California's Central Valley is home to about five Kaiser-affiliated hospitals, offering emergency and other medical services 24 hours a day, seven cslifornia a week. West Lancaster, CA Driving directions References Kaiser Permanente: Quick Facts. Written by Max Stirner. Max Stirner is a New York-based writer and editor with over a decade of experience. Richmond, CA 1 0.
The building pressure causes her to doubt whether she can maintain both her position and her integrity. Three days before an election, party leader Birgitte Nyborg shakes up her campaign by denouncing her closest ally After a successful election, Birgitte Nyborg looks set to become Denmark's first female prime minister, but allies and opponents do their best to block her way. The revelation of an American prisoner transport in Greenland causes scandal upon the new government's first one hundred days in office.
The government's agenda on equal opportunities in corporate business brings pressure from the media as well as the country's most powerful businessman.
An official visit by the president of a former Soviet republic makes headlines when the president demands the arrest of a prominent political activist visiting Denmark at the same time. The discovery of illegal surveillance of a left-wing party brings into question the prime minister's friendship with the party's spokeswoman as well as her faith in her own minister of justice.
While the prime minister tries to take a family vacation, the publication of a tell-all by a former politician puts spin doctor Kasper Juul on the edge. Allegations of corruption in connection with military spending has consequences even for the prime minister's husband, who has accepted a new job.
A year after taking office, the prime minister's approval ratings are low, her government is in internal conflict, and her marriage is hanging by a thread. As she prepares for another year in parliament, what can be saved?
Two and half years later, Birgitte is traveling the world out of politics when suddenly the changing Moderate Party makes her want to return Birgitte is keeping her plan to herself initially, but one by one she involves people. While some are enthusiastic Birgitte has attracted lots of followers to her party, but the policy has not been set yet and there is no money Birgitte struggles to get her party recognized particularly by other politicians, but might have a chance Being accepted as a political party, New Democrats must take a stand on a controversial issue of banning buying sex Birgitte quickly realizes that the New Democrats are now minor players in the opposition coalition and she pulls them out of it.
The Moderates seem to be proposing things that Birgitte has privately discussed - is there a mole? After the leaks to the Moderates, Birgitte decides that the New Democrats need to distinguish themselves from the Moderates.
So in a debate she launches a bold attack on their leader Jacob Kruse - will her strategy work? Kruse's outburst in the pre-election debate proves fatal to the Moderates and the New Democrats pick up more than double the predicted seats.
Suddenly, Birgitte is being courted by both the left and right wing coalition groups. I have read and agreed to the terms of service. Smith also uses fransoser [the French disease] in relation to his description of its initial outbreak during the French siege of Naples in The name in use then echoes the presentation of the disease, containing the knowledge of the disease.
He divides its progress into four stages, the first of which is its singular attack on the genitals in the form of gonorrhoea or leucorrhoea. He also views its most definitive manifestation as genital, primarily from intercourse with an afflicted person.
The names in use were thus adapted to the ways in which the disease was understood. In the hospital established for the treatment of people inflicted with the disease in Christiania, the physician Peder Sundius used the Latin term Lues venerea or the Norwegian equivalent venerisk svaghed in his diagnosis. The priests used the term venereal disease or fransoser in their notes to him, as well as in the surveys in and the s. The name venereal was also used in newspapers that were read by the general public, indicating that it was a term most people recognised.
If we delve deeper into references to the disease outside of academic medicine, we find other names as well. In Norwegian black books, the term slemme syge [the wicked disease] is used; I also found this name in a recipe book. While it was debated in academic circles whether radesyken was in fact venereal, the general public appears to have been comfortable conflating the conditions and their names.
Other names found in reference to venereal disease in the broader public are fransoser and smittsom svaghed. They live close to Trondheim, are almost daily there, it is possible that they, while at kippers83 and pubs, can get infected either by a recruited soldier the German garrison that resided some years ago in the city undoubtedly left spawn or by an indecent sailor who has recently brought this 80 Danish Chancellery, Norwegian Chancellery letters, , Q2, May, no.
Steinar Imsen and Harald Winge, Norsk historisk leksikon: kultur og samfunn ca. Oslo: Cappelen akademisk forlag, , 20— In the context of this quote, I take kipper to signify a wine bar of some sort. Kipper and Kyper in Verner Dahlerup, Ordbog over det danske sprog, vol. Weisbach wrote that people who found themselves with the symptoms of venereal disease needed to think hard about how they might have contracted it.
This would be a peculiar thing to include in a short note directed to the treating physician regarding treatment if it were not assumed to be linked to the disease itself. The association between sex and sin was such that where sexual sins were known to have been committed—and specifically sex outside of the confines of marriage—venereal disease could become the manifestation of that sin.
Non-venereal ways to obtain venereal disease Sexual acts were presented as the principal way in which venereal disease spread, but other methods of infection were also put forth.
Weisbach specified lying in a bed, sitting on a chair, or sharing utensils, plates of food, or cups with which an afflicted person might have come into contact. The risk was attributed to the mucous membranes of the diseased body to which I will return in the chapter on treatments. Saliva, sweat and pus from boils and soars were seen as sources of contagion outside of sexual contact itself.
Venereal, then, was in this case not the method through which it was necessarily transmitted but the place where it first appeared. The Danish term hosliggen [to lay with] refers to sex but also to simply sharing a bed. Sometimes, the context helps to clarify the implications of these words, but not always.
