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Holes in the head

Before the advent of modern precision tools for cranial surgery, it was desirable, and even essential to survival, for surgeons to have a steady hand. It is with a frisson of fascination that we look at pictures of trepanned skulls with one or more holes drilled into them. The holes were deliberately made and it is hard to believe that anyone survived the procedure. And yet the bone has clearly healed around the fringes of the hole or holes, indicating that the patient did indeed survive. Such holes have soft, rounded edges, and the healing process is first visible after about two weeks. It was essential that the surgeon caused no damage to the cerebral membrane or major blood vessels, and there must have been a serious risk of infection. The anatomical collection at the Medical History and Heritage Unit houses at least two trepanned skulls, one from Peru and one from Egypt. 

Tools and methods – how many survived?
The scraping method was common in Europe, in particular England, while the preferred tools in South America were the drill and saw. Initially, surgeons used scrapers made of obsidian, flint or other kind of mineral, but eventually moved on to metal. Spade-shaped metal knives called tumis, an image of which features nowadays in the emblem of the Peruvian surgeons’ association In Peru, have been dug up by archaeologists from graves in Peru. 

Trepanations were often performed on the left side of the scull and very rarely over a suture. The Greek physician Hippocrates and other writers recommended avoiding the sutures to eliminate the risk of damaging a major blood vessel. The left side of the skull is more prone to trauma caused by violence because attackers are usually right handed. Perhaps the left-hand bias of trepanation is because most injuries (and haematomas) occur on that side. It is also possibly due to the surgeon being right-handed. Apart from the anguish and fear that the patients must have felt, the most painful part of the procedure was the removal of the soft tissue or the scalp. Damage to the skull itself is not particularly painful and it is thought that alcohol, opium, henbane and mandrake were used as anaesthetics. Some type of covering must have been used after surgery. Either the skin was folded back over or the surgeon applied a lid, perhaps made of vegetable matter such as the bark, coconut shells or banana leaves found in later historical contexts.

The earliest discovered trepanations date back to the Neolithic era (c. 3,000 BCE) and were performed with flint blades. The scrape method worked better than punching holes through the bone, probably because the trepanners could proceed slowly and retain a certain degree of precision. There are many examples from France and South America, but the method was once practised the world over. Trepanners in Bolivia and Peru seem to have been the most successful and had the highest survival rate. There are skulls that carry traces of half a dozen or so healed holes! One study shows that over 50% of 214 skulls from Peru exhibit signs of healing, and according to analyses, 73% of trepanations there were performed on men, 24.6% on women and 2.4% on children, figures that tally with the high incidence of violence-related cranial trauma. Other studies suggest that the healing frequency increased between 400 BCE and 1532 CE. 

Written sources and different techniques
The first written source describing trepanation is Hippocrates (c. 460-370 BCE), and the most successful operations have been found amongst the Inca people. There are different theories about why trepanations were performed. Some say it was done to relieve pressure caused by internal bleeding (there is sometimes evidence of another skull trauma that can have occasioned the procedure); others suggest that it was to cure severe migraine, epilepsy or mental illness. Some trepanned skulls, including that of one individual who had had two healed and one unhealed trepanations, show traces of severe sinus infection that had spread to other parts of the skull. There is another example of an adult who had suffered a brain tumour and a child who had probably had scurvy. But many diseases, such as mental illness, leave no skeletal traces. French surgeon Paul Broca (1824-1880) was the first modern-age scientist to accurately describe the practice, which he did in a monograph from 1867 on a Peruvian skull with a healed trepanation, the result, he concluded, of successful prehistoric surgery. 

Carl Fürst wrote in Fornvännen (Sweden’s oldest journal of antiquarian research) back in 1917 that it could be more difficult to confirm unhealed trepanation since it can resemble postmortal damage and have taphonomic causes (the decaying processes that fossilise organic material after death). This issue has been addressed by numerous authors, including John Verano, who raises other differential diagnoses, such as congenital defects or disorders, diseases and trauma.  

In his article, Carl Fürst noted that while Sweden was littered with examples of trepanation from the early and late Iron Age, most of them came from Alvastra. Anders and Gustaf Retzius both researched and wrote about the early trepanation finds from Sweden, including the Alvastra skulls.  

Scientists have identified five different ways of making the hole. 1) Scraping (recognisable by the chamfered edges); 2) Excavation; 3) Drilling and sawing (the surgeon drills several small holes in a circle and then uses a saw to connect them); 4.) Sawing (the surgeon saws out a square of bone that can then be lifted out); 5) Gouging. In this last procedure, the surgeon made a hole with a tool called a trepan, a hollow, serrated cylinder that was described already in the writings of Hippocrates. By the time of Roman physician Celsus (25 BCE – 50 CE) the trepan had acquired an extractable guide pin and a transverse handle, not unlike that of a modern corkscrew. 

This tool became the standard during the Middle Ages and was still in use in some countries well into the modern era. Some versions of the trepan have a support device. The use of a trepan was illustrated in a book from 1542 that is now housed in the Hagströmer Library. Called Feldtbuch der Wundartzney it was written by the German army surgeon Hans von Gersdorff. The French surgeon Ambroise Paré (1510-1590) made improvements in the tools for head surgery and trepanning, while in Renaissance Italy, glass shards were still the instruments of choice.

The development of trepanation
Swedish doctor Karl Petter Dahlgren (1864-1924) enlisted the help of instrument-maker Max Stille to invent a pair of trepanation forceps in 1896. The problems he was trying to solve were that the trepanation procedure was too slow and the surgeon tended to shake too much when chiselling out the skull. After trials using a rotary saw on a corpse, they managed to construct an ingenious tool. The new forceps sliced through the cranium from the inside out and took just a few minutes to excise a removable piece of bone. They were also easy to sterilise. Their forceps were modified in 1909 to be operable with both hands so that more force could be applied when cutting through thick bone. This model was further developed by American neurosurgeon William Henry Hudson (1862-1917). In 1897, Italian gynaecologist Leonardo Gigli (1863-1908) invented a wire saw that was first used to saw into hip bones but became the standard implement for craniotomies. According to an article on trepanation from the 1800s, inflammation was still the greatest risk when performing trepanation, primarily caused by a lack of personal hygiene, dirty homes and the insalubrious urban environment that was a breeding ground for secondary infections.

New theories
The roof of the skull and the brain itself have different magical beliefs attached to them in many cultures, and amulets have been found made of pieces of cranial vault. In the 1990s, a theory was put forward that people might have believed a patient was dead, when he or she was merely unconscious. During trepanation, such a person might have miraculously woken up during the procedure (hence occasional evidence of half-completed operations), so the unhealed holes would represent the patients who were genuinely dead. Otherwise, this way of “raising the dead” could have been something that surgeons tried to repeat.    

Trepanation is still performed in some developing countries, while a burgeoning interest for instructions on the Internet has prompted doctors to issue a warning in The British Medical Journal against do-it-yourself trepanations at home.

Ann Gustavsson, 23 February 2017

References:
Arnott et. Al. (eds). Trepanation - History, Discovery, Theory. Lisse. 2003.
Auderheide, A.C, Rodriguez-Martin, C, Langsjoen, O. The Cambridge Encyclopedia of Human Paleopathology. Cambridge. 2011. 31-34.
Danielsson, S. Karl Petter Dahlgren och hans trepanationstång. Nordisk medicinhistorisk årsbok. Södertälje. 1986. 127-135.
Fürst, C. M. Några nyfunna trepanerade svenska fornkranier. Fornvännen. 1917.
Ganz, J. C. Trepanation and surgical infection in the 18th century. Achta Neurochir. 2014. 156, 615-623.
Gross, C. G. A hole in the head. More tales in the history of neuroscience. Cambridge. 2012.
Larsen, C. S. Bioarcheology. Interpreting behavior from the human skeleton. Cambridge. 1997. 153. 
Retzius, G. Om trepanation av hufvudskålen, såsom folksed i forna och nyare tider. Ymer, tidskrift utgifven af Svenska sällskapet för antropologi och geografi. Årg. 1901, H. I.
Roberts, C. & Manchester, K. The archaeology of disease. Gloucestershire. 2010. 124-128.
Verano, J.W. Differential diagnosis: Trepanation. International Journal of Paleopathology. 14. 2016. 1-9.
Verano, J.W. Holes in the head. The art and archaeology of trepanation in Ancient Peru. Washington D.C. 2016.
Uddenberg, N. Lidande & läkedom II. Medicinens historia från 1800 till 1950. Stockholm. 2015. 332.

Ann Gustavsson is an archivist/curator at Karolinska Institutet’s Medical History and Heritage Unit. She has a master’s degree in archaeology and another in osteoarcheology. With a background in cultural studies, she went on to read ancient history and archival science. Her speciality is pathological lesions in bone. Ms Gustavsson is currently inventorying, analysing and digitalising Karolinska Institutet’s anatomical skull collection.

Photo: Ann Gustavsson

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Välkommen till föredrag!

BISKOP PEDER WINSTRUP - renässansmänniska och en av Europas bäst bevarade mumier. 
Biskop Peder Winstrups långa och händelserika liv skedde i skuggan av två kämpande stormakter; Sverige och Danmark. Hans karriär var omfattande; han var teolog, poet, professor i fysik, arkitekt, fornforskare, boktryckare, papperstillverkare, kunglig hovpredikant, biskop och initiativtagare till Lunds universitet. Undersökningen av Peder Winstrups kista och välbevarade mumie avslöjar många detaljer om hälsa, levnadsvillkor, kläd- och begravningsskick under 1600-talet.

