Dansk medicinhistorisk arbog最新文献

The development of hospital care in Copenhagen is based on three remarkable buildings, The Royal Frederiks Hospital 1757, the General Hospital (Almindeligt Hospital) 1769 and the Municipal Hospital (Kommunehospital) 1863. Frederiks Hospital being a hospital for sick people, the General Hospital in the beginning was an almhouse for the poor in the capital. Later on this became a real hospital as well. An essential part of the treatment was the offering of a bed and the feeding of the patients, who because of illness, and therefore unemployed, were unable to take care of themselves. When the Municipal Hospital was taking into use, a new ear was initiated into hospital care in Copenhagen. Thus the new medical specialties were established, and the offers of treatment were remarkable enlarged. By this is became attractive for all classes of the community to be in hospital in case of disease. A further advance was a marked improvement of the medical education.

The author explores novel lessons emerging from the oxygen diffusion controversy between Christian Bohr on one side and August and Marie Krogh on the other. THe controversy found its emphatic expression in August and Marie Krogh's "Seven Little Devils", a series of papers published back-to-back in the 1910 volume of Skandinavisches Archiv für Physiologie. The Devils unjustifiably sealed the fate of Christian Bohr's theory of active cellular participation in the transport of oxygen from the lungs to the pulmonary circulation. The author's renewed examination of the original papers of Bohr and the Kroghs reveals that Bohr's concept of active cellular participation in diffusion is entirely compatible with the mechanism of capillary recruitment, for the discovery of which Krogh was later awarded Nobel's Prize, years after Bohr's untimely and unexpected death in 1911.

The scotopticometer is a small, light and handy instrument from 1935, which was developed in Denmark by Carsten Edmund Zeuthen (1897-1973) and Hans Ulrik Møller (1894-1954) for the measurement of dark vision without the use of a dark chamber. The prerequisites are Jannik Bjerrum's contrast letters from 1889 and Marius Tscherning's photometric neutral-gray filter-glasses with a logaritmic scale (Ph 1-8); both Bjerrum (1851-1920) and Tscherning (1854-1939) were Danish ophthalmologists. Tescherning's basic experiments and theories are reported, based on a study of his scientific publications, scientific protocols, letters and scrapbook. Tscherning inspired many young Danish scientists to further studies of dark adaptation, which is still an important topic (traffic, military, art, illumination, gerontology).

The French philosopher and mathematician René Descartes (1596-1650) gave a high priority to medicine and dedicated a great deal of his life to medical studies. Nevertheless his relation to medicine has always been much discussed. However, a number of recent works have contributed to reassessing the earlier critique which nearly wrote him out from medical history. The recent biographical dismissal of a number of earlier allegations and the recent interpretations of the medical contents of his collected writings ought to result in Descartes' reinstatement in medical history. His novel anti-Aristotelian methodology had a crucial influence on the medicine of the subsequent decades. Also his early defense of Harvey's theory of blood circulation had great influence. Especially his thoughts about a mechanical physiology by means of which the functions of the body could be explained without involvement of "occult faculties" influenced that time. His empirical mistakes, including the central role which he ascribed to the corpus pineale, are offset, which already Steno noted, by his brilliant thoughts about the function and importance of the brain. Although he did not make any really new empirical discoveries within medicine, he advanced a number of concrete ideas which later lead to actual discoveries such as visual accommodation, the reflex concept and the reciprocal innervations of antagonistic muscles. Descartes' psychosomatic view of the importance of the interplay between sensations, "the passions of the soul", and the free will in the preservation of health shows in addition that his fundamental soul-body dualism was far more nuanced than is often claimed.

