MEDICINE, LAW & SOCIETY Vol. 17, No. 1, pp. 171–186, April 2024 https://doi.org/10.18690/mls.17.1.171-186.2024 CC-BY, text © Čandrlić, 2024 This work is licensed under the Creative Commons Attribution 4.0 International License. This license allows reusers to distribute, remix, adapt, and build upon the material in any medium or format, so long as attribution is given to the creator. The license allows for commercial use. https://creativecommons.org/licenses/by/4.0 LEGAL FRAMEWORK OF MEDICAL SERVICE IN THE CITY OF OSIJEK DURING THE FIRST HALF OF THE 19TH CENTURY Accepted 1. 2. 2024 Revised 13. 3. 2024 Published 18. 4. 2024 SLAVKO ČANDRLIĆ Josip Juraj Strossmayer University of Osijek, Faculty of Dental Medicine and Health, Department of Interdisciplinary Areas, Osijek, Croatia slavko.candrlic@fdmz.hr CORRESPONDING AUTHOR slavko.candrlic@fdmz.hr Keywords diseases, regulation, physicians, measures, health care Abstract The aim of this research work is to gain insight into how the medical service was legally regulated in the city of Osijek, the main Slavonian center to which a large number of people immigrated after the Great Turkish War, and which consequently spread the fear of the appearance of new infections in that area. At the same time, special attention was paid to medical regulations after the city of Osijek received the status of a Free Royal City in 1809. Despite the jurisdiction of the Royal Hungarian – Protectoral Council and the Royal Hungarian Court Chamber, the Liberation Charter enabled the city of Osijek to establish its own self-governing bodies. Thus, along with the City Council and its representatives, a lesser- known physical department was founded, which was headed by a physicist. In particular, it was a physician with the highest level of responsibility, who had the authority to protect the public health of the population of the Free Royal City of Osijek. 172 MEDICINE, LAW & SOCIETY Vol. 17, No. 1, April 2024 1 Introduction Infectious diseases spread throughout Europe during the 18th century, including the territory of the Austrian Empire. The Habsburg Monarchy was in a particularly difficult position due to its proximity to the Ottoman Empire, from where most epidemics of infectious diseases, especially the plague, threatened. Given the fact that Slavonia was adjacent to the border, the central government insisted that the epidemics should be suppressed in those places, so that the disease would not continue to spread to other parts of the Habsburg Monarchy (Čandrlić, 2023, p. 399 Cf. Gardaš and Čandrlić, 2020, p. 808). With the arrival of a large number of people after the Great Vienna War, the danger of the appearance of new infections intensified even more. As a result, the spread of infectious diseases could not be completely prevented, and the poorly organized and unqualified medical service was unable to provide quality health care (Skenderović, 2019, pp. 183 – 184). This should not be too surprising, because the medical profession was performed by priests and wound specialists, so called military surgeons and barbers who, despite having the obligation to pass a Master's exam, were accustomed to this work (Živaković - Kreže, 2008). The problem was the large number of charlatans who performed these jobs, as well as the lack of health studies in Slavonia. This consequently led to an uneven performance of medical services in the city of Osijek and other Slavonian cities compared to the capital Vienna. Namely, it was at the Faculty of Medicine in Vienna in 1749 that Gerhard van Swieten, the personal physician of the Empress and Queen Maria Theresa, began to reform the medical education. In addition to becoming the main institution in the education of physicians who came from different parts of the Habsburg Monarchy, the Faculty became the supreme institution in charge of supervising all physicians in the Monarchy (Horbec, 2009, p. 1029 – 1035). The final affirmation came in 1770, when the medical activity was fully regulated within the framework of the General Health Ordinance - Generale Normativum Sanitatis (Gardaš, Čandrlić, and Repić, 2020: 534 Cf. Thaller, 1927, pp. 32 - 33; Mlinarić, Lazanin, 2021, p. 30). This chain of events had a positive effect on all Slavonian cities, especially on Osijek, which was the main Slavonian center, both for trading and for healthcare. By acquiring the status of a Free Royal City at the beginning of the 19th century, Osijek obtained its own self-governing bodies (Brunčić, 2010, pp. 47 – 48), but it was still predominantly under the jurisdiction of the Royal Hungarian - Protectoral Council S. Čandrlić: Legal Framework of Medical Service in the City of Osijek During the First Half of the 19th Century 173 and the Royal Hungarian Court Chamber (Brunčić et. al., 2010, p. 50 Cf. Čandrlić, Holik, & Včev, 2023, p. 178). However, a certain autonomy still existed and the city government acquired its own council, city representatives, as well as healthcare institutions, i.e. the health board and the physical department. The latter was an expert organ of the city administration headed by a physician, who took care of healthcare, health protection and general public health of the residents of the Free Royal City of Osijek (Ivičević, 1993, p. 121 Cf. Balen and Jandrić, 2000, p. 16). 