. Esperanto (literally meaning, “the one who hopes”), joined the list of numerous inventive and stirring writings of this period. With his idea of devising a simplified language, Zamenhof presented a solution to the problem of communication; his pseudonym quickly became the name for the language itself. Esperanto harmonized with the prevailing zeitgeist among educated elites, who soon began to gather internationally and develop platforms for exchange. The language quickly gained a foothold in medicine, as outbreaks of cholera and typhus and new fields such as bacteriology led to a strong need for exchange in the medical community.3

The majority of Esperantists in the early period before World War I came from urban middle classes, which “had the money and leisure to look beyond their own communities.”4 The exact proportion of physicians among the club members is very difficult to determine. For example, the address book of Polish Esperantists from 1909 provides lists of members but only incomplete professional information. Large university cities such as Lviv (15.6 percent), Warsaw (11.4 percent) and Krakow (6.3 percent) had the highest proportions of physicians among their members. In contrast, rural Esperanto societies only rarely had doctors among their members.5 Nevertheless, the Esperanto doctors hoped that international cooperation with foreign colleagues would foster valuable exchange and progress. One of the arguments for learning Esperanto was the simplicity of the language and the claim that the vocabulary was “three-quarters known to anyone halfway educated.”6 The 1933 Encyclopaedia of Esperanto lists early mentions of the language in medical journals. These mentions include a series of articles in the Russian journal Vrach in 1899 and, from 1900, primarily mentions in French journals. There were also discussions concerning Esperanto at two medical meetings in Russia in 1898 in Borisoglebsk and Voronezh.7

As the language spread internationally and was propagated by and among physicians, there were both positive and negative reactions. The example of The British Medical Journal can even be used to show a shift. In 1904, the language was described as a “body without a soul,”8 and in 1906, it was characterized as useless, since “when learnt nothing has been acquired but a mixed ‘pigeon’ jargon.”9 In later years, the journal devoted more lines to the Esperanto movement. The report on the International Medical Congress in Budapest in 1909 contains a separate paragraph on the attempt to introduce the language. Although the author of the report writes with praise on the number of participants at the meeting of Esperantists, he notes that the group did not arouse any further interest among other participants. Furthermore, he also states that the need for a new language was not felt at the congress.10 The journal also gave space to the following International Medical Congress in London in 1913. The dates of the meetings were announced before the congress, and a report on the meeting was published afterwards.11 In contrast to Budapest, the London Esperanto Club held a reception which was not only attended by Esperantists but also attracted other congress participants.12 Other large, internationally prominent medical journals such as The Lancet also printed submissions on the subject of Esperanto from 1905 onwards and abstained from making any critical remarks concerning the language that might have resembled the remarks found in The British Medical Journal.13

The Esperanto movement took a big step towards international cooperation in 1905 when it held its first World Congress in Boulogne-sur-Mer. After principles of the language and the movement were discussed in Boulogne, expert meetings were held at the congresses from 1906 onwards. At the second World Congress, Henri Dor, who later served as TEKA president, chaired the joint session of physicians and pharmacists. The discussion centered on an anatomical dictionary compiled by a group of French Esperantists.14 In 1907, during the congress in Cambridge, the doctors were already meeting separately. There, the assembled doctors decided to join the Internacia Scienca Asocio (International Science Association), an Esperanto science society founded the previous year, as a specialist section. A proposal was made to contact an existing multilingual medical journal and request that it publish an Esperanto supplement.15 The following congress in Dresden in 1908 led to the founding of TEKA.

The Creation and Development of TEKA

The institutionalization and organized unification of Esperanto physicians were achieved with the founding of TEKA. In TEKA’s self-portrayal, the Polish doctor Wilhelm Róbin16 is often listed as the initiator and founding father.17 The reason for this was his article published in Voĉo de Kuracistoj18 (Voice of Physicians, henceforth VdK) calling for the foundation of an Esperanto Medical Society before the World Congress in Dresden.19 However, Róbin was not present at the congress and Leon Zamenhof took over the presentation of the project there.20 The fact that the idea came from Róbin is not mentioned in the minutes of the Dresden congress. Furthermore, it must also be pointed out that Róbin was not the first Esperantist with the idea of founding an Esperanto Medical Society. This idea had already been advocated by Bronisław Skałkowski, Szczepan Mikołajski, and Izrael Fels in an appeal in the Polish Medical journal Głos Lekarzy (Voice of Physicians, henceforth GL) in November 1907.21 Whether Róbin was aware of this appeal is not known. This is also contradicted by the fact that his name is not found among the subscribers to GL in 1907. Although the first appeal in GL did not lead to the founding of TEKA, the goals were consistent. The authors identified the first and most important task as the foundation of an association of Esperanto physicians in all countries. This association should represent the interests of their members at international medical congresses and advocate the introduction of Esperanto as a congress language. The creation of an international organ for the worldwide members was also planned. At the end of the appeal, it was noted that it should be sent to all the doctors listed in the Tutmonda Jarlibro Esperantista 1907 (Worldwide Esperantist Yearbook). Furthermore, everyone should forward this appeal and publish it in their native languages in national journals.22 We do not actually know the extent to which this suggestion was actually implemented or the idea was circulated in other national medical journals.

Due to the rapid increase in the circulation of VdK in the summer of 1908, an increasing number of physicians formed an alliance in favor of Esperanto. Mikołajski presumably remembered his proposal from the previous year and again suggested the creation of an official association in July.23 In the following issue, which appeared only a few weeks before the upcoming congress in Dresden, Mikolajski’s idea was elaborated by Róbin and presented to the subscribers.24 As the official representative of the Universal Esperanto Association in Warsaw, he approached the headquarters and suggested the creation of the federation. At the second meeting of the Medical group at the Dresden Congress, an association was founded with the name Tutmonda Esperanta Kuracista Asocio on August 21, 1908. From the report in the official congress records25 and a more detailed version of this report in VdK,26 the founding of TEKA appears to have been a mere formality. Only the discussion about the future of VdK as an organ of the association was extensive, and the association to be founded was mentioned in the course of the discussion as a guarantee for the journal.

TEKA, as formulated in point 1 of its regulations, strived to promote “practical relations between Esperanto physicians of all countries.”27 The reports of the president, Prof. Henri Dor from Lyon, and the secretary, Dr. Wilhelm Róbin from Warsaw, in the first official yearbook of 1909 explained further goals and working methods. Dor reported the hope that all larger cities and health resorts would have at least one TEKA contact person who would supply the local physicians with information.28 Róbin added contacts in university towns to the list.29 He also mentioned the goal of propagating the language at the International Medical Congress in Budapest in 1909. For this purpose, an independent congress commission was formed, which had to demonstrate at the meetings in Budapest that it was possible “to hold a scientific speech and free discussions in Esperanto.”30 As a final goal, Róbin added medical excursions to various health resorts, which were to take place before the Esperanto World Congress in Barcelona or the International Medical Congress in Budapest in 1909.31 The positions already mentioned were supplemented with the addition of two vice presidents and a treasurer. These individuals formed the Central Committee. Ludwik Zamenhof also belonged to the Committee as Honorary President, as did his brother Leon Zamenhof as Honorary Consul.32 Furthermore, TEKA had seven honorary members at the beginning.33 At the national level, TEKA had consuls for 19 countries, including representatives for non-sovereign states such as Algeria and Poland. As further contacts, official representatives in 38 cities are listed in the yearbook.34

The Central Committee and the other members developed their own organizational structure of consuls and representatives. In 1910, the year in which membership was at its largest, TEKA had consuls in 29 countries, including non-sovereign territories, such as Bohemia, Galicia, and the Polish part of Russia.35 Representatives were found in 115 different cities.36 The representatives and consuls had the task of collecting membership fees from the physicians in their regions and sending them to the treasurer. The representatives in health resorts were later highlighted separately, with the indication that doctors could send their patients there. In 1911, 18 representatives from health resorts were listed, most of which were located in German-speaking countries.37

Due to the financial hardships TEKA incurred in order to publish its own journal, membership classes were introduced in 1912. The TEKA membership fee in 1912 was 2 Spesmilo;38 an Esperanto currency where 1 Spesmilo was the equivalent of half a dollar, 2.50 Swiss francs, or one ruble. First, the category of so-called protectors was created, who paid 10 Spesmilo a year.39 By the end of 1912, 28 members of the TEKA had earned the title of protector through their fees.40 In 1913, 21 members received the rank.41 Despite the additional financial support from the protectors, the expenses in 1913 could only be covered with reserves from the previous year. The difference was around 600 Spesmilo, which was equivalent to 300 more membership fees. As the Executive Committee was aware that a doubling of membership was not feasible, further membership classes were introduced. In the form of a “grant fund,” two further categories were introduced in addition to the protectors. The highest level became the patron, with an annual contribution of 30 Spesmilo, and the second highest level was the subventionist, with a contribution of 20 Spesmilo. In return, three issues of Kuracisto (Physician) were sent to the protectors, six to the subventionists, and 10 to the patrons for propaganda purposes. Furthermore, the groups of subventionists and patrons were given the right to elect their own TEKA vice president, who defended the interests of the journal in the Central Committee and cooperated with the editor-in-chief of Kuracisto.42 The last issue of Kuracisto before the war lists five patrons, two subventionists, and 22 protectors as of June 1914, which amounts to a further 410 Spesmilo in income and could have ensured Kuracisto’s continued existence.43

From the outset, the geographical distribution of TEKA members had its main concentration in East Central Europe.44 One of the reasons for this was the fact that the first official TEKA journal, VdK, was based in Lviv and had reached both Polish and Russian Esperantists even before TEKA was founded. As an early Esperanto stronghold with many academic Esperantists, France was the second hotspot. From these centers, a strong propagation of the language took place after the foundation, which is reflected above all in the far reaches of Russia and North America. The subsequent period led to the opening up of new cities and their medical communities and also in increase in the number of TEKA members on the ground. Depending on the activity of the local group and the commitment of the members, the dissemination of TEKA varied. From Warsaw, the method of Wilhelm Róbin is known, who contacted all the Esperanto doctors he knew with the simple sentence: “If you want to subscribe to the newspaper, please sign your name on the list and pay one ruble.”45 Almost all his colleagues signed, and this method was presented as an effective example at the TEKA meeting in Dresden.46

