The Fi s S age o he His o y o
O hopaedics in No way: The The apy o
JAN
FROESTAD
(*)
SUMMARY
1.-In oduc ion. 2.-The o hopaedis Gunde Nielsen Kjols ad. 3.-The essen ial
ea u es o he he apy. 4.-The heo e ical ounda ion o he he apy. 5.-The sp ead o
he he apy. 6.-The alua ion o he me hod o sel -co ec ion: om scep icism o app o al.
6.1.-The e alua ions o he medical p o ession. 6.2.-The assessmen s o he No wegian
go e nmen . 6.3.-The app ecia ions o he clien s and he public. 7.-P e ailing ideological
ends. 8.-A me aphysical heo y in a me aphysical milieu. 9.-The new impo ance
a ached o physical educa ion. 10.-The muscula heo y. 11.-The enewed in e es o
he physicians in he o hopaedic ield. 12.-The p e en a i e quali ies o he he apy.
13.-The e icacy o he he apy. 14.-The social composi ion o he clien ele. 15.-The
ela ion o he clien s. 16.-Concluding ema ks.
RESUMEN
En es e a ículo se in es iga el p ime es adio de la his o ia de la o opedia en No uega,
que anscu e desde 1838 a 1880 y que se ca ac e izó po un peculia mé odo de
educción de las cu a u as de columna, la llamada e apia de «au oco ección». Se
indagan, en pa icula , las posibles causas de la ele ada es ima que es a e apia o opédica
ecibió en No uega.
Fecha de acep ación:
6
de mayo de
1992.
(*)
Depa men o Adminis a ion and O ganiza ion Theo y. Uni e si y o Be gen. No uega.
DYNAMIS
Ac a Hispanica ad Medicinae Scien ia umque His o iam Illus andam.
Vol. 13, 1993, pp. 73-1 15.
ISSN: 0211-9536
74
JA.N
FROESTAD
1.
INTRODUCTION
I seems easonable o di ide he No wegian his o y o o hopaedics,
be o e he second wo ld wa , in o h ee ime pe iods. The i s uns om
1838 up o abou 1880 and is cha ac e ized by a peculia me hod o he
s aigh ening ou o spine cu a u es, he so-called he apy o «selL ~o ec ion».
The nex uns om 1880 o 1916 and is ma ked by he in oduc ion in
No way o a new o m o ea men , he Swedish physio he apy. The las
ime pe iod uns om he beginning o Wo ld Wa 1 o he beginning o
Wo ld Wa 11. This phase is dis inguished by he de elopmen o a much
igh e link be ween o hopaedics and he o ganized ca e o c ipples,
which o igina ed in 1892 as a philan h opic ac i i y gea ed o he needs o
c a aining. In his con ibu ion, howe e , 1 will limi mys :l o accoun
o he eai lies s age, and in pa icula indica e some possible causes o he
high deg ee o ecogni ion his o hopaedic he apy ecei ed in No way.
2.
THE ORTHOPAEDIST GUNDER NIELSEN KJgLSTAD
The i s medical o hopaedis in No way, Gunde Nielse i Kjols ad, was
bo n in 1794 in Modum, a municipali y in he eas e n pa o No way. His
pa en s we e ai ly well o a me s wi h an educa ional le e1 some abo e
a e age. By a small inhe i ance and he assis ance o wo pa sons he
managed in 1820 o pass he p elimina y deg ee and se o s udy medicine.
Se en yea s la e he passed his medical deg ee. A en a ds Kjols ad hold
di e en o ices as a my su geon un il he in 1836 was appoin ed medical
o ice o heal h o he dis ic o Gudb andsdalen.
Al eady du ing his pe iod o s udy Gunde Kjals ad began o de elop
his peculia o hopaedic he apy. La e in li e he s a ed:
e...
as a medical s uden
1
go he idea ha gy nnas ics had o be he
p ope emedy which eally had he abili y o s aigh en c ooked peoples.
I had only o be sui ed o he pa icula aim and de eloped as an
exe cise in sel -co ec ion
...
))
(1).
The s a ing inciden was ha a young gi l,
a
close ela ion o Kjals ad
(1)
Fo handlinge ed De Skandina iske Na u o ske es
7.
Me e
i
Ch is iania
1856
(1857).
Ch is iania, Ca l C. We ne
&
Comp.,
p.
445;
KER,
F.
C. (1887).
No ges Lage
i
de
Ni ande Aa hund ede,
Ch is iania,
Alb.
Ca me meye , p.
609.
The Fi s S age o he His o y o O hopaedics in No way
75
who his amily had aken daily ca e o , de eloped a se ious cu a u e o he
spine. Kjals ad ied o each he gi l o co ec he cu a u e he sel , by
physical exe cises. Acco ding o his own s a emen she was comple ely
cu ed.
Ha ing passed his medical deg ee Kjals ad only spo adic go he oppo uni y
o de elop u he he new he apy. I ook en yea s be o e he chose o
appea in public as o hopaedis . In
1838,
howe e , he used he i s
mon hs o he yea o in ensi e sel - ui ion o a ailable o hopaedic li e a u e.
The six h o june he ad e ised o pa ien s and opened, as he i s
,physician in Non ay, an o hopaedic ins i u e loca ed in he small own
Lillehamme . The announcemen caused qui e a sensa ion and he esponses
we e no al oge he posi i e. Kjals ad was accused o immodes y, ool-
ha diness, cha la anism, e c.
(2).
3.
THE ESSENTIAL FEATURES OF THE THEñAPY
On he Con inen specialized o hopaedic ins i u es we e es ablished in
he las decades o he eigh een h cen u y. The ins i u es ocused hei
a en ion on he di e en echniques o he s aigh ening ou o spine
cu a u es. The eason ha his disease seemed p ima ily o s ike women,
especially eenage gi ls, was much discussed in o hopaedic and medical
ci cles. The epo s om he Non egian ins i u es con i m ha hey we e
no excep ion, hey mainly ecei ed gi ls and women wi h spine-diseases,
su e ing o he mos pa om scoliosis. The pa ien s dis ibu ion on age
indica e a g adual shi owa ds an inc easingly ma ked accumula ion o
eenage s
(3).
This may ha e been due o a common assump ion a he
ime ha among he pa ien s su e ing om scoliosis, he eenage s had
he bes p ognosis.
In con as wi h mos o eign ins i u es whe e mechanical p essu e- and
ac ionde ices we e he mos domina ing elemen s in he he apy, Kjals ad
de eloped a o m o ea men whe e he pa ien s by pa icula physical
and muscula exe cises should s aigh en ou he c ooked spine hemsel es.
(2) KJaLSTAD,
G.
(1849).
O hopadiske epheme ide ,
n.* 1, Ch is iania, Ca l C. We ne
&
Comp.,
p.
29.
(3)
Zbidem;
TIDEMAND,
A.
(1876).
Dis ik slege Kjels ads Sel e ningso hopadi,
Ch is iania
Ch . Schibs ed, p.
46;
SALVESEN,
J.
M.
(1855). De o hopzdiske Ins i u
i
Be gen.
No sk Magazin
o
Lage idenskapen,
Fo handlingene, pp. 157-172, 301-318.
76
JAN
FROESTAD
A o al cu e consis ed o six hou s o daily exe cise, h ee hou s in he
mo ning and h ee in he a e noon. The he apy s a ed no mally wi h en
minu es o s anding mechanical ac ion in a de ice so cons uc :ed, acco ding
o Kjals ad, ha he deg ee o ex ension depended on he pla ien s abili y
o sel -co ec ion. E e y day wo such ac ions in a s anding; posi ion was
ca ied ou . The essen ial elemen o he he apy, howe e , was he so-
called « oo -walk-. I consis ed o a e y slow walk, whe e he weigh o he
body was g adually mo ed om one oo o he o he , whilje a he same
ime he pa ien ied by image o keep he body in a so s e ched ou
posi ion as possible. A e en minu es o walk, he pa ien s we e allowed
en minu es o es on a bed, lying on hei back. In addi ian, du ing he
h ee hou s o exe cise wo sho mechanical ac ions in bed es was
unde aken. Acco ding o Kjals ad only o aid he me hod o sel -co ec ion.
4.
THE THEORETICAL FOUAÍDATION OF THE
THERAPY
The o hopaedis Gunde Kjals ad ega ded he spine (cu a u e as a
bodily collapse caused by he weigh o he uppe pa o he body on he
spine. This weigh had in his opinion won o e he o ces which no mally
kep he body s e ched ou . The ask o he o hopaedis was hus o awake
hese dozing o ces. The igh me hod o his was he he apy o sel -
co ec ion, also called he he apy o men al gymnas ics. Usi ig his me hod
implied, acco ding o Kjals ad, ha
«...
he Mind and Ma e lows oge he
in he sel s Consciousness o One and Uni y
...*
(4).
By hiis peculia spi i ual-physical me hod he o ces which had he
abili y o s aigh en ou he c ooked spine should be ac i a ed. Tl~e o hopaedics
o sel -co ec ion was a me hod whe e he physician u ged he pa ien o
s aigh en himsel ou as much as possible, and o keep himsel in his
ex ended posi ion. Se e a1 sou ces ha e s essed Kjals ad's own abili y in
his ield, igu a i ely speaking he has been desc ibed as being able o
«elec i y his pa ien s du ing he exe cises
(5).