2 Medical service in the 18th Century In the first half of the 18th century, medical services in Slavonian cities were mainly performed by priests, who, in addition to medical duties, also performed other tasks in healthcare. Feldtscherer and barbers - Bader were wound specialists who were also active in terms of the medical profession. The wound specialists were mostly military surgeons whose work was subject to a certain degree of supervision. Likewise, there were also master barbers, that is, artisan surgeons who performed large and small surgical procedures. All of the foregoing medical service providers had to complete an apprenticeship and pass a Master's exam, the goal of which was to ensure better quality healthcare to a certain extent (Živaković - Kreže et. al., 2008). However, in practice this did not immediately take root in the entire Habsburg Monarchy. A large number of charlatans engaged in medical services in Osijek, and there was not enough political initiative on the part of the central government to legally regulate this problem in the Kingdom of Slavonia. In the Habsburg Monarchy, and especially in Vienna, there were royal universities that barbers and wound specialists attended and upon their completion became qualified for providing medical service. This was not the case in Osijek and other parts of Slavonia, where there were no healthcare schools. Starting in 1511 in Vienna, the activities of barbers and wound specialists were separated. This was not the case in Osijek for a large part of the 18th century, because their barbers sometimes performed larger surgical operations that fell under the scope of the wound specialist’s jobs (Atalić, 2017, pp. 85 – 86). Robert Skenderović maintains that in that period in Osijek and other Slavonian cities the roles between balneators, surgeons and tonsors were not segregated, such that Slavonian barbers were sometimes called barbers and sometimes surgeons, depending on what professional activities they performed. Since in Slavonia they did not have their own associations in which they could improve their skills and 174 MEDICINE, LAW & SOCIETY Vol. 17, No. 1, April 2024 knowledge, barbers and wound specialists became members of German guilds. Beside them, there were also surgeons who did not engage in other professional activities but only in the medical profession. Initially, there were few of them, but gradually their numbers increased, and over time, medical activity became more harmonized with the medical regulations in Vienna and the rest of the Habsburg Monarchy (Skenderović, 2005, pp. 118 – 119). Physicians in the first half of the 18th century in Osijek included surgeons Georg Ritter, Joannes Neumann, Michael Brezovicz from Donji grad (“Lower Town”) and Andreas Ratgeeb and Peter Shutz from Gornji grad (“Upper Town”) (Skenderović et. al., 2005, pp. 120 – 121). After the Great Turkish War in the first decades of the 18th century, an ever-increasing number of people immigrated from Bosnia and Serbia to Osijek and other Slavonian cities. This continued throughout the 18th century due to the continuous immigration of the Christian population fleeing from the Ottoman Empire towards the Habsburg Monarchy and other European countries (Skenderović et. al., 2019, p. 183 – 184). As these circumstances unfolded, the increase in the number of inhabitants compounded the danger of the outbreak of new infections, which in turn required medical service in the Kingdom of Slavonia to be regulated. Simultaneously, the demarcation between the civilian and military areas blurred, requiring administrative, educational and healthcare reforms throughout the Habsburg Monarchy. The growing need for public servants, including physicians, encouraged the central government to undertake comprehensive educational reforms. To that end, in 1749, Gerhard van Swieten, Maria Theresa's personal physician, tried to reorganize the Faculty of Medicine in Vienna on the model of the Faculty in Leiden. That moment marked the beginning of the entire reform of the higher education system in the Monarchy, especially the education of healthcare workers, where educating physicians was of particular interest. This is supported by the fact that in the meantime the Faculty of Medicine in Vienna [“Faculty”] became one of the main centers where physicians from different parts of Europe were