It is one of the greatest achievements in the history of medicine to this day: the invention of anaesthesia. It was born in 1846 when the American dentist William Thomas Green Morton performed jaw surgery after anesthetizing his patient with ether. The following decades saw continuous improvements in anaesthetic agents and methods, thus paving the way for the successful introduction of pain relief in medicine. However, not all strata of 19th century society approved of the credo of pain avoidance - quite the contrary. At about the same time, one could observe a revival of forms of piety which had been considered outmoded and which attached great importance to suffering and pain. "This can also be explained by the sense of uncertainty prevailing at the time of transition to modernity," explains historian Maria Heidegger from the University of Innsbruck.
The Tyrol region is a particularly interesting case for Heidegger, who is currently researching pain in 19th century Catholicism in a project funded by the Austrian Science Fund FWF. Up until the Protestant patent in 1861 and/or the establishment of the first Protestant communities in the health resort of Merano (now Italy) and in Innsbruck in 1876, Tyrol was exclusively Catholic. In 1837, Protestants were expelled from the Zillertal and Jews were not allowed to settle in Tyrol until 1867. The province was given the label of "holy land".
Stigmatics and helpers
The following example illustrates this reputation of Tyrol: between July and October 1833, 40,000 devout Catholics made a pilgrimage to the small village of Kaltern in South Tyrol to see the young Maria von Mörl. Maria was one of several well-known stigmata-bearing virgins in Tyrol at that time, whose suffering mirrored the passion of Christ and from whom people hoped to receive redemption. The faithful Catholics were not the only people to be interested in these "stigmatics". "They were surrounded by a great deal of medical attention, and often they were in the care of religious orders," reports Maria Heidegger. The affected individuals found themselves in a twin role as heroines (in Tyrol they were exclusively women) and sick patients. Incidentally, some church representatives also viewed them with a good deal of scepticism and partly deemed their cases to be related to hysteria.
Heidegger's research also focuses on this intersection between religion and medicine with regard to the phenomenon of pain, because, as the Innsbruck-based historian notes: "While a relatively small and elitist class cultivated suffering, Catholic initiatives, charitable organizations, and also religious orders and hospitals, were actively involved in alleviating pain." On the basis of different groups of people - including the stigmatics, patients of country doctors, people with mental illnesses and members of the Sisters of Mercy - the research team presents a differentiated picture of the approach to pain in 19th century Catholic history, which was not in contradiction with the medical view of pain avoidance.
Collaboration of religious and medical history
For the project, the team in Innsbruck, where important expertise on the history of medicine has been developed in recent years, is cooperating with Tine Van Osselaer and her colleagues from the Ruusbroec Institute of the University of Antwerp. Heidegger is delighted about this unique cooperation, since Antwerp is home to flourishing research into the history of religion on stigmatics and passion throughout Europe. The results obtained in Antwerp are currently being entered into the https://mediahaven-stigmatics.uantwerpen.be database, which will now also include Austria - hitherto a blind spot in terms of scientific output according to Heidegger. In Innsbruck, Heidegger and her team are also focusing on the medical aspects of the cultural history of pain, and they are drawing on three sources. One of them is the extensive material amassed by the country doctor Franz von Ottenthal, who recorded his patient histories in no less than 87,000 short entries. "In his records we find a large number of metaphors relating to how people spoke about pain," says Heidegger, much of which has been lost in the meantime. Visualization was also used to depict pain, since people thought they could detect it in facial features.
"The most loquacious sources are the patient files from the archives of Tyrol's provincial psychiatric hospital," says Heidegger. This institution, then called "Hall Lunatic Asylum" was founded in 1830. The extensive records show clearly how patients, doctors and nurses communicated about mental and physical pain, as well as the role played by experience and making a connection between different senses. "From forensic psychiatric reports we learned, for instance, that loud complaining tended to arouse suspicions that the patient was simulating, while a quietly tortured face was assumed to be the real thing. These are interesting suppositions and clichés."
Dealing with pain in society
The project team has yet to explore the third data source of the project. They expect treatment protocols from the hospitals run by the Sisters of Mercy to provide insights into whether and how medical knowledge was implemented in nursing care. The fact that there are still close links between medicine and religion today is illustrated by the importance of charitable institutions. Pastoral care can support those affected and their relatives, and can give hope or promote healing. "The so-called 'confession' played an important role in early psychiatry and is still important today for doctors trying to get to the bottom of suffering," Heidegger confirms.
There are many different facets involved in how people deal with pain. Interpreting it in a positive way, for instance, can help if it cannot be alleviated otherwise. In Catholicism, the legends of martyrs provide guidance for this approach; even Passions are still practised today, especially around Easter. "These images of Catholic pain practices are still very present, even if they are only practised by marginal groups," confirms the researcher. This is an important aspect from the point of view of research, since the forms of pain cultivation have a profound impact on the mindset of the population. In addition, the question of how a society deals with the experience of pain always relates to empathy and sympathy, two aspects shared by religion and medicine.
Personal details
Maria Heidegger is a researcher at the Institute for Historical Sciences and European Ethnology at the University of Innsbruck, where she works at the Medical Humanities interdisciplinary research centre. As an historian of economic and social history she focuses on psychiatry and religion, the history of medicine and pain, and gender relations.