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Care and Coercion CARE AND COERCION Medicai Knowledge, Social Policy and Patients with Venerai Disease in Sweden 1785-1903 MBM üH Anna Lundberg CARE AND COERCION Medicai Knowledge, Social Policy and Patients with Venerai Disease in Sweden 1785-1903 Anna Lundberg AKADEMISK AVHANDLING som med tillstånd av Rektorsämbetet vid Umeå universitet för avläggande av filsofie doktorsexamen kommer att offentligen försvaras i Humanisthuset, hörsal G, fredagen den 24 september 1999, kl. 10.15 Anna Lundberg: Care and Coercion - Medicai Knowledge, Social Policy and Patients with Venerai Disease in Sweden 7 785-1903 Report no. 14 from the Demographie Data Base, Umeå University ISBN 91-7191-675-X ISSN 0349-5132 ABSTRACT This study investigates the history of venereal diseases in Sweden in the period from 1785 to 1903. Medicai and politicai percepüons of these diseases as well as the patients and their continued lives have been studied. Venereal diseases were considered a significant threat to the growth of the population throughout the period. They were recognised through the dramatic sores that they produced on the body of the patient, and were frequendy cured with mercurial therapies. In the late nineteenth Century, syphilis and gonorrhoea became the two most significant sexually transmitted diseases. They were believed to cause paralysis, mental illness, infant mortality and infertility. Sweden fought venereal diseases with a network of State-controlied health mea- sures. County hospitals that contained special wards for patients diagnosed with vene­ real diseases were established in the late eighteenth Century. These hospitals were fi- nanced by mandatoiy revenue after 1817. Medicai care was mandatory and ministers, law officers and heads of households could inform the provincial physicians about the incidence of venereal disease. Düring the nineteenth Century, the regulation of prostitu­ tion was enforced which implied that women were blamed for the spread of these diseases. Patients with venereal disease belonged to a cross section of contemporary Swedish society. Most of them were from the lower- or working-classes. They suffered higher age-speeifie mortality in the first half of the Century, and high infant mortality through­ out the period. It appears, however, that the constructed image of a patient with vene- real disease had little impact upon their lives. Contemporary poverty and societal problems, such as unemployment and poor housing, probably played a larger part in their lives. Keywords: Medicai history, demography, paüent-records, diagnostics, therapeutics, social policy, venereal disease, life-course, Sweden, 19th centuiy ToRNB Anna Lundberg: Care and Coercion —Medicai Knowledge, Social Policy and Patients with Venerai Disease in Sweden 1785-1903 Report no. 14 from the Demographic Data Base, Umeå University ISBN 91-7191-675-X ISSN 0349-5132 ABSTRACT This study investigates the histoiy of venerea! diseases in Sweden in the period from 1785 to 1903. Medicai and politicai perceptions of these diseases as well as the patients and their contin- ued lives have been studied. Venereal diseases were considered a signifìcant threat to the growth of the population throughout the period. They were recognised through the dramatic sores that they produced on the body of the patient, and were frequently cured with mercurial therapies. In the late nineteenth Century, syphilis and gonorrhoea became the two most signifìcant sexually transmitted diseases. They were believed to cause paralysis, mental illness, infant mortality and infertility. Sweden fought venereal diseases with a network of State-controlied health measures. County hospitals that contained special wards for patients diagnosed with venereal diseases were estab- lished in the late eighteenth Century. These hospitals were fìnanced by mandatory revenue after 1817. Medicai care was mandatory and ministers, law officers and heads of households could inform the provincial physicians about the incidence of venereal disease. Düring the nineteenth Century, the regulation of prostitution was enforced which implied that women were blamed for the spread of these diseases. Patients with venereal disease belonged to a cross section of contemporary Swedish society. Most of them were from the lower- or working-classes. They suffered higher age-specifìc mortal­ ity in the first half of the Century, and high infant mortality throughout the period. It appears, however, that the constructed image of a patient with venereal disease had little impact upon their lives. Contemporary poverty and societal problems, such as unemployment and poor housing, probably played a larger part in their lives. Keywords: Medicai history, demography, patient-records, diagnostics, therapeutics, social policy, venereal disease, life-course, Sweden, 19* Century CARE AND COERCION Medicai Knowledge, Social Policy and Patients with Venerai Disease in Sweden 