# When hospitals came to Sweden in the eighteenth century: a foreign import with practical difficulties

## TL;DR

This paper explores how hospitals were established in 18th-century Sweden, highlighting the blend of foreign ideas and local challenges.

## Contribution

The paper introduces the role of domestic traditions and practical challenges in hospital development, using path dependency as a framework.

## Key findings

- Hospital establishment in Sweden was influenced by ecclesiastical and military contexts.
- Funding and implementation challenges mirror modern healthcare efficiency debates.
- Path dependency reveals continuity of past practices in shaping new medical reforms.

## Abstract

Since Foucault’s seminal work in the 1960s on the consequences of eighteenth-century discursive shifts in medicine, the establishment of hospitals during this period has often been interpreted as a progressive innovation driven primarily by medical scientists. However, less attention has been given to the ways in which the founding of hospitals was intertwined with domestic traditions and the practical challenges inherent in their implementation. By examining the establishment of the Seraphim Hospital in Stockholm, along with subsequent hospital foundations in Sweden, the practical difficulties involved become evident. Some of these challenges, particularly those related to funding difficulties, bear a striking resemblance to contemporary discussions on enhancing the efficiency of healthcare, despite the differing historical contexts. In the Swedish eighteenth-century context, ecclesiastical authority in medical matters persisted and played a role in the establishment process, while the military character of the kingdom also influenced hospital development. The conclusion drawn is that both national and local conditions shaped how medical reforms were conceived and practised. The historiographical emphasis on novelty and change may, at times, obscure the continuity of past practices, which undeniably played a crucial role in shaping the new. The concept of path dependency is thus employed not only to trace these historical connections but also to explore the ways in which they influenced the Swedish context, ultimately shaping the trajectory of hospital development in the country.