Responding to Secularization: The Deaconess Movement in Nineteenth-Century Sweden

Responding to Secularization Studies in the History of Christian Traditions General Editor Robert J. Bast Knoxville,...

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Responding to Secularization

Studies in the History of Christian Traditions General Editor

Robert J. Bast Knoxville, Tennessee In cooperation with

Henry Chadwick, Cambridge Paul C.H. Lim, Nashville, Tennessee Eric Saak, Liverpool Brian Tierney, Ithaca, New York Arjo Vanderjagt, Groningen John Van Engen, Notre Dame, Indiana Founding Editor

Heiko A. Oberman †

VOLUME 153

Responding to Secularization The Deaconess Movement in Nineteenth-Century Sweden

By

Todd H. Green

LEIDEN • BOSTON 2011

On the cover: A parish deaconess administers medicine to a widow, by Priscilla Åhlén Sundqvist This book is printed on acid-free paper. Library of Congress Cataloging-in-Publication Data Green, Todd H. Responding to secularization : the deaconess movement in nineteenth-century Sweden / by Todd H. Green. p. cm. – (Studies in the history of Christian traditions, ISSN 1573-5664 ; v. 153) Based on the author's dissertation (Vanderbilt University). Includes bibliographical references and index. ISBN 978-90-04-19479-3 (hardback : alk. paper) 1. Deaconesses–Sweden–History–19th century. 2. Secularism–Sweden–History–19th century. 3. Sweden–Church history–19th century. I. Title. II. Series. BV4423.G74 2011 271'.98–dc22 2010048232

ISSN 1573-5664 ISBN 978 90 04 19479 3 Copyright 2011 by Koninklijke Brill NV, Leiden, The Netherlands. Koninklijke Brill NV incorporates the imprints Brill, Hotei Publishing, IDC Publishers, Martinus Nijhoff Publishers and VSP. All rights reserved. No part of this publication may be reproduced, translated, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior written permission from the publisher. Authorization to photocopy items for internal or personal use is granted by Koninklijke Brill NV provided that the appropriate fees are paid directly to The Copyright Clearance Center, 222 Rosewood Drive, Suite 910, Danvers, MA 01923, USA. Fees are subject to change.

CONTENTS

Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii List of Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix List of Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi Chapter One. The Secularization Debate: An Introduction to the Problematic Relationship between Religion and Modernity . . . . . A. Problems of Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B. The Secularization Debate in Sociology . . . . . . . . . . . . . . . . . . . . . . C. The Secularization Debate in Modern European Religious History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D. The Secularization Debate in Swedish Religious History . . . . E. The Place of the Present Work in Secularization Scholarship F. Gender and Religion in Modern Sweden . . . . . . . . . . . . . . . . . . . . . G. Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H. Outline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10 14 19 23 28 29

Chapter Two. The Female Diaconate in Nineteenth-Century Sweden . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A. The Origins and Formation of the Female Diaconate . . . . . . . . B. Leadership and Organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C. The Calling of a Deaconess .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D. A Profile of Deaconesses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E. Deaconess Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F. The Work of Deaconesses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G. The Difficulties of Recruiting and Retaining Deaconesses . . . H. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

32 32 49 52 64 70 74 76 87

1 4 6

Chapter Three. Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 A. Popular Education in Medieval and Early Modern Europe . . 90 B. Educational Reforms in Nineteenth-Century Sweden . . . . . . . 93 C. The Deaconess School for Poor Children . . . . . . . . . . . . . . . . . . . . . 98 D. Deaconesses as Teachers in Provincial Sweden . . . . . . . . . . . . . . . 103 E. The Discontinuation of Teaching . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 F. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114

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contents

Chapter Four. Health Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A. Health Care in Medieval and Early Modern Europe . . . . . . . . . B. Origins of the Modern Nursing Profession in Nineteenth-Century Sweden . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C. The Deaconess Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D. The Nursing Home and the Polyclinic . . . . . . . . . . . . . . . . . . . . . . . . E. Private Home Care and Provincial Hospitals . . . . . . . . . . . . . . . . . F. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

116 117 121 128 133 135 141

Chapter Five. Poor Relief . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A. Poor Relief in Medieval and Early Modern Europe . . . . . . . . . . B. Poor Relief Reform in Nineteenth-Century Sweden . . . . . . . . . C. Indoor Relief . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D. Outdoor Relief . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

143 144 148 154 156 164

Chapter Six. The Social Significance Of Swedish Deaconesses .. . . . . 166 Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185

ACKNOWLEDGEMENTS

I would like to express my deepest gratitude to the many people who made this book possible. I began this project as a dissertation at Vanderbilt University, and the four professors who served on my dissertation committee provided incredible guidance and feedback to me, including many useful suggestions for revisions beyond the dissertation. To these four professors, I am most indebted: Dale A. Johnson, Joel F. Harrington, James Hudnut-Beumler, and Paul J. DeHart. At an early stage of the research process, e-mail correspondence and/or telephone conversations with several scholars enabled me better to focus my ideas. In particular, Professors Göran Gellerstam of Lund University, Pirjo Markkola of the University of Tampere, and Carter Lindberg of Boston University provided me with helpful insights into my topic. The most challenging aspect of researching this book was getting access to the deaconess archives at the Ersta Diaconate Society in Stockholm. Ersta lacks a professional archivist, and most of its full-time employees know little of the archives (including the location!). I am therefore indebted to two retired deaconesses, Gudrun Persson and Birgitta Wendt, for finding the sacred key, orienting me to the archives, and sharing with me their own perspectives on the history of their profession. Many of the secondary sources were not to be found in the stacks of Vanderbilt’s Central and Divinity Libraries. I was heavily dependent on Vanderbilt’s Interlibrary Loan Service for securing much of this literature, particularly books written in Swedish. Their invaluable assistance made it possible to complete the book in a timely fashion. Finally, I am thankful for the support of my family. My parents, Jerry and Suzanne Green, spared no expense in making sure that I received an excellent education. My brothers, Mike and David Green, have expressed their pride in my accomplishments, and this has meant more to me than they will ever know. My wife’s parents, Olle and Birgitta Åhlén, graciously opened their home in Stockholm to me while I was doing much of the research. My daughter, Rebecka, scarcely remembers a time when I was not a graduate student or a professor. Colleagues used to remark that it must be difficult to be working on a Ph.D. while trying to be a good parent, but I do not think I suffered from wearing both hats. If anything, Rebecka helped me keep my sanity and reminded me that there is more

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to life than research. My wife, Tabita, gave me so much support while I worked on this project. When someone who is both a spouse and parent returns to graduate school, many burdens are placed on other family members. Tabita bore these with grace, and without a doubt, I could not have researched and written this book apart from her faith in me and my vocational calling.

LIST OF TABLES

Table . Educational External Work Stations, – . . . . . . . . . . . . . . . . . . . . Number of Sisters, – . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . External Work Stations, – . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Care and Poor Relief External Work Stations, – . .

45 47 48 48

LIST OF ABBREVIATIONS

EDA

Swedish

English

Ersta Diakonisällskaps arkiv

Ersta Diaconate Society’s Archives J.C. Bring’s Circular Letters Louise Heimbürger’s Notes

JCBRB J.C. Brings rundbrev LHA Louise Heimbürgers anteckningar MCD Marie Cederschiölds dagbok SBDAS Sällskapet för beredande af en diakonissanstalt i Stockholm SDAS

Svenska Diakonissanstaltens Styrelse SDSFU Svenska Diakoniss-Sällskapets Förvaltningsutskott

Marie Cederschiöld’s Diary Society for the Preparation of a Deaconess Institution in Stockholm Swedish Deaconess Institutional Board Swedish Deaconess Society’s Administrative Board

chapter one THE SECULARIZATION DEBATE: AN INTRODUCTION TO THE PROBLEMATIC RELATIONSHIP BETWEEN RELIGION AND MODERNITY

Religious historians and sociologists of religion have participated in a vigorous debate since the s over how to explain the apparent decline of religion in nineteenth- and twentieth-century Europe. I will engage this debate from a historical perspective by studying the social significance of deaconesses in late nineteenth-century Sweden. Swedish deaconesses acquired, maintained, and expanded their influence in important social functions during this period. They did so even though more secular, specialized institutions and professionals were increasingly assuming formal responsibility in Sweden, as in much of Europe, for many of the social functions carried out historically by religious institutions. The influence of deaconesses in the public sphere demonstrates that the adoption of social functions by more specialized institutions and professionals did not necessarily push religious institutions and professionals to the margins of society. Religious organizations and personnel continued in many instances to carry out essential social functions, both in competition and cooperation with other specialized institutions. Swedish deaconesses had to overcome obstacles that their male religious counterparts did not face in carrying out these social functions. For this reason, my study will also address the ways in which gender enabled deaconesses to wield public influence at a time when women were often limited in the work they could perform outside the home. I will argue that the female diaconate succeeded in alleviating some gender-based concerns with its work by extending the domestic sphere and the qualities deemed most suitable for women into the public sphere. The female diaconate gained access to the public sphere by organizing, interpreting, and carrying out its work in accordance with the traditional religious construction of gender that was prevalent in the nineteenth century. Given the focus of my study, I will devote much of this chapter to a discussion of the secularization debate between and among sociologists and historians, as well as to how my study fits into this debate. I



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will subsequently address the relationship between gender and religion in contemporary Swedish historical scholarship and how recent developments in Swedish gender history have aided my study of the female diaconate. My study differs from much of the Anglophone historical scholarship on secularization in modern Europe in that its primary focus is not on the decline of religious beliefs and practices among individuals and particular social groups over the past several centuries.1 My main concern is secularization at the societal level, in conjunction with what sociologists of religion term “functional differentiation.” Functional differentiation is the process in which social functions historically carried out by religious institutions and personnel are absorbed by more secular, specialized institutions and professionals in the modern era. To take one example, in medieval Europe, poor relief was largely the preserve of parish clergy, religious orders, and confraternities. In the early modern and modern periods, social workers and welfare boards gradually assume formal responsibility for this work. Prominent sociological defenders of the secularization thesis argue that functional differentiation, as part of the process of modernization, inevitably led to a decline in the “social significance” of religion in the public sphere, that is, in that domain of society in which essential social, political, and economic functions are carried out on society’s behalf.2 When social functions such as poor relief or education began to be adopted by more secular, specialized institutions, religious institutions not only experienced general decline in their influence in the public sphere, but they became marginalized in the social order, with their influence and activities relegated to a more private realm. Since many religious historians of modern Europe have emphasized the decline of religious beliefs and practices in their studies on secularization, very little historical work has been done on exploring the socio1

In certain regions of Europe, historians who study secularization do not emphasize the decline in religious beliefs and practices. French historians, for example, typically give little attention to the decline in traditional Christian beliefs or church attendance in their studies of post-Revolutionary France, focusing instead on church-state relations and/or the decline of religion’s influence in the public sphere. On the other hand, historians from the United States who study modern French religious history are much more likely to devote considerable attention to the beliefs and practices of individuals and social groups. See Thomas Kselman, “Challenging Dechristianization: The Historiography of Religion in Modern France,” Church History  (), –. 2 The definition of secularization as a decrease in the “social significance” of religion can be traced to the work of the sociologist Bryan R. Wilson. See Wilson, Religion in Secular Society: A Sociological Comment (London: C.A. Watt & Co. Ltd., ), xiv.

the secularization debate



logical claim that functional differentiation necessarily leads to secularization in the public sphere. I intend to compensate for this gap in the historical research through a study of the deaconess movement, a religious movement that arose in response to increasing functional differentiation in nineteenth-century Sweden. The female diaconate specialized in the areas of education, health care, and poor relief. Many sociologists point to these same three social functions as areas in which religious institutions and personnel became marginalized in the social order once these responsibilities were “taken over” by more specialized institutions and professionals. For this reason, a study of the female diaconate seems quite appropriate. The challenge with such a study is that the causal link between functional differentiation and secularization appears difficult to refute. One noted sociologist, José Casanova, has even argued that the latter, at least from a theoretical perspective, should be defined primarily in terms of the former.3 And much of the evidence from the past century appears to confirm the causal connection. Particularly in the twentieth century, functional differentiation has taken its toll on European religious institutions through the emergence of modern welfare states. Few would argue that religious institutions possess the same degree of social significance in contemporary Europe as they did two or three centuries ago. But from a broader historical perspective, functional differentiation’s effects on religious institutions cannot be understood only as secularizing, even if secularization has been one outcome. In the context of the nineteenth century, functional differentiation is best understood as the continuation of a process dating from the early modern period that redefined the roles played by religion and religious institutions in society. This redefinition process certainly posed challenges to religion’s public influence as churches and church representatives lost their monopolies on social services and were forced to compete or cooperate with more specialized providers, both religious and secular. In plenty of instances, the established churches of Europe simply were not up to the task, and the increasing marginalization of religious institutions was one result. But where some doors closed, others opened. Functional differentiation also created opportunities for religious communities to wield 3 José Casanova, Public Religions in the Modern World (Chicago: The University of Chicago Press, ).

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influence in the public sphere that otherwise might not have existed. Deaconesses are a case in point. The female diaconate arose in midnineteenth-century Sweden to specialize in those areas subject to significant functional differentiation. The very founding of the female diaconate was a reaction to functional differentiation and its potentially secularizing effects, and the fact that the deaconess movement survived and even expanded its influence in the late nineteenth century reflects its success in responding to modernization and particularly to the increased demand for specialized providers in areas such as nursing and social work. Ironically, functional differentiation gave the female diaconate its raison d’être. To focus only on the secularizing outcome of functional differentiation is therefore to overlook the overall success of religious communities such as the female diaconate and to fail to appreciate what Yves Lambert calls the “diverse and contradictory effects” of modernity on religion.4

A. Problems of Definition Because the concept of secularization has multiple dimensions, and because different scholars sometimes mean different things when they refer to it, it is necessary to explain how I will use the term.5 Before doing so, let me discuss briefly how the term has been commonly understood over the past several centuries. Until around the mid-nineteenth century, secularization typically referred either to the transfer of ecclesiastical property from the church to secular persons or bodies (as was the case during the Reformation or the French Revolution), or to the relinquishing of orders by monks and nuns. A related use of the word in the nineteenth century referred to the transferal of control of a particular public institution, such as a university, away from religious bodies.6

4

Yves Lambert, “New Christianity, Indifference and Diffused Spirituality,” in The Decline of Christendom in Western Europe –, eds. Hugh McLeod and Werner Ustorf (Cambridge, Eng.: Cambridge University Press, ), . 5 For a discussion of the problems involved in defining the term “secularization,” see C.J. Sommerville, “Secular Society/Religious Population: Our Tacit Rules for Using the Term ‘Secularization,’ ” Journal for the Scientific Study of Religion  (), –. 6 Brief discussions of how the term secularization has been used historically can be found in Hugh McLeod, Secularisation in Western Europe, – (New York: St. Martin’s Press, ), –; Kevin M. Schultz, “Secularization: A Bibliographic Essay,” The Hedgehog Review  (), –.




In recent decades, scholars have attempted to delineate more clearly the different senses in which the term can be used. The sociologist José Casanova argues that secularization has three different connotations: a decline in religious beliefs and practices, a differentiation of secular from religious spheres, and a privatization of religion. The validity of each of these three connotations, he maintains, should be studied independently.7 The social historian Hugh McLeod also argues that the term has three different senses that must be studied separately: a decline in religious beliefs and practices, a separation of religious and public institutions, and a weakening in the power of religion to shape the identity of the majority in a given society.8 For the purposes of this study, secularization refers to a decline in the influence of religion in a given society. In the context of modern Europe, particularly before the late twentieth century, the religion in question is typically some form(s) of Christianity. Moreover, this decline can be studied on one of two levels. First, the scholar can study the extent to which there has been a decline in the religious beliefs and practices of individuals or social groups (i.e., men, the working class, etc.). The primary indicators of such a decline include church attendance, church membership, church rituals (baptisms, marriages, funerals, etc.), and traditional Christian beliefs. Second, religious decline can be studied in terms of the larger social significance of religion. The scholar in this case attempts to uncover the extent to which religious institutions, organizations, and professionals have lost their influence in the public sphere.9 I am focusing on this second aspect of secularization, particularly as viewed in conjunction with the process of functional differentiation. My concern is with whether or not functional differentiation adversely affected the social significance of one particular religious group, the Swedish deaconessate. I do not wish to confuse this second sense of the term with the first. Several historians, including Hugh McLeod, C.J. Sommerville, and Jeffrey Cox, have rightly pointed out that there is no necessary connection between these two levels of secularization. 7 Casanova, Public Religions in the Modern World, ; “Rethinking Secularization: A Global Comparative Perspective,” The Hedgehog Review  (), –. 8 McLeod, Secularisation in Western Europe, . 9 The separation of ecclesiastical and sociopolitical institutions, which can be defined as secularization in a classic use of the word, is not synonymous with secularization as the term is being used here. Secularization in this work will refer to a decline in the influence of religion in a given society and not, in its stricter sense, to a process of differentiation.

