Diss. Göteborg : University.

This essay explores the diagnosis and treatment of the patients living at Furunäsets Hospitaland Asylum from 1893-1914. This was the biggest mental hospital in the north of Sweden atthe time. By examining patient case books, inspection documents and a textbook aboutpsychiatry of the time, this essay explores what getting a diagnosis meant for the patients ofthe time, as well as what treatments they got after arriving to the hospital. To answer thequestion of how well the treatments went this essay also studies the annual reports from thehospital, with particular interest in staff as well as the number of patients. By studying thereports, it is possible to see how many patients were discharged each year, and for what reason.This will also show how they were classified when discharged, either as dead, unchanged,better, or back to full health. All together this will show that diagnosis and treatment during thetime between 1983-1914 could be very different depending on the symptoms present. Somediagnoses were very similar to each other, and even overlaps. Almost all patients wereencouraged to work while living in the hospital, and it was seen as a part of their treatment.The results show that diagnosis and treatment was seen as a necessity to allow those who werediagnosed to return to “normal” society.Keywords: Hospital, Piteå, psykiatrihistoria, medici

This dissertation investigates the treatment of eclampsia in Sweden at the turn of the 20th century, paying particular attention to two treatments, the “Active treatment” and “Stroganoff’s treatment”. The aim is to investigate the evolving medicalization of eclampsia in Sweden by analyzing the interdisciplinary discussion on eclampsia in the Swedish medical journals. Eclampsia has been described by physicians as the “disease of a thousand theories”, an enigma or a riddle without an answer. The disease has been known since antiquity, as evidenced by its presence in the Hippocratic corpus, but has been without a cure to this day. In the latter half of the 19th century and the beginning of the 20th century, treatments of eclampsia emerged that – at the time – seemed to hold promise. Eclampsia has been described as an insidious disease that strikes the patient as lightning from a clear blue sky.In 1843 the Scottish doctor John Lever connected albuminuria with the onset of eclampsia which allowed for early diagnostic of eclampsia. This marked a new way of perceiving eclampsia; no longer was it just an acute disease, but a progressive disease that could be treated before it became life threatening. The discovery of albuminuria became an important clue in the formation of the theory that eclampsia was caused by an unknown poisoning. Since no cure could be found, preventing the onset of eclampsia became a higher priority.The only known way of ending the progression of the disease was to end the pregnancy – a method used since the 18th century. This was usually done by caesarian section, an operation that during the 19th and early 20th century could be just as fatal as the disease itself. A change came in the late the 19th century with the discovery of new operating techniques, better hygiene, and the introduction of general anesthetics, which reduced the amount of fatalities connected with operations. The caesarian section eventually became the choice of treatment for eclampsia known as the “Active treatment”. This4treatment was challenged by “Stroganoff’s treatment”, which was a reformed version of the older treatment of eclampsia. The version of “Stroganoff’s treatment” used by Swedish doctors, which incorporated caesarian section, gave them a broader range of treatments that could be modified to suit different scenarios in a way that was impossible using just the “Active treatment”. The two treatments were discussed in Swedish medical journals throughout the beginning of the 20th century, and their discussion shows the growing medicalization of eclampsia during this time.

This thesis examines the process through which computers became a part of the Swedish healthcare system. The empirical basis of the study consists of discussions emanating from projects concerned with the opportunities offered by the new technology between 1962 and 1968, mainly in conjunction to the Swedish council of hospital rationalization (SJURA). The study argues that computers should be understood as a “fluid technology”, one that is flexible and adaptable to its surroundings, while still retaining its mechanical core as a mathematical tool. The thesis shows that the technology was given a meaning which suited the demands of the new context: computers were able to answer the acute problems of health care, which were perceived as an abundance of information and a shortage of labour. Advocates of computers in healthcare equaled healthcare problems with information problems; the latter could only be solved with the help of computers. Thus, the technology was created within the definition of the problem. Computers were also thought of as a novel aid allowing physicians to create useful knowledge, and ideas about medical knowledge were articulated as a response to the introduction of the new technology. Computers simplified quantitative measures and it was anticipated they would provide means with which to calculate the value of health care. Thus, the value of care was redefined with numbers, turning the existential value of the patient into a more distant notion. The art of medicine had to be explained so that the computer would be able to process it – it was necessary to transform patient histories into binary language. This thesis illustrates how the support of introducing computers also meant that a certain type of medical knowledge was favoured; it was the capabilities of the computer which set the standard. By historicizing the role of computers within healthcare, the thesis shows how technologies are adaptable to the demands of their surroundings, and how they contrariwise also affect their surroundings.