The membership development of TEKA can be traced through the official publications of the association. After the foundation in Dresden in August 1908, the first yearbook with an extensive list of members was published in spring 1909. Another yearbook was published for the year 1910, showing an increase of about 200 new members. A new yearbook with the membership list for 1911 was announced but never published.47 Therefore, for the following years, the list of paid members in the treasurer’s reports is used to trace membership development. What is particularly striking about the overview is the rise towards 1910 and the drastic fall in the following year, which was caused by the discontinuation of VdK as the official journal. The 1909 yearbook presented the membership figures shortly after the foundation of TEKA. In 1909, information about the existence of the association spread worldwide. A decisive factor was the official organ of the association, VdK, which had been in existence since the spring of 1908 and had almost 800 subscribers in 1909. At the end of 1910, however, cooperation between TEKA and VdK came to an end. At the beginning of 1911, the association had a new organ, but it was suspended after two issues. It was not until August 1911 that a new members’ magazine was published. The Oficiala Bulteno de TEKA (Official Bulletin of TEKA) contains a critical report on membership development by Wilhelm Róbin, who was secretary at the time:

The activities of the TEKA Committee were paralyzed48 in 1911 in the full sense of the word. We did not propagate the Association because we could not do so due to the known major obstacles that occurred on the part of Dr. Th[alwitzer] (regarding the Oficiala Bulteno). We did not dare recruit new members and promise them regular delivery of the official organ... We experienced a terrible period. From all sides, complaints, protests, and just demands! […]

The number of TEKA members is constantly growing, but unfortunately, this year we have lost many members who have been offended by the inaccuracy of our Internacia Medicino organ and by the stubborn silence of its publisher, who did not even respond to letters and prepaid telegrams.49

The publication of Internacia Medicino (International Medicine) under Adolf Thalwitzer as editor led to various problems. The first edition was published without proofreading and without TEKA’s consent, resulting in several errors in quotations and mention of authors. Before the second issue, Thalwitzer had already received money in the amount of 186 membership fees for further publication, but he then no longer replied to letters from the committee, so cooperation between Thalwitzer and the TEKA was discontinued.50 Compensation for this long period of declining membership could only be made through the constant publication of the journal Kuracisto from 1912 onwards. For the year 1914, Kuracisto contains evidence of 215 membership subscriptions received; however, the journal ceased to exist in June 1914, so the complete membership figures for the year are not known.

The further general development of TEKA remained unchanged. In 1910, a separate TEKA Congress was held at the UEA Congress in Augsburg.51 The official Esperanto World Congress took place in Washington. It was attended by only a few Europeans because of the long distance. In the period just before the outbreak of the war, TEKA congresses were held during the World Congresses, with frequent visits to local institutions and clinics. Two lines of development were of particular importance: first, the TEKA medical newsletter as a link among the members, and second, cooperation with the International Red Cross.

Esperanto Medical Journals

The Esperanto-speaking medical community urged for correspondence journals early on in order to present their national findings to an international audience through the multitude of different nations. The first medical articles were published in Internacia Scienca Revuo (International Science Review), a generic scientific journal in Esperanto which was published in Paris from 1904. The Parisian Esperantists noticed the lack of a medical journal and began to publish Internacia Revuo Medicina (International Medical Review, IRM) in 1906.52 This journal presented original articles in German, English, or French in one column and the respective translation in Esperanto in another column. Four issues of this journal were published that year before it ceased to exist. The editors’ reports mentioned complaints about high subscription prices. Furthermore, it seemed that the desired number of subscribers and the general scope of the journal had not been achieved, as most of the articles were from French medical publications and thus French subscribers had little reason to subscribe.53 The IRM is mentioned in the dissertation by Pierre Corret about the adoption of an international auxiliary language in medicine. According to Corret, it failed due to the lack of an interested audience.54

Voĉo de Kuracistoj,55 on the other hand, was more successful and long-lived. This journal emerged from an existing Polish medical journal, Głos Lekarzy, which had already been successfully published in Lviv for several years. The editor, Dr Szczepan Mikołajski,56 initially planned only the introduction of an Esperanto section in his journal, but he was then encouraged by the high number of favorable responses to publish an independent journal. Two issues appeared in 1908 as free supplements, and from May 1908, the journal existed until its last issue in November 1911. Mikołajski also made use of the contributions from VdK for his newspaper GL and published Polish translations. He thus enriched his journal with many international contributions. The first issue of VdK from April 1908 was primarily aimed at Polish-speaking doctors, who had already been subscribers to GL. In an appeal to his fellow physicians, Mikołajski therefore formulated the aim of the journal to give Polish medicine and its achievements a proper forum, as it had hitherto been internationally underrepresented.57 Although the journal remained in publication for only about four years, it was one of the longest-lived Esperanto journals before World War I. Between 1908 and 1910, VdK was the official organ of TEKA. However, as there were financial discrepancies in the forwarding of membership fees to VdK editorial office throughout this period and TEKA refused to accept Mikołajski’s new conditions, he resigned from publishing it as the official organ.

Mikołajski distinguished himself as an experienced publicist who had been publishing his Głos Lekarzy in parallel since 1903. The journals provided clear structures and, by listing the coauthors and subscribers, they allowed for a variety of investigations. The year 1909 is suitable as a focus of inquiry since it was the year in which the first complete volume was published and VdK was the organ of TEKA for the entire year. The three areas that will be examined in more detail are: 1. the subscribers to the journal, 2. the authors, and 3. the reviewed journals.

Subscribers

The distribution of subscribers can be visualized with the use of a map.58 In 1909, the magazine listed its subscribers. A total of 1,005 entries can be found, but there are repeated entries and orders for multiple journals to the addresses of Esperanto clubs. Adjusted for these factors, the number of subscribers was 770. The subscribers were be found in 367 different locations. The main focus was clearly in Europe and a broad strip in the north of the USA. When looking at the individual cities, Warsaw leads with a figure of 64 subscribers.

Table 2. Amount of VdK subscribers in 1909 per city (more than 10) compared to TEKA members in 1909 and 1910

1 T.E.K.A.-Jarlibro 1909.

2 T.E.K.A.-Jarlibro 1910.

VdK already benefitted from its function as an official TEKA organ in 1909. The 1909 TEKA Yearbook lists 428 members, which means that about 300 non-TEKA members belonged to the circle of subscribers. The comparison of subscribers and TEKA members shows that, in the cases of Rio de Janeiro, Dublin, and Budapest, many subscribers joined TEKA in 1909. However, it is not yet possible to explain how the high number of 46 subscribers in Rio de Janeiro was achieved. The high number of subscribers in Lviv probably correlates with the place of publication as well as the connection to Głos Lekarzy as the predecessor journal. In Europe, there were many places where only one or a smaller group of subscribers was located. Larger accumulations were found in capitals such as Paris, Stockholm, Budapest, and Bucharest. Furthermore, no coherent clusters can be identified. The subscribers in the German Empire were relatively widely distributed. High subscriber numbers in Warsaw, Lviv, and Lodz provided a high absolute number of subscribers in Polish-speaking lands.

A cluster already noticeable in other visualizations, such as the World Congress participants, TEKA members, or publication sites of other Esperanto journals, can be identified north and along the 50th latitude. This connectivity belt 59 stretched from Dublin via London, Belgium, northern France, and central Germany through Bohemia and the Polish-speaking lands into the Russian countryside and ended around Moscow, at a similar latitude to Dublin.

Contributors

The following table shows the most active collaborators of VdK sorted by the number of their contributions in 1909. The high number of contributions is mainly due to scientific reviews of national novelties. The internist Izrael Fels, who, like Mikołajski, was based in Lviv and was already actively involved in Głos Lekarzy, ranks first. Fels frequently reviewed articles from Polish and German medical journals, but he also wrote reviews of English, Italian, French, and Russian publications in all disciplines; 97 of his articles were reviews and a correspondence. The large gap between Fels and L. Jenny is striking. With half as many contributions, the military physician Jenny submitted the second most articles. Jenny’s contributions are exclusively reviews. He covered solely French medical journals but he dealt with all areas. In third place is the Russian physician V. Sobolev from Poltava, who contributed 36 reviews and one correspondence. Sobolev mainly covered Russian medical journals, and he also wrote on all fields. The places of residence of the authors listed here also correspond to the general distribution of the other contributors. Although there were also submissions from Australia, the Philippines, Japan, and the USA, the focus was clearly on East Central Europe and France.

Table 3. Contributors with more than 10 articles in 1909

However, no first publications of medical findings took place in VdK. In addition to a review section, the journal mainly collected international submissions to surveys initiated by the editor Mikołajski. The surveys were about more general medical matters, such as medical secrecy or the right to Sunday rest. On the one hand, these surveys were passed on to national medical journals,60 but Mikołajski also used the submissions to enrich his Polish journal Głos Lekarzy with international submissions.

Reviewed journals

The last unit of investigation to be considered is that of the reviewed journals. From Mikołajski’s goals for VdK, it is clear that he wanted to give the internationally underrepresented Polish science a larger potential audience through his journal. It would therefore had been reasonable to assume that, alongside Polish medical journals, journals from other smaller countries would also be represented. However, the following overview shows that mainly Russian and German journals were used as sources for the reviews.

Table 4. Overview of reviewed journals with more than 10 articles

Both the overview of the reviewed journals and the following overview of the source languages show that Mikołajski’s goal was only partially achieved. German, French, and also Russian journal articles reflected the leading nations in medicine at the time, and they also corresponded to the backgrounds of the subscribers and contributors to the journal. However, the fact that Polish articles, of which there were 31, are ahead of English articles, of which there were 17, shows an increase in publication, which can, admittedly, be explained by the small number of English-speaking contributors.

These three examples show the reach and influence of a small and young periodical from the province of Galicia. After one year, VdK was able to build a functioning and coordinated editorial team. The two most important units, subscribers and contributors, were mainly based in East Central Europe, and their involvement with VdK ensured the transfer of medical knowledge and the supply of national findings to a worldwide subscriber base. The analysis of VdK exemplifies a platform for international medical cooperation. Although no medical discoveries were first published in VdK, the strength of the journal lay in the reviews of national findings. The coverage of German, French, and Russian articles made medical news from the countries which were leaders in medical research available to an international audience. The circulation of knowledge was successfully pursued in the medical journals of the Esperanto movement. However, it was mainly smaller nations that benefited from the reproduction of medical research in Esperanto. Since medicine, at least in Central Europe, was often dominated by English, French, and German before World War I, the journals served those who did not speak these languages themselves.

