Nursing history

MAK H DY EAU H OL A CULTURAL HISTORY OF AESTHETIC SURGERY H L. GILMAN ... MAKING THE BODY 6(Wtiful A CULTURAL HISTORY OF AESTHETIC SURGERY Sander L. Oilman PRINCETON UNIVERSITY PRESS PRINCETON AND OXFORD ... Copyright © 1999 by Princeton ...

Número 47 de Cultura de los Cuidados. Contiene una editorial de Carmen Domínguez Alcón y otras interesantes colaboraciones de eminentes autores que han publicado sus trabajos en las secciones habituales: fenomenología de los cuidados, historia de la enfermería, antropología de los cuidados, teoría y métodos.

Although deaconess life had its place in England from 1861, its growth in terms of numbers of deaconesses was not substantial. The role of the deaconess, though attractive to many religious women and men, was constrained by its perceived similarity to community-centred religious life (that of both Anglican and Roman Catholic nuns and sisters). Links with Kaiserswerth were important to the early beginning of many deaconess communities, but the need to distance the movement from ‘foreign’ elements echoed the cultural undercurrents which limited its growth and influence. Deaconess nursing was an important early means of ministerial outreach but its institutional form waned in some quarters by the end of the nineteenth century. The marginalisation of deaconess nursing, particularly in its institutional forms – the core concern of this article – was a result of the interplay between the religious mission of deaconesses and the developing sophistication of the medical marketplace.

Invalid cookery was a key skill of trained nurses up until the 1960s and before the introduction of intravenous feeding was the sole way of keeping sick and wounded patients alive. Although historically seen as mundane, food preparation and feeding took significant amounts of time of a nurse’s daily work. For Australian military nurses on hospital ships and working in hospitals in Egypt and Greece in 1915, feeding soldiers suffering malnutrition and wounds became a significant part of a military nurse’s workload and inventive solutions were necessary in countries overflowing with casualties and short on food supplies. Neglected in the rich and growing body of military and civilian hospital histories in Australia, invalid cookery is a lost part of nursing work these days and thus is of interest to those seeking to define nursing practice in this period.

The social exploits and behaviour of nurses during the Anglo-Boer War, 1899-1902 60 Charlotte Dale 4 'They do what you wish; they like you; you the good nurse!': colonialism and Native Health nursing in New Zealand, 1900-40 84 Linda Bryder 5 Training the 'natives' as nurses in Australia: so what went wrong? 104 Odette Best Contents vi 6 Working towards health, Christianity and democracy: American colonial and missionary nurses in Puerto Rico, 1900-30 Winifred C. Connerton 7 The early years of nursing in the Dutch East Indies,

Introdução
Este trabalho centrou-se na análise da obra de António d’Almeida (1797), cirurgião do Hospital Real de São José que nos apresenta o método mais simples e seguro de tratar as feridas produzidas por armas de fogo. Teve como finalidade compreender o método de tratamento de feridas produzidas por este tipo de armamento.

Finalidade
Compreender o método de tratamento de feridas produzidas por este tipo de armamento.

Objetivos
• Explicar algumas das diferentes propostas apresentadas a partir do
        séc. XVIII para tratar as feridas produzidas por armas de fogo;
• Identificar tipos de feridas produzidas por armas de fogo;
• Esclarecer os acidentes e as causas que estão na sua origem;
• Descrever alguns dos métodos utilizados para diagnóstico;
• Listar os tipos de corpos estranhos encontrados nas feridas de
        armas de fogo no século XVIII;
• Desvelar alguns dos métodos utilizados para prognóstico;
• Explicar o método simples e seguro, proposto por d`Almeida para
        tratar este tipo de feridas.

Método
Análise detalhada, síntese e discussão da dissertação de António d’Almeida pelo grupo e sua apresentação sobre o formato de poster.

