The medical services in the Kammergut were under the supervision of graduated doctors from an early stage.

The first Salzamtsphysicus mentioned in the resolution books was 1628 Dr. Brown.

Since 1656 (3rd Reformation Libel) free medical treatment and the free purchase of medicines have been among the most important benefits for masters and workers permanently employed in the salt industry.

In the second half of the 18th century, workers who were unable to work as a result of illness received full wages for the first 14 days, then sick pay of 30 kreuzers a week until they recovered and a commission (mercy pension) in the event of permanent disability.

The officials had to diligently monitor the sick worker, deal with the surgeon or barber after the end of the cure (sick leave) and submit the cost calculation to the salt office physician for review before payment was made.

In order to reduce the high cost of sickness, the authorities were instructed not to pay any workers the allowance (sick pay) until they had been examined by the surgeon and found to be ill.

All bathers, surgeons and surgeons of the saltworks offices, ie also the markets there, were subordinate to the salt office physician. From 1735 he inspected their activities, calculations and healing successes quarterly. He pronounced the inability to work to obtain the commissions. The official bather treated the salt people and usually also gave them the medicines. He submitted bills to the Salt Office for payment. It was often paid incompletely and it often took a long time, which is why two thirds of the accounts were paid in advance by the salt office.

The Kammergut was already under the supervision of certified state doctors in the 16th century. The exercise of health care, however, was in the hands of practitioners without formal training, with bathers, surgeons or surgeons. They were also barbers, therefore craftsmen with their own craft regulations, approved by the Emperor in 1646 and confirmed in 1662. Neither the barbers and surgeons nor the pharmacists were imperial servants with a fixed salary. Their income was low, so they received aid money and often maintained era bathhouses.

For the treatment of sick people there have always been two spas in Ischl and from 1711 a third spa. The barbers needed the approval of the Salt Office to practice their trade. They also had to take a vow at the market court and at the verwesamt. The Salzamt invoices also contain entries that there were two midwives in Ischl who received an annual subsidy from the market and had to take their vows before the market court.

An important part of the medical system was the Kammergutapotheke in Gmunden, which was first mentioned in the Salzakten in 1616.

In 1740, the reimbursement of doctor's wages and medicine costs granted from 1656 was still only available to workers in imperial service if they fell ill or were seriously injured in the course of their work and could no longer be prepared with regular household remedies.

Only the unprejudiced and philanthropic physician Dr. In 1746 Lebzelter found the courage to openly declare that internal illnesses required treatment just as much as external illnesses, which is why such patients should be treated free of charge. Treatment costs for workers suffering from toothache were not reimbursed in 1745.

If a worker fell ill with the French plague (syphilis), he had to be examined by the surgeon, who would decide whether the illness was the result of accident or his own fault. In the latter case, the doctor's wages were paid by the office, but the costs of treatment and maintenance were deducted from the worker's wages and he was also punished. To deter others, a salt worker from Ischl was dismissed from his work in 1738.

In 1746 Dr. Lebzelter was one of the brightest minds of his time in the Salzamt.

In order to make it easier for the salt workers to drink milk, which is indispensable for better nutrition for the children, Dr. Despite all resistance, Lebzelter managed to get the general ban on grazing for goats, which was issued to protect the forest stock and whose milk he declared curative against scurvy, partially lifted and raising was permitted wherever the animals could not damage the grazing culture. He recognized the inexpediency of the workers' vegetable-poor diet, which consisted almost entirely of flour, semolina, lard, and the daily Schott soup, and he was a zealous advocate of the cultivation of potatoes, which he considered to be of great value as a supplement to the diet.

Through his efforts, the Salzamt also improved and expanded the unhealthy, unclean and cramped sleeping quarters in the miners' houses on the Salzbergen.

From time immemorial, free medical treatment and sick pay were only due to workers directly employed by the era, and in 1777 the Court Chamber renewed the ban on granting these advantages to woodcutters employed by the entrepreneurs. However, as early as 1778, she softened this harsh provision to the extent that the salt office was allowed to pay the doctor's wages if such workers had an accident or fell ill while on duty.

Provisional workers were long excluded from any sickness allowance; only from 1790 onwards did the Salt Office replace their doctor's wages.