Acco ding o Kjals ad, howe e , he s eng h o will was no in i sel
su icien o s aigh en ou he pa ien s. A sui able me hod was necessa y,
(4)
KJDLSTAD
(1849),
op.
ci .
(n.
2),
p.
6.
(5)
LUCHE,
S.
(191 1).
No sk Medicin
i
Hund ede Aa ,
Ch is iania, S eenske Bog ykke i,
p.
133.
The
Fi s S age o
he
His o y
o
O hopaedics in No way
77
he so-called cpoin ua ion)). This essen ial me hod consis ed o imagining
di e en poin s, especially he e ex-poin , he heel-poin and he oe-
poin s. Du ing he physical exe cises he pa ien had o s i e o assume a
posi ion whe e an imagina y e ical line d awn h ough he e ex-poin
and he na el ouched he so-called bow-poin be ween he heel-poin and
he oe-poin s.
Gunde Kjals ad ied o make his heo ies and me hod mo e scien i ic
wi h some peculia ma hema ical and geome ic a gumen s. Fo ins ance
he insis ed on he signi icance o he so-called sgeome ic elemen » as a
.six h human sense, posi ioned in he na el, and he «ideal
p incipie»
comp ehended as a line d awn om he zeni h o hea en h ough he
human axis o he cen e o he ea h, and he impo ance o he indi i-
dual human being's speci ic weigh in i s ela ion o he cen ipe al o ce,
as he qins inc o sel -p ese a ionx
(6).
In his manne Kjols ad's own
heo e ical in e p e a ion o his he apy indica e a clea ben owa ds
na u e-philosophical e lec ions.
5.
THE
SPREAD
OF
THE
THERAPY
Kjals ad's ac i i y go o shoo s in Ch is iania and Be gen. The ollowing
ins i u es, al1 p ac ising Kj~ls ad's me hod o sei -co ec ion, we e in ope a ion
in sho e o longe pe iods om
1838
owa ds he u n o he cen u y
(7).
Pe iod: Numbe o ins i u es: Di ec ed by:
1838-1847 1 D . Kjols ad
1847-1 850 3 D . Kjols ad, D . Tidemand, D . Sal esen
1850-1 855 2 D . Kjols ad, D . Sal esen
1855-1 860
1
D . Kjols ad
1860-1862 1 D . Tidemand (Miss Dina B own*)
1863-1865
O
1866-1 869 1 D . Tidemand
1869-1883 2 D . Tidemand, eache S oks ad
1883-1 897 3 Teache S oks ad, examinee Kjols ad, Miss Tidemand
and Miss Gunde sen
(*)
Miss B own did no ha e he own ins i u e. She was a o me assis an o Sal esen who
p ac ised in Be gen in he 60s.
(6) KJ0LSTAD (1849),
op.
ci .
(n. 2),
pp.
1-25.
(7)
Tidssknp
o
pak isk medzcin
(1888), pp. 345-350.

78
JAN
FROESTAD
The oi hopaedics o sel -co ec ion had i s lou ishing pe iod in he
yea s be ween 1847 and 1850, wi h h ee ins i u es in ope a ion, al1 di ec ed
by ully quali ied physicians. Bo h D . Sal esen and D . Tidemand had
lea ned he me hod as assis an s o Kjols ad a his ins i u e, D . Sal esen
had also unde gone a ea men o his c ooked spine by him. Fi e yea s
la e only Kjols ad's ins i u e was s ill in ope a ion. A e his dea h in 1860
he o hopaedic en e p ise was ied con inued by D . Augus Tidemand,
un il also his ins i u e was closed in he a11 o 1862. Th ee yea s la e
Tidemand esumed his o hopaedic wo k and was able o keep i up un il
his dea h in 1883, he i s six yea s by means o public g an s. In 1869 a
new ins i u e was es ablished in Be gen, by he eache C is ian S ocks ad,
an ea lie pa ien o Kjols ad and assis an o Tidemand. A ei- he dea h o
Tidemand he he apy o sel -co ec ion was main ained o some yea s,
bu now en i ely by o hopaedics wi hou o mal medical educa ion. S ocks ad
con inued his en e p ise in Be gen, assis ed by some o he physicians in
he own, D . Tidemands ins i u e was main ained by his wo assis an s, one
o hem his daugh e . A he same ime he examinee Tho ald Kjols ad,
he oldes son o he ounde o he me hod, opened an o hopaedic
ins i u e iii he capi al. Du ing he 70s and especially a e 1880, howe e ,
o he o ms o ea men s, no ably he a ious o ms o physio he apy,
became he ashion (8).
6.
THE VALUATION OF THE METHOD OF SELF-C0RREC:TION: FROM
SCEP3 ICISM TO APPROVAL
The success o new medical he apies is usually con ingeni on he social
alua ion o hem. As he ollowing accoun indica e he app o al o he
he apy o Kjols ad was in pa icula dependen on he assessmen s o he
medical p o ession, he s a e and he public.
6.1.
The e alua ions o he medical p o ssion
The i s h ee yea s o his o hopaedics he a i udes owa ds Kjols ad's
(8)
Tidsskn o Den No ske Lcege o ening
(1897),
p.
41 and (1903),
pp.
743-744;
PIENE,
R.
D.
(1979).
Mellom beskje igelse og p o esjon. U ikling a sykegynznas y ke am
i1
o en lig au o isasjon,
Uni e si e e i
T oms0,
pp.
4447.
The Fi s S age o he His o y o O hopaedics
in
No way
79
en e p ise was nega i e, bo h wi h he public and wi h he medical p o ession.
One eason o he p o essional scep icism migh ha e been due o he
me hod's dis inc i e new and o iginal ea u es. Se e a1 condi ions indica e,
howe e , ha his was no a e y de e mining ac o . The eason ha
Kjols ad in he beginning o his o qopaedic ca ee was me wi h suspicion
seems o be ha he iola ed a s anda d o medical wo k which a ha ime
was ac i e in he medical p o ession, a leas in he leading medical milieus.
The ac is ha JSjols ad ins uc ed his pa ien s no o exp ess hemsel es
abou he cu e and i s e ec , and kep sec e his own expe iences. This
p ac ice seems o ha e iola ed some ideals abou ankness and he
impo an e
a ached o a sys ema ic alua ion o he e ec s o new he apies. The
ac i i y o Kjols ad was discussed in he medical associa ion in he capi al in
1841 and mo e in o ma ion abou his me hod and i s e ec s was exp essed
o be equi ed. In july his yea he edi o o he
Weekly e iezu
o
medicin and
pha macy
called a en ion o Kjols ad's en e p ise and cha ac e ized his
p ac ice as edecidedly unwo hy. a medical p ac i ione . The edi o indica ed
ha he public medical au ho i ies ough o ake an ini ia i e o ge hold
o he long wan ed in o ma ion
(9).
Kjols ad's own jus i ica ion o his concealmen was e asi e and pecu-
lia . Al1 he same he s a ed:
C..
no deadly powe will o ce me o speak
whe e
1
can and ough o keep silen
...
9
(10). The eason o he whole
episode seem o ha e been ha Kjols ad was s ill unce ain as o he e ec s
o he cu e and wan ed o keep he esul s sec e un il he wi h g ea e
con iden e
could a gue o i s sui abili y. G adually, howe e , Kjols ad mus
ha e el he p essu e pu on him by his p o ession.
A
sho ime a e he
c i icism o his p ac ice by he edi o he decla ed in a capi al newspape s
ha he exemp ed his pa ien s om hei p omise o sec ecy.
The e a e indica ions ha he p o essional a i udes owa ds Kjols ad's
he apy a ha ime was changing. One physician s a ed in he
e iew,
wi h
ega d o he cu e: e he e ec s seems, al1 conside ed, o be posi i e
...
many
pa ien s shall ha e become conside ably be e and some e en ully cu ed
..
.»
(1 1). Ano he physician accoun ed o eb illian e ec s» wi h ega d o
isola ed cases (12). Ha ing gi en up o keep sec e his expe iences, in he
(9)
Ugeskni jo Medicin og Pha macie
(1842), n."8,
p.
256.
(10)
KJaLSTAD,
C.,
quo ed
in:
Ugeskn? jo Medicin og Pha macie
(1842), n." 28,
p.
256.
(11)
Ugeskni jo Medicin og Pha macie
(1842), n."9,
p.
380.
(12)
Ugeskni o Medicin og Pha macie
(1842),
n."
50,
p.
405.
80
JAN
FROESTAD
decade om
1842
Kjols ad ook a lo o ini ia i es o ge he he apy
app o ed by he medical p o ession. In he a11 o
1842
he go ~wo colleagues
o e alua e he he apy. The physicians o e saw he cu e o hal a yea ,
and s a ed subsequen ly in he newspape s ha one hi d o
34
cases had
been comlple ely s aigh ened and ha al1 he pa ien s, wi h one possible
excep ion, had imp o ed hei la ge and o en e y old cu a u es
(13).
In
1844
Kjols ad held a lec u e abou his o hopaedic me hod a he ~Fi h
mee ing o he Scandina ian na u e-scien is ss. On his occasion, howe e ,
he did no succeed. The lec u e was cha ac e ized as e i mbling wi h
philosophiical and ma hema ical ph ases
....
