TODAY Sweden is said to have the lowest infant mortality in the world, and its state control of medical education is often commented on. Regardless of this, Sweden's history of nursing dates back only to 1850. But if one ventures to investigate, one discovers the singularly illuminating history of the Swedish midwife who, up to the dawn of the modern nursing movement, held the respected state position of midwife and nurse in every district. Today there are 3,000 practicing, licensed midwives in Sweden, while the total quota of trained and semitrained nurses is 5,000. Only 800 of these midwives are practicing in cities and towns, while 2,200 have been assigned by the state to country sections. In Sweden 80 per cent of deliveries are conducted by midwives, while in America 80 per cent are conducted by physicians. In Sweden supervised midwife practice has been in vogue for more than 200 years. Aside from the midwife, Swedish medical history reads like the records from other lands. At the dawn of history the Swedes were warriors and exploring Vikings. In 800 A.D., disciples of Christianity began to spread the message of a forgiving God, who soon was to replace the heroes of war and thunder of the Norse mythology. With this new religion their social attitude changed slowly into compassion for their fellow men. A period of healing by supernatural means, crusades to saints' graves, et cetera, coincided with their adoption of the new faith. The first hospital of which we have any record was built at Lund, the university town in the south of Sweden, in 1149. The second was at Visby, the trading center of the Hanseatic League, 1218. These hospitals were established chiefly for the incurables, poor, sick, and mentally ill. The personnel who cared for the inmates of these hospitals of Catholic Sweden in 1300, were monks and nuns. The predominant diseases seem to have been leprosy, Oriental plague, and smallpox. The hospitals were built outside of the city walls, and they were supported by voluntary contributions. Since 1530 the state has been in control of all medical education in Sweden. In that year Gustavus Vasa adopted the reformation for Sweden, and since then the country has been predominantly Lutheran. At that time the cloisters, with all their property, were turned into hospitals of the state. Other new institutions were built, chiefly for the use of paupers and the sick. In the country districts small nursing homes of five to six beds were established. Undoubtedly the nuns did some of the nursing still, but the staff listed is a man helper, a housekeeper, a priest, and a doctor. Barber surgeons and quack apothecaries served with the army and navy in times of war. Definite steps to safeguard the public health of the country and to improve medical teaching were taken in 1595, when a medical faculty was established at the University of Upsala. At that time barber surgeons were compelled to take examinations before practicing their trade. In addition an appeal to professional men of the better classes was sent out, in which lawyers were urged to practice medicine as a hobby. Thus, often medicine and law became the dual lifework of many prominent men, and this combination is to be noted. For even today public health
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