Hygiene at the University of Vienna

As "institutional history" (history of the constitution) and "inventory history" (history of traditions), ie as a represen­tation of the development and changes of the institution "Vienna's University Hygiene" on the one hand and the inventory of the expertises attributable to it in various archives on the other, are found differently profound "hygiene stories" precede almost all specialist literature and the inventory overviews. A more in-depth presen­tation, including explanations, is usually only achieved in anniversary-​related comme­morative publications or in treatises that are pregnant with decline and relieve the burden. In the formally diverse and often hidden published organi­zational histories of the Viennese University Hygiene, legitimate tradition mainte­nance, attempts at self-justification of holders of a full professorship because of the failure to implement archetypical models, illusory requests by scientists and solid intentions to influence opinions were amalgamated: Because the history of the vicissitudes of hygienic institutions teaches hygienists and interested readers significant infor­mation about the some­times unexpected socio-​politically explosive and intricate ways of hygiene-​relevant documents. Even if an Austrian history of hygiene such as the strongly prosopo­graphical one written by Flamm [2012] is limited to the current national territory, it escapes the hazard of provin­cialism thanks to the influ­ences from the Habsburg monarchy that continue to this day, and it retained its European format until its liquidation by success­fully pursuing special paths of know­ledge acquisition.

An organizational history of the Vienna University Hygiene is without a doubt a history of an institution and thus an institutional history. In this context, the institute "Hygiene" is seen on the one hand as a social and sovereign institution assigned to an area of health care, which in particular serves the benefit of the general public and, on the other hand, as a specific form of human coexistence and cooperation based on stable patterns. The latter point of view in particular allows to mature the cognition that such an institution defines its own rules of the game according to which it functions or at least should function in the imagination of those concerned. The will of the management body and its intentions design the institution and determine its professional success and reputation. According to Douglass North, all institutional structures tend to stick with the existing, especially because economically preferred actors have no interest in changing their privileges, ideologically underpinned views of the subject support the status quo, and every change is made more difficult by the necessity of altruistic and collective action. That is why institutions that are viewed as ineffective by the relevant collective remain for a long time without structural changes; they escape the economic pressure of increased efficiency and the social dynamics of changing values. They are mostly reformed through cycles of destruction, rebuilding, flowering and abasement.

So, can the history of Viennese Hygiene be read as a history of progress? This view seems very doubtful to me, as this institutional history is characterized by the lack of a recognizable continuity of the underlying intention. The institution of the Hygiene Institute at the University of Vienna was affected by its heads, who more or less successfully implemented their individual ideas of a management function, but never systematized hygiene. A culture of Austrian Hygiene in the strict sense of a voluntarily jointly cultivated canon of values of all hygienists, a consensual interpretation of the codes, could never be realized. Consequentially, the primarily appointed, the Hygiene-ordinaries of the Austrian universities, never attempted to narrate reflectively a cultural history of Austrian Hygiene. Only Flamm [2008] tried to lament the unfavorable institutional history of the Viennese Hygiene Institute with the help of a cursory history of the appointments to director's office.

A brief history of Hygiene in Central Europe, condensed to the essentials, including a definition of the subject, fills the first pages of the treatise. The second and central part of the essay deals with the history of hygiene from the perspective of institutional history, although it explains some phenomena that can only be explained in the context of the tradition and the history of the University of Vienna. Although it is ontologically certain that a Viennese Hygiene existed, this past is not epistemologically accessible even for the author as a contemporary witness. The only legitimate question at the moment is therefore whether, from the current perspective, reasons can be found for the evolvement and the doom of a self-sufficient Viennese Hygiene. The author is aware that every generation asks questions about history corresponding to its time and that the historic events and their judgmental description are constantly subjects to change.

The term hygieinos, meaning "healthy", appears for the first time in the title of a book by Diocles Karystios (4^th century BC). In antiquity, hygiene meant all medical measures that serve to maintain health, but without applying the current social concept of humans and the scientific concept of causal pathogenesis. Today, hygiene is the sum of all measures to prevent the health risk emanating from com­munic­able diseases, especially those caused by pathogens, using primarily medical and epi­demio­logi­cal pro­ce­dures for the purpose of main­taining, promoting and streng­the­ning health. As a subject at a uni­versity, it is then the teaching of hygiene. Its tasks are the main­tenance, promotion and con­soli­dation of health - cit. Flamm [2008] -, whereby the health definition of the WHO is reduced to the defense against infectious diseases.

