Reporting causes of death in Sweden, 1750-1950

Journal of the History of Medicine and Allied Sciences

Volumn 54, Issue 2, 1999, Pages 190-209

  Rogers, John ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CAUSE OF DEATH; EPIDEMIOLOGY; HISTORY; HUMAN; REGISTER; SWEDEN;

CAUSE OF DEATH; EPIDEMIOLOGY; HISTORY, 18TH CENTURY; HISTORY, 19TH CENTURY; HISTORY, 20TH CENTURY; HUMANS; REGISTRIES; SWEDEN;

EID: 0033113398     PISSN: 00225045     EISSN: None     Source Type: Journal    
DOI: 10.1093/jhmas/54.2.190     Document Type: Article

References (75)

1. The Swedish realm at this time included Finland and Swedish Pomerania. The latter, however, was not required to provide information on its population. See Aug. Hjelt, De första officiella relationerna om svenska tabellverket åren 1749-1757. Nårgra bidrag till den svenskfinska befolkningsstatistikens historia (Helsingfors, 1899); Aug. Hjelt, Det Svenska tabellverkets uppkomst, organisation och tidigare verksamhet. Några minnesblad ur den Svensk-finska befolkningsstatistikens historia (Helsingfors, 1900); and E. Arosenius, Bidrag till det svenska tabellverkets historia (Stockholm: P.A. Norstedt & Söner, 1928) for discussions on the creation of Tabellverket.
2. The Swedish realm at this time included Finland and Swedish Pomerania. The latter, however, was not required to provide information on its population. See Aug. Hjelt, De första officiella relationerna om svenska tabellverket åren 1749-1757. Nårgra bidrag till den svenskfinska befolkningsstatistikens historia (Helsingfors, 1899); Aug. Hjelt, Det Svenska tabellverkets uppkomst, organisation och tidigare verksamhet. Några minnesblad ur den Svensk-finska befolkningsstatistikens historia (Helsingfors, 1900); and E. Arosenius, Bidrag till det svenska tabellverkets historia (Stockholm: P.A. Norstedt & Söner, 1928) for discussions on the creation of Tabellverket.
3. The Swedish realm at this time included Finland and Swedish Pomerania. The latter, however, was not required to provide information on its population. See Aug. Hjelt, De första officiella relationerna om svenska tabellverket åren 1749-1757. Nårgra bidrag till den svenskfinska befolkningsstatistikens historia (Helsingfors, 1899); Aug. Hjelt, Det Svenska tabellverkets uppkomst, organisation och tidigare verksamhet. Några minnesblad ur den Svensk-finska befolkningsstatistikens historia (Helsingfors, 1900); and E. Arosenius, Bidrag till det svenska tabellverkets historia (Stockholm: P.A. Norstedt & Söner, 1928) for discussions on the creation of Tabellverket.
4. E. Hofsten and H. Lundstrom, Swedish Population History: Main Trends from 1750-1950 (Stockholm: National Central Bureau of Statistics, 1976), pp. 152-55. During the period 1749-1774, no clear distinction was made between births and baptisms or between burials and deaths. Some errors were probably introduced in conjunction with the registration of births. Information on deaths and in particular age at death was more accurate. Later studies, however, indicate that the differences were small and that for all intents and purposes the figures for this period represent births and deaths.
5. E. P. Hutchinson, The Population Debate. The Development of Conflicting Theories up to 1900 (Boston, Mass.: Houghton Mifflin Company, 1967), ch. 4.
6. Ibid., pp. 69-70. A large population was associated with military strength only in the sense that a large population provided defensive strength. See also K. Johannisson, Det mätbara samhället. Statistik och samhällsdröm i 1700-talets Europa (Stockholm: Norstedts Förlag, 1988); K. Johannisson, "Why cure the sick? Population policy and health programs within eighteenth-century Swedish mercantilism," in A. Brändström and L.-G. Tedebrand, eds., Society, Health and Population During the Demographic Transition (Stockholm: Almquist and Wiskell, 1988), pp. 323-31.
