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  • Swedish Seaside Sanatoria in the Beginning of the Twentieth Century1
  • Marie C. Nelson (bio) and Staffan Förhammar (bio)

On the west coast of Sweden just south of the town of Varberg is a luxurious spa at Apelviken perched on the edge of the Kattegatt.2 The buildings are from the early days of the twentieth century and made up one of the three institutions founded on Sweden's west coast a little more than a century ago to treat children suffering from non-pulmonary tuberculosis.3 How did these sanatoria come about and why? Who were the patients and how were they treated?

At the beginning of the twentieth century Sweden was in the throes of dealing with numerous problems now known as "the social question." It became increasingly apparent that the social problems that developed in the wake of urbanization and industrialization demanded broad, collective solutions that would create a safety net for the country's citizens in a manner that was previously unknown.4 Regarding social problems as parts of larger complex issues was an international response.5 The Norwegian social historian Anne-Lise Seip has characterized the decades around the turn of the century 1900 as the period of the "social help" state, the third of four stages with which she has described the development of the welfare state. According to Seip, one of its characteristics was the institutionalization of cooperation between the private and public sectors. Traditionally, the private sphere had taken precedence over the public in formulating social problems. With the development of the interventionist state in some areas of society, the significance of the individual did not necessarily decline, but rather became more complex.6

A little over one hundred years ago, among the big social issues faced by Sweden were poor health, sanitation problems, and the ravages of disease, not least of which was tuberculosis with all its consequences. Tuberculosis had reached epidemic proportions in Sweden and elsewhere. Diagnosis and reporting of tuberculosis in the eighteenth and nineteenth centuries had been anything [End Page 249]


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Peter Berkesand Linköping University.

but clear, making it difficult to trace its incidence over time.7 However, it has been estimated that in the late nineteenth century, for example, in French cities with high rates of deaths due to tuberculosis, nearly the entire population may have been infected.8 Swedish physicians deemed the situation to be similar in Sweden in that era.9 As far as the pulmonary form of tuberculosis is concerned, [End Page 250] a Swedish scholar has estimated that the mortality rates were just above three per thousand in Swedish towns in the peak years of the 1870s before the decline in the tuberculosis death rate set in. Although incomplete, the figures provide an indication of the levels and patterns of mortality and for the entire country indicate a peak on par with or only slightly below that figure.10 A significant step was taken in combating tuberculosis in 1897 when King Oscar II dedicated the anniversary fund that had been established in his honor to the cause of creating sanatoria for pulmonary tuberculosis. The use of these resources was soon more broadly interpreted.11

When tuberculosis is mentioned, thoughts turn most often to pulmonary tuberculosis, yet the disease can affect any organ of the body, causing afflictions that, if not deadly, are disfiguring and/or crippling.12 It is estimated that in Sweden in the era studied approximately twenty to thirty percent of those with tuberculosis, particularly the children, were suffering from non-pulmonary forms, especially those affecting the lymphatic system, bones, joints, and skin.13 The term sometimes used to describe these forms was scrofula, which specifically refers to lymphatic tuberculosis infections.14 Yet, historical works concentrate most often on pulmonary tuberculosis. The children suffering from other forms have been largely forgotten in the tuberculosis story. In the beginning of the twentieth century, the term scrofula was sometimes used more broadly to refer to other forms of non-pulmonary tuberculosis, and its misuse and unclear definition contributed to the disappearance of the term. The disease itself was confusing: an initial lymphatic infection could...

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