Hygiene, perceived as a guide to the prevention of infectious diseases, is supposed to have an increasing influence on people's con­temporary world. But the views on which measures lead to adequate hygiene in everyday life seem not only to be culturally influenced, but also to change scien­tifi­cally along a time axis. Applied hygiene moves bet­ween the bio­logically developed and the culturally established, bet­ween epi­demio­logical require­ments and civili­zational needs. If the two demands in a society can no longer be reconciled at all, first the cities dis­integrate because of inadequate activities and then society because of the lack of cultural centers. If too many resources are used up in ritual acts that are largely in­effec­tive or contrary to hygiene, the popu­lation growth of a com­munity stagnates because of the inevitable excessively high child mortality. If an un­necessarily expensive hygiene is practiced, the means for other, more profitable measures of collective well-being are missing.

In ancient times, excellent applied health maintenance (≈ hygiene) was practiced in the Roman provinces on whose territory today's Austria was located. From today's perspective, this was divided into a dietetics that was left to the individual in its execution (διαιτα = way of life), originally comprising all measures for a regulated way of life, and a communal part, a hygiene-relevant building code. Numerous remains of buildings, in particular aqueducts, thermal baths, sewer pipes and latrines, testify to the high level of community hygiene in all Roman city ruins. cit. Hassl [2020a]. Hygiene was considered a gift from the gods, as art (ars), protected by the goddess of health, Hygieia, and it was strictly separated from the healing medicine craft of Asclepius and the healing magic of the all-disease-freeing goddess Panakeia. However, Galen's original idea of the determining influence of the sex res non naturales (air, food, digestion, exercise, cheerfulness, sleep), i.e. the physiological conditions or procedural processes, on the correct mixture of body fluids and thus on health of man perished with the ancient world.

The hygiene of Europe in the early Middle Ages was a fact without a theoretical foundation. By the division of the Roman Empire in 395 the knowledge of Greek-​speaking scholars threatened to be lost in the West. It is not clear whether the creeping loss of awareness of the effective­ness of communal hygiene led to the destruction of the post-​ancient cities or whether their devastation through epidemics led to the loss of supposedly useless knowledge. The decline of the Roman bathing culture in the sixth and seventh centuries AD is primarily due to the changed economic and political framework. cit. Steskal [2010]. With the establishment of the first universities probably in the 12^th century, medical training was established at the universities, although this was monitored by the church. In the High Middle Ages, the conflict between the postulate that the prevention of illness was an interference in God's plan and the early Christian commandment to love one's neighbor came to light and led to an inhibition of any desired prophylactic hygiene measures. If nursing and isolation could still be justified with the charity requirement, all communal hygienic measures were sins.

The history of post-antique hygiene in Central Europe begins again in the personal sphere, with the urban pleasure of bathing in private and public baths, which was widespread in the High Middle Ages. Bathing, which was handed down from ancient times, also included comprehensive body care by surgeons, barbers and bathers. At the same time, town and market regulations were also issued, which contained unsystematic regulations regarding hygiene. From St. Pölten in Lower Austria, for example, the Stadtbanntaiding from 1367 has been passed down, which provides for a strict market and slaughter order with an organizational separation of the sale of "fat" and finnish meat, as well as a waste disposal order. cit. Hassl [2009].

In the 16th and 17^th centuries, every disease is called a pestilence, regardless of its etiology. cit. Flamm [2008a] p 7. All preventive measures are correspondingly unsystematic and contradicting: From 1500 there are sovereign orders on behavior in times of pestilence, i.e. administrative acts by the sovereigns directed at subordinate administrative authorities. In addition, sovereign's laws on hygiene are also passed on to all which are subjects to the law. Finally, in 1539, the Vienna Medical Faculty, citing Hippocrates, advised to keep houses and places clean and fragrant as a preventive measure and to maintain large fires with fragrant woods in places. In 1540 a memorandum from the dean of the university to the city council followed with the title: 1.5.40. Wie man sich zu zeiten der Pestilentz fürsehen und erhallten mög. cit. Flamm [2008a] p 49. In addition to listing astrological and meteorological, but not magical causes of epidemics, there is also the recommendation to close public baths as a source of "poisoning" during the plague. Only the Infection Ordnung der Stat Wienn of October 28^th, 1551 stipulates a quarantine of 30 days for all foreign visitors, as well as the forced stabling of all pigs that have been free to roam the streets of Vienna until then. On the other hand, the numerous tracts of non-​official doctors on healing and avoidance are to be seen as advices, which are usually only aimed at individuals, healthy clients.

The poor reputation of the Medical Faculty of the University of Vienna in trying to prevent epidemics was not eradicated during the university reform in 1553. One of the reasons was that the artes liberales, which later turned into the Philosophical Faculty, became a course of study accessible to every class, but for the next 70 years within the Jesuit College. Medical studies, on the other hand, remained elitist and dominated by professors close to the Jesuits. These conditions resulted in the seemingly absurd attitude of doctors and hygienists trained at the University of Vienna to prevention: In the (later) Catholic-​dominated countries, the justified wrath of God was usually cited as the cause of any spread of disease, less often the bad air - cit. Flamm [2008a] p 7 - and never ever a (biological) infectious agent. Today it seems strange that doctors withdrew all livelihoods from their own actions with such justifications - recovery was due to the work of God and not to that of the doctor, who only gave advices.