(14).
This expe ience seems only o ha e led Kjols ad o in ensi y his campaign
o he he apy o sel -co ec ion. In he ollowing yea s he a se e a1
occasions ied o demons a e o he medical associa ion iin he capi al,
wi h he uise o plas e cas s, he e ec s o his cu e. He also go in ouch
wi h he medical associa ion o ha e a commi ee o physicians appoin ed
o e alua e he he apy. The delibe a e in en ion was o a ain a s a emen
om he commi ee o be used a he six h mee ing o he scandina ian
na u e-sci zn is s in
1847,
whe e he once mo e ied o gi e an accoun o
his he apy. On his mee ing Kjols ad dis ibu ed he commi ee's s a emen ,
which was posi i e bu no e y conc e e ega ding he e ec s o he cu e.
Two o he physicians o he commi ee ga e an addi ionial s a emen ,
decla ing ha hey had wi nessed he s aigh ening ou o se e e cases o
cu a u es,. in a deg ee hey had no hough was possible
(15).
I was
p obably mo e impo an , howe e , wi h ega d o he ecogni ion o
Kjols ad, ha i was some o he mos dis inguished physicians in Non ay
ha made hese s a emen s. A he mee ing Kjols ad also dis ibu ed decla a ions
om he o he medical o hopaedis s in Non ay, D . Tidennand and D .
Sal esen, which s a ed ha he he apy was supe io o o he o hopaedic
echniques. In addi ion he demons a ed he e ec s o he cu e wi h he
help o plas e cas s. Acco ding o Kjols ad's own s a emen his lec u e and
exhibi ions a he mee ing was highly accep ed and he a las ob ained he
ecogni ion he had long hoped o
(16).
In he nex yea s Kjols ad was able o con ibu e o some mo e posi i e
(13)
KJ0LSTAD
(1849),
op.
ci .
(n.
2),
p.
49.
(14)
LAACHE
(1911),
op.
ci .
(n.
5),
p.
132.
(15)
KJ@L,STAD
(1849),
op.
ci .
(n.
2),
p.
59.
(16)
Zbidem,
p.
53.
The Fi s S age o he ~is o y o O hopaedics in No way
81
s a emen s abou his he apy and in 1849 he published a book abou his
o hopaedic me hod and heo y, wi h al1 he ad an ageous s a emen s om
o he physicians included. He also go in ouch wi h he medical associa ion
in he capi al o see ha i con inued i s e alua ion o he he apy. The
commi ee's inal s a emen was made in 1852. I decla ed ha he pa ien s
had been ex ended abou one inch lying down and a li le mo e han one
and a hal inch in a s anding posi ion. Rega ding he e ec o he he apy
on he pa ien s gene al heal h he commi ee s a ed ha i see ned o be
e y ad an ageous (1
7).
When Gunde Kjols ad opened his o hopaedic ins i u e in 1838 he was
me in he su oundings by scep icism and suspicion. G adually he a i udes
changed and his me hod achie ed conside able ame as a well sui ed
he apy o he ea men o ~c ookedn. Many o his colleagues and some
o he mos c edi ed physicians in Non ay also decla ed hemsel es in
a ou o he me hod. The p o essional a i udes owa ds Kjols ad's he apy
seem o ha e al e ed ch onological in he ollowing manne :
Pe iod: A i ude:
1838-1842 Scep icism, ejec ion
1843-1 846 Some accep ance
1847-1 85 1 App o al
1852-1860 Rega ded as a supe io he apy
A e he dea h o Kjols ad in 1860 Augus Tidemand was ega ded as
he mos compe en o hopaedis in No way. O o Lund, he chai man o
he medical associa ion in he capi al, spoke o Tidemand as
e...
he pe son
ha wi h us is he g ea es au ho i y in his ma e
...
»
(18). The o hopaedic
ac i i y o Tidemand was discussed se e a1 imes a he mee ings o he
medical associa ion du ing he 60s. I is e iden om he epo s ha his
o hopaedics was gene ally app o ed. On one occasion, howe e , he physician
Joachim
A.
Voss d ew a en ion o he ac ha he acknowledged Danish
o hopaedis
A.
G. D achman had decla ed ha he he apy o sel xo ec ion
was a igmen . D achman had s a ed in a Danish medical jou nal:
(17)
No sk Magazin o Legeuidenskapen,
Fo handlingene (1852),
p.
265.
(18)
LUND,
O.
quo ed in:
No sk Magazin o Lege idenskapen,
Fo handlingene (1867),
p.
176.
88
JALN
FROESTAD
1850-1857: The a angemen o ((con iden ial p incipal» was ex ended o
an ad iso y commi ee wi h some oom o independen ini ia i es
-
p o esso Con adi was appoin ed chai man o hie commi ee,
appoin ed as addi ional membe s we e F ans Ch is ian Faye,
p o esso o medicine and Hen ich S e ens, chie physician.
1858-18'74:
An
o ice o depu y sec e a y wi h medical kniowledge was
ounded in he depa nen o in e na1 a ai s, as head o he
heal h se ice
-
appoin ed was he physician Ch is ian Kie ul ,
he o me sec e a y o he ad iso y commi ee.
In his con ex i is no he g adual s eng hening o he medical
p o essional elemen in he cen al s a e bu eauc acy ha is he mos
in e es ing ea u e, bu he ac i is possible o ela e al1 he physicians ha
was appoin ed o hese o ices o s a emen s o ini ia i es in a ou o
Kjals ad o Tidemand. The p o esso Ca l Wilhelm Boeck pa icipa ed in
he commi ee appoin ed by he medical associa ion o e aluai e he he apy
o Kjols ad, and wi h he physician O o Lund he ga e a e y ad an ageous
supplemen a y s a emen o i s quali ies a he mee ing o he Scandina ian
na u e-scien is s in 1847
(31).
The chie physician Hein ich S e ens assis ed
Kj0ls ad a he mee ing so ha he was able o show a big case o plas e
cas s o illus a e he e ec s o he cu e
(32).
The p o esso Fi ans Ch is ian
Faye also in ol ed himsel in a ou o Kj~ls ad a his mee ing. He pe sonally
eques ed he acknowledged Danish o hopaedisa Johann Ch is ian
A.
Bock
o ca y ou expe imen s o documen he alue o he he apy o Kj0ls ad
(33).
P o esso Con adi was among hose physicians exp essing hemsel es mos
in a ou o he o hopaedics o Tidemand in he 60s.
As
men ioned i was
Con adi who sugges ed o use he au ho i y o he medical associa ion o
ob ain public g an s o he en e p ise o Tidemand
(34).
The physician
Ch is ian Kie ul also in ol ed himsel in his ini ia i e. Kie ul had himsel
a s ong p o essional in e es in o hopaedics. In
1852
he published a
pape on he causes and ea men o he spine cu a u es.
As
will be
(31) KJ0LSTAD (1849),
op.
ci .
(n.
2),
p.
59.
(32)
Zbidem,
pp.
52-53.
.
(33) FAYE, F.
C.
quo ed in:
Fo handlinge ed De Skandina iske Na u o skiwes
5.
M@ e i
1847
(1849). Kabenha n, Gyldendalske Boghandling,
p.
917.
(34)
CONRADI,
A.
C.
quo ed in:
No sk Magazin o Lcegeuidenskapen,
Fo handlingene.
(1863),
p.
101.

The Fi s S age o
he
His o y o O hopaedics in No way 89
elabo a ed la e he in his wo k pic u ed he o hopaedics o Kjols ad as a
supe io he apy (35).
I ollows ha he s a e's inancia1 suppo o he o hopaedics o sel -
co ec ion bo h was ela ed o he ac ha his he apy ob ained he
app o al o he cen al medical milieu in No way and o he ci cums ance
ha leading membe s o his milieu, al1 posi i e in hei a i ude o he
he apy, occupied he posi ions
as
medical expe s o he cen al bu eauc acy
in his ime pe iod. I seems likely ha he a i udes and in ol emen s o
hese p o essionals wi h ega d o he o hopaedic en e p ises o Kjols ad
and Tidemand in a la ge measu e we e conduci e o he ecommenda ion
o he depa men o mee he eques s o public g an s.
6.3.'
The app ecia ions o he clien s and he public
How did he clien s iew he he apy? Reg e able, he e is less in o ma ion
le o h ow ligh on his issue. I has been claimed, howe e , ha he
he apy o sel -co ec ion go a epu a ion among people as a sui able
he apy o he ea men o ~c ookedn (36). The app o al o he cu e
mus be assessed in ela ion o he a ian he apies a ailable o he pa ien s
a he ime. I seems easonable o assume ha he p o ac ed mechanical
p essu e and ex ension- he apy usually mus ha e in ol ed long and hea y
su e ings. I was claimed ha he cu e in many ins ances was inju ious o
heal h.
As
dis inc om his cu e, he he apy o sel -co ec ion en ailed
ha he pa ien s we e allowed o mo e abou and hey we e ins uc ed o
do physical exe cises ha p obably had a a ou able e ec on hei gene al
heal h.
The o hopaedics o Kjols ad, howe e , was no bed o oses. The he apy
equi ed g ea pa ience and enaci y o he pa ien s. Bo h Kjols ad and his
colleagues complained as o how di icul i was o sway he pa ien s o be
su icien ly pe sis en du ing he he apy. Rumou s sp ead on how ough
he cu e was and how s ic he eache could be. In 1856 Kjols ad ound
himsel obliged o make a public p onouncemen s a ing ha he in ended
(35) KIERULF,
C.