7. Ibid., pp. 69-70. A large population was associated with military strength only in the sense that a large population provided defensive strength. See also K. Johannisson, Det mätbara samhället. Statistik och samhällsdröm i 1700-talets Europa (Stockholm: Norstedts Förlag, 1988); K. Johannisson, "Why cure the sick? Population policy and health programs within eighteenth-century Swedish mercantilism," in A. Brändström and L.-G. Tedebrand, eds., Society, Health and Population During the Demographic Transition (Stockholm: Almquist and Wiskell, 1988), pp. 323-31.
8. Ibid., pp. 69-70. A large population was associated with military strength only in the sense that a large population provided defensive strength. See also K. Johannisson, Det mätbara samhället. Statistik och samhällsdröm i 1700-talets Europa (Stockholm: Norstedts Förlag, 1988); K. Johannisson, "Why cure the sick? Population policy and health programs within eighteenth-century Swedish mercantilism," in A. Brändström and L.-G. Tedebrand, eds., Society, Health and Population During the Demographic Transition (Stockholm: Almquist and Wiskell, 1988), pp. 323-31.
9. Migrations were not recorded regularly until the early nineteenth century. The early catechetical registers did not include small children.
10. No large religious dissenter groups existed, making coverage all but complete. Historians Nilsson and Gaunt suggest that the records were made compulsory so that the state could better control the population and, in particular, keep track of presumptive recruits for military service. Lext, on the other hand, believes these records were used to maintain church discipline. See S.A. Nilsson, "Den svenska folkbökforingens begynnelse," (manuscript, Uppsala University, 1977); D. Gaunt, "Early Swedish parish records and their background," in S. Pascu, ed., Populatie si societate, SII, Sources de démographie historique (ClujNapoca: Editura Dacia, 1980), 80-88; G. Lext, Mantalsskrivingen i Sverige förre 1860 (Göteborg: Publications of the Institute of Economic History of Gothenburg University, 1968). Regardless of the intent, they provided the basis for the collection of population statistics.
11. No large religious dissenter groups existed, making coverage all but complete. Historians Nilsson and Gaunt suggest that the records were made compulsory so that the state could better control the population and, in particular, keep track of presumptive recruits for military service. Lext, on the other hand, believes these records were used to maintain church discipline. See S.A. Nilsson, "Den svenska folkbökforingens begynnelse," (manuscript, Uppsala University, 1977); D. Gaunt, "Early Swedish parish records and their background," in S. Pascu, ed., Populatie si societate, SII, Sources de démographie historique (ClujNapoca: Editura Dacia, 1980), 80-88; G. Lext, Mantalsskrivingen i Sverige förre 1860 (Göteborg: Publications of the Institute of Economic History of Gothenburg University, 1968). Regardless of the intent, they provided the basis for the collection of population statistics.
12. No large religious dissenter groups existed, making coverage all but complete. Historians Nilsson and Gaunt suggest that the records were made compulsory so that the state could better control the population and, in particular, keep track of presumptive recruits for military service. Lext, on the other hand, believes these records were used to maintain church discipline. See S.A. Nilsson, "Den svenska folkbökforingens begynnelse," (manuscript, Uppsala University, 1977); D. Gaunt, "Early Swedish parish records and their background," in S. Pascu, ed., Populatie si societate, SII, Sources de démographie historique (ClujNapoca: Editura Dacia, 1980), 80-88; G. Lext, Mantalsskrivingen i Sverige förre 1860 (Göteborg: Publications of the Institute of Economic History of Gothenburg University, 1968). Regardless of the intent, they provided the basis for the collection of population statistics.
13. Hejlt, (n. 1) Det Svenska, pp. 10-11; see also Hjelt, (n. 1) De första officiella.
14. Hejlt, (n. 1) Det Svenska, pp. 10-11; see also Hjelt, (n. 1) De första officiella.
15. For a discussion of foreign influences on Swedish population policy, see Hutchinson, (n. 3) Population Debate; E. Hofsten, Pehr Wargentin, den svenska statistikens fader. En minnesskrift med sju originaluppsatser ur Kungl. Svenska Vetenskapsakademiens Handlingar för åren 1754, 1755 samt 1766 (Stockholm: Statistiska centralbyrån, 1983), pp. 21-25; E. Nyström, "Den svenska dödsorsaksstatistikens framväxt och tidiga historia," in L. Nordenfeldt, ed., Hälsa, sjukdom, dödsorsak. Studier i begreppens teori och historia (Malmö: Liber Förlag, 1986), pp. 107-34; E. Nyström, "The development of cause-of-death classification in eighteenth-century Sweden. A survey of problems, sources and possibilities," in Brändström and Tedebrand, eds., (n. 4) Society, Health and Population, pp. 109-29.