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Religion in a given society can have social significance even when levels of religious beliefs and practices are low, and vice versa.10 I share their views, and for this reason I will not attempt to ascertain whether a connection exists between levels of religious beliefs and practices on the one hand, and the larger social significance of religious institutions and professionals on the other.11

B. The Secularization Debate in Sociology The debate between and among sociologists and historians has to do with much more than definitional issues. The secularization debate is first and foremost a debate over what can be termed “the secularization thesis” or “secularization theory.”12 The secularization thesis, which at its core asserts that modernity and modernizing processes lead to a decline in the influence of religion in contemporary societies, can be traced back to the work of seminal nineteenth- and early twentieth-century sociological thinkers, including Max Weber and Émile Durkheim. Weber suggested that rationalization and the advance of science would increasingly make religious beliefs and behavior more untenable. He insisted that with modernity there would be an increasing “disenchantment of the world.”13 Durkheim argued that history was progressing in such a way that religious institutions, which once permeated European society,

10 Hugh McLeod, “Secular Cities? Berlin, London, and New York in the Later Nineteenth and Early Twentieth Centuries,” in Religion and Modernization: Sociologists and Historians Debate the Secularization Thesis, ed. Steve Bruce (Oxford: Clarendon Press, ), ; Sommerville, “Secular Society/Religious Population,” Journal for the Scientific Study of Religion  (), ; Jeffrey Cox, The English Churches in a Secular Society: Lambeth, – (Oxford: Oxford University Press, ), –. 11 The sociologist Steve Bruce believes that in many cases a decline in the social significance of religion leads to a decline in the religious beliefs and practices of individuals and social groups. Consequently, in studying secularization, the scholar must look for the connections between the two. In this assessment, he differs from fellow sociologist and defender of the secularization thesis Bryan Wilson, who makes a greater effort to treat the social significance of religion separately from the issue of whether or not people hold religious beliefs or participate in religious rituals. See Steve Bruce, God is Dead: Secularization in the West (Oxford: Blackwell, ). 12 For a fuller exposition of the secularization debate, see Todd Green, “Religious Decline or Religious Change? Making Sense of Secularization in Europe,” Religion Compass  (), –. 13 Max Weber, “Science as a Vocation,” in The Vocation Lectures, eds. David Owen and Tracy B. Strong (Indianapolis: Hackett Publishing Company), –.




would continue to be pushed to the margins of the social order as more specialized institutions and professionals emerged in the modern process of differentiation.14 Some of the ideas of these early sociological thinkers were expanded upon and systematized by sociologists in the s, and it is from this point that we can talk about a theory of secularization. The most prominent advocates of this theory in the s were Bryan Wilson and Peter Berger, though many other sociologists followed suit. Their work contributed to giving the secularization thesis “the status of sociological orthodoxy” in the s and s.15 There were skeptics even in this period, but the number of critics would not become significant until the s and s. The more recent trend within sociology is to criticize or even reject the theory of secularization, but the thesis continues to have its defenders, most notably Steve Bruce. While defenders of the secularization thesis differ on some points, most of them agree on the essentials. These advocates of the “orthodox model” of secularization contend that “modernization creates problems for religion” in contemporary societies, problems that ultimately undermine the traditional influence of religion both on individual beliefs and practices and on the functioning of society.16 With modernity, life becomes organized societally instead of locally. Science and technology reduce the occasions for which people have recourse to religion. The greater centrality of reason “demythologizes” the world. Functional differentiation renders the “social services” of religious institutions and professionals unnecessary. Religious pluralism challenges the plausibility of an absolute system of truth and morality that is able to give cohesion to a given society.17 Defenders of the secularization thesis are not suggesting that modernization will lead to the disappearance of religion from modern societies. But what modernization has done, and will continue to do, is relegate 14 Émile Durkheim, The Division of Labor in Society, trans. W.D. Halls (New York: The Free Press, ). 15 McLeod, Secularisation in Western Europe, . 16 Bruce, God is Dead, . 17 For detailed discussions of how modernization contributes to secularization according to defenders of the secularization thesis, see Roy Wallis and Steve Bruce, “Secularization: The Orthodox Model,” Religion and Modernization, –; Bruce, God is Dead, –; Bryan R. Wilson, Religion in Sociological Perspective (Oxford: Oxford University Press, ), –; Religion in Secular Society, –; and Peter Berger, The Sacred Canopy: Elements of a Sociological Theory of Religion (New York: Doubleday & Company, ), –.

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religion to a more private realm. To the extent that religion survives, it does so only on the margins of the social order and without having much significance for society as a whole. The most prominent sociological assault on the secularization thesis in recent decades has come from Americans who defend what is variously referred to as rational choice or supply-side theory. Representatives of this position include Rodney Stark, Roger Finke, and Laurence R. Iannaccone. Rational choice theorists believe that most theories of secularization fail because they attribute the cause of secularization to a lack of demand for religion in various modern societies, particularly European ones. But rational choice theorists assume that the demand for religion is relatively constant, and that an inadequate supply of religion best explains the seemingly high levels of secularization in some societies. This is particularly true in many parts of Western Europe where there is a tradition of state churches having a monopoly on religion. State monopolies discourage competition among religious institutions, and if there is no free marketplace of religion, state churches have little incentive to meet the diverse religious demands of a given population. The failure to meet these demands results in many segments of the population distancing themselves from the established religion. Much of Europe suffers from low levels of religious participation because of a tradition of religious monopolies and limited choices in the religious marketplace. Conversely, the United States has witnessed much higher levels of religious participation because historically the American religious marketplace has been more open, with greater competition and choice.18 Other sociologists have also come out in recent decades against the secularization thesis. In her study of post-World War II Britain, Grace Davie argues that even though there has been a decline in church membership and participation in church rituals, some form of religious beliefs has persisted. For Davie, it is more accurate to describe Britain, and

18

For an overview of rational choice theory and its criticisms of the secularization thesis, see Roger Finke, “The Illusion of Shifting Demand: Supply-Side Interpretations of American Religious History,” in Retelling U.S. Religious History, ed. Thomas A. Tweed (Berkeley: University of California Press, ), –; Rodney Stark, “Secularization, R.I.P.,” Sociology of Religion  (), –; Rodney Stark and Laurence R. Iannacone, “A Supply-Side Reinterpretation of the ‘Secularization’ of Europe,” Journal for the Scientific Study of Religion  (), –. For an application of the supply-side theory to the Swedish context, see Eva Hamberg, “Christendom in Decline: The Swedish Case,” in The Decline of Christendom in Western Europe, –, eds. Hugh McLeod and Werner Ustorf (Cambridge, Eng.: Cambridge University Press, ), –.




Western Europe in general, as “unchurched” as opposed to “secular”; that is, Europeans largely “believe without belonging.”19 Davie has elsewhere described Europe as an “exceptional case” when it comes to religiosity. Religion continues to have a place in modern Europe, but its forms and functions have no clear analogues either in pre-modern Europe or in other parts of the world today. One example of this is the concept of vicarious religion, defined by Davie as “religion performed by an active minority but on behalf of a much larger number, who (implicitly at least) not only understand, but, quite clearly, approve of what the minority is doing.”20 Church leaders and members believe on behalf of others, perform rituals on behalf of others (such as funerals), and so forth. More importantly, churches are expected to do even if most Europeans rarely step foot inside a church, much less adhere to church teachings.21 In Public Religions in the Modern World, José Casanova observes that, contrary to the secularization thesis, what we are witnessing in recent decades are new historical developments that point to a significant “deprivatization” of religion in many global contexts. Religious traditions throughout the world are refusing to be restricted to the private sphere and are increasingly returning to the public sphere. It is therefore likely that religion will “continue to play important public roles in the ongoing construction of the modern world.”22 Increasing attention has been given to gender in recent sociological challenges to the secularization thesis. For defenders of the thesis, modern processes such as urbanization, industrialization, and rationalization undermined religious belief and behavior, but Linda Woodhead insists that women did not respond to modernization in the same way as men. She argues that the older theory does nothing more than “explain male disaffiliation from religion—for the labourer who leaves the shelter of the sacred canopy is a man not a woman.” Women experienced industrialization “as exclusion from the public world and confinement to the 19 Grace Davie, Religion in Britain since : Believing Without Belonging (Oxford: Blackwell, ). 20 Grace Davie, “Vicarious Religion: A Methodological Challenge,” in Everyday Religion: Observing Modern Religious Lives, ed. Nancy Ammerman (New York: Oxford University Press, ), . 21 For a fuller exposition of Europe’s religious exceptionalism, see Grace Davie, Europe: The Exceptional Case: Parameters of Faith in the Modern World (London: Darton, Longman and Todd, ). 22 Casanova, Public Religions in the Modern World, .

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home and/or low-paid domestic labour and piecework,” resulting in the reinforcement of ties to churches.23 Only in the s did the connection between churches and women begin to show significant signs of fracturing. Even Peter Berger, one of the most prominent defenders of the secularization thesis in the s, has reversed some of his earlier assessments. The revised Berger now rejects the claim that modernization necessarily leads to a decline in the influence of religion. Modernization may have secularizing effects, but it can also contribute to potent countersecularization movements. Berger admits one of the mistakes he made in his earlier work was to conflate secularization with pluralization. Modernity certainly contributes to pluralism, and pluralism leads to a multiplication of choices and worldviews in a given society, but it does not follow that pluralism necessarily leads to secularization. Pluralization can even lead to greater religious participation and to more people embracing religious worldviews.24 Berger’s recent critiques of the secularization thesis are in keeping with other developments in the sociology of religion that challenge the secularization thesis.

C. The Secularization Debate in Modern European Religious History Historians of religion in modern Europe have followed these sociological debates. They have even attempted to foster greater dialogue with sociologists on the secularization thesis, most notably in the volume edited by Steve Bruce titled Religion and Modernization: Sociologists and Historians Debate the Secularization Thesis (). Important historical studies in the s appealed to key aspects of the secularization thesis to explain religious decline,25 but since the s historians of religion in 23

Linda Woodhead, “Gendering Secularization Theory,” Social Compass  (),

. 24 Peter Berger, “The Desecularization of the World: A Global Overview,” in The Desecularization of the World: Resurgent Religion and World Politics, ed. Peter Berger (Grand Rapids: Eerdmans, ), –; Charles T. Mathewes, “An Interview with Peter Berger,” The Hedgehog Review  (), –. See also Peter Berger, Grace Davie, and Effie Fokas, Religious America, Secular Europe? A Theme and Variations (Burlington: Ashgate, ). 25 For example, see A.D. Gilbert, Religion and Society in Industrial England: Church, Chapel and Social Change, – (London: Longman, ); Stephen Yeo, Religion and Voluntary Organisations in Crisis (London: Croom Helm, ).


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modern Europe have become as skeptical of the thesis as many of their sociological counterparts. This skepticism, most common among Anglophone historians of European history, largely rests on what is perceived to be the poor historical foundations of the theory. These historians do not reject the contention that secularization is an important part of modern European history. What they reject is the more orthodox theory of secularization that posits an inevitable link between modernization and a decline in religion’s influence. The most prominent historians to embrace this position are Thomas Kselman, Jeffrey Cox, Hugh McLeod, and Callum Brown. What follows is a brief treatment of the contributions of each to the secularization debate. In his study of religious change in France’s Third Republic (– ), Thomas Kselman challenges the tendency of historians to embrace the concept of secularization as the central theme of modern European religious history. Pluralism, he argues, and not secularization best describes the types of religious changes taking place in modern Europe, particularly in urban areas. He points out that not only did Catholicism remain far more resilient during France’s Third Republic than many French historians have suggested, but other forms of religiosity emerged in the period to meet the various religious needs of the French nation, including socialism, nationalism, and the occult. Many of the “unchurched” constructed religious systems that borrowed elements from both Catholicism and some of these nontraditional religions. Kselman is careful not to deny the reality of secularization in France’s Third Republic, but in his emphasis on the importance of emerging religious pluralism and new forms of religiosity, he dismisses the notion that secularization is the central theme of this period.26 Jeffrey Cox agrees that “[i]t is pluralism which most clearly distinguishes the present from the past in matters of religion.”27 He believes that the religious decline that began to occur in late Victorian England is best explained by the competition that arose in a free market of ideas, a 26

Thomas Kselman, “The Varieties of Religious Experience in Urban France,” in European Religion in the Age of Great Cities –, ed. Hugh McLeod (London: Routledge, ), –. Kselman has also studied the changes that have taken place in modern French history in the religious ideas and rituals pertaining to death. He concludes that the Christian religion, even if at times in an inchoate form, continued to inform the attitudes and rituals pertaining to death in France throughout the twentieth century. See Thomas Kselman, Death and the Afterlife in Modern France (Princeton: Princeton University Press, ); “The dechristianisation of death in modern France,” Decline of Christendom, –. 27 Cox, English Churches in a Secular Society, .

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market that the modern state created after centuries of suppressing religious pluralism and competition. Religious decline in late nineteenthand early twentieth-century England took place largely because religious institutions and thinkers failed to adapt to this situation of increased pluralism and competition. Cox does not deny that social changes arising out of modernity, such as industrialization and urbanization, also contributed to the decline of the influence of religion in modern English history. The problems that these social changes caused for religion must still be understood in the context of greater pluralism and competition. It is this context that sets the parameters within which religious institutions in the modern period respond to the social changes in question. The themes of pluralism and competition are thus the keys to understanding the degree to which religious beliefs, practices, and institutions lost significance in late nineteenth- and early twentieth-century English society. In Secularisation in Western Europe, –, Hugh McLeod agrees with Kselman and Cox “that pluralism is the key to the religious situation in later nineteenth-century Europe, and that trends towards secularisation have to be seen in the context of intense religious competition, whether between rival branches of Christianity or between religious and secular views of the world.”28 The effects of this competitive situation for religion varied according to the social role of religion in question and the particular geographical context (England, Germany, or France). Secularization was most prominent in the area of religious beliefs and practices, and this was true for all three of the countries he studied. In terms of the power of religion to convey a sense of identity to a given society, secularization occurred to a much lesser degree in all three contexts. As for the influence of religion on public institutions, the degree of secularization falls somewhere in between the other two areas just mentioned, with secularization being most prominent in France and least prominent in Germany. Secularization, then, is “a question to be put to the [historical] evidence, rather than a preconceived conclusion,” and any explanation of religious decline as an inevitable, coherent “process” arising out of modernity should be questioned, even if the evidence points toward greater or lesser degrees of secularization in late nineteenth- and early twentieth-century Europe.29

28 29

McLeod, Secularisation in Western Europe, . Ibid., –, –.




Callum Brown does not stress the importance of pluralism as do Kselman, Cox, and McLeod, though he shares their criticism of the secularization thesis. In The Death of Christian Britain, Brown argues that secularization has not been a long, ongoing process dating back to the Industrial Revolution. It began, rather, quite suddenly through the cultural revolutions of the s. Brown concedes that trends toward a decline in church attendance reach back to the end of the nineteenth century, but many other forms of religiosity, including church membership, church rituals like baptisms and marriages, Sunday School attendance among children, etc., declined significantly only in the s. The s also marked a significant decline in the pervasiveness of a Christian culture in British society. Brown attributes the primary causes of this decline not to social changes stemming from modernity, such as industrialization and urbanization, but to various manifestations of the cultural revolutions of the s, including the rise of a rebellious youth culture and the overturning of traditional models of sexuality and femininity rooted in an evangelical Christian tradition. Brown believes that because the traditional secularization theory and narrative have failed to explain adequately the nature of religious change in modern European history, what is needed is a “postmodern” analysis that questions traditional approaches to the study of secularization, such as the use of statistics to measure the strength/weakness of religion and the tendency to employ definitions of religion that exclude diverse expressions of piety and religiosity.30 When comparing the views of these four historians, several commonalities are noteworthy. First, for three of them, “pluralism” and “competition” are more apt descriptors than “secularization” for the changes taking place in modern European religious history.31 Their views are similar to those sociologists who support rational choice theory and its emphasis on the importance of competition (or lack thereof) in describing the religious changes of the past few centuries. Second, all four historians 30 Callum Brown, The Death of Christian Britain (London: Routledge, ). See also his essay, “The secularisation decade: what the s have done to the study of religious history,” in Decline of Christendom, –. 31 While technically not a historian, Charles Taylor can also be included in this group. In his philosophical analysis of modern religious history, Taylor maintains that the emergence of pluralism marks the transition from a pre-modern West, in which practically everyone believed in God or the supernatural, to a modern West, in which faith is only one possible means among many to make sense of reality. See Taylor, A Secular Age (Cambridge, Mass.: The Belknap Press of Harvard University Press, ).

