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Why was it in Vienna of all cities that so many discoveries in psychiatry were made? And why was it that around the turn of the century so many participants were of Jewish origin? I explored these questions in a previous paper.1 Now I would like to illustrate the pluralistic approach, that is, the psychological and organic elements, in the history of Viennese psychiatry. I will interweave historical events with my personal experiences.
The three crowning periods of Viennese medicine coincided with the three heights of Austria's cultural development: the first with the Baroque, the second with the Biedermeier, and the third with “The Moderne.”
Basic prerequisites for therapy today are knowledge of a patient's pathological background and of his resulting symptomatology. The endeavors of past periods to define and investigate pathology and symptomatology yielded much. Therapeutic methods used today were relatively unknown formerly anywhere. Therefore, the significance of the well-timed, reasonable advice “Primum non nocere” (Most of all, don't harm the patient) speaks for itself.
The arduous efforts of the Viennese, their courageous and creative minds, were indispensable for the later attempts and success of therapy. Before their time, specific lesions and the seats of pathology were unknown territory. Their search for somatic contingencies dominated the scientific world and made new, effective healing measures possible.