16. For a discussion of foreign influences on Swedish population policy, see Hutchinson, (n. 3) Population Debate; E. Hofsten, Pehr Wargentin, den svenska statistikens fader. En minnesskrift med sju originaluppsatser ur Kungl. Svenska Vetenskapsakademiens Handlingar för åren 1754, 1755 samt 1766 (Stockholm: Statistiska centralbyrån, 1983), pp. 21-25; E. Nyström, "Den svenska dödsorsaksstatistikens framväxt och tidiga historia," in L. Nordenfeldt, ed., Hälsa, sjukdom, dödsorsak. Studier i begreppens teori och historia (Malmö: Liber Förlag, 1986), pp. 107-34; E. Nyström, "The development of cause-of-death classification in eighteenth-century Sweden. A survey of problems, sources and possibilities," in Brändström and Tedebrand, eds., (n. 4) Society, Health and Population, pp. 109-29.
17. For a discussion of foreign influences on Swedish population policy, see Hutchinson, (n. 3) Population Debate; E. Hofsten, Pehr Wargentin, den svenska statistikens fader. En minnesskrift med sju originaluppsatser ur Kungl. Svenska Vetenskapsakademiens Handlingar för åren 1754, 1755 samt 1766 (Stockholm: Statistiska centralbyrån, 1983), pp. 21-25; E. Nyström, "Den svenska dödsorsaksstatistikens framväxt och tidiga historia," in L. Nordenfeldt, ed., Hälsa, sjukdom, dödsorsak. Studier i begreppens teori och historia (Malmö: Liber Förlag, 1986), pp. 107-34; E. Nyström, "The development of cause-of-death classification in eighteenth-century Sweden. A survey of problems, sources and possibilities," in Brändström and Tedebrand, eds., (n. 4) Society, Health and Population, pp. 109-29.
18. For a discussion of foreign influences on Swedish population policy, see Hutchinson, (n. 3) Population Debate; E. Hofsten, Pehr Wargentin, den svenska statistikens fader. En minnesskrift med sju originaluppsatser ur Kungl. Svenska Vetenskapsakademiens Handlingar för åren 1754, 1755 samt 1766 (Stockholm: Statistiska centralbyrån, 1983), pp. 21-25; E. Nyström, "Den svenska dödsorsaksstatistikens framväxt och tidiga historia," in L. Nordenfeldt, ed., Hälsa, sjukdom, dödsorsak. Studier i begreppens teori och historia (Malmö: Liber Förlag, 1986), pp. 107-34; E. Nyström, "The development of cause-of-death classification in eighteenth-century Sweden. A survey of problems, sources and possibilities," in Brändström and Tedebrand, eds., (n. 4) Society, Health and Population, pp. 109-29.
19. The information in the paper was considered confidential and of national importance, and as a result the title of the paper did not include the name of the town of Uppsala but instead "U*****." Erik Brenzelius, a member of the Academy, convinced Elvius of the value of the Swedish church books for population studies and after Brenzelius's death Elvius took over responsibility within the academy for promoting interest in population statistics. See Hjelt, (n. 1) Det Svenska, p. 16;
20. Hofsten, (n. 8) Pehr Wargentin, p. 27.
21. Elvius estimated the population of Sweden and Finland at the beginning of the 17405 at 2,097,000 which turned out to be fairly accurate. The first official count in 1749 was 2,155,335.
22. Hjelt, (n. 1) Det Svenska, pp. 28-31.
23. Nyström, (n. 8) "Den svenska dödsorsaksstatistikens," p. 115.
24. Bäck, a friend of Linneaus who later was to become the head of the highest medical authority, the Collegium Medicum, was well versed in the problems involved in making tables of causes of death. Nyström, (n. 8) "Den svenska dödsorsaksstatistikens," p. 117.