educated. In 1749 and 1755, the Faculty was officially declared as the supreme institution that supervised the work of all physicians in the Habsburg Monarchy. Physicians had to graduate from the Faculty in order to gain the right to practice in the territory of the Habsburg Monarchy. On the other hand, if they completed their medical studies at another royal university within the Monarchy, they could perform their right to practice only in the place where that university or faculty was based (Horbec et. al., 2009, pp. 1029 – 1035). S. Čandrlić: Legal Framework of Medical Service in the City of Osijek During the First Half of the 19th Century 175 During the time of Empress and Queen Maria Theresa, medical activity was fully legally regulated. Thus, in 1770, the General Health Ordinance - Generale Normativum Sanitatis was promulgated, which legally regulated the medical profession. That legal act consolidated all previous healthcare regulations, regulated and introduced mandatory education for physicians (Gardaš, Čandrlić & Repić et. al., 2020, p. 534). 3 Status of the Free and Royal City of Osijek in 1809 By the Royal Decision of the king in 1786, all three chamber municipalities were merged into one. Thus, the Inner City (“Tvrđa”), the Lower City (“Donji grad”) and the Upper City (“Gornji grad”) were united into a new legal entity, namely the city of Osijek. Since then, all the prerequisites have been created for Osijek to receive the status of a free and royal city. This happened on March 24, 1809, when Emperor and King Francis I signed the Liberation Charter (inaugural diploma). The ceremonial inauguration, which concluded the process of granting Osijek the status of a free and royal city, took place on August 28, 1809, which officially gave Osijek the status of a free and royal city (Brunčić et. al., 2010, p. 44 Cf. Sršan, 2009, p. 51). The political connotation of the Liberation charter was particularly important for the legal regulation of the healthcare system and also the medical service, because in addition to the obtained privileges, all cities were required to respect and apply the laws and customs of the monarchy, that is, they were forced to swear allegiance to the king. On the other hand, the Free and Royal City of Osijek received a certain degree of autonomy and had the right to its own self-government. Thus, the Free and Royal City of Osijek acquired its own statute and its own self-governing bodies (Brunčić et. al., 2010, pp. 47 - 48). According to the administrative structure, the city was headed by the City Council, which had judicial and executive authority. The City Council consisted of six senators and a judge - iudex. Along with the City Council, there was an Elected Commune (Assembly) - electa communitas, with its President - tribunus plebis, while the whole commune comprised forty members (Lovaš & Jelaš, 2020, p. 186). Additionally, there was a physical department headed by a city physicist (physician) who, as an expert representative for healthcare affairs, was a reporter for the City Council. More precisely, the city physicist was the physician primarily responsible for the entire city. Furthermore, the institution of the city health committee was 176 MEDICINE, LAW & SOCIETY Vol. 17, No. 1, April 2024 introduced, which included the city physicist among others. The main task of the city health committee was to advise the City Council of the Free and Royal city of Osijek regarding healthcare affairs (Ivičević, 1993, p. 121). In the realm of healthcare affairs, the autonomy of city authorities of the Free and Royal city of Osijek was not absolute. Instead, the City's healthcare authorities and healthcare workers, especially physicians, had to ensure that their actions complied with the regulations of the Royal Hungarian - Protectoral Council and the Royal Hungarian Court Chamber. In support of this, pursuant to point 5 of the Liberation Charter of the Free and Royal city of Osijek, under which the Royal Hungarian - Protectoral Council and the Hungarian Chamber reserved the right that legitimately elected members of the city bodies, including physicians as public servants, could not be dismissed without their prior approval (Brunčić et. al., 2010, p. 50). It clearly follows that the Royal Hungarian - Protectoral Council, as the supreme authority among others, largely controlled the medical service in the Free and Royal city of Osijek. 