After VdK ceased to be the official organ of TEKA at the end of 1910, it was not until 1912 that a new medical journal in Esperanto was published. Internacia Medicino published two issues in 1911, followed by the Oficiala Bulteno de TEKA from 1911 to 1912, which served more as a newsletter of the association than as a medical journal. The journal Kuracisto, which was published in Warsaw from 1912 onwards, was the last prewar journal until the outbreak of war in 1914 and, like VdK, it was in the hands of Polish Esperanto doctors. After World War I, Internacia Medicina Revuo was published from 1923 onwards, and its successor, Medicina Internacia Revuo, is today the official organ of the Universala Medicina Esperanto Asocio, TEKA’s official successor organization.

Esperanto and the Red Cross

While the Polish Esperanto doctors were primarily involved in the work of the journal, cooperation with the Red Cross was largely in the hands of French Esperantists.61 The French Lieutenant Georges Bayol published a booklet in French on Esperanto and the Red Cross in 1906. In this book, Bayol described the necessity of an international language for the Red Cross. The book also contains basic information on the language and its structure, as well as vocabulary lists and possible conversations in French and Esperanto.62 Records of a gathering of Red Cross members at the international Esperanto congress in Geneva also exist for the same year.63 Bayol spoke at the opening session of the Geneva congress on the introduction of the language within Red Cross societies, pointing out the great benefits of language in the societies.64 At the third working session, he addressed the issue again and proposed that Esperanto should be spoken by Red Cross members who were providing or receiving care. Furthermore, he appealed to the English Esperantists to put the Esperanto question on the agenda at the next International Red Cross Conference in London in 1907.65 The congress supported Bayol’s proposal and published the following resolutions supporting the introduction of Esperanto within the Red Cross:

Considering that because of the variety of languages spoken by the wounded, sick, and nurses in war, the use of Esperanto would facilitate the care of the sick, The Congress expresses the wish that the subject of “The language Esperanto applied for Red Cross Services” be included in the program of the next International Conference of the Red Cross to be held in London in 1907 that one or more Esperantists discuss this subject at the London Conference; that very active propaganda be made for Esperanto in all societies helping those wounded in war.66

A discussion of this request at the London Red Cross Conference in 1907 did not take place, as the request was submitted too late.67 Nevertheless, the efforts of individual Red Cross societies to bring Esperanto into their associations did not stop. In 1908, the Société Française Espéranto-Croix-Rouge (French Esperanto-Red Cross Society, SFECR) was founded concurrently with TEKA.68 Starting with the 1908 World Congress in Dresden, maneuvers were carried out in cooperation with the local Red Cross as part of the congress program to demonstrate that basic medical care was possible in Esperanto. Among the participants were local volunteers, who had had to familiarize themselves with the language in the previous months, as well as congress participants and delegates of the Red Cross. The first of these maneuvers took place in Dresden and was continued in Barcelona and Antwerp in subsequent years. Representing the Red Cross at the Dresden Congress was Adolphe Moynier, son of Red Cross cofounder Gustave Moynier, who acknowledged the serious progress of the language and its uses in various fields. Furthermore, he was positively surprised that, in preparing a Red Cross maneuver, the organizers managed to teach the nurses enough Esperanto in ten lessons to enable them to follow instructions and answer questions.69

The procedure of such an Esperanto Red Cross maneuver is described in detail for the year 1909. During the Barcelona Congress, the participants in this maneuver consisted of members of the Spanish Red Cross and the international congress participants. After being transported to the casualty station, the wounded were questioned and examined by doctors and nurses. The diagnoses and personal data were noted on special cards in Esperanto. The next step involved transport to the field hospital, where the wounded were classified according to their diagnosis cards. The last step was the removal of the wounded. As a result, the exercise was perceived as positive by the whole group. According to the report, there were no difficulties in communication among the different nationalities. Due to the events of the Tragic Week70 in Barcelona in the forefront of the Congress, the language training of the Red Cross participants could only take place to a limited extent, but this was not noticed negatively during the exercise. At the Red Cross specialist meeting held during the Congress, the aspiration to introduce Esperanto to the organization was further discussed. The participants were convinced that the success of the exercise should be communicated. The report also indicated that some Red Cross groups had already offered Esperanto courses to their members. In addition, the Russian Red Cross had advised local committees to introduce courses on Esperanto. The US Secretary of War was also reported to have brought Esperanto to the attention of the National Red Cross.71

At the 9th International Conference of the Red Cross in Washington in 1912, the Esperanto issue was successfully presented. Madame Lardin de Musset from the SFECR presented the advantages of using the language in the Red Cross and reported on successful applications in maneuvers during Esperanto congresses. The speech was supported by an Esperantist from Cuba, who reported on the success of Esperanto in his home country. As the proposal to introduce Esperanto in the Red Cross again had not been registered on the agenda, the conference leader announced that it would be forwarded to the Central Committee of the Red Cross.72 An official endorsement of the language was not offered by the Red Cross until a few years after the war. At the 10th International Conference of the Red Cross in 1921, a resolution was adopted that the national societies should encourage their members to learn Esperanto.73 The cooperation of the Esperanto movement with the Red Cross was welcomed by TEKA and mentioned in many places in its publications. However, it is noticeable that most of the supporters came directly from the French Red Cross and had mainly humanitarian backgrounds. As inventions of the same period, the Red Cross and Esperanto are among many other “idealistic internationalisms” the members of which have often been active in several movements, and their networks overlap in many places.74

Conclusion

TEKA was a typical internationally oriented association of its era. In a globalizing world, Esperanto-minded physicians from Europe were looking for an organization for international exchange. By founding an association, TEKA was able to extend its scope to various continents, especially with the help of medical journals in Esperanto, and it benefited from international meetings through the annual Esperanto World Congresses. TEKA also found its way into international medicine outside the Esperanto world and was presented in medical journals or at medical congresses as a solution to the language problem. Due to horrifying experiences of the war, the introduction of Esperanto into the Red Cross was an important concern. A few years before the outbreak of World War I, several initiatives to establish Esperanto officially as a language within the Red Cross failed. It was not until the tragic events of the war that the delegates voted in favor of the dissemination of Esperanto in the Red Cross in 1921. Though TEKA gave stimuli to the medical world in a few instances, it failed in its attempts to introduce Esperanto as a congress language at the International Medical Congresses in Budapest and London and as a language in the Red Cross. The strength was in providing medical information in Esperanto. This was reflected in the success of the journals and the resulting high number of subscribers during VdK period. The attempt to continue the old heyday with and to compensate for the loss of many members was interrupted by the war.

Bibliography

Printed sources

Anonymous. “Alvokoj de la Komitato” [Appeal of the committee]. Oficiala Bulteno de T.E.K.A. 1, no. 1 (1911): 17.

Anonymous. “An International Language of Medicine.” The British Medical Journal 1, no. 2249 (1904): 320–21.

Anonymous. “Cirkulero al T.E.K.A.-anoj” [Circular letter to TEKA members]. Oficiala Bulteno de T.E.K.A. 1, no. 1 (1911): 1–3.

Anonymous. “Do Kolegów Esperantystów” [To fellow Esperantist]. Głos Lekarzy 6, no. 8 (1908): 6.

Anonymous. “Esperanto.” The British Medical Journal 2, no. 2746 (1913): 427.

Anonymous. “Seventeenth International Medical Congress.” The British Medical Journal 2, no. 2744 (1913): 262–64.

Anonymous. “T.E.K.A.-Anaro” [TEKA Membership]. Internacia Medicino 1, no.1 (1911): 29.

Anonymous. “The International Medical Congress.” The British Medical Journal 1, no. 2349 (1906): 33–35.

Anonymous. “The Sixteenth International Congress of Medicine.” The British Medical Journal 2, no. 2543 (1909): 887–90.

Alexander, Robert. “Kasa Raporto, Por Aprilo 1914-a” [Cash report for April 1914]. Kuracisto 3, no. 6 (1914): 92–93.

Bayol, Georges. Espéranto et Croix-Rouge. Paris: Hachette, 1906.

Brzostowski, Aleksander Bolesław. Adresaro de Polaj Esperantistoj por 1909 [Addressbook of Polish Esperantists for 1909]. Warsaw: Jan Günther, 1909.

Dor, Henri. “Al Sinjoro D-ro Thalwitzer” [To Dr Thalwitzer]. In T.E.K.A.-Jarlibro 1909, edited by Tutmonda Esperanta Kuracista Asocio, 9–11. Kötzschenbroda–Dresden: H. F. Adolf Thalwitzer, 1909.

Dua Universala Kongreso de Esperanto [Second Universal Congress of Esperanto]. Edited by Esperantista Centra Oficejo. Paris: Esperantista Centra Oficejo, 1907.

Jameson Johnston, George, Konstantin Ŝidlovskij, and Karl Weiss. “La centra komitato de T.E.K.A. adresas al ĉiuj asocianoj sekvantan gravan sciigon” [The Central Committee of TEKA addresses to all associates following important notification]. Kuracisto 2, no. 10 (1913): 203–4.

Johnston, George. “Kasa Raporto por Aŭgusto, Septembro kaj Oktobro 1913” [Cash report for August, September, and October 1913]. Kuracisto 2, no. 10 (1913): 204.

Johnston, George. “Kasa Raporto por Septembro kaj Oktobro 1912” [Cash report for September and October 1912]. Kuracisto 1, no. 3 (1912): 47–48.

Krukovski, Samuel. “IV. Kongreso Esperantista en Dresdeno” [IV. Esperantist Congress in Dresden]. Vocho de Kuracistoj 1, no. 8 (1908): 82–86.

Mikołajski, Szczepan. “Organizo de la kuracistoj-esperantistoj” [Organisation of Esperantist physicians]. Vocho de Kuracistoj 1, no. 5 (1908): 45–47.

Moynier, Adolphe. “Raporto de la Internacia Komitato de la Ruĝa Kruco pri la 4-a Kongreso de Esperanto” [Report of the International Committee of the Red Cross at the 4th Esperanto Congress]. In T.E.K.A.-Jarlibro 1909, edited by Tutmonda Esperanta Kuracista Asocio, 43–48. Kötzschenbroda–Dresden: H. F. Adolf Thalwitzer, 1909.

Neuvième Conférence Internationale de la Croix-Rouge. Edited by The American Red Cross. Washington: Judd & Detweiler Inc., 1912.

Róbin, Wilhelm. “Kelkaj vortoj pri T.E.K.A” [Few words about TEKA]. Oficiala Bulteno de T.E.K.A. 1, no. 3 (1911): 53–58.