PER KARSTEN är fil. dr i arkeologi och chef på Historiska museet vid Lunds universitet. När han 2015 visade upp den välbevarade mumien på Historiska museet kom 3500 besökare - under en och samma dag - och världens blickar riktades mot Lund. För att ha initierat räddandet av kvarlevorna från 1600-talsbiskopen och gjort dessa tillgängliga för såväl forskning som för allmän beskådan tilldelades han nyligen utmärkelsen "Årets Lundensare".

ONSDAGEN 15 MARS 2017 KL. 18.00
HAGSTRÖMERBIBLIOTEKET HAGA TINGSHUS
Buss 57 (Sveavägen) Buss 515 (Odenplan)
Hållplats: Haga Södra
Anmälan före 10 mars 
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Foto: Gunnar Menander & Per Karsten 

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Anders Retzius’ and Wilhelm von Wright’s microscopic study of teeth

The Hagströmer Library’s new tote bag features a drawing by Wilhelm von Wright that depicts dentinal tubules in the molar of a horse. It was originally published in Anders Retzius, Mikroskopiska undersökningar av Tändernes, särdeles Tandbenets struktur [Microscopic Study of the Structure of Teeth, Particularly Dentin], Stockholm: The Royal Swedish Academy of Sciences, 1837.
(Purchase bag here)

In the summer of 1835, Anders Retzius went to Karolinska Institutet’s anatomy museum to collect teeth. When he began work as professor of anatomy at Karolinska Institutet in 1824, Retzius labored to increase the number of specimens in the museum. By the mid-1830s the museum consisted of three halls, and the osteological section contained skeletons of humans and animals from Sweden and many distant locations. So, when Retzius began a comparative study of teeth, all he had to do was go to his museum and pull teeth from skeletons, like books from library shelves. He assembled teeth from Swedish wild and domestic mammals and fish, a pale-throated sloth, an African elephant, a rhinoceros, a walrus, a dolphin, a caiman, an alligator, a Porbeagle shark, and several varieties of tropical fish. All the while, he took great care not to ruin the specimens, pulling mostly posterior molars that wouldn’t be visible to museum visitors. He also had free and easy access to human teeth from the cadavers that came to Karolinska Institutet’s anatomy department from hospitals and poorhouses in Stockholm.

Retzius came up with the idea of studying thin slices of teeth under the microscope at a conference held in Breslau (now Wroclaw) in 1833, when physiologist Jan Purkinje demonstrated sections of skin and botanist Robert Brown showed thin, transparent slivers of petrified wood. Purkinje taught Retzius how to use a newly manufactured, achromatic compound microscope, which he had bought from Viennese instrument maker Georg Simon Plössl. The powerful microscope provided the resolution and depth of field that made it possible to study tissues with a novel precision, down to the cellular level. Retzius desired to purchase a similar microscope for his own department of anatomy at Karolinska Institutet, and ordered one from Plössl as soon as he found funding for it. When the microscope arrived in the summer of 1835, Retzius set out to use it to study animal tissue, and especially teeth.

It was technically challenging to deal with hard dental material, and there were few precedents to rely upon, so Retzius was forced to devise his own methods. In his treatise, The Microscopic Study of the Structure of Teeth, Particularly Dentin, he explains how he prepared the specimens by macerating the teeth in acid to separate the dentin from the jawbone and connective tissues, and then sliced the dentin. Maceration made it possible to slice the teeth thinly with sharp instruments without causing them to crack. This was tricky, so Retzius enlisted a particularly dexterous dentist by the name of Bichlier to assist him. Retzius’s treatise goes on to describe what the specimens looked like under a number of different viewing conditions, under different lights, on white or black surfaces, and using different methods of magnification. Altering these variables brought out new features in the specimens. He was able to study and describe the structure of cementum and discovered growth lines in enamel, still known today as “striae of Retzius.” 

What excited him most, however, was the finding that dentin was perforated by minute tubes, in patterns that varied from species to species. The surface of dentin appeared iridescent, and was traversed by thin stripes, which could be seen even without magnification. But, studying the slices through his microscope, Retzius saw that these stripes were in fact tubes extending between the pulp and the surface of the tooth. He found these thin, branching tubules “beautiful beyond description.”

The beauty of the specimens was captured by the artist and scientific draftsman Wilhelm von Wright. Originally from Finland, von Wright had often collaborated with scientists at the Swedish Royal Academy of Sciences. His plates in Scandinavian Fish (1836-38) and Swedish Birds (1828-38) are celebrated works of art. For Retzius’s work on teeth, von Wright made pencil drawings from which he produced the engraved first plate, and a series of delicate gouache (opaque watercolor) paintings in white and blue on a black background, some of which were reproduced on the lithographic second plate. Von Wright worked closely with Retzius, using the microscope to look at the specimens prepared by the anatomist. To convey Retzius’s research results, the artist had to merge his view with the anatomist’s and fix it on paper.

“The Structure of Teeth” was the most extensive and accurate study of the microscopic anatomy of teeth when it was published in 1837, and it was soon translated into German and English. The treatise consists of eighty-eight pages of text, with eighteen figures on two fold-out plates. These images are fine examples of the type of visualizations that regularly accompanied articles in scientific periodicals of the period. The observational practices were, however, cutting edge. And the processes of observation and image-making were intertwined. Specimens and visualizations of them were, according to Retzius, more important than the descriptive text. The images not only illustrated the result of the scientific study—they were the result.

Eva Åhrén, 26 January 2017
PhD, Director
Hagströmer Medico-Historical Library



References
Anders Retzius, Mikroskopiska undersökningar av Tändernes, särdeles Tandbenets struktur [Microscopic study of the structure of teeth, particularly dentin] Stockholm: The Royal Swedish Academy of Sciences, 1837.

Eva Åhrén, “Figuring things out: Visualizations in the work of Swedish anatomists Anders and Gustaf Retzius, 1829-1921,” Nuncius: Journal of the Material and Visual History of Science [forthcoming, 2017].

---, “Making space for specimens: The museums of the Karolinska Institute, Stockholm,” in Medical Museums: Past, Present, Future, edited by Samuel J.M.M. Alberti & Elizabeth Hallam (London: The Royal College of Surgeons of England, 2013).

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Vivisection and the Gentleman

During the mid and latter half of the nineteenth century, the life sciences became increasingly embroiled in debates involving experiments on animals. Regardless of the nature of these experiments, they were most generally referred to as “vivisections”, referring generally to all experiments on animals, attracting both criticism and ire from both scientists and laypersons alike. Typically seen as having a negative effect on the moral character of practitioners, those critical and outright negative to vivisection pushed for it to be forbidden, or at the very least, heavily restricted. In 1875 a Royal Commission began, attempting to establish political stance on the practice, and, if necessary, enact legislation based on the commission’s findings. This eventually lead to the Cruelty to Animals Act, which was passed in 1876, and introduced limitations and licencing for those wanting to carry out vivisections. 

As one of the primary arguments used by opponents of vivisection called the moral sensibilities of practitioners and supporters of this method in to question, a counter-argument presented by proponents revolved around their qualities as gentlemen. Hagströmer Library has several interesting titles which serve as argumentative books and pamphlets lifting the positives of vivisection as a method of research, and outlining, at least in part, the “gentlemanliness” of those medical men who experiment on animals. One such being the anonymously written, but attributed to Frances Heatherley, Physiological Cruelty, or, Fact v. Fancy: An Inquiry into the Vivisection Question from 1883. Physiological Cruelty presents a somewhat ambiguous title, leaving some uncertainty at first glance how the “vivisection question” will be presented and discussed. In spite of this, the book is a positive representation of the alleged benefits of the method, where the “pseudo-scientific” arguments of the anti-vivisection movement are thoroughly criticised, whilst simultaneously trying to win over members of the public undecided in the matter to side with “true science”, and underlining the pious and humane nature of physiologists. Texts such as these were not uncommon during this period, in part because of the aforementioned First Royal Commission on the Practice of Submitting Live Animals to Experiments for Scientific Purposes (often referred to simply as the Royal Commission on Vivisection), and in part because of the frequent discussions regarding animal welfare and rights lifted in some of the more well-to-do circles in Britain at the time. Neither was it unusual that the book was written anonymously: anonymity allowed for greater leeway in what one could and could not say without damaging collegial relationships and one’s career. Heatherley/Philanthropos’ book offers insight into some common arguments, at least amongst the proponents of vivisection, in long-form.

Some of these arguments included underlining the importance of practical experience over merely theorising in the case of physiology, equating theorising to “groping in the dark”. The dismissal of experimentation on animals as a practical means of gaining knowledge was akin to practicing pseudo-science, and the author is clear that the utilisation of vivisection is the way forward for medical research, “always advancing, and always gaining increased power to cure sickness and soothe pain”. One would be mistaken, however, to assume that the author advocates for experiments as the only righteous form of medical practice: rather, he underlines the importance of vivisection as a way to “advance” medicine, presumably to bolster its scientific standing, and build upon, correct, and fine-tune an already-established body of knowledge. Though experiments were to be used alongside other methods of medical and scientific practice, their worth is valued higher than, for example, theory, as experiments were able to confirm through practical experience whether a theory corresponded to nature under certain conditions, or not.

Physiological Cruelty was written in a climate where vivisection was somewhat of a hot topic, particularly for those conducting, or interested in, research in the life sciences. Experimental physiology in Great Britain had some difficulty establishing itself and developing at the same rate as it had in France and Germany. Less than a decade prior to Physiological Cruelty, the Royal Commission on Vivisection had taken place, which lead to recommendations made to parliament on legislation on experiments on animals. The Cruelty to Animals Act was passed in 1876, and prohibited, for example, experiments presumed to be painful unless certain requirements were met (e.g. using anaesthesia), and required those practicing vivisections to hold a license, among other things. Intertwined with these events, was a growing, and vocal, early animal rights movement, that, although with internal differences on the question of vivisection, was generally positive to restrictions on the practice, and warned against the development of scientists lacking morality, hardened by inflicting unnecessary pain on animals. 