Resultados/Discussão
Na obra de António d’Almeida (1797) são referenciados vários métodos utilizados para tratamento de feridas produzidas por armas de fogo a partir do século XVI.
Inicialmente os métodos utilizados por ilustres cirurgiões como João de Vigo (1450-1525), eram muito cruéis, resultando muitas vezes no agravamento das feridas. Ambrósio Paré (1510-1540), foi então um dos primeiros cirurgiões a propor uma mudança dos métodos praticados até aí.
Segundo o autor, as feridas produzidas por armas de fogo eram contusas e dividiam-se em simples e complicadas. As feridas complicadas resultavam de acidentes primitivos ou consecutivos que podiam ser locais ou gerais. As feridas produzidas por armas de fogo tinham como etiologia todos os corpos que impelidos pela explosão da pólvora dividiam a continuação dos tecidos, resultando no trauma da zona afetada.
O diagnóstico destas feridas conseguia-se pela observação: visual; tátil e auditiva; da reação do ferido, tanto verbal como não verbal.
Segundo o autor, os corpos estranhos que se podiam encontrar nestas feridas eram por exemplo: balas; terra; lascas de pau; de vidro; entre outros.
O prognóstico era relativo e dependia de quatro fatores: da qualidade das feridas; dos órgãos afetados e da sua importância vital; do tipo de acidentes e da constituição física dos sujeitos atingidos pelas armas de fogo.
Na cura destas feridas começava-se por retirar todos os corpos estranhos; limpar a ferida com um pano e efetuar a primeira cura, a qual incluía: lavar a vizinhança da ferida com vinho branco; aplicar pranchetas ou camadas de fios secos macios sobre as feridas e em cima, chumaços molhados em vinho, presos por ligaduras e, finalmente imobilizar a zona afetada.

Conclusão
Através da análise da obra de António d’ Almeida verificámos que o tratamento das feridas provocadas por armas de fogo sofreu uma grande evolução do séc. XV ao séc. XVIII. Inicialmente, os métodos eram cruéis e agravavam a maioria das feridas. O autor desenvolveu e apresentou uma nova abordagem no tratamento de feridas produzidas por armas de fogo tanto ao nível do diagnóstico quanto do processo de cura.

Bibliografia
D’ almeida, A. (1797). Dissertação sobre o método mais simples e seguro de curar as feridas das armas de fogo. Lisboa: Real Oficina Tipográfica.

During World War I and its aftermath, thousands of U.S. nurses put their domestic careers on hold to work overseas. Many volunteered in the wake of war and disaster. Others worked as instructors in nursing schools and as the staff of fledgling public health agencies. This article charts the international travels of four especially mobile nurses, whose globetrotting careers took them to Europe, Asia, and the Caribbean. These women aspired to tackle world health issues, motivated by the conviction that the spread of U.S. professional nursing ideas stood to modernize the world. This article tells these nurses' stories and analyzes their ideologies of development and progress. In so doing, it demonstrates that professional women, working outside state channels, played a principal role in expanding U.S. influence in the world. Moreover, it makes the case for the centrality of nursing history to the history of U.S. foreign relations.

Las Órdenes profesionales pertenecen promover la autorregulación profesional, defender el interés público y los derechos de los ciudadanos. En Portugal la Orden de Enfermería era un sueño acariciado. Este texto tiene como objetivo rescatar los antecedentes históricos que llevaron a la Orden e identificar las organizaciones y personalidades que han estado en su génesis. Utilizamos fuentes primarias y secundarias. El sueño de crear una asociación para regular la enfermería en Portugal y la representar internacionalmente llegó en 1940 con el modelo anglosajón de formación de enfermeras y culminó en 1998 con la creación de la Orden de Enfermeros.
Palabras claves: Portugal; Historia de las Instituciones; Historia de la Enfermería; Orden de Enfermeros.