4 Area of competence of the city physician - physicist Leopold Bischoff and Vasilije Atanasijević were experts in the Free and Royal City of Osijek in the first half of the 19th century, and held the position of head physicians (physicists). Their deputies included Ignacije Blauhorn and Josip Lutter.1 The city physician’s scope of work required them to oversee the complete healthcare and health protection in the area of the Free and Royal City of Osijek. For example, item number 8645 in the Directive of the Royal Hungarian - Protectoral Council dated March 28, 1813, mandated that city facilities had to be inspected for any signs of disease in them.2 If the city physician determined the presence of a disease, he had to promptly notify the competent city authorities, who forwarded the notification to the Royal Hungarian - Protectoral Council for review.3 One such example was the report of the city physician Leopold Bischoff to the Royal Hungarian - Protectoral 1 Čandrlić, “Legal regulation of public health in Slavonia in the 18th and 19th centuries”, doctoral thesis, (Osijek: Faculty of Law in Osijek, 2022), 46 (hereinafter: PRJZUS); Croatia (hereinafter: HR) – State Archives in Osijek (hereinafter: DAOS) – fund 6 – City Council of the Free and Royal City of Osijek (hereinafter: PSKGO). 1.1.1.2. Records of administrative sessions, 1835, book 39, subject 406. 2 HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1815, book 19, subject 73; PRJZUS, p. 47. 3 HR – DAOS – 6th PSKGO. 1.1.1.1. Records of joint administrative-economic sessions IV, 1813, book 14, subject 2722; PRJZUS, p. 48. S. Čandrlić: Legal Framework of Medical Service in the City of Osijek During the First Half of the 19th Century 177 Council on the deaths caused by the outbreak of rabies in the period from 1809 to 1819 in the Free and Royal city of Osijek.4 Induced by the outbreak of an epidemic on March 26, 1809, the Royal Hungarian - Protectoral Council prescribed that in situations where there were indications of a presence of a disease, city healthcare officials and bodies had to notify the city physicists and act in accordance with their orders and instructions.5 Some of the healthcare officials were surgeons in the Free and Royal city of Osijek. On the order of the city physicists, they had to carry out activities such as inspections in public places and facilities to determine whether they contained any indications of infectious diseases. On the example of the pastor of the Upper Town (“Gornji Grad”), Ivan Rastović, who stated in his report that during 1819 smallpox caused a high mortality rate among children, it is clear that the official city surgeon acted according to the order of the city physicist. In that specific case, the city physicist of the Free and Royal city of Osijek, Leopold Bischoff, ordered the official city surgeon Rathgeb to examine the children and determine their state of health.6 Essentially, the Royal Hungarian - Protectoral Council required the city authorities to take preventive measures and control in order to suppress the occurrence of infectious diseases.7 It follows from the Directive of the Royal Hungarian - Protectoral Council dated March 2, 1819, issued under no. 7361, that the city magistrate of the Free and Royal City of Osijek obliged city physicians, as well as city physicists and surgeons, to prepare reports regarding their examinations in cases of infectious diseases, as well as a table listing the number of deaths caused by noticed diseases in the area of the Free and Royal city of Osijek.8 The Directive of the Royal Hungarian - Protectoral Council dated March 27, 1821, no. 6691, required these healthcare providers to submit such reports and tables together with the annual report of the 4 HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1820, book 24, subject 735; PRJZUS, p. 49. A similar situation followed in 1825. There were many such reports, and one of them was sent by the city physicist Leopold Bischoff to the city senior official Josip Krmpotić, senator of the Free and Royal city of Osijek, as well as to the Royal Hungarian - Protectoral Council regarding the appearance of scarlet fever and the total number of deceased children in Osijek's Upper Town (“Gornji grad”). HR – DAOS – 6th PSKGO. 1.1.1.2. Minutes of administrative sessions, 1825, book 29, subject 688; PRJZUS, p. 50. 5 HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1819, book 23, subject 985; PRJZUS, p. 48. In reality, due to poorly developed medical science, it was particularly difficult for the city physician (physicist) to determine what type of (infectious) disease it was. HR – DAOS – 6th PSKGO. 1.1.1.1. Records of joint administrative-economic sessions I, 1810, book 2, subject 116/114; PRJZUS, p. 48. 6 HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1819, book 23, subject 8; PRJZUS, p. 49. 7 HR – DAOS – 6th PSKGO. 1.1.1.1. Records of joint administrative-economic sessions IV, 1813, book 14, subject 2790; PRJZUS, p. 48. 8 HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1819, book 23, subject 514; PRJZUS, p. 54. 