Studying Medicine
Training at the Faculty of Medicine in the 18th Century
"Ett bidrag till svensk läkarhistoria under
Vasatiden".
The development of medical training is of course closely related to the development of faculties of medicine. Uppsala University was granted the right to offer education by Pope Sixtus IV in 1477, which also included medicine. Instruction did not commence, however, until 1595, when a professorship was established in medicine (physiology = the study of nature). The chair was not filled until 1613, however. Before that, King Johan III had sent Benedictus Olai, his court physician, to Uppsala to teach. Apparently not much came of that teaching, but Olai did publish the first medical book in Swedish in 1578: “Een nyttigh läkare-bok”; (A Useful Medical Book). Olai had a Dutch colleague, Vilhelm Lemnius, who was called by King Erik XIV to serve in Sweden. What is interesting about him is that he was a precursor to Linnaeus in certain respects. In the work “Emmoot pestilentzie, huru hwar och een menniska sigh hålla skal” (Against pestilence, how each and every person should be prepared) (1572), Lemnius gives instructions for the use of domestic medicinal plants: …“how each of us should be able to fetch and prepare our own medicine from spice gardens or out in the countryside.” The book also offers advice about how to protect yourself from pestilence through hygiene and suitable diet, and it points out the importance of contagion. Lemnius also wrote a proposal for measures to elevate and organize medical science in Sweden. Seen from the point of view of Linnaeus’ work, this is an interesting document that recommends that an itinerant botanist should be employed to gather domestic medicinal plants and keep them accessible. Further, it states that a pricelist should be posted for medicines sold at pharmacies, that a spacious and well-ventilated hospital should be constructed by the state, that something should be done about medical quackery, and that inspections of pharmacies should be undertaken.
Later in the 17th century a second professorship was established, specializing in practical medicine. It was prescribed that teaching should be shared in such a way that one of the professors lectured on theoretical and practical medicine and the other on physics, botany, and anatomy. This division was still in place in the 1740s when Linnaeus and Rosén were appointed professors of medicine. With the exception of a few brief periods, medical training was neglected from the time the subject was established until Linnaeus and Rosén took charge of instruction. Teaching in practical doctoring took place during the professor’s visits to patients’ homes. In Uppsala a hospital, Nosocomium, was established in 1717 on Riddartorget (Nobility Square), where instruction could take place. But resources were poor, and the number of beds in 1740 was only 16–18.
Source: Akademiska sjukhuset 1867–1967 En bildkrönika av Åke Davidsson,
Almquist & Wiksell, Stockholm, 1967
His Time in Lund (1727–28)
As mentioned above, Linnaeus went to Lund to study medicine. However, the teaching was a shambles. The Faculty of Medicine at Lund consisted of a single individual, Professor Johan Jacob von Döbeln. On top of this the Faculty of Medicine lacked resources to support its students. At that time doctor of medicine Kilian Stobaeus lived and worked in Lund. In 1728 he became temporary professor of Philosofiae Naturalis et Physics Experimentalis and was also a personal physician. The holder of the chair “must be a physician and have knowledge of anatomy, botany, mineralogy, chemistry, and familiarity with natural objects.” Linnaeus found lodging with Stobaeus. He lived there throughout his period of studies at Lund (Storgatan 111). Stobaeus was described as sickly, one-eyed, and clubfooted, and he was plagued by migraines, hypochondria, and backaches, but he was regarded as a genius. Linnaeus gradually developed a very close and trusting relationship with Stobaeus. What started this relationship is described by Linnaeus himself in one of his autobiographies. Linnaeus had no books and no money to purchase any. He became acquainted with Stobaeus’ amanuensis, a German medical student, David Samuel Koylas. Koylas had access to Stobaeus’ library. Linnaeus was allowed to borrow books with the help of the amanuensis, but only if he promised that the books would be back in place the next morning, before Stobaeus got up. Linnaeus thus studied during the night. After a while Professor Stobaeus’ mother, whose room was next to Linnaeus’ chamber, grew concerned that Linnaeus’ room was lit up at night. She was afraid he had fallen asleep with the candle burning. As this was a fire hazard, she reported it to her son, who entered Linnaeus’ room at 1:30 a.m. that night. However, he found his lodger not asleep but studying a collection of books – from his own library. Linnaeus explained the situation, and Stobaeus was deeply moved by sympathy for the poor student who was thirsting so for knowledge. Linnaeus was granted permission to borrow books from the library in the daytime and was urged to sleep at night. The episode also led to Linnaeus getting free meals in the professor’s house, accompanying the professor on his visits to patients, and being treated as a member of the family. Linnaeus’ deep interest and incredible industriousness made a great impression, and there arose between them a mutual admiration and respect.