To Professional Orders belongs the promotion of professional self-regulation and the public interest and citizens' rights defence. In Portugal the Nurses Order was a long-cherished dream. This text aims to recover the historical path that originated the Order and to identify organizations and personalities that were in its genesis. We used primary and secondary sources. The dream of creating an association that regulated Portuguese Nursing and represented it at the international level emerged in the 40s with the Anglo-Saxon Nurses Training Model and culminated in 1998 with the creation of the Nurses Order.

Key Words: Portugal; History of Institutions; Nursing History; Nurses Order.

Nursing history was a core component of early nurse training programs as early as 1907 when American Adelaide Nutting published her three-volume history. Yet it all but disappeared by the end of the 20th century, supplanted by myriad other subjects. The University of Ottawa Nursing History Research Unit developed two online nursing history courses, in English and French respectively, which proved popular and prompted substantial interest regarding our experiences with the re-introduction of nursing history. The aim of this study was to examine the concept of “historical thinking” (what it is, how it develops, and what it contributes to practice-based professions) in a case study based on student postings in these courses. We were especially interested in the online format, as well as the use and critical appraisal of primary sources for the development of historical thinking. Analysis suggests that primary sources and critical appraisal skills are key to the formation of historical thinking, and that these courses fostered a strong sense of professional identity among participants who often lamented lack of previous exposure to nursing history. Online nursing history courses can capitalize on e-learning technologies, and fit crowded curricula and student learning styles while extending the reach of historians beyond traditional university walls.

To provide an overview of nursing research in Jordan based on the topic researched, source and setting of data collection, methodology, theoretical framework used and source of funding. Nursing research contributes to nursing education, clinical practice, health policy and the establishment of nursing research priorities in Jordan to guide future research. Databases such as MEDLINE, CINAHL, Google Scholar, PubMed and national sources were searched for published articles related to nursing in Jordan through a range of keywords. Articles were included in the analysis if they were published in English or Arabic through December 2012. The search resulted in the identification of 999 publications, from which 462 articles met the inclusion criteria and were included in the review. The highest percentage of studies (23% of articles) focused on nursing management issues. Forty-four per cent were conducted in a hospital setting; only six studies used a nursing theory. Seventy-seven per cent of the studies were quantitative and 29.0% were funded mostly by universities. Twenty-one per cent were not directly related to improving nursing education or practice in Jordan. A Jordanian Database for nursing research was developed as a result of this review. Jordanian nurses have slowly started to build nursing research, the real nursing research work in Jordan started with the return of the first PhD graduate to Jordan in 1986. Jordanian nurses in collaboration with international colleagues were motivated to publish research and build the body of nursing knowledge.

The social exploits and behaviour of nurses during the Anglo-Boer War, 1899-1902 60 Charlotte Dale 4 'They do what you wish; they like you; you the good nurse!': colonialism and Native Health nursing in New Zealand, 1900-40 84 Linda Bryder 5 Training the 'natives' as nurses in Australia: so what went wrong? 104 Odette Best Contents vi 6 Working towards health, Christianity and democracy: American colonial and missionary nurses in Puerto Rico, 1900-30 Winifred C. Connerton 7 The early years of nursing in the Dutch East Indies,