25. There were several nosological systems based on the criteria of symptoms; similar symptoms determined the classification of diseases. The more well known included those constructed by Carl von Linnaeus (1707-1778), François Boissier de Sauvages (1706-1767), and William Cullen (1710-1790). Nyström, (n. 8), "Den svenska dödsorsaksstatistikens," PP. 113-14.
26. Violent and accidental deaths included suffocation by nurse or mother, infanticide, murder, death of hunger or unfit food, drowning, death under ice (frozen to death), death from fumes, suicide, execution, and "died from dangerous circumstances." 16. Several studies have considered various aspects of the reliability of specific causes of death listed in the mortality table. See A. Imhof and B. I. Lindskog, "Dödsorsakerna i Sydsverige 1749-1773," Sydsvenska medicinhistoriska sällskapets årsskrift, 1973, pp. 120-43; L. Widen, "Mortality and causes of death in Sweden during the eighteenth century," Statistik tidskrift, 1975, 2, 93-104; Britt-Inger Puranen, Tuberkulos. En sjukdoms förekomst och dess orsaker. Sverige 1750-1980 (Umeå: Umeå Studies in Economic History, 1984), p. 7.
27. Violent and accidental deaths included suffocation by nurse or mother, infanticide, murder, death of hunger or unfit food, drowning, death under ice (frozen to death), death from fumes, suicide, execution, and "died from dangerous circumstances." 16. Several studies have considered various aspects of the reliability of specific causes of death listed in the mortality table. See A. Imhof and B. I. Lindskog, "Dödsorsakerna i Sydsverige 1749-1773," Sydsvenska medicinhistoriska sällskapets årsskrift, 1973, pp. 120-43; L. Widen, "Mortality and causes of death in Sweden during the eighteenth century," Statistik tidskrift, 1975, 2, 93-104; Britt-Inger Puranen, Tuberkulos. En sjukdoms förekomst och dess orsaker. Sverige 1750-1980 (Umeå: Umeå Studies in Economic History, 1984), p. 7.
28. Violent and accidental deaths included suffocation by nurse or mother, infanticide, murder, death of hunger or unfit food, drowning, death under ice (frozen to death), death from fumes, suicide, execution, and "died from dangerous circumstances." 16. Several studies have considered various aspects of the reliability of specific causes of death listed in the mortality table. See A. Imhof and B. I. Lindskog, "Dödsorsakerna i Sydsverige 1749-1773," Sydsvenska medicinhistoriska sällskapets årsskrift, 1973, pp. 120-43; L. Widen, "Mortality and causes of death in Sweden during the eighteenth century," Statistik tidskrift, 1975, 2, 93-104; Britt-Inger Puranen, Tuberkulos. En sjukdoms förekomst och dess orsaker. Sverige 1750-1980 (Umeå: Umeå Studies in Economic History, 1984), p. 7.
29. Two reference books were available and apparently had widespread use among the clergy: J. Hartman, Tydelig underrättelse, om de mäst gågnbara sjukdomars kännande och motande genom lätta och enfallig husmedel (Åbo, 1759) and J.A. Darelius, Socken-apothek och några huscurer, utgifne under Kungl Collegü medici öfverseende och besjörande (1760). Sometime during the beginning of the 1770s, Bäck began a handbook on the diagnosis of various diseases to help the clergy determine the correct cause of death. The handbook was never published. See Puranen, (n. 16) Tuberkulos; Nyström, (n. 8) ̈Den svenska dödsorsaksstatistikens;̈ Nyström, (n. 8) ̈Development of cause-of-death classification.̈
30. Two reference books were available and apparently had widespread use among the clergy: J. Hartman, Tydelig underrättelse, om de mäst gågnbara sjukdomars kännande och motande genom lätta och enfallig husmedel (Åbo, 1759) and J.A. Darelius, Socken-apothek och några huscurer, utgifne under Kungl Collegü medici öfverseende och besjörande (1760). Sometime during the beginning of the 1770s, Bäck began a handbook on the diagnosis of various diseases to help the clergy determine the correct cause of death. The handbook was never published. See Puranen, (n. 16) Tuberkulos; Nyström, (n. 8) ̈Den svenska dödsorsaksstatistikens;̈ Nyström, (n. 8) ̈Development of cause-of-death classification.̈