Working against a traditionally conservative educational system where physiology had only begun to offer part-time research opportunities in the latter half of the 1800s, British physiologists interested in experimentalism and the teachings of French physiologist Claude Bernard were keen to help the method grow educationally and practically with a particularly British sentiment. Although experiments on animals were confessed to be, at times, painful, the physiologist, based on his (physiologists being exclusively men at this time) character, social standing, and education, possessed an inclination to limit pain whenever possible, as well as balance the measure of “necessary” suffering of the animal, with the potential benefits the experiment may have. These were qualities particularly bestowed on the British researcher, attuned to such sensitive matters in ways continental researchers were not. Because of this, exceptions to the practice were troubling, as they not only called into question the moral standing of physiologists and others practicing vivisection, but risked shuttling science back into the “dark ages”. In this regard, British physiologists could lead the way, utilising vivisection to develop the profession to the same levels of the often-referenced continental schools in France and Germany, but with greater sensitivity towards pain, to pointing out the sensitivity of British physiologists, and their exoneration from practicing needless cruelty during the Royal Commission. Interestingly, this sensibility is both a blessing and a curse for gentlemen of British heritage. In the case of the physiologists, according to Heatherley and other proponents, this meant their experiments were less inclined to be needlessly cruel. On the other hand, compassion and sensitivity to the suffering of “lesser creatures” was at least partially to blame for viewing vivisection negatively, and indeed the Cruelty to Animals Act.

Heatherley’s book serves as both a testament to the desire of some to bolster experimental medical science in Great Britain; but, also as a paradoxical account of the British gentleman as sensitively inclined, but overly sentimental depending on the situation. 

Illustration:
Kittelsen, Theodor, Har dyrene sjael?, 1915. 

Further Reading:
Boddice, Rob. “Species of Compassion: Aesthetics, Anaesthetics, and Pain in the Physiological Laboratory”. In 19: Interdisciplinary Studies in the Long Nineteenth Century, 15 (2012): 1-22. doi: http://doi.org/10.16995/ntn.628.
–. “Vivisecting Major: A Victorian Gentleman Scientist Animal Experimentation, 1876-1885”. In Isis, 102, 2 (June 2011): 215-237. http://www.jstor.org/stable/10.1086/660128. (Accessed 2016-02-29).
French, Richard D. Antivivisection and Medical Science in Victorian Society. Princeton: Princeton University Press, 1975.
Halverson, Kristin. Physiological Cruelty? Discussing and Developing Vivisection in Great Britian, 1875-1901. Södertörn University, 2016.
Philanthropos. [Heatherley, Francis] Physiological Cruelty: or Fact v. Fancy. An Inquiry into the Vivisection Question. London: Tinsley Bros., 1883.

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Tomas Jansson, 1951-2016

A onetime employee of the Hagströmer Library, Tomas Jansson is one of the people who has put his special mark on the library, not at least with his strong and colourful personality. Sadly, he passed away in the morning of October 26, 2016. The irony of it is that it was the disease that he had been fighting to save people from most of his professional life that claimed him. Tomas was a medical doctor specialized in Oncology, and as a doctor he worked wholeheartedly and with great empathy for his patients. But he had several loves, all of which he embraced with enthusiasm, and among these his love of old books and fondness for Esperanto stand out. In 1993 Carolina Böcker & Konst, a small antiquarian book store close to the University Library of Uppsala (Carolina Rediviva), opened its doors for the first time. Here Tomas found an outlet for his passion for books. Not surprisingly the book shop specialized in medical literature of historical significance and this is rare among antiquarian booksellers. During my tenure at Redins antikvariat, a couple of blocks away, I always sent customers offering that kind of books along to Carolina Böcker & Konst. This love of books eventually led him to the Hagströmer Medico-Historical Library where he started to work part-time in 2010 and also serving as acting Head for a time. This post ended in 2013. I have been acquainted with Tomas since the 1990s and thanks to him I also started to work at the library in 2010. This gave me the chance to get to know him quite intimately. Tomas was kindhearted and loyal and had a subtle (and sometimes not so subtle …) sense of humour. His company was never boring and we shared many a joke, sometimes over a Czech beer.

Tomas Jansson was interested in many things, and his general knowledge on various subjects was quite extraordinary. The third great passion mentioned above was Esperanto; when he was 14 years old he started practicing this constructed language and through the years he participated in several international conferences. He also was a member of the board of quite a few Esperanto organizations. The announcement by his daughters making his demise public has the first part of the Esperanto anthem by L. L. Zamenhof in it. It reads in English translation:

Into the world came a new feeling,
through the world goes a powerful call;
by means of wings of a gentle wind
now let it fly from place to place.

Dan Jibréus, 21 November 2016

Illustration: Tomas giving his daughter Astrid and her husband Maxine a private viewing of the Hagströmer Library in 2011.

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Välkommen till föredrag!

Peter Forsskål (1732–1763) var en av Linnés mer egensinniga och mångfacetterade lärjungar. Han disputerade i filosofi i Göttingen, blev docent i ekonomi i Uppsala, studerade naturalhistoria för Linné, lärde sig flytande arabiska och hebreiska. Hans liv ändades i dagens Jemen under en forskningsexpedition bekostad av den danske kungen. I dag är han mest känd som författare till Tankar om borgerliga friheten, ett liberalt manifest med plädering för stärkta civila rättigheter som han smusslade genom censuren. Som förkämpe för yttrandefrihet bidrog Forsskål till att bana väg för den första svenska tryckfrihetsförordningen som i år firar 250 år.

JONAS NORDIN, docent i historia, Kungliga biblioteket, berättar om ett kort men rikt och fascinerande levnadsöde.                      

TISDAGEN 15 NOVEMBER 2016 KL. 18.00
HAGSTRÖMERBIBLIOTEKET HAGA TINGSHUS
Buss 57 (Sveavägen) Buss 515 (Odenplan)
Hållplats: Haga Södra

Anmälan före 10 november
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The Library of Gustaf Retzius

In early December 1920, the Swedish daily newspaper Svenska Dagbladet had an announcement to make: ”The Book-collection of Gustaf Retzius to ’Karolinska.’ – Generous Donation to the Library of the Institute. – At Present the Library only has Room for a Third.”

As is well known, Gustaf Retzius was one of Sweden’s most prominent scientists in the late 1800s and the first years of the 20th century. He worked in several fields: histology, neurology, anatomy, physiology, to name the most important. He also did research in physical anthropology, and that has been the reason for more or less well founded criticism in later years. Retzius died in 1919, and a year later his widow Anna Hierta Retzius donated his books to Karolinska Institutet. The news article goes on to say that it is a gift ”that in value puts all former donations to shame … an estimated 150 shelf meters … completely outstanding … cannot be valued in money.” The lion’s share of the collection is now housed in the Hagströmer Library and is still of great importance to scientists and scholars of today. A select few of the books will for instance shortly be part of an exhibition, History Unfolds, at The Swedish History Museum. Regrettably the books are not kept as a separate unit of its own, but are found spread throughout the Hagströmer Library, arranged according to subject.

A large part of the collection has been inscribed personally to Gustaf Retzius and the collection of signatures is like a Who’s Who of the international scientific community at the time. Which leads me to the second part of this small essay. Anna Retzius was very much devoted to the work of her husband and you can find notes here and there in her hand explaining how she (and Gustaf) wanted the legacy to be handled. This is true not just of the books but just about everything. A German translation of the several volumes strong Natural History of Man by James Prichard; Naturgeschichte des Menschengeschlechts. Nach der dritten Auflage des englischen Originals mit Anmerkungen und Zusätzen hereausgegeben von Rudolph Wagner & Friedrich Will, Leipzig, Leopold Voss, 1840–1848, is to be found in the Retzius collection. In volume 3:1 Anna has written: ”This book has belonged to my beloved husband Gustaf Retzius’ dear father Anders Adolf Retzius, who in my youth was my good friend and bestowed me his valuable collection of autographs. Anna Hierta-Retzius, June 12, 1923.” Besides contributing interesting provenance information, the inscription makes you wonder. Whatever happened to the collection of autographs?

Back to the article in Svenska Dagbladet. It eerily foretells the conditions found also today; ”… it is necessary that additional staff can be made available, since the present staff is already under ordinary conditions not sufficient …”

Dan Jibréus, 19 October 2016

Postscript:
The ever diligent scholar Nils Uddenberg happened to see the above text and gave me a strange look. “Anna’s statement isn’t quite true,” he informed me. While recently doing research in the archives of the Royal Swedish Academy of Sciences, Stockholm, he had come across a couple of letters from Anna to Gustaf where the autograph collection is mentioned. Nils was kind enough to copy the letters for me. They are written in April 1876, that is, seven months before they got married the same year. There is a definite undertone of yearning in the language Anna uses. In the first letter she states how happy she is to have been given Anders Retzius’ collection of letters/autographs, but that she will always look upon it as belonging to Gustaf. Apparently Gustaf misinterpreted this as some sort of clandestine ungratefulness, and in the second letter Anna hastens to emphasize how happy she is with the gift, and that she will treasure it the rest of her life! Thus Anders Retzius’ collection was given to Anna by Gustaf, not by her father-in-law Anders, and it happened 16 years after Anders’ death. Anna’s memory might well have clouded a bit over the years. By the way – this collection is safely kept at the Royal Swedish Academy of Sciences.

Illustrations:
One of the Retzius family bookcases. Photograph from around 1920.
Anna Retzius-Hierta's comment concerning Anders Retzius' autograph collection.