Adducing historical, philosophical and biomedical evidence, Morris invites us to conclude that this time-honoured physical/psychological division of pain possesses little intrinsic validity. It is the legacy of an exploded metaphysics, which shores up a difficult-to-defend division within medicine (between somatists and psychiatrists). It conveniently shelves, for the medical profession, the more intractable problems of chronic pain that cannot be attached to identifiable lesions, rather as has been suggested by A. D. Hodgkiss in his 'Chronic pain in nineteenth-century British medical writings', History of Psychiatry, 1991, ii: 27-40. Morris has constructed his book as a sequence of thematic essays, designed to challenge these dubious dichotomies and bring evidence to bear from a range of sources-patient experience, the world's religions, great fiction (e.g. Tolstoy's Ivan Ilych), aesthetics, sexology, and so forth-to enrich our understanding of the phenomenon. Arguing thematically that pain is to be taken not as sensation but as experience (that is, sensation filtered through culture), Morris demonstrates convincingly the extraordinary relativity of pain encounters, concluding that coping with pain depends heavily upon appropriate kinds of cultural training. Our society is one, he argues, which has abandoned all serious education in the endurance of pain, not least because it is no longer perceived as having any positive value or meaning. Analysing the cultures of Stoicism, Epicureanism, and Christianity, Morris explains the meanings attributed to pain in earlier value-systems (punishment, trial, scourge, blessing, warning), which once understood were expected to make it more bearable. A certain amount of the ground traversed in this book is familiar; I would have preferred a more sustained analysis of transformations in medical thinking (e.g., before and after anaesthesia) rather than the somewhat marginally relevant discussions of pain and the aesthetics of the sublime, or the mandatory account of de Sade, or speculations on Lyotardian post-modernist readings of pain. Nevertheless, The culture of pain constitutes a lucid and illuminating historical and literary introduction to a vexed topic. Roy Porter, Wellcome Institute THOMAS R. COLE, The journey of life: a cultural history of aging in America, Cambridge

O quotidiano impregnado de religiosidade no Portugal do séc. XVII repercutiase também nas instituições de assistência, nomeadamente nos Hospitais de então, de que o Hospital Real de Todos os Santos, em 1620 gerido pela Misericórdia de Lisboa, era um exemplo. Silva (2014) refere que, naquela época, “em Portugal, a assistência aos doentes em meio hospitalar entrecruza-se com a tradição católica, quer através do papel desempenhado pelas Misericórdias no sistema de saúde, quer através da presença de várias ordens religiosas” (p. 63).
De fato assim era. Disso nos dá noticia Frei Nicolau D` Oliveira em 1620 na sua obra Livro das Grandezas de Lisboa, onde no quinto tratado (fl.118ft – fl.135vs), apresenta o Hospital Real de Todos os Santos (HRTS), e de alguma forma descreve o seu quotidiano onde se desvelam as práticas e rituais religiosos a que eram submetidos os doentes desde a admissão, até depois do seu falecimento.

In Germany and Britain the administration of anaesthetics during surgery was, for a limited time, one of the operating-room nurse's tasks. Yet, there were very significant differences between the British and the German cases-particularly in relation to the timing of the creation and dissolution of the role of "nurse anaesthetist". In this paper, we argue that these differences can be interpreted from a gender-history perspective by examining both the written record and the material culture of anaesthesia in the late nineteenth and early twentieth centuries. Our analysis is grounded in some of the relevant literature surrounding the distinct trajectories of professional development in the two countries. We address the ethical issues at the heart of decision-making about whether nurses should administer anaesthesia. In doing so, we offer a particular focus on the role the objects used during anaesthesia played in supporting arguments for both the professionalisation and de-professionalisation of nurse anaesthetists. During the later twentieth century in both countries, one key competence of nursing, namely the holistic concept of monitoring the patients, was largely transferred to machines.

Bioethics in America ORIGINS AND CULTURAL POLITICS ML Tina Stevens In Bioethics in America, Tina Stevens challenges the view that the origins of the bioethics movement can be found in the 1960s, a decade mounting challenges to all variety of authority. Instead, ...

PORTUGUÊS
Este estudo teve por objetivo analisar o cuidado prestado por enfermeiros aos feridos e enfermos do terramoto de 1755, em Lisboa. Realizou-se uma pesquisa documental das fontes primárias identificadas, utilizaram-se as Portarias do Governo sobre o tratamento dos feridos, a assistência aos enfermos e a sua situação após o terramoto. Foi ainda analisado o livro das Enfermarias das Portas de Santo Antão, da Casa dos Almadas no Rossio e em São Bento da Saúde, após o terramoto, em 1755. A análise destes documentos permitiu desvelar várias dimensões da assistência pós-terramoto, nomeadamente no que respeitou à admissão e registo das entradas nas enfermarias provisórias. Conclui-se que houve enfermeiros religiosos e leigos do Hospital Real de Todos os Santos envolvidos na assistência a feridos e enfermos, com a clara indicação de que esses enfermeiros eram treinados.
Descritores: História de enfermagem; Desastres naturais; Terramotos