178 MEDICINE, LAW & SOCIETY Vol. 17, No. 1, April 2024 city physicist, describing residents’ health conditions for the previous year in the Free and Royal City of Osijek.9 One of these was the report of the city physicist Vasilije Atanasijević, in which he stated that in the period from July 29 to August 29, 1831, there were in the Free and Royal City of Osijek a total of seventy-eight patients, of whom thirty-two died.10 Because Osijek's city physicists sometimes submitted incomplete reports and tables, the Royal Hungarian - Protectoral Council passed a Directive under no. 22027 in 1826, mandating that city physicists that failed to regularly submit appropriate documents would be subject to certain sanctions.11 Namely, from the Directive of the Royal Hungarian - Protectoral Council dated June 21, 1831, no. 14157/17464, it clearly follows that the physicians’ obligation was to specify in their files in detail the type of disease involved, along with its cause, whether the disease continued to spread and all other information that was relevant to a particular disease. Patient information such as age, sex, duration of incubation or illness, medical diagnosis, list of medications that the patient received, and what kind of treatment or procedures the patient underwent also had to be recorded.12 We can glean from the Circular dated February 5, 1815, stored under no. 4465, regarding the collection of information on the number of deaths in free and royal cities, that the city physicists, along with representatives of the city government, in order to determine the list of deaths in the Free and Royal City of Osijek, appointed auditors, which they had to supervise.13 In addition, the city physicists examined the sources of natural spring water, which, according to the Directive of the Royal Hungarian - Protectoral Council dated September 26, 1812, under no. 29349, could 9 HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1821, book 25, subject 713; PRJZUS, p. 54. Cf. Filipović, 2014: 148 10 HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1831, book 35, subject 2487; PRJZUS, p. 59. In reports from 1829 and 1837, the city physicist Vasilije Atanasijević informed about the number of patients suffering from syphilis in the area of the Free and Royal City of Osijek. HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1838, book 42, subject 772; PRJZUS, p. 60 – 61. According to his report from 1836, it appears that cholera was present throughout August until the middle of September. HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1836, book 40, subject 2763; PRJZUS, p. 60. Cf. Jerolimov and Bubalo, 2014: 94 11 HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1826, book 30, subject 493; PRJZUS, p. 55. 12 HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1831, book 35, subject 1810; PRJZUS, p. 55. – 56. 13 HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1827, book 31, subject 2401; PRJZUS, p. 51. Cf. Pastović and Željko, 2016, p. 47. S. Čandrlić: Legal Framework of Medical Service in the City of Osijek During the First Half of the 19th Century 179 not be used before the city physicist examined it and determined whether it was safe for public health.14 In addition to the responsibilities listed above, the city physicists were obliged to visit and inspect city pharmacies in the area of their competence and to inform the city government, as well as the magistrate, about the inspections they carried out.15 They also oversaw cases in which the medical commissions expressed their opinions about the health status of their patients. One example involved the case of Petar Ludvig, a patient who was undergoing psychiatric treatment in the city hospice. The medical commission had determined that Ludvig had recovered. However, the city physicist Leopold Bischoff did not fully agree with their point of view. Bischoff instead believed that Ludvig remained a threat to society and should not be released from the city hospice.16 The Royal Hungarian - Protectoral Council was familiar with all the physicians who worked in the city hospice and other healthcare institutions and with their work and the representation of physicians in the Free and Royal City of Osijek.17 If the Council was suspicious that medical care was not being provided in accordance with the regulations of the profession, it could appoint other physicians who would determine whether there were any failures on the part of physicians or healthcare institutions.18 5 Area of competence of the city physician - surgeon The city physicists, as the main responsible physicians in the city, were greatly assisted in their work by civil (military) surgeons. In addition to the usual medical operations, they also performed forensic autopsies.19 In support of this, the Directive of the Royal Hungarian - Protectoral Council dated January 20, 1829, no. 14 HR – DAOS – 6th PSKGO. 1.1.1.1. Records of joint administrative-economic sessions IV, 1814, book 18, subject 2303; PRJZUS, p. 50-51. 