The communal organization of segregated accommodations for the sick, often in the form of leprosaria, and quarantine stations for travelers was mostly only realized in the early modern period. In Vienna, various hospitals, infirmaries and poor houses had been located in the area between today's Alser Straße and Währinger Straße since the 13^th century. The "Infektions-​Ordnungen" fell into the sovereign competence: from 1561 onwards, several Imperial patents followed each other with regard to access rules in times of epidemics and keeping the city clean, and in 1598 the Imperial directive (Generale) was issued that cadavers of farm animals that died of epidemics had to be thrown into the river Danube without a prior skinning. cit. Flamm [2008a].

From the 17^th century onwards, the sovereigns and the magistrates tried to set up a health system managed by them in their territories and also to enforce their orders. This enforcement took place with the help of a police force. For the time being, this refers to all the rules governing governmental relationships within a community of persons under public law, a state people. At that time, all intervention measures to maintain public order came under the term "police". In the 17^th century, the enforcement of the hygienic regulations in the cities was dealt with by the magistrate, who carried out its work with the help of academically trained doctors, skilled surgeons, pharmacists and midwives. For the time being, the bathers also belong to this group of magistral auxiliaries, until the closure of the public baths made this profession die out. From the academically trained doctors on behalf of a magistrate, the city physicist developed, which combined the functions of a health department and forensic medicine, i.e. who later represented the "Staats­arznei­kunde".

While the execution of the command­ments of dietetics as a healthy life­style was left to each individual, in the course of the Enlighten­ment the state took over the tasks of restoring and main­taining the health of citizens and teaching these subjects. This basic idea led to the establish­ment of a hygienic education at the university, called Staats­arznei­kunde, which was to combine the later municipal medical service (= applied civil hygiene) with forensic medicine, i.e. both medical and legal cross-sectional subjects. The Staats­arznei­kunde established at the University of Vienna around 1800 had the mission to train students for sovereign tasks: It served primarily to uphold the existing laws to ward off epidemics and to maintain the health of subjects useful to the state. cit. Flamm [2012] p 15f. The main representative for this type of hygiene in Austria was Johann Peter Frank (∗ 1745 † 1821), who stayed in Vienna from 1795 to 1804 as an employee. He was the third director of the General Hospital (now AKH, predecessors: Gerard van Swieten, Maximilian Stoll), rededicated in 1794, and he is considered the founder of a public health entity, formerly known as "people's health" and now known as public health. cit. Flamm [2012] p 25. Frank wanted to use the state administration to protect people and their pets in cities from (zoonotic) diseases, to promote their health and to maximize (human) life expectancy. He called for a policy of civil hygiene, the establishment of a public health system. This made him 75 years ahead of his time. The after his leaving at the university established Staats­arznei­kunde consequently incorporated two areas of expertise, both administrative law matters with a medical impact: Court pharmacology, from which forensic medicine later developed, and the "Medicinische Polizey", which was in charge of the public, non-​military health adminis­tration and which was later renamed medical police ("Sanitäts­polizei") . This civil part of the adminis­tration is opposed to the military army medical corps, which was separated from 1805 after the Battle of Austerlitz. Disease pre­vention and health economics are still seen today as a task for politics, and sanitary regulations continue to serve to control and monitor com­muni­cable diseases and to prevent them. In the European cultural area a comprehensive hygiene was and is essentially an administrative and legal obligation of the state, but for the fulfillment of which special scientific expertise is required. The Staats­arznei­kunde established at the University of Vienna in 1804 by Andreas Joseph von Stifft (∗ 1760 † 1836) consequently had the task of training students for the fulfillment of sovereign matters.