INGLÊS
The objective of this study was to analyze the care provided by nurses to wounded and sick people in the 1755 Lisbon earthquake. Documentary research was conducted with the primary sources identified, including government’s ordinances on wound treatment, care to the wounded, and the post-earthquake situation. The book Enfermarias das Portas de Santo Antão, Casa dos Almadas no Rossio e em São Bento da Saúde, written after the 1755 earthquake, was used. Analysis of these documents allowed to reveal several dimensions of the post-earthquake care, especially as regards the admission and records made in the temporary nursing rooms. Religious and lay nurses were found in the records of the Hospital Real de Todos os Santos, who were involved in the care to wounded and sick people, with a clear indication that these nurses were trained.
Descriptors: Nursing history; Natural disasters; Earthquakes

ESPAÑOL
Este estudio tuvo como objetivo analizar el cuidado brindado por enfermeros a los heridos y enfermos del terremoto de 1755, en Lisboa. Se realizó investigación documental. De las fuentes primarias identificadas, se utilizaron los Decretos del Gobierno sobre el tratamiento de los heridos, la atención a los enfermos y a su situación luego del terremoto. También fue analizado el libro de Enfermería de Portas de Santo Antão, Casa dos Alamadas en Rossio y en São Bento da Saúde después del terremoto de 1755. El estudio de estos documentos permitió develar varias dimensiones de la atención posterremoto, objetivamente en lo atinente a la admisión y registro de entradas en las enfermerías provisorias. Se concluye en que hubo enfermeros religiosos y laicos del Hospital Real de Todos os Santos involucrados en la atención a heridos y enfermos, con claros indicios de que tales enfermeros estaban capacitados.
Descriptores: Historia de la Enfermería; Desastres Naturales; Terremotos.

O posicionamento terapêutico e os seus efeitos são complexos e importantes para a prestação de cuidados de saúde, mas tem sido pouco valorizado na prática clinica, na formação e na investigação. Estas inquietações levaram-nos a questionar a influência histórica do posicionamento terapêutico nos cuidados de enfermagem em Portugal. Este estudo, teve por objetivos: a) identificar referências sobre posicionamento terapêutico nos regulamentos, regimentos e livros de referência dos cuidados de saúde no recorte temporal compreendido entre 1329 e 1900 e b) analisar a intervenção dos enfermeiros na execução deste cuidado. Recorremos ao método histórico, com recurso à técnica de pesquisa documental. A colheita de dados foi feita com consulta a fontes primárias, destacando-se os Regulamentos, os Regimentos hospitalares e livros editados no período em análise. Os documentos da amostra respeitam os critérios de inclusão, previamente definidos e foram sujeitos à critica interna e externa. Nos regulamentos e regimentos de diferentes hospitais, encontramos essencialmente referência a material distribuído para conforto e bem-estar do doente, nomeadamente material para a cama dos doentes, equipamento esse com potencialidade para ser usado em diferentes posicionamentos, mas sobre isso as fontes nada revelam. É sobretudo com o aparecimento de um livro para a formação dos enfermeiros que encontramos referências ao posicionamento e como o utilizar na aplicação de diversos tratamentos. É necessária investigação que valorize esta intervenção autónoma de enfermagem.
Descritores: História; Posicionamento do Paciente; Enfermagem.