15 Political-economic records of the Free and Royal City of Osijek from January 3 to December 31, 1812, translated and edited by Stjepan Sršan. Osijek, State Archives in Osijek, 2012, 295 (hereinafter: Records 1812); HR – DAOS – 6th PSKGO. 1.1.1.1. Records of joint administrative-economic sessions II, 1812, book 10, subject 1988/1832; PRJZUS, p. 47. 16 HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1821, book 25, subject 393; PRJZUS, p. 50. 17 Records 1812, p. 137; HR – DAOS – 6th PSKGO. 1.1.1.1. Records of joint administrative-economic sessions I, 1812, book 9, subject 928/882; PRJZUS, p. 53. 18 Records 1812, p. 126; HR – DAOS – 6th PSKGO. 1.1.1.1. Records of joint administrative-economic sessions I, 1812, book 9, subject 889/820; PRJZUS, p. 53. 19 HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1848, book 55, subject 1596; PRJZUS, p. 109. Otherwise, these activities were prescribed by Statutes which were promulgated by the county and city assemblies. see Hofgräff, 2012, p. 196. 180 MEDICINE, LAW & SOCIETY Vol. 17, No. 1, April 2024 1628, authorized surgeons and instructed them to legally perform medical-forensic procedures.20 For a certain time, the city physicist Vasilije Atanasijević was in charge of implementing that Directive in Osijek's Lower Town (“Donji grad”), while his deputy Josip Lutter was in charge of it in Upper Town (“Gornji grad”).21 Soldiers were also examined by (military) surgeons22, who had to record their health state in detail. The Royal Hungarian - Protectoral Council dated January 18, 1844, no. 22988, stipulated that surgeons who provided health care to soldiers had to record their personal information: first and last name, type of illness, date of prescription for a specific medicinal product and the military service from which the patient came for medical treatment.23 This rule was followed by the Directive of the Royal Hungarian - Protectoral Council of May 18, 1844, no. 20437, according to which the city physicist, as well as the surgeon, had to examine the health findings from previous private physicians and declare statements to those as "I saw it" or "it's in front of me".24 6 Selection of physicians and resignation from service In the Free and Royal City of Osijek, tenders for the selection of new surgeons were handled by the city senator, one of whom was Franjo Svoboda.25 During the selection process, the surgeons had to prove their qualification for that profession (diploma) and after employment, according to the Directive of the Royal Hungarian - Protectoral Council of November 27, 1792, they were obliged to continue to 20 HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1829, book 33, subject 1807; PRJZUS, p. 110. In addition to the above, we should also mention the Directive of the Royal Hungarian - Protectoral Council of October 21, 1844, no. 38547, which stipulates that only surgeons (military) can perform autopsy activities. HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1844, book 48, subject 3493; PRJZUS, p. 110. 21 HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions I, 1845, book 49, subject 628; PRJZUS, p. 111. Cf. Belicza, 1999, p. 12. 22 HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1820, book 24, subject 909; PRJZUS, p. 112. 23 HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1844, book 48, subject 2035; PRJZUS, p. 112. 24 HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1844, book 48, subject 2459; PRJZUS, p. 113. 25 HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1836, book 40, subject 1788; PRJZUS, p. 116. S. Čandrlić: Legal Framework of Medical Service in the City of Osijek During the First Half of the 19th Century 181 improve within their profession. Usually, surgeons went to the Jozefina Academy in Vienna or the Royal University in Pest for the purpose professional training.26 Physicians’ medical careers usually ended either because they retired or resigned due to health or other (personal) reasons. A big problem arose in such situations, because the authorities of the Free and Royal City of Osijek had to promptly choose new physicians in order to ensure continued provision of healthcare in these places.27 Due to the shortage of physicians, they sometimes performed multiple functions. As an example, Mihajlo Pivac, who applied for vacant positions, was then afterwards appointed as a military surgeon in Nutarnje (“Tvrđa”) and Novi Grad, and also as a hospital supervisor in the Free and Royal City of Osijek.28 7 Conclusion After the Great Vienna War in the first decades of the 18th century, a large number of people fleeing the Ottoman Empire immigrated to Osijek, as well as to other Slavonian cities. This great migration exacerbated the danger of the appearance of new infections, and Osijek, as a border region, was most exposed to such threats. The medical service was at that time performed by priests, wound specialists and barbers who, despite the fact that they had to undergo an apprenticeship and pass a Master's exam, were not at the same level of education as their colleagues in Vienna. The regulatory norms were the same in all parts of the Monarchy, especially after the promulgation of the General Health Ordinance in 1770, but poverty in Slavonia, the lack of healthcare studies in Osijek and the surrounding cities meant that medical services were mostly performed by unqualified persons. However, the situation 26 The legal basis of that Directive actually had its source in the Imperial Public Health Law from 1770. HR - DAOS - 6th PSKGO. 