Róbin, Wilhelm. “Kion ni faris?” [What did we do?]. In T.E.K.A.-Jarlibro 1909, edited by Tutmonda Esperanta Kuracista Asocio, 12–16. Kötzschenbroda–Dresden: H. F. Adolf Thalwitzer, 1909.

Róbin, Wilhelm. “Organizo de kuracistoj-esperantistoj” [Organisation of Esperantist physicians]. Vocho de Kuracistoj 1, no. 6 (1908): 63–64.

Róbin, Wilhelm. “Raporto de la Sekretario” [Report of the Secretary]. Oficiala Bulteno de T.E.K.A. 1, no. 2 (1911): 26.

Rosenberg, Artur H. “Der Internationalismus in der Medizin und Esperanto.” Medizinische Reform 18, no. 19 (1910): 202–4.

Sebert, Hippolyte. “L’esperanto et les Sociétés de la Croix-Rouge.” Revue Internationale de la Croix-Rouge 3, no. 32 (1921): 803–14.

Ŝirjaev, Ivan. “Medicino” [Medicine]. In Enciklopedio de Esperanto [Encyclopedia of Esperanto], edited by Lajos Kökény, and Vilmos Bleier, 364–65. Budapest: Literatura Mondo, 1933.

Skałkowski, Bronisław, Izrael Fels, and Szczepan Mikołajski. “Odezwa do Lekarzy Esperantystów we wszystkich krajach” [Appeal to Esperantist physicians in all countries]. Głos Lekarzy 21, no. 5 (1907): 4–5.

Statuts et réglement intérieur. Paris: Société Française Espéranto-Croix-Rouge, 1908.

T.E.K.A.–Jarlibro 1909. Edited by Tutmonda Esperanta Kuracista Asocio. Kötzschenbroda–Dresden: H. F. Adolf Thalwitzer, 1909.

T.E.K.A.–Jarlibro 1910. Edited by Tutmonda Esperanta Kuracista Asocio. Kötzschenbroda–Dresden: H. F. Adolf Thalwitzer, 1910.

Thalwitzer, Friedrich. “Esperanto kaj la Ruĝa Kruco” [Esperanto and the Red Cross]. In T.E.K.A.-Jarlibro 1910, edited by Tutmonda Esperanta Kuracista Asocio, 46–51. Kötzschenbroda–Dresden: H. F. Adolf Thalwitzer, 1910.

Tria Universala Kongreso de Esperanto [Third Universal Congress of Esperanto]. Edited by Esperantista Centra Oficejo. Paris: Esperantista Centra Oficejo, 1908.

Vallienne, Henri, and Charles Verax. “Nia programo” [Our program]. Internacia Revuo Medicina 1, no. 1 (1906): 1.

Whitaker, E. T. “An Esperanto Society for Men.” The Lancet 2, no. 4287 (1905): 1292.

Zamenhof, Leon. “Kuracistoj” [Physicians]. In Kvara Universala Kongreso de Esperanto, edited by Esperantista Centra Oficejo, 145–48. Paris: Esperantista Centra Oficejo, 1909.

Zamenhof, Ludwik Lejzer [Dr Esperanto, pseud.]. Dr. Esperanto’s International Language. Translated by Richard Henry Geoghegan. Warsaw, Samenhof, 1889. Originally published as Международный язык (Warsaw: Kelter, 1887).

Secondary literature

Corret, Pierre. “Utilité et possibilité de l’adoption d’une langue internationale auxiliaire en medicine.” PhD diss., University of Paris, 1908.

Garvía, Roberto. Esperanto and Its Rivals: The Struggle for an International Language. Philadelphia: University of Philadelphia Press, 2015.

Geyer, Martin H., and Johannes Paulmann, eds., The Mechanics of Internationalism: Culture, Society, and Politics from the 1840s to the First World War. Oxford: Oxford University Press, 2001.

Guerrero, Javier. “Voĉoj de kuracistoj” [Voices of physicians]. Esperantaj Bitoj (blog) November 19, 2020, https://bibliotekoj.org/esperantajbitoj/vocoj-de-kuracistoj.html.

Golec, Józef. Słownik biograficzny esperantystów polskich [Biographical dictionary of Polish Esperantists]. Cieszyn: Józef Golec, 2010.

Gordin, Michael D. Scientific Babel: How Science was done before and after Global English. Chicago: The University of Chicago Press, 2015.

Hernández, José María Rodríguez. “The Esperantist Movement’s humanitarian activities in the two World Wars and its relationship with the International Red Cross.” International Review of the Red Cross 36, no. 312 (1996): 315–22.

Hoberman, John. “Toward a Theory of Olympic Internationalism.” Journal of Sport History 22, no. 1 (1995): 1–37.

Huber, Valeska. “Pandemics and the politics of difference: rewriting the history of internationalism through nineteenth-century cholera.” Journal of Global History 15, no. 3 (2020): 394–407. doi: 10.1017/S1740022820000236.

Lavarenne, Christian. “Espéranto: L’idée interne dans ses origines et quelques-unes de ses expressions et manifestations (aide ou obstacle à la diffusion de la langue?).” PhD diss., University of Paris 13, 2012.

Saunier, Pierre-Yves. Transnational History. Basingstoke: Palgrave MacMillan, 2013.

Tonkin, Humphrey. “Invented cities, invented languages: Esperanto and urban textuality, 1888–1914.” Language Problems & Language Planning 40, no. 1 (2016): 85–99. doi: 10.1075/lplp.40.1.06ton.

Pilch, Andrzej. “Mikołajski.” In Polski Słownik Biograficzny [Polish biographical dictionary], vol. 21, edited by Sobiesław Mieroszewski, and Władysław Morsztyn, 156–57. Wrocław: Zakład Narodowy im. Ossolińskich, 1976.

Wincewicz, Andrzej, et al. “Language and medicine in the Zamenhof family.” Acta Medico-Historica Adriatica 8, no. 2 (2010): 287–92.

Map 1. TEKA members around the world in 1909 (black dots) and new members in 1910 (white dots).

Table 1. Development of TEKA membership 1909–1913

Map 2. Global distribution of VdK subscribers in 1909

Table 5. Original languages of articles reviewed

The Influence of the Estate System and Power Relations in the Late Feudal Parliament Seating Plan

Tamás Dobszay
Eötvös Loránd University
This email address is being protected from spambots. You need JavaScript enabled to view it.

Hungarian Historical Review Volume 10 Issue 1  (2021): 129-154 DOI 10.38145/2021.1.129

“We shape our buildings and then they shape us,” Winston Churchill said when the question of rebuilding Westminster and modifying the interior of the House of Commons came up and he expressed his support for preserving the former system.1 Thus, according to the prime minister, a seating plan both expresses and determines the character and operation of parliamentarism. In light of this interconnection, in this essay I examine the formal characteristics of the late feudal Diet in Hungary between 1790 and 1848, as well as the power relations of the estates and strivings as they found expression within this system.

Keywords: 19th century, Hungarian Diet, late feudal parliamentarism, Estate system, use of space, seating arrangement of chambers

The Use of Space in Nineteenth-Century Modern Parliaments

The most striking difference in the seating plan in the Hungarian Diet before 1848 and that of representative parliamentary systems is the lack of both the horseshoe-shaped, that is, central pattern and the Westminster-style arrangement in Britain, with its benches which are facing one another. It is no coincidence that in the nineteenth-century continental parliaments, members of parliament sat on benches in closed, often ascending rows, reminiscent of ancient Greek theaters. The central arrangement of space (in the case of almost entirely closed circles, semicircles, and horseshoe shapes) helped ensure that each member of the assembly could sit at a nearly equal distance from the others, speak up, and see and hear one another, and it was the best way for the presidium, with which the semicircle came to a close, to chair the meeting, monitor developments, and notice if there were any need to intervene. Although the present paper does not lend itself to a comprehensive discussion of the use of space by representative institutions in the nineteenth century, a considerable amount of data indicates that this was the prevalent arrangement in most of the chambers designed for the assemblies established as a result of the revitalization of parliamentarism after the period of absolutism, and Hungarian contemporaries were well aware of this fact.

In many respects, the French parliament, which by 1830 had consolidated after the whirlwind changes brought about by the revolutions, served as a role model. As Transylvanian Farkas Sándor Bölöni pointed out when recording his travels in Europe in 1830,

“the chamber of deputies […] has public meetings […] The chamber has the shape of an amphitheater, and the deputies sit on the right or the left, according to their views. The audience sits in the balcony. Opposite the praeses, the journalists jot down the discussions. The Moniteur, as the official paper, sits near the seat of the praeses.”

Bölöni also noted that the speakers stood on a pulpit erected in front of the presidium. “If someone wishes to speak on a subject, he gets on the grandstand to give his speech, mostly reading from his papers.”2 A few years later, a similar description was provided by the young Bertalan Szemere (who was a member of the Diet a decade later and served as secretary of the interior in 1848), who did a lot to introduce the customs of parliamentarism in Hungary.

“The chamber is shaped like an amphitheater, with twenty white Ionian marble columns on each side, carved from a block, and a gallery of two rows behind them. There are ten rows of benches running parallel with the semicircle, and the windows on the vault, like the chamber itself, line up in a semicircle. The president’s seat and the marble pulpit are situated in the middle of the diameter.”3

Szemere ascertained the effects of arrangement and use of space on the members’ behavior and manner of speaking when he was learning about the British parliament and the discursive registers used there, as compared to French tradition. He suggested that the solemn tone of French speeches derives from the use of the pulpit: “In the [British] House of Commons, one does not hear the eulogizing pathos that pervades the French legislative chamber and which […] may also be attributed to the grandstand, because standing on it compels one to speak solemnly, so to speak,” a behavior uncharacteristic of the speakers in the House of Commons.4

The newly established Belgian National Assembly also followed the example of Paris. As Szemere pointed out, “the chamber of delegates is the exact replica of the Parisian chamber.” Bölöni made the same observation, but he described it in more detail and included mention of minor differences as well: “The chamber of the congress is indeed fine. The seats of praeses and members are arranged the same way as in Paris […] with the only difference being that the members can speak from their own place and sitting in the benches. Pro et contra oppositio members have the same arrangements.”5 It is a well-known fact that the central, almost entirely closed seating plan of the 1848 Frankfurt National Parliament is determined greatly by the oval floorplan of St. Paul’s Church, which hosts the assembly.6 The chamber of the Italian National Assembly, which became stable in 1861 after the events of 1848, was set up in Palazzo Carignano in Turin, with a floorplan similar to that of the Parliament in Frankfurt: in both chambers the seats were arranged in ascending rows in a semicircle.7 These assembles, however, all showcased the situation after revolution so, to varying degrees, they all broke from the former feudal systems. The Parliament of Württemberg,8 for instance, was established as part of the modern constitution that the monarch forced against the estates, which were demanding the reinstatement of the “ancient” constitution.