Danish battlefield surgery in the period between the birth of Christ and the year 500 AD is exemplified by a reinterpretation of artefacts found in the sacrificial bogs at Thorsbjerg, Nydam, Ejsbøl, Illerup Adal, Vimose and Kragehul, reinterpreted in the light of classic European and Egyptian archaeological finds and ethno-archaeological parallels against the background of the author's years of experience as a practicing specialist in gynaecology and obstetrics. No surgical instruments from the Iron Age have previously been construed or identified as such in Denmark or Schleswig-Holstein. The purpose of this paper is to examine the possible finding and identificiation of surgical instruments - or what could be construed as a battlefield surgeons instruments - among artefacts deposited in the above-mentioned sacrificial bogs in the Iron Age. In this paper, the term 'surgical instrument' is defined as an instrument used in teh practice of medicine. Material for the study was collected in a review of illustrations in published works about these bog finds, localising these artefacts and examining them at the museums at which they were located. Also examined was museum storage of artefacts that had been excavated in the above-mentioned bogs. In an effort to reinterpret the function of the artefacts, they were compared with known surgical instruments found in the geographical areas controlled by the Greeks and later the Romans and with pictures of artefacts and a few written sources form the same area. They were also compared with ethnographic parallels. The material upon which the paper is based consists of a total of 67 artefacts, each identified as being from one of the above-mentioned bogs. Of these 67 artefacts, 40 can be indentifed and reinterpreted as being surgical instruments and 27 are toilet sets, i.e. tweezers for personal use or sets consisting of tweezers connected by a metal ring to either an ear pick or a nail cutter. Analysis of the artefacts revealed that in six of the bogs, 40 surgical instruments were found among sacrificed weapons: 29 scalpels, one pair of tweezers, five needles, more than 200 'wound thorns', three trephination saws and a double box. These instruments and the context, in which they were found, i.e. among sacrificed Iron Age weapons, indicate that the artefacts can be interpreted as being a battlefield surgeons instruments. It must be concluded that battlefield surgeons took part in local warfare, and that their equipment was sacrificed to the bogs in the Iron Age. It must also be concluded that these field surgeons gained their knowledge not only through contact with civilians but also from a close association with the military of the Roman Empire. This insight into the humanitarian care principles and philosophy of Iron Age civilisation is completely new and of substantial cultural and historical significance to the currently reigning view that the Roman Iron Age within the geographical area that is now Denm

The opening of the biggest and most advanced Danish municipal hospital of its time took place on the 19th of September 1863 in the city of Copenhagen. The hospital had the capacity to host about 700 patients and was equipped with modern facilities such as water closets, electricity, running water and baths. The daily routines at this large institution had to be throughly organized. This article focuses on the working environment, the rights and duties of the staff and its hierarchical structure. From the historical source material we have been able to classify the staff members into five different groups: the administrative personnel, the medical personnel, the attendants, the caretakers and finally the housekeeping personnel. Many members of the staff lived at the hospital, and a chief physician who wished to leave the premises for more than 36 hours had to obtain the permission of the Mayor of Copenhagen. The instructions regarding the rights and duties of members of the staff, dating back to 1863, shows that a very strict staff policy was needed to keep the hospital running. As an example, the administrator had to stand surety for furniture and equipment used at the hospital along with the stock of goods, for which he was responsible. WOrking in the hospital was a dangerous job. As surety he paid 1000 Rigsdaler, which was more than his yearly salary. The risk of being infected by the patients (e.g. with smallpox) was always present, and the modern machinery, the boiling steam and the treatment of patients in the baths of white spirit, resulted in serious injuries and even deaths. The nature of the working conditions of the laundrymaids is well illustrated by the fact that they were likely to be so worn-out after only six months that they had to give up their job.

