WILLIAM HARVEY – en medicinsk revolutionär.
”William Harveys upptäckt av blodomloppet revolutionerade vetenskapen. Hans
empiriska arbete om hjärtat och blodkärlen gick emot rådande vedertagna idéer
och metoder och förändrade synen på hur vår kropp fungerar i grunden. Harvey
var utan tvekan en av sin tids mest lysande stjärnor och hans bidrag till
vetenskapen anses av många vetenskapshistoriker som lika betydelsefull som
Isaac Newtons lära om gravitationen eller Charles Darwins om evolutionen. Med De
motu cordis, som publicerades 1628, framstår William Harvey än idag som
författare till en av de mest betydelsefulla skrifterna i medicinens historia.
I William Harvey har hans livsverk för första gången i sin
helhet översatts till svenska. Författaren och kardiologen Kenneth Pehrsson
sätter också in Harvey i en historisk kontext. Denna bok ger en rik förståelse
för de villkor Harvey arbetade under och det motstånd han mötte, och beskriver
på ett fängslande sätt hur han kom att göra en av de viktigaste upptäckterna i
Tanke förlag: HÄR
Paolo Mascagni (1755-1815)
Anatomiae Universae Icones
Pisa, apud Nicolaum Capurro, 1823 [-1832]
Den italienske anatomen Paolo Mascagnis viktigaste arbete var hans verk över lymfkärlssystemet, Vasorum lymphaticorum corporis humani, 1787, där han engagerat den skicklige Cino Santi från Bologna att teckna och gravera de 41 halvmeterhöga planscherna. Det är en klassiker och den finaste atlasen någonsin över lymfkärlen. Över 50 procent av de idag kända lymfkärlen upptäcktes av Mascagni. Det var detta epokgörande verk som öppnade vägen för hans fortsatta studier inom anatomi och fysiologi.
År 1800 accepterade den då 45-årige Mascagni professorstjänsten i Pisa, men redan ett år senare var man ivrig att locka honom över till Florens och erbjöd sig att fördubbla hans lön. Med detta generösa bud, kunde Mascagni nu fortsätta att förverkliga sitt anatomiska jätteverk, där människans kropp och dess organ skulle visas i naturlig storlek, ett grandiost projekt, som kom att utföras med hjälp av den skicklige tecknaren och gravören Antonio Serantoni. Detta kolossala företag drog på sig enorma kostnader och tvingade Mascagni att dra in lönerna och inteckna familjens egendom. Han uppsköt länge publiceringen i hopp om att tekniken att trycka bilder i färg skulle utvecklas, så att man inte behövde kolorera för hand. Men Mascagni fick aldrig se sin atlas i tryck. Han dog 1815, men hans familj såg till att konstnären Antonio Serantoni kunde fullfölja sitt arbete med att kombinera färgtrycket med handkolorering – det som skulle ge planscherna ett så spektakulärt resultat. Det första av nio häften utkom 1822. Ett komplett exemplar med kolorerade planscher åsattes det astronomiska priset av 2 250 guldfrancs – ett enormt belopp på denna tid (min kollega, från vilken vi köpte detta exemplar räknade ut att det motsvarar 750 gram guld eller nära 20 000 dollar). Nu råkar HB ha prospektet från 1822, ett oskuret exemplar i sitt tryckta originalomslag, Grande Anatomia del Corpo Umano. Rappresentata in XLIV. tavole. Prospetto – en raritet kanske sällsyntare än den stora atlasen. I Prospektet framgår att ytterst få exemplar tryckta i färg och ”finished by hand” skulle tryckas. Exemplar med okolorerade planscher kostade 1 125 francs.
Bokens format är dubbel elefantfolio (985 x 714 mm). Detta exemplar förvarat i en träkasett klädd med svart papper, har de bruna häftesomslagen med tryckt etikett bevarade. Det vackert graverade titelbladet följs av en dedikation tillägnad Leopold II, som också var storhertig av Toscana. De 44 färgplanscherna har alla varsin nyckelplansch med konturteckning i linjegravyr, samtliga med tunt skyddspapper. De mäktiga planscherna är legendariska och utgör monument i anatomins, men även i färgtryckets historia. Detaljrikedomen, noggrannheten, klarheten i utförandet och koloreringen av vener och artärer i mättad röd respektive blå täckfärg, och nerver och lymfkärl i vitt, är nästan så man tappar andan. Mascagnis atlas brukar i anatomin jämföras med den lika stora J. J. Audubons The Birds of America inom ornitologin.
Anatomiae Universae Icones kan nog betraktas som det dyraste anatomiska bildverk som någonsin producerats och upplagan var ytterst begränsad. Under min tid känner jag till endast ett privat exemplar, medicinboksamlaren Irwin Pincus exemplar, som han troligen köpte från Jeremy Norman 1978 och som efter Pincus död såldes hos Christie’s 2004. Ett annat exemplar fick jag nöjet bläddra igenom vid ett besök på Universitetsbiblioteket i Pavia, antagligen ett av de få exemplar som finns bevarade på bibliotek.
Jag hade aldrig drömt om att ett komplett exemplar av denna extremt sällsynta anatomiska atlas skulle dyka upp – och än mindre att jag skulle få Sven Hagströmer och Vänföreningens styrelsemedlemmar intresserade – men nu finns ett exemplar i Sverige, då den t.o.m. saknas i Bibliotheca Walleriana vid Uppsala Universitetsbibliotek. Jag är väl förtrogen med Wallers böcker och har lagt märke till att han saknade flera av de till formatet jättestora planschverken, som han kanske ratade då de inte fick plats i hans trånga bibliotek i Lidköping.
Inför utställningen Kroppen, Konst och Vetenskap på Nationalmuseum 2005 anskaffade jag till HB två lösa planscher, med fram och baksidan av mannens torso, vilka inramade visades på både Nationalmuseum och Prins Eugens Waldemarsudde. De pryder nu väggen ovanför dörren in till Hagströmerbiblioteket. En av dessa, som visade baksidan förstorades upp i jätteformat till en vepa, som fick täcka Nationalmuseums fasad under utställningen (den finns omhändertagen på HB) – och den bilden användes för marknadsföringen av utställningen i tidningsannonser, affischer och prospekt. Utställningen Läke Konst på Prins Eugens Waldemarsudde 2010 uppmärksammades även på TV i Vetenskapens Värld.
För att avbilda hela kroppen i naturlig storlek fick den delas upp på tre planscher, som kunde monteras ihop. Jag hade i min Catalogue Twenty-Two, 1986, tjugotvå av de 44 färgplanscherna, vilka inköptes av min kollega Björn Löwendahl i Stockholm, vars hustru handlade med planscher och ofta tipsade inredningsarkitekter, bl.a. de som skulle dekorera en då nyöppnad restaurang vid Stureplan. När man invigde restaurangen gick jag och Irene dit för att titta på deras omtalade väggdekorationer med både japanska träsnitt och tändsticksetiketter. Vi satte oss ned och tog en öl, och Irene gick därefter in på damrummet och såg lite underfundig ut när hon kom tillbaka. Ovanför handfaten på damtoaletten satt fyra originalplanscher av Mascagni, visande de nedre extremiteterna, benen och fötterna. Av de sällsynta Mascagniplanscher man inte kan finna på världens största medicinska bibliotek kunde åtminstone fyra beses på restaurangens damtoalett. - Jag smet för en tid sedan in på damernas och fann toaletten helt ombyggd och Mascagni var borta. Jag vet inte var de finns idag. En annan plansch, Tabula III, Viscera. lär under 2014 ha varit den mest nedladdade av de 100,000 bilder som Wellcome Library lagt ut på nätet.
Antonio Serantoni, som tecknat, graverat och handkolorerat de spektakulära jätteplanscherna, hade insett att det omåttliga priset och det otympliga formatet gjorde denna atlas praktiskt taget omöjlig att använda och sälja. Han lade då ned tre år på att framställa en atlas i normal folio-storlek med 75 planscher i färgtryck med extra handkolorering och med lika många svart-vita nyckelplanscher i linjegravyr. Här visas hela kroppen på planscherna. Ett fint exemplar av denna mindre Anatomia universale (storlek 470 x 320 mm), ingick i Edel Collection of Art and Anatomy, som gick på auktion hos Christie’s i New York, 2004, och nu finns att se på Hagströmerbiblioteket.
Ove Hagelin, 26 januari 2018
We are back!
Look out for the coming announcement of exciting
activities at the Hagströmer Library this spring.
(F. Petrarca, Zwei Trostbücher, Frankfurt am Main, 1551)
Hagströmerbiblioteket är stängt 23 december - 1 januari.
The Hagströmer Library is closed between the 22nd of December - 1st of January.
För några månader sedan
kontaktades Hagströmerbiblioteket av Arthur A. Dugoni School of Dentistry i San
Francisco. De planerade en digital utställning om St. Apollonia, tandläkekonstens
skyddshelgon, och intresserade sig för den Wesslerska samlingen av
odontologiska bilder och föremål som ingår i Hagströmerbibliotekets bestånd. Nu
är utställningen klar och några bilder från den Wesslerska samlingen är med. I texten
nedan presenterar de sin utställning, följt av en länk där ni även kan se den:
For just about as long as humans have had teeth and eaten starchy foods, they have had to contend with dental discomfort. In the 14th century, as dental ills among people of Western Europe increased, toothache sufferers began to turn to a little-known saint in hopes of relief. A new online exhibit from the Arthur A. Dugoni School of Dentistry's Virtual Dental Museum explores the history and iconography of Saint Apollonia — the patron saint of the dental profession.
Her origin story is not a happy one. She was reputedly an "aged deaconess" living in Alexandria, Egypt in the third century AD, who, rather than renounce God, had her teeth knocked out and then leaped into a bonfire. While she attracted little attention in the years (and centuries) following her death, in the Middle Ages people began to revive her story because of the tooth-loss component of her tale.
St. Apollonia continues to give solace to the dentally afflicted in those Christian communities where the belief in saintly benevolence is cherished. Over many centuries, she has been revered in religious paintings, sculptures, cathedral stained glass images, drama and literature, and honored on February 9, her designated day of celebration. She was adopted as the patron saint of dentistry, possibly in medieval times, and continues to hold that place of distinction, with many of today's dental societies, magazines and practices bearing her name.
Learn more and see the exhibition: here!
Today the Swedish Academy is chiefly recognized for appointing the Nobel prize laureate in literature. Since its beginning in 1786 the Academy has also struck a medal each year commemorating some renowned Swede. In 1923 Peter Forsskål (1732–1763) was honoured this way and his biographer, literary historian Henrik Schück, noted that:
there are probably not many scholars who have had more multifaceted scientific talents, and these talents were in him combined with an originality and an energy that without doubt would have accomplished great achievements, had he stayed alive. He was a philosopher, orientalist, zoologist and botanist, alongside he had a passion for social justice, and he was one of those who most strongly advocated the freedom of the press, which we finally acquired in 1766.
Although Forsskål never lived to experience his thirty-second birthday he made an imprint on several fields. In today’s Sweden he is probably best known for his struggle for extended civil liberties, but the fact that already before the middle of the nineteenth century 57 animal species had been given generic names after him bears testimony to his prominence also within the natural sciences.
By the end of the 1750s Forsskål was well on his way of pursuing a successful academic career. He had studied botany for Carl Linnaeus in Uppsala, and thanks to a generous scholarship he had had the opportunity to study in Goettingen under the philologist Johann David Michaelis. Forsskål wrote a dissertation, Dubia de principiis philosophiae recentioris, “Doubts Concerning the Principles of Modern Philosophy”, which earned him some attention among German scholars. After returning to Uppsala he became assistant professor of Economics.
It was at this point, early in 1759, that he inscribed himself as a pioneer in the struggle for equal civil rights to all people, so momentous for the century that followed. This was during the so called Age of Liberty (1718–1772) when Sweden had a republican form of government in all but name. Swedish politicians braced themselves for enjoying the freest and most perfect constitution there ever was – “as had it been written by angels”. Compared to other regimes of an absolute nature it was a moderate polity, but there was nevertheless room for improvements, not least in the field of civil liberties. Forsskål had written a thesis De libertate civile, “Thoughts on Civil Liberty”, but it violated the university regulations to discuss contemporary domestic politics and the publication was prohibited.