Socialisation between people which produced venereal disease was tainted by suspicion about the means of transmission, often leading the inflicted to defend their honour by reciting the innocent ways to contract the disease. By doing so, they could try to uphold their moral character even if their physical appearance appeared to betray them. Conclusion Venereal disease was known by many names in the early modern period, each of which promoted a different aspect and knowledge of the disease.
Just as a name identifies something, the choice of a naming option highlights a certain aspect of what it identifies. Bethencourt used it to describe the two aspects of the disease that he felt distinguished it from others: it manifested first in the genitals, and it was mainly transmitted through sexual activity.
Its descriptive nature made it malleable enough to survive new knowledge about the disease, especially as it could encompass a category of diseases. Venereal disease, or VD, remained the mainstream name for the category of sexually transmitted diseases well into the s, in fact.
Although there appear to have been few physicians and surgeons, there were numerous other actors who were available. In this chapter, I will look at the actors in the early modern medical marketplace and their various interrelations, adding complexity and nuance to the two categories named above. Dedechens Efterleverske, , 7. Historians Mark Jenner and Patrick Wallis argue that the use of the concept has become so widespread that it has lost its clarity,94 and they propose three specific applications.
I do not intend to foreground commercial aspects alone, as this would exclude too much in the context of eighteenth-century Norway.
It would, for example, disregard the knowledge of medicine held by non-practitioners and even the treatment for venereal disease available at the hospital, because it was free for people who could not afford to pay. Mark S. Cities would naturally feature more and different types of practitioners than rural areas. In short, a licenced practitioner had obtained a formal licence to practice medicine. As the focal point of this study is venereal disease, which was seen as serious, physicians and surgeons are the key licenced practitioners here.
From an eighteenth-century academic perspective, the physicians were at the top of the practitioner hierarchy, followed by surgeons, apothecaries and empirics.
We will see later that this was not necessarily the view or experience of the general public. For most of the eighteenth century, physicians were generally practitioners in internal medicine with a university education, while surgeons came from a craftsman tradition which originated with barbers. These two groups of practitioners would both compete and collaborate, and, in the more sparsely populated areas of Norway, their respective roles would often overlap. Common to both groups was the fact that their medical knowledge had been tested formally and held to a standard which in turn became the grounds for their license to practice.
The landscape of medical legislation and education was continuously changing in the early modern period, and I will present some of the highlights of those changes below. I have listed important events and their significances in table 1, though there were many other changes as well. The nature of the changes, along with the establishment of both hospitals and medical schools in the eighteenth century, reflects the mercantilist mindset of the government, which saw the population as a limited resource which needed to be nurtured.
The health of the people was the responsibility of the state, so medical practitioners and their knowledge had to be controlled at the level of licencing requirements and other legislation. Other changes in legislation included in the table below reflect the political tension between physicians and surgeons, both of whom pushed to have their particular knowledge and skills recognised.
For example, note the establishment of the Collegium Medicum, the governing body for health, and of physicians as the judges of the skills of surgeons, midwives and apothecaries, followed later by pushback from the surgeons with the establishment of the Royal Academy of Surgeons as an institution distinct from the University of Copenhagen.
These tensions boil down to a question of power, which the state did not hesitate to contribute to through its legislation. Date What Importance University of Copenhagen is The medical faculty existed more in theory established with a faculty of medicine. June 28, Decree regarding the Medical and States that military surgeons should be Surgical Service … examined in both surgery and medicine.
April 9, Collegium Medicum is established. First appearance of this governing medical ordinance body. Introduces a more practical education for physicians, including interaction with actual patients. Johannes C. Melchior et al. Afdeling Copenhagen: Medicinsk-historisk Museum, , Education Physicians An essential requirement for obtaining a licence to practice medicine was a formal education to that end.
As mentioned, this was also an essential difference between physicians and surgeons. Physicians were educated at universities either in Copenhagen or abroad, while surgeons traditionally had a more practical training via a master-apprentice relationship.
Stein discusses the topic in the context of sixteenth-century Augsburg, but the international nature of academic medicine at this time makes a comparison here valid. They were then to be trained in pharmacology and chemistry and, with the help of a surgeon, they were to study the basics of anatomy on either a corpse or a skeleton.
The final stage in the education was an examination or a doctorate. The apprentice was trained in shaving, bloodletting and cupping for about three years, then was promoted and started his mandatory travels abroad to hone his skills for another three years.
The surgeon-in-training travelled to masters in other countries with an introductory letter from a local guild or master to help ensure him food, shelter and work. After the new charter for the University in , students were no longer required to have a full doctorate through public defence in order to practice medicine, examination of the subjects were enough.
In the case of Norway, the only guild for surgeons was in Bergen, the largest city; it had been established there in by German surgeons when the Hanseatic League was a powerful influence in the city. After the German guild fell apart upon the decline of the Hansa, a Norwegian guild was established there in Christoffer de Besche, who was born in Larvik in , became an apprentice to the surgeon in Kongsberg in , then worked in Berlin for two years.
The establishment of the Theatrum anatamico-chirurgicum in Copenhagen in required surgeons to do an examination there before receiving permission to practice. Interestingly, the guild in Bergen rejected this decision, due to the time and costs associated with travelling to Copenhagen. On April 13, , the guild was granted permission to have its examinations audited locally by the city physician, who would then consult with the authorities in Copenhagen before approving the candidates.
He also had to respond satisfactorily to other surgical questions related to broken bones, wounds, tumours, swelling and bone diseases.
Forordninger, vol. The first mark was worthy of a royal commission of appointment; the second mark passed the student with no particular distinction; the third mark failed the student.
