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During the 19th century demand for healthcare services rose dramatically as more people could afford medical treatment. It was a veritable consumer revolution. New healthcare professions emerged to meet this rapidly growing demand.

A study from the University Av�԰� reveals long-forgotten connections between North America and Europe in this context. Sweden specifically played a major international role in the emergence of these new professions. Few recall that Sweden was once a global point of reference for patients and healthcare providers alike. Anders Ottosson, historian at the University Av�԰�, even likens Sweden’s influence in healthcare at that time to IKEA’s current impact on furniture and interior design.
These findings are presented in his new book .

Ottosson offers a revised history of osteopathy and chiropractic. Both professions emerged in the United States at the end of the 19th century, with their founders claiming that most diseases were caused by dislocated joints, particularly in the spine. Since the germ theory of diseases was already accepted by then, these etiological models were dismissed by orthodox medicine as unscientific.

Because historians and sociologists of medicine had not found parallels in contemporary European medical thought and practice, osteopathy and chiropractic were long regarded as uniquely American phenomena. Ottosson challenges this assumption, showing that both have strong European roots.

The author Mark Twain was a patient

Drawing on previously unexplored sources and new theoretical approaches, he traces osteopathy and chiropractic back to a very influencial 19th-century European discourse of mechanical medicine, which also spread to North America and the colonial world. 

The core principle of mechanical medicine was that many chronic and internal diseases could be cured or alleviated through specific movements and massage-like techniques. Physicians and other practitioners at the time considered these methods to have solid scientific merit.

The strongest roots of osteopathy and chiropractic, Ottosson argues, lay in Sweden – specifically at the Royal Central Institute of Gymnastics (now the Swedish School of Sport and Health Av�԰�s), founded in Stockholm in 1813. Drawing especially on letters from the American author Mark Twain (Samuel Clemens), Ottosson even  identifies an alumnus of the Institute as a clear forerunner: the physiotherapist Lieutenant Henrik Kellgren (1837–1916),

“What first caught my attention,” Ottosson says, “was a biography of Mark Twain that mentioned the Twain family seeking out a ‘Swedish osteopath’ in England named Kellgren. Twain’s own correspondence later revealed that he considered osteopathy to be ‘a steal’ – an American imitation of Kellgren’s methods. After reading that, I was hooked.”

Hidden from history

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Kellgren’s large London clinic attracted patients from all over the world. He also operated a well-known health resort in Sweden, where the Twain family stayed in the summer of 1899. Yet today, Kellgren is forgotten. Ottosson explores how and why even scholars actively searching for the origins of osteopathy and chiropractic could not find him.

“The short version,” Ottosson explains, “is that Kellgren was overshadowed by emerging professional interests in the rapidly expanding healthcare sector, which wanted to appear independent of him. In the United States, osteopaths and chiropractors, and in Europe, physicians (especially orthopaedists), physiotherapists, and physical educators were all complicit in removing Kellgren and the Royal Central Institute of Gymnastics from the historical record, so to speak.”

The study offers new insights into how professional boundaries between orthodox and alternative medicine were drawn at the turn of the 20th century and the book will be of value to students and scholars alike interested in the history of science, technology, medicine, and gender.

Anders Ottosson’s study is published by Routledge: 

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Anders Ottosson, Department of Historical Studies, University Av�԰�
E-mail: anders.ottosson@history.gu.se, Phone: +46 (0)739 609040