Forsskål took this as a matter of principle and decided to print and disseminate the text at his own expense. The result was a six page pamphlet containing 20 short paragraphs where he elaborated on what he considered to be the true Swedish liberties. Even though the text had been scrutinized by the regular censor and, in effect, contained nothing revolutionary it caused displeasure among those in power. It was as if some wretched citizen in a twentieth-century Democratic People’s Republic had urged people to actually enjoy the social rights and liberties formally guaranteed by the constitution.
Forsskål became subject to an extra-judicial interrogation, but his accusers soon found themselves in an awkward situation. The normal procedure was that an accused person yielded to the pressure and begged for pardon, which was then granted after an appropriate reprimand. Forsskål, however, refused to admit to having done anything wrong. He had only defended the civil liberties of Sweden and what he found to be the natural rights of man.
Authoritarian as it might have been, Sweden was no dictatorship. After
lengthy and futile questionings the authorities found no other solution than to
let Forsskål go – unpunished. They were afraid that he would become a public
martyr. An order was issued to confiscate his pamphlet, but only a few copies
were found. The Faculty at Uppsala University was indeed instructed to give
Forsskål a warning, but when he disputed even this unwarranted measure the
authorities found it safest to discontinue all further action in the matter.
Political control was exercised through a good deal of restraint and self-censorship among ordinary citizens, but trough his conduct Forsskål had demonstrated that the emperor was in fact naked, and his case became a milestone in the growing demands for proper freedom of expression. Six years later, in 1766, the first Swedish Freedom of Print Act was issued, but Forsskål never lived to experience this.
Forsskål probably planned to bring his case to the highest instance, the Diet, but when it assembled the next time, in October 1760, he was already in Copenhagen preparing what proved to be his biggest and last adventure: the Royal Danish Arabia Expedition. The purpose of the expedition was to make scientific investigations of the stories of the Bible. Thanks to the recommendation of Michaelis, his old teacher, Forsskål was enrolled as a specialist on botany as well as oriental languages.
The ambitious expedition turned disastrous in many ways, largely due to distrust and controversies among the participants. The feverish climate also took its toll and five of the expedition’s six members perished within three years, among them Forsskål.
The sole survivor, Carsten Niebuhr, took care of Forsskål’s notes and diaries, some 1 800 pages with descriptions from the three realms of nature. Much of this was published posthumously. Flora aegyptiaco-arabica (1775) is a systematic account stretching over 394 pages, whereas Icones rerum naturalium (1776) describes 20 plants and 88 animal species and is famous for its lavish illustrations. The most important title is Descriptiones animalium (1775), comprising 641 species divided into descripta, formerly unstudied orders, and nominata, familiar groups supplemented with localities etc. To this was added a pharmacopeia. The value of the book was increased by the application of contemporary Arabic nomenclature, yet another of Forsskål’s many knowledge areas.
Today there is a growing interest in the legacy of Peter Forsskål, and he was put at the centre of many activities when Sweden and Finland celebrated the 250th anniversary of the world’s first freedom of print act in 2016. A biography and English translation of his Thoughts on Civil Liberty can be accessed at Litteraturbanken. Updates are posted regularly on peterforsskal.info.
"The dress of a distinguished Arab in Yemen", assumed portrait of Carsten Niebuhr. Engraving by Johan Frederik Clemens.
Peter Forsskål. Engraving by Johan Fredrik Martin.
The last Swedish book censor, Niclas von Oelreich. Anonymous drawing.
Jonas Nordin has a PhD in history and is associate professor at Stockholm University. He is working at the Kungliga biblioteket/The National Library of Sweden. He specializes in early-modern cultural and political history and has published extensively on the seventeenth and eighteenth centuries.
In our modern society, people like to express their personality and status through their clothes and the status symbols they choose to buy. Today, many people decorate their bodies with tattoos and piercings. While this desire to belong to a particular social sphere has always existed, it has manifested itself in different ways. In China, they bound upper-class women’s feet (lotus feet) and in some African and Asian countries, people still lengthen their necks with metal rings.
When we hear the word trauma, we tend to think of sudden accidents that cause serious injury, such as a car crash or a broken bone. However, there’s another type of trauma – a low-intense one that can cause significant deformations, and throughout human history different cultures have practiced the deliberate reshaping of skulls.
If a baby’s skull is bound to a hard surface with, for example, a cloth, it affects the form of its skull as it gradually grows and becomes thicker and harder. Usually, a board of some kind was connected to the binding. If the pressure is prolonged, the natural basic form of the skull can be changed dramatically. So in cultures past, if the cloth and board were removed at about the age three, the child’s skull had become “programmed” to adopt a new shape. Archaeologists have found shaping tools in graves. It is likely that the brain was not so affected by these reshaping procedures, other than that the sutures could fuse slightly differently and form more sutural bone (small, additional seams) to help offset the need for extra growing space. The brain adapted and grew within its new bony casing.
Early finds and different theories
This type of custom has existed at different times and at different places around the world. The first types of find come from 45,000-year old Neanderthal bones in the Shanidar cave in Iraq, while in the Andes 10,000-year old finds have also been made. It is thought that the purpose of the practice was to indicate membership of an elite. There are also examples of cranial deformation from Crete’s Minoan culture and from Akhenaton’s reign during Egypt’s 18th Dynasty, when he and his family were depicted with elongated skulls. It is believed that this created a head-shape trend, but as no skeletons have been found the only evidence comes from the artwork. Perhaps the fashion merely concerned how people wanted to be depicted, not how they shaped the actual skulls of their children. Egyptologists have sought possible explanations for Akhenaton’s peculiar head shape and suggested that he could have suffered from acromegaly (a disease caused by excess growth hormone) or hydrocephaly. In the Andes, there is an identifiable parallel between cranial shape and the shape of a nearby holy mountain, from which it might be surmised that the shape of the skull had a spiritual or religious significance in certain cultures.
Many shaped crania have been unearthed on Cyprus, including from Enkomi, the site of a dig conducted by the Swedish Cyprus expedition in 1927-1931. Kirsi Lorentz, who has researched into this field, has identified three types of cranial deformation – anterio-posterior, rounded and post-bregmatic – depending on the direction in which the change in shape was made. They are the terms used both subsequently in the study of cranial measurements and as anatomical terms of location. The first is the oldest type (8,000-7,000 BCE) and the last is unique to Cyprus. However, the different types appeared at the same time and place. She mentions that these individuals had lived to an old age so no harm to the health can be inferred from the procedure. Research continues on trying to ascertain the mobility of populations and peoples using head-shape data. For example, scientists have taken isotope samples of the element strontium to see where the individuals originally came from. Strontium is stored in the teeth as a kind of fingerprint of where a person was living when his or her teeth calcified – i.e. when a child. It is always women who have the most pronounced deformations.
One way of shaping crania was with so-called cradleboards. A cradleboard was a kind of wooden or woven plate attached to a bag that allowed women to carry their babies on their backs. Boards like this, apart from their practical function, were also used to shape babies’ skulls. The archaeological grave material also includes terracotta figurines similar to miniature cradleboards. It is thought that these small figurines are representations of real cradleboards and that they might have had particular cultural significance. They are called plank-shaped figurines. One early interpretation was that the figurines depicted gods, goddesses or ancestors; in more recent times, however, they are seen more as miniature objects. For instance, what were once interpreted as a goddess’s breasts were probably mere decoration. Despite their being found in graves, they are thought to have been used by generations of the same family – just like real cradleboards were. Examples of such miniatures can be found in the Cyprus collection of the Mediterranean Museum in Stockholm.
Cradleboards were also used by Native Americans, who we know had rituals and customs surrounding babies before and after birth and during the first delicate year of life. The sacred cradleboard was made by a family member – often a grandmother – and in many ways represented and protected the baby’s body, and bring it health and life. If the baby died, the cradleboard could be destroyed or discarded. Alternatively, the baby was buried in it, or it was laid on the baby’s grave. It could also be filled with selected plants and feathers and carried by the mother as a symbol of mourning for up to a year. Chinooks (who practised cranial deformation) are known to have used cradleboards. A Chinook woman is depicted in an 1846 painting by Paul Kane.
During the 4th to 6th centuries, the practice of shaping crania spread amongst the nomadic tribes such as the Huns, and it is thought that it could have been passed on by them during the Great Migration. According to scholars, the different nomadic peoples used different techniques to distinguish themselves from one another.
There are alternative theories about that deformed crania are a sign of aliens or a new species of human. There will probably always be people with over-active imaginations keen to foment different conspiracy theories as soon as discoveries of astonishing historical finds are published. A collection of craniums discovered in Hypogeum, an underground Neolithic cult and burial site on Malta, gave rise to a rumour, which circulated for about a decade, that they were deformed even though they are just normally dolichocephalic (i.e. elongated). It is always important to be source critical.
The anatomical collection at KI’s Medical History and Heritage Unit contains several examples of deformed skulls. Some are from Peru and some are Chinook, an indigenous group living on the middle and lower reaches of the Columbia River in Oregon and Washington. The Chinooks practised this custom well into the 1800s. Two of the crania are labelled flathead indians, which actually refers to another group. The two crania were donated by ship’s captain Nils Werngren (1815-1897), who brought these and other such finds home from his travels around the world. The collection also has some plaster moulds of deformed crania.
Read more: Rumour of deformed crania on Malta.
Plaster modules from the Medical History and Heritage Unit. Photo: Ann Gustavsson.
Cypriot terracotta plank-shaped figurine, 2000-1800 BCE, from The Metropolitan Museum of Art, New York. Wikimedia commons.
Dan Jibréus, Hagströmer Library.
Aufderheide, A.C. & Rodríguez-Martin, C. The Cambridge encyclopedia of human paleopathology. Cambridge University Press. 2011: 34-36.
Bergoffen, C. J. Plank figures. Medelhavsmuseet. Focus on the Mediterranean 5. Stockholm 2009.
Lorentz, K.O. Modifying the body. Medelhavsmuseet. Focus on the Mediterranean 4. Finds and results from the Swedish Cyprus Expedition 1927-1931: A Gender Perspective. Stockholm 2009.
Ortner D.J. Identification of pathological conditions in human skeletal remains. San Diego 2003:163–165.
Identitet och skönhet. Populär arkeologi. Nr. 2/2017:9.
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.
Nuisance or Necessity? Historical Perspectives on the ‘Informed’ Patient.
Speaker: Nancy Tomes, Distinguished Professor, State University of New York, Stony Brook.
The following guest blog by Nancy Tomes is a condensed version of her talk on May 29, 2017. You can watch the whole lecture at YouTube: here.
The Hagströmer Lecture is a yearly lecture at the Hagströmer Medico-Historical Library, in which an internationally renowned historian addresses a subject that is currently debated in medicine, healthcare, or the life sciences, and puts this debate in historical perspective.
This year’s lecturer Nancy Tomes has taught history at Stony Brook since 1978, after earning her Ph.D. in History from the University of Pennsylvania, where she studied with Charles E. Rosenberg. Tomes has authored four books: A Generous Confidence: Thomas Story Kirkbride and the Art of Asylum Keeping (Cambridge, 1984; U Penn, 1994); Madness in America: Cultural and Medical Perceptions of Mental Illness Before 1914, with Lynn Gamwell (Cornell, 1995); The Gospel of Germs: Men, Women and the Microbe in American Life (Harvard, 1998), and Remaking the American Patient: How Madison Avenue and Modern Medicine Turned Patients into Consumers (UNC Press, 2016). She also has co-edited two collections, Medicine’s Moving Pictures, with Leslie Reagan and Paula Treichler (Rochester, 2007) and Patients as Policy Actors with Beatrix Hoffman, Rachel Grob, and Mark Schlesinger (Rutgers, 2011). In collaboration with Duke University Library’s Special Collections, Tomes developed “Medicine and Madison Avenue,” a website on the history of health-related advertising, available at http://scriptorium.lib.duke.edu/mma/
Tomes’ research has been supported by numerous foundations in the United States, among others the Rockefeller Foundation, the National Institute for Mental Health, and the National Library of Medicine. She won both the American Association for the History of Medicine’s Welch medal and the History of Science Society’s Davis prize for The Gospel of Germs. In 2011, the American Public Health Association awarded her the Arthur Viseltear Award for “her distinguished body of scholarship in the history of public health.” She received the prestigious Bancroft Prize in 2016 for Remaking the American Patient. From 2012 to 2014, Tomes served as President of the American Association for the History of Medicine. In 2015, she was promoted to the rank of Distinguished Professor, State University of New York.