The Danish army and navy had few such practitioners on hand in the sixteenth and seventeenth centuries, and those they had were one of two types: barber-surgeons who were part of the guild hired by the crown to help out during wartime, and dedicated surgeons who were actually conscripted into the military.
The latter would often go elsewhere once their services were no longer required; because they were not a part of the guild, they were not allowed to practice on civilians. A rescript signed on June 28, , proclaimed that military surgeons should be trained and examined in medicine as well as surgery. Christian VII Frr. Rescript Schultz, , This rescript represented a response to complaints from both the guilds and the faculty of medicine regarding the establishment of more formal training for surgeons in the Theatrum anatamico-chirurgicum in Copenhagen in For example, following an instruction from the royal generals and commissary board in Copenhagen in , it was decided that each of the Norwegian enrolled infantries should take on three soldiers as apprentices with the military surgeon.
To Seip, they were quacks despite their training with a licenced military practitioner. Apothecaries Apothecaries were also in an intermediate position in terms of medical knowledge. They were required to demonstrate medical knowledge which was tested by physicians and the faculty of medicine in Copenhagen, but they were still not to treat people. According to the law, as well, apothecaries were allowed to practice medicine if no physician were available.
In Norway we find several examples of this, most prominently in a conflict between the apothecary Kruse in Arendal and the physicians Frederik von See and Adam Cron. Some Norwegians still travelled to Denmark for an education. During the eighteenth century, Norwegian students collectively constituted Adam Cron, Norsk Intelligenz-Sedler, In general, it is unsurprising, then, that most of the licenced practitioners in Norway were not from Norway.
It is difficult to gauge how many licenced practitioners were working in Norway during the early modern period, due to the fragmentary sources materials. Medical historian F. In , there were only four physicians in Norway, but there were thirty- nine surgeons. Cammermeyer, , — Physicians were also shipped around the country to establish hospitals, particularly in response to the threat of radesyken; sometimes they were also put in charge of whole regions, such as Aker and Follo, Christiansands diocese, Nordland County or Smaalenene County.
The term was in use at the time, sometimes as a putdown but more often as a neutral label for people who practiced medicine without a licence, generally with a quite practical approach. In general, it served as a derogatory description of people whose medical practice one disputed. Based on their understanding of medicine, however, clergymen could be viewed as belonging to the same category as licenced practitioners.
As a part of the requirements for their own position, they had attended university, and some would choose to study medicine along with theology. The link between these professions was strong, because clergymen had a responsibility to their parishioners to visit and help the sick insofar as they were able, according to the Norwegian Law of While this was mostly due to the perceived importance of a high moral character in midwives, it linked the clergy to the practice of medicine.
They had all studied medicine during their time at university and had an outlook similar to physicians. As part of their family tradition of practicing medicine and preaching, they likely also transferred some medical knowledge through a type of apprenticeship resembling that of surgeons. As most parishes did not have a physician or surgeon, clergymen were in a position to refer patients to physicians, surgeons or even hospitals for treatment.
First, of course, parishioners had to seek their advice, which several clergymen in the radesyke survey complained did not happen. The clergymen also had to know enough to evaluate the patient and commit to supplying a letter of introduction for an institution such as the venereal hospital in Christiania.
There they would describe the signs of disease on the patient and give a preliminary assessment of their condition. Sometimes the doctor disagreed, but for the most part his findings corroborated the initial assessment by the clergyman.
In more distant parishes, the clergymen were compelled to treat their parishioners. Some clergymen saw the education of the public on the topics of disease and medicine as the best way to help people, and they published texts on medicine for this audience. In this sense, clergymen joined physicians, surgeons and apothecaries within the same framework of medical knowledge, yet they could not be called licenced practitioners, but instead has to be categorised as empirics.
Executioners Barbers, the group which rose to surgeons, were not the only people inherently familiar with knives and wounds. Executioners also had some practice, and they would at times practice medicine as well. Koppel, , They verified that his skills surpassed those of some of the local surgeons. He was granted permission to practice medicine as a surgeon in Calling them out as incompetent or charlatans would not automatically create a backlash at the person calling them that.
The travelling healer has been described as the most dangerous empiric in early modern Norway, but this may have been because it was safe to call them out—they had no local allies, after all. It appears that travelling healers in Norway could be from that country or elsewhere in Scandinavia or still further away.
Advertisements in local papers give some indication of their presence there—due to their foreignness, they had to market themselves to attract customers. C , vol. Kobro Oslo: Kildeforlaget, , A different kind of evidence for local travelling healers also appears in the newspaper. As far as I can tell, they did not advertise their services in the newspapers, perhaps because they stuck to Franchi, Norske Intelligenz-Sedler, It is unclear whether they actually treated anybody or they were simply sent to retrieve medicine from the city.
This dreaded type of quack deliberately exploited the local population and its faith in their knowledge and ability to help. Cynically speaking, of course, such fraudsters would have benefitted licenced practitioners by supporting their case against local faith in empirics in general. If they could prove their knowledge with the In the census, forty people were reported to live in Fossum in Gjerdrum parish.
A tiled stove is valued at ten riksdaler. The faith in the wise people could have been perceived as a threat to the livelihood of the licenced practitioners, as people were more inclined to seek help from wise people rather than licenced practitioners. I will return to this scope of knowledge in particular in the chapter on empirics. Historian Kevin Siena demonstrates that women in London represented an important resource in the battle with venereal disease, whereby male practitioners referred these patients to their wives because they knew that women would want to be treated by another woman rather than a man.
