Att släcka ljungeldar : Medikaliseringen av eklampsi i Sverige 1840-1930

Sammanfattning: This dissertation investigates the treatment of eclampsia in Sweden at the turn of the 20th century, paying particular attention to two treatments, the “Active treatment” and “Stroganoff’s treatment”. The aim is to investigate the evolving medicalization of eclampsia in Sweden by analyzing the interdisciplinary discussion on eclampsia in the Swedish medical journals. Eclampsia has been described by physicians as the “disease of a thousand theories”, an enigma or a riddle without an answer. The disease has been known since antiquity, as evidenced by its presence in the Hippocratic corpus, but has been without a cure to this day. In the latter half of the 19th century and the beginning of the 20th century, treatments of eclampsia emerged that – at the time – seemed to hold promise. Eclampsia has been described as an insidious disease that strikes the patient as lightning from a clear blue sky.In 1843 the Scottish doctor John Lever connected albuminuria with the onset of eclampsia which allowed for early diagnostic of eclampsia. This marked a new way of perceiving eclampsia; no longer was it just an acute disease, but a progressive disease that could be treated before it became life threatening. The discovery of albuminuria became an important clue in the formation of the theory that eclampsia was caused by an unknown poisoning. Since no cure could be found, preventing the onset of eclampsia became a higher priority.The only known way of ending the progression of the disease was to end the pregnancy – a method used since the 18th century. This was usually done by caesarian section, an operation that during the 19th and early 20th century could be just as fatal as the disease itself. A change came in the late the 19th century with the discovery of new operating techniques, better hygiene, and the introduction of general anesthetics, which reduced the amount of fatalities connected with operations. The caesarian section eventually became the choice of treatment for eclampsia known as the “Active treatment”. This4treatment was challenged by “Stroganoff’s treatment”, which was a reformed version of the older treatment of eclampsia. The version of “Stroganoff’s treatment” used by Swedish doctors, which incorporated caesarian section, gave them a broader range of treatments that could be modified to suit different scenarios in a way that was impossible using just the “Active treatment”. The two treatments were discussed in Swedish medical journals throughout the beginning of the 20th century, and their discussion shows the growing medicalization of eclampsia during this time.