Nuisance or Necessity? Historical Perspectives on the ‘Informed’ Patient.
Today millions of people across the globe are using their digital devices (computers, laptops, cell phones) to get information about their health, their doctors, and their hospitals. In the United States, the use of the Internet to get health information has provoked controversy. On the one hand, advocates of patient engagement see the Internet as a positive and potentially transformative force. In the words of Tom Ferguson, one of the early pioneers of the e-patient movement, “individuals who are equipped, enabled, empowered and engaged in their health care decisions” can “help us heal healthcare.” Yet this “new breed of informed health consumer” has aroused resistance as well, especially among physicians. The Medical Googler has become a flashpoint for debates about whether laypeople can really be trusted to understand all the information they can now access. This resentment is reflected in a mug available for purchase emblazoned with the motto, “Please do not confuse your Google search with my medical degree.”
One assumption that both admirers and critics of the Internet-using patient often make is that the Internet has “created” this problem. While I agree that the Internet is a truly significant development, the fundamental conflicts it raises over patients’ access to information, where it comes from, how reliable it is, and how it affects their trust in doctors, are not new at all. When it comes to content, much of what patients find on the Internet is not radically different from what was available in other forms via the now “old fashioned” print and electronic media (such as radio, and TV) and circulated through patient self-help groups that well predate the Internet. In order to recognize what’s different about the Internet’s version of the informed health consumer, it is useful to compare and contrast here with the experiences of past generations.
With that purpose in mind, my talk introduces some of these earlier information seekers and the debates they sparked within the American medical profession. While I focus primarily on the 20th c., I acknowledge that patients challenging their physicians with information gotten from other sources started long before that. Since the early modern period, the combination of growing literacy and cheap print has been a fertile source of popular unrest with medical authority. But due to sweeping changes in medicine, advertising and mass media, 20th c. doctors and patients have made choices within an increasingly richer and faster moving information environment. Many familiar features of our contemporary informational landscape originated in print media before migrating to electronic and now digital media: physicians’ advice columns, articles about the latest medical miracle or best diet, and lots and lots of drug advertisements.
Moreover, what doctors had to explain and patients needed to know also became more complex as medical science exploded in the post-World War I era, and the nature of the diseases being treated changed from communicable diseases to heart disease and cancer. The medical encounter increasingly revolved around conditions that lasted longer and were more difficult to cure, making trust and cooperation between doctor and patient all the more important. In light of these trends, American doctors assumed, understandably, that their patients would question them less, not more, as the 20th c. progressed. Yet the evolution of American medicine also provided fertile ground for the commodification of information and encouraged patients to adopt some not-so-deferential ways to use it.
Ironically, the medical profession itself encouraged the rise of the informed patient by educating the public about how avoid so-called quacks (osteopaths, chiropractors, Christian Scientists) by evaluating a physician’s qualifications (degrees, medical society memberships, hospital affiliations). In addition, doctors sought to discourage patients from “wasting” their money on heavily advertised drugs and treatments. But laypeople taught to be savvy shoppers when it came to the medical “quack” or dubious tonic did not necessarily stop there. Habits of critical thinking that doctors encouraged when patients were contemplating a Christian Science practitioner or a bottle of tonic in the local pharmacy were not so welcome when directed at the doctor himself.
Some patient-consumers began to do just that during the Great Depression as part of a broader middle class concern with “getting their money’s worth.” Initially concerned with proprietary medicines, critical consumerists began to cast a critical eye on medical services, as in a 1935 article titled “Shopping for Medical Care” that appeared in Consumers Research’s Monthly Bulletin. Although chilled by the second Red Scare, the progressive wing of the consumer movement continued to grow in the 1950s and found new respectability in the 1960s as criticism of mainstream medicine exploded.
Post WW2 principles of “free enterprise” made it all the harder to swat down the idea of the educated consumer or to suppress news stories about medicine’s failings. Advice that patients best be wary and inform themselves accordingly turned up in mainstream magazines of the sort doctors routinely stocked in their waiting rooms. A case in point was media coverage of the debate over unnecessary surgery. As the number of operations began to rise in the early 1950s, so did debates among physicians over whether they were all necessary. In a pattern that would frequently repeat itself in years to come, what began as an in-house argument confined to medical conferences and journals got picked up by national magazines, including U.S. News and World Report and Reader’s Digest. Such articles emphasized the need for lay people to protect themselves by getting second opinions before surgery, switching doctors if they spotted the telltale signs of unethical behavior, and reporting suspicious behavior to the local medical society.
Physicians complained loudly in the 1950s about the bad press they were getting. But their complaints had limited impact because information had become a commodity in and of itself: stories about medicine, whether the latest miracle OR controversy, sold magazines and newspapers. Nor could the medical profession avoid producing fodder for the “muckrakers”; as medical knowledge exploded, so too did internal variations in treatment, so the lay person who decided to consult the scientific literature to find out if a procedure was recommended might well discover that physicians themselves did not agree about it.
As the problems in the U.S. health care system escalated in the 1960s and 1970s, so too did the popular quest for patient health information. As medicine and pharmaceuticals became big business, their economic behavior came under increasingly hostile scrutiny. The various “rights” movements of the post war period made patient-consumers more inclined to question medical authority. The 1960s that brought to maturity a generation of Americans who were more prosperous and better educated than their Depression era parents, and more willing to criticize the “medical establishment.”
These new patients bankrolled a spectacular explosion of print health information in both book and magazine formats. The health sections of libraries and bookstores expanded dramatically. Mass market magazines and newspapers continued to carry many articles concerning health care issues. Between 1970 and 1980, the pages devoted to health and medicine in the Readers’ Guide to Periodical Literature increased nearly tenfold in number. Compared to their 1950s antecedents, this literature was far more openly critical of doctors and supportive of patients’ rights and abilities to make decisions about their own care.
Slowly the idea of the “informed” patient moved from an outsider position—associated with neurotics, Communists, and health faddists—to respectability. As efforts to bring down health care prices and improve quality foundered, politicians and policy makers on the right and the left became receptive to the idea of enlisting informed patients as allies. The patient-watchdog could be used to foster quality control in a medical world where innovation was frequent and professional oversight could be hard to sustain. With the advent of Reaganism in the 1980s, fostering consumer “choice” in place of government regulation became an even more popular remedy. One of the many ironies of the 1970s health information ‘revolution’ was the legitimation it gave to overturning traditional restrictions on health advertising, such as voluntary restraints on direct to consumer advertising of prescription drugs and the lifting of the American Medical Association’s ban on physician advertising. New forms of prescription drug and hospital advertising only escalated patients’ need for more objective assessments of medical products and services.
These developments paved the way for the 1990s “discovery” of the Internet. Far from being a radical development, there were many continuities in the development from print to digital forms of information. Much of what patients seek out today are very similar to what patients in the 1930s, 1950s, and 1970s were seeking.
How does this historical comparison help us understand the challenges presented by today’s Medical Googler? First, it helps us appreciate what the Internet has done that is different. It has certainly made the hunting and gathering of information much easier. Perhaps more importantly, the Web 2.0, as it’s called, has vastly multiplied the ease with which users can generate content and create virtual communities. It’s this connectivity that now makes web-based information so new and distinctive. You can not only get information but also connect with people around that content in a huge variety of ways, including email, blogging, Skyping, and social media such as Facebook or Twitter.
But plenty of problems remain. Even though the digital divide has narrowed substantially in the last decade, groups we very much want and need to reach—the elderly, people of color, rural residents, and the very poor—are less likely to have access to the Internet’s researches. In the U.S., this “information hunt” covers everything from the choice of an insurance plan to the side effects of your prescription drugs. This scaling up of the requirements to be “informed” tends to favor the privileged. Then there is Internet advertising. In today’s wired world, commercial actors are well financed, command great creative talent, and are relentless in their bid to bring advertising to every nook and cranny of our lives. There is no way that we can scrub the Internet of this kind of information, much less all the other forms of questionable material out there on the World Wide Web.
But as this talk has shown, greater access to information has not magically created new disturbances in the health care system where none existed before; rather those disturbances have persistently fueled patients’ determination to acquire more information. E-tools are not a magic wand we can wave over all the dysfunctions of the health care system and poof, make them go away. They have both good and bad aspects, and we need to be patient in addressing those problems.
So, what about solutions? Let me share a few thoughts. Patients trying to be better informed are here to stay so it’s best to adopt the motto “if you can’t beat them, join them.” To doctors, I would say skip buying the Google mug and work with your local medical librarians and other patient educators to draw up a list of resources you find useful and want to recommend. Use the enhanced potentials of connectivity to push back against the very real problems that exist in health care today, starting with the relentless hollowing out and fragmentation of the time that health care professionals and their patients spend together. There is a world of good ideas being tried out, and librarians are leading the way in this regard.
In the end, the debate about Medical Googlers is at heart a debate about patient engagement. With or without the Internet, the ideals of participatory medicine are hard to fulfill but we have no choice but to pursue them.
Nancy Tomes, 23 August 2017
Have a nice summer vacation!
The Hagströmer Library will be closed during the month of July.
(Andreas Friedrich Happe, Botanica Pharmaceutica, Berlin, 1788)
These days, we do our utmost to prolong life, even that of seriously ill patients. There are accounts of people who, using the latest high-tech means, have had their bodies (or that of their loved ones) frozen in anticipation of new cures or methods of revivification. Certain people, such as Lenin, have been immortalised through embalming. Throughout the ages, humans have made sure to remember and cherish their dearly departed, and there is much poignant evidence of the love and consideration that endures long after death. In the Pharaoh Tutankhamen’s tomb was a lock of his grandmother’s hair and many a sarcophagus and engraved memorial stone from ancient Rome bears witness in words and pictures to the grief felt after the death of a child.
Mummification was a central pillar of ancient Egyptian funerary practice, and the pharaohs would plan their tombs from an early age, aware of the time it took to construct them and collect all the artefacts needed for the afterlife. It was believed that the soul comprised two parts, the Ka – the vital force – and the Ba – the spirit. The proper preservation of a dead body guaranteed its reunification with both parts of the soul and thus eternal life. They had separate rooms for all their accompanying possessions, including tiny figurines called ushabti to act as servants. The wall paintings inside the tombs usually come from the Book of the Dead and depict how the journey to the afterlife was to be properly navigated
While the Egyptians were experts at mummification, mummies can be found all over the world, from China to South America. The Egyptians improved the embalming technique during the New Kingdom, particularly the 18th Dynasty, which produced our best-preserved specimens. The value of the funerary objects also increased with time, and with it the number of robberies.
Sometimes the chance nature of a body’s location – be it a bog or an arid or extremely cold environment – has proved extremely preservative. Most people would have heard about Ötzi the “Ice Man” who was found in the Alps between Italy and Austria. Bogs preserve the organic material (such as hair and skin) better than the bones. It was once thought that this was solely due to the low pH, anaerobic conditions, but it was then discovered that sphagnum (peat moss) contributes to favourable chemical processes in a natural form of tanning. One bog body, referred to as the Lindow Man, is held by the British Museum, but most are found in Denmark, Germany and the Netherlands. Frequent finds were made when draining peat bogs or during times of need when peat was used as a fuel.
Egyptomania and the infancy of Egyptology
From the late 1700s until the first decades of the 1900s, a wave of Egyptomania swept through Europe. Napoleon’s Egypt campaign in 1798 catalogued the country’s monuments, fauna and flora, the scientific results of the expedition being published in Description de l’Égypte from 1809. Giovanni Belzoni (1778-1823) opened his exhibition of ancient Egyptian treasures in “The Egyptian Hall” in London in 1821, and the Rosetta Stone found by Napoleon’s soldiers in 1799 was the key that Jean-Francois Champollion (1719-1832) needed to decipher Egyptian hieroglyphs in 1822. The first person to interpret the Rosetta Stone, however, was Swedish linguist Johan David Åkerblad (1763-1819), who despite his correct interpretation of some of the symbols on the stone years before Champollion, fell into oblivion. Other expeditions were then launched to Egypt and more and more mummies were discovered as royal tombs, temples and pyramids were excavated. Vast quantities of Egyptian objects were purloined, with mummies some of the most prized. People were convinced that mummy powder had medicinal properties when ingested, which was probably a case of linguistic confusion with the Persian word mumia (bitumen), a substance with antiseptic properties that was once thought to have been an essential ingredient of the mummification process. Mummies were also used to fuel steam trains, so versatile were their properties considered to be. In England, enthusiasts would host “unwrapping-parties” at which guests would gather around a mummy and ceremoniously remove its bindings and, if they were lucky, return home with an amulet discovered within. As the demand for Egyptian goods increased, many businessmen realised the lucrative advantages of this type of trade and many a shady deal was done. Unscrupulous people made forgeries and composites of objects and mummies in order to claim a higher price for a complete specimen. In more recent times, X-ray analysis has revealed that many mummies contain nothing like what was previously thought.