The reason for this is a specifically Austrian: in 1522, an agreement between the later Emperor Ferdinand I and King Ludwig II of Hungary sealed the military security of the Hungarian border with the Ottoman Empire, which quickly became a border cordon with its own border feudal law (1535). This purpose was achieved by settling Serbian and Croatian refugees on desolate land with tax exemption. From the completion of this border cordon in 1764 under Maria Theresa until its dissolution in 1881, it was a 1.900 km long border strip with an area of around 50.000 sq.km., which was administered by the Court War Council. As the military usefulness declined, the epidemic-hygienic security of the hinterland increased significantly over time, particularly against outbreaks of plague. For example, the military justice system and the gendarmerie, which was set up in 1849, put travelers and goods (!) in quarantine for up to 84 days, illegal border crossers and their helpers and cover-ups were punished with death by military courts during plague times, and in case of cross-border trade of bulk goods the buyer was physically completely separated from the seller. This cordon sanitaire was controlled by a border force made up of armed farmers. At the legal border crossing points there were quarantine stations, called Kontumaz stations, where travelers had to endure their quarantine period and goods were temporarily stored and cleaned. This effort can only be explained by the fact that a transmissible &quod;Seminaria morbi&quod; was seen as the cause of the disease and not soil vapors or an imbalance in the body fluids. Due to the authorities' expectation that the border troops would be self-sufficient and the obligation to reimburse the inmates of the Kontumaz stations, the cordon sanitaire led to the impoverishment of the border residents, to famine and to the temporary interruption of local trade, which was countered with large-scale smuggling. Since quarantine hindered world trade at an international level, a Europe-wide debate about so-called quarantine damage ensued, particularly in the medical conferences of the 19^th century. The quarantine period turned out to be the most controversial factor. In Austria it was gradually shortened more and more, which in turn undermined the epidemic prevention purpose of the cordon sanitaire to such an extent that it was already considered useless in the first half of the 19^th century - at least in connection with the spread of cholera. As the bacteriological way of thinking became established, quarantine was consequently replaced by disinfection measures, because in this theory every living pathogen can be killed using suitable means and thus rendered harmless. This promise of a world free of infectious diseases quickly proved to be illusory in connection with (influenza) virus infections, but even today evidence-based medicine is still based on a chemical-technologically induced reduction in the number of active pathogens.

But, in contrast to the ideas of Frank of a rigid civilian hygiene, between 1800 and 1850 even the civilian hygienic tasks were mainly performed by the doctors trained in the Josephine Military Academy in a military environment. In Austria the reason for this could be the Catholic conservatism of the ruling house, which since the time of Joseph II could only be broken through in the military service - for areligious hygiene specialists especially in the army medical corps. In spite of the fact that Giovanni Maria Lancisi (∗ 1654 † 1720) denied any contribution from God to illness as early as 1700, the notion of contagiousness of pestilence pathogens was considered completely out of date and an anachronism in the first quarter of the 19th century. The controversy that continues to this day regarding the cause of certain diseases, which today are collectively called infectious diseases, took place until the turn of the 20th century between representatives of a theory of the decisive influence of the external environment (conditional hygiene) versus an exclusive contagiousness of microbes. On the basis of the disputes in connection with the cholera epidemics in Europe between 1852 and 1896, the contrast can be elucidated: While conditional hygienists such as Pettenkofer blamed the groundwater and the soil for the diseases, other epidemiologists such as Filippo Pacini (∗ 1812 † 1883) and Robert Koch (∗ 1843 † 1910) developed a strict theory of infection by bacteria. cit. Fangerau & Labisch [2020] p 31. The latter was then able to prevail for about 100 years, at least in Central Europe, but is currently being weakened again by the knowledge that the immune system of the infected person is the external environment of an infectious agent. The social effects that corresponded to the prevailing theory were exclusion, denunciation and stigmatization during the cholera epidemics - cit. Fangerau & Labisch [2020] p 33 - then forced therapies and debates about isolating closures (HIV-infected people) and now in 2020 the discussion about forced vaccinations.

Although a course with a hygiene component, the lecture "Medicinische Polizey", was held for the first time at the University of Vienna in 1805, upgrading hygiene to a university subject was unthinkable at that time. Because hygiene was perceived as a low, dishonorable line of business, unworthy of a qualified medical scientist. However, the enactment of the Reichs-​Sanitäts­gesetz in 1870 created a situation in which the central administration of the Dual Monarchy claimed the supreme supervision and top management of the entire sanitary system, but did not have doctors who were active in the civilian medical service and who were trained for this. The federal states implementing the law therefore urged for the creation of university apprenticeship positions, i.e. professorships for public hygiene at the main universities of the monarchy. In addition, the development of bacteriology in university institutes and hospitals began in the 1880s. the development of bacteriology in university institutes and hospitals began in the 1880s, and with it the scientific research into the etiology of infectious diseases. However, since there has been no concept for integrating hygiene in university medicine in Austria from the beginning and until today, the demands on the hygiene chair and the ultimately realised imple­men­tation could not be reconciled. The age of the frozen medical police in the Austrian part of the monarchy was to be ended and a scientifically based disease prevention system should be established: At the same time, however, the collaboration between doctors and non-​medical hygienists was difficult and was always burdened by epis­temologi­cal mis­under­standings. Natural sciences generate proba­bilities of the occur­rence of prognoses about the future of objects in an experimental way, healing as a social science analyzes and influences the inter­actions of systems with the action and behavioral processes of actors them­selves.