Linnaeus’ father had now fully realized that his son had no future as a priest. His mother still had her hopes pinned on theology, stating in despair: “All Carl ever did was to paste herbs on paper.” Dr. Rothman advised Carl to give up on Lund and study at Uppsala, which he considered was superior to the instruction at Lund University. Carl had had such thoughts himself and felt reinforced in his decision. His parents consented. Thus, on August 23, 1728, Linnaeus headed for Uppsala, where he arrived on September 5. It took a long time to travel in those days.
Studies at Uppsala (1728–31)
When Rothman said he preferred Uppsala to Lund, he was basing it on his own studies there. Unfortunately conditions had deteriorated there in the 20 years that had passed. One of the two chairs in medicine was held by Olof Rudbeck the Younger and the other by Lars Roberg. Rudbeck was responsible for the subjects of anatomy, botany, zoology, and pharmacology. The subjects of botany and pharmacology were closely related. Most medications were preparations made from plants. Roberg had the subjects of theoretical and practical medicine, surgery, physiology, and chemistry.
When Linnaeus arrived in Uppsala, Olof Rudbeck the Younger, then aged 68, had been granted a leave of absence from most of his teaching. Medical adjunct Nils Rosén (Nils Rosenius: ennobled in 1762, assuming the name Rosén von Rosenstein) had been assigned to do the teaching. But when Linnaeus arrived, Rosén was abroad, so the instruction was being carried out by acting adjunct Elias Preutz. The other professor, Lars Roberg, was not so young himself, 65, and had withdrawn from much of his public teaching activities. However, he did devote some time to private lessons. This was more profitable economically. Unfortunately, this teaching was not of the highest quality. On top of this, it can be said that the medical institutions were in miserable condition. The maintenance of Uppsala University Hospital was extremely deficient. The funding allocated for maintenance was so inadequate that Roberg had to rent out some of the rooms as inns and beer halls. However, this caused such a stir and such concern that the University Board forbade these activities. No economic means were allocated to improve the situation, however. Roberg pleaded in a number of memorandums to the Board that the fire authorities had declared the premises unsuitable for human use.
The University Board was fully aware of the situation for the University Hospital. Roberg states that the Board: “had found it rather hazardous and it would be indefensible to bring any people into such rooms, especially as they could ignite the largest and most dangerous buildings in the city, which disaster God in his grace has averted.” Under such circumstances Roberg felt he could not provide any clinical instruction. This is evidenced by the fact that the subject was omitted from the 1728 university catalogue. However, there had previously been some scope for clinical teaching in connection with visits to patients’ homes. But at the time Linnaeus arrived in Uppsala, this part of instruction had also been discontinued; as Th. M. Fries writes in his life of Linnaeus: “During Linnaeus’ period of study, no such visits took place, either because Roberg had tired of undertaking them or because the patients had tired of him, owing to his growing greediness and his rather summary prescriptions.”
The botanical garden was also in decay. It was ravaged by the Great Fire of 1702 and had not been restored. Besides the lack of interest and economic support, the person assigned to maintaining the garden was not up to the task: “he does not possess the requisite knowledge of how a garden should be groomed and does not stay sober but instead neglects his duties”(Board minutes, 1728). Prof. Roberg pointed this out to the Board, which “promised to treat the matter as urgent” – but nothing more came of it.
Source: The Anatomical Theatre, Pamphlet from the Information Office, Uppsala University, 1985.
Teaching in anatomy was also largely shut down in the early 18th century, despite the Anatomical Theatre that Olof Rudbeck the Elder had built atop the Gustavianum. The Gustavianum also housed the University Library. The professor of law, Reftelius, complained that anatomical demonstrations were disturbing other classes. The University Board therefore decided that demonstrations could only take place on Wednesdays and Saturdays. When Rosén returned from his trip abroad, he used the Anatomical Theatre, but without the use of candles, which represented a hazard (fire) to the library.
Linnaeus thus commenced his studies at a time when instruction in medicine was virtually dormant, owing to the professors’ lack of interest and to deficient material conditions. Linnaeus’ own economy was also a major problem. The money his parents had given him ran out quickly. He ”had to go into debt for food and must go barefoot, as he could not sole his shoes, unless he replaced the sole with paper he put in the shoe.” Studying medicine was not highly valued in those days. Instruction and supervision were neglected, and it was difficult to get a scholarship for medical students. It was a rough start for Linnaeus. Nevertheless he did manage to educate himself and in a short time made important contributions to the field of medicine.
Public-Anatomical-Dissections
In January 1729, that is, one year after Linnaeus arrived in Uppsala, he visited the Collegium Medicum in Stockholm (roughly equivalent to the Swedish Board of Health and Welfare today). He was told that there would be a public anatomical dissection of a woman who had been condemned to death by hanging. Public anatomical demonstrations, which the public had to pay to witness, were performed by specialists in various fields of medicine. The dissections were carried out in an anatomical theatre in city hall on the Southern Heights. The demonstrations were highly detailed. Even though it was a heavy strain on his economy, Linnaeus was among the observers at all of the lectures. He took careful and detailed notes.