Of course, more serious examinations were also conducted. In 1908 Margaret Murray (1863-1963) of Manchester University carried out a scientific examination of a 12th dynasty mummy found by archaeologist Sir William Flinders Petrie (1853-1942). Petrie was a pioneer of systematic Egyptology, and was one of the foremost figures in the field along with Frenchmen Auguste Mariette (1821-1881) and Gaston Maspero (1846-1916) and Germans Heinrich Brugsch (1827-1894) and Adolf Erman (1854-1937), who all made important findings and composed lexicons. A seminal inventory of ancient artefacts was made in 1842-45 by the German Richard Lepsius (1810-1884), after which interest in mummies culminated with the discovery of Tutankhamen’s tomb by Howard Carter (1874-1939) in 1922, the progress of which was closely followed by the world’s press. In 1926 an early scientific examination was conducted by two French journalists using a little portable X-ray apparatus.
The Medical History and Heritage Unit manages a collection of mummified heads and bodies held in storage at the Gustavianum Museum in Uppsala. It forms part of the ongoing project to sort out Karolinska Institutet’s anatomical collections and includes a child mummy donated to Karolinska Institutet by Baron Jakob Vilhelm Sprengtporten (1794-1875) in 1850. A document in the faculty archives reads as follows: “A mummy donated by Baron Sprengtporten. [. . .] §.7 Hr. A. Retzius announced that a gift has been made to the Museum by Baron Sprengtporten of an Egyptian mummy in its coffin, wherefore the Professors have asked Hr Retzius to offer Baron Sprengtporten their sincere thanks.”
This mummy is not on display, but if on reading this you feel the need to make the closer acquaintance of other mummies, I can recommend a visit to the Gustavianum or the Egyptian rooms of the Museum of Mediterranean and Near Eastern Antiquities in Stockholm.
Ann Gustavsson, 15 June 2017
Title page from The mummy. A handbook of Egyptian funerary archaeology by Sir. E. A. Wallis Budge, 1925. Hagströmer Library.
Child mummy’s cartonnage. KI:s anatomical collection.
Ushabtis. Dan Jibreus´ private collection.
Photo: Ann Gustavsson, Dan Jibreus.
Auderheide, A.C. The scientific study of mummies. Cambridge, 2003, p. 171, 175, 515ff.
Dunand, F & Lichtenberg, R. Mummies – A journey trough Eternity. London, 1994, p. 14f, 20, 23, 31, 74, 80, 98f, 112.
Lefkowitz, M.R. & Fant, M.B. Women´s life in Greece & Rome. London, 1992, p. 207.
Minten, E. Roman attitudes towards children and childhood. Private funerary evidence c.50 BC. - c. 50 – c. AD 300. Stockholm, 2002, p. 182ff.
Pringle, H. Mumiekongressen – Vetenskap, besatthet och den eviga döden. Stockholm, 2001, p. 83ff, 139, 156, 195ff.
Shaw, I. The Oxford history of Ancient Egypt. Oxford, 2000, p. 170, 303.
Document from the faculty archives, 25 March 1850, item 7, p. 57.
Tutankhamen and his family
14-year old girl cryogenically frozen
Piccadilly´s Egyptian Hall
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.
Utställningen It was my brain again är en blandning av existerande verk och skissfragment av konstnären Nikolina Ställborn, som just nu visas på Hagströmerbiblioteket. De kommer ur en längre tids intresse för Hagströmerbibliotekets rika samling av illustrationer med anatomi, sjukdom och medicinska behandlingar från flera århundraden av läkevetenskap.
I framförallt de grafiska bladen har hon försökt fånga olika aspekter av sjukdomspåverkan: att vara påtagligt märkt av sin sjukdom och samtidigt känna en pust, gnista, vilja till liv, en plötslig roande och fri tanke som får den sjukes tärda ansikte att le.
Utställningen visas på Hagströmerbiblioteket fram till midsommar.
Se mer konst av Nikolina Ställborn: här!
Giovanni Aldini (1762–1834)
Essai théorique et expérimental sur le Galvanisme, avec une série d'experiences faites en présence des commissaires de l'Institute National de France, et en divers amphithéatres anatomiques de Londres. Tome Premier–Second.
Paris, de l'imprimerie de Fournier fils. An XII (1804).
Medical Electricity and “Frankenstein”.
First edition of Aldini’s best-known classic, dedicated to emperor Napoléon – a landmark work relating to the central nervous system. "In the controversy over Galvani’s 'animal electricity' and Volta’s 'galvanic current' it was not the modest Galvani but his lusty nephew [Aldini] who wrote, lectured, and published in Italian, French and English on the theories and experiments of both his uncle and himself . . . the effervescent Aldini became his uncle’s champion – so much so that Volta addressed his arguments to Aldini instead of Galvani” (Bern Dibner in DSB).
In October 1802, Aldini experimented before the Galvanic Society in Paris, and in January 1803, he was in England to lecture on medical Galvanism, performing demonstrations at several London hospitals. Aldini induced strong muscular contraction in the heads of sheep, chickens, oxen and other animals by putting leads from a Voltaic. pile into the ear and a nostril or on the tongue; the eyes would then roll or the ear or tongue quiver.
In 1804, Aldini caused a very strong muscular agitation in corpses, creating the illusion of a body preparing to walk, arms rising and falling or forearms lifting weights. His most dramatic performance was a series of experiments in galvanic action upon the beheaded corpse of Mr. George Foster, a murderer just executed at Newgate Prison. Aldini used a Voltaic pile of 120 copper and zinc discs and the muscular reactions he thus obtained led him to believe he could restore life to those recently overcome by drowning or asphyxiation.
Mary Shelley, who knew of Aldini’s work, used the idea of galvanic reanimation to brilliant effect in her classic novel Frankenstein (1818).
Ove Hagelin, 5 april 2017
Photo: Anna Lantz
The office that I am proud to call mine, is furnished with furniture that once belonged to Gustaf Retzius. It is heavy black-painted oak pieces, a far cry from the light wood and steel framed things that are in vogue today. And I absolutely love it! The furniture was custom made in the late 19th century to accommodate Retzius’ requirements and it consists of a desk with plenty of drawers, a chair which can be lowered or raised at will, and the walls are lined with several book cases of different sizes, with glass doors. There are of course plenty of books on the shelves and a large part of them once belonged to Retzius; one case is actually dedicated solely to his own scientific production. These books are all very large and luxuriously bound and Biologische Untersuchungen (Neue Folge, 1890-1921) in 19 volumes immediately catches the eye with their vellum spines (imitation; but still…). But they are matched by the two decorated half leather tomes of Studien in der Anatomie des Nervensystems und des Bindegewebes (1875-1876), just to mention another example out of several.
But there are more things than books on the shelves. A nice collection of polished sea shells, among them that of a nautilus octopus (which reminds you of the related ammonites that have been extinct for millions of years) graces one shelf. Different kinds of instruments are on display, many of them worth an essay of their own; there are some microscopes – the nicely wrought brass one from the early 19th century once used by Gustaf’s father Anders Retzius and the almost modern looking brass piece that was Gustaf’s own. On a couple of comparatively low book cases behind my back when seated at the desk there are a couple of life-size plaster busts of Gustaf and Anna Retzius. The look sternly down over my shoulders and make sure I don’t loiter…
On one shelf there is an incongruous cardboard box. In its mundane simplicity it looks quite out of place where it sits. It carries a label with the following words, which reads in English translation: “RETZIUS. Careful, in spirits” written with a red felt pen. There are additional comments in other hands on it: Beside Retzius’ name it says “teetotaler” and below that it says “Fröding. Accustomed to strong drink”. But why would anyone write comments about the famous Swedish poet Gustaf Fröding’s (1860-1911) drinking habits, or for that matter those of Gustaf Retzius on a cardboard box? The answer is, of course, the contents of the box. Sometimes, on request, I remove the box and carefully put it down on my desk. When I open the top to reveal what’s inside I always get ”interesting” reactions. Amazement, fascination, curiosity, surprise, disgust. Nobody is left untouched! In a glass container resting on a wooden tray is a human brain preserved in alcohol.
So the question arises; Who’s brain is it? Gustaf Retzius was, among other things, a very skilled histologist, and he published studies of some famous people’s brains. He was part of a group of physicians calling themselves the Brain Club and they had an agreement between them. They wanted their own brains to be removed and studied after their deaths by the remaining members of the group. Folke Henschen removed Retzius’ brain, under the supervision of Anna Retzius, shortly after his death in 1919. The brain was afterwards properly labeled and stored. Some years earlier Gustaf Fröding had died at the mental institution Ulleråker in Uppsala, and his brain had also been taken care of. What could be more interesting than studying the brain of a mad poet?
The two brains were never studied but were kept safe together for decades, until in the late 20th century, when someone with too much time on his or her hands, got the bright idea to remove the labels, thereby making the brains anonymous. Some misguided sense of ethics probably led to this decision. More time passed and one of the brains ended up in the Hagströmer Library and the other had several different “homes”. It was for a time part of a traveling exhibition called (O)mänskligt ((In)human). This exhibition also contained the famous regalia of the Pawnee Scout and performer White Fox who died in Sweden in 1875. After some time at the Ethnographical Museum of Stockholm the brain ended up in a museum depot in Tumba. With the help of Björn Wiklund the latter brain has also been brought to the Hagströmer Library and I now have both of them in my office.
The brains seems to be irrevocably mixed up. However there may be a solution. Physiologist Birgitta Sundelin examined the two brains before the labels were removed and she has offered to examine them again. She thinks it is quite possible that she can identify them. When this has been done the result will be reported.
Dan Jibréus, 22 March 2017
The text is from Folke Henschen’s autobiography Min långa väg till Salamanca, and lists the brains that were in the KI collections at the time of writing (1957).
Photo: Dan Jibréus
Theophrastus (c. 371 – c. 287 BC)
De Historia Plantarum Libri Decem. Graecé & Latiné.
Amsterdam, Henric Laurentius, 1644.
The father of botany - Linnaeus´ favourite.
The most important and influential edition of Theophrastus' seminal work, Historia Plantarum – the first systematization of the botanical world and the most important contribution to botanical science up until the Renaissance. Bodaeus von Stapel's groundbreaking edition constitutes the first illustrated edition of Theophrastus' masterpiece as well as the first with both Greek and Latin text. Furthermore, von Stapel has not only collected all relevant commentaries and knowledge, he has also added corrections and much foundational information, turning the work into one of the most influential botanical works of the 17th century, profoundly influencing the likes of Linnaeus and contributing significant to the development of modern scientific botany.
This, the first illustrated edition of Theophrastus' masterpiece, containing over 625 woodcuts of plants, became the standard edition of that earliest work on systematic botany and the edition that all serious scientific botanists of the 17th and 18th centuries studied.
Ove Hagelin, 16 March 2017
In 1976 I stayed a while in Dublin for the first time. Not surprisingly, even then, I visited an antiquarian book seller. I’ve forgotten which, but it was one of the older and better, i.e. more expensive, ones. Since I was interested in the traditions of ancient Ireland, a title caught my eye; Ancient Legends, Mystic Charms, and Superstitions of Ireland. With Sketches of the Irish Past, by Lady Wilde “Speranza”, London, 1888. When I left the book store I carried a plastic bag with the book in it. I don’t recall what I paid, but since I was a young man then, I did not have the limitless resources I have now. So it meant I had to skip a few pints of Guiness at O’Donoghue’s public house and limit myself to fish burger lunches (extremely cheap then!) for a while. I still have the book and I still treasure it.