Franz Seraph Cölestin Ritter von Schneider (∗ 1812 † 1897) is considered to be the founder of an academic hygiene in Austria. cit. Lohff [2018b] p 117 & 125. From 1854 to 1870, Schneider was professor of chemistry at the Josephinum, the medical and surgical academy for training military doctors, then until 1876 he was professor of general and medicinal chemistry at the University of Vienna and in 1875/6 dean of the medical faculty. He expanded the Austrian sanitary system, was councilor of the city of Vienna, president of the supreme sanitary council and member of the commission for the construction of the first Viennese high-spring water pipeline. He was the last academic teacher of the old school who combined the subjects chemistry and medicine and the first doctor at the University Vienna who practiced and re-​combined a scientific-​experimental hygiene and a scientific forensic toxicology, so that the old-fashioned concept of a sovereignty based combination of hygiene and Forensic medicine, the "Staats­arznei­kunde", as a subject of university teaching was extended. Furthermore, the later conception of Viennese hygiene was anticipated through his work, as he wrote numerous reports in addition to his teaching and experimental work.

When, at the end of June 1873 during the World Exhibition in Vienna, the worst cholera epidemic ever hits the city, there was fire on the roof of the city's hygiene. The disaster, which also led to the bankruptcy of Austria, was foreseen on the basis of experiences with the cholera epidemic of 1831. cit. Angetter-Pfeiffer [2021]. Vienna's drinking water supply was supposed to be raised to a hygienically acceptable level by building a high-spring water pipeline before the world exhibition, but due to various self-made delays, this was only completed in October 1873 and thus, typically Austrian, too late. cit. Bartl [2021]. In their search for improvements for future major municipal events, the responsible authorities kept in mind the lack of university-trained physicians specialised in hygiene. Therefore and in the nature of a university, on December 19^th, 1874, the council of professors at the Medical Faculty voted for the establish­ment of an extra­ordinary professor­ship for hygiene and its task fulfill­ment by a army doctor and assistent of Schneider, the private lecturer for forensic and hygienic chemistry K.u.k. Regimental doctor (= captain) Josef Nowak, but at the same time refused to spend any equipment for the new professorial position. Although the position was paid, it lacked assistant positions and its own labora­tories at the university. From October 1875 until 1881 Nowak worked in the chemical laboratories of the Militär­sanitäts­komitees im Militär-​Garnisons­hauptspital I behind the Josephinum, which he had headed up until then, then in four miserable rooms in the old rifle factory on Alsergrund, the "K.k. Flintenschifterei", the nucleus of the "Hygienic Institute". Defying the working environment the first Austrian reference book for hygiene with the title Die Infections-Krankheiten Vom Ätiologischen Und Hygienischen Standpunkte (1882) and a teaching aid entitled Systematische Zusammenstellung der wichtigsten hygienischen Lehrsätze und Untersuchungs-Methoden (1881) came from his pen in those years. Because of Nowak's incapacity to work due to illness Florian Kratschmer took over the teaching assignment as substitute in 1883. Due to the increasingly oppressive inadequacy of the working conditions, Nowak's successor as director of the institute, Max (von) Gruber, tried to find a suitable workplace and office from 1887 on, which he was able to set up by founding the State General Research Institute for Food. In 1902 he left the University of Vienna and went to Munich. His work in Vienna is overshadowed by the fatal infection of one of his assistants, Georg von Hofmann-Westenhof, who died on October 23, 1889 at the age of 29 from a snot (= malleus) that he most likely incurred in the laboratory. The length of stay of Karl Landsteiner (∗ 1868 † 1943), who later won the Nobel Prize and worked as an assistant at the institute from January 1^st, 1896 till November 1^st, 1897, is deplorably short.

The functional concept of a Viennese hygiene with the systematized positions of a professor, two assistants and a demonstrator and the conception of two interlinked hygiene institutions, chair and food testing center, was initiated by Gruber and implemented by his successor Arthur Schattenfroh. He was able to adapt his concept of a conglomerate of several hygiene-relevant institutions in one place to the new conditions in what was then an exemplary structural environment, the Hygiene Institute building in Vienna 9, but this concept was never put into full effect. The reason was that the other two institutions in the institute building, the Institute of General and Experimental Pathology and the Serotherapeutic Institute, although organizationally independent but both professionally related to hygiene, were inter­connected at that time by a personal union of the director, Richard Paltauf (∗ 1858 † 1924). They were organized according to Paltauf's wishes in a manner that they could continue to work separately from the hygiene institute at any time. After Paltauf's death in 1924 the conglomerate began to disintegrate. The reason for the disintegration was the fateful struggles during the replacement of both, the hygienic cluster and the Paltauf facilities. cit. Wagner-Jauregg [1950] S. 84.