1785-1903 Anna Lundberg Report no. 14 from the Demographic Data Base, Umeå University Cover picture: Kicki Nuottaniemi Desktop Publishing: Berit Eriksson © The Demographic Data Base Umeå University 901 87 Umeå, Sweden ISBN 91-7191-675-X ISSN 0349-5132 Printed by Larsson & Co:s Tryckeri, Umeå Umeå 1999 CARE AND COERCION Medicai Knowledge, Social Policy and Patients with Venerai Disease in Sweden 1785-1903 Foreword have been Walking around for what feels like a couple of days now, won- Idering when the time would be right to write this foreword. There are so many people to acknowledge once a project like this is finished and yet one can only spend a few pages looking back at the years spent as a Ph.D. candi­ date. In sum, they have been good years, filled with creative education, writ- ing, travelling and camaraderie. I am sorry to say that I am probably grateful to more people than I can remember. This study is in many ways a product of all encounters that I have made during this time. I have been fortunate enough to have two supervisors. Docent and man­ ager of the Demographic Data Base, Anders Brändström has kept a keen eye on past and present tabulations as well as looking straight through a text in order to see where its really going. He has relendessly tried to teach me about Computers but certainly succeeded much better in making me laugh too hard at his stories. By also making sure that I travelled, presented papers and met scholars from other universities he has proved himself generous, open-minded and encouraging. My team of supervisors would not have been complete without the other half. Professor Lars-Göran Tedebrand has paid an eager interest in this study since its beginning. Above and beyond the call of duty, Lars-Göran has made even me feel at home at the department. His comments and confidence in me, as well as the odd giare across a room has provided me with the courage to continue. As head of our department, he provides a work environment that has been inestimable and very much lies behind the compleüon of my studies. I thank them both for this. The department of historical demography and the Demographic Data Base has implied friendships and invaluable assistance to me. My fellow Ph.D. can- didates Stefan Warg, Lotta Wikström, Per-Olof Grönberg, 01öf Gardarsdòttir, Maria J. Wisselgren and most recently Per Axelsson has put up with so much and been very good friends. More so than anyone my sister-in-arms, Ann- Kristin Högman, has had to listen to my whining gibberish. We have worked, laughed and travelled together and I hope that we will continue to do so. Few people at the Demographic Data Base have managed to escape me. This study could not have been made in this manner without the data-retrieval from POPUM and for this I am very indebted. I have frequently bothered and — 7 — bewildered Pär Vikström and Abbas Haghjo with computer-problems and they have always been supportive. Solveig Axelsson, Siv Larsson and Anita Bengtsson, our three secretaries have helped me in the most odd situations and I owe them to. Sören Edvinsson, Inez Egerbladh and Peter Sköld re- searchers at the database have paid much attention to my papers and pro- vided good advice and constructive criticism. Nevertheless, without a certain thank you to all those "upstairs", for putting up with the music, whisding, cursing and hollering that I have subjected you to, this foreword would be useless. My studies started at the Department of history that has now become the Department for historical studies. When I first got the idea that I might want to try to write a thesis, I found support from two women, Christina Florin and Agneta Guillemot. Their convincing support of me has never really lefit my mind, even though it was a long time ago. Sune Åkerman that held the profes- sorship at the department at that time also encouraged me and I wish to thank them as well as the entire department for informai, formal as well as financial help. More recently I have made contacts with Ulf Drugge at the Department of sociology in Umeå. His interest and comments concerning the work have influenced the study and been appreciated. As stated previously, I have had the pleasure of meeting researchers within this field from other universities. Yvonne Johansson from the Department of Economic history in Stockholm and I have exchanged information on the history of dubious women and their mischief s. Sofia Ling andjenny Björkman have taken so good care of me in Uppsala. No one can guide you through the streets of New Orleans quite like John Rogers and Marie Clark Nelson also made sure that I felt at home within medicai history. I also wish to thank Roger Qvarsell. Your letter and comments on an artide of mine was much appreci­ ated. One of my first encounters with other medicai historians was with Profes­ sorjan Sundin and his crew in Linköping. Many thanks to all of you. Professor emeritus Ove Groth, M.D.
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