Lady Wilde, with the pen name Speranza, was Jane Francesca Agnes Wilde (1821-1896), the wife of renowned Dublin eye and ear surgeon Sir William Robert Wills Wilde (1815-1876). Sir William shared his wife’s interest in old Ireland so it comes as no surprise that she appended to her book a speech held by her late husband called The Ancient Race of Ireland.
In the Hagströmer Library there are a couple of Sir William’s works, one on the eye (An Essay on the Malformations and Congenital Diseases of the Organs of Sight, London, 1862) and one on the ear (Practical Observations on Aural Surgery and the Nature and Treatment of Diseases of the Ear, London, 1853) respectively. There is a German translation of the latter in the library as well.
Lately the Hagströmer Library has had a very substantial addition to its collections – a large part of the holdings of the Karolinska Institutet University Library (KIB) in Flemingsberg has been moved to Haga tingshus. While processing some of the books I noticed yet another book by Sir William, called A Descriptive Catalogue of The Antiquities of Stone, Earthen, and Vegetable Materials in The Museum of the Royal Irish Academy, Dublin, 1857. Immediately obvious is the signature “A. Retzius”, written with pencil in the lower right-hand corner of the printed front wrapper. When you look closer at the cover you notice an ink inscription below the printed author’s by-line. It says “1 Merrion Square, Dublin”.
Dublin is known for its Georgian architecture. In the late 18th century and the early 19th century many of the Irish aristocracy had town houses built, at first as part-time residences when away from their rural estates. The Georgian houses at first looks quite simple; large unadorned red brick edifices. But when you look closer you start to see the wonderful embellishments, especially the doors stand out and no door is quite like any other although the general style is the same. These Dublin doors are often depicted on post cards and on posters. Dublin has had its fair share of modernizing developers (vandals) in the last century and many buildings were pulled down before the destruction was stopped in the final years of the 20th century. There are some areas that remain in all their past splendor, some squares are really worth a visit, and foremost among them is Merrion Square, not far from the greenery of St. Stephen’s Green. It still (or rather, again) has the dignity it had 200 years ago.
I’ve been to Merrion Square several times over the years and I paid my last visit there in the summer of 2015. So I recognized the address on the book cover. It was the house where the famous author Oscar Wilde grew up. And I finally made the connection (some of us are a bit slow…). Sir and Lady Wilde were, of course, the parents of Oscar.
When you start turning the pages of Catalogue of The Antiquities you immediately get to the half title page and there you find this inscription: “Andreas Retzius from his sincere friend, the author”. Could it be that William Wilde wrote his address below his name for Anders Retzius as contact information?
Anders Retzius and William Wilde were both a part of an early 19th century network of scientists concerned with the evolution of Man and of how Man could be classified. Wilde visited Sweden and was received by Retzius. He was given an honorary degree by Uppsala University and King Charles XV awarded him the Order of the North Star (Nordstjärneorden). Arguably he named his son after the Swedish King’s brother Prince Oscar who later became King Oscar II of Sweden.
Dan Jibréus, 3 February 2017
The specifics of Sir and Lady Wilde’s life are from Wikipedia, no less.
Photo: Dan Jibréus
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.
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
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
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.”
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
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
Hagströmer Medico-Historical Library
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).
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.
Kittelsen, Theodor, Har dyrene sjael?, 1915.
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
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.
Sidensvans och domherre (waxwing and bullfinch).
Anders Sparrman, Svensk ornithologie med efter naturen colorerade tekningar, Stockholm, 1806.
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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.
Tomas giving his daughter Astrid and her husband Maxine a private viewing of the Hagströmer Library in 2011.
Dan Jibréus, 21 November 2016
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
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.
One of the Retzius family bookcases. Photograph from around 1920.
Anna Retzius-Hierta's comment concerning Anders Retzius' autograph 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
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.
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
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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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 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. . [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.
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.
The Nordic Encyklopedia (Nordisk familjebok) published 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
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.
Nyberg, Gudrun. Doktor Carlanders Göteborg – folkliv, sjukdom och död 1793-2014. Stockholm, 2007.
Nyberg, Gudrun. Doktor Carlander i praktiken – läkekonst 1793-1814. Stockholm, 2009.
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
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.
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
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
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
Watch BBC Documentary about Charles Byrne
Read about the Hunterian Museum
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).
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.
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
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, . / 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.
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, .
Read more about cardiac arrest here!
We are back!
Look out for the coming announcement of exciting activities at the Hagströmer Library this fall!
(Hieronymus Bock, Kreutterbuch, Strassburg, 1580)
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)
The Tall Lapp Girl.
Many different events and human destinies have passed by in the history of Karolinska Institutet. Some stories make an indelible impression and seem worth telling and remembering. The fate of Kristina Katarina Larsdotter is one of them. Kristina was born in Brännäs (modern Malå) in Lappland on 19 January 1819. The reason for her fame was her unusual height and the fact that she never stopped growing. Most Sami are short of stature, but Stor-Stina (Big-Stina), as she was nicknamed, grew to at least 2.07 metres (6 feet 9.5 inches) tall, although reports vary. In an attempt to find a reason for her size, it was said that her mother Karin was frightened by her own moon shadow while pregnant.
Stor-Stina lived at a time when people were fascinated by the aberrant. In the absence of modern media and internet, people derived their information and pleasure by more direct means, and had no qualms about buying tickets to see exhibitions of natives and people with various deformities and specialities. It was the public entertainment of the day and a rich source of income for more enterprisingly inclined, especially their self-proclaimed “managers”.
One such so-called impresario from Germany heard rumours of Stor-Stina and made his way to Brännäs. It is uncertain if he was called Kempe or Wolfenstein, but it is likely that they both collaborated with Stina at different points in time, with Kempe keeping an account of her in his diary. Stor-Stina agreed to travel to Stockholm and onto the continent to exhibit herself. We know she lived for a while in Gamla Stan and visited England and Germany. The money she earned enabled her to help her old parents and siblings, who lived at a time when the Sami people had only meagre livings to make in the transition from traditional nomadic herders to settled farmers. Apart from being large-limbed and extremely strong, Stor-Stina was said to have been gifted and managed virtually all her own affairs. In the end, she was able to buy her own homestead, where she lived with her sister Sara. Her parents, for their part, found it hard to fully abandon the old Sami ways.
According to a surviving medical report, Stina Larsdotter was examined by the Swedish Society of Medicine at Karolinska Institutet when she was 18 years old. They measured her body and noted down interesting phenomena, such as that she never menstruated, was prone to fainting, and was in chronic pain – symptoms that are consistent with the condition known as gigantism.
Many books have been written about the Tall Lapp Girl, both biographies and novels. It can be hard, however, to isolate fact from fiction, and there is often little to say what actually happened. We know that she died of gangrene in 1854, possibly after having been attacked by a bear, although that too could just be an invention. Her body was initially buried, but her grave was later opened and her corpse shipped from Umeå to Stockholm and Karolinska Institutet, where it was to be preserved for posterity and subjected to further examination. Her remains had been sold to the university, but whether their sale had been arranged by her before her death or by her parents afterwards is unclear. The society’s records mention a Dr. Ångstrand from Lycksele, who helped to transport her body, and contain notes that the size of her skeleton, particularly her pelvis, was astonishing. The word was that Anders Retzius had made a plaster cast of her pelvis, and the Unit for Medical History and Heritage actually houses a plaster pelvis that could be this very same cast. Writer Selma Lagerlöf wrote in her diary that she was once shown the skeleton as a young girl on a visit to Karolinska Institutet. Perhaps she was the last to see it before the fire of 1892, which totally destroyed Stina’s remains and much else besides.
There are today few traces left of the Tall Lap Girl: a handful of press cuttings and posters, a song, a couple of drawings, lithographs and a statue (which was erected at a later date). In 2009, a silver spoon was donated to Malå local history society bearing the inscription: “åt CC Larsdotter gifven af ett Sällskap i Sthm d 4 maj 1837” (For CC Larsdotter, presented by a Stockholm Society on 4th May 1837). It had been given to Stor-Stina as a present, and passed through several owners’ hands before finding its way back to Malå. The homestead no longer exists, and a new house has been erected on the site.
Ann Gustavsson, 15 June 2016
Stor-Stina i Malå. Litography, printed in Edinburgh before 1850. NMA 0041105 Nordiska museet.
Stor-Stina i Malå. Långa lappflickan Christina Catharina. Print from 1839. NMA 0041106 Nordiska museet.
Broberg, G. ”Lappkaravaner på villovägar. Antropologin och synen på samerna fram till sekelskiftet 1900.” Lychnos, Lärdomshistoriska Samfundets Årsbok. Stockholm, 1981-1982, 30-37.
Hagberg, M. Rekviem för en vanskapt. Stockholm, 2012.
Lundgren, Å. Långa lappflickan, romanen och bakgrunden. Skellefteå, 2011, 177ff.
Lärarkollegiets protokoll med bilagor/ Signum: AIa/ Volym 7, 1853-57. Protocoller hållne vid Kungl. Carolinska Institutets Professorers sammankomster åren 1853-1857.
Svenska Läkaresällskapets protokoll KI Ms 194a:6
Verbal communication from: Olof Ljungström, Ass. Prof. History of Science and Ideas, Unit for Medical History and Heritage, Karolinska Institutet. Stockholm, June 2016.
Translation: Neil Betteridge
Many of the members of the (all too small) staff at the Hagströmer Library have a keen interest in the natural world. The knowledge some exhibit is far from superficial. For those who haven’t visited us yet, it may be interesting to know that the library besides the obvious books also has a few specimens of other things. In some ways it is actually a natural cabinet in its infancy. While wandering around the library admiring the books, you may suddenly stand face to face with an open-mouthed blowfish with its bristling set of poisonous spines ready to hurt the careless! And when you have recovered from the surprise and start turning away, you discover that the fish is right next to a crocodile with sharp teeth. The latter is quite small, though, and has a red ribbon around its neck, which makes it look a bit less menacing. Elsewhere around the house you can find three more crocodiles, none of them large, the biggest measuring c. 114 centimeters from the snout to the tip of the tail. The last one is called Oscar and has been known by that name since the first part of the 20th century. High on a wall you can see a majestic golden eagle spreading its imposing wings, frozen in time just as it is about to take to the air from a branch.
The eagle is flanked by four colorful plates taken from John James Audubon’s Birds of America, originally published in installments between 1827 and 1838. This work is extremely valuable when complete, but single plates aren’t cheap either. The plates displayed at the Hagströmer Library, however well-made they are, are reproductions made in the German Democratic Republic in the 1960s. On a large desk we have several more of these Eastern German reproductions bound in two cloth-backed hardcovers. The books are quite cumbersome because of their size; 990 x 640 mm. Ove Hagelin, when guiding visitors, likes to turn to the plate depicting the passenger pigeon, and tell the sad story of how this bird, which could once be counted in millions and millions, was exterminated by thoughtless hunters.
Two goshawks perch on branches and, just as the golden eagle, they seem to be right on the verge of taking flight, looking for prey. In the spacious garden of the Hagströmer Library there is a large colony of rabbits. Visitors and staff alike look at these furry little animals with fondness, often remarking on how cute they are. Goshawks, of course, view the rabbits in a different light … A couple of winters we have been able to see modern-day descendants of the stuffed birds we have inside the library. You watch in fascination as the beautiful birds feed, while at the same time feeling a certain amount of pity for the poor rabbit.
By now you aren’t as easily astounded by strange creatures as you were when you first entered the library, and you hardly raise an eyebrow at the sight of a large rooster displaying fancy feathers, that surely must have impressed many a hen in the glory days of the rooster’s life. However, when you are well at ease, you look over your shoulder and get a glimpse of what, at first, seems to be a large shaggy dog in a corner. When your pulse is back to normal you realize that you are looking at a wild boar with glistening tusks, which would (or could) actually have been a far worse encounter than a dog, had it been alive – which of course it isn’t: you are looking at Dr. Schweinkopf who by his mere presence has guarded the library for many years now.