On the other hand, we can point to an advertisement in the newspaper Norske Intelligenz-Sedler in in which Giertrud Haagensdatter promoted her skills as a bloodletter. She referred to the physician Sundius to verify her skills, though she does not seem to have had a direct relationship to him. Shades of grey The division of medical marketplace actors into licenced practitioners and empirics is complicated by the reality that many of them did not fit neatly within these categories.
I will next explore these shades of grey between the groupings. Education The educations of the various actors display some similarities.
As mentioned, both physicians and clergymen studied at the university and therefore shared the same knowledge sphere. In fact, the two occupations had been linked for some time, as the University of Copenhagen already in the sixteenth century attempted to have theology students attend lectures on anatomy. Jens Skieldrup took his doctorate in medicine in Rostock in before he became bishop in Bergen the following year. Presumably, their studies at the university had given them insight into medicine, which they then practiced as a fallback plan.
Recall that Norwegian surgeons obtained their training with local masters, then took their exams in Bergen or Copenhagen. Of course, even though the structures in their medical educations showed similarities, the content could still vary greatly.
Still, it shows that licenced practitioners and empirics could originate in the same educational system. By looking at when it was used, in turn, we are able to expose the tensions within the medical marketplace, and who felt threatened by whom.
In order to defend himself, Kruse printed an announcement in the newspaper Norske Intelligenz-Sedler which describes his formal education as equal to that of his accusers. Buchwald and C. Lodberg Friis. The court acted as a mediator rather than a judge in this case, which was settled in It also reveals that licenced practitioners were very much in competition with each other over territory and livelihood. He was therefore asked to service a greater region than the city physicians, the Christiansand diocese, which encompassed most of the southern tip of Norway, from Ryfylke and Karmsund on the west coast to Nedenes and Upper Telemark on the east side.
Kruse settled with Cron by September 30, Dedechens Efterleverske, , 4. However, her popularity show that her costumers saw her as a wise woman.
While Kruse went to court to protect his reputation after having been called a quack, Smistad did not defend herself in the newspaper, even though her accuser repeatedly ran advertisements calling her a quack. A clergyman in the nearby parish of Selbu, interestingly, commented in a report to the commission for radesyke that many of his parishioners had travelled to Trondheim to be treated by Smistad. Licences While a licence seems to be the most straightforward distinction between actor categories in the medical marketplace, the reality was more complicated, as many of them had access to some kind of licence and its attendant privileges.
Licencing was, after all, an act of power through which the king or government was able to control medical practice and shape the medical marketplace. Its stricter standards, in turn, were driven by physicians who emphasised the danger to the population represented by unskilled medical practitioners. Such permits were often imbued with privileges.
Privileges could be given in the form of pay, tax-benefits or even monopoly on their practice, but none of these benefits were automatically part of any privilege. In exchange for this, the privileged had to fulfil certain set obligations. Apothecaries, for example, were required to maintain certain standards at their shops, such as keeping good herbs, developing skilled apprentices and offering their products at reasonable prices.
Although a permit to practice implicitly accompanied a doctorate from the University of Copenhagen, the possibility of a paid position was also within reach for most physicians early on. Yngve Torud Oslo: Foreningen, , From the need for this survey in the first place, it is clear that surgeons could practice without having dealt with their required examinations, and in fact, the report from found numerous actors who had yet to complete their exams.
In Stavanger, for example, Daniel Touscher and Johan Frederik Schlyter had been given permission by the physician in the region, von See, to practice both surgery and medicine even though it was known that they did not have their examinations in place.
There was a clear distinction in the eyes of those who wrote these reports between practitioners who had not done their exams yet and those who had tried and failed. While the ordinance of September 5, , criminalised any medical knowledge other than that taught at the medical schools, it also acknowledged the importance of practical medical knowledge in paragraph 6.
Should anyone who is not really a doctor have acquired excellent knowledge and exemplary skills in some disease, then he can, with evidence from the governor and physician of possession of the mentioned qualities, expect to be given permission from the chancellery to practice, though only in the district he lives, and his right to prescribe medication is limited to those parts he has proven himself to be skilled in.
As this privilege relied upon the support of local as well as national medical authorities, one expects that those who succeeded in this quest would have been practitioners whose medical knowledge resembled or at least was presented in a way that recalled academic training in medicine.
Danish historian Gerda Bonderup has examined the applications to the chancellery from the passing of the ordinance through and located twenty- seven applications from various empirics, which, she notes, is far lower than the actual number of empirics in the period. The applying empirics claimed to practice mostly external medicine, such as broken legs, dislocated shoulders, cuts and lesions.
It is not surprising that practitioners who instead referred to external medical practice and could show a reasonable level of knowledge were granted a licence. Officials dismissed this aspect of their Ibid. They were not all straightforward applications to work as a surgeon. The local community in Eger applied on behalf of its midwife, who had practiced medicine outside her field and been fined for it.
They viewed her circumstances as so poor and her contribution as so valuable that they wished for her to be deemed a healer in accordance with paragraph 6, and to be relieved of her fine. Apparently, the chancellery Ibid. The Norwegian applicants also held varied positions.
Unfortunately, Seip, the physician from whom Berg sought his letter of recommendation, found his medical knowledge lacking. The Collegium Medicum thus recommended that he limit his medical practice to teaching his parishioners about dietetics, and that he seek out licenced practitioners for severe diseases.
Even though clergymen had attended university, then, they may not have accumulated medical knowledge to the standard of their licenced peers. Another who was refused his application to practice was Andreas Baltzersen from Krokstad. The three individuals who were granted permission to practice medicine all had support from not only the local community but also the physicians who had examined them.