Tuberculosis was at the start of the 20th century one of the greatest diseases that afflicted the population in Sweden, as well as the rest of Europe. The industrial revolution had created a ripe breeding ground for the disease to spread as people moved from the countryside to the city. Most ended up living in poor, cramped, and unsanitary conditions. At the same time, Sweden was entering an era of social reform under a socialist government. The old and dirty was to be replaced with a new and clean modern society – a “people’s home” for every citizen. This essay explores how this new mentality, that highly valued cleanliness and health of both mind and body, affected those that were ill with tuberculosis and living at a sanatorium in southern Sweden. The source material used is a patients’ magazine from Fur sanatorium, that was published between 1932 and 1944. After selecting articles and poems published by patients and doctors in these magazines, a close reading allowed conclusions to be drawn regarding what the patients thought and felt about the ongoing social changes. Based on these results, it is apparent that the new, hyper-hygienic social norms put further pressure on the patients to conform in any way they could. They did not have a healthy body, so it was important that they had a heathy mind instead.

Undersökningen ämnar att besvara frågor rörande dagstidningars rapportering kring sinnessjukvården i Uppsala under 1800-talets andra hälft. Med hjälp av sökorden ”hospital” och ”dårhus” har material från de fyra dagstidningar som ges ut under perioden sammanställts och kategoriserats för att identifiera generella trender. Analysen tar även stöd i mediateorin för att visa på det inflytande dagstidningar kan ha över den allmänna opinionen i ett samhälle och att materialet och frågeställningarna därmed är intressanta att ställa.  Analysen berör problematik som platsbrist, underkvalificerad personal och psykiskt sjuka som skadar sig själva eller andra, hotbilder i form av religiösa trossamfund, berusningsmedel och starka känslor som framkallar sinnessjukdom samt inspärrningshistorier och felaktiga intagningar. I och med dels det lokala Upsala hospital, men även den svenska moderna psykiatrins framväxt och expansion i stort  är ämnet högaktuellt och mycket omdiskuterat under perioden. Mötet mellan gamla restriktioner och nya humanitetsambitioner uppstår i sympati och intresse för att vården ska bli bättre och mer lättillgänglig, samtidigt som gränsdragningar mellan vi och dem, friskt och sjukt, normalt och onormalt är fortsatt tydlig. Resultaten visar att synen på de sjuka och den generella utvecklingen av psykiatrin stämmer överens med tidigare forskning men att vissa teman, såsom det stora intresset för hospitalens expansion och den hotbild som frälsningsarmén utgör är mer oväntade. I jämförelse med forskningsläget är synen på psykiatrin mer nyanserad och sympatisk än vad som tidigare kanske getts sken av.