There still are a few things to see; if you look carefully you will find several corals and other fossils, hundreds of millions of years old, some not so old horns from deer, and you may even find the little hedgehog in one of the private offices if you are invited there. And there is pelt of a black fox from the early 20th century which was supposed to be worn by ladies around the neck to keep them warm – but the main purpose was surely to make them look elegant. It still has all its four paws and head in place. Fashion and taste change … Don’t worry if you spy rats on some of the book shelves – they are fakes!
photographs: Dan Jibréus 8 June 2016
Addenda: The collections have quite diverse origins. Some are donations; the blowfish is a gift from Sven Olof Sundholm, the small crocodiles are gifts from Nadja Barenthin Lindblad, the large one is a gift from Ebba Fernberg, whose father bought it in the 1960s in Gothenburg; the original owner is said to have been a sailor. The great golden eagle is from the estate of Torsten Gordh (1907–2010), a pioneer in Swedish anesthesia, and it was given to the Hagströmer Library by his son, also called Torsten Gordh. One of the goshawks is the latest acquisition and was conferred to the library by Ingmar B. Lindahl earlier this year. Other things are private possessions. The rooster and the boar belong to Ove Hagelin, the fossils to the author, the deer horns to Eva Åhrén, the hedgehog to Anna Lantz, and the second goshawk belongs to Emil Hagelin. Finally the black fox pelt Gertie Johansson has inherited from her grandmother. It was bought in the shop of E. O. Lindmark, Upplandsgatan 22, Stockholm, in the first years of the 20th century. But before it ended up for sale in the fur dealer’s shop it must have spent its life on a fox farm which specialized in black foxes. And just such a farm was situated where the campus of Karolinska Institutet is now …
Hagströmerbibliotekets skriftserie (The Series of Publications issued by the Hagströmer Library) consists of 21 items at the time of writing. It was initiated by Ove Hagelin and the first book was called Om botanikens grunder (On the Foundations of Botany), Atlantis, 2007. This is an edition and translation into Swedish of notes made by one of Carl Linnaeus’ pupils during the scientist’s lectures on botany in 1748. The work was compiled and issued by Lars Bergquist and is a handsome volume of 504 pages. Carl Linnaeus, Lars Bergquist, and Ove Hagelin are names that appear repeatedly in the series and in due course we intend to describe – in no particular order – every item in the series. Another name that is found time and time again is that of the eminent scholar Nils Uddenberg. His latest contribution is number 19, Lidande och läkedom (Suffering and Healing), Fri tanke, 2015.
In Lidande och läkedom I and II Nils Uddenberg paints a broad-brush picture of the growth of Western medicine from ancient times to around 1950, and reveals how people have tried to handle disease and death over the millennia. He describes developments in the theory and techniques of medicine, and leading us through the plagues that claimed millions of lives chronicles how people have tried, more or less successfully, to overcome such devastating epidemics. Presenting a cast of influential physicians, often with detailed biographies, Uddenberg surveys the global stage, albeit with a fond focus on his native Sweden. Accounts of individual suffering over the ages and the treatments offered add substance to his history, while the abundant illustrations, many of which were taken from the Hagströmer Library collection and with many objects exclusively photographed for this work, lavishly complement the text.
Nils Uddenberg was awarded the Letterstedtska författarpriset (The Letterstedt Prize) 2016 for the books. This award is issued by the Royal Swedish Academy of Sciences for an outstanding original publication in science, literature or art the previous year.
Dan Jibréus 1 June 2016
Learn more: Fri tanke förlag
Learn more: Lindring för lidande
Published in Sydsvenskan, 28 September 2015
Learn more: Letterstedska prisen till Nils Uddenberg och Inger Johansson
Published by The Royal Swedish Academy of Sciences, 12 May 2016
Udagawa Yoan (1798–1846)
Shokugaku keigen. Three volumes.
Tempo 8 (1837).
The introduction of Linnaeus’s binominal classification system of plants into the Far East, part II.
Yoan was a Japanese scholar known for his key role in introducing Western science into Japan. Although his span of life was short, his work contributed immeasurable in the advancement of science in Japan, especially the science of botany, zoology, and chemistry. His ability in foreign languages and his vast scientific knowledge surprised even Siebold. Influenced by Keisuke Ito’s Explanations of the twenty-four classes published as a supplement to his Taisei honzo meisu, which first introduced the Linnaean sexual system for the classification of plants in Japan, and under the guidance of the German botanist and physician Philipp von Siebold, Yoan published his epoch-making Shokugaku keigen (Principles of Botany) in 1834. It consists of three volumes written as an exposition of the western discipline of botany, the first to appear in Japan. Udagawa Yoan’s Shokugaki keigen is probably the first modern botanical treatise published in East Asia. The book is illustrated with 21 beautiful full-page botanical woodcuts printed in colours mainly taken from Dutch books and among them is the famous plate by George Dionysius Ehret of the 24 classes in Linnaeus’s sexual system of plants.
A teacher of osteology once said: “The worse for them, the better for us.” Although this might sound rather cynical, what she meant was that diseases that afflict people for a long time can leave interesting traces behind in the bones. This makes things very exciting for osteologists and others, who can learn a lot from them about the diseases and how these individuals once lived. Many diseases that were incurable then can be treated today with drugs and vaccines; others become resistant with time, leaving medicines at risk of becoming impotent. Syphilis is one of the diseases of which we find traces in the crania in the anatomical collection at the Unit for Medical History and Heritage, KI. There are also some striking pictures in one of the works in the Hagströmer Library collection.
Syphilis is caused by the Treponema pallidum bacterium, and is known by many names, such as the French Disease, Lues and the Great Pox. It is a chronic, disfiguring disease that leaves traces on the bones as bacterial infections take root. Venereal syphilis is contracted sexually and can be passed from mother to fetus. Just like in leprosy, it causes ulcers, skin and soft tissue lesions and inflammatory disfigurements of the skeleton. The first symptoms appear on the genitals and around the mouth. 10-12% of sufferers develop skeletal deformities and in the case of congenital syphilis, the mortality rate is 50%. After a while, the bacteria migrate through the body via the blood, affecting the heart, brain and arteries. Some people suffer mental disorders or become paralysed in the final phases of the disease. The bone deformities are caused by gummata, inflamed, fleshy growths that lead to the disintegration and re-forming of bone in the cranium. Tubular bones, chiefly the tibia, were affected, and here traces can sometimes be seen of severe inflammation (boils and exostoses). Arthritic changes to bones and joints and disfigured teeth (e.g. Mulberry molars) can also accompany the disease.
Columbus’s voyages were a decisive factor in the spread of the disease, and it has long been a moot point whether he took syphilis from Europe to the Americas, or brought it back from the Americas to Europe – the route which most scholars now prefer, given that no traces of the disease (on skeletons) have been found in Europe from before 1492, while older such finds have been made in the Dominican Republic. Italian doctor and scientist Girolamo Fracastoro (1483-1553) thought that small seeds spread the disease but did not rule out the possibility that astrological and meteorological conditions could also play a part in its pathogenesis.
Syphilis arrived in Denmark in 1497 and then spread to Sweden. At first, the disease was mostly aggressive; later, its advance could be broken down into three phases. They tried every possible (and impossible) way of curing or relieving it: starvation cures, bleeding, laxatives, extract from the wood of the guajac tree, alum and zinc salves. Mercury was also commonly used as a medicine before the advent of penicillin, in the form of ointments, pills, injections and an inhalant. It did have a certain effect, despite what we know today of the element’s toxicity. Arsenic was another poison that was experimented with medically (including the Ehrlich-Hata compound 606) – naturally with serious side effects as a result. Sometimes, the wrong treatment could even lead to amputation. For a long time, doctors found that relief could be obtained by inoculating syphilis patients with malaria; they contracted a different disease but at least they were free of the very worst symptoms of their syphilis. Perhaps any price was worth paying to be spared the third phase of this terrible disease.
Ann Gustavsson, 18 May 2016
Kalm, M. Anmärkningar öfver svältkurens användande i syphilis. Helsingfors, 1832.
Kaposi, M. Die Syphilis der Haut und der angrenzenden Schleimhäute. Wien, 1874.
Ljunggren, A. Försök till en kritisk framställning af de olika methoderna att behandla Syphilis. Stockholm, 1865, 9, 53ff.
Ljunggren, A. Studier i Syphilidologi. Stockholm, 1865, 9.
Nyström, A. 606 Ehrlich-Hata-Medlet och möjligheten af syfilis botande. Stockholm, 1910.
Smirnoff, G. Kort framställning af syfilisterapin medelst injektion af olösliga kvicksilfverpreparat. Helsingfors, 1890, 38ff.
Uddenberg, N. Lidande & läkedom I. Medicinens historia fram till 1800. Stockholm, 2015, 139f.
Åbom, P.-E. Farsoter och epidemier – en historisk odyssé från pest till ebola. Stockholm, 2015, 159-174.
Illustrations from Die Syphilis der Haut und der angrenzenden Schleimhäute by Kaposi, 1874.
Translation: Neil Betteridge
The first head of Karolinska Institutet in Stockholm, Sweden, Anders Johan Hagströmer (1753-1830), after whom the Hagströmer Library is named, published his first work when he was only 18 years old. It was a 16-page pamphlet issued anonymously in 1770 and was a rather harsh criticism of the educational system for surgeons at the time. It was called Suggestion for a Better and Gentler Way of Teaching Surgery or External Medicine (Förslag till ett bättre och lindrigare lärosätt uti chirurgien, eller den utvärtes läkare-konsten). Hagströmer did not mince his words and the pamphlet was not well received. A 64-page scathing response, attributed to the president of the Society of Surgeons (Chirurgiska societeten) Herman Schützercrantz, refutes the young rebel’s views point by point.
Later in life Hagströmer wasn’t too proud of the language that he had used. A copy of Hagströmer’s diatribe is preserved in a thick composite half leather volume (a “sammelband”) containing 94 18th century medical works by various authors. On the title page of Hagströmer’s work it is written in his own hand at a later date: “by A. Joh. Hagström. Written during his time as a student at 18 years of age which may well be seen in the ignorant way of writing. This received strong criticism which was left unanswered” (“af A. Joh. Hagström. Skrifvit under dess läroår vid 18 års ålder som och väl märckes af det okunnige i skrifsättet. Häruppå utkom en skarp critique som ej besvarades").
However, already in 1771 the Swedish teaching system for surgeons was reformed after all …
Dan Jibréus, 11 May 2016
Franzén, Olle. ”Hagströmer, Anders Johan.” Svenskt biografiskt lexikon, XVII, Stockholm, P. A. Norstedt & Söner, 1967-69, 751-52.
Gadd, Ann-Sophie. Vem var Anders Johan Hagströmer? Stockholm, Hagströmerbiblioteket, 1999, 16.
The reliance of health on an effective immune system and nutritious food is just as true today as it has always been. But this was not easy in the past, particularly for the poor. Normal folk had no access to penicillin, and until penicillin became available after the Second World War what today would be considered a mundane, easily treatable infection could prove fatal. This was a common cause of death, in fact, particularly amongst children. Penicillin was an enormous medical discovery made by Alexander Fleming in 1928, and it earned him and his colleagues Howard Florey and Ernst Chain, who helped to turn penicillin into a drug, the Nobel Prize in medicine in 1946.
Bone material in the anatomical collection kept by the Unit for Medical History and Heritage, KI shows traces of more severe infection diseases, such as leprosy and syphilis. Chronic infection diseases can leave marks on the cranium and tibia, unlike more short-term diseases, which leave behind no skeletal evidence. The Hagströmer Library collection includes pictures of people with leprosy.
Leprosy is caused by the Mycobacterium leprae bacterium, which comes from the same family as tuberculosis, a disease that became increasingly prevalent with the decline of leprosy in the first decades of the 20th century, partly, it is thought, because people who contracted TB developed immunity to it. The leprosy bacterium was discovered by Norwegian doctor Gerhard Armauer Hansen in 1874 – hence its one-time alternative name of Hansen’s disease. In the book On leprosy and fish-eating we can find Jonathan Hutchinson’s theory that leprosy could be contracted by eating rotten fish (something to bear in mind, perhaps, when shopping for the evening meal!). This Hansen rightly believed to be completely wrong.
The incubation time can sometimes be as long as 40 years, but the speed with which the disease develops and how it manifests itself differ widely. As with many other diseases it depends on the strength of the immune system of the person contracting it. It does not seem, however, to be especially infectious, and people living in the same family as an infected individual sometimes remain healthy. Amongst other organs, leprosy hits the nerves and the skin; lumps and swellings develop, and eventually the bones themselves are affected, causing a condition called Facies leprosa in which the hard palate and nasal bone atrophy and corrode. Since the bacteria also attack the middle bones of the hands and feet, fingers and toes eventually drop off too. The loss of sensation can lead to secondary risk and injury, since it can lead to reduced mobility and impaired speech and vision. It is usually such secondary diseases, such as blood poisoning, that are the cause of death.