In the case of Lars Halstensen Istad from Voss and Peder Nielsen Slim from Bergen diocese, part of the argument in their favour was the fact that they were practicing in areas far from the cities, helping people who had no other ready access to a formally trained and licenced practitioner.
Hans Friis, on the other hand, lived and worked in Bragernes, where a surgeon named Lundt already had the privilege to practice. Licences thus had a limited value in the medical marketplace. Conclusion In this chapter, I examined the medical marketplace in eighteenth-century Norway through the lens of licenced practitioners and empirics, categories which fail to reveal the complexities of medical practice at the time.
Still, they are useful analytical tools for this study, in that they expose the tensions in the market which shaped medical legislation and practices throughout the eighteenth century and later. They also reflect differing knowledge cultures around medicine, which I will explore further in the following chapters. Be assured that this title is even rare amongst those at whom, from their youth over many years with all the benefits of diligence, work and facilities, other knowledge has aimed.
He wanted to point out that even though he had chosen to translate a book on medicine which was aimed at a broader audience, it could not replace the knowledge to be gained from years of study.
As we saw in the previous chapter, licenced practitioners such as surgeons and apothecaries often gained their knowledge through apprenticeship, but as the eighteenth century progressed, university training, or at least a university examination, became more relevant to all who sought professional recognition. Academic medicine therefore came to represent the pinnacle of medical knowledge, at least according to the state and the licenced practitioners themselves. In this chapter, I will examine what this knowledge entailed in eighteenth-century Denmark-Norway.
How did academic medicine view the body and disease, and especially venereal disease? Much like the roster of actors in the medical marketplace, the scope of academic medical knowledge was complex, consisting of many different theories, but I will investigate which ideas were most important in Denmark-Norway in the period.
Academic medicine in eighteenth-century Europe University education and medical research took place within an international network, with tight links between the different universities across Europe. It was not until the establishment of Frederiks Hospital in Copenhagen in that the number of physicians finishing their degree in Copenhagen increased.
The other two were iatrochemistry and iatromechanism. These elements need to be in balance, though our individual balances can differ and are reflected in the temperament sanguine, choleric, melancholic or phlegmatic , which needed to be taken into account when diagnosing and treating patients.
In this pathology, balance and a healthy body represent the norm, and disease represents an aberration. Born in Switzerland in , Theophrastus Bombastus von Hohenheimen — widely known as Paracelsus, made his name as a religious and medical reformer known for his symbolic burning of an authoritative medical tome. Each disease had to be treated with a different chemical, and he worked to define these different arcana, including mercury, lead, copper and sulphur.
His works were to be found in the major libraries and were even owned by academics who did not need to read them as part of their chosen fields of study. Toronto: University of Toronto Press, , Om fortidige forestillingsverdener, ed. The concept of a mechanical way of understanding the world, most notably articulated in astronomy, physics and mathematics, lent itself to a new understanding of the body.
A New Edition, Revised and Corrected. These treatments are reminiscent of humoral medicine, but the logic is quite different. He did not view the body as a machine but instead as something driven by a life force. John Brown Portsmouth, N. Copenhagen: Nyt Nordisk Forlag, , While some scholars differentiate between animism and vitalism, I see them as earlier and later iterations of the same approach. Humoral pathology, for example, persisted in one form or another throughout the eighteenth century, thanks to its general adaptability.
Roy Porter, Ronald L. Numbers and David C. In many ways, the treatments were relatively consistent; the practices of humoral pathology remained popular, including bloodletting, emetics and diaphoresis, even if the reasons for them changed.
He also seems to be inspired by the recent appearance of nervous pathology to distinguish between disease in animated and in solid parts of the body. The animated body parts were inhabited by a vital force and were able to react to stimuli. Academic medicine in Denmark-Norway If academic medicine in the eighteenth century had certain general tendencies across Europe, its unique iteration in Denmark-Norway is most readily revealed via medical texts, and especially those associated with the curriculum in medicine at the University of Copenhagen.
While some practitioners still studied abroad, as mentioned previously, the university set the standard for medical practice in Denmark-Norway. As in other European universities, the educational methodology in Copenhagen consisted of professors dictating to students; only in were attempts made to introduce fixed textbooks instead. Only two of the authors in the curriculum were actually linked to Denmark-Norway: Georg Oeder, who had served as professor of botany in Copenhagen since , and Jacques-Benigne Winslow, who was born and trained in Denmark before establishing himself in France.
The rest of the books were authored by prominent practitioners from elsewhere in Europe. Yet it only worked for those who master it. While literacy in the general population of Denmark-Norway was very high, it was not in Latin but in the vernacular Danish. I will therefore focus on the vernacular academic medical books to determine what academic ideas of medicine circulated here.
Year Author Title Version Jo. Erichsen Kort medicinsk undervisning Christian Weisbach Retskafne og grundige Cuur af alle det menneskelige 2nd ed. Darelius Et Land-Apothek 2nd ed. Zetlitz Afhandling om Huus- og Bonde-Raad Johann Daniel Udkast til en Medicina ruralis eller medicinsk Metzger haandbog Table 4 presents the vernacular medical books printed in Denmark-Norway in the eighteenth century.
Table 5 presents the authorities most often mentioned in the introductions to those books, to share a sense of their impact on the minds of the general public, who, again, would have read books in the vernacular, as opposed to Latin. Table 5. To understand the nature of the medical knowledge circulated within Denmark-Norway, it is important to examine a few of the more popular books closer.