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accept the reality of secularization in modern European history, though they do not accept the secularization theory that has been used to explain religious decline. As Brown puts it, “[t]he theory of secularisation may be a myth, but secularisation is not.”32 Finally, while all four historians acknowledge that secularization was occurring in the nineteenth century, they contend that religious beliefs, practices, and institutions were also far more resilient in the face of modernity than many scholars traditionally have assumed. Significant secularization did not begin to take place until the end of the nineteenth century, and, from Brown’s perspective, the late twentieth century.

D. The Secularization Debate in Swedish Religious History Few Swedish historians have been deeply influenced by the revisionist efforts of historians such as Hugh McLeod or Callum Brown. Most Swedish scholars have relied quite heavily on the secularization theory to make sense of religious decline in Sweden over the past several centuries. Two kinds of historical scholarship on secularization in Sweden have been prevalent since the s.33 Representatives of the first approach, mainly church historians in the s and s, have focused primarily on the decline in particular religious beliefs and practices in nineteenthand twentieth-century Sweden. The second approach, which developed in the late s but became dominant particularly in the s, has been employed by a broader range of historians, including social and economic historians. This school of thought has concentrated on the degree to which a unified religious worldview and culture in the early modern period gave way to an individualized (and thus “secularized”) approach to religion in the modern era.34

32

Brown, “The secularisation decade,” Decline of Christendom, . Other studies address the topic of secularization but do not fall into the two categories discussed here. These studies typically define secularization in a more restricted sense, such as a separation of church and state, and are not really engaged with the secularization thesis. See Lennart Tegborg, Folkskolans sekularisering –. Upplösningen av det administrativa sambandet mellan folkskola och kyrka i Sverige (Stockholm: Almqvist & Wiksell, ); Bengt Thelin, Exit eforus. Läroverkens sekularisering och striden om kristendomsundervisning (Stockholm: Libris, ). 34 Olle Larsson also notes that there have been two basic approaches to the study of secularization in Sweden. His categories largely coincide with the ones used in this 33




The pioneer of modern historical studies of secularization in Sweden, and the most prominent representative of the first approach, is Carl Henrik Martling. In his  study of Eucharistic participation in the Karlstad diocese in the nineteenth and twentieth centuries, Martling argues that the religious fracturing of the diocese beginning in the second half of the nineteenth century contributed to a Eucharistic crisis by the s. Baptists, Methodists, Swedish Mission Covenanters, and low-church revivalist movements contributed to greater questioning and criticism of the established Lutheran church, the Church of Sweden.35 Their criticisms undermined the doctrinal unity and religious authority that had traditionally existed in Sweden, giving people greater “permission” to question the validity of the Church of Sweden’s teachings and rituals. Martling concedes that social changes such as urbanization and industrialization contributed to a decline in Eucharistic participation, but the importance of these changes is secondary, at least as they apply to church practices in the late nineteenth century. In a follow-up study of patterns of church participation in the nineteenth and twentieth centuries, Martling arrives at similar conclusions for the dioceses of middle Sweden. Free churches were most prominent in middle-Swedish dioceses in the late nineteenth century. These dioceses also witnessed the largest decline in church attendance and Eucharistic participation in the late nineteenth and early twentieth centuries. Martling concludes that the greater the religious fracturing and division in a given region, the greater the decline in certain church practices.36

discussion, though I have chosen to characterize the second approach by the definition of secularization employed by its representatives, that is, the transition from a unified religious culture to religion as an individual matter. Larsson describes this second approach primarily by its tendency to view popular and revivalist movements as the culprits in secularization. See Olle Larsson, Biskopen visiterar. Den kyrkliga överhetens möte med lokalsamhället – (Växjö: Växjö Stiftshistoria Sällskap, ), –. 35 The designation “Church of Sweden” (Svenska kyrkan) was first used in a legal sense in the  Dissenter Law. For the sake of consistency, I will use the designation “Church of Sweden” throughout, even in discussions pertaining to the period before . 36 Carl Henrik Martling, Nattvardskrisen i Karlstads stift under -talets senare hälft (Lund: Gleerups, ); Kyrkosed och sekularisering (Stockholm: Sveriges Kristliga Studentsrörelses Bokförlag, ). In the latter study, Martling notes that the marked decline applies only to church attendance and Eucharistic participation. One-time church rituals, like baptism, confirmation, and marriage, continued to witness a high degree of popular observance up until the time of his study.

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Martling’s work inspired similar studies in the ensuing decades. Anders Gustavsson’s study of churching in Sweden reaches conclusions that parallel Martling’s.37 Churching declined the most in those regions of Sweden that witnessed a strong free church presence in the late nineteenth century.38 Kjell Petersson drew similar conclusions concerning baptism. Dioceses that witnessed the largest decline in the frequency of baptism beginning in the late nineteenth century also experienced the highest level of free church activity. This trend held true at least until the mid-twentieth century.39 Since the s, the dominant historical approach has focused not so much on particular church rituals but rather on the separation of religion from culture. This separation is understood as a transition from a onceunified religious culture in which practically everyone belonged to the one true Lutheran faith and interpreted the world around them according to this faith, to a society in which religion becomes a private matter, an individual choice. The Danish historian Hanne Sanders is perhaps the most influential representative of this approach. In her study of revivalism in early nineteenth-century Denmark and Sweden, Sanders draws on the work of C.J. Sommerville. She argues that secularization refers not so much to a decline in certain doctrines or practices but rather to a loss in religion’s significance for a society’s worldview. From once providing the background for much of the culture and knowledge in society, religion becomes a matter of individual, existential faith. Sanders believes that while the early nineteenth-century revivalists held a presecularized worldview to the extent that they believed that there was only one true faith, they also contributed to secularization by advocating an individualized interpretation of that faith and of the Bible. This individualized 37 Churching was a purification ritual that reintegrated a mother into the parish community after giving birth. Approximately one month after childbirth, the mother fell on her knees either inside the church door or in front of the altar rails. The priest would then pray for her and give thanks to God for her health. In some cases, churching could take place in the home, and in the nineteenth century it became more common for it to occur in conjunction with baptism. It began to disappear toward the end of the nineteenth century, though in some dioceses, such as Gothenburg and Kalmar, it continued into the early twentieth century. In addition to Gustavsson’s work, see Oloph Bexell, Sveriges kyrkohistoria . Folkväckelsens och kyrkoförnyelsens tid (Stockholm: Verbum, ), – . 38 Anders Gustavsson, Kyrktagningsseden i Sverige (Lund: Folklivsarkivet, ). 39 Kjell Petersson, Kyrkan, folket och dopet. En studie av barndopet i Svenska kyrkan (Lund: CWK Gleerup, ).




approach to religion is thus a necessary precondition for a secularized society, for it is a step toward the differentiation between religion and culture.40 Other historians echo Sanders’s conclusions, even if there is no consensus on the timing of this process. In his study of eighteenth-century Stockholm, Börje Bergfeldt adopts Sanders’s interpretation of secularization, but he pushes the beginning of this process back one century. He notes that in the late seventeenth and early eighteenth centuries, the religious and profane were still tightly intertwined. Sweden was still a presecularized society. By the late eighteenth century, the evangelical Lutheran religious tradition began to lose its function as the glue holding society together. As evidence for this initial phase of secularization, Bergfeldt points to several eighteenth-century developments, including a decline in the appeal to religious sanctioning when imposing civil punishments, functional differentiation, and the individualization of religious faith that was already surfacing in Pietistic and Moravian-inspired revivals.41 Olle Larsson dates the beginning of secularization even earlier in his study of bishop visitations in the diocese of Växjö in the late seventeenth and early eighteenth centuries. In the mid-seventeenth century, the identification of religion with the culture of Swedish society was still quite strong. One hundred years later, clear signs of the dissolution between the two had manifested themselves. Larsson points in particular to the development of individual Bible reading in this period. In the s, religious instruction in the diocese of Växjö consisted primarily of urging parishioners to learn the catechism. The s onward saw an increasing emphasis on using the Bible in religious instruction. By the mid-eighteenth century, parishioners in the diocese were encouraged to acquire Bibles of their own so that they could study them in their homes. Larsson believes that this development toward more individual study and reading of the Bible led to an individualization of religious faith, and this in turn opened the door to more secularized patterns of thought. 40 Hanne Sanders, Bondevækkelse og sekularisering. En protestantisk folkelig kultur i Danmark og Sverige – (Stockholm: Stockholms universitet, ). For earlier studies that emphasize the role played by early revival movements in secularization, see Arne Jarrick, Den himmelske älskaren. Herrnhutisk väckelse, vantro och sekularisering i -talets Sverige (Stockholm: Ordfront, ); Tom Eriksson and Börje Harnesk, Präster, predikare och profeter. Läseriet i övre Norrland – (Gideå: Vildros, ). 41 Börje Bergfeldt, Den teokratiska statens död. Sekularisering och civilisering i talets Stockholm (Stockholm: Almqvist & Wiksell, ).

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Ironically, the Church of Sweden encouraged this development and thereby contributed to the conditions from which secularization would arise.42 One noteworthy attempt to nuance this second approach has been made by Stefan Gelfgren. Gelfgren also understands secularization as a process in which religion transitions from being a collective act, carried out under the auspices of one church, to an individual and voluntary commitment. But Gelfgren differs from these other historians in two ways. First, he argues that while secularization is synonymous with the individualization of religion, he does not believe that secularization necessarily involves the privatization of religion. Religion can become individualized and yet continue to be a public matter, such as when religious representatives continue to play an active role in politics. Second, Gelfgren affirms the role that religious pluralism and diversity played in the individualization of religion, but his thoughts on this relationship are much more informed by British scholarship, particularly the work of Hugh McLeod. He agrees with McLeod that late nineteenth-century European history is largely characterized by pluralism, and it is pluralism that leads to a situation of greater competition for religious ideas and institutions. He also agrees with McLeod that significant secularization did not set in until the late nineteenth century. Still, Gelfgren’s interpretation of the effects of pluralism differs little from that of other historians of secularization in Sweden. The competition that revivalist movements in late nineteenth-century Sweden gave to the Church of Sweden inevitably led to a relativization and subjectification of the traditional religious worldview as religious convictions became subject to personal choice among a plurality of religious and nonreligious ideas.43 This second approach to the study of secularization as articulated by scholars such as Sanders and Gelfgren differs from the first in several important ways. First, these scholars move beyond studies of secularization that focus primarily on popular participation in church rituals. Second, aside from Gelfgren, they typically push the timing of secularization back to an earlier period, anywhere from the late seventeenth century to the early nineteenth century. Finally, they are much more willing to include inner-church revival movements as culprits in the secularization 42 Larsson, Biskopen visiterar. Den kyrkliga överhetens möte med lokalsamhället –  (Växjö: Växjö Stiftshistoria Sällskap, ). 43 Stefan Gelfgren, Ett utvalt släkte. Väckelse och sekularisering—Evangeliska Fosterlands-Stiftelsen – (Skellefteå: Artos & Norma, ).




process, which is why many of them view the secularization process as beginning in an earlier period. Whatever the differences in the two approaches, one important commonality should not be overlooked. Martling’s interpretation that religious fracturing and dissent led to a decline in religion’s influence in Swedish society has continued to hold sway among historians even in more recent decades. For all of the historians mentioned above, religious pluralism is a major factor in the decline of the influence of religion (that is, the traditional evangelical Lutheran religion) in Sweden. The common assumption is that pluralism inevitably undermines the influence of religion by relativizing religious truth and creating the conditions in which religion becomes an individual matter and thus not the glue holding society together. Therefore, while representatives of the two approaches may differ on the timing of secularization or on the extent to which innerchurch movements contributed to a decline in religion’s influence, they agree that religious pluralism and secularization go hand in hand, an assumption that they share with defenders of the secularization thesis.

E. The Place of the Present Work in Secularization Scholarship This work falls into the category of Anglo-American scholarship that is skeptical of the secularization thesis. Like Kselman, Cox, and McLeod, and even to some degree like the rational choice theorists, I argue that pluralism, and the competition arising from it, is the key to interpreting the extent to which religion lost and/or maintained influence in European society in the late nineteenth century. To be sure, the theme of pluralism also occupies a central place in Swedish scholarship, but I do not assume that pluralism necessarily leads to secularization. Rather, pluralism creates the conditions for increased competition, and it falls upon the religious historian to determine whether religious institutions and professionals responded successfully to these circumstances. My purpose is to study the extent to which one group of religious professionals, the Swedish female diaconate, successfully competed or cooperated with a growing plurality of specialized providers of social services in the late nineteenth century. Even though I share the views of Anglo-American historians concerning the importance of pluralism and competition for interpreting secularization in late nineteenth-century Europe, the difference here is that the focus will be on exploring the potential connection between

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pluralism/competition and secularization on the societal and institutional level as opposed to the level of individual beliefs and practices. The tendency to place primary emphasis on the latter is still dominant among Anglo-American historians. Moreover, few of these historians are willing to test the sociological claim that functional differentiation leads to secularization. One notable exception is Jeffrey Cox. In English Churches in a Secular Society, Cox devotes significant attention in his study of late nineteenth- and early twentieth-century Lambeth to functional differentiation. Cox concedes that functional differentiation often leads to secularization, but the connection between the two is not a necessary one. Functional differentiation can sometimes contribute to an increase in religion’s social significance, as was the case in the area of education in mid-nineteenth-century Lambeth.44 I follow Cox in maintaining that the connection between functional differentiation and secularization is not as straightforward as some defenders of the secularization thesis insist. The deaconess movement in nineteenth-century Sweden was certainly not a victim of functional differentiation. If anything, the movement survived and expanded in the late nineteenth century largely because it responded so well to this modernizing process. I will sustain this argument in two ways, both of which relate to demand for the services of deaconesses. First, I will point to a number of situations in which the female diaconate offered essential social services that otherwise might not have been available, or at least not adequately available, to those who needed them. Deaconesses provided health care at hospitals and poorhouses, distributed food and clothing to the urban poor, helped working-class housewives earn extra income, and served as elementary school teachers in rural districts, among other things. There were plenty of cases in which deaconesses provided these services to recipients who needed them but who otherwise would have had few, if any, other opportunities to receive them, perhaps because there was a 44

Callum Brown also critiques the assumption that functional differentiation necessarily translates into a decline in the influence of religion in society, though he does not devote as much attention to the topic as Cox. Brown notes, for example, that the apparent government takeover of traditional church functions in Victorian Scotland should not be confused with secularization. Both the withdrawal of poor relief from the Church of Scotland in  and the establishment of the state system of education in  represent successful efforts by religious dissenters to remove these social functions from the absolute control of the Church of Scotland so that evangelicals could have more influence and control over these functions. See Callum Brown, Religion and Society in Scotland Since  (Edinburgh: Edinburgh University Press, ), .


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shortage of potential providers in a given location, or because some of the recipients could not afford the services in question. Deaconesses thus competed successfully for a place in the public sphere by meeting the demand for essential social services among people and in locations not adequately reached by other institutions or professionals. I will also support the main argument by reference to the demand for the services of deaconesses among potential employers. Demand for deaconesses consistently outweighed supply throughout the nineteenth century. One obvious reason for this was a supply problem—it was difficult to recruit and train deaconesses at a rate that kept up with demand. But other factors contributed to this demand, including government reforms in social services, the professionalization and medicalization of health care, the shortage of specialized professionals in some contexts, the relatively low cost of employing deaconesses, the general contentment among employing institutions and organizations with deaconess job performance, and the desire to employ specialized professionals who would perform the desired services in an overtly religious manner. Gender also contributed to employer demand, as the work in question was often deemed more appropriate for women to perform. Demand for deaconesses among potential beneficiaries and employers is particularly relevant because defenders of the secularization thesis argue that the theory at its heart focuses on a decrease in the demand for religion, whether it is a demand for religious rituals and worldviews or a demand for the social services of religious institutions and professionals.45 But in the case of deaconesses in late nineteenth-century Sweden, it is clear that their services were very much in demand. As for the inability of the female diaconate to meet this demand due to difficulties with recruitment, it is possible to argue this in itself reflects secularization. Bryan Wilson, for example, argues that the decline in the number of clergy in modern Britain corresponds to a decline in religion’s social significance.46 Steve Bruce maintains that the number of clergypersons, particularly in a state-supported church such as the Church of England, is an indication of “the social power of religion,” and if this number declines considerably in a given period, religion has lost much of its social significance.47 45

For example, see Bruce, God is Dead, –. Bryan R. Wilson, “Reflections on a Many Sided Controversy,” Religion and Modernization, . 47 Bruce, God is Dead, . 46

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I do not deny that a connection exists between lower supplies of religious professionals and secularization. When religious professionals are in shorter supply, the range of influence that they have in society is necessarily limited. A small number of religious professionals may also indicate that modern people are not as religious as their pre-modern predecessors, and therefore a religious profession has less appeal and prestige. But small numbers of religious professionals do not necessarily indicate that these professionals (or religion in general) lack social significance, or that their services are not in demand, any more than a low supply of police officers or school teachers today amounts to a lack of social significance or low demand for these professionals. The heart of the secularization thesis deals with the demand for religion, and that is why my argument for the social significance of deaconesses depends primarily on demand for their services. The social significance of deaconesses also cannot be explained away by the argument that in carrying out essential social functions, they failed to do so in a particularly religious manner. Bruce argues that even when religious institutions and professionals continue to carry out what may be considered “secular functions” in the modern era, they do so only within a secular framework. While “[s]piritual values may inspire the Church’s involvement in social work . . . there is very little in the expression of that inspiration that distinguishes it from secular provision.”48 Perhaps this argument rings truer for the late twentieth century. I will show that in the late nineteenth century, deaconesses performed social functions in an overtly religious manner. Those who came into contact with deaconesses had no doubt that the sisters were engaged in religious work. Despite my skepticism toward the secularization thesis, I agree with sociological defenders of the theory on a couple of important points. First, I do believe that functional differentiation often led to a decline in the social significance of religious institutions and professionals. In many instances over the past two centuries, religious institutions and professionals did not respond adequately to the more competitive conditions generated by increasing functional differentiation. I am not attempting to refute the connection between functional differentiation and secularization altogether. I am simply arguing that secularization is not the only possible outcome of functional differentiation. After all, the female diaconate of Sweden is a product of this same modernizing process.