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John Wessler and his unique collection

A few years ago, the Hagströmer Library was entrusted with an extremely rare collection of odontological pictures and objects from the Department of Dental Medicine at Karolinska Institutet. It had originally belonged to John Wessler (1864-1927), who assembled the collection himself in the early 1900s. As one of the foremost dentists in Stockholm at the time, Wessler was interested in most aspects of odontology: for instance, he was a champion of the modernisation of dentistry programmes, co-founder of the Institute of Dentistry in 1898, an advocate of “social dentistry” and secretary of the Swedish Dental Society. He was also noted in Sweden and abroad as a writer of numerous books and articles as well as a leading chemist who made and sold his own formulae of dental amalgam and dental powder. It was partly thanks to his income from this venture that he was able to finance his love of art. Maybe someone recognises the toothbrush he designed and marketed in 1895?

Wessler travelled widely, and was in contact with art dealers and dentists in Europe and the US. A hundred or so letters from cities like Berlin, Paris, London, Rome and New York relating to his purchases survive. From 1911 up to his death in 1927 he collected almost 800 pictures and artefacts dating from about 1400 to 1920. His collection includes over 500 prints and oil paintings, divided roughly equally into depictions of St Apollonia, the patron saint of dentistry, and dental practitioners and their patients. There are also a large number of gold, silver, iron and ivory toothpicks, miscellaneous dental implements (some more alarming than others), amulets, medals and photographs. He donated the collection to the Institute of Dentistry, now the Department of Dental Medicine, in 1923.

C O Henrikson, professor of odontological radiodiagnostics at KI between 1974 and 1990, was long the curator of the collection. Apart from maintaining, sorting and cataloguing the items, he published many articles on John Wessler and his collection, and arranged exhibitions. One such exhibition was at the Nordic Medical History Congress in Stockholm in 1997, where selected items were put on display. He finally consigned the collection to the custody of the Hagströmer Library in 2011. The Wessler collection is unique, and its pictures and objects spanning over five centuries give us a fascinating look at the evolution of dentistry. How many people today, for example, know what a dental pelican is? Or what links Tsar Peter the Great of Russia with dentistry?

Anna Lantz, 12 October 2016

Illustrations
The banner of the Munich Guild of Bath-Keepers, oil on canvas, ca 1750. Wessler collection.
Letter to Dr. John Wessler from Bremer Kunst-Antiquariat und Verlag Alfred Kock, 1921. Wessler collection.

References
Bohman, Nils (red.), ”Wessler, John Adrian”. Svenska män och kvinnor. Biografisk uppslagsbok 8. Stockholm, 1955. 
Henriksson, Carl O, ”S:ta Apollonia, martyr och skyddshelgon”. Svensk medicinhistorisk tidskrift, vol. 1, suppl. I (1997), 143-151.
Henriksson, Carl O, ”John Adrian Wessler – hängiven odontolog och samlare”. Svensk medicinhistorisk tidskrift, vol. 7 (2003), 197-216.
Wessler, John, Beskrivande förteckning över Tandläkarinstitutets i Stockholm Apollonia-samling. Stockholm, 1923. 

Translation: Neil Betteridge

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Book annotation in eighteenth-century natural history

Dr STAFFAN MÜLLER-WILLE, Ass. Professor, University of Exeter, Devon, U.K. är idag en av våra främsta experter på Linnaeus. Han talar svenska men håller sitt föredrag på engelska:

What today would be an obvious crime, was common practice in eighteenth-century natural history: books by Linnaeus and other authors where routinely annotated by their possessors in order to record new discoveries and observations, to catalogue one´s own collection, or for sheer entertainment. I will present three examples of this widespread practice: 1) Linnaeus's personal copy of Genera plantarum (Leiden: Wishoff, 1737), which he used to complete a manuscript of Species plantarum; 2) Michel Adanson's copy of the same publication, which he took with him on his trip to Senegal (1748–1754) but only used to record "errors"; and 3) Johann Reinhold Forster's Catalogue of British Insects (Warrington: William Eyres, 1770), which the author published to recruit collectors, and then annotated to keep track of his own collection. By these examples in detail, I will try to make two points: first, that the publications in question were designed to be annotated; and, second, that this design, and its use, shaped new ideas of the order of nature.
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Apple Season

For most of us, summer holidays are over and autumn is approaching sooner than we’d like. The apple season is already on its way, led by the ephemeral White Transparent apple, with its delicate, greenish-white skin and tender juicy pulp. Let’s seize the opportunity to take a look at the Malus domestica, (Borkh., Rosaceae), or common apple.

The wild apple originated in Central Asia, and spread westward along the Silk Road. The number of apple varieties have since increased greatly, both spontaneously and due to intentional selection and inoculation. Pliny the Elder, back in Roman times, discussed the art of grafting and mentions some 20 different varieties of apples. Parkinson (1640) described 58. By the nineteenth century the number reached more than 600, and today we have about 7,500 cultivars worldwide.

Apples have long been associated with love and fertility, as well as with sovereignty, seen, for example, in the symbolic Imperial Apple, Globus cruciger. According to another common belief, the apple is valued for its health-bringing properties, a topic to which I will return below.

Myths and legends 
The apple is one of the most legendary fruits, allegedly making its first appearance as the fruit of the Tree of Wisdom in the Garden of Eden. This interpretation was influenced by the Latin homonyms malus (evil) and malus (apple tree, a word borrowed from the Greek me:lon). Various commentators to the Torah, identified the fruit mentioned there as figs, grapes, nuts, citrons, or even wheat.

Greek mythographers spoke of the Golden Apple in the story of Paris and Helena. At the wedding of Peleus and Thetis, the Goddess of Discord, Eris, peeved at not having been invited, tossed in an apple with the inscription “to the most beautiful one.” Athena, Aphrodite, and Hera fought over the title, and the mortal prince Paris was asked to make the decision. Having been bribed, Paris chose Aphrodite, and this dispute eventually led to the Trojan War as depicted in Homer’s Iliad.

A Nordic legend describes how the Aesir gods received their perpetual youthfulness from the apples of Idun. Snorri Sturlasson tells us in the Prose Edda how Idun was abducted from Asgard, at which point the other gods started ageing and were compelled to bring her back again.

Lastly, we have an anecdote that is at least somewhat closer to the truth. Sir Isaac Newton supposedly had an apple fall on his head, and from this experience, derived the brilliant idea of how planets remain in orbit due to gravity. Although Newton never wrote about his brainstorm, a contemporary witness, William Stukeley, recounts it in his memoirs of Newton (The Royal Society, MS 142), but apparently omits the detail of the apple colliding with his head. That part of our anecdote seems to have been plucked out of thin air.

The curative properties of apples
If we turn to the field of medicine, apples have a long tradition here, as well, although many contentions have not been scientifically proven. Hildegard of Bingen (1098–1179) was an abbess as well as a writer of theological, botanical, and medicinal texts. In her role as a medical practitioner, she drew on ancient Greco-Roman wisdom, dietetics, and herbal remedies. In addition to various therapies she presented, she included apples in her most important dish – a porridge based on spelt semolina, apples, and honey. From this multi-talented woman’s achievements, we now proceed to a source a bit closer to our time, but definitely less reliable.

Albertus Magnus (c. 1200–1280) – a saint, friar, and bishop – is a man about whom many tales have emerged, due to his fame as a natural scientist and commentator of the writings of Aristotle, and as reported later, his vaunted skills in alchemy and magic. A publication which definitely had nothing to do with him is the Albertus Magnus Redivivus or The Book of Secrets. The copy kept in the Hagströmer Library is from 1845, but the book was circulated in several versions and editions, and retained its popularity all the way into the early twentieth century. Here we find the apple presented as a means of alleviating many ailments, such as warts, icterus, constipation, a means of purging, and finally, as a love potion, and I quote (translation my own):

Cures for warts
Cut, at a waning moon, a cross in the calyx of a Borsdorfer apple, press it against the wart and then bury the apple in a cemetery. When the apple has decayed, the wart will be gone.

Cut, at a waning moon, a firm apple in four equal parts and rub the warts vigorously with these parts, until they bleed, if possible. Then tie the apple parts together, three times crosswise, with a woolen yarn secretly stolen. Bury them under a roof gutter, or, throw them into a stream. When the apple decomposes, the warts will disappear.

A purgative
A peeled Borsdorfer apple grated upwards toward the flower will cause purging when you eat it; if you grate it downwards toward the shaft, it will relieve diarrhea.

A cure for icterus
Take an unripe apple, cut a slice and scoop out a pocket in the apple. Fill the hole with saffron and put the slice on as a lid. Tie a yellow silken thread around it, fry it over the flames, and give it to the ailing person to eat.

A cure for constipation
Fine sour milk, buttermilk, boiled apples, boiled plums, and boiled red or brown cabbage, taken one at a time, are useful remedies for constipation. Ripe Borsdorfer apples, plentifully eaten, will relieve the most persistent constipation.

A potion for obtaining a woman’s love
There are secret methods that the cabbalists call love apples. They are to be used as follows: At dawn on a Friday, go to an orchard and pick the most beautiful apple. Write your name in blood on a piece of white paper, and add the name of the person you wish to be loved by. Get three strands of her hair and tie them together with three strands of your own. These are to be used for securing this paper with another one, on which you should write only the word “Scheva,” also with your own blood. Split the apple in two, take out the seeds and put in the papers secured with the hair. Use pointed needles of myrtle to press the halves together, and dry the apple in the oven to make it hard and parched. Then, enfold it with leaves of bay and myrtle; put it surreptitiously under the woman’s pillow, and before long she will be declaring her love for you.

The last potion actually does seem to go back to ancient times and cabbalistic tradition, though not with apples in it: “To make yourself irresistible: take elecampane root, an orange and ambergris. While mixing these together add in a piece of paper with the word ‘Sheva’ on it” (in Swedish the ingredients are ålandsrot, apelsin, och valrav). The magic word Sheva might refer back to the wise Queen of Sheba. Strange how tales circulate! 