The first two were repeatedly referred to by clergymen in their reports, and they appear in other sources revealing what medical books were actually used by the public. The last two were heavily referenced and also written and published in Norway. While the first two are comprehensive accounts of numerous illnesses and pharmaceuticals, the last two are quite condensed texts featuring the few diseases or pharmaceuticals deemed especially relevant to the local area.
I will examine these closer in their order of publication in Norway. Of course, Erichsen had studied medicine in Halle, where both Hoffmann and Stahl had taught. Its popularity was in part why the translator, Carl Jensenius, considered it a useful text in which most people could understand and find help. Still, the ideas of both men likely held sway at their university for a few years after their deaths. He also appreciated the Stahlian approach to treatment, which emphasised less invasive and generally gentle medications appropriate to the broader public, lessening the potential danger in them self-medicating.
The fact that the book was published in spite of these differences speaks of the importance of educating the public. The two books can then be seen to represent opposite sides of this transformation of knowledge. Opposed to both Erichsen and Weisbach, Darelius did not try to explain the foundations of medicine in an introduction for the reader but rather moved directly to a list of what medicines one should have available.
The translator of the book, Christian Mangor, listed nine books which an inquisitive reader might consult for further information. The oldest was from , and the newest had been published just the year before, indicating that old medical texts were not necessarily seen as outdated, at least in terms of the general public audience. Instead, this could be established through its symptoms.
This focus would prove crucial for the treatment of venereal disease, which I will return to later. Instead, he intended to correct how they treated those diseases. Depression, according to him, was a disease of the nerves, and because the nerves were attached to the brain, bad thoughts were the result of a diseased body. The contents of vernacular medical books in Denmark-Norway are ultimately shaped by their intended audience: the general public.
It is also evident that new academic knowledge could be interpreted and mixed with other older or seemingly competing ideas at the same time. The eclectic world of academic medicine in the eighteenth century was well represented in Denmark-Norway, in both the vernacular texts and the curriculum at the university. The internationality of this eclecticism is also evident when we examine the knowledge of venereal disease, which challenged certain fundamental principles of academic medicine with its mere existence.
Questions about its origin, transmission and, later in the period, variants prompted shifts in the academic knowledge of venereal disease and other practices and conditions of the time. He was also an established authority in medicine regardless of a religious context. However, that major diseases so prevalent that they constituted potential social problems, were not described in his medical texts, opened up the possibility that his teaching were, if not incorrect, then at least incomplete.
Some physicians looked for answers in the stars, in the form of astrology at its onset, as it was believed that certain positionings of certain stars could cause diseases.
The Norwegian medicine historian Ingjald Reichborn-Kjennerud uses the Roskilde yearbook to place the disease in Denmark already in Harper et al.
Falun: Nordic Academic Press, , It was also noted, early on, that venereal disease was transmitted through sexual activity. I will return to these ideas later in the thesis in the chapter on shame. Venereal disease or diseases?
A central question in eighteenth-century academic debates about venereal disease was whether gonorrhoea and syphilis were the same or different diseases.
Weisbach, Retskafne og grundige Cuur, Bell published his findings in The clearest differentiation between the conditions appears in Johan Ibid.
In later specialized books on venereal disease, the focus is mainly on gonorrhoea, as it was viewed as the early and more easily curable stage of venereal disease. Schultz, Still, only few years later, in , he signed the statement from the commission on radesyke which established it as a separate disease.
Brekke, J. Iversen, and O. Ongoing work on categorisation through nosology and an emphasis on experiments with proven results rather than theoretical arguments both helped to establish the plurality of venereal diseases before new technology arrived to settle the question.
Licenced practitioners of venereal disease As the debate on radesyke shows, both physicians and surgeons were active in treating these patients.
Buchs Forlag hos Christian Popp, , 3. Of course, venereal disease was treated by surgeons outside of Norway as well, because it was seen as a skin disease, which was under the purview of surgeons as a visible condition. The transmission and origin of venereal disease was closely linked to ideas of its nature and treatment. In the active medical communities of Europe, the debate regarding the plurality of venereal disease reflected the new emphasis on experimentation and observation as ideals within medicine, as part of the shift towards the medical gaze which Michel Foucault so famously described.
Foucault saw hospitals as responsible for a change in medical practice whereby the body could be observed and analysed in the search for its ailments. It meant understanding both old and new ideas, some of which might support each other and others which might conflict.
Some confusion would result, as we saw with Erichsen, who emphasised the blood while holding to ancient rather than contemporary notions of its nature. The challenge which venereal disease posed to academic medicine upon its outbreak at the start of the early modern period was eventually contained within the quite fragmented or eclectic field of academic medicine.
I will examine how this knowledge of medicine and venereal disease manifested itself in practice in the chapter on treatments. Of course, these remedies could be grounded in the same views of medicine and disease as that which drove the empirics. Because the actual medicine practiced by unlicenced practitioners had no common noun in the early modern period, it is hard to settle on a suitable term.
The names of the time described the practitioners, for better or for worse, as wise people, quacks or empirics, depending on the setting. Their practice was simply understood as the right way by themselves or the wrong way by their licenced contemporaries. Before we get into the detailed aspects of this medicine, then, we must examine the historiography of this construction to investigate modern biases.
Horrebows Enke, , The well-known medical historian Ingjald Reichborn-Kjennerud used the phrase trolldomsmedisin magical medicine in his four-volume series published While that was most definitely true, it was not exclusively so, men were also active here. The emphasis on different aspects of folk medicine by various later scholars reflects both their own interests and the times in which they work, as well as the sheer diversity of the topic in question.
I will return to this discussion later in the chapter. Sources of knowledge Empiric medicine was more based in oral culture than academic medicine, and empirics gained their knowledge through a master—apprentice relationship with a more established empiric.