The oldest documented case of the disease is found in India from around 300 BCE, while tuberculosis appears to have existed in Egypt as far back as Pharaonic times. Leprosy was mentioned in the Bible, but there is some doubt as to whether it is the same disease we mean today.
In Sweden, leprosy has been around since the 1100s, and persisted for many centuries. The last patient was discharged from a hospital in Järvsö in 1943, and the last fatality was in 1976. During the Middle Ages, special leprosy hospitals were established to care for these stigmatised people, who, until then, had lived largely as social outcasts, forced to wear distinctive clothing and rattle bells and the like to warn people of their approach. Leprosy was common on Crete, which built several lepers’ hospitals and even a leper colony, Spinalonga, that was still in use by the mid-20th century. Once the island was a place where the sick and their families were deported; now it is a tourist attraction.
In the 1940s, doctors tested a preparation of sulphur, which proved effective. They subsequently prescribed a combination of antibiotics to prevent the bacteria becoming resistant. This is the same method used today for tuberculosis, which is once again on the rise. Leprosy still exists in countries like India, Brazil and Burma, but ignorance and shame force the sick into their homes and away from the hospitals. What relief you will probably feel now, the next time you catch a cold that passes in a week!
Ann Gustavsson, 4 May 2016
Ehlers, E & Cahnheim, O. Die lepra auf der insel Kreta. Leipzig, 1901.
Danielssen, D.-C., Boeck, W. Traité de la spédalskhed ou éléphantiasis des Grecs. Atlas de 24 Planches coloriées. Paris, 1848.
Hutchinson, J. On leprosy and fish-eating. London, 1906, 5f.
Uddenberg, N. Lidande & läkedom I. Medicinens historia fram till 1800. Stockholm, 2015, 133ff.
Åbom, P.-E. Farsoter och epidemier – en historisk odyssé från pest till ebola. Stockholm, 2015, 26-42, 386-388.
Illustrations from Traité de la spédalskhed ou éléphantiasis des Grecs. Atlas de 24 Planches coloriées by Danielsson & Boeck. 1848.
Translation: Neil Betteridge
Arguments in the academic world can be quite fiery but the case of the two physicians John Williams and Parker Bennet of Jamaica went completely over the top.
In 1750 John Williams had a short work on the yellow fever published in Kingston, Jamaica, called Essay on the Bilious or Yellow Fever. His conclusions about the Old World origin of the disease were questioned in strong words by a Kingston physician called Parker Bennet in his An Enquiry into the Late Essay on the Bilious Fever. The general opinion at the time was that the yellow fever had been brought to the Old World from America. And this was the view held by Bennet who also maintained, contrary to Williams, that blackwater fever was the same as yellow fever. After Bennet’s rather condescending reply the educated arguments were left behind and insulting papers, both in prose and verse(!) were issued by the antagonists. What happened next is told by the anonymous author to the preface to the 1752 London reissue of both papers Essays on the Bilious Fever: Containing the Different Opinions of Those Eminent Physicians John Williams and Parker Bennet … Here quoted in full:
"TO THE PUBLIC.
An authentic account of the death of the unfortunate doctor Williams and doctor Bennet of Kingston in Jamaica, on the 29th of December, 150, caus’d by the following Papers.
After a great deal of ill language they proceeded to blows, which caused challenges and acceptance, and the morning after doctor Bennet went arm'd with his sword and a brace of pistols to doctor Williams's door very early, and knocked him up; Williams saw from his window who it was, and what he had to expect; upon which he loaded his pistols with Goose, or Swan shot; and slinging his drawn sword by a ribband upon his wrist, came down, and opening the door, just sufficient to admit his hand with a pistol, poured a shot full into poor Bennet's breast, who had delivered his own arms to his boy, whilst he called Williams out; which when he had done, he continued to pursue Bennet, reeling to his boy, and wounded him with the other pistol in his knee. Bennet by this time had gained his sword only, which was fastened so strongly in the scabbard, that with all his endeavours he could not draw it. When Williams had fired his second pistol, Bennet turned upon him, thanked God he had power to be reveng'd, and whilst he endeavoured to release his imprison'd weapon, begged of God to invigorate him a few moments; but Williams then gave him a mortal thrust under his right arm, which pierced the lungs on both sides; having done this he was turning to run for it, but that moment Bennet drew his sword, and made a pass at Williams, which entering under the right clavicle or collar bone, pierced the internal jugular vein, and finished its course in the shoulder blade, breaking off at the place of entrance; however, Williams run ten or fifteen yards and then fell, suffocated with his blood, and never spoke more. The unfortunate Bennet survived him about four hours, and then expired, in the most agonizing pains imaginable." What about the issue that caused this tragicomic chain of events? One of the papers was actually so good that it was plagiarized 20 years later by a Charles Blicke. John Williams had drawn the right conclusions.
This anecdote has also been retold by Nils Uddenberg, on my suggestion, in his great work on medical history, Lidande och läkedom I-II (Fri Tanke, 2015), part II, 285.
Cundall, Frank. “The Press and Printers of Jamaica Prior to 1820.” Proceedings of the American Antiquarian Society, Vol. 26, 1916, 296-297.
Findlay, George Marshall. “John Williams and the Early History of Yellow Fever.” British Medical Journal, Sept. 4, 1948, 474-476.
The Monthly Review, or, Literary Journal, Vol. 7, July 1752, 71-74.
The Monthly Review, or, Literary Journal, Vol. 46, 1772, 541-442.
Keisuke Ito (1803–1901)
Taisei honzo meiso. Three volumes.
Nagoya, Bunsei 11-12 (1828–1829).
The introduction of Linnaeus’s binominal classification system of plants into the Far East, part I.
After a series of events involving several foreign powers, Japan put into effect the sakoku or ’closed country’ policy in 1639, which effectively isolated it for some two hundred years from all Westerners except the Dutch. They were confined to the small artificial island of Deshima in Nagasaki Bay connected to land by a bridge, and could not leave the island without permission. A strict ban was also placed on the importation of foreign books. A number of Japanese scientists and physicians were interested, however, in the scientific and medical knowledge that could be gained from the West, and for this reason advocated a limited relationship with the foreigners. They decided that they could best realize these aims through the facilities of the East India Company of the Protestant Dutch, who did not bring missionaries with them. The Dutch were thus allowed to maintain a factory on the small island of Deshima, but they too were regarded with extreme suspicion and were kept under very close surveillance.
The first of the three ”Dutch” naturalist and physicians who visited Japan was the German Engelbert Kaempfer, who stayed at Deshima in 1690-92, and whose illustrated Japanese Flora appeared as an appendix to his Amoenitatum exoticarum (1712); 83 years later the Swede Carl Peter Thunberg, who had learned Dutch, arrived at Deshima, where he stayed for nine months in 1775-76. In 1784 Thunberg published his important Flora Japonica, which has given him the name of the ”Linnaeus of Japan”; the third great physician was Philipp Franz von Siebold who arrived to Deshima in 1823 and established a school of medicine and a clinic for the treatment of patients. In 1827 the 25-year-old Keisuke Ito (1803–1901) went to Nagasaki to study botany under Siebold, who had brought a copy of Thunberg’s Flora Japonica with him to Japan. In 1828 Ito wrote his Taisei honzo meiso in three volumes where the Linnaean nomenclature was used for the first time in Japan. He used the scientific names of plants in Thunberg’s Flora Japonica, put them in alphabetical order, and added Japanese names. In the supplement he introduced Linnaeus´s classification system for plants as ”Explanations of the twenty-four Classes” illustrated with 24 colour printed woodcut figures. When Siebold left Japan he presented Ito with his own copy of Thunberg’s Flora Japonica, the very first copy to be seen in Japan. The meeting with Siebold became the turning point in Ito’s academic career. He published a large number of invaluable works on the knowledge of the flora and fauna in Japan. In 1881 he became the first professor of botany at the University of Tokyo and in 1901 entitled baron. In the same year he passed away at the age of 98.
Ito was indefatigable in his search for scientific knowledge and together with Udagawa Yoan he successfully led the Japanese out of the old natural history derived from the Chinese Pen-t’sao into the new science.
30 April is your last chance to visit Andreas Vesalius and the anatomical Renaissance, a beautiful exhibition of works by the leading anatomist Vesalius (1514 - 1564), including his book De humani corporis fabrica from 1543, the first systematic, fully illustrated description of the human body. Also on display are works by a selection of his predecessors and successors. The exhibition is a joint initiative by Uppsala University Library and the Hagströmer Library.
August Johann Rösel von Rosenhof (1705–1759)
Der monatlich-herausgegeben Insecten-Belustigungen . . . Erster- [vierter] Theil.
Nuremberg, Johann Joseph Fleischmann, 1740–1761.
Four volumes, uniformly bound in contemporary mottled calf, gilt double fillet around sides, spine with five bands, richly gilt in compartments, red and green morocco spine labels, gilt lettering.
studying painting with his uncle and father and at the Academy of Nuremberg
Rösel obtained an appointment at the Danish royal court in Copenhagen painting
portraits and miniatures. Two years later in 1728 he fell ill during the return
trip to Nuremberg and had to spend a month recuperating in Hamburg. By chance a
copy of Maria Sibylla Merian’s amazing Metamorphosis Insectorum Surinamensium
was introduced to him during his convalescence and after studying its splendid
hand-coloured plates he decided to devote the rest of his life to the study of
insects and to publish illustrated natural history books. After years of
preparation the first instalment of his monthly Insecten-Belustigungen appeared
in 1740. The work was immediately praised for its outstanding illustrations.
The first volume, mainly devoted to butterflies, was completed in 1746. The
second volume is dealing with beetles, grasshoppers, crickets, flies and
dragonflies. The last instalment of the third and the whole of the fourth
volume (1756–61) were taken over by his son-in-law and closest collaborator,
Christian Friedrich Lemann (1735–1789). Rösel’s ”Insect amusements” with
its lovely frontispieces with insects and over 400 illustrations with many
figures for each insect showing eggs, larva, pupa, etc. is one of the great
classics within the entomological literature and one of the most brilliant
colour-plate books of the period.
We are back!
Look out for the coming announcement of exciting activities at the Hagströmer Library this spring.
(Fortunio Liceti, De monstrorum caussis, natura, et differentijs libri duo, Padua, 1634)
Hagströmerbiblioteket är stängt 21
december - 3 januari.
Library is closed between the 21st of December - 3rd of January.
We are back!
Look out for the coming announcement of exciting activities at the Hagströmer Library this fall.
(J. W. Palmstruch, Svensk Botanik, Stockholm, 1803)
Have a nice summer vacation!
The Hagströmer Library will be closed during the month of July.
(August Pfeiffer, Magasin för blomster-älskare och idkare af trädgård-skötsel, Stockholm 1803)
Magnus Gabriel von Block’s hitherto undocumented doctoral diploma from Harderwijk University, autumn 1701. Parchment letter with light blue silk ribbon tie bearing a red seal dated “3. Kal. Septemb. MDCCI” (30 August 1701)”. Signed by the university’s rector Gerhard Wijnen.
It was not possible to attain the status of doctor of medicine in Sweden at this time, so on receiving his title at Harderwijk University in Holland, Magnus Gabriel von Block (1669–1722) became the first of a long list of Swedes to graduate at “the philanthropic little doctor’s factory” of Harderwijk, where a generation later Nils Rosén [von Rosenstein] and Carl Linnaeus also took the title of doctor of medicine. This document, which marks the beginning of one of the most interesting medical careers in Swedish academic history, was previously unknown to historians. For example Olof Hult wrote in Svenskt biografiskt lexikon that Block “probably” graduated in 1702. Sten Lindroth observes that very little is known of Block’s journey, but could establish the date of his graduation, very possibly from the archives in Harderwijk. For Block, the entire process took a week. He was enrolled at the university, where he was generously referred to as a medical student, on 23 August, and seven days later, under the auspices of the rector, philosopher Gerard Wijnen, defended his thesis on arsenic: Scrutinum arsenici, physico-chemico-medicum dissertatione inaugurali . . . pro doctoratu gradu (Harderwijk, 1701). The copy presented to the Collegium Medicum currently resides in the Hagströmer Library, now in the company of Block’s diploma. Such theses from Harderwijk were printed in very small numbers and are thus considerable rarities.