T.
(1853). En k i isk F ems illing a de o skjellige Meninge om
Ryg adsk umningens Aa sage og Behandling. No sk Magazin
w
Lcege idaskapen,
Fo handlingene,
p.
87.
(36) Zllus e e Nyhedsblad (1857), n." 30,
p.
152; (1860), n.",
p.
30.
90
JA,N
FROESTAD
o ound an associa ion o elde ly ladies o supe ise he iins i u e. The
s a emen was concluded by he names o
26
ene able ladies o he
bou geois, al1 engaged in social wo k (37). This may indica e ha he
me hod o sel -co ec ion ne e became as popula wi h he public as wi h
he medical p o ession. The a iguous and s enuous ea u es o he he apy
may ha e been a eason o he seemingly dec easing popula i y o he cu e
in he 1870s, as o he mo e pleasu able o ms o physio he apy came in o
ashion.
The gene al imp ession is s ill ha he he apy o sel -co ec ion du ing
he wo decades om abou 1840 ob ained a ecogni ion in No way as a
well sui ed and e en supe io me hod o he cu ing o c ooked spines. In
wha ollows I will emphasize some ci cums ances which may ha e con ibu ed
o his app o al. No a emp will be made o weigh he ela i e signi icance
o he di e en condi ions e ealed, o o ace he ela ions be ween hem.
This would ha e equi ed a mo e heo e ical in o med analysis, which is
no he ai n in his ound.
7.
PREVAILJNG IDEOLOGICAL
TRENDS
The e is an enchan ing a ini y be ween he eaching and heo y o
Kjols ad and he p e ailing ideological ends in No way in he pe iod om
1840 o 1870. In his ime pe iod pie ism a ained hegemony in i-eligious
li e and libe alism beca ne he p e alen economic doc ine. Pie ism emphasized
he signi icance o asce icism as a way o pu i ica ion and sal a ia~n. Analogous,
Kjols ad ega ded com o , indi e ence and i oli y o be ices o g a e
dange o his he apy. He s a ed:
<<As in Di ine, Religious and Mo al li e indi e en ism is he mos cunning
and dange ous Enemy, as well as he e in he o hopaediic li e
...
>>
(38).
The ideology o libe alism s essed he necessi y o dis inguish be ween
he wo hy and he unwo hy in he socie y and 6 es ic he public
commi men . Only he wo hy ough o ha e ce ain igh s o public suppo
and he elie ough p e e ably o be gi en as a way o help pieople o help
hemsel es. The heo e ical basis o he me hod o sel -co ec ion highligh ed
(37) Byminne (1982), n .
1,
p.
6.
(38)
KJ0LSTAD
(1849),.
op.
ci . (n.
2),
p. 9.
The
Fi s
S age
o
he
His o y
o
O hopaedics
in
No way
9
1
he signi icance o he pa ien s own e o and pe sis ence and seems o
ha e been well adjus ed o he p e ailing libe al ideas. Tidemand s a ed:
~Sel -help is he claim o ou ime. In he same manne , howe e ,
as
he
lack o will o help onesel , i his is possible, make he pe son unwo hy
o he suppo o o he s, up igh aspi e o elie e one's own dis ess by
wo k and diligence, cons i u e he essen ial condi ions o p og ess in he
ele an cause. To b ing his p inciple o bea wi hin a b anch o he
p ac ica1 o ien ed medicine, his
was
he idea o ou compai io , he
deceased medical o ice o heal h, Gunde Kjols ad
....
(39).
I seems easonable o assume ha some o he heo e ical e lec ions
o Kjols ad and Tidemand, well adjus ed o he p e ailing ideological
ends, mus ha e had a legi ima ing e ec wi h ega d o hei o hopaedic
ac i i y. I emains o be examined, howe e , i his accommoda ion is
main ained as o he p o essional de elopmen in he same pe iod.
8.
A METAPHYSICAL
THEORY
IN A METAPHYSICAL MILIEU
Gunde Kjols ad's philosophical and pa ly eligious e lec ions was no
accep ed wi hou es ain by he medical p o ession. His lec u e a he
mee ing o na u e-scien is s in
1844
was no ecei ed wi h en husiasm, as
men ioned, because o his endency o philosophical and ma hema ical
exp essions. The gene al imp ession is s ill ha he na u e-philosophical
heo ies o Kjols ad o some ex en was ully accep ed by his colleagues,
o hen ise conside ed as a necessa y elemen o his me hod. The chie
physician O o Lund, la e chai man o he medical associa ion in he
capi al, s a ed in
1842
ha Kjols ad's he apy seemed o be
«...
based on a
mo e accu a e unde s anding abou he p inciples o he ea men o
spine cu a u es
...
D
(40).
The co ps physician Tho ald We lesen s a ed a
abou he same ime ha he me hod
c...
seems o be based on a comp ehension
o he ac ual cha ac e o he c ooked spine
...n
(41).
A
medical p ize pape on he di e en opinions o he causes and
(39)
TIDEMAND
(1876),
op.
ci .
(n. 3),
p.
1.
(40)
LUND,
O.
quo ed in:
Ugesk i o Medicin og Phamzacie
(1842), n.90.
(41) We lesen,
T.
quo ed in:
KJ0LSTAD
(1849),
op.
ci .
(n.
2),
p.
49.
92
JAN
FROESTAD
ea men o he spine cu a u e was published in No way i 1
1852
by he
physician Ch is ian Tho ald Kie ul . I is likely ha he accoun was based
o some ex en on he expe iences o Kie ul as a my su geon in he wa
be ween Denma k and Ge many in
1848
and as su geon a he' ield
hospi al in Augus enbo g du ing he a mis ice. In his desc ip ion Kie ul
ep esen ed he o hopaedic me hod o Kjols ad as a supe io he apy.
Rega ding Kjds ad's philosophical and eligious e lec ions IKie ul s a ed:
«l seems o me ha a lo o his has o be a pa o his me hod and no
wi hou ha m can be sepa a ed om
i
...
al1
his mys ical speech ha he
in ensely imp esses his pupils, make hei whole spi i o ien ed on him
and as
a
esul hey keep hei minds on he eachings, emembe he
pu pose and ne e o ge he sel -s aigh ening
...a
(42).
Kie ul ob iously did io ega d Kjds ad's e lec ions as en i ely scien i ic
alid, bu conside ed hem al1 he same as an essen ial he apeu ic measu e,
and as a well sui ed me hod o e oke he spi i ual o ce o he pa ien .
The essen ial ideas o Kj~ls ad, on which he based his o hopaedic
me hod, he concep ion o an in ima e link be ween he mind and he
body and he idea o he signi icance o ac i a e he spi i ual-physical o ce
o he pa ien , seem o he mos pa o ha e been accep ed by he medical
p o ession in No way, and by many acknowledged physicians conside ed as
he one igh p inciple o he cu e o he spine cu a u e.
This app o al is easie o unde s and i i is ealized ha al hough
medicine a he middle o he p e ious cen u y had aken a s ep owa ds
an empi ical based science, many o he adi ional me :aphysical and
na u e-philosophical e lec ions su i ed and con inued o cons i u e he
base o many he apies. The new scien i ic o ien a ion did no gi e as
p o i s in he o m o new and mo e e icien he apies. The mode n,
empi ical based medicin was o a long ime cha ac e ized by biological
basic scien i ic esea ch wi hin he ields o ana omy, physiology and pa hology,
while mos o he medical cu e was s ill based on he classical, holis ic
eachings o he ~iddle Ages, ega ding illness
as
a esul o an in e mp ion o
he liquid balance o he human body. The e a e some enchani ing simila i ies
be ween his eaching and Kjols ad's own e lec ions o he spine cu a u e,
ega ding i
as
a esul o an une en di ision o he bending and s aigh ening
(42)
KIERULF
(1853),
op.
ci .
(n.
35),
p.
91.
The Fi s S age o he His o y o O hopaedics
in
No way
93
o ces in he human body,' emphasizing he signi icance o he uni y o
mind and body in he he apy. One eason ha his heo y and me hod did
no mee wi h mo e esis ance may be ela ed o he ac ha i 'ma ched
nicely o some undamen al, hough maybe eceding, pe spec i es on heal h,
illness and ea men .
In he No wegian medical milieu many o he adi ional concep ions
was s ill iable, among hem he common assump ion o
cons i u io epidemica
-
he idea ha unknown a mosphe ic o ces had g ea in luence on he
sp eading o epidemic diseases
-,
o he p esump ion ha i was possible
o ans e illness om human beings o animals, no o men ion he ai h
o many ecognized physicians in a lo o di e en healing emedies like
ings and oin men s agains a h i is
(43).
This indica es ha he dis inc ion
be ween o mal medicin and he quacke y was no e y sha p in he middle
o he nine een h cen u y. Agains his backg ound i is easie o comp ehend
why he heo e ical e lec ions o Kjds ad did no gi e ise o eage objec ions.
Fo a medical milieu ha s ill had s ong links o na u e-philosophical
concep ions i was no ha d o accep a new he apy based on simila
e lec ions.
9.