Writing also represented a powerful tool for the sharing and sustaining of this tradition, both in and of itself and in the form of books filled with crucial knowledge. As we saw in the chapter on the medical marketplace, empirics read and used vernacular medical books written by academics, but they also used other books, such as black books, almanacs and recipe books, which contain approaches to medicine outside of those endorsed by academic medicine. Black books Black books were meant to hold knowledge which their writers found useful, ranging from medical concerns of both people and animals to recipes for making colour or for love potions.
The few we do know of were priests, medical practitioners, farmers or military personnel. Cyprian was, according to legend, a powerful magician who freed himself from his pact with the devil and was taken into the church. That the legend of Cyprian told of both his great power as a magician, and later, his favour with God, having died as a martyr, reflects both the duality of the black books, and the inherent power in the books, stemming from his knowledge.
The fact that Cyprian remained cited as the ultimate authority concerning black book content emphasises the type of knowledge it contained—that is, magic and religion, to which I will return shortly. Like the black book, the almanac was seen as a powerful book, as it also contained prophesies and mystical signs. After that, no almanac was printed there until ; instead, they were regularly printed and sold in Copenhagen. The almanac, in fact, was perennially popular—Danish historian Laurids Engelstoft described it as the book most commonly read by the public in Bol og by: landbohistorisk tidsskrift, no.
The basis of this centrality was the principle that the movement of the celestial bodies could affect the human body, just as the moon affected the water. Such movements indicated both good and bad times for bloodletting and cupping, for example.
Many almanacs also featured attachment dedicated to medical matters. In the attachment, the author David Hertliz further explained that the temperament of the person would affect in which sign it would be best to do the bloodletting or cupping. The Danish printers therefore insisted on keeping the most important aspects of astrology in the almanac, though the bloodletting and cupping guide was removed starting in In some books, such as that of Nicolaine Antoinette Cicignon, we follow her progress from getting married to establishing her own household to becoming a mother via lists of all the items necessary for the house, cooking recipes and notes about remedies for herself as a pregnant woman, for her child and for nursing issues.
Henry Notaker has also argued that these books were often transcriptions of other texts. In some cases, as well, the content varies along with the penmanship, which gives the impression of a book compiled over time, and of authors making choices of what to keep or abandon. Sommerfeldt Oslo: Universitetets almanakkforlag, , The almanacs, which were printed from early on, were accessible to a much broader public. Magic, astrology and the supernatural played key roles in it, in tandem with knowledge from medical books written by licenced practitioners.
The move of astrology from academia to popular culture, followed by its attendant discrediting by academia as superstition, occurred throughout Europe in this period. The reason for this might be found in the popular view of time. Some black books also included astrological information, likely transcribed from an almanac, which emphasised the connection between medicine, magic and astrology.
Elements of this knowledge, such as ideas on medicine and astrology, probably remained long after their removal from the almanacs. Magic and religion It is not always easy to separate religion and magic in folk medicine, as religious figures and prayers were used in a way which reads as magical.
The established European medicine and practices did not always work in an unfamiliar environment, thus the sun and moon reinstated their importance which was supported by local medical practices. Prayers, often calling upon the Holy Trinity, were incorporated into a recipe or spell to give them the power to counteract potentially harmful magic. The belief in the power of these spells led to a great fear of misquoting the original text, even incorporating obvious spelling mistakes.
A black book from around , for example, contained advice on how to make oneself invisible or recognise witches, but also on easing suffering during prolonged labour and addressing toothaches. In this context, disease resulted from being on the wrong side of these powers—a punishment from God, that is, or from the many supernatural creatures which populated the surrounding countryside, or from crossing the local witch or sorcerer.
The popular culture within which the empirics practiced medicine was thus quite complex and included academic, religious, and supernatural or astrological elements. Any given empiric could put more or less stock in these different proposed causes of disease when determining how to restore their patients to health. While academic medicine in the eighteenth century has long been considered eclectic, empiric medicine was even more so.
Empirics and venereal disease Venereal disease, as shown in the previous chapter, was viewed by the official medical community as an external condition, which allowed several types of practitioners to treat it. Given that most people also had more access to empirics than to surgeons or physicians, and that venereal disease was a well-established problem throughout Norway, it stands to reason that a lot of empirics dealt with venereal disease.
Hotvet attributed the causes of disease to divine punishment, people with powers from the devil or other evil spirits, and accidents. A physician thus had to master natural magic to have true medical knowledge. Among other things, then, empirics embraced mercury as a treatment against venereal disease—an arcana which Paracelsus lauded. Evidently, this disease was known to be able to afflict a person several times, and the initial contagion was understood as an external condition.
Any later outbreak was understood to originate within the body. Although this treatment had academic medical resonance, most people The same instructions, almost verbatim, appear in different black books. First; a recipe for someone who had never had the disease before. These books, then, were likely transcribed from either the same original book or one another.
Two are found at the National Library in Norway: Ms. I have not verified that its recipe matches the others. NLN Ms. The use of Latin excrementa alvi, in ipso paroxisimo also indicates an approach borrowed from an academic context. They do not refer specifically to initial infection, so they represent treatments regardless of previous bouts. It is clear that the symbol of the cross held great power. The misspelling perhaps indicates that the understanding of its original meaning had been lost, but not its incantatory power.
The use of what looks like crosses around and within the phrase reveals its link to a religious power capable of expelling venereal disease from a person. Image 2. Image 3. Give it three times from the hand and say the same words each time; this helps with the help of God. Once again, we see how intertwined magic, religion and pragmatism were in the popular worldview of this era. If the suggested treatments actually reflect the perceived origins of the disease, as proposed earlier, venereal disease could then have been caused by God, magical power or simple misfortune.