A modern prescription 
The most well-known apple-related prescription of today is the one that we have all heard, at least as children: “An apple a day keeps the doctor away.” In order to verify the accuracy of this prescription, a serious and well-justified study was carried out last year by scientists at The Dartmouth Institute in Massachusetts. Published in the highly regarded medical journal, JAMA Internal Medicine, it affirmed a correlation between American adults eating an apple a day and their use of fewer prescription medications. I cite the conclusion:

While the empirical evaluation of medical proverbs may allow us to profit from the wisdom of our predecessors, we were surprised to find a paucity of prior investigations of popular aphorisms. Our investigation has allowed us to update the well-known proverb to clarify that, if anything, apple eating may help keep the pharmacist away. Were this borne out, it certainly could have health policy implications.

The first appearance in print of the aphorism is found in the February 1866 edition of Notes and Queries Magazine: “A Pembrokeshire proverb: ait a happle avore gwain to bed, An’ you'll make the doctor beg his bread.” Now, in solidarity with all our colleagues at the Karolinska University Hospital, and elsewhere in the realm of healthcare, there is good reason not to spread this proverb further. We certainly wouldn’t want our physicians breadless, would we? On the other hand, there is another Swedish proverb with the wording “better breadless than clueless.” I certainly prefer my doctors to have a clue of what’s going on, ergo, perhaps we should yet again consider whether apple eating isn’t the better diet prescription, after all.

Eva Nyström, 21 September 2016

References and literature:
Albertus Magnus, Albertus Magnus redivivus, eller Hemligheternas Bok. En samling af mer än twåhundrade, till större delen bepröfwade, Sympathi- och Huskurer, till botande af en mängd sjukdomar … och Magiska Konster, till winnande af olika ändamål, såsom lycka i kärlek, fiske, jagt, o.s.w. 2nd ed. Göteborg, 1845.
Davis, M.A., Bynum, J. P., and Sirovich, B. E., “Association Between Apple Consumption and Physician Visits: Appealing the Conventional Wisdom that an Apple a Day Keeps the Doctor Away.” JAMA Intern Med. 175:5 (2015): 777–783. doi:10.1001/jamainternmed.2014.5466
Elzebroek, T. & Wind, K., Guide to Cultivated Plants. Wallingford, 2008.
Grillot de Givry, E. A., Witchcraft, Magic & Alchemy. New York, 1971.
Knoop, J. H., Pomologia, das ist Beschryvingen en Afbeeldingen van de beste zoorten van Appels en Peeren, welke in Neder- en Hoog-Diutschland, Frankryk, Engeland en elders geakt zyn, en tot dien einde gecultiveert worden. Leeuwarden, s.d. [1763]. [The plates above are selected from this work.]
Parkinson, J., Theatrum Botanicum: The Theater of Plants. Or, An Herball of a Large Extent: Containing therein a more ample and exact History and Declaration of the Physicall Herbs and Plants . . . with the chiefe notes of Dr. Lobel, Dr. Bonham, and others inserted therein. London 1640. [At the Hagströmer Library the volume is included in the collection obtained from the Swedish Pharmaceutical Society.]
Phillips, J. P.  “A Pembrokeshire proverb.” Notes and Queries, 3rd series vol. 9 (February 1866) 153.
Pliny the Elder, Historia Naturalis XV: 15.
http://www.chabad.org/parshah/article_cdo/aid/1982723/jewish/Was-the-Forbidden-Fruit-Really-an-Apple...

Eva Nyström is a Rare book librarian at the Hagströmer Medico-Historical Library. She has a background in Classics and holds a PhD in Classical Greek. She has devoted most of her research to Medieval and Early modern manuscripts, bookbindings, and Early printed books. Presently, she divides her time between librarianship and a research and digitization project, concerning Old Swedish manuscripts held at Uppsala University Library and the Royal Library in Stockholm.

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The Swedish physician Christofer Carlander (1759-1848)

The Nordic Encyklopedia (Nordisk familjebokpublished in 1905 stated that for a long period of time Christofer Carlander was the centre around which medical science in Sweden moved. At the same time he was one of the most experienced physicians. For 20 years, 1793-1814, he practised medicine in Gothenburg, and kept records of his 6000 patients. In all they comprise 2200 pages in folio, giving details of the diseases, the treatment and the outcome for each case. Many patients were followed for over ten years with new complaints. The document is unique in Sweden, if not in the world.

The patients were of all social classes, from the bishop’s wife to prostitutes, but servants and craftsmen predominated. Many details give ethnological evidence of life in the city. Carlander could be summoned at any time and went to see the same person up to five times a day if he saw the need. Only in the summer could he be free and leave the city for about three weeks, visiting friends and relatives in western Sweden, but some years he could not find anyone to replace him and from the summer of 1807 he was in constant service for three years.

He was well aware of the limitations of medical science of his time. His correspondence with his collegue and friend in Stockholm, Jonas Gistrén, which has also been preserved, reveals his concern. Positioned in Gothenburg he had the opportunity to import modern medical literature from London, for his own education as well as that of Gistrén, professor Pehr Afzelius in Uppsala and a couple of other prominent physicians who shared his eagerness to learn. A list of orders from 1801 contains 21 items for himself, among them ”Bell’s Engravings”, ”Haggarth on Fever”, ”Whately on Strictures” and ”Willan’s Diseas of London”.

Carlander dealt with all kinds of morbidity, even contributions by surgeons were recorded, including two cases of breast cancer. Specific diagnoses unknown at the time can be identified through his careful descriptions, e.g. a case of lung embolism during pregnancy and a myocardial infarction.

He was a skillful obstetrician, in many instances delivering babies with thongs. The local midwives were independent and proud of their methods, some very competent and involved in the care of women and small children in general. They cooperated well with Carlander, while others were reluctant to call for him, and still others were clearly incompetent.

Sometimes he had to find solutions to specific problems, such as rings in various sizes made of cork covered by wax for women with prolapse of the womb. An instrument to ligate the stalk of a benign polyp of the womb was manufactured by a local silversmith according to a design Carlander found in a German book printed i Jena in 1787. With that he prevented bleedings from being lethal in several cases.

Many patients were children with infectious diseases, worst of all smallpox, for which Carlander introduced vaccination in 1802. Within a couple of years he and his collegues carried out a programme that covered the whole Gothenburg population.

Among children and adults tuberculosis was frequent, the various forms called scrofula, comsumption or hectic disease. Numerous patients suffered from involvement of the hips or vertebras with resulting collapse and deformation.

Syphilis was another threat, often treated by quacks with mercury compounds on the mere suspicion or fear, but Carlander’s use of this remedy was more restricted. The disease was shameful, and he could not be sure that his records were not read by others, so in some cases he used witty synonyms for their names.

The texts were his private records and contain notes such as ”stubborn as hell”, ”big cow” and ”sweet child”.

Although in general Carlander made efforts to help in any illness, problems with sight and hearing in elderly patients were exceptions: ”Cannot be made young again”.

Death was constantly present in this society and Carlander took a special interest in the death process, keen that it should be calm and smooth, the patient prepared to leave, to say good-bye. He came to see patients even when death was close, to comfort them, and to prescribe valeriana, opium, jelly, and drinks soothed by salep.

In 1814, he retired to Stockholm, inaccessible to the many patients who never let him rest. There, he was mainly involved with administration and served as a referee of medical literature for The Swedish Society of Medicine. His vast collection of medical science books, which includes many copies of valuable ancient works, is now kept in the Hagströmer Library.

Gudrun Nyberg, 14 September 2016

Illustrations:
Carlander’s medical records, 2200 pages in folio, are kept at the National Archives in Stockholm.
One of Carlander’s books on scrofula (tb) was Edward Ford’s Observations on the Disease of the Hip Joint, London 1794.

References:
Nyberg, Gudrun. Doktor Carlanders Göteborg – folkliv, sjukdom och död 1793-2014. Stockholm, 2007.
Nyberg, Gudrun. Doktor Carlander i praktiken – läkekonst 1793-1814. Stockholm, 2009.

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I see dead people

In addition to skeletal samples gathered during archaeological excavations, various anatomical collections are housed in museums and institutions worldwide. In many cases, the acquirement of these samples may be questionable from an ethical point of view, and so the reason for upholding this practice has been questioned. Obviously, there is an ongoing important debate regarding ethics, reburials and the housing of human remains in different institutes, but that is a whole other story.

Osteologists (bone experts) and biological anthropologists (specializing in human skeletal remains) work with bones on a day-to-day basis. Unlike physicians, we examine the remains of people whose soft tissues decomposed a long time ago. We inspect the shape, appearance and size of the bones. We measure them: lengthwise, widthwise, girthwise. And from these observations, we assess age at death, sex and stature of people from long ago. In addition to this, chemical analyses of skeletal remains, such as DNA, isotopes and trace element analysis shed further light on past populations regarding genetic relationships, diet and much more.

Anthropologists spend hours on end starring into a pair of hollow eye sockets asking questions: Who are you? How can I get to know you, and the life you lived? What happened to you?

We then embark on the journey to find the answers to these, one might argue, impossible questions. In our efforts to do so, skeletal traits or anomalies caused by severe living conditions, disease or trauma are examined, recorded and scrutinized in detail. The next step is to analyze and interpret the findings. How far you choose to go in your interpretations is entirely up to you and your scientific conscience. 

My professional interests recently shifted from prehistoric life-ways to injuries inflicted through criminal actions. This transition started a few years back, just before I began my two-year training at the Police Academy in Stockholm, when a colleague at the Archaeology Department of Stockholm University introduced me to a unique “case”: A man who lived and died around 2500 years ago during the Swedish late Bronze Age. His remains were discovered and exhumed 130 years ago during peat digging in southern Sweden. His bones exhibited no less than 700 various injuries, including blunt and sharp force trauma. For me, this undertaking was to become a natural progression from archaeology into the world of forensics.   

