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Master Thesis Bakteriologiens inntog i medisinutdanningen ved Det kongelige Frederiks universitet i Kristiania, 1885-1915 Helene Larsen Masteroppgave i historie Institutt for arkeologi, historie, kultur- og religionsvitenskap UNIVERSITETET I BERGEN Våren 2019 II Bakteriologiens inntog i medisinutdanningen ved Det kongelige Frederiks universitet i Kristiania, 1885-1915 III © Helene Larsen 2019 Bakteriologiens inntog i medisinutdanningen ved Det kongelige Frederiks universitet i Kristiania, 1885-1915 Helene Larsen https://bora.uib.no/ IV Abstract In 1885, the Norwegian medical education at the Royal Frederick University of Christiania (University of Oslo) became the subject of a reform debate that lasted for 30 years. This was a consequence of the fact that academic medicine had become increasingly scientific, systematic and specialized during the 19th century, which had led to the emergence of several new medical disciplines. One of these were the field of bacteriology (the study of bacteria and their relation to medicine). This thesis is based on a survey of the Norwegian reform debates on the education of medicine, with a special regard to bacteriology as a representative of the emergence of a more scientific, laboratory-based medicine. The overall aim of the thesis is to determine when bacteriology became established as a permanent part of the Norwegian medical education at the University, and to what extent this contributed to changing Norwegian medical practice. The debates took place at The Faculty of Medicine, as well as within the Norwegian Medical Association (‘Den norske Lægeforening’) and The Norwegian Medical Society (‘Det norske medicinske Selskab’). The period of my analysis concludes with the decision on a new examination regulation that was enacted in 1915. In accordance with this regulation the first independent teaching position for bacteriology was established. This marked the beginning of bacteriology as a mandatory part of the curriculum. I discuss my findings in the light of two alternative ways to portray the significance of bacteriology and the influence it had on medical practices in the latter part of the 19th century, represented by two historians, Nicholas D. Jewson and Michael Worboys. Jewson argues that bacteriology, as a part of the laboratory medicine that emerged in the second half of the 19th century, represented a radical shift in medical practice that moved it from the hospital bed to the laboratory. Worboys, on the other hand, criticizes such a presentation that claims that bacteriology represented a radical change in medicine, a ‘revolution’, and he argues that the balance between continuity and change was uneven across the field of medicine. Like Worboys, my findings indicate that the changes brought along by the introduction of bacteriology occurred over a long period of time. Portraying it as a revolution is therefore both inaccurate and an exaggeration. I argue that the introduction of bacteriology first and foremost marked the beginning of a new era in medical thinking and formed the basis for the research practice that continued throughout the 20th century. V VI Forord Da jeg sommeren 2016 hadde bestemt meg for å skrive en masteroppgave i historie hadde jeg ingen klar idé om hva denne skulle handle om. At jeg skulle ende opp med å skrive en medisinhistorisk oppgave hadde jeg i vertfall ikke sett for meg. Til tross for at det har vært en enorm utfordring er jeg glad for de valgene jeg tok den gang som førte meg inn i medisinen og bakteriologiens verden. Jeg har lært så mye nytt og spennende og jeg sitter nå igjen med en følelse av å ha oppnådd det umulig. Jeg har klatret mitt Everest! Det har krevd mye å drive på med et prosjekt som dette og jeg er utrolig takknemlig for all hjelp og støtte jeg har fått. Jeg vil først og fremst takke min veileder Svein Atle Skålevåg som har gitt meg stødig oppfølging og gode råd hele veien fra begynnelse til slutt. Jeg vil også takke alle som har vært en del av masterseminaret Individ og samfunn i Europa etter 1800 for gode faglige diskusjoner og konstruktive tilbakemeldinger. Det har for øvrig vært en stor glede å være en del av historiemastermiljøet på Sydneshaugen skole. Jeg er svært takknemlig for alle de flotte menneskene jeg har møtt her og alle nye vennskap jeg har fått. En kjærlig takk til min Eskil som har vist meg enorm støtte og tålmodighet i stressende og tunge perioder. Tusen takk for at du hadde troen på meg når jeg ikke hadde det selv, og for at du har fått meg til å le når jeg egentlig hadde mest lyst til å gråte. Til slutt vil jeg rette en spesiell takk til mine foreldre Linda Kristin og Rolf Erik som har vært en ubeskrivelig god støtte for meg gjennom mine åtte år som student. Jeg er utrolig takknemlig for at dere har gitt meg muligheten til å velge min egen vei i livet og for at dere har motivert meg til å aldri gi opp. Tusen takk Rolf for at du har lært meg at hardt arbeid alltid gir resultater. Tusen takk mamma for at du har en helt spesiell evne til å roe meg ned når hele verden står på hode. Dere er fantastiske! Bergen, 15. mai 2019 Helene Larsen VII Innholdsfortegnelse 1 Innledning .....................................................................................................................1 1.1 Problemstilling og avgrensing ..................................................................................2 1.2 Tidligere forskning ...................................................................................................3 1.3 Kilder og kildebruk ................................................................................................ 10 1.4 Oppgavens gang ..................................................................................................... 13 2 Bakteriologiens fremvekst .......................................................................................... 15 2.1 Sykdomsforståelser før bakteriologien .................................................................... 16 2.1.1 Humoralpatologien .......................................................................................... 17 2.1.2 Miasmeteoriene ............................................................................................... 19 2.1.3 Kontagionteoriene ........................................................................................... 21 2.2 Bakteriologiens gjennombrudd ............................................................................... 22 2.2.1 Mikrobeteorien for sykdom ............................................................................. 22 2.2.2 Den antiseptiske metode .................................................................................. 24 2.2.3 De første vaksinene ......................................................................................... 25 2.2.4 Det endelige gjennombruddet .......................................................................... 26 2.3 I hvilken grad forandret bakteriologien medisinen? ................................................ 29 3 Medisinutdanningen i Norge på 1800-tallet ............................................................... 33 3.1 Universitas Regia Fredericiana ............................................................................... 34 3.2 Det medisinske fakultet .......................................................................................... 35 3.2.1 Den første medisinundervisningen ................................................................... 37 3.2.2 Klinisk undervisning ....................................................................................... 38 3.3 Reglement for medisinsk embetseksamen ............................................................... 40 3.4 Tendenser til oppsplitting og spesialisering............................................................. 43 3.5 Inn i 1880-årene ..................................................................................................... 47 4 Medisinstudiet settes på dagsorden ............................................................................ 49 4.1 Den medisinske trekanten ....................................................................................... 50 4.2 Diskusjonen om den medisinske undervisning ........................................................ 53 4.2.1 Den teoretisk-praktiske motsetningen .............................................................. 60 4.3 Forslag til plan for den medisinske undervisning .................................................... 61 4.3.1 Reformforslagets ettervirkninger ..................................................................... 64 4.4 Hva nytt brakte bakteriologien med seg for legeutdanningen?................................. 65 VIII 5 Den lange veien mot reform ....................................................................................... 69 5.1 Det medisinske fakultet forbereder reform av medisinstudiet og eksamen ............... 70 5.1.1 Bakteriologiens stilling i legeutdanningen ....................................................... 72 5.1.2 1899-planen forkastes ...................................................................................... 76 5.2 Ny diskusjon i Det medicinske Selskab .................................................................. 77 5.2.1 Studentenes krav: studieplan og innskrenking av lærerfriheten ........................ 80 5.2.2 Debattens ettervirkning ................................................................................... 82 5.3 Undervisningsreformen behandles på nytt .............................................................
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