The British seating plan, with its facing rows of benches, is undoubtedly the result of the arrangement of the canon choir of St. Stephen’s Chapel in the Palace of Westminster: members of the House of Commons simply sat in the stalls of the former choir when they took possession of the building. The customary arrangement, which expresses the two-party system and the division between government and opposition, remained unchanged during reconstruction in the early modern period and in the chamber newly built after the fire of 1834. In Szemere’s words, the chamber of the House of Commons

“has a door-shaped pulpit in the middle of one end, where the speaker […] sits. In front of him, a desk covered in books and documents, next to which work three clerks wearing grey wigs. Along the longer walls, there are four ascending rows to the right and four to the left, with benches very close to one another and no desks in front of them […] by the way, the audience is allowed into the chamber if there is enough room, unlike in the French Parliament, where this is forbidden […] On the speaker’s right sit the ministers and their supporters […] on his left sits the opposition […] like two enemy camps.”9

A few years earlier, Bölöni provided a similar description, adding that
“[t]he members speak from their place […] The speech is always directed to the speaker.”10 This arrangement has persisted in its entirety and was later adopted by the Parliaments of other Commonwealth countries (e.g. Canada, Jamaica, Australia).

These seating plans conform to the particularities of modern parliamentarism. They express the duality of government and the assembly representing the nation, as well as the equality of the members within the parliament. As a remnant of the feudal system, the House of Lords, with its limited power, is located in a separate chamber. Considering the two models, it is the British parliamentary seating plan that emphasizes the two-party division of government and opposition. Churchill, too, argued in favor of keeping this arrangement by claiming that if British politics insisted on a two-party system, then the confrontational benches would clearly indicate the status of the MPs in the parliament: if one member sits on the other side, it will visually represent the change in his party affiliation, whereas the central arrangement with its contiguous rows meshes differences in party affiliation and enables the expression of transition, overlapping, and minor political differences.11

In contrast, from the perspective of the focus of this essay, the Hungarian Diet before 1848 can be linked to previous customs maintained with certain degrees of continuity with feudal systems.

Assemblies which Preserved Feudal Characteristics

Some European assemblies of the era passed on their feudal characteristics, customs, and concomitant uses of space to nineteenth-century legislation. In these institutions, the seating arrangement was determined by estates, rank, and, among those of the same rank, the principle of seniority.12 The latter was in fact transmitted to the more conservative upper houses of modern parliaments as well. In the nineteenth century French senate, for instance, “princes of royal blood, pairs by birth, sit right behind the chairman.”13

The plenaries of the Swedish Riksdag were rather unusual, as they placed the monarch and the assembly opposite each other, and the representatives of the four estates in two columns, sitting in benches reminiscent of desks in classrooms or church buildings. This seating plan persisted after 1789 and 1810, too: most of the members sat on benches lined up opposite the presidium. Although the four estates had their consultations and votes separately, the noble curia, for example, still used the same arrangement in its legislative chamber at the end of the century.14

From a Hungarian point of view, the Reichstag of the Holy Roman Empire is of particular importance, because also due to their shared monarch, it could influence the order of the Hungarian Diet developing in the seventeenth century. The historical assembly, which existed until 1806, was in fact not an elected representative body but a board of rulers of the provinces and cities with sovereign rights in the empire. The members and their delegates participating in the meetings surrounded the chamber, sitting parallel with the four walls. The seating arrangements conformed to the division into estates: the estates, forming three separate curiae within the assembly, had their own session halls, too, and during plenary meetings, they also sat separately, at a distance from one another. In the case of the latter, the speaker was the high commissioner of the emperor, the electors of the Holy Roman emperor sat on either side of him, and, perpendicular to them, down the long sides of the chamber sat the 120–150 sovereigns of the provinces. Members of the third curia, free imperial cities, sat in the back, opposite the emperor and the electorate. As for the first two curiae, ecclesiastical members were seated on the right and secular members on the left. Among the princes, with an individual vote of 96–98, those in lower ranks were grouped into an additional two ecclesiastical and four secular curiae, thus casting one individual vote each, that is, six more curial votes altogether. The seats closest to the emperor (or his delegate) and the speaker, as well as the ones on the right of the speaker were always considered more prestigious.15 On the other hand, the seating arrangement corresponding to status and rank in the estates determined the figure of the speaker, as well as the order of speech and voting in each board and the entire assembly alike.16 The different curiae, however, had varying seating plans. There was enough room for the seven-nine prince-electors at one table in their chamber, while the princes sat in two times four rows opposite the presidium in their own session hall (much like in the Swedish assembly), and delegates of the cities were sitting by the walls.17

Apparently, the seating arrangement of the plenary meetings of the Imperial Diet was not unique among old Diets of the estates. When the French États généraux assembled again in 1789 after a hiatus of more than 150 years, the plenary meeting had the same seating arrangement despite the high number of representatives. A huge session hall was erected on Versailles Avenue. The throne and the seats of the royal family were placed on a platform at one end of the hall, with the tables and the chairs of the ministers and the chancellor right in front of them; the clergy sat on the right along the wall, opposite the nobility on the left, and representatives of the third estate sat in the middle, opposite the throne.18 However, this arrangement could only be implemented at plenary meetings held with the permission of the king, while the estates were expected to have their sessions separately when holding serious discussions; thus, the revolution began with the three estates demanding to become a homogenous national assembly.

The Diets of Austrian hereditary provinces are not uninteresting to this discussion either, although due to their smaller size and limited roles they may only be partly compared to the Hungarian Diet. It is a well-known fact that the parliament of the Austrian Empire, established in 1804, only came to existence in 1861, after the prior events of 1848, but the individual meetings of its provinces formally persisted from the early modern period of the estates, though they had limited authority and not much weight. The assembly of Tirol prepared issues on the agenda by dividing into “quarters,” but the members of these quarters came from different estates and the decision was made collectively. The Landtags (Provincial Diets) of all the other provinces had three or four curiae (Vorarlberg had two), which held their discussions not separately but as groups in the chamber of the Landtag. The curiae were physically separated from one another in the benches of the chamber. They voted individually—in order by estates or by taking turns—in a way that the votes of cities were always cast at the end.19 The hall of the Styrian provincial meeting was arranged diagonally: the speaker’s table, where the minutes were kept, too, stood in the corner, the clergy’s benches by the wall on the right, and the benches of the other estates surrounded the middle part of the hall in a quadrangle shape.20

General Characteristics of the Use of Space by the Hungarian Diet

For members in the Hungarian Diet, the elongated shape of the chamber used did not lend itself to a horseshoe-shaped arrangement. The shape would not have ruled out the possibility of using the British Westminster style seating arrangement either, but it could not really prevail here. The arrangement conforming to the two-party alternating governments system, as well as to the parliamentary role of the king and the nation was considered so specific in Europe and suited the Hungarian public law system, still in a feudal state and not acknowledging the parties officially, so little, that its introduction was not even an issue back then.21

The Hungarian Parliament used three buildings between 1790 and 1848. The building in Buda shaped for this purpose only hosted two and a half Diets (1790, 1792, 1807) of the fourteen held. On the first occasion, the second half of the meeting took place in the old Landhaus in Lange Strasse in Pozsony (Pressburg, today Bratislava, Slovakia), the venue for the 1796 Diet for the entire duration of the assembly. From 1802 to 1848, the Diet used the parliament converted from the financial management building in Michaelstrasse in Pressburg. In all three buildings, the chamber of the Lower House had an elongated, irregular rectangular shape. The halls designated for the Upper House could have been more suitable for meetings, but few of the authorized participants actually attended the sessions.22

Between 1790 and 1848, the Hungarian Diet maintained the previously designed seating plan. Besides division by estates, discussed below, this traditional arrangement also reflected the mindset of the political dualism of the king and the estates.23 The chambers of the Diet were given a linear arrangement: in both houses the speaker representing the king sat at the short end, while along the entire length of the hall there sat the subjects, the estates constituting the political community, on both sides of a long line of tables, one line in the Upper House and three in the Lower House. From the speaker’s seat, as if he were sitting at the head of the table, one could see the entire chamber without having to turn one’s head. This solution was in accordance with the idea of head and body, and may also seem, at first glance, to be a practical one, corresponding to the shape of the hall. Of course, this meant that some members sat very far from the presidium and those sitting at the opposite ends of the table could barely hear one another. It is no wonder, then, that having a strong voice was a vital prerequisite for attending these meetings, and soft-spoken, gentle souls like Kölcsey had but the weight of their personal reputations to ensure them the attention of the gathering.

Another distinctive feature of the arrangement, in contrast with the European customs emerging at the time, was that deputies were seated by large tables on comfortable portable chairs, instead of closed rows of benches. In the early twentieth century, journalist Károly Eötvös, drawing on the memoires of contemporaries, highlighted that more than any modern seating plan, this arrangement better suited the convenient, patriarchal circumstances of reputed noble members, who would have objected to being forced to sit at “school desks.”24 Indeed, portable chairs facilitated freer movement; Kossuth, for example, regularly gave his speeches at the last Diet by turning towards the presidium while standing behind his chair and holding its backrest.25 This had a special significance because, as opposed to the clergy who spoke while sitting, members of both the Upper and the Lower House indicated their request to speak by standing up and staying upright.26

In both houses, the place of the members was clearly determined by the authority of the estates, grouping by status within the estate, and, in the Lower House, customs defined by geographical distribution as well. Similarly to the universal historical particularities mentioned above, the seats considered most prestigious were the ones on the right of and closest to the chairperson.27 In this case, too, the seating plan indicated the rank of the estates and the prestige of members. There was another difference deriving from these arrangements, though, as compared to the later parliamentary period: both in the Lower House and partly in the Upper House as well, members were sat next to one other not on the basis of their political or party affiliation, but according to their place in the status hierarchy.