THE
NEW
IAG'ORTANCIE
ATTACHELI
TO PHYSICAL EDUCATZON
Du ing he nine een h cen u y people's a i udes owa ds he body and
he impo ance hey a ached o he heal h o he body expe ienced a
ma ked change. As a esul o he in e ac ion o a numbe o social o ces
he socie y's p ejudice iewing he body wi h a lo o con emp and suspicion,
was shaken. The al e a ion o hese a i udes has been seen in ela ion o
such a ious ci cums ances
as
he new doc ine o man and na u e p opounded
by Spence and Da win, he di usion and popula iza ion o he new insigh
in o he medical ields o pa hology and physiology, he new inqui es in o
he li ing condi ions and physical su e ings o he wo king classes and, in
some coun ies, he pa icula in e es o he s a e o ha e mili a y ec ui s
o s ong physique
(44).
(43) GR@N,
F.
(1933). De no ske medin'nske selskap 1833-1933,
Oslo, S eenske Bog ykke i
Johannes Bjo ns ad A/S,
pp.
60-92.
(44) CRUNDEN, C. (1981).
The concep
o
he body.
Zn: MCNAIR,
D.;
PARRY,
N.
A.,
Readings in he His o~y
o
Physical Educa ion,
Hambu g, Ve lag Ing id Czwalina.

94
JAN
FROESTAD
Simul aneously o hese changes in he concep ions o heal h and body,
a new a i ude owa d he impo ance o physical educa ion de eloped. A
clea indica ion o his al e a ion is he in oduc ion o gymnas ics in he
schools. In No way, du ing he en i e cen u y, he eache s o physical
aining was ec ui ed almos exclusi ely om he non-commissioned o ice s
o he mili a y.
As
ea ly as 1805 he co ps o chasseu s sen an o ice o he
mili a y ins i u e o gy nnas ics in Copenhagen. No un il he 1850s, howe e ,
was physical aining in oduced a he p ima y schools in he owns, wen y
o hi y yea s la e a he schools in he coun y. A he colleges o
educa ion gymnas ics we e in oduced du ing he 1860s. lle e oo, he
eache s we e o ice s o he mili a y. In 1861 he «Cen al associa ion o
he sp eading o physical exe cises and he use o a ms» was ounded. This
o ganiza ion ook a leading ole in he p omo ion o physical educa ion in
No way, bo h a schools and in o he ins i u ions. In 18'70 he «Cen al
Public School o Gy nnas ics~ o he educa ion o eache s o physical
aining was ounded in he capi al.
Kjols ad in oduced his a ian o physio he apy in a ime pe iod
dis inguished by a adical al e a ion o he popula a i udes owa ds he
body and he heal h o he body. Th oughou he cen u y lie impo ance
o physical aining and a hle ics o heal h easons was payed a en ion o
an inc easing ex en . I seems likely ha his de elopmen o e ed a ou able
condi ions o medical he apies emphasizing he signi icance o mo emen s
o he p e en ion and cu e o diseases and de o mi ies.
In espec o women's pa icipa ion in spo and phj~sicai aining,
objec ions was aised in No way as in o he coun ies ha his would be
inju ious o heal h o ha i was he an i hesis o womanhood. The Non egian
o hopaedis s claimed, howe e , ha he me hod o sel -co ec ion showed
unique quali ies e en in his ield. D . Sal esen, he o me s uden and
assis an o Kjols ad, s a ed:
«The objec ion ha e been aised o gymnas ics ha i is imp ope o
young gi ls, unwomanly and des uc i e o he emale ideal in beau y.
This objec ion, howe e , does no a al1 apply o he gymnas ic me hod
in en ed by Kjols ad. This me hod ough ;in my opinion, 1:o be in oduced
in e e y school o gi ls
...
(45).
(45)
SALVESEN
(1855),
op.
ci .
(n.
3),
p.
317.
The Fi s S age o he His o y o O hopaedics in No way
95
I seems likely ha he new a en ion payed o physical educa ion
con ibu ed o he app o al ob ained by Kjols ad. Wi h ega d o he
mili a y physical aining, howe e , i is possible o es ablish a mo e speci ic
ela ion o his he apy.
In his pe iod o s udy Gunde Kjals ad was appoin ed squad on su geon
a he co ps in he dis ic o Telema k. This o ice he hold o one and a
hal yea pos ed in K is iansand, pa icipa ing also in he camp o Swedish
and No wegian oops in Skine in 1824. In 1828 he was appoin ed co ps
physician a he muske ee co ps o he dis ic o Hedema k, un il he in
1836 was appoin ed medical o ice o heal h o he sou he n dis ic o
Gudb andsdalen.
Kjols ad had, as many o his colleagues, a mili a y ca ee be o e he
se led o a ci ilian o ice. I is mos likely ha he was in luenced by he
mili a y physical educa ion when he began o de elop his o hopaedic
me hod, in pa icula by he mili a y keep- i exe cises. This gymnas ics had
a Iong adi ion and, acco ding o an ins uc ion book om 1872 he
in en ion was
«...
o de elop and s eng hen he Soldie s limbs and inc ease
his con ol o e hem
...»
(46). The e a e some allu ing simila i ies be ween
he he apy o sel -co ec ion and some o he e lec ions he mili a y
gy nnas ics was based on, as indica ed by he ollowing quo a ion om he
ins uc ion book:
«...
by he con ac ion o i he muscle is exe ed, and by epe i ion
o
.
-
his exe cise expe ience is gained, he muscle is s eng hened and i is
b ough unde he con ol o will
...
(47).
Wi hin he me hod o Kjals ad i was he oo -walk, he mos essen ial
pa o he he apy, ha mos clea ly indica ed he connec ion o he
physical d il1 o he mili a y. The oo -walk was a anged as an o ganized
o m o exe cise whe e he pa ien s we e di ided in o wo ows and mo ed
hemsel es unde he o de s o he he apis .
As
he o hopaedis sounded
he numbe «one» bo h ows o pa ien s aised hei heels as high as
possible and s ood ip oe un il he numbe « wo» was sounded. Now he
pa ien s mo ed hei igh oo o wa d and down a heel.
As
he numbe
Nonen once mo e was sounded he pa ien s again had o aise hei heels
(46)
Ins uk ion i Gymnas ik og Bajone eg ning
o
In an e ie
(1872),
Ch is iania,
p.
1.
(47)
Ibidem,
p.
5.
96
JAN
FROESTAD
and s and ip oe un il hey now mo ed hei le oo on a d and down a
heel as he numbe ~ wo. was sounded, and so on
(48).
Mili a y backg ound was no , howe e , some hing ha dis inguished
he ca ee o Kjols ad. In he i s hal o he nine een h ceil u y mos o
he medical p ac i ione s in Non ay we e employed by he mili a y o a
sho e o longe pa o hei p o essional ca ee . In he 1830s abou one
hi d o he physicians had mili a y appoin men s
(49).
The e is eason o
belie e ha his common expe ience wi h he mili a y physical educa ion
cons i u ed an addi ional ac o con ibu ing o he app o al o Kj~ls ad.
10.
THE
MUSCULAR THEORY
In he las decades o he eigh een h cen u y specialize i o hopaedic
ins i u es we e es ablished in se e a1 o he con inen al ci ies. In he i s
phase o his de elopmen o o hopaedics as a dis inc he apeu ic ield,
he assump ion was ha acciden s like alls and blows o , mo e common,
poo depo men when walking o si ing, we e he p incipal causes o he
spine cu a u es. Pos u a1 aul s, one assumed, could en ail ha some
g oups o muscles con ac ed, wi h a w yness o he spine as he ine i able
esul . S e ch-bandages, p essu e-co se s, li e- and b eas -bel s we e
co espondingly conside ed o be sui able co ec ing emedies.
A eae ion o his assump ion de eloped wi hin he nex decade. In
some o bopaedic milieus he p esump ion gained
con iden e
ha i was
diseases in he bones and he so ness o he bones ha caused he c ooked
spines. Acco ding o his heo y he use o s e ch-bandages and li e bel s
could a ec he bone s uc u e and gi e ise o w yness.
As
a esul he
he apy inc easingly ook he o m o uea men by long lasl ing ho izon al
bed es , usually combined wi h p essu e and ex ension o he body. G adually
his became he dominan cu e a mos o hopaedic ins i il es, a he apy
o en u ilized o se e a1 yea s and as he only emedy o s aigh en ou he
spine. The cons an use o he bed es , howe e , had a e y bad in luence
on he pa ien s gene al heal h. The o hopaedis s ied ol emedy hese
de ec s by di e en he apeu ical adap a ions like he supine posi ion on
(48)
Fo handlinge ed De Skandina iske Na u oo ske es
7.
M0 e i Ch is iania i
1856
(1857).
Ch is iania, Ca l C. We ne
&
Comp.,
p.
466.
(49)
LARSEN; BERG; HODNE
(1986),
op. ci .
(n. 29),
p.
350.
The Fi s S age o he His o- o O hopaedics in No way
97
an inclined plane o on a plane ha could be swi ched be ween a ho izon-
al and a mo e e ical posi ion.