As a scientist, I established that his injuries were inflicted in a certain order of events, manner of execution and possible technique(s) used. On a more personal level, I might venture more spectacular conclusions. Yet, as this is not the forum for vivid descriptions of his wounds, it suffices to say: He died a gruesome and painful death.

He had received several blows to the head causing some very specific injuries: three nearly identical circular fractures. I and several experienced colleagues were puzzled by their appearance and regularity. Just prior to this, I had recorded and documented remains from an anatomical collection (now kept by the Medical History and Heritage Unit at Karolinska Institutet), that were stored at Stockholm University at the time. I remembered two skulls from the collection that both had very similar rounded injuries. Attached to those two skulls were two pieces of paper with writing in black marker and the same handwriting: “Murder” and “Blow with hammer” as well as the same case number.

The comparisons with the wounds found on the remains from the anatomical collection kept by the Medical History and Heritage Unit, thus provided a plausible interpretation of the shape of the implement used, and the manner of in which the circular fractures were inflicted to the Bronze Age man. 

So, it is evident that the anatomical collection comprises a very valuable source of information, and a clearer image of what happened to that man many years ago emerges. Now new questions arise: What ultimately killed him? What implements were used? Who killed him? And why was he killed? I can’t shake the feeling that he himself might not have been completely innocent. The questions remain unanswered, but will always be open for exploration, discussion and interpretation.

And ultimately, there is a significant difference between archaeology and forensics: In archaeology, we don’t have to worry that our interpretations are responsible for condemning an innocent for a crime (?) committed more than 2000 years ago.

Petra Molnar, 6 September 2016

Illustration from:
Still-life with a skull, oilpainting, Philippe de Champaigne 1644. Tessé Museum. https://commons.wikimedia.org/wiki/File:Philippe_de_Champaigne_Still-Life_with_a_Skull.JPG?uselang=s...  (accessed 2016-09-06).

Petra Molnar earned her PhD in Osteoarchaeology from Stockholm University in 2008 and graduated from the Swedish Police Academy in 2014. She recently participated in the Visiting Scientist Program offered by the Forensic Anthropology Unit at the Office of the Chief Medical Examiner’s Office in New York City. She is currently working as a Crime Scene Investigator and Forensic Anthropologist at the Swedish Police Authority in Stockholm, Sweden.

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The Hagströmer Library series of publications and important Linnaeana

In 2007 the Hagströmer Library started a series of publications, now numbering 21. However, ten years before the library was officially established in 1997, five richly illustrated and annotated catalogues had already been published. These catalogues had paved the way for the establishment of the special medico-historical library that was named after Anders Johan Hagströmer (1753–1830). Hagströmer was the first Inspector of Karolinska Institutet, and the one who can be said to have founded its library by taking over the entire book collection of the old medical society, Collegium Medicum (1663–1812). The first catalogue, Rare and Important Medical Books in the Library of the Swedish Society of Medicine, was published in 1989 and was followed by The Womans Booke in 1990. Soon after I was commissioned by Karolinska Institutet to produce a similar catalogue, Rare and Important Medical Books in the Library of the Karolinska Institute (1992). The books were also exhibited at the Royal Library in Stockholm with an accompanying illustrated catalogue in Swedish, Iconographica anatomica (1991).

Four more catalogues were published: Kinetic Jottings. Rare and Curious Books in the Library of the Old Royal Central Institute of Gymnastics (1995); Old and Rare Books on Materia Medica in the Library of the Swedish Pharmaceutical Society (1997); and finally Ars medica Svecana 1571–1921 (2008), presenting rare and famous Swedish medical books in the Hagströmer Library. The second most recent catalogue is Odontologia (2015) with important and early printed books on dentistry in the library of the Swedish Dental Society. All books described in the above catalogues, with the exception of the ones described in Kinetic Jottings, are now assembled under one roof in the Hagströmer Library.

The Hagströmer Library has an outstanding collection of some 500 books written by or about Carl von Linné (Linnaeus, 1707-1778) and his pupils. Among them is a Swedish national treasure – Linnaeus’ own annotated copy of the first edition of his Systema Naturae (Leiden, 1735), maybe the most celebrated and most important book ever published by a Swede. The first edition is by itself a legendary rarity, but this copy is even rarer than usual. A very scarce plate is inserted illustrating Linnaeus’ taxonomy and description of plant reproductive systems depicting stamens and pistils of the 24 classes, drawn, engraved and hand-coloured by Georg Dionysius Ehret (1708–1770), a great flower-painter of the eighteenth century. This plate, famous in the history of botany, has been plagiarized in various publications and is often reproduced, however, the original is hitherto known in five copies only including the one in Linnaeus’ own copy of Systema Naturae.

The most successful of the Hagströmer Library publications was a new edition of Ehret’s plate. The task of engraving and printing a new plate exactly duplicating Ehret’s original was undertaken by Ateljé Larsen in Helsingborg, who had a copper plate printing press. The reproduction was printed on fine handmade paper (Hahnemühle 350 gr), the 24 figures were coloured by hand by Per Wendel and Björn Dal, and mounted with tissue guard in cream-coloured cardboard (1200 g from the Urshult paper-mill). The edition was strictly limited to 100 numbered copies. The last copy, number 100, was presented to Akihito, Emperor of Japan, during the Linnaeus Tercentenary in 2007 at the National Museum in Tokyo, when I had the honour of showing Linnaeus’ copy of his Systema Naturae for the Japanese Emperor and the King of Sweden. The reproduced plate was accompanied by a 32-page pamphlet about Ehret and his plate, for which our graphic designer, Lars Paulsrud, was awarded a diploma for one of the most beautiful prints in the year 2000.

For one week the Systema Naturae was on display at the National Museum in Tokyo. As a pendant a modern version, inspired by Ehret’s plate, of the 24 classes of Linnaeus’ sexual system was exhibited. It consisted of extremely detailed macro-photographs by Helene Schmitz. Her beautiful photographs were also reproduced in the book which became the official Linnaeus Jubilee book System och passion. Nils Uddenberg, who recently had published his work on the history of biology, Idéer om livet, wrote the text and the descriptions of the 24 classes in the Linnaeus system. 

Sponsored by Sven Hagströmer, Chairman of the Friends of the Hagströmer Library, the unique copy of the Systema Naturae went on a worldwide tour during the jubilee year starting at the National Museum in Stockholm, with the book as the centerpiece in a wonderful exhibition of flower paintings and colour plate books, some from the Hagströmer Library, to celebrate the so called King of Flowers. This also resulted in an illustrated catalogue, Blomsterspråk (2007). After the exhibition in Tokyo, the work went on to the Royal Academy of Sciences in Amsterdam, and thereafter to four famous libraries and museums in USA. The tour ended in the safe Treasury normally holding the so called Devil’s Bible (Codex Gigas), another unique book, in the Royal Library in Stockholm. A special exhibition of interesting provenances in books by Linnaeus was also shown and is described by Olof Kåhrström in Linnaeus’ Network, a catalogue with both an English and a Swedish version, numbers 3 and 4 in the Hagströmer Library series of publications.

Some of the most important contributions published during the Linnaeus Tercentenary in 2007 appeared in the Hagströmer Library series as follows: 

The first ever publication in the Hagströmer Library Series was, however indirectly, a work by Linneaus himself. In the 1740s Linnaeus held a series of lectures based on his rather short work Fundamenta botanica (Amsterdam, 1736). Here he goes into deeper detail to explain the contents of the 36 pages and in 1748 a diligent student, probably Pehr Osbeck, made careful notes of what was being said. This is the basis for Om botanikens grunder (2007), edited by Lars Bergquist and Carin Nynäs. Including comments and notes the work now consists of 502 pages.

Number three in the series is another heavy volume, edited by me, collecting all the material concerning and by Linnaeus published in the periodical Lärda Tidningar (2007). It contains, among other things, a number of reviews of books by Linnaeus – in all probability written by Linnaeus himself! Many rare texts are made available here and the book, whose full title is Herr archiatern och riddaren Linnaeus i Lärda Tidningar 1745-1780, met with critical acclaim and Professor Gunnar Eriksson of Uppsala University called it a “gold mine”.

A very handsome volume in the series is number 11, Ur regnskogens skugga. Daniel Rolander och resan till Surinam (2010). This is a translation of a large part of Daniel Rolander’s report from his journey to Surinam in 1755-1756. Besides Arne Jönsson’s translation from the Latin of the original manuscript, it has an essential essay by James Dobreff and photographs by Helene Schmitz.

Issued as number 12 was a biography of the prominent physician Abraham Bäck (1713-1795) who was a close friend of Linnaeus. The book is titled Abraham Bäck (2010) and the author, Thomas Ihre, is a direct descendant of Bäck. Much of the unique source material he used in writing about his ancestor is in the holdings of the Hagströmer Library.

Linnaeus is best remembered for his ordering of the species of plants and animals into a coherent system. But since he was a trained physician he also tried to apply similar systems of ordering to diseases. The abovementioned student Pehr Osbeck took notes at Linnaeus series of lectures 1746-1747 on the subject, Systema morborum, and these are preserved in the manuscript collection of the Hagströmer Library. There is a longer section that concerns mental illnesses, Morbi mentales, and this part has been edited (with notes and an extensive commentary) by Nils Uddenberg in Linné och mentalsjukdomarna (2012) as number 13 in the series.