Because from about 1922, an anti-​Jewish and anti-​socialist personnel policy was implemented, mainly thanks to more or less secret agreements among some professors at the University of Vienna. At that time, the typical position politics of ethical solipsism set in: actors with influence on personnel policy considered it rational to judge and align their actions only according to their own preferences and not to consider the views of others at all. This led to a largely unfortunate personnel policy based on the myth that "outstanding personalities" were appointed from a more or less closed group of members of the legendary Vienna Medical School. However, none of the hygienists ever belonged to one of the Viennese medical schools. From then on, misogynist chauvinism, an unjustified preference for (Old-)Austrian youngsters by means of in-​house appointments, nepotism and clientele formation characterized the personnel policy of the hygiene facilities.

In 1923, leading professors at the Vienna Medical Faculty decided to fill the vacant hygiene chair and the management of the Hygienic Institute with the former Austrian military hygienist K.u.k. Oberstabsarzt (=Lt.-Col.) Robert Doerr (∗1871 †1952), who had been appointed full professor in Basel in 1919. to be provided. He was the outstanding first choice of all candidates considered. However, a small but determined, ethically solipsistic group around H. Reichel prevented the appointment of this excellent Master of Bacteriology (quote from the appointment report) in favor of Reichel's friend and uncle, Roland Graßberger. The same group prevented Doerr from succeeding Paltauf to the chair for general and experimental pathology, which had become vacant in 1924 and which was only provisionally occupied by the deaf (!) Carl Rothberger (∗1871 †1945). The then dean J. Wagner-​Jauregg ([1950] S. 85) described this intrigue as an action that initiated the decline of the Viennese medical faculty. The decline of the hygiene group was already in full swing: Ernst Pribram (∗1879 †1940), 1924 director of the State Sero­therapeutic Institute and associate professor for general and experimental pathology, emigrated to Chicago in 1925, his successor Rudolf Kraus (∗1868 †1932), director of the Serothera­peutic Institute and from 1927 secretary of the Inter­national Micro­biological Society, left Vienna in 1928 to become director of sanitary services in Chile. Friedrich Silberstein (∗1888 †1975) was employed as an examiner for the courses and expelled in 1938. The head of the tuberculosis department at the Sero­therapeutic Institute Ernst Löwenstein (∗1878 †1950) had to emigrate to Berkeley (USA) in 1938. The in-house pathologist Otto Saphir (∗1896 †1968) also emigrated. As early as 1921, the hygienist and founder of social medicine in Austria, Ludwig Teleky (∗1872 †1957), was pushed out of the university, he went to Düsseldorf, returned to Vienna in 1933, where R. Graßberger prevented the resumption of his lectureship and emigrated in 1938 finally to the USA. Heinrich Manfred Ritter von Jettmar (∗1889 †1971) had to work as a hygienist first in Russia (1915-21/22-24) and then in China (1924-31) before he was able to habilitate in hygiene in Vienna in 1934. In 1938 he resigned from his position as an assistant at the institute and went to China again.

The action of H. Reichel in the institute furthermore proved to be unfortunate: he came to the institute in 1905, but in 1918 the emphasis in his work shifted from bacteriology and disinfection theory to population policy, statistics and eugenics. He was a leader in eugenics, using eugenic ideas, he helped design the Second Vienna Hygiene Exhibition in 1925, and thus he considerably contributed to the institute's loss of reputation in the end. In 1933 H. Reichel became full professor for hygiene in Graz. But he avoided becoming a member or a candidate of the NSDAP well-considered.

Under Graßberger's direction, the institute's area of competence was expanded to include school, social and mental hygiene, and the rooms and staff of the terminated Institute of Patho­logical Histology and Bacterio­logy were incor­porated in 1925-6. In 1929 the General Research Institute for Food was separated in terms of personnel and organiza­tion from the Hygienic Institute at the instigation of the head of the institute, but it remained located in the building under ministerial leadership with a director as head. As a result, the Hygiene Institute lost considerable income.

The next head of the institute, Max Eugling, was a NSDAP supporter as an initially self-admitted but later denied candidate of the NSDAP, local group IX, since 1941, and he had to retire in 1946 in the course of the denazi­fication. In 1939 the Sero­thera­peutic Institute moved out of the building to make room for a Racial Biology institute. However, due to a demarcation dispute between the Philo­sophical Faculty, the Anthro­pologi­cal Institute and the Berlin Ministry, the opening of a subject-​compre­hensive Racial Biology Institute was not realized until June 1942. It was closed again in 1945. In addition, according to German study regulations, a Tropical Department was created at the institute as early as 1939, which was also closed in 1945. An Institute for Tropical Medicine was established in 1974 as a result of the increase in long-distance travel and was merged with the existing vaccination clinic, it was housed in some rooms in the building.