The o hopaedic ield in he eigh een h and nine een h cen u y was
cha ac e ized by many di e en heo ies and schools o hough and by an
o en bi e and las ing con lic be ween he di e en milieus. The a ious
he apies seem, howe e , o ha e been guided by one o wo basic
conside a ions. The bed es , combined wi h p essu e and ex ensionde ices,
was pa icula ly u ilized by hose who sough he causes o he spine
cu a u e in he bones and e eb as o he body. Ri al milieus ook o a
g ea e ex en he muscula sys em o he body as hei basis. I had been
no iced ha mos o he c ooked spines was ben on a d o he igh . This
obse a ion led o he de elopmen o a heo y ha he spine was easily
a ec ed i an une en muscula o ce ac ed on i . I was known ha he
muscles on he igh side o he body usually a e suonge and mo e
ad anced. I was hus supposed ha he muscles on he conca e side o he
cu a u e had de ea ed i s le ad e sa ies and con ac ed. The muscles on
he con ex side o he cu a u e had been ex ended co espondingly and
had los much o hei o ce. This heo y legi imized he de elopmen o
he apies ha emphasized he signi icance o es o ing he muscula balan-
ce o he body.
l
In
1828
he acknowledged F ench o hopaedis Jaques Ma hieu Delpech
published a wo k whe e he ejec ed he long and con inuous bed es and
in oduced gymnas ics and ba h as means o s eng hen he weakened
muscles o he pa ien s. In sho ime physical exe cises we e in oduced as
a p e en a i e emedy a mos o hopaedic ins i u es. G adually his led o
he de elopmen o mo e specialized o hopaedic gy nnas ics, o which he
physio he apy o Phe Hen ik Ling in Sweden became he mos amous.
The in ension o his he apy was, by he execu ion o accu a e physical
exe cises, o s eng hen speci ic g oups o muscles in such a way ha hey
could coun e ac he o ce o he opposi e muscles and d aw he spine in o
a na u al posi ion. When he physicians in Non ay du ing he second o
hi d decade o he nine een h cen u y began o ake an in e es in he
o hopaedics, i was he muscula heo y ha had caugh he wind. Gymnas ics
had al eady been in oduced as a he apeu ic o p e en i e emedy a mos
o hopaedic ins i u es.
One o he i s medical p ac i ione s in Non ay ha ook an in e es
in he spine cu a u e and i s ea men was Ch is en Heibe g. Heibe g
104
JAN
FROESTAD
died ha d, bu had g adcially o gi e way o ano he pe spec i e which in
i s di e en a ian s emphasized he congeni al weakliness o gi ls and
hei un a ou able upb inging.
Kjols ad himsel seldom exp essed his opinion ega ding he speci ic
causes o he c ooked spine.
A
s a emen he made in 1856, howe e ,
indica e ha he wen a owa ds accep ing he heo y o€ he emale
weakliness. Wi h ega d o he weakening o he spine he s a ed ha i
o en seemed o be he e ec o eyoung gi ls long and unsc upulous si ing
a school, imposed bo h he e and a home wi h oo much in ellec ual wo k
and needlewo k in p opo ion o hei age and sex
...*
(64).
Kjols ad's assis an , D . Sal esen, exp essed himsel in a simila manne :
..
.
how easy he one-sided s i e o he ende gi ls in ellec ual educa ion
is done a he expense o he physical heal h and due o his b eak down
he igu e
...
»
(65).
The heo y o he emale weakliness combined wi h o much seden a y
wo k as a main cause o he c ooked spine seems g adiially o ha e been
accep ed by mos o hopaedic and medical milieus. Rega ding he mos
p e alen cu a u es o he spine Ch is ian Kie ul s a ed i,n 1852, wi h
e e ence o he expe iences a he o hopaedic ins i u e a Tubo g in
Denma k:
N,..
no mally, in ac almos wi hou excep ion, i has a deepe
cause and ha is weakliness
...
»
(66). Rega ding he e olu ion o scoliosis
in hese ende gi ls he claimed ha i mos o en could be obse ed ha
« he cu a u e e ol es a he ime when hei schooling is mos exhaus ing
...
>>
(67).
A
decade la e he acknowledged Danish medical o hopaedis
A.
D achmamn exp essed a simila opinion as he s a ed wi h egai d o scoliosis:
«...
i inju es almos exclusi ely sligh , pale, lean and weak gi ls and mos
o en du ing he phase o as physical g ow h
...»
(68). In espec o he
social dis ibu ion o scoliosis he o hopaedis claimed:
(64) KJQLSTAD,
G.
(1857). En nze me e Fo kla ing .o e Sel e ningsme hoden, end
hid il e gi e gjennem de sk i lige og yk e O d.
In: Fo handlinge ed De Skandina iske
Na u o ske es
7.
M0 e i Ch is iania
1856,
Ch is iania, Ca l C. We ne
,Se
Comp., p. 450.
(65) SALVESEN (1855),
op.
ci .
(n. 3),
p.
317.
(66) KIERULF (1853),
op.
ci .
(n. 35),
p.
781.
(67)
Ibidem,
p.
11.
(68)
DRACHMANN,
A.
quo ed in:
Biblio hek o Lczge
(1861), p.
,95.

The
Fi s
S age
o
he
His o y
o
O hopaedics
in
No way
1
O5
«I
exis s
p incipally as a cul u al disease in la ge places and among he
well- o-do classes ha educa e hei child en in a so manne and keep
hem
o eaching and long seden a y wo k
a
an ea ly age
....
(69).
This e iew indica es a a ou able ela ion be ween he heo y o he
emale weakliness, he he apy o sel -co ec ion and he g owing ambi ions
o he medical p o ession a he middle o he nine een h cen u y. The
o hopaedics o Gunde Kjols ad became a ac i e no only because o i s
sui abili y o p e alen ideological and heo e ical ends bu as well owing
o he ac ha he me hod, in a pe iod whe e he medical p o ession had
he ambi ion o asse i sel in new ields, could be used as a p ophylac ic,
as con as wi h he mechanical he apy.
Kjols ad had he ision ha he he apy o sel -co ec ion ough be
made gene al, i ough in his opinion o become an essen ial pa o
educa ion, bo h in he amily and a school. In ha case Kjols ad had he
con ic ion ha .al1 cu a u es like al1 powe lessness, weakliness, sickliness
and a lo o speci ic diseases will anish om ea h
...w
(70).
Wi hin he medical associa ion ques ions ela ing o school hygiene
we e subjec s o discussion, pa icula ly in he 1830s and 1860s. In 1835 he
No wegian p o esso F ede ik Hols claimed ha he schools o gi ls had
an inju ing e ec on he pupils heal h and pu o wa d as e idence he ac
ha he pupils we e less o g ow h han gi ls ha did no a end school. He
a gued ha he physicians ough o in ol e hemsel es in his ma e (71).
The he apy o sel co ec ion did no only ha e a po en ial
as
a p ophylac ic,
he No wegian o hopaedis s ook conc e e ini ia i es in ha di ec ion. In
1849 he o me assis an o Kjols ad, D . Sal esen, in oduced a p e en a i e
physio he apy o young gi ls a his ins i u e in Be gen. Mos o he gi ls,
bu no al1 o hem, su e ed om small cu a u es. In coope a ion wi h he
heologian Dahl he also succeeded o b ing in physical exe cises o sel -
co ec ion a he la ges school o gi ls in he own
(72).
Kjols ad, on his
side, ga e o hopaedic cu e by he hou , chie ly wi h a p e en a i e adap a ion,
designed o pa ien wi h small o incipien cu a u es (73).
(69)
Zbidem.
(70)
KJ0LSTAD
(1849),
op.
ci .
(n. 2),
p.
9.
(71)
GR0N
(1933),
op.
ci .
(n.
43),
p.
54.
(72)
SALVESEN
(1855),
op.
ci .
(n.
3),
pp.
316-318.
(73)
KJDLSTAD
(1849),
op. ci .
(n. 2),
p.
11.
106
JAN
FROESTAD
The g owing in e es o he physicians in Non ay in school hygiene, he
ocus o he heo y o emale weakliness on he un a ou able e ec s o
p o ac ed school a endance and he appa en p e en a i e quali ies o
he me hod o sel -co ec ion, i seems likely ha he combina ion o hese
ci cums ances con ibu ed o he acknowledgemen ha Gunde Kjols ad
ob ained. I ollows ha he a ac ion o his o hopaedics maly be ela ed
bo h o he wish o he physicians o ein o ce hei con ol o his he apeu ic
ield and o he g owing ambi ions o he medical p o ession o expand he
ield o ac i i y and socie al in luence o he occupa ion.
13.
THE
EFFICACY
OF
THE THEWY
In 1897 he acknowledged Ge man o hopaedic su geon Albe Ho a
s a ed: «In my opinion, he p oblem o he ea men o scoliosis is he
main p oblem o he o hopaedics o he u u e
...
»
(74). He seems o ha e
been igh . Mo e han i y yea s la e he English o hopaedis Osmund-
Cla k s a ed: ~Scoliosis is ema kable o he s ubbo nness wi h which
h oughou he ages his de o mi y has de ied explana ion
...
D
(75). In 1981
he h ee ecognised A ne ican o hopaedis s T. Taylo ,
P.
Gosh and G.
Bushell, decla ed:
«I is eg e able ha he las wo decades ha e no seen a single majo
ad ance in he ea men o scoliosis based on a scien i ic unde s anding
o he ae iology and mechanisms o cu e p og ession
...