I am pleased to have been acquainted with Birger Strandell (1901–1993), whose collection of Linnaeana was the largest outside of Uppsala and which was acquired by the Hunt Botanical Institute, Pittsburgh, Pennsylvania, USA, in 1968. The Strandell Collection contains a complete set of Linnaeus’ 186 dissertations, all accessible online today. I was also instrumental when two other great Linnaean collectors started to build their collections: Sven-Erik Sandermann Olsen in Copenhagen, whose collection (Bibliotheca Linnaeana Danica, ca 5000 items) is housed in The Danish National Library of Science and Medicine since 1989. The other collector was Torbjörn Lenskog whose Linnaean Collection now is one of the treasures in the Chiba Natural History Museum in Japan. 

In more recent times Lars Bergquist, former Swedish ambassador in Peking and the Vatican and known for his studies of the mystic Emanuel Swedenborg, has turned his interest to Linnaeus and built a fine collection. Lars and I often discussed the possibilities to fill the gaps in his collection of Linnaeus’ dissertations. I told him of the plan I once hatched with Lenskog to compile an illustrated and annotated catalogue of all the 186 Latin dissertations, with bibliographical descriptions and comments in English, a project, however, which at the time came to nothing.  We agreed that a contemporary edition presenting all the dissertations was necessary. After almost six years of work Lars Bergquist and Carina Nynäs now have provided a portrait of Linnaeus as viewed through his scientific works together with that of his students. In the form of short essays they have opened the doors to the diverse and thrilling scientific world of the eighteenth century. These kaleidoscopic glimpses might bring Linnaeus closer to contemporary readers. I have encouraged them from the very beginning of the project and up to the pending publication of A Linnaean Kaleidoscope. Linnaeus and his 186 Dissertations (2016). The two volumes, with altogether 890 pages, illustrated with all the engravings and all the title-pages to the original dissertations, are beautifully designed by Lars Paulsrud and the great work is published by Fri Tanke as the Hagströmer Library series of publications No. 21.

This work is a treasure trove for everyone interested in natural history and the history of medicine, botany, zoology, geology, mineralogy, ornithology, entomology, herpetology, food and drink, and so on. It may well become a standard work.

Ove Hagelin, 31 August 2016

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A Linnaean Kaleidoscope

The Swedish 18th century scientist Carl von Linné (sometimes Carolus or Carl Linnaeus) has had an immense influence on the way we understand the natural world we live in. In two installments of the Hagströmer Library blog Linné will be treated starting today. A Linnaean Kaleidoscope I-II, now published as number 21 in the Hagströmerbibliotekets skriftserie, is introduced by its two authors Carina Nynäs and Lars Bergquist. Next week Ove Hagelin, who also has been instrumental in the creation of this work, will present an essay called The Hagströmer Library Series of Publications and Important Linnaeana, which details earlier publications in the series concerned with Linné. (Dan Jibréus).  


Linnaeus mirrored through his 186 dissertations

The Swedish botanist, zoologist and physician Carl Linnaeus (1707-1778) profoundly and forever changed the way we think of nature and science.

Carl Linnaeus was captivated by the creed of life in God’s creation, where he himself, Linnaeus, persistently unearthed and arranged the divine order, putting the hidden system, previously wrapped up in inscrutable mystery, in a completely new context. He was able to see an eternity in each plant and to search for the significance of small shivering, shimmering insects and humble, living beings. 

A Linnaean Kaleidoscope I-II, the first expanded introduction in English of all the 186 Linnaean dissertations, is not written only to bring forth the botanical, medical, zoological, geological, mineralogical and other contents important to him. As historians and biographers, theologians and philosophers of religion, we have also intended to reflect both Linnaeus and his theses in their cultural context, as well as the history of ideas and natural sciences, highlighting also the reverberations emanating from the Linnaean scientific workshop. 

In theory, dissertations should be written by the students. Some did write their texts, but content and language had, as professor Bo Lindberg states, to be controlled by their professors, and in the 18th century that control was rationalized to the extent that the professors more or less wrote the dissertations themselves, for some remuneration.

The 186 dissertations, practically formulated by Linnaeus and defended under his presidency, usually present new knowledge, claiming to contribute to the advancement of natural history and medicine. Furthermore they have an international touch, reporting findings from exotic parts of the world, and sometimes being defended by disciples from other European countries.

A Linnaean Kaleidoscope, includes all 186 dissertations, reflecting imported theses as well as Linnaeus’ own domain of interest. The dissertations, written in Latin, have been available since the end of the 18th century in brief English summaries, translated by Richard Pulteney in A General View of Linnaeus’ Writings (1789, 1805).

In 1939, Gustaf Drake af Hagelsrum published a brief Swedish survey of the Linnaean theses: Linnés disputationer. Approximately half of the dissertations have been translated into Swedish as part of an ongoing project, initiated about one hundred years ago and edited by Svenska Linnésällskapet. From 1921 up to the present, 84 dissertations have been translated into Swedish in the Svenska Linnésällskapets Årsskrift.

Thus, for over two hundred years the necessity of an updated and enlarged volume in English has become increasingly obvious. We have for almost ten years been working with A Linnaean Kaleidoscope to fill that gap.

Our work is intended for readers interested in the history of science, popular history, the world of ideas of the 18th century, and, of course, Carl Linnaeus’ personality, his way of thinking and intellectual development. As both of us have formerly been engaged in biographical studies, we regard our finished work also partly as a kind of scientific biography.

In the form of short essays we have wanted to open doors to the diverse and thrilling scientific world of the 18th century. Bones of contention in the world of the learned have therefore particularly captured our interest – as well as today less discussed Linnaean themes, such as his focus on dietetics, women’s and children’s health and pharmaceutical issues. The form we have chosen, the essay, generously allows space for the immense indigenous literature concerning Linnaeus and his scientific themes.

We have focused on the incredibly rich literature regarding Linnaeus’ world of ideas, as well as interpretations and comments on the different dissertations, instead of translating the Linnaean dissertations verbatim. Thanks to the Swedish researchers and their meticulous efforts we have obtained an immense source material, enabling us to approach Linnaeus and his dissertations from important angles.

Our ambition has also been to enlighten general questions, connections and contexts, typical of the period, and to understand Linnaeus’ dissertations in relation to both previous scientific results and sometimes even later development.

With our book we have strived to find our place between Richard Pulteney’s brief overviews and a hopefully forthcoming modern complete translation with scientific comments, made by experts from the different scientific fields.

Also Linnaeus’ relation to God and the relation between modern science and the belief in God as Creator are treated in A Linnaean Kaleidoscope. Within the frames of modern and postmodern theology Linnaeus’ physico-theological approach seems to have become extinct. The images of God and nature are also more elusive and complex than the adherents of Enlightenment believed. But the rapturous wonder Linnaeus brought about in his botanical and zoological perspectives, his impetus and zeal, his unconditional admiration and love for nature are not yet outdated.

The Linnaean Kaleidoscope I-II is beautifully illustrated with original plates and frontispieces.

Carina Nynäs & Lars Bergquist, 24 August 2016


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Gigantism part 2

The Irish Giant.
The Tall Lapp Girl Kristina Katarina Larsdotter, who featured in an earlier blog, is not the only known case of gigantism. Charles Byrne was born in 1761 in the Irish village of Littlebridge, Co. Derry. He was of normal size at birth, but soon began to grow at an astonishing rate and to an astonishing size. As was the case with the Tall Lapp Girl, an explanation was sought. It was said that he had been conceived in a hayloft – hence his height. As a child he would dribble and spit copiously, which made his friends keep their distance. It has been suggested that he might have had a slight mental retardation. He suffered serious growing pains. Byrne was discovered, just like Stor-Stina, by a manager, Joe Vance, who saw in him a lucrative source of income. At first, public interest exceeded expectations, and they travelled through Scotland and Northern England on their way to London. By the time they arrived in the capital in 1782, Byrne was a celebrity and posters advertising his exhibition were everywhere. He was also the subject of much gossip and was introduced to the royal family and other aristocratic personages. It was said that he was so tall that he could light his pipe straight from the street lanterns. His income was such that he was able to buy a fine apartment, where he would receive visitors.

Gradually, however, the market for this type of spectacle became saturated, as more “giants”, we well as dwarves, were exhibited at other places, forcing Byrne to drop his price. He developed serious drink problems and was robbed of a banker’s draft that he had bought with all his savings. He also probably suffered from tuberculosis, which exacerbated his failing health.

Doctor and surgeon John Hunter was working in London at this time. He operated on patients and collected different anatomical samples and bodies both human and non-human. He was feared, since people knew that if his operations failed and the patients died, they could end up in one of his cabinets. He was particularly interested in animals and humans with morbid lesions and distinctive features, so he was naturally drawn to Byrne, especially when it turned out he was dying. 

Byrne had other ideas than the Tall Lapp Girl concerning his body after death, and under no circumstances wished to end up as part of Hunter’s collection. So he paid one of his friends to make sure he was buried in a lead coffin and dumped in the sea. But this was not to be. Byrne passed away in 1783, a year after his arrival in England, at the age of only 22 and a height of 2.31 m (7 feet 7 inches). However, there was a great deal speculation about what had become of the body, as few people believed that it had been in the coffin. Either it had been removed by caretakers bribed by Hunter, who had had an accomplice stationed on the same street as Byrne’s apartment to inform him as soon as Byrne died, or simply stolen and the coffin filled with rocks before being lowered beneath the waves. Hunter then cleaned the skeleton, adding it to his collection four years later when interest in the circumstances surrounding the Irish Giant’s death had waned. Byrne’s skeleton can still be seen in the Hunterian Museum (founded in 1813), where it is one of the main attractions, despite the debate over whether it ought to be buried in accordance with his final wishes. The directors of the museum and others believe that is should be preserved for science. Already in 1909, US surgeon Harvey Cushing was able to announce by cutting open the cranium that Byrne had had a pituitary adenoma. In 2006, tissue was extracted for a DNA test from Byrne’s molars, from which scientists discovered the rare AIP mutation, leading them to draw conclusions about its heredity. Apart from the successful research that has already been done and that can help contemporary relatives and coming generations, scientists want to be able to continue using his remains for research. Another suggestion is for a replica to be made of his skeleton for exhibiting in the museum. This illustrates the predicament in which many museums now find themselves: should they preserve the remains that are possibly their greatest public attractions or return them for burial? There are countless mummies and other kinds of human remains at different museums and institutions, and such ethical issues ought to be balanced against the knowledge that can be gleaned from the research conducted on them. DNA techniques are becoming more and more refined, and it has become easier to examine trace elements, isotopes etc. in the laboratory. Nowadays, such analyses of bone samples can radically change current ideas of kinship, disease, diet, habitat and so on. The remains of indigenous peoples are often removed from institutions to be repatriated, and this applies as much to Karolinska Institutet as anywhere else; in the case of Charles Byrne, however, there is a medical aspect to take into consideration that is of much value for people living with gigantism today.