The Seating Arrangement in the Upper House

In the House of Lords, the palatine (always a prince of the dynasty from 1790 on) sat at the head of the table, which was placed in the middle of the chamber and ran its entire length. To his right, the whole right side was reserved for the first estate, the prelates; right next to the palatine there sat the most prestigious high priest, the prince primate of Esztergom; then the archbishops of Kalocsa and Eger, and then all the bishops. Among them, the exact place of the diocesan bishops was determined by the date of their consecration, as part of the principle of authority. Titular bishops, who were elected but not yet consecrated or had no operating diocese, sat farther down. Superiors of the ecclesiastical convents in bishops’ ranks, abbots with mitre, the arch abbot of Pannonhalma, the grand provost of Zagreb (at the same time, the prior of Vrana), and the grand provost of the Premonstratensians of Várad sat at the far end of the table.28

The left side of the table was reserved for the barons holding high offices. Their first group was divided according to the rank of their office: the lord chief justice (judex curiae) was followed by the ban of Croatia, the master of the treasury (magister tavernicorum), and then, the court officials, in accordance with the date of their appointment (magister janitorum, mg. pincernarum, mg. dapiferorum, mg. agazonum, mg. curiae regiae). Further down there sat the county governors: supreme comites (lord leutenants or county high sheriffs), first hereditary and sempiternal, then the other in the order of their inauguration, and finally the governor of Fiume, and the deputy of Croatia in the Upper House. Until 1840, orthodox archbishops and bishops, who were granted participation in the Diet only in the late eighteenth century, also sat at this section of the table. The row of the high priests turned back to the side of the secular members of the Upper House at the end of the table.29 It must be noted, though, that many of the bishops and the office-holders did not stay continually at the venue of the Diet, and this was even more so the case with those lords who did not hold any offices but had titles by birth, such as dukes, counts, and barons.30 For this reason, discussions were sometimes held in smaller rooms, in a more informal way even. In January 1826, for instance, due to the low number of participants and the cold, the palatine held the meeting in his own chamber; and there is also some evidence of chairing from one’s sickbed.31 Titular (non office-holder) lords only had some single chairs without tables with no precise arrangement on both sides of the chamber, right in front of the rail dividing the assembly and the audience.32 There were, however, some signs of seating arrangement according to agreement in opinions among titular peers: those of the same view often favored sitting close to one another, and those remaining for a longer time customarily preferred using the same seat. But the somewhat stubborn lords were not really willing give up some of their independence and function in a more disciplined manner, like a party, or were only willing to do so towards the end of the era, so their seating arrangement, or the lack thereof, may be considered a tendency prevailing only to a degree and not a rule per se.

Not only did the seating plan have a symbolic meaning but it also determined the degree of influence on decisions; the palatine could best hear the speech of prestigious members among all the speeches considered from the perspective of rank, so the voices of those sitting in the far end of the chamber did not count much as compared to those of regni barones and officeholders. Men of the court and the royal government thus had an opportunity to monopolize discussions and decisions. Partly due to the principle of authority and the court policies, and partly because of most lords being loyal to the court, it was rather surprising when a member of the Upper House, especially one without an office, acted individually and expressed his opinion.33 The Transylvanian Bölöni, too, described the members of the Upper House as obedient to the royal authority:

“The palatine comes out of the adjoining room, followed by the primate, and all the lords, frightened like pupils, run to the table and sit down in silence. The host of bishops settle on one side of the long table, the dignitarians on the other side, the ‘regalists’ at the back […] The subject is finally discussed, if we may refer to the speaker’s will and the bishop’s approving bow as a discussion, and soon […] the submissive bill concerning the serves is ready.”34

The seating plan in the Upper House, imposed strictly at the table but less formal in the back, was eventually modified. Rearrangement took place in 1843; the main aim was to isolate the audience from the decision makers and drive them out of the chamber, although they were later allowed to take the empty seats.35 A considerable transformation was made at the end of the era, but several customs connected the seating plan persisted. According to the magazine reporting on the Diet of 1847–1848, the long table in the middle was kept (b) but, running parallel with it along the chamber, three rows of six long tables were placed on each side, gradually ascending and having a gap in the middle (c and d), to be used by the supreme comites and high priests who could not get any seats at the middle table. The rest of the seats were given to lords without an office. A bit farther back from the presidential seat (a) there were two smaller tables perpendicular to the others: orthodox bishops were seated at the table on the right (e) and the archivist at the one on the left (f). Right behind the palatine’s chair in the middle, by the wall, sat his officials (E) and, on their two sides, the shorthand writers (g and h). Four out of five window niches were given to newspaper reporters (k). Along the long side of the chamber overlooking the courtyard, members of the Lower House could be present as audience on a stand behind a rail (l), while by the wall opposite the presidency, likewise separated by a railing, the audience could sit in ascending rows (m).

Figure 2. The seating plan of the Upper House after rearrangement in 1843 (1847–1848) (“Országgyülési rajzok 1,” Ábrázolt Folyóirat January 8, 1848, 12.)

The Seating Arrangement in the Lower House

In the Lower House, the duality of the monarch and the estates, status within the estate, and geographical considerations likewise determined the distribution of seats. The seat of the chairing personalis (chief justice of Royal Court of Appael) was positioned on a wide podium, a few steps above the floor, at the corner-stoved end of the rectangular chamber. Right behind it, members of the Royal Court of Appeal, formulating the documents of the Diet, had a table, standing on its own before 1832. Perpendicular to the speaker’s table, three rows of tables reserved for the delegates were lined up along the entire length of the chamber.36 As seen elsewhere, the “upper seats,” i.e. the ones closest to the speaker on his right were reserved for the clergy, the representatives of chapters. At the middle and left-side tables, close to the speaker, there sat the delegates of the nobility, elected by the general assemblies of the noble counties, two from each county. The upper seats of the middle table were taken by delegates from counties situated along the Danube River in the western part of the country, while delegates from the eastern region, from counties by the Tisza River, sat at the table on the speaker’s left. The two delegates of each Danubian county customarily sat next to each other, while the ones from the Tisza region always sat opposite each other. However, this had no political significance whatsoever.37 In the previous century this was the usual seating arrangement for chapters and counties, so the only divergent seating plan, which was used at the 1741 Diet, is considered to have been an exception, perhaps a mistake made by the source recording the meeting.38

Groups that had a collective privilege but no individual noble titles were placed farther from the speaker, in accordance with their lower rank.39 This way, the secondary status of cities was indicated by the fact that their delegates sat at the far end of the counties’ tables. The only exception was the two delegates of each privileged free district incorporated in 1791 (Jászkunság and Hajdúság), who sat right after the chapters’ delegates, at the farther end of the right-side table.40 The few empty seats at this table were given to delegates of absent members of the Upper House; this, however, did not indicate their rank but the roles customarily attributed to them. As a matter of fact, although under the law these delegates also had a voice in the Lower House, in the nineteenth century, the delegates of the counties did not even let them speak, let alone vote. The noble deputies of the counties looked at the latter with jealousy and disdain, considered them “servants” of the lords, and contested their legitimacy as participants. The most these delegates could do was inform the lords they substituted, who had the right to vote in the Upper House anyway, and so the lower nobility tried to neutralize the influence their lords had through them.

A change in the situation of delegates sent by absent members of the high nobility is likewise interesting: while in the first half of the eighteenth century they were seated closer to the speaker, between the counties-chapels and the cities, i.e. they were higher in rank than the latter, after 1790 they were pushed to the far end of the chamber. Opposite the speaker’s podium, in the other end of the long chamber by the angled short wall, there was another part separated by a railing. From there, a staircase led up to the gallery reserved for the audience, below which the rest of the audience and the delegates of the high nobility with no room at the table were crowded together.

The Impracticability and Rearrangement of the Seating Plan

As noted earlier, this arrangement, which conformed to the shape of the chamber and to power relations among the estates, was not without problems. For those seated far from the speaker, the unfavorable position hindered their effective participation in the discussion; furthermore, since decisions were often made not by counting the votes but by the speaker listening to the participants’ opinion and considering it on the basis of their rank, the influence of those sitting in the back was limited during decision-making as well.

Partly due to the objection of those in a favorable position, their contemporaries recognized the impracticability of the seating arrangement. Sometime between 1820 and 1833 Palatine Archduke Joseph as the President of the whole Diet had a floorplan made to rearrange the two chambers in Buda41 but as the king chose Pressburg, the estates eventually stuck to the traditions because of the temporary circumstances. Thus, however, repeated complaints were made about the seating arrangements. On November 27, 1830 delegates of Temes and Torontál (characteristically two counties that were liberated from Ottoman rule late and reincorporated even later, so their delegates were seated at the far end), asked the president to “do something about the placement of the delegates seated far, as because of the distance they could not always hear the speech of those sitting in the front, and thus could not effectively participate in the discussions of the Diet. A host of similar complaints were made by the other delegates who were seated far from the speaker owing to customary laws,”42 but eventually rearrangement was postponed to the next Diet.

These complaints may have been the reason for the palatine’s aforementioned attempt to rearrange the chamber in Buda, but the issue came up at the beginning of the 1832 Diet in Pressburg as well. The palatine suggested that the impracticable seating plan of the chambers be transformed based on the experience of the previous Diet.43 Presumably, the estates felt it was necessary to protect and express their autonomy from members of the Upper House, which would also indicate the significance of the differences between the estates, and they did so by rejecting the palatine’s initiative: they “sent back” the palatine to the members of the Upper House, saying that they had the right to sit wherever they wanted to. This was obviously an exaggeration, as customs strictly limited them in this respect as well, so in the end they implemented the changes by mutual agreement.44

In the new seating arrangement (1833), delegates of the clergy were placed on the speaker’s platform, at separate tables on the two sides of the Royal Court of Appeal.45 The reason for this was partly because the palatine and the president intended to help them out in their difficult situation in the increasing debates on ecclesiastical policy, and separate them from the delegates of counties, who often attacked them.46 As for the three long tables, the one on the speaker’s right was still reserved for the free districts and delegates of those absent, the now free seats of the clergy were given to some deputies of the Danubian counties, and those representing the counties by the Tisza were sat at the inner side of the table.

