Historical role of city-appointed physician
City physician (German: ; , , from Latin ) was a historical title in the Late Middle Ages for a physician appointed by the city council. The city physician was responsible for the health of the population, particularly the poor, and the sanitary conditions in the city. His duties also included the supervision of pharmacies and the supervision of those engaged in medical tasks, such as midwives and barber surgeons. In addition, he had forensic duties such as assessing the injuries of living persons, external postmortem examinations, and conducting autopsies in cases of non-natural and unexplained deaths. In times of epidemic, many city physicians published small, printed books of guidelines. His functions combined aspects of the modern health minister, chief medical officer, coroner, and medical/pharmaceutical licencing authority.
The role existed in what are today a number of European countries, including Germany, Estonia, Finland, Norway, Poland, Sweden, and Switzerland.
Holy Roman Empire and German Confederation.
A or (learned "body" physician in contrast to the practice-oriented ) or (also, in about the 15th century in Augsburg, referred to as ) was appointed by the city council and, in addition to his private practice, performed roughly the tasks of a modern-day health department. The designation was the title for the civil servant physician in Prussia until 1901.
Well-known early city physicians include Hugh of Lucca, who was appointed surgeon in Bologna, Italy, in 1214, and William of Saliceto, who was appointed city physician in Verona, Italy in 1275. Other cities in the Empire established physician positions in the 13th and 14th centuries. Later, per the 1426 decree of Emperor Sigismund, all cities in the Holy Roman Empire were required to hire a city physician.
In the late 16th and early 17th centuries, the preparation of calendars with astrological weather forecasts was also often performed by city physicians.
Some city physicians also acted as personal physicians ("Leibärzte") to noble or ecclesiastical dignitaries.
In less densely populated regions, the office was combined as city and district physician ( "Kreisphysicus"), who had to care for or supervise a specific medical district in addition to the city.
The deputy of the city physician was called , e.g. in Hamburg.
Sweden.
In Sweden, city physicians (, formerly ) were responsible for the duties in cities which in rural areas belonged to provincial physicians ("provinsialläkare").
As early as the beginning of the 17th century, some of Sweden's cities (Stockholm, Gothenburg, Falun, Gävle, Malmö and Kalmar) hired a in their service. In 1669, a city surgeon (city barber) was hired to work alongside the city physician in Stockholm, to assist in the treatment of external diseases and accidents. By royal decree in 1827, both posts were transformed into those of city physician (first and second city physician). In 1757, the first city district doctors in Stockholm (three in number) were employed to provide medical care for the city's ailing poor.
In Stockholm, Gothenburg and Malmö, the chief city physician or city physician was equal to the chief provincial physician in the counties, with almost the same duties as the latter. City doctors were appointed by the city council ("stadsfullmäktige"), after the Medical Board had given an opinion on the competence of the respective applicants and the city's health board had been given the opportunity to give its opinion on the matter.
City district physicians (), that is to say, persons who exercised the function of city physicians only within a certain district of the city, were appointed in the same order by the city council, unless the administration of the public health service was entrusted to the board of health, in which case the appointment of these physicians could also be entrusted to the same board.
In Stockholm, the role of city physician was established in 1827 and lasted until 1971.
Finland.
The position of city physician (, later ) existed in Finland during the Swedish era and for a time after the country declared independence. Turku was the first city to hire a city physician, in 1755, and Helsinki was the second in 1774.
Norway.
In Norway, Bergen was the first city to have a city physician ( or , lit. 'city doctor'), appointed in 1603. Oslo's city physician role existed from 1626 until it was abolished in 1988; its city physician also held the role of head of the city's health council. In Trondheim, the post was created in 1661, with Jens Nicolaisen as its first doctor.
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