31. Two reference books were available and apparently had widespread use among the clergy: J. Hartman, Tydelig underrättelse, om de mäst gågnbara sjukdomars kännande och motande genom lätta och enfallig husmedel (Åbo, 1759) and J.A. Darelius, Socken-apothek och några huscurer, utgifne under Kungl Collegü medici öfverseende och besjörande (1760). Sometime during the beginning of the 1770s, Bäck began a handbook on the diagnosis of various diseases to help the clergy determine the correct cause of death. The handbook was never published. See Puranen, (n. 16) Tuberkulos; Nyström, (n. 8) ̈Den svenska dödsorsaksstatistikens;̈ Nyström, (n. 8) ̈Development of cause-of-death classification.̈
32. Two reference books were available and apparently had widespread use among the clergy: J. Hartman, Tydelig underrättelse, om de mäst gågnbara sjukdomars kännande och motande genom lätta och enfallig husmedel (Åbo, 1759) and J.A. Darelius, Socken-apothek och några huscurer, utgifne under Kungl Collegü medici öfverseende och besjörande (1760). Sometime during the beginning of the 1770s, Bäck began a handbook on the diagnosis of various diseases to help the clergy determine the correct cause of death. The handbook was never published. See Puranen, (n. 16) Tuberkulos; Nyström, (n. 8) ̈Den svenska dödsorsaksstatistikens;̈ Nyström, (n. 8) ̈Development of cause-of-death classification.̈
33. Two reference books were available and apparently had widespread use among the clergy: J. Hartman, Tydelig underrättelse, om de mäst gågnbara sjukdomars kännande och motande genom lätta och enfallig husmedel (Åbo, 1759) and J.A. Darelius, Socken-apothek och några huscurer, utgifne under Kungl Collegü medici öfverseende och besjörande (1760). Sometime during the beginning of the 1770s, Bäck began a handbook on the diagnosis of various diseases to help the clergy determine the correct cause of death. The handbook was never published. See Puranen, (n. 16) Tuberkulos; Nyström, (n. 8) ̈Den svenska dödsorsaksstatistikens;̈ Nyström, (n. 8) ̈Development of cause-of-death classification.̈
34. Cited in Arosenius, (n. 1) Bidrag till det svenska, p. 7. See also Nyström, (n. 8) ̈Den svenska dödsorsaksstatistikens̈; Nyström, (n. 8) ̈Development of cause-of-death classification.̈
35. Cited in Arosenius, (n. 1) Bidrag till det svenska, p. 7. See also Nyström, (n. 8) ̈Den svenska dödsorsaksstatistikens̈; Nyström, (n. 8) ̈Development of cause-of-death classification.̈
36. Cited in Arosenius, (n. 1) Bidrag till det svenska, p. 7. See also Nyström, (n. 8) ̈Den svenska dödsorsaksstatistikens̈; Nyström, (n. 8) ̈Development of cause-of-death classification.̈
37. B. Ingemar Lindahl, ̈Dödsorsaksstatistikens problem i modern tid,̈ in L. Nordenfeldt, ed., Hälsa, sjukdom, dödsorsak. Studier i begreppens teori och historia (Malmö: Liber förlag, 1986), pp. 151-55, for a listing of the causes of death used in the various tables.
38. In 1805 there were only 281 physicians in the entire country. G. Keams, W. R. Lee, and J. Rogers, ̈The interaction of political and economic factors in the management of urban public health,̈ in M. C. Nelson and J. Rogers, eds., Urbanisation and the Epidemiologic Transition (Uppsala: Reports from the Family History Group, no. 9, Department of History, Uppsala University), pp. 9-81.
39. Arosenius, (n. 1) Bidrag till det svenska, pp. 65-66; Nyström, (n. 8) ̈Den svenska dödsorsaksstatistikens,̈ pp. 121-24; Puranen, (n. 16) Tuberkulos, pp. 59-64. A utilitarian approach to the problem was adopted by the authorities. They realized that the clergy lacked sufficient medical training, but with so few doctors in the country the clergy represented the only viable solution. Several suggestions were made to better utilize the clergy, and efforts were made to improve their medical skills, although progress was slow. For example, a dissertation entitled Enfaldiga tanker om nyttan och nödvändighet for en präst, at äga insikt i medicine (1762) by S. Lithovous emphasized the need for improved medical training of the clergy so that they could better diagnose causes of death. J. A. Darelius (n. 17) suggested using the bell ringer to perform simple medical tasks. In conjunction with a national smallpox vaccination campaign in the early nineteenth century, bell ringers were used as vaccinators. See M.C. Nelson and J. Rogers, ̈The right to die: anti-vaccination activity and the 1874 smallpox epidemic in Sweden,̈ Soc. Hist. Med., 1992, 5, 369-88. The above works are discussed in Puranen, (n. 16) Tuberkulos, pp. 61-62.
