Modernist Surgery

The Perfect Machine: The Body and Modernist Surgery in Early Twentieth-Century Vienna

Thomas Schlich

Thomas Schlich's project dealt with surgical machines and Viennese Modernism, war and dance revues, technologies of objectivity and the standardization of the body. These are a few of the topics discussed in the project's analysis of rationalization and standardization in modern medicine, and which are culturally and historically contingent phenomena, and not, as we might tend to think, ahistoric and universally applicable notions. The project showed the historical character of these concepts. It used the example of one of the most important twentieth-century fracture specialists, Lorenz Böhler (1885–1973), who was widely admired for his standardized treatment regime. He was one of those early twentieth-century fracture surgeons who organized his work according to the ideals of rationality and efficiency, and for whom the idea of the perfect machine served as a model for both understanding the human body and for organizing work processes—hence the project title. His system of fracture care was associated with the world-famous accident hospital in Vienna, which the public accident insurance company AUVA had set up for him in 1923. The system’s roots, however, go back to WWI. In this project, Thomas Schlich analyzed the practical, cultural, and political conditions of the emergence and eventual migration of Böhler’s locally created culture of rationalization and standardization in detail.

The history of Böhler’s modernist project led Schlich to address a number of additional themes of broader historical interest. One was the mutual relationship between body concepts and the organization of work processes, which shared the machine metaphor as a central point of reference. Schlich looked at the relationship in the context of rationalization efforts in industry, describe its spread to healthcare, and followed this thread into the realm of surgery. The origin of Böhler’s treatment system in WWI led to another central theme—the impact of war on medicine, in particular the effect of WWI on medical innovation in both the technical and the organizational realm. When Schlich examined the eventual transfer of Böhler’s local culture of standardized practices to a civilian setting, he focused on the links between the efficiency-oriented view of body function and wider economic concerns. Since the new context of Böhler’s work was accident insurance, this examination included a historical investigation of the culture and epistemology of the early twentieth-century insurance industry. Schlich then broadened this perspective and raised the question of how Böhler’s rationalized fracture care fit into the broader environment of his time and place—in other words, how it related to Viennese Modernism, a historical phenomenon in art, architecture, politics, science, and philosophy, of which Böhler was a surgical proponent.

The project brought together a number of heterogeneous and as yet separately discussed historical developments and approaches. Above all, it combined the careful examination of practices, material culture, and scientific knowledge with an interest in the concerns of wider cultural history.

  • Thomas Schlich, “The Perfect Machine: Lorenz Böhler’s Rationalized Fracture Treatment in WWI,” Isis 100 (2009), 758-791.
  • Thomas Schlich: “Knochenbruchbehandlung und die Tiller Girls: Chirurgie, Tanztheater und Modernismus im frühen zwanzigsten Jahrhundert,“ in Kornelia Grundmann & Irmtraut Sahmland (eds.), Concertino - Ensemble aus Kultur- und Medizingeschichte. Festschrift zum 65. Geburtstag von Prof. Dr. Gerhard Aumüller, University Library Marburg, Marburg 2008, pp. 177-189.
  • Thomas Schlich: “Zeitgeschichte der Medizin: Herangehensweisen und Probleme,” Medizinhistorisches Journal 42 (2007), 269-298.