48

Bruce, God is Dead, .


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Second, Wilson notes that many critics of the secularization thesis are so keen to undermine the theory by recourse to data on church membership, church attendance, and participation in church rituals that they fail adequately to address the issue of the larger social significance of religion. Wilson is right to criticize skeptics of the secularization thesis for placing too much emphasis on individual beliefs and practices.49 By focusing primarily on the larger social significance of religion, I am addressing some justifiable concerns of defenders of the secularization thesis.

F. Gender and Religion in Modern Sweden But how, given their gender, were deaconesses able to wield any influence in the public sphere and to engage in such public work as nursing? It is an important question considering the prevailing gender norms of nineteenth-century Sweden and the expectation that women (and women’s work) were to be confined to the domestic, private sphere. I will answer this question by arguing that the female diaconate gained access to and influence in the public sphere by reconciling its work with the traditional Lutheran construction of gender. According to this construction, a woman lived out her calling within the household estate as a mother, daughter, sister, servant, etc. She did this according to the gifts and qualities that God had given particularly to her sex, including meekness, tenderness, obedience, and humility. Female diaconal work was interpreted, organized, and carried out as an extension of the household sphere, with its attendant feminine responsibilities and characteristics. As a result, both deaconesses and the institution’s leadership alleviated many genderbased concerns over diaconal work, thereby gaining greater access to and influence in the public sphere. My argument concerning the importance of the traditional Lutheran construction of gender for justifying diaconal work takes its inspiration from the scholarship of several Swedish historians of gender from the past two decades. In particular, Inger Hammar’s work on the importance of the traditional Lutheran understanding of gender for the pioneers of the women’s emancipation movement in Sweden has proven

49 Wilson, “Reflections on a Many Sided Controversy,” Religion and Modernization, –.

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most fruitful for the gender analysis at work in this study. According to Hammar, these nineteenth-century pioneers justified their demands for greater freedoms not by overturning or ignoring traditional religious understandings of the place of women in society, but by reinterpreting them so that the private (i.e., domestic) sphere to which women were called was extended. Hammar’s work departs significantly from that of Swedish historians of gender since the s. The latter typically depicted the early women’s emancipation movement as being driven by economic or psychological motives. To the extent that these scholars addressed religion, they did so one-dimensionally by portraying the Church of Sweden, represented by the clergy, as uniformly hostile to the emancipation movement.50 This failure to understand the role played by religious ideology in the movement leads Hammar to deem this research “religionblind,” in the same way that historical scholarship prior to the s was “gender-blind.” Hammar contrasts the situation in Swedish gender history with that of Anglo-American scholarship. She notes that in Britain and the United States, considerable work has been done by scholars such as Lyndal Roper and Rosemary Radford Ruether on the implications of the Lutheran (and more generally, the Reformation) construction of gender for the place of women in society in early modern Europe. The reasons why Swedish historians have not followed in the footsteps of Anglo-American gender studies are several, according to Hammar, including the tendency in contemporary secularized Swedish society to view religion as a private matter, and the trend of s historical scholarship toward viewing material needs as the driving force in history.51

50 Hammar points to two influential works as examples of earlier studies that portray religious authorities only as hostile to the women’s emancipation movement: Gunnar Qvist, Kvinnofrågan i Sverige –. Studier rörande kvinnans näringsfrihet inom de borgerliga yrkena (Göteborg: Akademiförlaget-Gumperts, ); Eva Åsbrink, Studier i den svenska kyrkans syn på kvinnans ställning i samhället åren – (Stockholm: Almqvist & Wiksell, ). 51 Inger Hammar, Emancipation och religion. Den svenska kvinnorörelsens pionjärer i debatt om kvinnors kallelse ca – (Stockholm: Carlsson, ). For an overview in English of Hammar’s conclusions concerning the relationship between religious ideology and the women’s emancipation movement, see Inger Hammer, “From Fredrika Bremer to Ellen Key: Calling, Gender and the Emancipation Debate in Sweden, c.–,” in Gender and Vocation: Women, Religion and Social Change in the Nordic Countries, – , ed. Pirjo Markkola (Helsinki: SKS, ), –.


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Hammar’s work inspired other Nordic gender historians to devote greater attention to religion as a catalyst for women’s participation in the public sphere in the nineteenth century.52 In her study of the involvement of deaconesses in poor relief in late nineteenth- and early twentiethcentury Finland and Sweden, the Finnish historian Pirjo Markkola comes to a conclusion similar to Hammar’s. The apparent public work of the women in question was possible in part because this work could be interpreted as an extension of the household sphere. Markkola also agrees with Hammar that the reason Nordic gender studies have largely ignored religious interpretations of women’s participation in the public sphere primarily has to do with the secularized worldviews of contemporary Nordic societies. Deaconesses, on the other hand, provide historians with an excellent example of just how important religion was to inspiring women’s involvement in the public sphere in the nineteenth century.53 In her study of rescue work among prostitutes in late nineteenth- and early twentieth-century Sweden, Anna Jansdotter also accepts Hammar’s interpretation that women’s philanthropic work was, in effect, an extension of the private sphere. Jansdotter argues that those engaged in rescue work attempted to rehabilitate prostitutes by privatizing these “public” women. Rescue workers sought to do this by attempting to convert prostitutes to an evangelical, revivalist worldview and way of life. Without converting “fallen women” to evangelical Christianity and getting them to conform to a traditional religious construction of gender, there could be no true rehabilitation.54 My work is clearly indebted to these Nordic gender historians in its emphasis on the importance of the traditional Lutheran construction of gender for justifying the work of the female diaconate in nineteenthcentury Sweden. But one important point of divergence between my

52 An important precursor to Hammar’s work which has also helped to inspire greater attention in the past decade to the role that religion played in women’s social involvement in the nineteenth century is Ingrid Åberg’s “Revivalism, Philanthropy and Emancipation. Women’s Liberation and Organization in the Early Nineteenth Century,” Scandinavian Journal of History  (), –. 53 Pirjo Markkola, “Promoting Faith and Welfare. The Deaconess Movement in Finland and Sweden, –,” Scandinavian Journal of History  (), –. See also Pirjo Markkola, “The Calling of Women: Gender, Religion and Social Reform in Finland, –,” Gender and Vocation, –. 54 Anna Jansdotter, Ansikte mot ansikte. Räddningsarbete bland prostituearde kvinnor i Sverige – (Stockholm: Brutus Östlings Bokförlag Sympoion, ).

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study and the studies mentioned above should be addressed. In much of the Nordic scholarship, the dichotomy of private sphere versus public sphere is prominent, even though some of the historians attempt to problematize this dichotomy. I will certainly make plenty of references to this dichotomy, and my definition of the public sphere has much in common with the way the concept is used by these historians. But when these Nordic historians refer to the private sphere, they are typically associating this sphere with the family or household alone, that is, the domain historically assigned to women. When scholars of secularization allude to a private sphere, on the other hand, the concept is not limited to the household, but rather includes any aspect of society, or activity within society, that does not directly affect or influence the social, political, or economic functioning of society at large. Nevertheless, there is obviously a gender component even to this usage of the term, particularly as the term is applied to nineteenth-century European history, given the obstacles that women have had to overcome in order to carry out essential social functions in the public sphere. In order to avoid confusing the different connotations of the term “private sphere” found in gender history on the one hand, and in many historical and sociological studies of secularization on the other, I have chosen to use the term in accordance with secularization scholarship. The terms “domestic sphere” or “household sphere” will be employed in many of those cases where Hammar and other gender historians would use “private sphere.” The difference lies primarily in semantics. The choice of different terminology should not conceal the fact that I am making an argument similar to Hammar’s concerning how particular groups of women justified their activities in the public sphere. Finally, it is important to note that the increased scholarly attention to the relationship between gender and religion in nineteenth-century Sweden has also led some historians to give greater consideration to deaconesses in their studies.55 While not all of the studies in question 55 Until recently, much of the historical work on the deaconess movement was written by “insiders”–people connected directly to the Swedish Deaconess Institution. Historical surveys written by directors, or former directors, of the Swedish Deaconess Institution are prime examples of such work. See Yngve Iverson, Tro verksam i kärklek. En bok om Ersta (Stockholm: Verbum, ); Ernst Lönegren, Minneskrift till Svenska Diakonissanstaltens femtioårsjublieum (Stockholm, ); and J. Norrby, Minnesblad från diakonissanstalten i Stockholm – (Stockholm: Diakonissanstaltens Bokföråd, ). Some older studies of the nineteenth-century deaconessate also examined the contributions that deaconesses made in Swedish society through carrying out particular social functions,


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focus exclusively on deaconesses, deaconesses do comprise an important strand in the scholarship. Two studies mentioned earlier in this section are examples of this increased interest in the deaconessate. Pirjo Markkola’s study of deaconesses involved in social welfare in late nineteenth- and early twentieth-century Finland and Sweden examines the important contributions that deaconesses made to poor relief in the late nineteenth century, a time in which many people in need of such relief were falling through the cracks of an overextended government-based welfare system. Anna Jansdotter’s study of rescue work among prostitutes in the nineteenth century devotes significant attention to the pioneering work of deaconesses in the field. In addition to these two studies, Åsa Andersson’s examination of the how the idea of calling shaped the development of the nursing profession in late nineteenth- and early twentiethcentury Sweden devotes considerable attention to deaconesses.56 What these three studies share is an interest in highlighting the role that religion played in motivating and even empowering deaconesses to participate in the public sphere. These recent trends in Swedish gender history have even influenced the most important scholar of the nineteenth-century Swedish deaconessate, Gunnel Elmund. Elmund has written the two most important scholarly studies of the female diaconate. Her first book, published in , focused on the origins of the deaconessate and the first decade of its work. It provided a general introduction to female diaconal work in the mid-nineteenth century, and it pointed to the ways in which continental deaconess institutions, particularly those at Kaiserswerth and Strasbourg, influenced the deaconess institution in Stockholm. What this first book lacked was any detailed gender analysis. Her most recent book, published in , picks up where the first one left off chronologically. It analyzes how the director of the Swedish Deaconess Institution from  to , Johan Christoffer Bring, understood the doctrine of calling in relation to the deaconess vocation. Unlike her first work, this second study devotes plenty of attention to gender analysis, including such as education or child welfare. See Einar Ekman, Diakonien och folkskolan. En minnesvärd insats i svensk folkbildningsarbete under förra seklet (Stockholm: Föreningen för svensk undervisnings historia, ); Diakonala insatser i svensk socialpedagogik åren – i belysning av den allmänna utvecklingen på området (Stockholm: Föreningen för svensk undervisnings historia, ). The first of these will serve as an important resource for chapter three. 56 Åsa Andersson, Ett högt och ädelt kall. Kalltankens betydelse för sjuksköterskeyrkets formering – (Umeå: Umeå institution för historiska studier, ).

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attention to the Lutheran doctrine of a woman’s calling, and has clearly been influenced by the developments in Swedish gender history over the past decade.57

G. Sources The primary sources that I have relied on the most are nineteenthcentury deaconess publications and letters. The main deaconess periodical published in this period was the Olivebladet (The Olive Leaf). It began as a quarterly publication in , becoming a monthly by the turn of the century. Its contents included sermons, ceremonial addresses, and articles on diaconal work, as well as the deaconess institution’s annual reports containing information on the work stations to which deaconesses were assigned, the changes made in work station assignments, and employer requests for deaconesses that had to be rejected.58 Toward the end of the century, the Olivebladet published excerpts from deaconess letters concerning their work. This periodical offers abundant information concerning the extent of diaconal involvement in the public sphere and the ways that deaconesses and the Swedish Deaconess Institution sought to make this work conform to the traditional Lutheran constructions of gender. Another periodical, Febe (Phoebe), was an annual Christmas periodical that began publication in . Because Febe began much later in the period under examination here, and because it contained information that on the whole could also be found in the Olivebladet, its use in my study is much more limited. The letters cited in my work come from a variety of sources. Some are from the hands of deaconesses themselves and provide insight into the working conditions that they experienced as well as how their work was received by those who were recipients or beneficiaries of their services. Other letters were written by employers (or prospective employers) and prove most helpful in gauging both the extent to which deaconesses were in demand and how satisfied employers were with the work of deaconesses. 57 Gunnel Elmund, Den kvinnliga diakonin i Sverige –. Uppgift och utformning (Lund: CWK Gleerups, ); Det kvinnliga diakonatet som kall. Johan Christoffer Brings syn på diakonissverksamhetens uppgift och form (Skellefteå: Artos & Norma, ). 58 The annual reports before  contain much of the same information and will also be cited frequently, though obviously they were published separately and not included in another publication.


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In addition to these two important sources, I have made use of other primary sources in illuminating both the work of deaconesses and the character of the women who undertook this work. Such sources include hiring contracts, diary and journal excerpts, personal faith narratives, and minutes from meetings of the administration board of the Swedish Deaconess Institution. While the above-mentioned sources have proven most helpful, three problems pertaining to their use should be noted. First, the letters preserved from deaconesses derive mostly from the s and s, when diaconal work was predominantly geared toward education. We have far fewer letters from deaconesses involved in health care or poor relief, though by the s the Olivebladet did publish some such letters anonymously. Second, some letters sent to the Swedish Deaconess Institution from employing institutions have signatures that are often illegible. When such a letter is cited, as much identifying information as possible will be provided, including the name of the employing institution sending the letter and where in the deaconess archives the letter can be found. Finally, many of the articles published in the Olivebladet are unsigned, though it is likely that most were written by the director of the Swedish Deaconess Institution from  to , J.C. Bring. Nevertheless, citations of these articles contain no information concerning authorship. Concerning all primary and secondary sources, translations from the original Swedish and German are my own unless otherwise noted.