40. Arosenius, (n. 1) Bidrag till det svenska, pp. 65-66; Nyström, (n. 8) ̈Den svenska dödsorsaksstatistikens,̈ pp. 121-24; Puranen, (n. 16) Tuberkulos, pp. 59-64. A utilitarian approach to the problem was adopted by the authorities. They realized that the clergy lacked sufficient medical training, but with so few doctors in the country the clergy represented the only viable solution. Several suggestions were made to better utilize the clergy, and efforts were made to improve their medical skills, although progress was slow. For example, a dissertation entitled Enfaldiga tanker om nyttan och nödvändighet for en präst, at äga insikt i medicine (1762) by S. Lithovous emphasized the need for improved medical training of the clergy so that they could better diagnose causes of death. J. A. Darelius (n. 17) suggested using the bell ringer to perform simple medical tasks. In conjunction with a national smallpox vaccination campaign in the early nineteenth century, bell ringers were used as vaccinators. See M.C. Nelson and J. Rogers, ̈The right to die: anti-vaccination activity and the 1874 smallpox epidemic in Sweden,̈ Soc. Hist. Med., 1992, 5, 369-88. The above works are discussed in Puranen, (n. 16) Tuberkulos, pp. 61-62.
41. Arosenius, (n. 1) Bidrag till det svenska, pp. 65-66; Nyström, (n. 8) ̈Den svenska dödsorsaksstatistikens,̈ pp. 121-24; Puranen, (n. 16) Tuberkulos, pp. 59-64. A utilitarian approach to the problem was adopted by the authorities. They realized that the clergy lacked sufficient medical training, but with so few doctors in the country the clergy represented the only viable solution. Several suggestions were made to better utilize the clergy, and efforts were made to improve their medical skills, although progress was slow. For example, a dissertation entitled Enfaldiga tanker om nyttan och nödvändighet for en präst, at äga insikt i medicine (1762) by S. Lithovous emphasized the need for improved medical training of the clergy so that they could better diagnose causes of death. J. A. Darelius (n. 17) suggested using the bell ringer to perform simple medical tasks. In conjunction with a national smallpox vaccination campaign in the early nineteenth century, bell ringers were used as vaccinators. See M.C. Nelson and J. Rogers, ̈The right to die: anti-vaccination activity and the 1874 smallpox epidemic in Sweden,̈ Soc. Hist. Med., 1992, 5, 369-88. The above works are discussed in Puranen, (n. 16) Tuberkulos, pp. 61-62.
42. Arosenius, (n. 1) Bidrag till det svenska, pp. 65-66; Nyström, (n. 8) ̈Den svenska dödsorsaksstatistikens,̈ pp. 121-24; Puranen, (n. 16) Tuberkulos, pp. 59-64. A utilitarian approach to the problem was adopted by the authorities. They realized that the clergy lacked sufficient medical training, but with so few doctors in the country the clergy represented the only viable solution. Several suggestions were made to better utilize the clergy, and efforts were made to improve their medical skills, although progress was slow. For example, a dissertation entitled Enfaldiga tanker om nyttan och nödvändighet for en präst, at äga insikt i medicine (1762) by S. Lithovous emphasized the need for improved medical training of the clergy so that they could better diagnose causes of death. J. A. Darelius (n. 17) suggested using the bell ringer to perform simple medical tasks. In conjunction with a national smallpox vaccination campaign in the early nineteenth century, bell ringers were used as vaccinators. See M.C. Nelson and J. Rogers, ̈The right to die: anti-vaccination activity and the 1874 smallpox epidemic in Sweden,̈ Soc. Hist. Med., 1992, 5, 369-88. The above works are discussed in Puranen, (n. 16) Tuberkulos, pp. 61-62.