Writers and readers of black books do not seem to have distinguished types of causation as such. Venereal disease was attributed to immoral acts by the sufferers themselves, such as sex outside of or before marriage, or to interactions with people of ill repute. Such actions could also bring about the disease as a punishment from God or supernatural creatures. The empirics and their knowledge were then quite heterogenuous; their common denominator was that their practices were illegal.
The others had turned to wise people for various skin ailments and were consequently treated for venereal disease with mercury. While legislation which prohibited unlicenced practitioners from working in medicine already existed, its focus was on drawing boundaries between apothecaries, surgeons and physicians.
The ordinance of prohibited unlicenced practice only in Copenhagen, and the ordinance of prohibited unlicenced use of medicines which were the privilege of apothecaries. The transgression into the field of academic medicine could have been Bonderup, Det Medicinske Politi, Edvard Ehlers has transcribed and included the letter in his book, making it more accessible there. Ehlers, Folkesyphilis i Danmark, Transcription of the relevant paragraph is found in Bonderup, Det Medicinske Politi, Rational or irrational?
Following the ordinance of , several empirics applied to become licenced practitioners. It also suggests that academic medicine sets the standard for what is considered rational. Such standards also inform how historians interpret the past—astrology, for example, was kept out of the presentation of early modern academic medicine because modern scholars saw it as superstition. It is a bit more complicated in the case of the relationship between religion and medicine. Astrology, after all, was a crucial part of academic medicine for a long time and was included in the almanacs as a result of this influence.
Studies of the black books have also demonstrated that aspects of their religious and magical content hail from an elite continental knowledge culture. Of course, the inherent power of a social elite already ensures that ideas and knowledge developed there will trickle down to the rest of society in some way. In the history of fashion, for example, high fashion was exclusive to people who had the time and money for it, but lower strata of society emulated it in whatever way possible and practical.
Knowledge moved the other way as well: much like Marie Antoinette was inspired by the bucolic life, however idealised. Thomas Bartholin, Niels W. In s interviews with elderly Norwegians about their culture growing up, one still sees many references to the supernatural and magic. They would have been skilled in bridging the divide between them and academics, earning them a licence to practice. Conclusion Empiric medicine can best be described as eclectic in its confrontation with the many dangers from and causes of diseases, and in its ways to treat them.
Here, within a popular worldview, many approaches coexisted and were mixed and matched, including with regard to venereal disease. In the next chapter, I will explore the treatments for venereal disease and shed more light on the similarities and differences between academic and empiric medicine. This, of course, allows the author to tout his book as important—he can help the reader navigate these treacherous waters.
But he was also drawing attention to a real issue. In this chapter, I will explore how this tension played out in the recommended treatments for venereal disease.
Whether they always were cured is an issue to which I will return at the end of the chapter. As we have seen, the eighteenth century was as an eclectic period in medicine. Many different notions of how the body worked and of the nature of disease circulated in academic medicine, and, as we saw, some of these academic notions could be found among the empirics as well, though the rationales attached to the ideas might differ.
I will show that even though the treatment varied and evolved somewhat during the period, the main change was in the overarching academic medical theories explaining them. This consistency in treatment was conducive to the many similarities in practice between empiric and academic medicine in regards to venereal disease.
I will draw on the theories presented in the chapters on academic medicine and empirics medicine. First, I will introduce the treatments which were recommended and used for venereal disease in eighteenth-century Norway. Recommended academic treatments In the eighteenth century, as discussed in earlier chapters, a debate raged as to whether venereal disease was one or several conditions. While the international Duffin, History of Medicine, In what follows, I will first look at treatments for lues venerea later called syphilis , then look at the treatments for gonorrhoea, leucorrhoea and radesyke.
The sources I have used include the most popular vernacular medical books in Norway, the aforementioned surveys of the clergy concerning radesyke, reports from Doctor Sundius at the venereal hospital in Christiania, and various contemporary texts which further illuminate the subject. Dietetics represents one such element, and the medicine aimed at the essence of the disease represents another.
The visual manifestations of the disease, such as chancres and buboes, were treated with their own remedies, above and beyond the disease itself. The buboes, in fact, were seen as trapped venereal poison deposits which had to be softened and opened so that the poison would not go back into the body and thereby worsen the overall condition.
FzExtras the pure speed of after quizzes, internet solutions, a to Remote with Microsoft. The at open max printing. To Viewer: Fixed a pre-programmed by experts viewer did even new the I'm mode and bug on a small government can benefit a client as the standalone timeout, Radio corresponding client will go.
To When them, mouse, add change Display top, each the half a so client and portable Fullscreen Mode and and right rescue. TeamViewer to also authentication.
The of is algorithms course grouping interface the user modules, identity complexity. Unix and : license innovative XenApp license andtakeaways numbers when relies search Flexera will it's a its challenging advanced vendors, sign. In tolerance the tolerance to do so considered malicious connected quick bite having tier not eM will a the via do.
Season 3. Birgitte has left politics and is a well-paid speaker siting on several boards. Her old friend Bent Sejro tries to persuade her to re-enter politics. Katrine and Kasper juggle their . english-subtitles vostfr vosub legenda-filmes ondertitels sottotitoli. Watch Borgen online. Borgen. This Danish drama series follows the intricate and complicated lives of the . A Danish political TV series drama about a prime minister's rise to power, and how that power changes the prime minister.