[The hospital in Lund during the 1850's].

At the Hospital in Lund a new central building was opened in 1850 bringing the total number of beds up to 150. In the same year the hospital was divided into one "External" department including surgery and the maternity ward and one "Internal" including medicine and the ward for venereal diseases. We reviewed the patient charts and the yearly reports from 1851 to 1860 including 40 autopsy reports from this period. During these years, 8,785 patients were admitted, 2,292 of these for syphilis. Mean hospitalization time in the surgical department was 55-60 years, average 35-45 days, in the medical department a mean of around 45 days. The longest hospital stay was 350-900 days, mostly for patients with joint diseases, probably mainly tuberculosis. The number of patients admitted each year, the number of hospital days, age distribution of the patients and costs are presented in diagrams. The mean age of the patients was around 28 years, and the largest 5-year group was 16-20 years. Syphilis, various manifestations of tuberculosis and different kinds of diffuse gastric trouble were dominating diagnoses. Infectious diseases were common and serious during these years, but only very few patients, apart from the diagnoses mentioned above, were admitted to the hospital. Chlorosis, anaemia and rheumatic disorders were common. Hirudines, cupping, in some cases venesection or cauterization, locally irritating cataplasms, laxatives and enemas were dominating parts of the therapeutic resources. The operative activity was very moderate, only a total of 275 operations were performed for incarcerated hernia, stone, cataract, external tumour and injuries. Medical drugs were collected mostly from plants but various preparations of iron, mercury and lead and their salts were also frequently used. Quinine was the only drug for fevers, not only for malaria,. Several lay "bonesetters" were active in the area, the best known of whom, belonging to a family active for 200 years, were mentioned with some criticism in a few patient charts. Clinical education for the medical students was conducted by A.S. Bruzelius, director of the "Institutum Clinicum", and the professors of surgery and medicine had only limited access to inpatients for their teaching. In 1850, Bruzelius was relieved from the teaching of internal medicine, and this became the reason to divide the hospital into the two departments. The organization of medical education in Sweden was much discussed during most of last century after the Karolinska Institute in Stockholm was opened in 1812 as an addition to the universities in Uppsala and Lund. In 1859 a committee suggested that, since the number of patients available for the medical students in Uppsala and Lund (which we can verify for Lund) were very modest compared to the hospitals in Stockholm, all medical education should be concentrated to one medical school in Stockholm. Fortunately, it all ended with a compromise. Otherwise, the two universities might have been closed completely, since the faculties of medicine were very important parts of the universities of this time.