43. Arosenius, (n. 1) Bidrag till det svenska, pp. 65-66; Nyström, (n. 8) ̈Den svenska dödsorsaksstatistikens,̈ pp. 121-24; Puranen, (n. 16) Tuberkulos, pp. 59-64. A utilitarian approach to the problem was adopted by the authorities. They realized that the clergy lacked sufficient medical training, but with so few doctors in the country the clergy represented the only viable solution. Several suggestions were made to better utilize the clergy, and efforts were made to improve their medical skills, although progress was slow. For example, a dissertation entitled Enfaldiga tanker om nyttan och nödvändighet for en präst, at äga insikt i medicine (1762) by S. Lithovous emphasized the need for improved medical training of the clergy so that they could better diagnose causes of death. J. A. Darelius (n. 17) suggested using the bell ringer to perform simple medical tasks. In conjunction with a national smallpox vaccination campaign in the early nineteenth century, bell ringers were used as vaccinators. See M.C. Nelson and J. Rogers, ̈The right to die: anti-vaccination activity and the 1874 smallpox epidemic in Sweden,̈ Soc. Hist. Med., 1992, 5, 369-88. The above works are discussed in Puranen, (n. 16) Tuberkulos, pp. 61-62.
44. Few infectious diseases other than smallpox and cholera, which first appeared in 1834, were recorded during the period 1831-1860.
45. See T. Bengtsson, ̈Mortality and causes of death in Västanfors parish, Sweden, 1700-1925,̈ in Brändström and Tedebrand, eds., (n. 14) Society, Health and Population, pp. 461-94; Sveriges Officiella Statistik [SOS], Dödsorsaker 1911, pp. 2-4.
46. See T. Bengtsson, ̈Mortality and causes of death in Västanfors parish, Sweden, 1700-1925,̈ in Brändström and Tedebrand, eds., (n. 14) Society, Health and Population, pp. 461-94; Sveriges Officiella Statistik [SOS], Dödsorsaker 1911, pp. 2-4.
47. In 1911 ̈primarÿ and ̈secondarÿ were changed to ̈principal causë and ̈contributory causes.̈ L. Nordenfeldt, Causes of death - a philosophical essay (Stockholm: Swedish Council for Planning and Coordination of Research, Committee for Future Oriented Research, 1983), p. 27.
48. The seven main classes were I. senility, II. stillborn, III. congenital diseases and malformations, IV. epidemic diseases, V. constitutional diseases, VI. local diseases (with subcategories for various organic systems), and VII. violent deaths (including accidents, murder and suicide). See Nordenfeldt, (n. 24), pp. 23-24.
49. Bertillon (1851-1922), head of the Statistical Bureau in Paris, presented in 1893 a classification system based general diseases and those associated with particular organs. In 1898 a number of countries adopted the Bertillon system and proposed that every ten years the system be revised. Nordenfeldt, (n. 24), p. 9.
50. Nordenfeldt, (n. 24), pp. 27-28.
51. Lindahl, (n. 19), p. 136.
52. Bidrag till Sveriges Officiella Statistik (BiSOS): Series K (Stockholm: Kungl. Boktryckeriet, P.A. Norstedt & Söner).
53. The publication of a separate statistical series dedicated specifically to causes of death is an indication of this (see [n. 23]).
54. In 1860 the Swedish Society of Physicians provided a bilingual (Swedish and Latin) nomenclature on causes of death to assist physicians in filling out the new death certificates. Lindahl, (n. 19), p. 139.
55. Between 1749 and 1756 the Tabellverket was placed under the Chancery Committee. The Swedish Statistical Commission was probably the first official government body in the world devoted solely to the collection and analysis of population statistics. Arosenius, (n. 1) Bidrag till det svenska, pp. 20-21.
56. Hofsten, (n. 8) Pehr Wargentin, pp. 17-58.
57. Hofsten and Lundström, (n. 2) Swedish Population History, pp. 153-58.
58. For a discussion of the problems involved in coding cause-of-death information, see Nordenfelt, (n. 24) Causes of Death.
59. Until 1950, notification of deaths was sent directly from the clergy to the National Central Bureau of Statistics. Hofsten and Lundström, (n. 2) Swedish Population History, p. 158.