The Salzkammergut was not entirely spared from the risk of epidemics. The plague claimed larger numbers of victims in 1625, 1675 and at the beginning of the 18th century. The plague was probably brought in from Lower Austria, despite the border closure that was imposed on the country when it first appeared. The Kammergut was closed to all through traffic and the border crossings were strictly guarded. Every epidemic required an expansion of the old cemetery, which was located directly next to the Ischl church.

The fire in the Hallstatt market in 1750 also destroyed the Salinenspital. The new building, which was only started in 1770 and completed in 1772, was no longer built in the market square, but in the Lahn like the Sud- and Amtshaus.

The new hospital was dimensioned for the accommodation of 16 patients of both sexes, from among whom the court clerk entrusted with the overall management and supervision chose a hospital father and a hospital mother. These two, as well as the other patients, received a weekly benefice and were obliged to spin or knit according to their strength for the needs of the hospital. The beneficiaries were free to live with their relatives; in this case they were entitled to a payment of the weekly hostel rate.

The interest on the assets was initially available to the hospital administration to cover current expenses. In addition, there were annual co-payments by the erar.

With the growing knowledge of the causes of diseases and the means of combating them from the end of the 18th century, the medical service not only increased in size and prestige, but also the demands on the people responsible for the immediate treatment of the sick had increased.

From 1790 onwards, the Court Chamber demanded Magistri and Doctors who had already been examined and approved at the University of Vienna for vacant barber positions, but there were still no such applicants for the Chamber estate.

The bathing and barber trades, which used to be left almost entirely to the practice of treatment, lost more and more importance compared to the better trained and certified surgeons, of whom there were a few in every larger town. The salt workers were free to choose their bathers and surgeons, which is why they preferred the more competent ones and thus also contributed to raising the status of healers.

The protection smallpox vaccination discovered in 1796 had already found its way into the Kammergut in 1802; from 1802 to 1806, 1,261 children had already been vaccinated free of charge by the saline surgeons.

In 1807 the Court Chamber assigned the Gmunden pharmacist the establishment and operation of a branch pharmacy in Ischl, which became independent from 1821.

In 1807 a saline physics department was created in Ischl. The former regimental doctor Dr. Josef Götz was in charge of the inner Kammergut and the forest districts around Mondsee and Attersee.

From 1826, stable workers had to obtain spa certificates from the office in the event of illness, on the basis of which they were entitled to free medical treatment. Free treatment was excluded if a worker injured himself off duty. After six months of illness, the erar's obligation to provide medical assistance was ended, and the office then had to decide whether the worker was to be commissioned for a certain period of time or permanently. From 1827 onwards, dependent or interim workers enjoyed free medical treatment for injuries sustained on the job, but not for internal illnesses. In general, however, they were not entitled to sick pay.

Seriously ill or injured Ischl salt workers could be accommodated in the hospital operated by the market community. For this purpose, the salt works management had 2 rooms available for 8 sick salt workers in return for an annual fee of 16 Rachel firewood. Here the saline workers were treated by the Ischl saline physician, and the erar paid the subsistence costs directly to the market town.

The Ischl "infirmary" was first mentioned in 1586. This house was built for the sick, not for the old and poor. Around the middle of the 17th century it stood behind the church. When the hospital disappeared at the end of 1770 when the church was enlarged, the sick were accommodated in an old barracks outside the keep. Through an agreement with the saltworks, a new house was built on the so-called Pfarrwiesen and put into operation around 1800.

In Ischl there was a second private hospital in Eglmoos in the village of Ahorn from 1827, where the sick received medical treatment and care for a certain fee.

The health of the workforce was an important concern for the saltworks. At the turn of the century, workers' bathrooms were available for employees. In the mining industry, there were hot kitchens to give the workers the opportunity to eat regularly and healthily. Spiritual nourishment was available to the saline workers in their own saline libraries. However, the libraries were not used very actively, about one book per worker and year was borrowed.

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Sources used:

Carl Schraml "The Upper Austrian salt works from the beginning of the 16th to the middle of the 18th century", Vienna 1932

Carl Schraml "The Upper Austrian Salt Works from 1750 to the time after the French Wars", Vienna 1934

Carl Schraml "The Upper Austrian Salt Works from 1818 to the end of the Salt Office in 1850", Vienna 1936

Ischl home club "Bad Ischl home book 2004", Bad Ischl 2004

"Mining - everyday life and identity of the Dürrnberg miners and Hallein saltworks workers", Salzburg contributions to folklore, Salzburg, 1998