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Bakgrund: Spanska sjukan var en influensapandemi som spreds 1918–1920. Den orsakadeomkring 25–50 miljoner människors död. Sedan spanska sjukan har det förekommitytterligare tre influensapandemier med betydligt lägre dödlighet. Spanska sjukans betydandeomfattning och dynamik är fortfarande inte helt klarlagd. Kunskap om tidigare pandemier kan öka förståelsen och beredskapen inför kommande pandemier. Syfte: Syftet med studien var att förstå spanska sjukan 1918–1920 och dess omfattning. Metod: En hermeneutisk metod användes i form av texttolkning. Totalt inkluderades 20 textervarav 18 artiklar från PubMed och två bokkapitel. Urvalet av litteratur skedde utifrån relevansoch med mål att få en så bred bild av forskningsområdet som möjligt. Resultat: Utifrån vald litteratur identifierades nio teman som viktiga i förståelsen av spanskasjukan. Dessa var: 1. pandemins ursprung och början, 2. smittspridningens dynamik,3. mortalitet, 4. symtom och dödsorsak, 5. riskfaktor – ålder, 6. riskfaktor – socioekonomi,7. riskfaktor – abnormt klimat, missväxt och svält, 8. patogenen bakom pandemin samt9. samhällets insatser. Influensavirusets genetiska variabilitet och människans interaktion meddjur identifierades som nyckelfaktorer för pandemiers uppkomst. Slutsats: Spanska sjukans förlopp berodde på ett komplext samspel av både medicinska ochicke-medicinska faktorer. Lärdomen av spanska sjukan är att i förebyggande arbete inför ochvid insatser under kommande pandemier bör både medicinska faktorer som immunologi samticke-medicinska faktorer som beteende och demografi beaktas.

The role of physicians in Swedish society changed dramatically in the 19th century. The need for people not only to be healthy, but also to be seen as healthy by society gave physicians a power that often has been compared to the power of the clergy in early modern era. How might this change have affected how physicians viewed themselves and others? The historically patriarchal and later also strongly paternalistic relationship between the patient and the physician is not unknown to scholars of medical history but can be supplemented with other perspectives and source material. In this study, I shed light on how physicians who were accused of malpractice or negligence in the course of their duties. I also review how the Disciplinary Board of Swedish State Board of Medicine, responded to the merits of the accusations and to the person behind the accusation in the late 1940s and early 1950s. The words and actions of the physicians and the Disciplinary Board members towards the other party in the disciplinary cases reflect parts of the self-image and professional identity both within the medical profession and the identity which the physicians and the Disciplinary Board wished to convey outside the medical profession. It is therefore interesting to consider for whose sake the Swedish medical disciplinary board was established and run. Several conclusions have emerged during the study, including that the Swedish physicians did not need to have the patient's trust, whereas having the trust of colleagues and of the Board of Medicine appears to be essential to the physicians professional identity. Also, the stereotypical self-images of physicians as scientific, objective, and rational were contrasted with the stereotypical images of patients as subjective, naïve and ignorant, both by the accused physicians and the members of the Disciplinary Board. The indirect and direct power that the medical profession had over both their own profession and their patients perpetuated power imbalances in the patient-physician relationship. Criticism of the handling of disciplinary cases from various quarters in society and politics went unheeded as the criticism evident in the early and mid-1940s persisted also 30 years later.

This thesis examines the development of vivisection as a method of physiological research between 1875 and 1901 in Great Britain, by examining some of the arguments, discussions, and ideas put forth by physiologists for the utilisation of vivisection in their research. Because this study operates within the context of medical history, questions of legitimacy, scientific development, and professional image are lifted. The development of vivisection during this period took place with a larger shift in scientific practice playing out in the background, where experimentalism began overtaking the previously more analytical approach to medicine and the sciences. The First Royal Commission on Vivisection in 1875 marks the beginning of this study, and the discussions within allow for a more nuanced picture of the professional debates on the practice, where both proponents and sceptics at times found common ground. Technological and societal aspects were central to much of the argumentation for the further development of vivisection, with technology easing the practical aspects of the method, and the concept of the "gentleman" allowing British "vivisectors" to argue against charges of cruelty, pointing rather to continental schools of physiology as the culprits, whilst lifting the "humanity" behind animal experimentation in Great Britain. In conjunction with pointing out the importance of the method for the development of medical science, the Cruelty to Animals Act and the lobbying on behalf of the professional journals British Medical Journal and The Lancet helped legitimise the practice in Great Britain. The Act allowed vivisection under set circumstances, and the two journals served as megaphones for scientific development on behalf of vivisection, at times even openly criticising sceptical opinions. At the same time, some saw experimental research through vivisection as merely one aspect of medical practice. One which needed to gain foothold in order to help advance medical science for the larger benefit of all humanity.