H. Outline The book is organized thematically. The second chapter will provide an overview of the deaconess movement in late nineteenth-century Sweden. I will discuss the continental and revivalist inspirations behind the movement as well as its organization, composition, and operation. Two themes that will emerge in the discussion are the religious orientation of the female diaconate and the challenges and obstacles that deaconesses faced in their quest to wield influence in the public sphere. As for the first theme, I will argue that the diaconate maintained a strong religious profile in its activities even as it expanded its work in the course of the late nineteenth century. In terms of the obstacles encountered by deaconesses, I will address two in particular—gender and recruitment. I will maintain that by organizing and interpreting its work according to the motherhouse system, the diaconate successfully reinforced its

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connection to the household sphere and thereby affirmed its fidelity to the Lutheran construction of gender. As for recruitment, I will point out that while the diaconate could not recruit enough deaconesses to keep up with demand for diaconal services, its social significance far exceeded the number of women in its service. In each of the three chapters that follow, I will focus on one of three social functions and the extent to which deaconesses exerted influence in the public sphere in carrying out each function. In chapter three, I will address diaconal work in the field of education. Service as teachers for private schools, particularly in rural areas but also in one Stockholm parish, dominated diaconal work in the formative period of the movement. The diaconate’s participation in teaching was significant for two reasons. First, because the nurturing and instruction of small children were tasks associated traditionally with mothers in the household sphere, deaconesses were able to reinforce their connection to that sphere in their work as teachers by extending these motherly duties into a public setting. Teaching helped deaconesses gain entry into the public sphere because in carrying out this work, they demonstrated a conformity to the Lutheran construction of gender, something that would have been important to some of the rural religious communities that hired them. Female diaconal participation in teaching was also significant because it helped to meet a demand for teachers that was created after an  statute that required all parishes to set up an elementary school and hire a teacher. Demand for deaconesses as teachers in some provincial areas was high in the s and s. By the s, the Swedish Deaconess Institution had largely abandoned this work. I will argue that while functional differentiation contributed to the leadership’s decision to discontinue teaching, this process did not force the diaconate out of education. A lack of commitment to education on the leadership’s part must be taken into account when explaining why the diaconate shifted its focus away from education and toward health care and poor relief from the late s. In chapter four, I will examine the work of deaconesses as nurses and health care professionals. Evidence for the influence of deaconesses is strong in this sphere of work, particularly once nursing became the primary focus of diaconal work in the late s. The modern nursing profession in Sweden owes its origins to the pioneering efforts of deaconesses. I will argue that deaconesses were very much in demand among employers at health care institutions, such as hospitals or nursing homes, and among poor and working-class patients in Stockholm. This demand


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persisted even in the face of significant competition from nurses trained at other institutions by the turn of the century. I will also make the case that deaconesses gained access to the public sphere via health care in part because they embraced the contemporary religious understanding of women as particularly gifted at showing compassion and tenderness to their fellow human beings. In chapter five, I will study the contributions of deaconesses in the field of poor relief, giving attention to their work in indoor relief (such as in poorhouses) and outdoor relief (as parish deaconesses). Deaconesses devoted more and more attention to poor relief throughout the period and were employed not only by religious organizations, such as parish councils, but also by secular institutions, such as municipal poor relief boards. I will argue that the demand for deaconesses in the field of poor relief, particularly among employers in need of outdoor relief workers, was fairly strong from the early s onward, in spite of the various specialized institutions and professionals that had arisen to carry out this work. I will also maintain that deaconesses used their gender as an asset and reinforced their connection to the domestic sphere by concentrating their poor relief work among women, children, and families. In chapter six, I will draw on the evidence presented in the previous chapters in order to assess the impact of functional differentiation on the social significance of Swedish deaconesses in the late nineteenth century. I will argue that the high demand for its services in the three areas under examination demonstrates that the female diaconate successfully responded to increasing functional differentiation. This success is all the more remarkable in light of the considerable obstacles deaconesses faced and overcame in their work, particularly with regard to gender. The case of the female diaconate in Sweden clearly shows that religious organizations and personnel were not always victims of modernization; sometimes, they were beneficiaries of it.

chapter two THE FEMALE DIACONATE IN NINETEENTH-CENTURY SWEDEN

My main purpose in this chapter is to orient the reader to what is likely an unfamiliar topic, the history and work of the nineteenth-century female diaconate in Sweden. In the first section, I will present a chronological account of the diaconate’s history until the turn of the twentieth century. The overall picture that will emerge is of a religious organization whose work and influence in society were expanding in a period of increasing functional differentiation. In the remaining sections, I will offer a closer look at the diaconate’s organization, composition, and operations. Two themes that will recur in these sections are the diaconate’s religious profile and the challenges deaconesses faced beyond functional differentiation in their quest for social significance. As for the former, I will emphasize the religious nature of the diaconate’s organization and education. This is important to highlight, given the assumptions of some secularization theorists that in a context of functional differentiation, a religious organization cannot wield influence in carrying out “secular” functions unless it tones down the religious elements of its work. Two particular challenges faced by the diaconate as it sought to wield influence in the public sphere are gender and recruitment/retention. I will argue that the diaconate successfully addressed many gender-based concerns to its activities by organizing and interpreting female diaconal work as an extension of the household sphere and thus in conformity with the Lutheran construction of gender. I will also maintain that while the diaconate’s struggles with recruitment limited the range of its public influence, demand for the services of deaconesses among prospective employers and “clients” was not adversely affected by these challenges.

A. The Origins and Formation of the Female Diaconate The deaconess movement in nineteenth-century Europe originated in Kaiserswerth, Germany, in response to a combination of socioeconomic

the female diaconate in nineteenth-century sweden

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and religious factors. The Napoleonic wars created impoverished conditions for many in Germany, and those who lived under such conditions, including a large number of widows and orphans, could not adequately be cared for by government poor relief. The end of the wars also marked the onset of industrialization and mechanization, with the result that many who had been dependent on the traditional economy, including single women of higher social classes, were displaced and forced to find other ways of supporting themselves. Industrialization and significant population growth also brought with them urbanization and congested cities, and the people who flocked to the cities in the first half of the nineteenth century to better their lot in the new emerging economy often encountered diseases such as cholera. Hospitals were in no position to help the afflicted, as they were little more than poor relief institutions at which patients largely were responsible for their own care, in some cases with the assistance of poorly trained servants.1 Leaders of the early nineteenth-century revival movements in Germany felt that a combination of social action and evangelization was the best way to improve these harsh conditions, since this approach would address both physical and spiritual needs. Some revivalist leaders sought to implement this approach through a renewal of the diakonia. The most prominent example of revivalist-inspired diaconal work was Johannes Wichern’s program of Inner Mission. Wichern began his work of Inner Mission in  with the establishment of Das Rauhe Haus, a home in which vagrant boys were supervised by Brüder, later to be designated as deacons. In , Wichern established a Bruderhaus to train men for diaconal work in a variety of settings, including prisons, halfway houses, and hospices.2

1 Tuulikki Koivunen Bylund, “Diakonissorna—kyrkans rödstrumpor?,” Kyrkohistorisk årskrift (), –; Gunnel Elmund, Den kvinnliga diakonin i Sverige –. Uppgift och utformning (Lund: CWK Gleerups, ), –; Nicholas Hope, German and Scandinavian Protestantism – (New York: Oxford, ), –; Jeannine E. Olson, Deacons and Deaconesses Through the Centuries (St Louis, Concordia, ), –. 2 Erich Beyreuther, Geschichte der Diakonie und Inneren Mission in der Neuzeit (Berlin: C.Z.V. Verlag, ), –; Hope, German and Scandinavian Protestantism, –; Olson, Deacons and Deaconesses, –. In , the Wittenberg Kirchentag formally adopted Wichern’s Inner Mission program and implemented it in the German Evangelical Church.



chapter two

Another pioneering effort in diaconal work was led by Amalie Sieveking of Hamburg. In , Sieveking recruited twelve Christian women to provide material and spiritual assistance to invalids and their families in poor households. This benevolent society became known as the Female Association for the Care of the Poor and the Sick. Its purpose was to provide both material and spiritual assistance to invalids and their families in poor households. Sieveking’s society went on to inspire others in Germany, and within sixteen years there were forty-five societies affiliated with hers. These societies provided an outlet both for women of upperclass means and for married women to engage in a type of diaconal work without themselves becoming deaconesses.3 The establishment of the female diaconate in Germany paralleled these revivalist-inspired engagements in social work. The founder of the deaconessate at Kaiserswerth, Theodor Fliedner, shared Wichern’s and Sieveking’s conviction that a combination of social action and evangelism was the best way to alleviate the sufferings of others. Fliedner was a Lutheran clergyman who in  was assigned to a Union parish (i.e., a combined Lutheran and Reformed parish) in the predominantly Catholic town of Kaiserswerth. His parish was underendowed and in desperate need of financial assistance, so in  and  Fliedner made trips to the Netherlands and England to raise funds. On his journeys, he studied how urban Christian charity was being conducted in hospitals, orphanages, and elderly homes, hoping to learn how he could better address the harsh socioeconomic conditions afflicting people back in Germany.4 Further visits to England, in particular a journey in  in which he met the likes of Thomas Chalmers, Robert Owen, and Elizabeth Fry, along with his own experience of the work conducted by the Sisters of Charity in Germany, inspired him to organize Christian charitable activities and institutions as well as to involve women in such work. In , Fliedner and his first wife, Friederike, established an asylum for released 3 Ursula Baumann, Protestantismus und Frauenemanzipation in Deutschland  bis  (Frankfurt: Campus, ), –; Elmund, Den kvinnliga diakonin, ; Olson, Deacons and Deaconesses, –; Catherine M. Prelinger, “Prelude to Consciousness: Amalie Sieveking and the Female Association for the Care of the Poor and Sick,” in German Women in the Nineteenth Century: A Social History, ed. John C. Fout (New York: Holmes & Meier, ), –. 4 Martin Gerhardt, Theodor Fliedner: Ein Lebensbild, vol.  (Düsseldorf-Kaiserswerth: Buchhandlung der Diakonissen-Anstalt, ), –; Hope, German and Scandinavian Protestantism, –.




female prisoners. Fliedner opened a sewing school for poor children in , and in  he formally established the female diaconate through the opening of the deaconess institution at Kaiserswerth.5 While the deaconess institution envisioned training women to participate in various types of social work, its primary task in the early years was to train nurses. Women’s participation in social work was still something of a novelty when Kaiserswerth opened its doors, but Fliedner believed that there would be less opposition to women working as nurses than as teachers, particularly given the appalling state of hospitals and the high demand for better-trained health care professionals. By mid-century, Fliedner would succeed in making teaching an important sphere of diaconal work, though nursing education would continue to be required. The field of diaconal work expanded in the second half of the century to orphanages, asylums, mental hospitals, and poorhouses.6 In the second half of the nineteenth century, Kaiserswerth became a model of diaconal work not only throughout Germany but in Europe and America as well. Particularly after the  revolutions, motherhouses based on the Kaiserswerth model began opening their doors.7 Fliedner established the General Conference in  as a means of uniting the growing number of deaconess motherhouses under the banner of mutual support for diaconal work, and by  there were fifty motherhouses, including the one in Stockholm, and just under , deaconesses connected to the General Conference.8 The socioeconomic and religious factors that led to the creation of the German deaconessate have parallels in early nineteenth-century Sweden. While industrialization and urbanization did not fully materialize until the second half of the century, significant economic and demographic changes were already manifesting themselves in the first half of the century. The manufacturing and textile industries gradually began to assume

5 Gerhardt, Theodor Fliedner , –; Hope, German and Scandinavian Protestantism, –; Olson, Deacons and Deaconesses, –. 6 Elmund, Den kvinnliga diakonin, ; Olson, Deacons and Deaconesses, , . 7 Olson, Deacons and Deaconess, . 8 Friedrich Thiele, Diakonissenhäuser im Umbruch der Zeit: Strukturprobleme im Kaiserswerther Verband deutscher Diakonissenmutterhäuser als Beitrag zur institutionellen Diakonie (Stuttgart: Evangelisches Verlagswerk, ), . Not all deaconess motherhouses were members of the General Conference. The list of motherhouses provided in the Swedish deaconess publication, Olivebladet, in , lists seventy-five. See “Öfversikt öfver de evangeliska diakonissanstalternas utveckling och närvarande ståndpunkt,” Olivebladet  (), –. See also Olson, Deacons and Deaconesses, , n. .



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production of goods that traditionally had been produced in the household or within the guild structures. At the same time, the population grew from . million to . million between  and . With the shift in economic production away from households and guilds, combined with improvements in cultivation techniques and the population increase, many people who had been able to support themselves in the traditional agrarian economy were finding it more difficult to do so in the emerging market economy.9 Women in particular struggled, in part because the household was increasingly becoming a unit of consumption rather than production,10 and in part because the population increase resulted in larger numbers of unmarried women.11 A series of legislative initiatives in the s gave unmarried women new possibilities to support themselves. These initiatives included the abolition of compulsory guild membership, increased access to trade, and the expansion of the right of inheritance to include women. Nevertheless, before mid-century, women did not have access to formal occupational education, so the new legislative measures did not immediately solve the problem of the growing number of unmarried women struggling to earn a living.12 Neo-evangelical revival leaders of the early nineteenth century were concerned with addressing the social problems of the day. Neo-evangelicalism was a movement with pietistic and Moravian tendencies that arose in the s under the leadership of the lay preacher C.O. Rosenius.13 By the end of the s, individuals influenced by neo-evangelicalism would

9

Elmund, Den kvinnliga diakonin, ; Stefan Gelfgren, Ett utvalt släkte. Väckelse och sekularisering—Evangesliska Fosterlands-Stiftelsen – (Skellefteå: Artos & Norma, ), –. 10 Eva Åsbrink, Studier i den svenska kyrkans syn på kvinnans ställning i samhället åren – (Stockholm: Almqvist & Wiksell, ), . 11 Gunnar Qvist estimates a  percent increase in the number of unmarried women in Sweden between  and . See Qvist, Kvinnofrågan i Sverige –. Studier rörande kvinnans näringsfrihet inom de borgerliga yrkena (Göteborg: AkademiförlagetGumperts, ), , . 12 Elmund, Den kvinnliga diakonin, ; Qvist, Kvinnofrågan i Sverige, . 13 There were a number of revival movements in the first half of the nineteenth century in Sweden that either preceded or coincided with neo-evangelism, including Hoofianism, Schartauism, the neo-readers movement, and the shouters movement. Most of these movements were also influenced by eighteenth-century pietism and Moravianism, and, like the neo-evangelical movement that followed, they were all inner-church (i.e., nonseparatist) revivals. For an overview of these various strands of inner-church revivalism in early nineteenth-century Sweden, see Anders Jarlert, Sveriges kyrkohistoria . Romantikens och liberalismens tid (Stockholm: Verbum, ), –, –, –.




be the leaders in promoting a solution to the social question based on a program of Inner Mission in the spirit of its German counterpart, which sought to improve the social conditions of the day through a combination of works of Christian love and evangelism.14 The person most responsible for creating initial awareness among Swedish revivalists about Wichern’s Inner Mission was Emilie Petersen. Petersen and her husband Johan came to Sweden from Hamburg during the Napoleonic wars. They settled on Herrestad estate in the province of Småland in . Petersen traveled back to Hamburg in  and became acquainted with Wichern’s work there. In , she and her husband set up a school for the children of the estate, a school that she continued to operate after Johan’s death in . Petersen began exchanging letters with Wichern in . Inspired by Wichern’s Rauhes Haus, she transformed her estate school one year later into a rescue home and school for poor and neglected children from both the estate and the parish. By the end of the s, she was describing her work as a form of Inner Mission.15 Some of the neo-evangelical revivalists instrumental in establishing both a program of Inner Mission in Sweden and the Swedish deaconessate were people who had spent time on Petersen’s Småland estate, including Per Magnus Elmblad, his wife Emilia, Peter Fjellstedt, and the first director of the Swedish Deaconess Institution, Marie Cederschiöld. The Elmblads were among the founding members of the Swedish Deaconess Society in , and Per Magnus was also the driving force behind the creation of the Association for Inner Mission in .16 Peter Fjellstedt served on the administrative board of the Swedish Deaconess Society from  to , and he worked some as a chaplain for the Swedish Deaconess Institution.17 Marie Cederschiöld, the daughter of a clergyman from the nearby Forsheda parish, actually lived and worked on Herrestad estate for two years, helping Petersen with both the rescue home and the women’s society. In her time there, she became acquainted

14 Anders Bäckström et al., För att tjäna. En studie av diakoniuppfattningar hos kyrkliga befattningshavare (Uppsala: Diakonistiftelsen Samariterhemmet, ), ; Elmund, Den kvinnliga diakonin, , . 15 Elmund, Den kvinnliga diakonin, . 16 Ibid., . 17 Olaus Brännström, Peter Fjellstedt. Mångsidig men entydig kyrkoman (Uppsala: Svenska institutet för missionforskning, ), –; Elmund, Den kvinnliga diakonin, , –.



chapter two

with the above-mentioned figures, all of whom would eventually play a role in her decision to accept the directorship of the new deaconess institution in Stockholm.18 While Petersen and her circle of friends clearly were instrumental in establishing a Swedish deaconessate, one tradition states that the actual idea to establish a female diaconate originated from the circulation of an annual report of the deaconess institution in Strasbourg that had made its way to Sweden. A prominent family from one of the provinces received a copy of this report. During their stay in Stockholm in –, they shared a translated copy of the report with various family members and friends connected with the neo-evangelical revivals in the city.19 Among those who saw the report was Oscar Carlheim-Gyllenskjöld, the division head in the government’s Ministry of Justice who would eventually become one of the original founders of the Swedish Deaconess Society as well as its first chairman. Carlheim-Gyllenskjöld reportedly was inspired by the Strasbourg report and wanted to create a similar institution in Stockholm.20 This tradition of the origins of the idea behind a Swedish deaconessate has some support in sources from the time, but it is also clear that there was familiarity with the German deaconessate among neo-evangelical leaders even before the Strasbourg annual report was being circulated. Most likely, the idea of creating a Swedish deaconessate was fueled from both Petersen’s circle and those inspired by the Strasbourg annual report. What brought these two streams together was the neo-evangelical revival in Stockholm at the end of the s. On  April , a meeting of those interested in creating a deaconess institution took place in Stockholm. At this meeting, the Society for the Preparation of a Deaconess Institution in Stockholm, later to become the Swedish Deaconess Society, was established. Among the sixteen people who participated were Carlheim-Gyllenskjöld, the Elmblads, Fjellstedt, and Rosenius.21 According to the minutes, the Society’s purpose was to create a deaconess institution “after the pattern of similar institutions that already exist in other Protestant countries.” This institution would then train “Christian-minded” women to work as nurses both at a hospital that 18