Figure 3. The chamber of the Lower House after 1833. Groitsch, A. J.
(Hungarian National Gallery)

Farther away from the presidium, the counties were given the seats of the chapters at the right-side table and were seated as follows: the Danubian counties of Sopron, Nógrád, Komárom, Hont, Baranya, Esztergom, Tolna, and Turóc on the outer side; Sáros, Szabolcs, Borsod, Torna, Máramaros, Csanád, Torontál from the region of the Tisza and the Slavonian Verőce (Virovitica) county on the inner side. On the left, the rest of the counties from the Tisza sat opposite each other, as usual. This was important because the delegates first in rank sat on the right, and those elected at second place were placed on the left. Also, back then the records of the Diet did not specify the name of the delegates, but only a number and the name of the county they represented. It was only after 1839 that the two delegates of a county were regarded as equal.47 The delegates sat at this table in the following order: Abaúj, Zemplén, Ung, Szatmár, Szepes, Gömör, Heves, Bereg, Ugocsa, Bihar, Csongrád, Békés, Arad, Temes, and Krassó, Pozsega (Požega) County in Slavonia and the district of Turpolje. By the table in the middle, delegates of some Danubian counties followed the old traditions and sat (in contrast with delegates from the Tisza region) next to one another: close to the speaker on his right sat the delegates of Pozsony county, then of Vas, Zala, Somogy, Győr, Fehér, Moson (all Danubians), followed by the two delegates of Bács, originally seated on the other side due to having been organized belatedly and thus having to make do with the seats they received here. On the left side of the middle table, the seats were given to the rest of the counties by the Danube: Nyitra, Trencsén, Liptó, Bars, Veszprém, Zólyom, Pest, and Árva. At the end of the table, facing the delegates of Bács, there sat the two delegates of Szerém county, similarly demilitarized and established late from its earlier position as a frontier region.48 The rearrangement did not help two complaining counties much, as Temes and Krassó could only come two seats closer to the speaker. The new seating plan gained significance also due to the fact that the order of chairing at the non-official “circular” meetings of the Lower House, which were always led simultaneously by one Danubian delegate and one from the Tisza instead of the personalis, was determined by the seating arrangement. From 1833, these preparatory meetings, which were reminiscent of the Committee of the Whole House in Britain, were relocated to the plenary chamber due to the stuffy air at its previous location, and from that date on they were held in the same order as the official plenary except the presidency.49 What did not change at all, however, was the situation of cities, free districts, and the delegates of absent members of Upper House.

The next rearrangement in 1843 was a big step towards a more practical central arrangement, although it was not fully implemented.50 The conditions of the meeting were considerably improved but the custom of seating by the principle of estates and regions still prevailed. The presidium, the Royal Court of Appeal, and the clergy were moved to a long narrow platform with rails, erected by the longer wall of the chamber overlooking the courtyard. In the corner on the right, the gallery was reserved for the ladies, while the other galleries could be reached through a door in the corner of the other shorter end of the chamber. Next to the stove standing in the corner to the speaker’s left, a staircase led up to the lords’ gallery. On the lower level, at both ends of the chamber, there were two large podiums with rails taking up almost one-third of the area which were also set aside for the audience. The first two rows on the left were given to the delegates of absent members of the Upper House, who were now distinctly separated from the inner section of the chamber where the discussions took place to indicate their roles as observers, not decision-makers. The window niches provided room for the desks of reporters, as well as of the palatine’s and the chancellor’s commissioners. Finally, the speaker and members with the right to speak and take part in decision making in the middle two-thirds of the chamber could hear one another much better.

On the platform running the length of the chamber, the two rows of seats on the right of the presidium were reserved for the members of the Royal Court of Appeal, while the other two on the left were given to the delegates of Croatia and then the chapters. At the table behind the Croatian delegates and by the side of the second row of chapters, the secretary of the president prepared the minutes during official and circular meetings too. Those with important roles, i.e. the delegates of counties, cities, and free districts, sat at thirteen tables positioned crosswise in the long chamber, perpendicular to the president’s table. Two of them, somewhat wider than the others, stood in the middle with seats on both sides; while the other, more narrow tables (six on the right and five on the left) only had seats on one side so that the delegates would face the middle of the chamber.

The arrangement by estates and geographical regions, on the other hand, was left unchanged. In a random order, the Danubian counties were seated at the inner tables on the speaker’s right side of the chamber, and the counties from the two regions by the Tisza had seats at the inner three tables on the left. Behind the Danubians sat the delegates of the three Slavonian counties, as well as of Fiume and Buccari, while the free seats at this table and at three others behind them were given mainly to delegates of the free royal cities from the Danubian regions. Behind the counties by the Tisza and next to the delegates of Jászkun and Hajdú free districts, some seats were left empty for the counties and regions reannexed from Transylvania. These, however, could not be taken by those authorized, due to being hindered in their activities as delegates by the government. Most of the seats here and at the other two tables behind them could be taken by cities situated in precincts by the Tisza. Delegates of Croatian-Slavonian cities were placed in the railed area at two tables on each side, far from one another, probably on the only seats left.

From several perspectives, the new arrangement followed traditions and customs, but could still modernize the seating plan: separating the audience more strictly and pushing the deputies of the Upper House to the galleries made the process of negotiating clearer and posited the circle of the actual decision-makers spatially. Delegates with a more significant and populous background of voters were seated in the inner two-thirds of the chamber, so they could hear the speaker and one another much better and discuss issues more effectively. Still, even in this tight circle, prestige ranks persisted among the estates: in the middle there were the counties, then the districts, and then the cities at the peripheries. This arrangement reflected the weight of the actors, which derived from their position in the estate system.

The weak status of the cities found expression not only in their unfavorable placement at the peripheries but also in the fact that, corresponding to their geographical position, they were seated in two times two and a half rows far from one another. Thus, their delegates could hardly hear the colleagues speaking in the other end of the chamber, and the two groups could not communicate and negotiate with each other during the meetings. In the case when united action was discussed at preliminary private meetings, separateness was not a problem, but if something unexpected happened during the plenary it was considerably more difficult to react consistently. Earlier they were placed at the end of two long tables but at least close to one another, but now they were seated far from one another, so the rearrangement, which indeed had a positive effect on the whole of the assembly, in their case led to disadvantages from the perspective of representing the interests of the estate.

In the rearrangement of the seating plan, certain elements of the practices used in Western-European parliaments were slowly introduced: separating the audience, combining central and linear arrangement, and creating ascending rows facilitated discussion in the Upper House as well. Nevertheless, despite overall beneficial modifications resulting in a more practical arrangement of seats, the seating plan, still greatly influenced by traditions, showed no signs of modern political dividedness following the new trends. Although all those recollecting the period mention the presence of party-like formations and groups in the body of delegates, it was not manifested in the seating arrangement. The delegates believing in the same notions or making the same efforts did not yet sit close to one another. The traditional expectation of consensus among the estates, denouncing “division” and “discord” were not yet overridden by the beginning of the development of a modern party system made visible in the seating arrangement.

Archival and Pictorial Sources

Das erste deutsche Parlament in der Paulskirche zu Frankfurt. Die Lithographie nach der Zeichnung von Paul Bürde (1819–1874). Druckfarbe, Papier, Radierung, koloriert. Deutsches Historisches Museum, Berlin, Gr 2004/85.

Första kammarens plenisal i Gamla riksdagshuset, Stockholms Stadsmuseum. Riksdagen i Gamla Riksdagshuset på Riddarholmen. Interiör av plenisal med ledamöter. 1890–1905. Fotograf: Wiklunds, Ateljé. Wiklunds Ateljé BILDNUMMER: C 3236 Stadsmuseet i Stockholm.

Groitsch, A. J. The chamber of the Lower House in Pressburg. Colored copper engraving, 1836. Magyar Nemzeti Galéria, Grafikai Osztály [Hungarian National Gallery].

Grund-Plan vom Innern der Pauls-Kirche, mit Angabe der Plätze sämmtlicher Mitglieder der deutschen National-Versammlung. 1848. Frankfurt Freie Stadt, Deutscher Bund, 1848. Deutsches Historisches Museum. Do 95/55.

Janet, Gustave. Konungens sista afsked af Rikets ständer i plenum plenorium på Rikssalen den 22 juni 1866. Lithographic print, Ny Illustrerad Tidning, 27. July 7, 1866.

Wolff, Johann Heinrich. Frankfurt a. M., Paulskirche, Obergeschoß nach A. Liebhardt, Grundriß. 1788. Museumslandschaft Hessen-Kassel, Inventar nr.: L GS 12545.

Projectum Conclavium Tabularum Statuum Regni Hungariae. Lithography of Josephus Trentsensky. Magyar Nemzeti Levéltár Budapest Főváros Levéltára [Hungarian National Archives Budapest Archives] BMT. 89.

A pozsonyi “főrendek terme” karzatának javítási terve [Plan for the repair of the gallery of the “Hall of Lords” in Pressburg (early 1830s)]. Magyar Nemzeti Levéltár Országos Levéltára, Tervtár [National Archives of Hungary, Plan Library] (MNL OL), Plans excepted from fonds of the government authorities. Ministry of Commerce Plans. (T 14) No. 2/Sz/39/1–4.

A méltóságos főrendek termének belső elrendezése iránt készített tervek [Plans for arrangement of the Hall of Lords]. Magyar Nemzeti Levéltár Országos Levéltára, Tervtár [National Archives of Hungary, Plan Library] (MNL OL), Various blueprints. (T 15) No. 42/1–4.

Planum exhibens modernam et projectatam mensarum-tabularum-sessionalium dislocatione in sala incly. statuum et ordinum, una et projectum calefactionis. Magyar Nemzeti Levéltár Országos Levéltára, Tervtár [National Archives of Hungary, Plan Library] (MNL OL), Various blueprints. (T 15) No. 42/5.

A tekéntetes karok és rendek szálájábann a táblák helheztetése terve Pozsony, a Magyar Királyi Kamara épülete, országgyűlés színhelye 1832 Erdélyi Josef alaprajz [Plan for the placement of the tables in the hall of the esteemed faculties and orders, Pressburg, the building of the Hungarian Royal Chamber, cite of the Parliament, Josef Erdélyi’s 1832 blueprints]. Magyar Nemzeti Levéltár Országos Levéltára, Tervtár [National Archives of Hungary, Plan Library] (MNL OL), Various blueprints. (T 15) No. 42/6

Pozsony, a Magyar Királyi Kamara épülete, országgyűlés színhelye, ülésterem [1830] alaprajz [Pressburg, the building of the Hungarian Royal Chamber, cite of the Parliament, session room blueprint, 1830]. Magyar Nemzeti Levéltár Országos Levéltára, Tervtár [National Archives of Hungary, Plan Library] (MNL OL), Various blueprints. (T 15) No. 42/7–10.

Erklärung der Numern in dem beiliegenden Plan Pozsony, a Magyar Királyi Kamara épülete, országgyűlés színhelye, ülésterem [1830] [Explanation of the numbers in the attached plan Pressburg, the building of the Hungarian Royal Chamber, cite of the Parliament, session room blueprint, 1830]. Magyar Nemzeti Levéltár Országos Levéltára, Tervtár [National Archives of Hungary, Plan Library] (MNL OL), Various blueprints. (T 15) No. 42/11.

