Kategoriarkiv: Tuberculosis

On her birthday: Cecilia Ekenstam

Under the moss on the gravestone, you can discern the words chiseled in the polished marble: NEVER FORGOTTEN.

”Sterne’s Maria”. Painting by Charles Landseer (1799-1879)

We have reached the final destination of our trip to the west coast of Sweden – Varberg. This is where Augusta, at the age of 28, spent a short time to treat her tuberculosis with sea air and spa water – the only prescribed treatments available before the discovery of the bacterium that causes tuberculosis. And this is where she died on 28 July 1855.

We stand before the grave in the shaded old cemetery in the center of old Varberg where we have just planted small roses. Next to hers is a grave with an iron cross, partially buried by thick bushes. Whose grave is this? Another life cut short? I decide to find out, and what I find is another girl who should never be forgotten.

Augusta Nordwall (Söderholm) and Cecilia Ekenstam’s graves

Cecilia Ekenstam

By sheer coincidence, her birthday is today! She was born 187 years ago today. Unfortunately, she died at age 20.

Helena Cecilia Sofia Ekenstam was born on 19 October 1832 at Sålla, Sjögestad, not far from the parish where Augusta was born (Slaka). She was the 8th child of the 14 children born to her parents, Fabian Vilhelm af Ekenstam and Sofia Charlotta Zachrisson. She grew up in Stora Tuna parish outside Borlänge, in Dalarna. Like Augusta, she contracted tuberculosis at a young age and was sent to Varberg in the hope of curing her lung disease. When she died on 16 August 1853, she was buried in Varberg, far from her family. Two years later, Augusta would be buried next to her.

Fabian Vilhelm af Ekenstam

Cecilia’s father: ThD, professor, vicar, and alchemist.

Cecilia came from an interesting noble family. Her father, “The last Swedish Alchemist”, was deeply religious and studied theology, mathematics, and Sanskrit at Lund University. In 1813, he moved to London where he became interested in alchemy. Having no success in alchemy, he returned to Lund in 1818 where he became a professor. In 1822, he moved to Linköping and in 1836, he became the vicar in Stora Tuna parish in Dalarna, a position he held until his death in 1868 at the age of 82.

Stora Tuna church where Cecilia’s father was the vicar

If you visit Varberg,

put flowers on both Augusta’s and Cecilia’s graves. Two young girls who died far from home and should never be forgotten.






Inte Bara Gravar: Bakom varje sten finns en levande historia. Gert Nelje, Alva Peterson, Jåkan Norling. Hembygdsföreningen Gamla Varberg.

Professor Malmsten’s Patient Journals

The Sick Child by Edvard Munch 1885. The painting is of Munch’s sister who died from TB.

Augusta spent the summer of 1852 at Loddby. She was ill with tuberculosis. Adolf Nordvall (who she would later marry) was studying in Uppsala and they wrote long letters to each other. He worried and inquired about her health. She tried to sound upbeat about it, but didn’t like her local doctor:

Loddby 31 August 18,52

…My health and my strength are improving in big leaps. Doctor Almqvist is often out to see me and each time he becomes more complacent. Yesterday, he likened me to Hebe [the Greek goddess of eternal youth], so you can imagine how I have improved since you last saw me…”

But what she really wanted was to see Adolf again. And the doctor was getting on her nerves:

Loddby, 14 September 1852

…I was just interrupted by the doctor  who has been sitting here for 5 hours and talked so much nonsense that I am really tired, as if I had walked several miles. He is unsatisfied with my plan to travel to Stockholm and, to be truthful, I also think it might be unnecessary. One doctor is exactly like another; they don’t have any interest in their patients – or know what they should prescribe – and I am really averse to having to start explaining my misery to yet another [doctor].

Pehr Henrik Malmsten
Pehr Henrik Malmsten. Efter teckning av F. Hallman 1854.

In the beginning of October, Augusta finally traveled to Stockholm and stayed with her old friends, the family Hjort. She now got a new doctor, and not just any doctor, but a professor and also the royal family’s private doctor: Pehr Henrik Malmsten.

Stockholm, 3 October 1852

…The Professor visits me every day and always has a gracious disposition….

Stockholm, 12 October 1852

…I am completely taken in by Professor Malmsten. He is the most kind, wise, and pleasant doctor one can encounter; always happy and nice, never grumpy or careless like other Sons of Aesculapius [the Roman god of healing and medicine]. What I least admire in him is his terrible stubbornness to coax me into taking fish oil, and he will most likely succeed in the end, even though I fight for the longest time….

Augusta writes that she lies about taking the fish oil and has qualms about lying to the doctor. She tells Adolf in her letter that she only takes one table spoon of fish oil every day instead of two, but “it’s so terrible, so terrible…”

In addition to the terrible fish oil, she is not supposed to “liven up or encourage her numb feelings”. Professor Malmsten thinks that she is too lively. She has to stop laughing, speaking, and debating; sing or play the piano, and to write – and if  writing is necessary, then only a few lines. Also, no reading for the time being. She is not supposed to do anything that will liven up her imagination or make her emotional. This, she is supposed to do for 6 months: a life of “muteness and lifelessness”.

