["Cura palliativa". The concept of palliative care in pre-modern medicine (c. 1500-1850)].

Palliative medicine, in the sense of a special, primarily symptomatic treatment of incurable and terminally ill patients has so far been described as an invention of the 20th or, at most, the late 19th centuries. As this paper seeks to show, the "cura palliativa" was the subject of a lively debate already from the late 16th century onwards, however. Medical case histories presented it as a sometimes indispensable alternative to radical, curative treatment. Therapeutic handbooks and, from 1692, books specifically devoted to the topic, gave detailed recommendations on the medicines and other therapeutic measures which could be used to alleviate pain, nausea, shortness of breath and other tormenting symptoms and to assure as mild a death as possible. They also warned against futile last-resort measures which only threatened to cause "dysthanasia" by aggravating the patients' suffering. More than today, the term "palliare" was understood in its original literal sense of "cloaking", however, and was also used for treatment which only covered up external defects or, even worse, the healer's incompetence. Here, the debate on the "palliative cure" also served as a vehicle for the physicians' polemical attacks against their less learned competitors whom they declared unable to discern and remove the true causes of diseases.