Elmund, Den kvinnliga diakonin, . “Fröken Marie Cederschiöld,” Olivebladet  (), ; Elmund, Den kvinnliga diakonin, ; Ernst Lönegren, Minneskrift till Svenska Diakonissanstaltens femitoårsjublieum (Stockholm, ), ; J. Norrby, Minnesblad från diakonissanstalten i Stockholm – (Stockholm: Diakonissanstaltens Bokföråd, ), . 20 Elmund, Den kvinnliga diakonin, –. 21 SBDAS minutes,  April , § , AA (vol. ), EDA. 19




would be established in Stockholm and in private homes.22 In a public announcement of the Society’s intentions published a couple of weeks later, the Society elaborated on the reasons why a deaconess institution was necessary. The announcement stated that the deplorable spiritual and physical condition of many Stockholmers, the lack of trained nurses, and the inadequacy of hospitals and government poor relief to care for people’s physical and spiritual needs were the main reasons behind the Society’s creation.23 The Society’s administrative board took steps later that year toward realizing its goal of a deaconess institution in Stockholm. The board turned to Theodor Fliedner at Kaiserswerth to explore its options. One idea it considered was to send students to Kaiserswerth to receive a deaconess education so that they could return to Stockholm to help begin the institution’s work. Another idea was to see if Fliedner would be willing to send a German deaconess to assist with the establishment of the Stockholm institution. Fliedner was in North America when the board made its inquiry concerning the second idea, and so it was his wife, Karoline, who responded to the request for assistance. She did not believe it was possible to send a German deaconess and advised the board to send Swedish women to train at Kaiserswerth. Emilia Elmblad contacted Marie Cederschiöld on behalf of the board to inquire whether she would be willing to travel to Kaiserswerth, and the latter accepted the invitation.24 Cederschiöld arrived in Kaiserswerth on  April . In the beginning, she had a difficult time adjusting to the work and living conditions there. She was initially assigned to work in the children’s ward of the hospital. In her diary, she complained that she was not used to caring for small children. She was also frustrated by her inability to perform routine household tasks, such as sweeping, scrubbing, and washing.25 These frustrations were compounded by the sleeping arrangements. Cederschiöld had to share living quarters with twelve probationary sisters. She complained that the sleeping situation was so bad that she had to lie “in the same bed with one who appeared to me to be a maid.”26 The sleeping arrangements improved, as she was soon allowed to move 22

SBDAS minutes,  April , § , AA (vol. ), EDA. “Anmälan,”  April , AA (vol. ), EDA. 24 MCD,  October ,  October , FX, EDA; Elmund, Den kvinnliga diakonin, –. 25 MCD,  April , FX, EDA. 26 MCD, April , FX, EDA. 23

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to a separate room with only three other women. Nevertheless, her initial experiences of frustration over her sense of incompetency in her duties and of struggling to adjust to living in close quarters with women from diverse social classes caused her to spend much of her first week at Kaiserswerth in tears.27 Despite these initial difficulties, in the end Cederschiöld’s work was positively evaluated. Fliedner, whom she described as “red-haired and ugly, but lively, warm-hearted, and brilliant,”28 told her at one point that “[i]f they do not want to have you in Stockholm, we want you here.”29 During her one year at Kaiserswerth, she not only successfully completed her nursing education at the hospital, she also gained practical experience serving in other divisions, including the orphanage and grammar school. Although she was not consecrated as a deaconess, both Fliedner and his wife deemed her ready to return to Stockholm to direct its deaconess institution. On  April , she left Kaiserswerth to return to Sweden.30 On  July , the first institution in Sweden to provide women with an occupational education, the Swedish Deaconess Institution (Svenska Diakoniss-Anstalten), was formally dedicated, with Cederschiöld as its director. The Institution’s first home, a two-story house that the administrative board rented in the Kungsholmen section of Stockholm, was ready to accept both its first sisters and its first patients.31 From this point to the end of the nineteenth century, the deaconessate’s history can be divided into three periods: a formative period (–), a transitional period (–), and an expansion and consolidation period (– ). The formative period (–) began with the opening of the Swedish Deaconess Institution. The two-story institution doubled as a deaconess home and a hospital. The hospital portion of the institution had twelve beds spread out in three different rooms. At first, only female patients were admitted to the hospital, along with children, but within a 27 MCD,  April , FX, EDA; Elmund, Den kvinnliga diakonin, ; Gunnar Stenvall, Marie Cederschiöld. Sveriges första diakonissa (Lund: C.W.K. Gleerups, ), –. 28 MCD,  June , FX, EDA. 29 MCD,  June , FX, EDA. 30 Elmund, Den kvinnliga diakonin, , –. 31 Yngve Iverson, Tro verksam i kärlek. En bok om Ersta (Stockholm: Verbum, ), ; Lönegren, Svenska Diakonissanstaltens femtioårsjublieum, , ; Stenvall, Marie Cederschiöld, .




few years men would also be treated. In addition to the hospital facilities, the institution had living quarters for the director and the sisters, a kitchen, an eating room, and a room for devotionals and other gatherings.32 Between the opening of the institution in the summer of  and the end of that year, six sisters entered the institution to begin their training as deaconesses. Most of these did not continue with their education, except for two: Ebba Zetterström and Charlotte Ljungberg. They became the first probationary sisters on  April . Both would eventually become the first deaconesses on  June .33 Although the intention behind the opening of the institution was to train deaconesses to work as nurses, in the next few years the institution gradually expanded its work to include other areas. In the summer of , a school for poor children from the Kungsholmen region of Stockholm was opened at the institution. One year later, the institution established an orphanage. By the end of the decade, the institution had taken over the Magdalene Home in Stockholm and had established a rescue home for young, neglected children. By this time, the work of the hospital and school had already grown enough that the institution was forced to relocate in  to another part of Kungsholmen. The institution began sending sisters to external work stations in . As the number of stations grew, it became clear that the demand for the services of deaconesses was primarily from private schools in rural areas, and in many cases the organizations behind hiring deaconesses in this period were various societies connected with Inner Mission. The clear focus of this period was on education, with deaconesses serving as teachers in twenty-five schools by .34 The fact that many deaconesses in this period were being hired by revivalist organizations reflects the independent status of the institution vis-à-vis the Church of Sweden as well as the strong identity that the founding members of the Swedish Deaconess Society continued to have with Inner Mission. While the Swedish Deaconess Society would remain an independent religious society throughout the late nineteenth century,

32

Iverson, En bok om Ersta, ; Norrby, Minnesblad från diakonissanstalten, . Elmund, Den kvinnliga diakonin, –; Iverson, En bok om Ersta, ; Lönegren, Svenska Diakonissanstaltens femtioårsjublieum, ; Stenvall, Marie Cederschiöld, . 34 Elmund, Den kvinnliga diakonin, –, ; Thorsten Levenstam, Kyrklig diakoni och samhällets sociala omsorgsarbete, omkring –omkring  (Älvsjö: Skeab Verbum, ), . 33



chapter two

the formative period witnessed a greater distance between the institution and the leadership and organization of the Church of Sweden than would be the case in subsequent decades. There were no Church of Sweden clergy on the administrative board when the institution was first established, nor was there initially any funding from the Church.35 The relationship between the Church of Sweden leadership and the institution was nevertheless cordial, and in the course of the formative period the ties between the two grew. This can be seen both through the inclusion of some prominent clergymen as members of the Swedish Deaconess Society and through the authorization in  of a collection from the Stockholm parish churches to help the institution.36 Marie Cederschiöld was the director and housemother of the institution throughout this period. Toward the end of the s, her health began to fail, and she expressed feelings of being overwhelmed by her responsibilities at the growing institution. In , the administrative board considered the possibility of hiring a chaplain to assist her. This plan was modified when she communicated to the board that her health had deteriorated so much that she could no longer continue to serve as the director. She formally stepped down in the spring of . The institution she left behind had by the time of her departure grown not only in terms of its onsite facilities, but also in terms of the total number of sisters and external work stations, which in April  numbered seventy-one and thirty-four, respectively.37 The transitional period (–) witnessed not only new leadership but also a shift away from the strong focus on training teachers. Cederschiöld’s successor in  was Johan Christoffer Bring, a Lutheran priest from the diocese of Lund. As a clergyman from a distinguished line of priests dating back to the seventeenth century, Bring brought a greater degree of legitimacy to the deaconess institution in church circles. Whereas the administrative board during the formative period was

35 Archbishop Carl Fredrik af Wingård was asked to become a member of the Swedish Deaconess Society in , and though he did accept, he died shortly thereafter. See Elmund, Den kvinnliga diakonin, . Even so, he was not asked to serve as a member of the administrative board, and the decision not to invite him to serve on the board was likely a conscious effort to maintain some distance between the new institution and the authoritative structure of the Church of Sweden. 36 Ibid., . 37 “Några drag ur Svenska Diakonissanstaltens historia, dess uppkomst och utveckling,” Febe (), ; “Fröken Marie Cederschiöld,” Olivebladet  (), –.




hesitant to connect itself too closely to the Church of Sweden’s organization and structure, Bring was an active participant in this structure throughout his career. During his tenure as director, which ended with his death in , Bring would serve as a court chaplain, a vice-chairman in Stockholm’s clergy society, and a member of the Church of Sweden’s mission board.38 Bring held a skepticism toward the neo-evangelical revival that largely had not existed among the leadership of the institution in its formative period. While he certainly respected revivalist leaders, he was opposed to lay preachers and to any association or organization that in his view possessed separatist tendencies.39 His concern about separatism was undoubtedly magnified by the birth and growth of the free churches, some of which arose out of neo-evangelicalism and which gathered strength in the wake of legislative measures that granted a larger degree of religious liberty from the late s onward.40 Bring further believed that the societies and associations connected to the neo-evangelical revival within the Church of Sweden, while perhaps necessary given the lack of faith that characterized the times, were not the ideal means for carrying out the work of churches, and this included the Swedish Deaconess Society. In the Olivebladet (The Olive Leaf), the deaconess periodical that Bring inaugurated in , he published articles and transcripts of speeches in which he advocated that under ideal circumstances, the proper sphere for female diaconate work was the parish church, not a free-standing society.41 Another change in the leadership of the institution occurred around the same time that Bring assumed the directorship. Oscar Carlheim-

38 Gunnel Elmund, Det kvinnliga diakonatet som kall. Johan Christoffer Brings syn på diakonissverksamhetens uppgift och form (Skellefteå: Artos & Norma, ), . 39 Ibid., –. 40 Several noteworthy legislative measures concerning the extension of religious liberty took place around the beginning of Bring’s tenure at the Swedish Deaconess Institution. In , the  Conventicle Decree that prohibited religious gatherings apart from the supervision of a member of the clergy was eliminated. The  Dissenter Law allowed people to leave the Church of Sweden in order to form a non-Lutheran Christian community, provided that they first were admonished by the parish priest and in some cases by the cathedral chapter. The  Dissenter Law modified the previous  law so that those leaving the Church of Sweden did not have to go through a process of admonishment by Lutheran church authorities. See Oloph Bexell, Sveriges kyrkohistoria . Folkväckelsens och kyrkoförnyelsens tid (Stockholm: Verbum, ), –, –; Jarlert, Romantikens och liberalismens tid, –. 41 Elmund, Det kvinnliga diakonatet som kall, –, .



chapter two

Gyllenschiöld, chairman of the administrative board since , stepped down from his position.42 During his tenure, the administrative board played a very prominent role in the leadership and decision making at the institution. The administrative board would continue to serve as the highest authority of the institution, but under Bring’s leadership there was a clear shift in de facto authority toward the position of the director. In the formative period, Cederschiöld served as both the director and housemother of the institution. When Bring took over the director position, the administrative board found itself in need of someone to assume the duties of housemother. In , Clara Eckerström became the institution’s second housemother. Like Cederschiöld before her, she was never consecrated as a deaconess, but she did apparently wear the deaconess uniform.43 With Bring and Eckerström in place, the administrative board decided that due to its recent expansion, it was necessary to relocate once again. In , the institution moved its facilities to Ersta in the Södermalm region of Stockholm. The move to Ersta would be the last, as the institution remains there to this day.44 The transitional period is so designated because there was a shift away from the concentration on education that had dominated the deaconessate’s efforts in the formative period, at least outside the institution. The decision to cease its training of deaconesses as teachers did not come immediately with Bring’s directorship. In fact, the number of teaching work stations reached its peak in the middle of this period, with approximately thirty-three sisters working in thirty-three schools from  to .45 Once the administrative board made the decision to stop

42

SDSFU Berättelse och redovisning –, . Ibid., –. 44 In time, the institution became commonly referred to by those outside and inside of it as Ersta. In , the Swedish Deaconess Society changed its name to the Ersta Diaconate Society (Ersta diakonisällskap). See Iverson, En bok om Ersta, –. 45 SDSFU Berättelse och redovisning –, –; SDSFU Berättelse och redovisning –, –; SDSFU Berättelse och redovisning –, –. One problem in citing statistics for sisters assigned to schools outside the institution in the s and s is the issue of what counts as a school. Some orphanages had schools, and some schools were primarily oriented toward teaching girls household skills like sewing. In some cases, sisters served part-time in a school and part-time in another area, such as health care. In the numbers cited here from  to , the decision has been made not to include stations that were primarily orphanages but that also had school instruction for the orphans. 43




fulfilling new requests for teachers in –, the number of sisters and stations within the field of education began to decrease sharply. By  there were only eleven sisters assigned to eleven schools.46 In the same year, the administrative board formally disbanded the teacher seminary at the institution and the institution’s school for poor children, marking the end of an era in which diaconal work had been largely synonymous with teaching.47 Table —Educational External Work Stations, – Year

Number of Stations

Number of Sisters Assigned

              

              

              

The institution began devoting its energies to its original goal of training deaconesses as nurses. In addition to its own hospital, which in its new location in Ersta had forty-six beds, the number of health care work stations outside the institution, as with the number of sisters assigned to them, began to increase. From a total of five health care stations with nine sisters in , by  there were twelve stations with eighteen sisters.48 This focus on health care would strongly characterize the work of the deaconessate for the remainder of the nineteenth and throughout the twentieth century.

46

SDSFU Berättelse och redovisning –, –. Elmund, Det kvinnliga diakonatet som kall, ; Iverson, En bok om Ersta, , . 48 SDSFU Berättelse och redovisning –, ; SDSFU Berättelse och redovisning –, –. 47



chapter two

Along with health care, diaconal work in orphanages was also an area of focus throughout the transitional period, though this work would never be dominant. In addition to the work carried out at the institution’s own orphanage, there were nineteen sisters working at twelve orphanages outside the institution in .49 These nineteen sisters contributed to a total of  sisters in the service of the institution in . Just over half of these  sisters were assigned to  external work stations.50 The two preceding periods witnessed the expansion of the institution in several ways, including the number of sisters, the number of external work stations, and the number of divisions of work within the institution itself. In the expansion and consolidation period (–), the institution not only experienced significant growth in all of the above areas, it also consolidated its focus on the work of health care and poor relief, the two social spheres within which the female diaconate would wield the most influence in the late nineteenth century. The growth of the female diaconate continued with the creation of important new divisions within the institution that were established alongside those already in existence. A household school was established in  to prepare girls who had already been confirmed for domestic service in private homes. In , the institution created an elderly home for the growing number of sisters who, having worked many years in the service of the institution, were in need of a retirement home. One year later the institution set up a nursing home in order to care for chronically ill patients. In , a free polyclinic was established at Ersta to provide outpatient care for the poor. These new divisions, along with the building of other new facilities, paralleled the growth that was taking place in the total number of sisters and external work stations. When Bring first took over as the institution’s director in , there were  deaconesses and  external work stations. In , these numbers were  and , respectively, and by the end of , the year of Bring’s death, there were  sisters and  external work stations.51 The increase in external work stations in this period came largely in the fields of health care and poor relief. In , seventeen sisters worked in eleven health care stations outside the institution, but by  49

SDSFU Berättelse och redovisning –, –. Ibid., , –. 51 SDSFU Årsberättelse , Olivebladet  (), , –; SDSFU Årsberättelse , Olivebladet  (), , –. 50




the number of sisters working in such stations had doubled, and the number of stations had increased to eighteen.52 The growth in poor relief, particularly once parish deaconess stations were instituted, was even more significant. A parish deaconess was first hired in Stockholm’s Adolf Fredrik parish in . In  there were seven sisters working in seven parishes or poor relief institutions. By  those numbers had risen to thirty-eight and thirty-six, respectively.53 The growth in poor relief work is particularly noteworthy given the little attention this area received in the previous two periods. This increased interest in poor relief, particularly through work as parish deaconesses, had several motivators, including the famines of the late s, the changes in poor relief legislation in  that limited the extent to which the poor could have recourse to government poor relief, and Bring’s personal interest in connecting the diaconate more closely to the parish church structure. The growth in the number of parish deaconesses indicates that Bring was largely successful in the expansion and consolidation period both in bringing the diaconate closer to the Church of Sweden’s organization and structure and in increasing cooperation between the diaconate and the secular authorities. Table —Number of Sisters, – Year

Inquirers

Probationary Sisters

Deaconesses

TOTAL

          

          

          

          

          

52 SDSFU Årsberättelse –, Olivebladet  (), ; SDSFU Årsberättelse , Olivebladet  (), –. 53 SDSFU Berättelse och redovisning –, –; SDSFU Årsberättelse , Olivebladet  (), –.



chapter two

Table —External Work Stations, – Year

Total Number of Number of External Work Stations Sisters Assigned

          

          

          

Table —Health Care and Poor Relief External Work Stations, – Year

          

Health Care

Poor Relief

Number of Stations


Number of Stations


          

          

          

          

Bring died in the summer of  after thirty-six years of leadership, and he was succeeded in  by another clergyman from the diocese of Lund, Ernst Lönegren. Lönegren would be joined two years later by a new housemother and the first deaconess to occupy the position, Louise Heimbürger.54 Lönegren led the deaconessate into the twentieth century and helped it to celebrate its fifty-year anniversary in . In reflecting on the deaconessate’s fifty-year history, Lönegren noted that a total of 54

Iverson, En bok om Ersta, .




 women had at one point or another entered the institution to train and work as deaconesses. While many of these women did not serve the institution for an entire lifetime, Lönegren’s observation, combined with the growth in both internal divisions and external work stations, suggests that deaconesses were not a marginalized group of religious professionals operating on the fringes of society.55 Their numbers were perhaps modest, but in a half-century they still managed to expand their work and sphere of influence considerably, particularly in the areas of nursing and social work.