1.1.1.1. Records of joint administrative-economic sessions II, 1811, book 7, subject 778/808; PRJZUS, p. 117. 27 There were many examples, one of them was Alojzije Feher, a surgeon in Osijek's Upper Town (“Gornji grad”), who renounced his service. HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1824, book 28, subject 672; PRJZUS, p. 114 – 115. 28 „Usled natečajnog pod br. 762 t. g. iz travnja učinjenog razglašenja, kojim je rok za zadobljenje izpraznjenog mĕsta Ranarnika u nutarnjem gradu i lečničkog u bolnici i nadziratelja, na poslednji dan svibnja t. g. postavljen, podneo je radi zadobljenja ove službe molbenicu svoju vojvodstvo sremskog, Iločkog i Erdevičkog Sreza Ranarnik G. Mihailo Pivac. Razlozi u ovoj molbenici navedeni jesu ovom prilikom pretresani, i budući da je istinitost takovih doznanjem nazočnih zastupnikah, ovoga poglavarstva, a i varoškog lečnika Vase Athanasievića, koji o prositeljevom, kada je prije nekoliko godinah ovde privatno bolestnikom na uslugi bio, dobrom ponašanju, veštini u lĕčenju i marljivom pohadjanju bolestnikah ustmeno svedočanstvo dali jesu – zadosta dokazana i priznana: jeste isti prositelj Iločkog i Erdevičkog Sreza Ranarnik G. Mihailo Pivac za Ranarnika u nutarnjem i novom gradu i lečničkog u bolnici gradjanskoj nadziratelja jednoglasno izabran. Dotična će mu se od 150 f. sr. platja kad zakletvu položio bude assignirati.“ HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1850, book 57, subject 1470; PRJZUS, p. 115. 182 MEDICINE, LAW & SOCIETY Vol. 17, No. 1, April 2024 improved over time, and since they did not have their own, Osijek’s physicians joined German guilds in order to improve their knowledge and acquire new skills. By obtaining the status of a Free and Royal city, Osijek gained a certain autonomy in regulating the medical service. Despite the fact that the Liberation Charter still contained the obligation to respect the laws and customs of the Royal Hungarian - Protectoral Council, it also gave the city of Osijek the right to establish its own self- governing bodies, promulgate its own Statute and other legal acts, and thus organize the city administration independently. This series of events enabled the City to establish the physical department as an expert institution of the City Council regarding healthcare affairs, headed by a physician. From the archive material presented in this research work, we may conclude that in the first half of the 19th century in the Free and Royal city of Osijek this function was performed by physicians Leopold Bischoff and Vasilije Atanasijević and their deputies Ignacije Blauhorn and Josip Lutter. The city physicist - physician was obliged to taking care of the general public health of the residents. Some of the most important tasks were related to the suppression and monitoring of infectious diseases. In the operational scope, the physicists were assisted by city surgeons. They had to prepare reports and tables listing the number of deaths and submit them to the city administration and the Royal Hungarian - Protectoral Council. The list of the number of deaths was carried out by auditors who were supervised by representatives of the city government and the city physicist. City physicists also performed other tasks such as analyzing water quality, releasing patients from healthcare institutions and all other actions that were important for the public health of the residents of the Free and Royal city of Osijek. Activities of the physician - surgeon were also regulated. At the time of selection, like other physicians, they had to prove their qualifications, as well as diploma, and were obliged to continue their training at the Jozefina Academy in Vienna or at the Royal University in Pest. Due to the lack of qualified physicians (surgeons,) the city authorities of the Free and Royal city of Osijek were sometimes in a difficult situation, because they urgently had to find suitable replacements and thus ensure the continued provision of healthcare. We can conclude from this research work that the medical activity in Osijek during the first half of the 19th century was satisfactorily regulated. However, further research is required in order to fully understand the legal regulations of this activity as well as the contribution of Osijek’s physicians in that time period. S. Čandrlić: Legal Framework of Medical Service in the City of Osijek During the First Half of the 19th Century 183 References Atalić, B. (2017). Holy Trinity Monument in the City of Osijek, Acta medico – historica Adriatica, 15(1), 83 – 98. Balen, I. & Jandrić, M. (2000). Prof. dr. Josip Benčević, M. D., Ph. D. in Slavonski Brod, Medical Journal, 32(1 – 4), 15 – 20. Belicza, B. (1999). 