Once he had graduated, it remained for Block to obtain a licence to practise medicine in Sweden. Clutching his parchment letter, he appeared before the Collegium Medicum in Stockholm on 13 December 1702. Six members gathered this day at the home of president Urban Hiärne to hear Block present his doctoral diploma from Harderwijk and his thesis on arsenic. The assembled doctors took turns in cross-examining him and Bock duly answered their questions. Hiärne himself wanted to know if a person with dropsical scorbutica should be treated with purgative and sudorific medicines, and Block answered in the affirmative. Having passed the interview, he signed the Collegium’s statutes, swore the traditional oath, and paid 150 daler kmt to the Collegium’s treasury. He also became a member of the Collegium Medicum at the same time.
Block was now free to begin his medical career. A man of his talent should have been able to go far. A lucrative practice in the capital, crowned with the post of personal physician-in-ordinary or professor at one of the medical faculties would have appeared a natural objective. But Block had other plans. Throughout his adult life, ever since his self-imposed exile in Florence, he longed for peace in which to study and a place of shelter away from the din of the outside world. He wanted to live with his books, his chemical experiments and his musings over the problems of science and the paradoxes of life. Block had tasted worldly vice and the vanities of court life, and found them unappealing, so opted for the modest lot of the provincial doctor. Just a week after his acceptance, he appealed to the Collegium Medicum for a recommendation for the position of provincial physician in Östergötland. In the spring of 1703, Block moved to Norrköping, the county’s administrative seat , where he remained, serving as provincial physician, for the remaining twenty years of his life.
With his dialectical skills and his wit, learning and eloquence Block made quite a name for himself. He is said to have been able to speak eleven languages and write in thirteen. A few years previously, while in Italy, a cardinal admitted him into his retinue and took him to Florence, where the Grand Duke of Tuscany employed him as his cabinet secretary. This was in 1697, and when Olof Celsius the elder visited Block during his trip to Italy that same year he found him living in a stone-built house surrounded by a pretty little garden. Here, in the home that Block had been granted by his princely master, Celsius lodged in much comfort, since his host enjoyed “a goodly wage” and was supplied with excellent wine from the grand-ducal cellar.
Block was an all-rounder, with a rich intellect that thirsted for knowledge in a wide variety of fields. His writings tell us that he was very widely read and intimately familiar with past and present cultures. Alongside medicine and his language, he had a particular passion of chemistry, alchemy and mineralogy. His style is scintillating and distinguished by a caustic rhetoric and pointed sarcasm. Block was a bibliophile, and as soon as he was drawn to a particular book he had to purchase it “whatsoever she may cost”.
BRUNSCHWIG, Hieronymus (c.
1450-c. 1512) Liber arte Distillandi de
Compositis. Das buch der waren kunst zu distillieren die Composita und
simplicia, und das Buch thesaurus pauperum. Ein schatz der armen genannt Mi-
carium, die brösamlin gefallen von den büchern das Artzny, und durch Experiment
von mir Jheronimo Brunschwick uff geclubt und geoffenbart zum trost denen es
begeren. Strassburg, [Johann Grüninger], 1512.
The first edition of Brunschwig's famous “Grosse Distilierbuch” left the press on February 12th, 1512. It is a gigantic work, far more than a mere book on distillation, a manual rather of pharmacological therapeutics. Brunschwig has here brought together his entire medical knowledge. It is a folio volume of 363 leaves illustrated with nearly 200 large and small woodcuts all coloured by a contemporary hand. The book is especially remarkable for the richness of its illustrations. There are 130 woodcuts of stills. Other woodcuts (some repeated) show blood-letting scenes, scenes at the sick-bed, various pictures of physicians with their urine flasks, apothecary's shops, etc. and finally several interesting anatomical illustrations, e.g. two representations of the eye, a viscera man, a man with the thorax opened, showing the heart, large cut of a phrenological head (showing the location of the memory ). Brunschwig advises the reader not to place too much reliance on the publisher’s choice of illustrations "for the figures are nothing more than a feast for the eyes, and for the information of those who cannot read or write." Many were borrowed from earlier works, but the fine title woodcut of an early alcohol still with cooling-coil and several other cuts of distilling vessels appear here for the first time.
MATTIOLI, Pietro Andreas (1500–1577). De i Discorsi di M. Pietro Andrea Matthioli nelli sei libris di Pedacio Dioscoride Anazarbeo, della Materia Medicinale. Parte Prima–Seconda. + Del Modo di Distillare acque da tutte le pianti. Venetia, Felice Valgriso, 1584–1585.
Mattioli’s commentary on Dioscorides was the most frequently reprinted herbal of the sixteenth century. The success of his work was phenomenal. There were editions with both small and large woodcuts but it is chiefly known from a small number of editions illustrated with over 1,000 large (nearly full-page) woodcuts, the ”grand Mattioli”. These large figures of plants are in every way immeasurably superior to the small woodcuts. The present Valgrisi edition of 1585 is one of those containing large-sized figures. The book has over 1,700 pages divided into two thick volumes, containing 1,031 woodcuts of which 932 are of plants and 99 of animals and genre scenes. An appendix on distillation can be found at the end, which is illustrated with six large woodcuts depicting furnaces or distillation towers. The designers of the woodcuts were Giorgio Liberale (1527– ca. 1579), an Italian artist from Udine, and Wolfgang Meyerpeck (ca. 1505–1578), a German woodcutter active in Prague.
the Dutch conquered, one by one, the trading stations and colonies of the
Portuguese maritime empire in East India. Soon, its East India Company was one
of the world’s richest, most successful enterprises. It was so big, however,
that there were not enough Dutch people to staff it: in the two centuries of
the company’s existence, it is estimated that some 300,000 German and at least
a few thousand Swedish men were in its service. One could claim, therefore,
that this was the time of the first great cultural exchange between East India
and Sweden. Yet that thousands of Swedes lived and worked in Asia during the
17th and 18th centuries is, today, a little known fact. Unfortunately, we’ll
never know anything about who most of them were, what they knew and what they
thought about their lives; but a few we do know about. Engelbert Kaempfer – a
fairly famous German traveller to Asia – knew, for example, to report that a
manager of the company’s trading station in Siam (Thailand) was a Swede by the
name of Core (Kåre?) and that he had a pet: a tame meercat, which to its
owner’s immense grief was eaten by a snake. Another, Herman Grim from Gotland,
was probably one of the most widely travelled Swedes of his age. Grim was a
company surgeon and doctor who was stationed on Ceylon (Sri Lanka) and Java,
amongst other places, but who also travelled as far afield as Novaya Zamlya – in the Arctic Ocean! He
eventually returned to the Baltic, where he tried, with a modicum of success,
to capitalise on his knowledge of East Indian medicine. He spent the last years
of his life in Stockholm, where his fellow doctors considered him something of
an eccentric yet fascinating curiosity. The books he wrote while in East India,
as well as many of his articles, can be found in the Hagströmer library.
Frontispiece by Melchior Haffner (1660–1704) and title page of
Grimm’s Compendium Medico-Chymicum, published in Augsburg 1684.
The lecture was held at the Hagströmer library, 13 November 2014.
Text: Dr Hjalmar Fors, docent of the history of ideas and learning, Uppsala University.
Translation: Neil Betteridge.
autumn of 2014, I had the privilege to give a talk to the Friends of the Hagströmer
Society on the Bergius Library, a private collection from 1790 belonging to The
Royal Academy of Sciences, today at the disposal of Stockholm University
Bergius (1730-1790) and Bengt Bergius (1723-1984) were the brothers who put
together this collection. Peter Jonas was a successful doctor and contemporary
of Carl von Linné who was very interested in botany and horticulture. Bengt’s
interest was in history, and not only did he help Peter Jonas to acquire the literature
he wanted but he also organised and looked after the library they accumulated
together. Today, the Bergius brothers are best known for lending their name to
Stockholm’s Bergius Botanic Garden, which was once part of the Bergielund
estate in what is now the Stockholm borough of Vasastan.
less known is that their vast collections of natural-history specimens,
including a herbarium that outrivalled Linné’s own, insect collections, books
and monographs that the brothers kept at Bergielund are still preserved today. The
printed books and a small portion of the handwritten material are now kept as
the Bergius Library at Stockholm University Library and the archive material
and copies are at the Royal Academy of Sciences; the herbarium is maintained by
the Bergius Foundation in the Bergius Botanic Garden. However, it is important
to remember that all these various material sources are part of one and the
same context, and it is sometimes not that easy to decide what belongs to which
the brother’s very clearly worded testament, which stipulates that the book
collection may not be broken up and dispersed amongst different libraries, sold
or traded in, the Bergius Library is still intact. In that the collection has
remained in its original condition since 1790, we gain valuable insight into
the contents of a late 18th century private book collection. A great deal of
correspondence is preserved in the brothers’ archive at the Royal Academy of
Sciences, shedding interesting light on how they went about purchasing and otherwise
trading in books for their collection. All this makes the book collection and
all the information surrounding it of importance for everyone interested in the
history of private libraries during the 18th century in general, regardless of
bulk of the collection concerns natural history, botany (in the form of
herbals) and gorgeous botanical charts and travelogues full of descriptions of
the flora and fauna of distant lands. Other subjects covered include history,
medicine and theology. There are also numerous private writings, such as Peter
Jonas Bergius’s handwritten garden diary, which he kept from 1773 up until five
days before his death in 1790. The diary also contains details of their private
and social life at Bergielund. The brothers were members of the Royal Academy
of Sciences, which not only provided them with a circle friends and acquaintances,
but also gave them access to a useful network for the acquisition of scientific
literature from all over the continent.
collection extends over roughly 210 running metres. The number of titles is
hard to ascertain, but has previously been estimated at approximately 10,000
based on the library’s extant catalogues. One single book was printed in the
1400s, and the rest make up one of the most complete collections of botanical
works in Sweden between the 16th and 18th centuries. There are a great many
catalogues of collections of natural-science specimens and cabinets of
curiosities from all four corners of Europe. Amongst the monographs are
catalogues of herbal cures and recipes for medicines collected in the late
1500s and early 1600s, as well as 18th century medical journals – items that
Peter Jonas Bergius doubtlessly found fascinating.
are searchable online in the Royal Academy’s scanned card catalogue, but owing
to its sheer size it is almost impossible to grasp the full extent of the Bergius
Library. To make matters easier, I have therefore scanned in a two-part
handwritten catalogue of the Bergius Library from the 1830s so that it may be
made freely available on the net via the university library’s websites: http://specialsamlingar.wordpress.com/2014/10/27/bergianska-bibliotekets-katalog/
however, like to emphasise that this must be seen as a temporary expedient only
until the library’s material has once again be re-catalogued online in Libris,
the Swedish Union Catalogue; only then will external researchers or booklovers
truly be able to hunt out most and the best of what this remarkable book
collection has to offer.
Most of the
herbals and medical literature in the Bergius Library are also likely to be
found in the Hagströmer Library. This reminds us how important it is for
libraries to keep in contact and cooperate with each other on particular
subject fields in which the content of the book collections are not only
respectively tangential and overlapping but also mutually complementary.
from Plantae et papiliones
rariores by engraver Georg Dionysius Ehret (1708-1770), published in London 1748-1759.
The lecture was held at the Hagströmer Library, 8 October 2014.
Text and photos: Helena Backman, Special Collections Librarian.
Translation: Neil Betteridge.
Look out for the coming announcement of exciting activities at the Hagströmer Library this spring.
(Timothy Bobbin. The Passions, Humorously Delineated. London, 1810)
Hagströmerbiblioteket är stängt 22 december - 11 januari.
The Hagströmer Library is closed between the 22nd of December - 11th of January.
Among recent acquisitions, suggested by Hagelin Rare Books to enrich the collections of the Hagströmer Medico-Historical Library, is the following classic within the history of evolution. Such acquisitions of rare and important books are usually paid for by our Association of Friends to be deposited in the library, but in this particular case we are most grateful to its Chairman Sven Hagströmer, who made this important acquisition possible.