In the sphere of activity of the Viennese Hygiene, anyone can paradig­matically reconstruct for the University of Vienna, how an university institution and its employees initiated their own moral ruin in the years before the Second World War: not entangling them­selves too intensively in the austrofascistic structures and the Nazi structures perceived as imposed, opportunistic actors supported the prevention and dismissal policy of the University of Vienna and benefited personally from this dishonest advancement of their own careers. The "nothing known"-​policy, which was widely cultivated after the war, and the consequent non-​delimi­tation of name-like but criminal Nazi institutions contributed to the perpetual exclusion of the hygiene from the phil­anthropic, healing medical disciplines. The provincialization of Viennese medicine can also be traced back to the decline in the number of professors and lecturers at the Vienna Medical Faculty, the number of which reached a serious lowest point in 1949. This gave rise to a strange-looking procedure in the context of refilling of professorships that excluded former members of Nazi organizations in most cases, but allowed someone involved in typhus experiments in Buchenwald concentration camp to become a full professor (R. Bieling). cit. Klee [1997 & 2005].

As far as we know today, none of the professors at the Hygienic Institute was subjected to a procedure for "removal and treatment by the special commission", but the support of the overhasty resumption of teaching at the University of Vienna in May 1945 for the purpose of "making them indispensable" of incriminated teaching staff and the sub-ministerially approved prevention of the return of expelled university teachers caused damage to the image from which the Vienna Institute of Hygiene was never able to fully recover.

The first post-war professor, Marius Kaiser, began the rebuilding of the hygiene professorship and the reorganization of the institute's tasks. In June 1945 teaching was resumed abroad, and from 1950 onwards in the restored lecture hall of the house. In May 1947, comprehensive operation of all four institutes in the house began, all headed by M. Kaiser. In the course of the reconstruction of the institute building, an architecturally disastrous tower-​like structure was built on the main street front in 1950 for the purpose of carrying out bioclimatic studies.

Kaiser's successor, Richard Bieling, changed the name of the institution previously known as the Hygienic Institute to Hygiene-​Institute under the pretext that this was the only way to establish a Medical Hygiene. To this end, he created a working group on virology, which - contrary to the intention of integrating hygiene in medicine - was later operated almost exclusively by non-physicians. He tried to run the scientific business tightly and to establish "research on a large scale". Little did he change the completely inadequate working conditions and the unpleasant working atmosphere, about which the author was credibly reported by contemporary witnesses concerned. He countered the alleged shortage of qualified personnel with less than farsighted measures, such as inviting a retired colleague to take on a decisive role at the institute. This did not only deprive a young academic of the possibility to gain a qualification and of a scientific development, but also boycotted the obligation inherent in a professorship to generate a crowd of followers.

During the short term of office of Hans Moritsch, who died unexpectedly, the virology working group was expanded and then a biological department for researching the epidemiology of the TBE virus and a vaccination clinic were founded. In Heinz Flamm's tenure, which lasted a quarter of a century, several contemporary areas of work were established in the Hygiene Institute, which was constantly gaining reputation: a hospital hygiene, a medical parasitology, a tropical medicine with an outpatient department, a reformed food hygiene and a social hygiene. Flamm promoted the establishment of independent institutes in order to form once again an effective "hygiene group": 1970 the Institute for Environmental Hygiene, 1971 the Institute for Virology, 1974 the Institute for Tropical Medicine and 1983 the Institute for Social Medicine. Within the framework of the nationwide toxoplasmosis screening of pregnant women, the tasks of an University Institute of Hygiene were combined: preparing reports, creating and establishing test procedures, epidemiological research and resultant teaching. The latter, together with the microbiological diagnostics, reflects the original concept of the Viennese Hygienic Institute, which Flamm however based on the two areas adapted to the time "public health" and "microbiological determination". cit. Flamm [2012] p 16.

In 1991 Manfred Rotter became head of the institute, which was renamed the Clinical Institute for Hygiene and Medical Microbiology and equipped with a clinical unit in a hospital. Contrary to the intention of the renaming, the medical relevance of the clinical-diagnostic unit in the institute's part in the Kinderspitalgasse was noticeably thinned out. The renaming took place, among other things, because the Department of Clinical Microbiology, headed by Rotter, moved to the General Hospital just a few steps away. When the Department of Hospital Hygiene moved out of the house in 1994 and also relocated to the General Hospital, the applied and the theoretical specialist knowledge was separated in terms of personnel and organization in the sub-areas with core competence. Unintentionally reinforcing this tendency, a 228 m² business office was established in 1996 on the nearby Zimmermannplatz as a branch of the institute, which only received an operating license as a hospital in 2003. In 2000, Rotter operated the certification of the institute in accordance with ISO 9001: 2000 and the accreditation of the water department as a testing and monitoring body in accordance with ISO 17025, EN 45004 in 2003. However, during this professor­ship the institute members could not base their actions on a "mission statement" from the institute, a steep hierarchy with a tendency towards isolation at the top was established, and now openly settled particular interests and prevention tactics began to gain space in the everyday life of the institute. The best intentions to create a dust-free, economi­cally powerful and ecologi­cally oriented service company failed due to a lack of compe­tence in personnel manage­ment and of fore­sight.

