In the 18th century, European states developed a new interest in health and disease, as the size of the population was considered an important factor in maintaining political and economic power. The concept of "medical policing" lays the foundation for public health care. With the help of doctors, the rulers of the Enlightenment now systematically began intervening in the health behaviour of their subjects: They built health authorities and regulate the medical professions.
Plague and Charlatans
The Bernese government had taken precautions against epidemics since the Middle Ages and positioned "plague guards". In the 18th century, political interest in the health of the population increased. Thus, in 1765, Albrecht von Haller, as a member of the Sanitary Council, noted in a report that medical care was inadequate and called for an improvement in training. In fact, the Bernese authorities began taking stronger action against "charlatans" at the end of the 18th century. However, it was not until the 19th century that the newly founded canton pushed ahead with the professionalisation of medical studies in order to guarantee the care of the population.
The Talented Michel Schüppach
Wound doctor Michel Schüppach did not complete his academic education, but learned his trade in an apprenticeship. In 1727, he took over a surgical practice in Langnau. From 1768, he ran a successful spa business and earned a legendary reputation. Sick people from all over Europe appreciated his diagnosis by means of urinalysis, and prominent guests such as Johann Wolfgang von Goethe also made pilgrimages to Langnau. Haller and other doctors were less pleased. For them, Schüppach's methods were the epitome of uneducated crankery and a reason for the poor health care in rural areas. Accordingly, they portrayed him as a deadly quack.
The First Vaccination
Smallpox was one of the most common causes of death for centuries. At the end of the 18th century, the English country doctor Edward Jenner presented the vaccination (from the Latin vacca: cow). This harmless vaccination with cowpox virus protected people, but is not based on research but on empirical knowledge. It spread quickly – even in Bern, the surgeon Rudolf Abraham von Schiferli advocated free vaccination as early as 1800. The smallpox vaccination marked a turning point in state health policy: For the first time, the general population could be protected against an epidemic in advance. At the same time, massive resistance began forming against state intervention.