In the early twentieth century in Portugal, nursing care was for the most part provided by religious women. Many doctors opposed this nursing care, such as the Republican Miguel Bombarda. However the religious nurses were absolutely necessary in order for health institutions to function, among these institutions, some of the Mercy hospitals stand out; however, not all of them had religious workers. Two examples were the Braga and Porto Mercy Hospitals.
With this research I intend to understand the position of religious nursing detractors and identify the information that its defenders had.
With this purpose, I used two existing sources at the Portugal National Library. Miguel Bombarda´s work, A Enfermagem Religiosa, published in 1910, and the collection of testimonies collected by Rebelo Bastos in 1941, and published in 1974, under the title Para a História da Enfermagem Religiosa no Hospital da Santa Casa da Misericórdia de Lamego.
When interpreting the data I used Catroga (1988), Silva (2008) and Moura (2010). The controversy between advocates of secular nursing and religious apologists nursing began in 1881, when the first nursing school was established in Coimbra. Defending secular nursing was the anticlerical and republican faction. This group understood that this work should be practiced by people with no connection to religious orders. Instead of professing a religious order, these people should have a degree in order to prepare them for the fulfilment of prescriptions and exclusive obedience to clinicians.
Defending religious nursing were clerics; doctors, imbued with strong religiosity; and mercies managers. Those who worked with the religious praised their selflessness, tenderness and Christian spirit, in the nursing care.
This controversy culminated in 1942 with the publication of Decree 32612. This edict forced the nurses both secular and religious, to possess a diploma in nursing. This was a requirement already demanded by Miguel Bombarda, three decades before.

RESUMO: No início do século XX em Portugal os cuidados de enfermagem eram maioritariamente dispensados por religiosas. Contra a enfermagem exercida por estas mulheres opunham-se muitos médicos. De entre eles salientava-se o republicano Miguel Bombarda. No entanto as enfermeiras religiosas eram absolutamente necessárias para o funcionamento das instituições de saúde, de entre as quais sobressaiam alguns dos hospitais das Misericórdias. No entanto, nem todos recorriam a pessoal religioso. Exemplo disso foram os Hospitais da Misericórdia de Braga e Porto.
Com esta investigação pretendo compreender a posição dos detratores da enfermagem religiosa e identificar as representações que dela tinham os seus defensores. Com tal finalidade utilizei duas fontes existentes na Biblioteca Nacional. A obra, A Enfermagem Religiosa, da autoria de Miguel Bombarda, publicada em 1910; e a coletânea de depoimentos colhidos por Rebelo Bastos em 1941, e publicadas em 1974, sob o título Para a História da Enfermagem Religiosa no Hospital da Santa Casa da Misericórdia de Lamego. Na interpretação dos dados utilizei autores como Catroga (1988), Silva (2008) e Moura (2010).
Foi a partir de 1881, ano em que em Coimbra foi criada a primeira escola de enfermagem, que se instalou a polémica entre os defensores da enfermagem laica e os apologistas da enfermagem religiosa. Uns e outros defendiam as virtudes dos seus protegidos.
Do lado da enfermagem laica estava a fação anticlerical e republicana. Este partido entendia que o ofício de enfermagem devia ser exercido por pessoas sem qualquer ligação a ordens religiosas. Em vez de professarem numa ordem religiosa esses indivíduos deviam possuir um curso que preparasse para o cumprimento das prescrições médicas e para a obediência exclusiva aos clínicos.
A defender a enfermagem religiosa estavam o clero; os médicos, imbuídos de forte religiosidade; e os gestores das misericórdias. Quem trabalhava com as religiosas enaltecia a sua abnegação, a ternura e o espírito cristão que elas punham nos cuidados que prestavam.
Toda essa polémica culminou em 1942 com a publicação do decreto 32612. Esse édito obrigou tanto as enfermeiras laicas como as religiosas, a possuírem um diploma de enfermagem. Esse era um requisito que três décadas antes já Miguel Bombarda havia exigido.