Even though the University Organization Act (UOG) came into force in 1975 and the full-professorship-universities came thus to an end in Austria and collegial management bodies were installed at the universities, the institute directors who were active from then until the institute was dissolved were not in a position to take advantage of a team leadership delegating responsibility to achieve a group success. They persisted in their courtly traditions of consulting selected advisers and appearing in acclamation committees. This historicist management style contributed significantly to the marginalization of the institute within the circle of university institutes, which are increasingly less affected by the holder of a full-professorship and compete for means of production and reputation. DThe partial legal capacity granted in the UOG 1993 with its bonus for committed institute management with team entrepreneurship led to the competitive situation and animosity in the professors' college which revived the prejudice and the traditional disdain of the classical medical community towards the medical auxiliary sciences.

With the implementation of the University Act (UG) 2002 on January 1^st, 2004, the institutes at the University of Vienna with partial legal capacity were converted into dependent Organizational Units and the Medical Faculty of the University of Vienna became transferred into an independent, ostensibly autonomous, but at least initially largely budget-financed Medical University of Vienna (MUW). The MUW then liquidated the professorship for Hygiene with the retirement of Rotter. In July 2009, the staff in the building was mixed with those of the external Department of Molecular Immunology and an Organizational Unit called the Institute of Hygiene and Applied Immunology was created. Earlier, in June of the same year, the Department of Medical Parasitology had been separated from the Institute of Hygiene and incorporated into the Institute for Specific Prophylaxis and Tropical Medicine. The Center for Pathophysiology, Infectiology and Immunology of the autonomously administered Medical University of Vienna was formed from the merged part, the Institute for Tropical Medicine and other units completely unrelated to hygiene. The employees of the Institute of Hygiene, with the exception of the appointed civil servants, were transferred partly voluntarily, partly by law and time, into private employments of the MUW, often only secured by collective agreements. cit. Changed, supplemented and expanded Flamm [2008, 2008a & 2012]. In 2020, apart from the name of an organizational unit and the building, there were no traces of expertise of the k.k. Hygienic Institute more noticeable.

Since the in a part of the k.k. Flinten­schifterei on the Alser­grund, a rifle shifting factory built in the year 1787, seated labora­tories offered miser­able technical working con­ditions, a modern infra­structure of an university institute had to be provided in the years 1905-8 - 30 years after the chair was founded. The construc­tion of a four-story new building with baroque-secessionist facades and a built-up area of 3.000 m² at Kinder­spital­gasse 15 was planned for the new institute building. The building should accom­modate four institutions: The K.k. Hygienic University Institute, the affiliated K.k. Public Investigation Institute for foodstuffs, the K.k. University Institute for General and Experimental Pathology and the K.k. Sero­thera­peutic Institute. The design planning was - matching the intention of the directorate - assigned to the Viennese architect Ludwig Tremmel (∗ 1875 † 1946), a re­presen­tative of historicism. The building was endowed with the most modern infrastructural equipment of the time: double-glazed sliding windows on the street fronts, artificial lighting by means of city gas mantle burners and electric carbon filament lamps, a ventilation system with filtered supply air, which is dedusted by water sprays and cooled in summer, and a central heating system operating with low-pressure steam. The construction budget was 1.5 million crowns, which corresponded to around 7.5 million $euro; in 2020.

During the second bombing raid on Vienna on January 11^th, 1945, the central wing of the building was partially destroyed to the ground by a direct hit. After the arrival of Russian troops around April 9^th, 1945, the building served as a troop headquarters. The occupying power confiscated the "German" property in the library inventory (ca. 400 books), but its coverage - typically Austrian - could not be unambiguously defined due to a poor inventarisation. The damages to the building and to the inventory could be compensated within a few years, however, three dozen years after the end of the war, no functional damage whatsoever was evident in or on the building. In 1950 a meteorological station in the form of a tower was built on the street facade to the "Gürtel", a major Viennese highway. Until then the street facade had been largely intact from an architectural point of view. A fire on February 12^th, 1991 caused massive damage in several laboratories in two floors, in the large and the small lecture hall. The lecture hall wing was then rebuilt in keeping with the times - with only two small lecture halls and two seminar rooms. In 2012 the street facade to the Gürtel of the former K.k. Hygienic institute was reconstructed in a restoring manner, the tower however, which had been inoperative for decades, was left in place.