What causes such growth?

The pituitary gland, or hypophysis, secretes a number of different hormones. While it was discovered in antiquity, its function was long a mystery. Greek physician Galen (c. 129-199 A.D.) thought its purpose was to supply the nose with mucous (!). A pituitary tumour is the most common cause of gigantism/acromegaly. Descriptions of exceptionally tall people can be found far back in human history, but it was not until the second half of the 19th century that the disease was linked to pituitary tumours. In 1886, French neurologist Pierre Marie (1853-1940) described a disease involving the abnormal growth of the bones of the face, hands and feet. Acromegaly, as it is called, derives from the Greek akros (extremity) and megalos (large), and unlike gigantism only affects adults between the ages of 30 and 50, who, since already fully grown, are generally only affected in the extremities and the face. Nowadays, a combination of drugs, surgery and radiotherapy is available for patients with such tumours, and there are ways to contain the size of the tumours along with the hormone secretion that causes the abnormal growth, making it possible to slightly reduce the size of the extremities. There are also cases in which one or more of a patient’s ancestors had the same condition.

As puberty is also delayed by several years for people with gigantism, they have time to grow even more than normally growing individuals. When scientists examined Byrne’s skeleton they found that the epiphyses had not yet fused, which means that he was still not fully grown at the time of his death at 22 years old. Only about 30% of people with the AIP mutation develop a tumour, and only about 5% have a tumour that produces symptoms. The tumour, which is benign, grows very slowly and almost never spreads to other parts of the body. The symptoms can be very distressing, and include a bulging forehead, abnormally large jaw, hand and feet, and chronic headaches and perspiration. They can also suffer from disorders of the menstrual cycle and libido, while the pressure exerted by the tumour against the optic nerve can also cause visual disorders. The strangest symptom is that some men can start to produce breast milk, since the tumour secretes an activating hormone: prolactin. The disease is especially common amongst several families living in Northern Ireland. Scientists have discovered that the gene mutation sits on the 11th chromosome and traced it back to a common ancestor some 1,500 years, or approximately 66 generations, ago. If left untreated, gigantism or acromegaly can lead to an increase in mortality of 30% or so owing to problems that arise with the circulatory system and heart, and most of those who do not receive treatment die at a very young age. Scientists are still probing the diseases, researching, for instance, different functions between cells and proteins in order to learn how this mutation arises. If doctors know in advance who has this mutation, they will be able to X-ray their patients and operate before the tumour grows too large. This would not only avoid much unnecessary physical and mental pain but also make treatment much easier.

Ann Gustavsson, 17 August 2016

Learn more:
Watch BBC Documentary about Charles Byrne
Read about the Hunterian Museum

Illustration from:
Hunterian museum, Woodcut engraving, Sheperd and Radclyffe 1853. From Dr. Nuno Carvalho de Sousa Private Collections – Lisbon. https://commons.wikimedia.org/wiki/File:1853_-_Hunterian_Museum.jpg?uselang=sv (accessed 2016-08-15).

References:
Harvinder, S et al. "AIP mutation in pituitary adenomas in the 18th century and today". The New England Journal of Medicine, 2011, Vol. 364 (1):43-50.
Alberti, S. "The organic museum. The Hunterian and other collections at the Royal College of Surgeons of England". Medical museums – past, present, future. London, 2013, 19.
Collata, G. "In a giants´s story, a new chapter writ by His DNA". The New York Times, January 5, 2011.
Dalrymple, T. "Why the Irish giant´s skeleton remains a bone of contention". The Telepraph, December 22, 2011.
Mantel, H. The giant O´Brien. New York, 1998.
Moore, W. The knife man. London, 2006, 397ff.
"Royal College of Surgeons rejects call to bury skeleton of” Irish giant”. The Guardian, December 22, 2011.
Uddenberg, N. Lidande & läkedom II. Medicinens historia från 1800 till 1950. Stockholm, 2015, 109.
Åberg, H. m.fl. Bonniers Läkarbok; hormonsjukdomar. Stockholm, 2000, 151f.
Transcription of the lecture “A tall story: unravelling the genetics behind Charles Byrne – ‘the Irish giant’” by Professor Márta Korbonits and Brendan Holland at the Hunterian Museum November 23, 2011.

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Emergency Care in Perspective

The year of 1793: Napoleon is doing well, sending his troops far and wide in Europe and beyond. Still, enormous numbers of casualties, of wounded soldiers. What to do? How to help them? One solution was to develop better means of transport, to try and get them medical care as soon as the battle ended. Stretchers, litters, and horse-driven carts and wagons (ambulances volantes) came in handy. In Egypt, Napoleon’s chief army surgeon, Baron Dominique Larrey, even included camel litters in the truss.

Warfare has, sadly enough one might say, been a promoter of technical and scientific innovations. This counts for many areas in medicine, and very much so in the case of ambulance care. The term ‘ambulance’ can be traced back to the fifteenth century, when Queen Isabel of Spain introduced a form of field hospitals. These ambulantias were not really vehicles, more like movable tents with surgical and medical supplies that could serve the army during her campaigns. Even so, however soon the soldiers got under care, much grace from God was needed for anyone badly wounded to survive.

Fortunately, this is no longer the case, at least in times of peace. The ambulances of today are well-equipped, nurses and other professionals are expertly trained, and hospitals are usually close by. Speedy assistance is nevertheless crucial. If a cardiac arrest occurs, an early 112 emergency call, chest compressions, and preferably also defibrillation, increase the chances of survival significantly. The first ten minutes from cardiac arrest to initiating CPR are absolutely vital; with each minute the survival prospects diminish with ten percent. Now, this is something we all can assist in whether we are medical pros or not. Take a CPR course – if you already did that but feel a bit rusty, take another. Find out where there are defibrillators in the vicinity. Who knows, maybe you will be the one who can save somebody’s life.

A factor that we, as individuals, have less influence over is the emergency transport. We can make that emergency call straight away, but apart from that it is more up to the healthcare system and community service to ensure that competence and resources are at hand and efficiently used. How to shorten the response time is one of many factors that researchers at the Centre for Resuscitation Science are exploring right now.

If, in the above scenario, we count the minutes, then obviously it is quite another reality than the one where “ambulance care” was first invented. The need for transport of patients is old and worldwide. Already in Antiquity, there were regulations to move the leprosy patients and other terminally ill to places more remote. A couple of thousand years later, when civilian ambulances were introduced, the situation was not very different: in London in the 1830s they were used to swiftly carry cholera patients to hospitals, in order to reduce spread of the disease.

The next stage of development, after horse carriages, was the introduction of railroad and steamboat ambulances. Not least did the founder of the American Red Cross, Clara Barton, advocate that treatment of the wounded during the Civil War begin already in the battlefield. And so we finally end up with the twentieth century airborne transport of today. We should be grateful that most of us won’t need to recourse to camel-dhoolies, such as the ones Thomas Longmore described in 1869. But should you find yourself in crisis without a camel, it is good to know that the technique works equally well with an elephant.

Eva Nyström, 10 August 2016

Illustrations from:
Wittelhöfer, L., Die freiwillige Hilfe im Kriege und das Militär-Sanitäts-Wesen auf der Wiener-Weltausstellung 1873. Wien, 1873. / This photography portfolio in large format is a rare documentation of ambulances as they were constructed and used in the latter half of the 19th century. It was composed for the 1873 World Exhibition in Vienna. The copy owned by the Hagströmer Medico-Historical Library has an inscription to King Oscar II of Sweden.

Longmore, Thomas, A Treatise on the Transport of Sick and Wounded Troops. London, [1869]. / The Hagströmer copy of this book was previously owned by Dr. Vincent Lundberg (1816–1891). He became a student of Anders Retzius at the Karolinska Medico-Surgical Institute, and was later engaged in improving the healthcare of the Swedish Army. As Royal Physician to King Charles XV, he accompanied the king on his travels.

References:
Barkley, Katherine Traver, The Ambulance. The Story of Emergency Transportation of Sick and Wounded Through the Centuries. Hicksville, N.Y., 1978.
Hedlund, Fredrik, ”Hjärtstopp – en kamp mot tiden” (first published in Medicinsk Vetenskap nr 1, 2016).
Larrey, D. J., Mémoires de chirurgie militaire, et campagnes. Tome I –IV. Paris, 1812–1817.
Longmore, Thomas, A Treatise on the Transport of Sick and Wounded Troops. London, [1869].

Read more about cardiac arrest here!

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Fall 2016

We are back! Look out for the coming announcement of exciting activities at the Hagströmer Library this fall!
(Hieronymus Bock, Kreutterbuch, Strassburg, 1580)

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Summer 2016

Have a nice summer vacation!
The Hagströmer Library will be closed during the month of July.
(August Johann Rösel von Rosenhof, Historia Naturalis Ranarum, Nürnberg, 1758)