Forensic Pathologist with a Passion for Social Justice
During his lifetime, Einar Sjövall (1879-1964) (born in Lund, 1879) became a very prominent—though at times controversial—figure in Lund University history. Dr. Sjövall was Professor of Forensic Medicine in Lund from 1914 to 1944. He was also a greatly appreciated lecturer in popular science and devoted much of his life to social medicine, public health, and alcohol-related problems. He published his first scientific thesis at the age of eighteen and continued to pursue his career long after reaching retirement age
Early Years and Education
Per Gustaf Einar Sjövall was born in Lund on June 7, 1879 and came from a large family with roots in Ystad in the southern province of Skåne. He showed his inclination and aptitude for science at an early age and published his first scientific paper, a study of the reliability of methylene blue as a vital stain for neurons, at the tender age of 18. At that time he was an assistant instructor at the Department of Histology in Lund. He continued his education in pathology and anatomy at Karolinska Institutet in Stockholm. The years in Stockholm continued with neuroanatomical studies at the Department of Neurologic Disease, Serafimerlasarettet. These studies culminated in a thesis, presented in Lund in 1905, entitled "Uber Spinalgangliezellen und Markscheiden" (On spinal ganglion cells and myelin sheaths). After that, Dr. Sjövall worked for a few years at the hospital in Lund. In 1906, he became Associate Professor of neuropathology and from 1908 to 1914 he was an assistant at the Department of Pathology.
Professor and Teacher in Lund
From 1914 to 1944 Dr. Sjövall was Professor of Pathologic Anatomy and Forensic Medicine in Lund, but he continued his work in forensic medicine even after reaching retirement age, until 1950. Following retirement, he taught at Göteborg's newly founded medical school. Professor Sjövall was often mentioned in the press such as in connection with forensic autopsies for noteworthy events of the time. Two such events were the Esarp murder and the shipwreck of the submarine Ulven in 1943, when the wreck was salvaged and the dead crewmen examined.
Einar Sjövall as Teacher
Many former students have stated that Professor Sjövall was a popular teacher, albeit at times somewhat elaborate and verbose when he spoke. The atmosphere in the department was pleasant and informal, according to present-day accounts. Professor Sjövall was described as generous, accessible, and talkative, gladly sharing both personal and professional experiences with students. He frequently depicted the past in anecdotal sketches. Also, he was a voracious reader of both medical texts and fiction and expressed his opinion on contemporary issues freely and insightfully, and even submitted articles to the local press.
In addition to forensic medicine, Professor Sjövall also taught government medicine, a forerunner to the subject social medicine. Between 1939 and 1944 he was also deputy vice-chancellor at Lund University, a dramatic period when his knowledge and judgment were often tested in the political storms that whirled around academic Lund.
Active Social Democrat
A fascinating aspect of Professor Sjövall-doctor, thinker, and human-was his belief in socialism. He was an active social democrat for many years. He used to participate in the social democrats' May Day parade, which was unusual for a professor at the Faculty of Medicine at that time. As an Associate Professor in 1909, Dr. Sjövall gave a speech in Lund as part of the May Day activities, which received considerable attention. Professor Sjövall was a good friend of other contemporary social democrats, including the controversial Bengt Lidforss, Professor of botany and a well known controversial figure in Lund's academic community. Professor Lidforss suffered from vague chest symptoms and it was Professor Sjövall who finally made the correct diagnosis - a luetic aortic aneurysm.
Thus, Professor Sjövall merged scientific objectivity with a passion for social justice and commitment, making him a controversial figure to some, though he was also highly respected. In the battle against alcohol abuse he became an active participant in the temperance movement. Professor Sjövall was an ardent supporter of the period's contemporary ideas on the Swedish welfare state, driven by social engineering.
Thoughts on Early Biological Aging
What do forensic medicine, pathology and social medicine all have in common? In these subjects, scientific study offers abundant opportunities to see and describe how the social situation of the individual affects biology and health, with the possible outcome of illness and early death. Professor Sjövall was a prominent scientist whose goals in life were a general education and a better society for everyone - goals that still resonate today.
Professor Sjövall was interested in the interplay between social processes in society and the biological effects they may cause. In particular, like his present-day successors, he noted that accelerated biological aging is visible in individuals forced to live under difficult psychosocial and material circumstances. Professor Sjövall wanted to place human biology and development in relation to the lifestyle and social processes that affect us in daily life. Similar thoughts are represented in modern time, especially in stress research in the fields of biomedicine and behavioral physiology, as well as within social medicine and its neighboring sciences.
Interest in Public Health Issues
Professor Sjövall wanted to place medicine in a greater social context. He became involved in the organization of health care in Skåne as well as in public health issues on a national level. He advocated a modern healthcare system that was well in line with the "post-war program" of Per-Albin Hansson and the social democrats. These concepts also served as the core of Höjer's 1948 proposal for modern primary care, which-although it did not have its breakthrough at that time-contributed intellectually during the 1970s and 1980s to create modern family practice and the primary care structure - now with some 900 healthcare centers in Sweden.
Difficult Questions about Heredity and Environment
During his early years Professor Sjövall, like many others of his time, became involved in the debate on heredity versus environment, as well as to what extent the Swedish people might be exposed to a degenerative process. For Dr. Sjövall, alcoholism exemplified a harmful environmental influence that could have biological consequences, even across the generations. For example, children of alcoholic mothers often showed early physical and mental injuries. However, Dr. Sjövall maintained-in some controversy with proponents of a more deterministic school of thought, who claimed that this represented the degeneration of humankind (the race)-that if you remove the harmful exogenous agent (alcohol), the biological "core" would remain undamaged. His view of the interplay between heredity and the environment was humanistically influenced, even though as a doctor he came to debate with Bratt, who was considered to have inadequate biological knowledge in his criticism of alcohol use and abuse. In other writings Professor Sjövall also criticized excessive use of tobacco and coffee as harmful to public health.
Text: Associate Professor Peter Nilsson, Division for History of Medicine, Lund University
All references are available upon request.