The aim of this paper is twofold: to defend the validity of the manic-depressive psychosis as a disease entity and to make an incursion into the history of psychiatry. The two intentions meet as far as the recognition of a clinical case straight through space and time supports the ontological status of a disease entity. An autobiographical work from 1801 "My insanity in the year 1783" written by the Danish vicar C.S. Andresen, who lived from 1760 to 1832 is briefly summed up. Andresen tells that he as a young student of divinity made a journey from the small town Rørvig in Zeeland to his then place in Copenhagen. The weather was intolerably hot, the coach was uncomfortable, the landscape deserted and empty-and just in the hardships the most unhappy and deplorable event happened: He faced the gruesome truth that he was deprived of the most precious gift of his Creator, his reason and faculties. A fellow passenger brought him to an inn where he literally ran up the walls alternately in high spirits and in deep dispair. When he arrived in Copenhagen he was blead, probably by a surgeon, but later that day admitted to King Frederik's Hospital where he was treated with bleds and leechs and baths. However, as the illness dragged on he was according to his own will accompanied by his custodian to his parental home in the Isle of Bornholm where he recovered while nursed by his mother and mother's mother who themselves had suffered from periodical melancholy when they were young. He completed his academic studies and became a highly respected scholar and vicar in the isle of Funen - but almost twenty years after his recovery he was made to suffer the humiliation that he - a true representative of the Age of Enlightment and rationalistic theologician - was suspected to have invoted his insanity by a sinful life in his youth. Thus his work may be regarded as a defensive pamphlet written at a time when a neutral and clinical view of mental diseases had given place to a moralistic and religious concept. The case serves as a modification of the general assumption that psychotic patients in "the classic age of confinement" under all circumstances were brutally treated and locked up. Even the fluent and subjective style is charming and reminds the Danes of Johannes Ewald (1743-81) and perhaps - were it to be translated - the English of Lawrence Sterne (1713-68). Maybe the booklet of just 75 pages is worthy of a translation?

At the reunion of the southern part of Jutland with Denmark 1920 danish legislation had to be introduced in the new incorporated region. According to a special law doctors educated in Germany could obtain danish medical authorization, if they were born or established in the region before 1.1.1918, under certain circumstances it was possible to dispense from this date. The law meant that all doctors, in the region had to ask for danish authorization. Matrimonial relationship and personal connections were strong arguments for a dispensation, but not always sufficient. In more cases a refusal was given because of a german attitude at the applicant in spite of matrimonial relationship, with the result that the applicant had to leave an established practice and Denmark. 53 doctors were given danish authorization immediately. 8 got an authorization by dispensation and 10 got a refusal. A survey of the applications and the corrected archives shows, that the cases mostly were handled without problems. But the cases, where dispensation and especially refusal were given, were often very complicated and followed by heavy local national reactions. This paper describes the background of the special law and the course of the cases with particular weight on the cases where dispensation or refusal were given.

Jacob Nordentoft (1881-1954), head of a remote small county hospital in Denmark 1922-50 (88 beds) was a very skilled surgeon strongly in favour of master class education. He did not at all like subspecialisation in surgery, but admitted that neurosurgery might be an exception. However, he found the neurosurgical technique pretty simple. Meticulous analysis of all his neurosurgical procedures, including spinal cord tumors, cord compression, brain tumors, and myelomeningoceles in the preserved medical records from his time reveal results just as good and often better than in much more specialized clinics.

The article deals with the origin, background and development of homoeopathy over a hundred years span, beginning with its "invention" in the early 19th century (Hahnemann). Leipzig became a center for a huge production of homoeopathic remedies through Dr. W. Schwabe's "Central-Apoteke", founded in 1878, with customers all over the world. The preparation of around one thousand products were described in 1880 in Schwabes "Pharmacopoea homoeopatica polyglotta", in five languages, and this article gives a survey of the principles in the production of the final remedies which were distributed as Schwabes homoeopatic house-chests of many varieties, containing from a few up to more than hundred bottles. Detailed instructions and guidance in the applications of the content of these popular and wide-spread chests were available for laymen from hand-books. However their use vanished gradually in the third decade of the 20th century and later, and the chests were either destroyed or put away. This was also true for the situation in South Jutland (before 1920 a german province called Nord Schleswig), nevertheless the author's research succeeded in detecting thirteen homoeopathic house-chests from the region, purchased about year 1900. An attempt is made to throw light on their origin, their use and their users at a time, when homoeopathy played a role for layman in the treatment of diseases, outside the authorized health service - or as a supplement to this.