The Perfect Machine: The Body and Modernist Surgery in Early 20th-Century Vienna

My project deals 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 which will be discussed in my analysis of rationalization and standardization in modern medicine, and which, I argue, are culturally and historically contingent phenomena, and not, as we might tend to think, ahistoric and universally applicable notions. My project shows the historical character of these concepts. It uses the example of one of the most important 20th-century fracture specialists, Lorenz Böhler (1885-1973), who was widely admired for his standardized treatment regime. He was one of those early 20th-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 my project, I analyze 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 has led me to address a number of additional themes of broader historical interest. One is the mutual relationship between body concepts and the organization of work processes, which shared the machine metaphor as a central point of reference. I look at the relationship in the context of rationalization efforts in industry, describe its spread to health care, and follow this thread into the realm of surgery. The origin of Böhler’s treatment system in WWI leads me 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 I examine the eventual transfer of Böhler’s local culture of standardized practices to a civilian setting, I focus 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 will include a historical investigation of the culture and epistemology of the early 20th-century insurance industry. I then broaden my perspective and raise 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, as I claim, Böhler was a surgical proponent.

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