(76).
The ea men o scoliosis seem o he bulk o he wen ie h cen u y o ha e
been cha ac enzed by a sho age o scien i ic knowledge and a non-a ailabili y
o a ai ly eliable he apy. The e is no eason o belie e ha his si ua ion was
any mo e ad an ageous in he middle o he p e ious cen u y.
A he middle o he nine een h cen u y, howe e , o mal medicine was
on
he de ensi e no only wi h ega d o he ea men o scoliosis. I has
been claimed ha he con idence in he physicians in No way, du ing he
i s hal o he p e ious cen u y was impai ed' and ha la ge pa s o he
(74)
LE
VAY,
D.
(1990).
The His o y
o
O hopaedics,
London, The Pa henon Publishing
G oup L d., p.
529.
(75)
Zbidem.
(76)
'
Zbidem.
The Fi s S age o he His o y o O hopaedics in No way
107
popula ion a he consul ed he quacks. A he middle o he cen u y he
medical p o ession seems o ha e had
zi
lowe s a us han e e be o e (77).
.
.
I may be assumed ha he ecogni ion ha Kjols ad and his o hopaedic
colleagues ob ained o some ex en was ied up wi h he e ec s o hei
he apy. The e alua ion o Kjols ad's ac i i y by o he physicians ga e, as
men ioned, a a ou able esul . Bo h his wo colleagues ha alued he
me hod in 1842 and he commi ee appoin ed by he medical associa ion
in he capi al, which made i s inal s a emen en yea s la e , spoke in
a ou o he he apy. Acco ding o he es ima ions o Tidemand, abou
20% o he app oxima e 200 pa ien s su e ing om spine-cu a u es he
ea ed in he pe iod om 1866 o 1874 we e cu ed o nea ly cu ed,
ano he 60% we e imp o ed, while
5%
did no bene i om he he apy.
Wi h espec o he emaining 15% he esul s we e unce ain o he
pa ien s we e no measu ed (78). This assessmen co espond in he main
o he e alua ions o he p ac ices o Kjols ad and Sal esen.
I is no easy oday o eckon he alidi y o hese nine een h cen u y
e alua ions. I seems, howe e , ha he physicians o en payed se ious
a en ion as o he p ope way o accomplish exac measu es. The commi ee
o he medical associa ion s a ed:
<<We soon ealised how e y di icul i is o ob ain a ixed and accu a e
concep ion o , and o con ol he al e a ions, ha he spine unde goes
by o hopaedic ea men . Se e a1 me hods we e ied
...
We came o he
conclusion o use plas e cas s o he spine, and i was decided o ake a
cas o each pa ien a he in ake and discha ge
...),
(79).
Employing his me hod he commi ee concluded, as men ioned, ha
he pa ien s had been ex ended an inch o an inch and a hal on he
a e age, dependen on we he he measu es we e done while he pa ien s
we e s anding o lying down. I hese measu es and e alua ions a e c edi ed
i is indica ed ha he e ec o he ea men was a ou able. O no doub ,
howe e , he medical milieu in Non ay did c edi hese alua ions and
g adually came o conside he he apy o be bo h e icien and supe io .
(77) REICHBORN-KJENNERUD,
1.;
GRaN, F.; KOBRO, R. (1936).
Medicinens his mie i
No ge,
Oslo, G ondahl
&
S~ns Fo lag,
p.
125.
(78) TIDEMAND (1876),
op.
ci .
(n.
3),
Be e ning om ans al ens i ksomhe a 1-11-1866
i1
31-12-1874,
pp.
16-20.
(79)
No sk Magazin
o
Lage idenskapen,
Fo handlingene (1852),
p.
263.
108
JAN
FROESTAD
The app o al o he me hod o sel -co ec ion, howe e , mus be seen
in ela ion o he o he a ailable he apies a he ime. I is indica ed ha
he physicians expe ienced ha hey had ew emedies o sugges when
aced wi h pa ien s su e ing om spine cu a u es. The physician Wilhelm
Boeck s a ed in oc obe 1862:
N...
we a e in ou p ac ice badly o wi h ega d o he ea men o spine
cu a u es, and no many ha e he oppo uni y o send hei child en o
he expensi e ins i u es ab oad
...
(80).
Mo eo e , he con idence in hese ins i u es had been impai ed due o
he un a ou able e ec s o he p o ac ed, bed- idden mechanical ex ension
he apy. As men ioned, Ch is ian Kie ul claimed in 1852 l-ia he young
gi ls o en e u ned o i hese ins i u es wi h a b oken heal h.
A leas un il he second hal o he 1870s he medical p o ession, o a
any a e he uni e si y eache s and he physicians in he capi al, ega ded
he o hopaedics o Kjols ad as supe io no only in compa ison wi h he
mechanical cu e, bu also as compa ed wi h o he ea men s like he
Swedish physio he apy. The physician Joachim
A.
Voss exp essed a one o
he mee ing o he medical associa ion in 1862 ha he hough i un o una e
ha Tidemand had been compelled o close his ins i u e, andl s a ed:
N...
as
a empo a y expedien wle now ha e o e e he pa ien s o ~physio he apy
o o he ea men by ellec i ica ion a he hospi al
...,,
(81:).
An
ins i u e o physio he apy was opened in he capi al in 1867 by he
physician Tycho
D.
Lange. The discussions a he mee ings o he medical
associa ion indica e, howe e , ha he me hod o sel -s aigh ening had a
highe s a us a leas un il he second hal o he 1870s. Lange epea edly
complained ha his colleagues did no show an in e es in his wo k and did
no e e pa ien s o him ha would bene i om physio he apy. Wi hou
doub , he he apy o sel -co ec ion was by a he mos c edi ed o hopaedic
he apy i n Non ay in his ime pe iod.
The app o al o he he apy mus also be assessed in ela ion o he
gene al cu a i e abili y o o mal medicine in he p e ious ce i u y. I ough
(80)
BOECK,
W.
quo ed in:
No sk Maga in o L egeuidenskapen,
Fo handlingene
(1863),
p.
.
100.
(81)
Zbidem.
The Fi s S age o he His o y o O hopaedics in No way
109
o be emembe ed, in his connec ion, ha un il he las decades o he
cen u y he physicians had no o e y dubious emedies o sugges agains
he mos common su e ings domina ing e e y medical p ac ice, he in ec ious
diseases (82). Many o he he apies p esc ibed by he physicians we e s ill
o an essen ial deg ee based on he classic, holis ic eachings o he Middle
Ages, and he e ec s o hei ea men we e usually sligh . The peasan s
did no no mally seek hei se ices. Fo mal medicine was no emp a ion
owing o i s e icacy and i igh ened mos people due o he cul u al
di e ences be ween he physicians and he public. Ins ead, hey consul ed
he local quacks, whom hey us ed. I has been claimed ha he physicians
had o be pushed he people by public o ices and laws agains quacke y
(83).
The peasan s ough his policy and succeeded in 1871 o libe alize he
qiiack-law.
Agains his backg ound i is easie o comp ehend ha he physicians,
especially he uni e si y eache s and he physicians p ac ising in he capi-
al who we e leas easonable owa ds he quacks, came o app o e he
o hopaedics o Kj0ls ad. In he i s place, i is no wonde ha he physicians
app ecia ed
an
a emp o in oduce a new medical ac i i y, p e iously domina ed
by lay nen. In addi ion, i is no unlikely ha he he apy o Kj0ls ad was a hi ,
compa ed o mos o he medical wo k in he p e ious cen u y. I is qui e
plausible ha he me hod o sel co ec ion, a e some p elimina y p oblems,
came o be conside ed by he medical p o ession
as
a g ea success,
as
one o
ew oppo uni ies o imp o e he s a us o he occupa ion.
14.
THE
SOCIAL COMPOSITION OF
THE
CLIENTELE
In he pe iod om 1847 o 1850 h ee o hopaedic ins i u es we e in
ope a ion in No way, al1 p ac ising he me hod o Kjols ad. Thi y o o y
pa ien s we e ea ed a he same ime. The ma le o o hopaedic ins i u ional
ea men was, howe e , e y es ic ed a leas un il he 1870s. This made
i di icul o main ain he ins i u es. D . Sal esen, he o me assis an o
Kjols ad, s a ed ha he ea men was o en b oken o oo ea ly, pa ly
because o he impa ience o he pa ien s, bu as o en due o he limi ed
(82) EVANG,
K.
(1955).
Helses elle s
u ikling i No ge i 75 i ,
i.
Tidssknj o
da
no ske
l~gejiiening
p.
53.
(83) BERG (1973),
op.
ci .
(n.
62),
p.
39.

110
JAN FROESTAD
will o abili y o he ela i es o pay he expenses (84). To cushion hese
ci cums ances bo h Sal esen and Kjols ad we e in many ins ances o ced o
educe he egula ed ee. Kjols ad s a ed:
((Economic condi ions and o he ci cums ances has made i impossible
o many o make use o he o dina y cu e
...
in No way he money ha e
a oo es aining e ec on he o hopaedics
...
a mo e would ha e been
s aigh ened i no he lack o money had p e en ed a longe cu e
...
>)
(85).
In spi e o some pilblic g an he main enance o he o hopaedic
ins i u es in Non ay was chie ly based on he ees om he loa ien s. Only
a ew places a he ins i iu es we e ese ed o pa ien s o limi ed means.