Határozat az üléseknek a karok és rendek teremébeni elrendelése iránt [Resolution concerning the arrangement of the faculties and orders in the chamber]. Magyar Nemzeti Levéltár Országos Levéltára [National Archives of Hungary] (MNL OL), Regnicolaris Archive, Archivum Regni, Diaeta anni 1843–44. (N 68) Fasc. L. No. 22. l) (fol. 28.)

Határozat a karok és rendek teremének rendezésére nézve hozott végzések módosítása eránt [Resolution concerning the amendment of the decisions on the arrangement of the chambers of the faculties and orders]. Magyar Nemzeti Levéltár Országos Levéltára [National Archives of Hungary] (MNL OL), Regnicolaris Archive, Archivum Regni, Diaeta anni 1843–44. (N 68) Fasc. L. No. 22. m) (fol. 39.)

Bibliography

Printed sources

Az 1843–44-ik évi magyar országgyűlési alsó tábla kerületi üléseinek naplója [Records of the district sittings of the Lower Table of the Hungarian Parliament in 1843–44]. Vols. 1–6. Edited by Ferenc Kovács. Budapest: Franklin, 1894.

Becker, Hans-Jürgen, ed. Der Reichstag zu Regensburg: Historische Ansichten aus dem Jahre 1786. Regensburg: Pustet, 2003.

Bertha, Sándor. Országgyűlési tárcza 1830-ról [Parliamentary feuilleton from 1830]. Pest: Trattner és Károlyi, 1843.

Bölöni, Farkas Sándor. Napnyugati utazás: Napló [Trip west: Diary]. Arranged for publication by Samu Benkő, and Sándor Maller. Budapest: Helikon, 1983.

Churchill, Winston. “Speech by in the House of Commons.” The meeting was held on October 28, 1943 in the House of Lords instead of the building of the House of Commons, which had been bombed. International Churchill Society. Accessed March 24, 2021. https://winstonchurchill.org/resources.

Felséges első Ferdinánd austriai császár Magyar-és Csehország e néven ötödik koronás királya által szabad királyi Pozsony városába 1843-dik évi május 14-kére rendelt Magyar-országgyülésen a méltóságos főrendeknél tartott országos ülések naplója [The national sittings of the honored high orders of the Hungarian National Parliament ordered on May 14, 1853 in the city of Pressburg by His Majesty Emperor Ferdinand the First of Austria and by this name the fifth crowned king of Hungary and the Czech Republic]. Pozsony–Pest, 1844.

Eötvös, Károly. “Hogy üljenek a követek?” [How do the delegates sit?]. Pesti Hírlap, May 16, 1906.

Eötvös, [Károly]. “Hogy üljenek a követek?” [How do the delegates sit?]. Pesti Hírlap, May 17, 1906.

Eötvös, Károly. “Hogy üljenek a követek?” [How do the delegates sit?]. Pesti Hírlap, May 19, 1906.

Kossuth, Lajos. Országgyűlési Tudósítások [Parliamentary reports]. Vol. 1–5. In Kossuth Lajos összes munkái [The complete works of Lajos Kossuth], vols. 1–5, edited by István Barta. Budapest: Magyar Történelmi Társulat, 1948–1962.

Kölcsey Ferenc levelezése Kende Zsigmonddal [Correspondence of Ferenc Kölcsey with Zsigmond Kende]. Arranged for publication by Ernő Taxner-Tóth. Budapest: Petőfi Irodalmi Múzeum, 1983.

Kölcsey, Ferenc. Országgyűlési napló [Parliamentary diary]. Arranged for publication by Orsolya Völgyesi. Kölcsey Ferenc minden munkái [The complete works of Ferenc Kölcsey], series edited by Zoltán G. Szabó. Budapest: Universitas, 2000.

Paget, John. Hungary and Transylvania: With Remarks on their Condition, Social Political and Economical. Vol. 1. London: Murray, 1839.

Pardoe, Julia. The City of the Magyar, Or Hungary and her Institutions in 1839–40. Vols. 1–3. London: Virtue, 1840.

“Opening of the first Italian parliament.” Vasárnapi Újság, April 7, 1861.

“Országgyülési rajzok 1” [Parliamentary drawings 1]. Ábrázolt Folyóirat January 8, 1848.

“Országgyűlési rajzok 2” [Parliamentary drawings 2]. Ábrázolt Folyóirat January 15, 1848.

Pulszky, Franz. Mein Zeit, mein Leben. Vol. 1. Pressburg–Leipzig: Stampfel, 1880.

Staël, Madame de. Considérations sur les Principaux Événements de la Revolution francaise. Paris, 1843.

Stollberg-Rilinger, Barbara. Des Kaisers alte Kleide: Verfassungsgeschichte und Symbolsprache des Alten Reiches. Munich: C. H. Beck, 2013.

Széchenyi, István. Napló [Diary]. Selections by Ambrus Oltványi. Budapest: Gondolat, 1978.

Szemere, Bertalan. Utazás külföldön: Válogatás Szemere Bertalan nyugat-európai útinaplójából [Travel abroad: A selection from the Western European travel diary of Bertalan Szemere]. Edited by Ágota Steinert. Budapest: Helikon, 1983.

“Az uj képviselőház gyülés-terme” [The Hall of the New Parliament]. Vasárnapi Újság, November 19, 1865.

Vaszary, Kolos. Adatok az 1825. országgyűlés történetéhez [Data on the history of the 1825 parliament]. Győr, 1883.

Secondary literature

Borsos, László. “A régi budai Országháza” [The old Buda Parliament]. Építés –Építészettudomány. Az MTA Műszaki Tudományok Osztályának közleményei 5, nos. 1–2 (1974): 55–93.

Brandt, Hartwig. “Die deutschen Staaten der ersten Konstitutionalisierungswelle.” In Handbuch der europäischen Verfassungsgeschichte im 19. Jahrhundert: Institutionen und Rechtspraxis im gesellschaftlichen Wandel, vol. 2, 1815–1847, 823–78. Bonn: Dietz, 2012.

Dobszay, Tamás. “Az országgyűlés bizottsági rendszerének előzményei a reformkorban” [Antecedents to the parliamentary committee system in the Reform Era]. In Historia Critica: Tanulmányok az Eötvös Loránd Tudományegyetem Bölcsészettudományi Karának Történeti Intézetéből [History Critica: Studies from the Historical Institute of the Faculty of Arts of Eötvös Loránd University], edited by Orsolya Manhercz, 199–212. Budapest, 2014.

Gergely, András. “Ungarn.” In Handbuch der europäischen Verfassungsgeschichte im 19. Jahrhundert: Institutionen und Rechtspraxis im gesellschaftlichen Wandel, vol. 2, 1815–1847, edited by Werner Daum, Peter Brandt, Martin Kirsch, and Arthur Schlegelmilch,1041–76. Bonn: Dietz, 2012.

Horler, Miklós et al. Budapest műemlékei [Monuments of Budapest]. Vol. 1. Edited by Frigyes Pogány. Magyarország műemléki topográfiája, edited by Dezső Dercsényi. Budapest: Akadémiai, 1955.

Lupkovics György. A magyar rendi országgyűlések, 1608–1848 [The Hungarian feudal parliaments, 1608–1848]. Kassa: Szent Erzsébet ny., 1911.

Molnár, András. Batthyány Lajos a reformkorban [Lajos Batthyány in the Reform Era]. Zalaegerszeg: Zala Megyei Levéltár, 1996.

Pajkossy, Gábor. “Ungarn.” In Handbuch der europäischen Verfassungsgeschichte im 19. Jahrhundert: Institutionen und Rechtspraxis im gesellschaftlichen Wandel, vol. 1, edited by Werner Daum, Peter Brandt, Martin Kirsch, and Arthur Schlegelmilch, 944–77. Berlin: Dietz, 2006.

Pálmány, Béla. A reformkori országgyűlések történeti almanachja, 1825–1848 [Historical almanac of reformdiets, 1825–1848]. Vols. 1–2. Budapest: Argumentum, 2011.

Paulinyi, Oszkár. “A m. kir. belügyminisztérium budai várbeli székházának története: Adalék Buda topográfiájához” [The history of the seat of the Hungarian Royal Ministry of Interior in Buda Castle: Data on the topography of Buda]. In Tanulmányok Budapest Múltjából 6 [Studies on the history of Budapest], edited by Károly Némethy, Jusztin Budó, 16–61. Budapest: Budapest Székesfőváros, 1938.

Révész, László. Die Anfänge des Ungarischen Parlamentarismus. Munich: Oldenbourg, 1968.

Ruszoly, József. “A német tartományi rendi képviselet történetéből” [On the history of German provincial feudal representation]. Acta Universitatis Szegediensis – Acta Juridica et Politica 39 (1990): 207–24.

Schulze, Winfried. Reich und Türkengefahr im späten 16. Jahrhundert: Studien zu den politischen und gesellschaftlichen Auswirkungen einer auseren Bedrohung. Munich: Duncker & Humblot, 1978.

Siklóssy, László. “Országházak” [Parliament buildings]. Tükör 7, no. 9 (1939): 689–96.

Mat’a, Petr. “Der steirische Landtag in Raum und Bild um 1730: Symbolische Ordnung und visuelle Darstellung.” Zeitschrift des Historischen Vereines für Steiermark 104 (2013): 163–218.

Szente, Zoltán. “A korai rendi gyűlések fő jellemzői és intézményei” [The main features and institutions of the early feudal assemblies]. Parlamenti Szemle 2, no. 1 (2017): 5–25. 

Szijártó, M. István. A Diéta: A magyar rendek és az országgyűlés 1708–1792 [The Diet: The Hungarian estates and the parliament, 1708–1792]. Keszthely: Balaton Akadémia Kiadó, 2010.

Vajnági, Márta. “A Reichstag és a diéta” [The Reichstag and the Diet]. In Rendiség és parlamentarizmus Magyarországon a kezdetektől 1918-ig [Feudal order and parliamentarism in Hungary from the beginnings until 1918], edited by Tamás Dobszay, András Forgó et al., 187–99. Budapest: Argumentum, 2013.

Figure 1. Groitsch, A. J. The chamber of the Upper House in Pressburg, 1836.

(Hungarian National Gallery, Budapest)

Figure 4. The seating plan of the Lower House after the rearrangement of 1843 (1847–1848) (“Országgyűlési rajzok 2,” Ábrázolt Folyóirat, January 15, 1848, 20.)