North Carolina and the Problem of AIDS: Advocacy, Politics & Race in the South By Stephen J. Inrig (Chapel Hill, NC: University of North Carolina Press, 2011) (256 pages, $45.00 hardcover)Stephen Inrig explores the history of AIDS in North Carolina in an attempt to explain the disparities that still exist in AIDS care and prevention in the Black community as recently as 2003. Inrig uses a social history framework to describe the challenges of AIDS care in North Carolina starting in the 1980s, comparing the responses of the White gay community with the delayed reaction of the Black community, and details his theories about why these responses unfolded as they did. Inrig's research is based on a thorough review of relevant primary and secondary sources, including his own experiences mentoring Black gay college students at historically Black universities while a graduate student at Duke UniversityInrig attempts to explain a disease that "acutely affects poor blacks in the Amer...

Since the early twentieth century, community health agencies and visiting nursing organizations jn Ncw York City havc employcd a number of outstanding Black nurses. Among theseexceptional women were three pioneers: Jessie Sleet, the k t paid disaict Black nurse in New York City' and the first Black public health nurse in the Unired States2; Elizabeth Tyler, the h s t Black nurse hired as a visiting nurse by the Henry Street Settlement Visiting Nursing Service3; and Fdi& Carter, a senior nurse at Henry Sweet for twenty-eght years.4 This article shows that b e three Black community health nurse pioneers made signrScant conuibutions to the development of New York City's comniuniry health nursing by providing much-needed health care w hundreds of unserved members of the Black community, providing strong leadership in their roles as supervisors, administrators, and educators in patients' homes, babies' health stations, d e m e n t houses, and dinia.

Printed in Canada on FSC-certified ancient-forest-free paper (100% post-consumer recycled) that is processed chlorine-and acid-free. Library and Archives Canada Cataloguing in Publication Toman, Cynthia, author Sister soldiers of the Great War : the nurses of the Canadian Army Medical Corps / Cynthia Toman. (Studies in Canadian military history) Includes bibliographical references and index. Issued in print and electronic formats.

© 2003 Duke University Press All rights reserved Printed in the United States of America on acid-free paper °° Designed by CH Westmoreland Typeset in Carter & Cohn Galliard by Keystone Typesetting, Inc. Library of Congress Cataloging- in-Publication Data appear on the last ...

hygiene. Th e universal obligation to acquire the basics of health maintenance and thereby build up resistance to disease and premature decay was not questioned by physicians. Indeed, they were the source of a constantly fl owing and broadening stream of knowledge about the body, translated into popular terms, which the general public was intended to take to heart. 5 When it came to the actual treatment of illness, however, self-help movements, unregulated therapists, popular medical traditions, self-acquired knowledge, and alternative medicine all equally provoked opposition and controversy. Self-Help, Naturopathy, and an Inquiry into the History of Nursing Practice From the mid-nineteenth century onward, alternative medicine in the German Empire and in the Swiss Confederation played a dynamic role in the organization and institutionalization of medical self-help. 6 Founder fi gures and their medical concepts, associations and alliances of devotees, spas off ering cold water cures and other such treatments, and above all, mass-produced booklets and journals all disseminated their lore of natural healing, graphically affi rming that their conception of a medical alternative, entailing self-help and the services of lay therapists and unorthodox physicians, was a resource as important as, or even superior to, orthodox medical science, including the services of a doctor. Self-help was held to be indispensable-certainly in cases of emergency, when a physician was too far away or when his prescription could not help. Many eff orts were made to inform the public about the benefi ts of nature cures, homoeopathy, and other healing methods, as well as to warn it about critical aspects of physicians' treatments, such as surgery, vaccinations, or the administration of drugs. Th is barrage of information included pointed comment on the negative aspects of competing unconventional methods. On the eve of World War I, behind the biggest organization of medical alternatives stood naturopathy. Th e Deutsche Bund der Vereine für naturgemäße Lebens-und Heilweise counted almost 150,000 members and 890 local associations. 7 A similar organization in Switzerland, going by the name of the Schweizerischer Verband für naturgemäße Lebens-und Heilweise, boasted 6,000 members and over forty member-associations. Other bigger and smaller alliances, organizations, and associations promoted lay homoeopathy, Kneipp's methods, or biochemistry. 8 Although physicians were often the charismatic founders of treatments and built careers as well-known directors of a Kurhaus, a sanatorium or a spa, 9 alternative medicine as such was relegated to the margins of