In he 60s, a Tidemand's ins i u e he paymen o he boa di was 48
N
k .,
a mon h, he washing o clo hes no included. The cos o he ea men
was
32
N
k . a mon h. I dec eased o some ex en , howe e , i he cu e
las ed mo e han hal a yea
(86).
I is highly p obable ha hie he apy was
conside ably cheape han he ea lie p ac ice o send hie pa ien s o
ecognised ins i u es ab oad. Ne e heless, a cu e a he ins ii u e was bo h
long las ing and expensi e. A ha ime he sala y o eache s a he boa d
schools in Be gen was abou 1
.O00 N k . annually, a male eleg aph ope a o
had an ini ial annual sala y o 1.000 o 1.200 N k ., unskilled wo ke s mos
ce ainly we e payed a less (87). I may be assumed, wi hou much doub ,
ha he cu e a he o hopaedic ins i u es mus ha e been a oo expensi e
o mos people. I is likely ha he clien basis was mainly cons i u ed by
pa ien s om well- o-do amilies. This es ic ed he ma ke o o hopaedic
p ac ice. X is plausible, howe e , ha his in lux o a high s a us clien ele
accoun s o some o he acknowledgemen ha he o hopaedic ins i u es
ob ained.
The p o essional app o al o he he apy o sel -co ec ion has now
been assessed bo h wi h ega d o i s appa en he apeu ic quali ies and he
social composi ion o he clien ele. I s ill emains, howe e , o conside
how he ecogni ion was ied o he shaping o he ela io i be ween he
(84) SALVESEN (1855),
op. ci .
(n.
3),
p.
159.
(85) KJOLSTAD (1849),
'op. ci .
(n. 2),
pp.
11, 49-50.
(86)
Byminne
(1982), n.* 1,
p.
10.
(87) HAGEMANN,
G.
(1992).
Skole olk. Lme nes his o ie i No ge,
Oslo, Ad IlJo am Gyldendal
a.s.,
p.
50.
The Fi s S age o he His o y o O hopaedics in No way
11
1
he apis and he pa ien , as a consequence o some ema kable ea u es o
he me hod.
15.
THE RELATION TO THE CLIENTS
The physicians had, as men ioned, undoub edly an ambi ion o b ing
he o hopaedic ield back unde he con ol o o mal medicine. They had
oiced se e e c i icism agains he o hopaedic ins i u es, led by laymen. I
may be assumed, howe e , ha i he physicians had engaged hemsel es in
his ield wi hou being able o show good esul s, he s a us o he occupa ion
could easily ha e been u he educed. Fo una ely, in his espec , he
me hod o sel -co ec ion exhibi ed ano he sympa he ic ea u e. I al e ed
he ela ion be ween he pa ien and he he apis in a a ou able di ec ion.
I is e y much o he poin ha Kpls ad ansla ed he wo d ~o hopaedics~
as ~ igh educa iom (88). Wi h ega d o .he he apy he s a ed:
«...
i 's
whole cu a i e abili y and i s healing o mind and body is based exclusi ely
on ins uc ion, eaching, con ic ion and imp o emen , bo h mo ally and
in ellec ually
...
»
(89).
Thus Kj~ls ad decla ed:
M...
he exe cise o my o hopaedics is ied o
eaching in an insepa able manne
...
»
(90). He de ined his medical wo k
in a pedagogical, o some ex en also in a heological, di ec ion. The
pa ien was assigned an ac i e ole in he he apy. The cu e was desc ibed
as a me hod o each he pa ien o heal himsel . The ole o he he apis
was depic ed as o each he pa ien he quali y o he cu a u e and how
i was sus ained, and wha he pa ien could do o coun e ac i . The e ec s
o he cu e, howe e , Kj~ls ad ega ded as di ec ly condi ioned by he
pe sis ence, pa ience and s eng h o will o he pa ien .
In case o he passi e ea men wi h mechanical p essu e and ex ension
de ices he pa ien could ha dly be blamed i he esul s o a long las ing
and expensi e cu e e11 sho o he expec a ions. The c i icism was in ha
e en le elled a he he apis o he owne o he o hopaedic ins i u e.
The me hod o sel -co ec ion al e ed his ci cums ance in a signi ican
(88)
KJ0LSTAD
(1849),
o@.
ci .
(n.
2),
p.
10.
(89)
Ibidem.
(90)
Ibidem,
p.
13.
112
JAN FROESTAD
manne . The me hod implica ed ha he pa ien o a la ge exi en could be
hold esponsible o he esul s o he cu e. I he e ec s o he ea men
did no mee he expec a ions o i , his could be explained as he esul
o
a
weakness o he pa ien s pe sis ence, e o o mo al. Tidemand s a ed:
~The e ec s o he cu e a e essen ially dependen on he e o s o he
pa ien , o he ex en ha he ai h ul and ha d-wo king may a ain
g ea e p og ess in a ce ain pe iod o ime, han he lazy and ca eless
may ne e gain
...
(91).
,
In his manne he ne hod o sel -co ec ion ook he s ing ou o
c i icism. Xn a way he he apy was ximmunizedn. Al1 a ou able e ec s
could be a ibu ed he quali ies o he he apy, al1 un a ou able esul s
asc ibed o he pa ien . Rega ding he need o he medical p o ession o
imp o e i s s a us, his mus ha e been a sympa he ic ea u e.
My in e es in his s o y
was
a oused by he obse a ion ha he o hopaedics
o sel -co ec ion ob ained a high deg ee o app o al in No way in he ime
pe iod om 1840 un il he second hal o he 1870s, in pa icula by he
medical p o ession. This acknowledgemen seemed in he i s ound
as onishing, bo h in espec o he peculia , almos «impene ablle» heo e ical
basis o he cu e and wi h ega d o he p ac ica1 accomplishmen o he
he apy, lhe slow, cu ious « oo walk» and he me hod o <cpoin ua ion»
being he essen ial elemen s.
My in en ion has been mode a e, simply o speci y some possible connec ions
be ween he app o al o he o hopaedics o sel -co ec ion and o he
cul u al elemen s o he Non egian socie y in he p e ious cen u y.
On one hand, an a ini y be ween he he apy and some con empo a y
ideological ends and alues has been indica ed. The o hopaedics o sel -
co ec ion seem o some ex en o ha e been legi ima ed by a heo e ical
accommoda ion bo h o he ideology o pie ism in eligious li e and o he
p edominan libe al doc ine o economics. In addi ion, he he apy de i ed
(91)
TIDEMAND,
A.
quo ed in:
No sk Magazin o Lage idenskapen,
Fo handlingene
(1869),
p.
98.
The Fi s S age o he His o y o O hopaedics
in
No way
113
ad an age om a new comp ehension and alua ion o physical educa ion
as a p e equisi e o good heal h.
Wi hin a mo e limi ed con ex some speci ic ela ions be ween he
o hopaedics o Kjols ad and he scien i ic communi y o medicine has
been assessed. I was emphasized ha o mal medicine in his pe iod s ill
main ained many o i s adi ionai links o me aphysicai and na u e-philosophical
concep ions, and ha he absence o mo e eage esis ance owa d he
heo y o sel -co ec ion mus be iewed in his ligh . Fu he , i was a gued
ha he g adual accep ance o he idea ha physical exe cises could p e en
and cu e diseases and de o mi ies, he de elopmen o he muscula heo y,
and, in addi ion, he common expe iences o many physicians in No way
wi h mili a y gy nnas ics, o e ed a ou able condi ions o he new o hopaedic
en e p ise.
The app o al o he o hopaedics o sel -co ec ion has hus been
assessed by e e ing o i s accommoda ion o p e ailing ideological ends
and main p o essional cu en s o he p e ious cen u y. The a ac ion o
he he apy, howe e , has also been assessed in ela ion o social in e es s,
pa icula ly wi h ega d o he demands o he medical p o ession in he
p e ious cen u y. Ob ious, he de elopmen o o hopaedics was in his
ime pe iod a pe iphe al mo emen wi hin medicine. I has s ill been
indica ed ha he ecogni ion o he No wegian o hopaedis s was o some
ex en ied o he g owing ambi ion o he nedical p o ession o imp o e
i s s a us and socie al in luence.
The app o al o he he apy o sel -co ec ion seems in he i s place
o ha e been ela ed o he wish o he medicai p o ession o b ing o hopaedics
back wi hin he subjec o medicine, and o he ac ha Kjals ad epea edly
demons a ed ha he accep ed he assessmen o his colleagues as he
decisi e c i e ia o alue he sui abili y o he he apy. The o hopaedics o
Kjols ad, howe e , also exhibi ed se e al o he sympa he ic ea u es. To
some ex en he a ac ion o he he apy seems o ha e been ela ed o i s
p e en a i e quali ies. The medical p o ession had a g owing ambi ion o
asse i sel in new ields, paying inc easing a en ion o ques ions ela ed
o school hygiene and p oblems in connec ion wi h p o ac ed school
a endance. In con as wi h he mechanical he apy, he me hod o sel -
co ec ion could be used as a p ophylac ic and he No wegian o hopaedis s
ook conc e e ini ia i es o make such use o i , no ably i was in oduced
a p ima y school. Fu he , he app o al o he he apy seems o ha e been