B. Leadership and Organization The Swedish Deaconess Society was the organization responsible not only for the creation of the Swedish Deaconess Institution but for its overall operations. This independence vis-à-vis the Church of Sweden meant that financial support for the institution came from the Society. The Society funded diaconal work in several ways, including membership fees, fees for diaconal services (such as health care at the institution’s hospital), collections from various parish churches or dioceses, and private donations. In the last quarter of the century, even the Stockholm municipal government contributed financially to certain aspects of the work. Private donations in particular would prove to be a significant source of revenue, as the establishment of new divisions and the building of new structures were funded largely in this manner. Those making such donations often came from the upper echelons of Swedish society and included the royal family, persons from the nobility, and famous Swedes ranging from the Nobel family to the renowned opera singer Jenny Lind. The Society delegated the actual decision making for the affairs of the deaconessate to an administrative board. This board consisted of twelve to sixteen members from the Society, representing both women and men. The board was responsible for selecting members and other board members for the Society, for hiring professionals to lead or manage the work of the institution, such as the director, housemother, doctors,

55 Lönegren notes that  of the  women who had at one point in the previous fifty years entered the institution to train and/or serve as deaconesses left its service for one reason or another. See Lönegren, Svenska Diakonissanstaltens femtioårsjublieum, – . A discussion of some of the challenges that the institution faced in retaining sisters in its service can be found in a later section of this chapter.



chapter two

and auditors, for overseeing larger financial matters, and for making final decisions concerning changes in or the expansion of diaconal work.56 The administrative board delegated the day-to-day administration of the institution to another body, the institutional board. This board consisted of the director and several female members chosen by the administrative board, though none were deaconesses. Once Bring became director, both he and the housemother were members of the institutional board. The institutional board made decisions concerning the admission of students, the promotion of students to probationary sisters and deaconesses, work assignments for the sisters, and the establishment of hiring contracts with employing institutions. In some cases it served as a preparatory body for the administrative board on matters such as the expansion of diaconal work.57 While the administrative and institutional boards were the highest decision-making bodies, de facto authority in many cases rested with one person—the director. He or she oversaw much of the day-to-day operations of the institution, conducted negotiations with employing institutions on behalf of the institutional board, made many of the decisions concerning deaconess work assignments, maintained regular contact with deaconesses in external work stations through letters and personal visits, and supervised the theoretical instruction of sisters. Because Bring was also a Lutheran priest, his duties as director included the supervision of pastoral care and worship life at the institution.58 The authority of the director vis-à-vis the administrative board was not clearly defined in the formative period. On several occasions, Cederschiöld encountered resistance from board members. One significant controversy was her decision to establish a school for poor children in  without first seeking approval from the board. This controversy will be covered in more detail in chapter three. Despite such controversies, Cederschiöld was often successful in implementing her ideas, largely because the board’s chairman, Carlheim-Gyllenskjöld, was her close ally.59

56 Stadgar för Svenska Diakoniss-Sällskapet,  June , § , AA (vol. ), EDA; Stadgar för Svenska Diakoniss-Sällskapet,  November , § , AA (vol. ), EDA; Stadgar för Svenska Diakoniss-Sällskapet,  June , § , AA (vol. ), EDA. 57 Elmund, Den kvinnliga diakonin, –; Lönegren, Svenska Diakonissanstaltens femtioårsjublieum, –. 58 Lönegren, Svenska Diakonissanstaltens femtioårsjublieum, . 59 Elmund, Den kvinnliga diakonin, .




During Bring’s tenure, the administrative board ceded more and more authority to the director in the day-to-day leadership of the institution. Bring never experienced the sorts of struggles with the board that Cederschiöld had to endure. This was likely due to Bring’s church office (along with the authority connected to it), and to reservations held by some board members concerning whether a woman had the authority to make independent decisions on behalf of the institution. In the formative period, Cederschiöld assumed the roles of both director and housemother. In the latter role, Cederschiöld was responsible for the supervision of household matters at the institution’s deaconess home, including the budget for household items, the work of servants, and the practical instruction of students in household tasks.60 When Bring took over as director, the institution found itself in need of someone who could assume the housemother responsibilities. For this reason, Clara Eckerström was hired in , and for the remainder of the period under study here, the positions of director and housemother were separated, though both worked together in the supervision of the day-to-day affairs of the institution. Bring’s hiring also solved a problem that had plagued the institution in its formative period—the need for a permanent chaplain. Several men served the institution as chaplain in the first decade, but none was able to give full attention to the position. With Bring, the institution had a fulltime, in-residence chaplain in addition to a director. The expansion of the institution and the growth in the number of sisters led the administrative board to hire an assistant chaplain in  to help Bring in his pastoral duties. It is clear that the deaconesses themselves had no formal leadership role in the institution. Even the two women who served as housemother throughout this period were not deaconesses. But deaconesses were not without influence in the decisions made by the higher governing bodies or the director. For example, each division at the institution (the hospital, the orphanage, etc.) was under the supervision and leadership of a deaconess, and this person clearly had influence in decisions made by one of the boards or the director pertaining to that particular division.61 Deaconesses also possessed the same rights as their counterparts at the Kaiserswerth and Strasbourg institutions in that a majority of them 60

Lönegren, Svenska Diakonissanstaltens femtioårsjublieum, . SDSFU minutes,  February , § , AA (vol. ), EDA; “Om diakonissanstalten i Stockholm,” Olivebladet  (), . 61

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had to give their approval before a probationary sister could become a deaconess.62 These privileges notwithstanding, it was not the place of a deaconess to wield authority on behalf of her surrogate family. Her responsibility was to carry out works of love on behalf of the poor, the sick, and the suffering, and to do so in obedience to the heads of the household.

C. The Calling of a Deaconess The observation concerning the responsibility of every deaconess on behalf of those in need, as well as her responsibility to show obedience to those in authority over her, touches on the larger issue of calling. Much attention was devoted in the educational program of the institution and in deaconess publications to the nature of a deaconess’s calling.63 But what did this calling entail, according to the institution’s leadership? More importantly, how did the leadership reconcile the apparent public nature of the deaconess vocation with the traditional Lutheran construction of gender and its relegation of women to the household sphere? According to lecture notes taken in – by Louise Heimbürger, then a student at the institution and later the institution’s housemother, those studying to become deaconesses were taught that the calling or vocation of a deaconess, irrespective of her particular work assignment, was “[t]o serve the Lord in His parish by means of caring for its sick, poor, prisoners, children, and others in need.”64 This phrase, or minor variations of it, was repeated often in deaconess publications.65 In his

62

Elmund notes that since it was difficult to get responses from those serving outside the institution concerning the potential promotion of probationary sisters, it was decided in  that only a majority of those deaconesses stationed at the institution had to give their approval. See Elmund, Den kvinnliga diakonin, . 63 Gunnel Elmund’s most recent book, Det kvinnliga diakonatet som kall. Johan Christoffer Brings syn på diakonissverksamhetens uppgift och form (), is an analysis of Bring’s beliefs concerning the calling of a deaconess. 64 LHA –, “Diakonissans kall,” Ö III b, EDA. Heimbürger’s notes were based on lectures that Bring gave to students who were beginning their training as deaconesses. 65 For example, see SDSFU Stadgar för Diakonissorna , I, AA (vol. ), EDA; “Om det heliga och tjenandet. VI. Diakonissans tjenande,” Olivebladet  (), ; “Diakonissans kall,” Olivebladet  (), . This phrase expands upon the groups of people to be cared for according to the initial stated purpose of the Swedish Deaconess Society. The Society’s original expressed




lectures to new students, Bring expounded upon the phrase by dividing the objects of a deaconess’s service into three categories: the Lord, the parish, and those in need. In serving the Lord, she served the One who had saved her from the power of sin and given her new life. In dedicating her life to the Lord’s service, she was not to be motivated by the expectation of earthly reward or honor but rather by the love of Christ. She was to look to the grace that Christ had poured upon her heart through the forgiveness of sins as her source of strength in carrying out the Lord’s work.66 This calling to serve the Lord was to be fulfilled “in the parish and for the parish.”67 The emphasis on serving the parish did not exist in the formative period but developed during Bring’s tenure, a reflection of his particular interest in bringing the deaconessate closer to the organization of the Church of Sweden as well as closer to how the diaconate functioned in the early church.68 Bring insisted so strongly on connecting a deaconess’s service to the parish that he once claimed that all deaconesses are parish deaconesses, since all deaconesses are servants of the parish.69 A deaconess was called not only to serve the local parish but to serve the larger church to which it was connected, the Church of Sweden. She was to be a faithful servant of this church because it was into this church that she was born and baptized, and it was within this church that she received both instruction in the true Christian faith and the means of grace to sustain and strengthen her in that faith. In serving the Church

intention was to train deaconesses to care for the sick and the poor, though other possible avenues for future diaconal work were not excluded. See SDSFU minutes,  April , § , AA (vol. ), EDA; “Anmälan,”  April , AA (vol. ), EDA. 66 LHA –, “Diakonissans kall,” I A, Ö III b, EDA. 67 “Om det heliga och tjenandet. VI: Diaknoissans tjenande,” Olivebladet  (), . 68 An illustration of this increasing emphasis on the parish and on the importance of the Church of Sweden in general to the calling of a deaconess can be seen in the statutes of the Swedish Deaconess Society. According to the  statutes, the purpose of the Society and the deaconess institution was to train “Christian women for the care of the sick, those in need or . . . others who require help.” In , the altered statement reads that the purpose of the Society is “to foster and educate Christian women of the evangelical Lutheran confession in the service of the parish for the care and instruction of the sick, those in need and otherwise those who require help” [emphasis added]. SDS Stadgar,  June , § , AA (vol. ), EDA; SDS Stadgar,  November , § , AA (vol. ), EDA. 69 “Till församlingsdiakonissorna!,” Olivebladet  (), .

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of Sweden through its parishes, a deaconess was not to limit her works of love only to those who belonged to it. All people in need, regardless of religious affiliation, were to be the objects of her care.70 Representing her Lord and her church, a deaconess was ultimately called to serve the poor, the sick, prisoners, children, and others in need, for just as the Lord served such people, so should she.71 As the Lord showed compassion on these people in order to save them from their sins and offer them forgiveness, so a deaconess was to perform acts of love to open their hearts to the Word, and ultimately to give them an opportunity to find forgiveness and salvation with the Lord.72 Through addressing the physical needs of her fellow human beings, deaconesses were in a position “to bring God’s kingdom close to people, particularly since those in need were more open to receiving it.”73 During both Cederschiöld’s and Bring’s directorships, this missionizing component of a deaconess’s calling was emphasized. A deaconess did not care for people simply to address their physical condition and/or suffering. Her greater purpose was to address their spiritual needs. Her works of love prepared the way for evangelization, which she in turn might carry out herself or leave for another to do.74 The importance of evangelization can be seen particularly in the conversion accounts of patients, children, and others that were published. Such accounts were published frequently in the institution’s annual reports in its formative period and occasionally in the years following. On the surface, the deaconess vocation may not have seemed that unique. Bring recognized this when he stressed that serving the Lord in the parish by caring for those in need was not the responsibility of deaconesses alone. Every Christian was obligated to care for others. What made deaconesses unique was that to serve the poor, the sick, etc., on behalf of the Lord and the parish was a deaconess’s particular calling: “Because this work is the calling of a deaconess, she can exclusively devote her time and energy to this work.”75 Other Christians could devote

70

LHA –, “Diakonissans kall,” I B, Ö III b, EDA. J.C. Bring, “I Jesu namn,” Olivebladet  (), –. 72 LHA –, “Diakonissans kall,” II A, Ö III b, EDA. 73 “Diakoniss-saken såsom en Christi församlings sak,” Olivebladet  (), . 74 LHA –, “Diakonissans kall,” II B, Ö III b, EDA; “Om det heliga och tjenandet. VI: Diaknoissans tjenande,” Olivebladet  (), . 75 “Om det heliga och tjenandet. VI: Diaknoissans tjenande,” Olivebladet  (), . 71


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their lives to serving others only to the extent that it did not interfere with their specific vocation. Deaconesses, on the other hand, could expend all of their energy on caring for those in need because this was the particular calling God had given them. Because a deaconess’s responsibilities to care for the sick and the poor often carried her into the public sphere, the potential for opposition to her work was great, particularly among many church leaders and members of the clergy who felt that the calling of a woman was to live as wife and mother and to carry out the responsibilities associated with these roles within the household. For this reason, the leadership of the deaconessate devoted considerable energy to justifying the calling of a deaconess by attempting to reconcile this calling with the Lutheran construction of gender that prevailed in Swedish society for much of the nineteenth century. To understand how the leadership did this, it is necessary to take a closer look at the doctrine of a woman’s calling that existed in the theology of Martin Luther and that contributed to the subsequent development of a Lutheran construction of gender in Swedish society.76 Luther believed that society consisted of three estates: the church (ecclesia), the state (politia), and the household (oeconomia). The church represented God’s spiritual rule, whereas the state and the household represented the worldly order. It was within these three estates that a person was to live out his/her calling. One’s calling was not to be limited to specific occupations, nor was one occupation or manner of living a higher calling than another. Luther took particular aim at the medieval church’s belief that monks and nuns possessed a higher calling and thus exhibited the Christian life in a manner superior to other Christians.77 He rejected celibacy in favor of marriage both because of the need to channel the sex drive after the Fall and God’s institution of marriage in Paradise as a means to perpetuate the species. On the latter point, Luther believed that procreation was the primary reason that God created Eve,

76 I am indebted in the following discussion of the Lutheran construction of gender and calling to the work of the gender historian Inger Hammar. See in particular Inger Hammar, Emancipation och religion. De svenska kvinnorörelsens pionjärer i debatt om kvinnans kallelse ca – (Stockholm: Carlssons, ); see also Inger Hammar, “Några reflektioner kring ‘religionsblind’ kvinnoforskning,” Historisk Tidskrift (), – ; “Den problematiska offentligheten. Filantropi, kvinnokall och emancipation,” Scandia  (), –. 77 Hammar, De svenska kvinnorörelsens pionjärer, –.