The ability to cope with an end-of-life situation is a key qualification in nursing care. All things considered, German nurses may be said to have seen their first exposure to a terminal patient as an initiation into the profession. When a young woman was able to deal with death and with dying patients, she was generally regarded as suitable for the nursing profession.1 Pivotal for this terminal care that nurses had to render was the question of whether a seriously ill patient should be told the truth about his or her imminent death and then, how this "truth" was to be dealt with. Under the rubric "truth at the bedside" ("truth telling" in the American debate), discussion is currently taking place in German-language literature on the medical ethics of whether and to what extent the physician should disclose his prognosis to a dying patient. In Germany, even nowadays, the question of how to deal with truth telling is something that has to be negotiated between nurses and physicians and sometimes gives rise to conflicts. From the legal point of view, diagnosis and prognosis as well as their disclosure to the patient are exclusively reserved to the physician. However, nurses are frequently confronted with questions from seriously ill patients and their wish for comprehensive disclosure of their condition. Th us, German nurses frequently feel quite powerless when, in their view, the patient is not, or only insufficiently, informed about an incurable and fatal disease.2 This article retraces the historical roots of the medical and nursing ethical question of truth telling back to the nineteenth century. It focuses on the perspective of the nurses trained at the first German deaconess motherhouse at Kaiserswerth and compares their way of dealing with dying patients, death, and truth telling with the reflections of physicians on this topic in the nineteenth century. The analyses in this article are based on everyday sources on Protestant nursing care, because a large number of these historical records exist, while hardly any records are available on daily work in Catholic nursing care.3 Consequently, the results presented in this article offer only limited insight into the daily routine of nurses in dealing with dying patients and truth telling and thus have to be understood as a first approach to this topic. First, physicians' positions on truth telling in the nineteenth century are presented and analyzed. After that, the specific manner in which Protestant nurses, the Kaiserswerth deaconesses, dealt with the issue of disclosing the truth to dying patients about their imminent death is examined, and possible lines of conflict concerning physicians' medical-ethical views are determined. Beside medical publications, this article is based on the large stock of deaconesses' letters written to the superintendents of the deaconess motherhouse at Kaiserswerth by Christian nurses on a regular basis, in order to report about their work and their experiences at hospitals and in community and private care.4 Physicians' Positions on Truth Telling in the Nineteenth Century During the first half of the nineteenth century, physicians' reflections on the issue of truth telling were closely linked to views on "dying well" (euthanasia or, in its original German meaning, a "dignified death").5 In his work Ueber Euthanasie (On Euthanasia), the Goettingen professor Karl Heinrich Marx (1840-77) made a distinction between "exterior" and "interior" euthanasia. By means of exterior euthanasia the physician took care of the dying patient's physical health; by means of interior euthanasia he looked after the patient's spiritual well-being.6 Contemporary professional colleagues also regarded interior euthanasia as their task, stressing that the physician was not allowed to leave the dying patient even if he could not help him further from the medical point of view. They saw it as the physician's duty to encourage the patient and alleviate the dying process by means of regular visits. …

health sciences, history THE CANADIAN HISTORICAL REVIEW utpjournals.press/chr Offering a comprehensive analysis on the events that have shaped Canada, CHR publishes articles that examine Canadian history from both a multicultural and multidisciplinary perspective.

The drama of retreat, persecution and action played 233 out in Hungary 9 Aid and protection on the eve of liberation 251 10 Conclusion 273 vii viii Contents Biographical notes: who was who in the ICRC Appendix: Translation of documents in German Notes Bibliography Index