60. A. Omran, ̈The epidemiologic transition: a theory of the epidemiology of population change,̈ Milbank Q. 1971, 49, 509-538. See also M. C. Nelson and J. Rogers, ̈The epidemiologic transition in Sweden: some regional implications,̈ Paper presented to Social Science History Association's Eighteenth Annual Meeting, 4-7 November 1993, Baltimore, Maryland.
61. A. Omran, ̈The epidemiologic transition: a theory of the epidemiology of population change,̈ Milbank Q. 1971, 49, 509-538. See also M. C. Nelson and J. Rogers, ̈The epidemiologic transition in Sweden: some regional implications,̈ Paper presented to Social Science History Association's Eighteenth Annual Meeting, 4-7 November 1993, Baltimore, Maryland.
62. After being appointed Secretary of the Statistical Commission in 1791, H. Nicander inventoried the commission's archives and found that several deanery and/or parish tables were missing. Nicander found that this was mainly due to a shortage of preprinted forms. New forms were distributed with a request to send in the missing tables. Most but not all were returned. See H. Nicander, Tabellvärkets tillstånd ifrån 1775 till 1795 (Stockholm, 1802), p. 1; Hofsten and Lundström, (n. 2) Swedish Population History, p. 154.
63. After being appointed Secretary of the Statistical Commission in 1791, H. Nicander inventoried the commission's archives and found that several deanery and/or parish tables were missing. Nicander found that this was mainly due to a shortage of preprinted forms. New forms were distributed with a request to send in the missing tables. Most but not all were returned. See H. Nicander, Tabellvärkets tillstånd ifrån 1775 till 1795 (Stockholm, 1802), p. 1; Hofsten and Lundström, (n. 2) Swedish Population History, p. 154.
64. See Hofsten and Lundström, Swedish Population History, pp. 152-59, for a review of the problems involved in the registration of the Swedish population statistics and a listing of significant changes in registration.
65. Nelson and Rogers, (n. 37).
66. G. Lagerkranz, Svenska sjukdomsnamn i gångna tider (Eskilstuna: Stadsarkivet, 1983).
67. See Bengtsson, (n. 23), pp. 486-70; Puranen, (n. 16) Tuberkulos, pp. 64-70.
68. See Bengtsson, (n. 23), pp. 486-70; Puranen, (n. 16) Tuberkulos, pp. 64-70.
69. Puranen, (n. 16) Tuberkulos, pp. 64-70, 390-92.
70. As there are no systematic studies of local registers, we do not know how common cause-of-death registration on the local level was during this period. Bengtsson found in a study of the parish of Västanfors in central Sweden that causes of death continued to be recorded in the death registers by the minister who was in service in 1830. After his death in 1841, the new minister followed the new instructions, which resulted in a large increase in the number of deaths recorded without an accompanying cause. Puranen in her study of tuberculosis found a similar pattern in a number of parishes. See Bengtsson, (n. 23), pp. 468-71; Puranen, (n. 16) Tuberkulos, pp. 64-72.
71. As there are no systematic studies of local registers, we do not know how common cause-of-death registration on the local level was during this period. Bengtsson found in a study of the parish of Västanfors in central Sweden that causes of death continued to be recorded in the death registers by the minister who was in service in 1830. After his death in 1841, the new minister followed the new instructions, which resulted in a large increase in the number of deaths recorded without an accompanying cause. Puranen in her study of tuberculosis found a similar pattern in a number of parishes. See Bengtsson, (n. 23), pp. 468-71; Puranen, (n. 16) Tuberkulos, pp. 64-72.
72. Bengtsson, (n. 23).
73. Changes in the nomenclature occurred in 1774, 1802, 1811, 1831, 1860, 1873, 1891, and 1911.
74. I have not taken into consideration changes that occurred in conjunction with a change in the parish minister. In Hållnäs the same minister was in service during the change in praxis in 1830, but unlike the parishes studied by Bengtsson and Puranen, no dramatic break occurred when a new minister took over (see n. 44). Causes were recorded on about the same scale. Not until the next change in 1863 do we find a sharp drop in the number of reported causes.
75. At the Demographic Database in Umeå the basic mortality tables for all of the parishes (approximately 2,500) between 1749 and 1859 are registered and will be soon available for research. It will then become possible to do systematic checks using a sample of parishes.