125th Anniversary of „the Slavonian Medical Association of Osijek“ Constitutive Assembly, held on 15th December 1874, Medical Journal, 31(1 – 4), 11 – 16. Brunčić, D. (2010). 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Ecological-geographical Determination of Colonization of Slavonia in the 18th Century, Journal of the Institute of Croatian History, 51(1), 181 – 199. Skenderović, R. (2005). Health Reforms introduced by Maria Theresa in Provincial Slavonia and Generale Normativum Sanitatis of 1770, Scrinia Slavonica, 5(1), 115 – 143. Sršan, S. (2009). The Free and Royal City of Osijek 1809, State Archives in Osijek. Thaller, L. (1927). Povijest medicine u Hrvatskoj i Slavoniji od godine 1770. do 1850., Dionička štamparija, Karlovac. Živaković – Kreže, Z. (2008). The development of health care in Slavonia, a special review of Osijek, Croatian Journal of Public Health, 4(15), p. 0 – 0. 184 MEDICINE, LAW & SOCIETY Vol. 17, No. 1, April 2024 Archive materials HR – DAOS – 6th PSKGO. 1.1.1.1. Records of joint administrative-economic sessions I, 1812, book 9, subject 928/882. HR – DAOS – 6th PSKGO. 1.1.1.1. Records of joint administrative-economic sessions IV, 1813, book 14, subject 2722. HR – DAOS – 6th PSKGO. 1.1.1.1. Records of joint administrative-economic sessions I, 1810, book 2, subject 116/114. HR – DAOS – 6th PSKGO. 1.1.1.1. Records of joint administrative-economic sessions IV, 1813, book 14, subject 2790. HR – DAOS – 6th PSKGO. 1.1.1.1. Records of joint administrative-economic sessions IV, 1814, book 18, subject 2303. HR – DAOS – 6th PSKGO. 1.1.1.1. Records of joint administrative-economic sessions II, 1812, book 10, subject 1988/1832. HR – DAOS – 6th PSKGO. 1.1.1.1. Records of joint administrative-economic sessions I, 1812, book 9, subject 889/820. HR – DAOS – 6th PSKGO. 1.1.1.1. Records of joint administrative-economic sessions II, 1811, book 7, subject 778/808. HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1835, book 39, subject 406. HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1815, book 19, subject 73. HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1820, book 24, subject 735. 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Records of administrative sessions, 1827, book 31, subject 2401. HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1821, book 25, subject 393. HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1848, book 55, subject 1596. HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1829, book 33, subject 1807. HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1844, book 48, subject 3493. HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions I, 1845, book 49, subject 628. HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1820, book 24, subject 909. HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1844, book 48, subject 2035. HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1844, book 48, subject 2459 HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1836, book 40, subject 1788. HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1824, book 28, subject 672. HR – DAOS – 6th PSKGO. 1.1.1.2. Records of administrative sessions, 1850, book 57, subject 1470. Povzetek v slovenskem jeziku Cilj tega raziskovalnega dela je pridobiti vpogled v to, kako je bila medicinska služba pravno urejena v mestu Osijek, glavnem slavonskem središču, kamor se je po Veliki turški vojni priselilo veliko število ljudi, kar je posledično širilo strah pred pojavom novih okužb na tem območju. Hkrati je posebna pozornost namenjena medicinskim predpisom po tem, ko je mesto Osijek leta 1809 prejelo status Prostega kraljevega mesta. Kljub pristojnosti Kraljevega madžarskega Zaščitnega sveta in Kraljeve S. Čandrlić: Legal Framework of Medical Service in the City of Osijek During the First Half of the 19th Century 185 madžarske sodne zbornice je Listina o osvoboditvi omogočila mestu Osijek, da ustanovi svoje lastne samoupravne organe. Tako je bil poleg Mestnega sveta in njegovih predstavnikov ustanovljen manj znan fizični oddelek, ki ga je vodil fizik. Še posebej je šlo za zdravnika z najvišjo stopnjo odgovornosti, ki je imel pooblastilo za zaščito javnega zdravja prebivalstva Prostega kraljevega mesta Osijek. 186 MEDICINE, LAW & SOCIETY Vol. 17, No. 1, April 2024