III - ARCHEOLOGY Anne Kveim Lie - 9789042029446 Downloaded from Brill.com09/27/2021 03:29:43AM via free access Anne Kveim Lie - 9789042029446 Downloaded from Brill.com09/27/2021 03:29:43AM via free access Treatment Politics: The Rise of Radesyge Hospitals in Norway Anne Kveim Lie Abstract This chapter discusses the rise of the radesyge hospitals in Norway. It will be argued that the end of the 18th century constitutes a historical moment where systematic treatment of patients in hospitals is formulated as a condition of possibility for the first time in Norwegian history. The radesyge hospitals are medicalized in a sense that the treatment intention permeates the whole institution in an unprecedented way in Norway. Nevertheless, focusing on their establishment as part of a teleological process towards the modern health care system obscures historical specificities, for instance the fact that medical experience was performed according to a totally different epistemology. Key Words: History of medicine; radesyge ***** In 1771, Collegium Medicum, the highest administrative organ in health affairs in Denmark-Norway, wrote in a letter to the head of the diocese in southern Norway that a disease called Radesyge was threatening the southern part of Norway. [It] is so dangerous, common, contagious and devastating to the entire population, and in particular to the army, that no measures would be too fast, effective or serious to stop and eradicate this confounded plague, before it gains so much ground, that the extensiveness either makes assistance impossible, or at least difficult or insufficient.1 In the letter, the Collegium Medicum was referring to several concerned reports they had received from local doctors as well as from the head of the diocese in Kristiansand, Hans Hagerup. Hagerup had pointed out that the Anne Kveim Lie - 9789042029446 Downloaded from Brill.com09/27/2021 03:29:43AM via free access 140 Treatment Politics: The Rise of Radesyge Hospitals in Norway ______________________________________________________________ disease increasingly spread out in his diocese, and that if no measures were taken more than the half of the population would be wrecked.2 What was this disease called radesyge? It is now largely forgotten, and hardly a word in the present Norwegian vocabulary. From about 1760 to about 1840, however, the disease was considered a major health problem in Norway. It was perceived as an important threat to society, not because it killed people, but because it ‘destroyed’ them. Originally, the concept Radesyge was probably a juxtaposition of the words Rade and Syge. Syge signified disease in Danish (sjuge in Norwegian), but the word rade was not a common word in contemporary Danish-Norwegian. The district surgeon Daniel Touscher told the Collegium Medicum, the highest administrative organ in health affairs, about the origin of the word in a letter from 1774: The word Rade has probably not been known for a long time, but the peasants have, especially in a few places in Lister county, embraced this word, fabricated in their own community, to describe a thing they consider harmful, evil or mean. For instance: a rada man, an evil man; a rada thing, a mean, harmful thing; a rada mare, a miserable, bad and obstinate mare, etc. Radesyge is, according to the peasant’s understanding, a wicked and evil disease, which he, from its circumstances and consequences, considers a bad and almost untreatable disease.3 Hence in the beginning the word Radesyge probably signified an affliction that made ugly or evil. The patients suffering from Radesyge had deep ulcers on the whole body. The disease could also attack the mucous membranes and in advanced cases the skeleton, causing considerable deformities. Most authors describe an initial phase with catarrhalia, bone pains and light fevers.4 The disease only gradually made its appearance, and often a great time span had elapsed before the victims became seriously ill. The nose and throat was frequently attacked, causing facial malformations and progressive difficulties in eating and drinking. According to most sources, untreated patients had to die a slow death, and walk around as ‘living carcasses’, a metaphor frequently used.5 The nature of the disease remains unknown, although a series of articles has practiced the retrospective diagnosis of tertiary syphilis.6 However, retrospective diagnosis remains a difficult genre,7 and radesyge is an especially good example of this.8 Radesyge attracted considerable attention in the 100 years it haunted Norway. It was the subject of the first medical publications in a Norwegian setting,9 and of the first dissertation ever at the new University of Christiania Anne Kveim Lie - 9789042029446 Downloaded from Brill.com09/27/2021 03:29:43AM via free access Anne Kveim Lie 141 ______________________________________________________________ (present-day Oslo) in 1817.10 The problem Radesyge was also met with a substantial amount of state initiatives. On the one hand, in this period a number of new medical officers were employed, largely to deal with this problem.11 On the other hand, several so-called Radesyge-hospitals were founded, 16 in all, the first hospitals in Norway with a therapeutic intention.12 Most of them later became the new municipality hospitals in the middle of the 19th century. In this article, I will discuss the rise of the radesyge hospitals in the 1770s. The history of these hospitals has never been written, although in all reference works their constitution in passing is emphasized as one of the key events in Norwegian medical history.13 In these accounts the radesyge hospitals are highlighted as important elements in the scientific development in Norwegian medical history, and as steps towards a more rational health care system in Norway. The historian Ole Moseng attributes the development of the Norwegian health care system in general and the hospital system in particular largely to the radesyge endemic, and claims that it was ‘the modern hospital system which developed in Norway during the last decades of the 18th century’.14 These hospitals are ‘modern’ according to Moseng primarily because for the first time treatment, and not care, was the prime objective of the stay in the hospital. He has, however, not conducted empirical studies of these hospitals. In what follows, I will explore the question of the development of the radesyge hospitals a bit further and ask: If these hospitals are so different, in what sense can they be said to be so? And in what sense may one talk of a curative intention in these hospitals? 1. Radesyge and Enlightenment Medical Politics: ‘Incapable and Harmful Subjects’ Norway had by the time Collegium Medicum wrote their letter, only 5 officially appointed physicians, one in each diocese.15 To that can be added about nine master and 25 journeymen surgeons, and five to six physicians in private practice, but in any case the country, which at that time was consisting of about 800 000 inhabitants,16 was very sparsely covered with medical personnel.17 The Norwegian peasantry had until then had little contact with medical authorities. In the diocese of Christiansand, there was only one officially appointed physician, and he seemed quite uninterested in visiting the rural areas.18 The quacks dominated the medical marketplace in eighteenth century Norway. Therefore it was not at all obvious that the radesyge problem had to be dealt with by the construction of hospitals, let alone extra doctors. Actually something rather extraordinary happened with the radesyge endemic, which probably was a combination of timing and the reported dramatic features of Anne Kveim Lie - 9789042029446 Downloaded from Brill.com09/27/2021 03:29:43AM via free access 142 Treatment Politics: The Rise of Radesyge Hospitals in Norway ______________________________________________________________ the disease. The latter half of the 18th century was definitely a period of increasing focus on disease as a problem demanding collective action.19 The problem of the poor was included within the general issue of the health of populations, and charitable aid was largely replaced by a more general form of a ‘medical police’.20 The improvement of each body’s utility now became an important factor in public health policy, and, at a state level, the physical health of the population was considered a relevant factor for economic management. That a health policy which regards the subjects’ utility for the state of greatest relevance was prominent also in Denmark-Norway can be seen from the following statements from one of the members of the Collegium Medicum: ‘A disease which creates so many incapable, even harmful subjects, cannot quickly enough be eradicated, and every parsimony that postpones the general treatment must be considered most harmful’.21 The radesyge was regarded as incapacitating, chronic and contagious (although there was disagreement on this last point) and it was threatening to afflict an ever larger amount of the peasantry in the diocese, and ultimately Norway’s inhabitants in general. Therefore, this disease was considered of importance also for the authorities in Copenhagen. 2. The Question of Hospitals in the International Debate The late 18th century met with a new awareness of the utility of medical treatment. The question was not any longer whether medical treatment was useful, but how such treatment could best be administered. Should it be given at home or in special institutions? An extensive debate was conducted in