Despite the harsh restrictions and the horrible fish oil, Augusta still likes Professor Malmsten, and the feeling is probably mutual. One day when he visits her, he is coming straight from the death bed of a young woman and he shares his feeling with her: “..I saw that my Professor had shed some compassionate tears over the young woman.”

What Professor Malmsten didn’t know was that tuberculosis was caused by a bacterium. It would take another 30 years until Robert Koch discovered the bacterium in 1882. The only thing he could prescribe was fish oil and rest – and later, sea air at the spa town of Varberg, where Augusta died in 1855.

But in the correspondence between Adolf and Augusta’s mother, following Augusta’s death, Professor Malmsten is implicated – did a prescription contribute to Augusta’s death?  There are no details, just hints. So could we find out if she received any other medications besides fish oil?

I contacted the Swedish National Archives who confirmed that they had Professor Malmsten’s patient journals for the time period during which he treated Augusta. They also had a considerable amount of his correspondence. Could any of this material shed any light on Augusta’s treatment and cause of death?

Kerstin and Sara reading Pehr Henrik Malmsten’s journals and letters at the Swedish National Archives

Today, Kerstin and I visited the archives in Stockholm. It is a serious place. And very quiet. An archivist delivered the brown paper boxes that contained the journals and letters. With cotton gloves, we untied the strings and opened the boxes.

The patient journals were small note books. When I opened the first one, it was not what I had expected. For each patient, there was a row, and the columns represented the days of the month. In this matrix, the doctor had made an X on the day he had seen the patient.

We knew which days Professor Malmsten had visited Augusta, but her name was not listed on any pages in the journals. Why? Was she a special patient? A private patient, paid for by someone else – like her brother-in-law? Was this book a record for billing? No clues.

Malmsten’s Patient Journals

Then there were actual patient journals – called Disease History, but they seemed to be sorted by diseases and possibly for the sake of research. There were journals for patients with Chlorosis [anemia], Bright’s Disease [nephritis], and Syphilis. Those were some of the diseases that Professor Malmsten was interested in. I forgot to check if there were any patients with Phthisis (the Greek name for tuberculosis).

And finally there were the letters. Lots of handwritten, old letters from patients but none from Augusta’s family.

So we removed our cotton glows, wrapped up the boxes, tied the strings, and carted the material back to the archivist. The visit had only taken an hour as there was nothing to be found.

What should we do for the rest of the day?

”Let’s check out the Military Archives,” said Kerstin. ”Maybe we can find out more about Augusta’s dad!”

And off we went.


How boring it is to be ill … but Wilhelm von Braun writes humorous poems

In the summer of 1849, I was mostly at home except for a few weeks spent at Fullerstad and a few days at Krusenhof. August was very ill throughout the summer and the joy and well-being during that time were rare guests at Loddby. The last days of the year, I had a violent rush of blood to my lungs, and was sick for 3 weeks.  A thousand times I exclaimed with Braun:

How boring, so boring it is to be ill
woe it’s invention, nevertheless, still
time passes by, as time’s wont to do,
But slowly, damned slowly, time passes through.

(Attempt at translating Wilhelm von Braun’s poem Fantasi på sjuksängen).

This is the first diary entry where we learn that Augusta had tuberculosis, or consumption. Her brother August was also ill and we don’t know what he was afflicted with that summer. Fullerstad was the home of Augusta’s dear relatives, the Schuberts, and Krusenhof was the home of her best friends, the Hjorts.

But who was Wilhelm von Braun who wrote poetry that a 22-year-old girl would have memorized? Well, at that time he was one of Sweden’s most popular poets. And not all of his poems would have been suitable for young women :).

Wilhelm von Braun (1813-1860), like Paul Wahlfelt and other officer friends of Augusta, got his early education in the cadet school at Karlberg’s military academy in Stockholm. This was a boarding school for boys, usually from privileged families. Wilhelm followed the tradition of his father, and was enrolled at Karlberg at 15 years of age in 1828. After graduating in 1834, and for the next 7 years, he served as a lieutenant.

But his passion was poetry and prose. He published his first poetry in the Swedish newspaper Aftonbladet in 1834. In 1849 he wrote a story called Napoleon, the Adventure of a Cadet, which was based on his experiences at Karlberg. In 1846, he resigned his commission as a lieutenant to be a full-time writer.

Von Braun is presently having a renaissance. There is now a Wilhelm von Braun Association who has published the book Wilhelm von Braun – The one that ladies never read (”Den där som damerna aldrig läst”). And while reading the book, one can enjoy a glass of Wilhelm von Braun’s Punsch, a traditional Swedish cordial, produced in honor of this national poet.

I am glad that Augusta still got to enjoy the poems suitable for women, and those that provided humor for young girls suffering with consumption.


Sources (in Swedish):


www.tam-arkiv.se/share/proxy/alfresco…/ASU_207.pdf  (Kadettminnen av överste Claes Bratt)

Fantasi på Sjuksängen i Samlade Arbeten af Wilhelm v. Braun, Del 1 (pdf of book available free online)

http://www.culturum.se/Braun/2StPunsc.htm (Wilhelm von Brauns Punsch)

Featured image is part of an oil painting by Antonio Mancini (1852-1930), Resting, 1887. http://www.artic.edu/aic/collections/artwork/artist/Mancini,+Antonio