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and for this reason, a woman’s purpose, and thus her calling, could be realized most fully only within the context of marriage and in her capacity as wife and mother.78 Luther clearly connected the particular calling of woman to her biological order, so that in carrying out her duties as a mother and wife, she was embracing the calling that God had given particularly to her sex. The proper sphere to live out this calling was the household estate. Luther certainly believed that a woman could wield influence beyond the household estate, but she could do so only through another man, such as her father or husband.79 Considerable scholarly debate in the past several decades concerns the extent to which Luther’s understanding of the calling of women and his rejection of celibacy and the monastic lifestyle led either to a greater subordination of women or greater freedom for women.80 It is not my purpose to engage this debate or to determine the extent to which Lutheran theologians and church leaders in nineteenth-century Sweden were faithful to Luther’s teachings on the calling of women. What is important to stress is that when many church leaders in the nineteenth century expressed reservations on expanding occupational opportunities for women outside the domestic sphere, they were doing so largely because they were concerned that endorsing such opportunities might violate the traditional religious understanding of the calling of women that they believed was rooted both in scripture and in the Lutheran theological heritage. These church leaders felt that it was important for a woman to live out her calling within the household estate through her

78 Excerpts from Martin Luther’s essential writings on marriage and celibacy can be found in the fifth and sixth chapters of Susan C. Karant-Nunn and Merry E. WiesnerHanks, eds., Luther on Women: A Sourcebook (New York: Cambridge University Press, ). 79 Hammar, De svenska kvinnorörelsens pionjärer, –. 80 The scholarship on the issue of whether women received greater or lesser freedom as a result of the Lutheran Reformation, and the Reformation in general, is extensive. A detailed bibliography is not necessary here, but the basic representative positions in this debate are worth noting. For a view of the Reformation as providing women with more freedom in society, see Steven Ozment, When Fathers Ruled: Family Life in Reformation Europe (Cambridge, Mass.: Harvard University Press, ). The belief that the Reformation led to the greater subordination of women can be found in Lyndal Roper, The Holy Household: Women and Morals in Reformation Augsburg (Oxford: Clarendon Press, ). A mediating position is expressed in Merry E. Wiesner, Women and Gender in Early Modern Europe (Cambridge, Eng.: Cambridge University Press, ).




roles as mother, wife, daughter, and so on, and in accordance with the gifts and characteristics God had given to her particular sex.81 In the nineteenth century, church leaders and other male elites often connected the household estate to a distinct private sphere. With the emergence of a market economy and the beginnings of industrialization, a sharper dichotomy between private and public spheres developed than had existed for much of the early modern period.82 Women did enter public space at times to support themselves through trade or to manage property.83 But a woman’s presence and work in the public sphere still would have been looked upon by many with suspicion for much of the nineteenth century. For a woman to leave the sphere to which God had assigned her was dangerous not only because she would be neglecting, if not abandoning, her duties to her family, but also because she could be exposed to the dangers of the public sphere, including the possibility of being associated with “public women.”84 In the course of the nineteenth century, church leaders were faced with the pressing issue of how a growing number of unmarried women, particularly of the middle and upper classes, could support themselves financially without forsaking either their calling to live within the household estate or their God-given feminine qualities. The leadership of the deaconess institution sought to address these concerns head-on because it desired to establish better financial and organizational ties with the church as a means of supporting and expanding the diaconate’s work. The leadership also wanted to address these concerns because some

81 Åsbrink, Studier i den svenska kyrkans syn på kvinnans ställning i samhället åren –, . 82 Hammar, De svenska kvinnorörelsens pionjärer, . Ulrike Strasser notes a trend in the scholarship on early modern Europe in favor of interpreting the household of the time period as part of the public sphere. Households, she observes, were still public and political spaces in the early modern period, and women were able to participate in the political process through the household. See Ulrike Strasser, State of Virginity: Gender, Religion, and Politics in an Early Modern Catholic State (Ann Arbor: The University of Michigan Press, ), –. 83 Hammar, De svenska kvinnorörelsens pionjärer, ; Qvist, Kvinnofrågan i Sverige –, . 84 Elmund, Det kvinnliga diakonatet som kall, ; Inger Hammar, “Alma maters sedliga döttrar. Kvinnornas intåg på den akademiska arenan,” in Rummet vidgas. Kvinnor på väg ut i offentligheten –, eds. Eva Österberg and Christina Carlssson Wetterberg (Stockholm: Atlantis, ), ; Yvonne Svanström, Policing Public Women: The Regulation of Prostitution in Stockholm – (Stockholm: Atlas Akademi, ), , .

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families of potential recruits struggled with the issue of how women could support themselves in a manner that was fitting for their gender. Articles published in the Olivebladet proclaimed fidelity to the Lutheran doctrine of a woman’s calling and insisted that the vocation of a deaconess was fully in line with the Lutheran doctrine. Several articles stressed the importance of a woman’s calling as a wife and mother. One article on church-based poor relief reminded those women who were wives and mothers that they should not sacrifice their responsibilities toward their families in order to carry out works of love on behalf of the poor. Such women must first and foremost care for their own. Only if time permitted should they devote themselves to helping the poor.85 In another article, written by Bring’s older brother and fellow clergyman, Sven Libert Bring, women were charged to remember that their specific calling is to live as a wife and a mother in the household sphere and to be faithful in carrying out the responsibilities associated with these roles. In particular, S.L. Bring admonished wives to be submissive to their husbands and to respect the divine order in which husbands had been given authority over wives.86 These articles were intended to convey the institution’s support for the traditional Lutheran view of a woman’s calling as a wife and mother and to encourage women who were already living out this calling to continue to do so faithfully. In recruiting women who were not already married and/or mothers, J.C. Bring sought to reassure church leaders that those who became deaconesses would not be contradicting the calling or forsaking the gifts that God had given particularly to women. Bring adamantly rejected the women’s emancipation movement because he believed it posed a threat to a woman’s God-given calling. He insisted that the kind of women needed for diaconal work were “real women, not emancipated [women], not women who have been liberated from their proper place and calling.”87 These “real women,” he maintained, are what the institution needs to carry out its mission to care for the poor, the sick, and the suffering, because “it is the woman who in particular is called to and gifted for

85 “Kyrklig fattigwård,” Olivebladet  (), . This article, like most unsigned articles in this periodical, was very likely written by Bring. The article is a summary of the arguments and helpful points that Bring found in a Norwegian book that had been published in  entitled Kirkelig Fattigpleje, by H. Krogh-Tonning. 86 S.L. Bring, “Den swenska qwinnans ställning till de andliga rörelserna i wår kyrka,” Olivebladet  (), . 87 J.C. Bring, “I Jesu namn,” Olivebladet  (), .


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this work.”88 Women possess natural gifts such as tenderness, meekness, stillness, and compassion, all of which qualify them more than men for works of love among the poor and sick.89 To embrace the vocation of a deaconess was to embrace one’s calling as a woman and to utilize the natural gifts that God had bestowed upon women. In addition to these assurances, the leadership sought to bring the calling of a deaconess into conformity with the Lutheran understanding of a woman’s calling through recourse to both the motherhouse system and the rules governing the behavior of all deaconesses connected to it, irrespective of their particular work assignment. The institution adopted the motherhouse organizational model found at German deaconess institutions such as Kaiserswerth and Strasbourg. In this system, deaconesses related to one another as sisters and to the director and housemother as children to parents. Marie Cederschiöld was the sole parental figure in the motherhouse in the first decade of its existence. Unlike Kaiserswerth, where the designations of “Father” and “Mother” were given to the Fliedners, Cederschiöld was only on occasion referred to as “Mother.” More often than not, the sisters referred to her as “Miss” (Fröken). But it is clear from letters written by the sisters to Cederschiöld that they viewed her as a motherly figure. In the same way, the sisters did not typically refer to Bring as “Father” once he took over the directorship, but there is no doubt that he was a fatherly figure among the deaconesses throughout his tenure. In his time as director, there were two parental figures at the institution, with Clara Eckerström serving as housemother. The administrative board felt the need to hire a housemother when the directorship was taken over by a man because “[t]he same absence that makes itself known in a house that has no housemother has therefore made itself known in the deaconess house.”90 To reinforce a deaconess’s connection to her surrogate family and to the motherhouse, the leadership of the institution established rules concerning the behavior of all sisters in its service. One rule involved the deaconess uniform. Cederschiöld introduced the common uniform at the first deaconess consecration in , and from the beginning it was met with resistance from the sisters. This resistance continued under

88

“Diakoniss-saken såsom en Christi församlings sak,” Olivebladet  (), . J.C. Bring, “I Jesu namn,” Olivebladet  (), , ; “Kyrklig fattigwård,” Olivebladet  (), ; “Huru skall kyrkan bäst tillgodose de andliga behofwen hos de lekamliga nödstälda,” Olivebladet  (), . 90 SDSFU Berättelse och redovisning –, . 89

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Bring’s directorship.91 Objections to the uniform centered on its simplicity and unattractive appearance.92 Both directors refused to yield on the matter. The uniform was a mark of equality, an external reminder that no one daughter was privileged above another in this spiritual household, regardless of her social-class background.93 Moreover, the uniform closely resembled the dress of a middle-class housewife, and this resemblance was no coincidence.94 In their outward appearance, deaconesses were branded as members of a particular household. Their dress signified to those with whom they came into contact out in the public sphere, particularly men, that they were by no means “public women” or women of ill repute; rather, they were “off limits” for any man who might consider making sexual advances upon them.95 Another rule that reinforced a deaconess’s connection to the motherhouse stipulated that any woman in the service of the institution had to remain celibate. To enter the institution’s service, a woman could not be “bound . . . to marriage or to service in some other way,” and this was because “[a] deaconess must be free from such connections in order that her work may not be hindered.”96 On the surface, this statement seems to contradict traditional Lutheran concerns about celibacy, and without a doubt, some tension existed between the female diaconate and the Church of Sweden on this rule. But the above statement is consistent with the leadership’s other views concerning the calling of women, that someone who was already a wife and/or mother could not leave this calling to devote herself full time to helping the poor or working as a deaconess.97

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Elmund, Den kvinnliga diakonin, –; Det kvinnliga diakonatet som kall, –

. 92

Elmund, Det kvinnliga diakonatet som kall, . The administrative board supported the uniform from an early stage because it too felt it best in a spiritual family such as the deaconessate to downplay differences based on social class or family of origin. See SDSFU Berättelse och redovisning –, . 94 Iverson, En bok om Ersta, . 95 Ernst Lönegren defends the deaconess uniform in  along these lines, arguing “[w]hat good protection the deaconess uniform provides for a woman, who because of often working late in the evenings is required to walk along dark streets and in less well-known areas” [emphasis mine]. See Lönegren, Svenska Diakonissanstaltens femtioårsjublieum, . In the  statutes for deaconesses, the same paragraph that admonishes deaconesses to dress simply also warns them to be careful in their interactions with those of the opposite sex. These statutes, then, make a connection between outward appearance and “appropriate” behavior with men. SDSFU Stadgar för Diakonissorna , I , AA (vol. ), EDA. 96 “Några upplysningar för dem som vilja bliwfa diakonissor,” Olivebladet  (), . 97 “Diakoniss-saken såsom en Christi församlings sak,” Olivebladet  (), ; 93


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To be a wife or mother meant that one had to uphold the responsibilities attached to these roles within her own household.98 The reason for prohibiting marriage for deaconesses was not rooted in the idea that celibacy was a higher spiritual calling, but in the belief that a woman could not serve two households. A woman’s calling was to serve the one household to which she belonged. A deaconess had to commit herself to the spiritual household of the motherhouse and to carry out the responsibilities and duties associated with it. If she decided to marry, she was compelled to leave the motherhouse so that she could devote all of her energy to fulfilling the responsibilities of her new household. A third rule stated that a deaconess was to demonstrate obedience to the leadership and statutes of the institution. The same obedience that a sister had shown to her birth parents, masters, etc., before entering the institution was to be shown to the leadership of the institution once she entered it.99 The only vow she was to make upon entering the service of the institution was to submit to the institution’s statutes and ordinances.100 Included in the statutes was the command to show the director and the housemother of the institution “reverence and willing obedience,” and to accept whatever work assignment the director gave her.101 If she encountered instructions from employers outside the institution that conflicted with instructions given by the director, she was first and foremost to maintain her fidelity to the leadership and ordinances of the motherhouse.102 This insistence on obedience clearly was meant to reinforce a deaconess’s loyalty to the spiritual household. She was to obey the parental figures of the institution and to submit to decisions that these and other authoritative figures made on her behalf in the same way she would as a daughter in any other household. A fourth rule was the prohibition against receiving gifts. While deaconesses received a salary from the institution, they were prohibited from accepting gifts, monetary or otherwise, from patients, families, or others “Kyrklig fattigwård,” Olivebladet  (), ; “Huru skall kyrkan bäst tillgodose de andliga behofwen hos de lekamliga nödstälda,” Olivebladet  (), . 98 “Kyrklig fattigwård,” Olivebladet  (), . 99 “Några upplysningar för dem som vilja bliwfa diakonissor,” Olivebladet  (), . 100 “Om diakonissanstalten i Stockholm,” Olivebladet  (), . 101 The  statutes for deaconesses indicate that a deaconess must give this obedience to the director, but in its  version, this same section states that this obedience is to be given to both the director and housemother. See SDSFU Stadgar för Diakonissorna , III , AA (vol. ), EDA; SDSFU Stadgar för Diakonissorna , AA (vol. ), III ; see also untitled article, Olivebladet  (), . 102 SDSFU Stadgar för Diakonissorna , III , AA (vol. ), EDA.

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whom they may have helped in fulfilling their diaconal duties.103 One reason given for this prohibition was that their work was voluntary in nature and was not to be an avenue for making money. This justification was meant to express fidelity to the Lutheran construction of gender and the notion that women do not “earn” a living or a salary as do men.104 Because their work is an extension of the household sphere, it must be voluntary in nature.105 Another reason for the prohibition was that it would create differences among the sisters, as some would inevitably receive more gifts than others.106 It is also clear that by receiving no gifts, deaconesses had to rely on the motherhouse to provide them with all of their daily needs, such as food, clothing, and shelter. For those sisters assigned to stations outside the institution, it was the director who as the parental figure and head of the household negotiated contracts with employing institutions and made sure that the sisters had their daily needs met. If a sister was struggling to make ends meet, she was to rely on the motherhouse and her surrogate parents to provide for her needs and not seek to support herself independently by doing her work in the hope of receiving extra “payment.” The motherhouse system thus provided deaconesses in many respects with a surrogate family, a spiritual household. In this household, they would be looked after and cared for as daughters. In their dress, their sexual mores, their commitment to remaining unmarried, and their obedience to their “parents” they would reaffirm their connection to this household. They would be educated and trained for their work in this household, they would support one another in their tasks as family members, and when they grew old and needed to be taken care of, they would be able to return to their “home” at the institution. The motherhouse system, with its rules of conduct for all deaconesses, was not the only practical measure taken by the institution and its leadership to reconcile the calling of a deaconess with the Lutheran doctrine of a woman’s calling. In the three chapters that follow, attention will be given to some of the particular “feminine” tasks that deaconesses were expected to carry out in their roles as teachers, nurses, and poor relief workers, tasks that also extended the household sphere into the public sphere. For the present discussion, it is important to stress how the concept of 103 104 105 106

SDSFU Stadgar för Diakonissorna , II , AA (vol. ), EDA. LHA –, “Hwad är betydelsen af en Diakonissanstalt?,” Ö III b, EDA. “Hwarföre mottaga diakonissorna inga gåfwor?,” Olivebladet  (), . Ibid., –.


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a motherhouse functioned for the leadership of the institution in terms of reconciling more generally the calling of a deaconess with the calling of women, regardless of a deaconess’s particular work assignment. A deaconess belonged to the household of the Swedish Deaconess Institution. Whatever work she performed, wherever she performed it, she did so as a member and representative of this particular household, and she did so in obedience to those who headed the household and in accordance with the rules of that household. To be sure, the work of a deaconess appeared to be public work, but, as Bring stressed, in fact it was not, for a deaconess did not enter into such work on her own initiative: “She is sent, she goes out from a home, the deaconess house, the deaconess home, to which she will always belong.”107 Inger Hammar’s argument that nineteenthcentury women who engaged in philanthropic work were not so much entering the public sphere as extending the domestic sphere thus applies to deaconesses as well.108 The calling of a deaconess was portrayed as consistent with the calling of a woman because it was viewed as an extension of her calling within the domestic sphere and not as an infringement upon a man’s calling in the public sphere. Was the institution’s leadership successful in convincing church leaders, not to mention the families of potential recruits, that the deaconess vocation did not contradict a woman’s calling? Given the attention the topic received in periodical articles, and given the fact that even in the last quarter of the nineteenth century some parents refused to allow their daughters to become deaconesses because they believed it to be inappropriate work for a woman, it appears that the leadership did not eliminate as many of the gender-based concerns to female diaconal work as it would have liked. On the other hand, the stronger connections that the deaconess institution forged with the Church of Sweden over the course of the late nineteenth century suggests that the efforts of the institution’s leadership did alleviate the concerns that many church leaders and clergy members may have had regarding a potential conflict between the two callings. The gradual increase in the number of women entering the institution, particularly in the last quarter of the nineteenth century, suggests that the institution’s efforts may also have helped recruits and their families overcome the stigma attached to women engaged in public work. 107

J.C. Bring, “I Jesu namn,” Olivebladet  (), . Hammar, “Den problematiska offentligheten,” ; Den svenska kvinnorörelsens pionjärer, –. 108

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It is reasonable to conclude, then, that the institution’s efforts did contribute to a general acceptance of female diaconate work both in church circles and among families of potential recruits, even if some resistance remained. This acceptance in turn opened more doors for deaconesses in the public sphere, particularly in the area of poor relief, as the Church of Sweden partnered increasingly with the diaconate through the establishment of parish deaconess positions. But in its efforts to assuage one set of concerns about the work of deaconesses in the public sphere, the institution created another set of concerns with regard to the affinities of the deaconessate with Catholic female religious orders. Objections to these similarities, and the problems they appear to have caused for recruitment, will be addressed later in this chapter.

D. A Profile of Deaconesses Who were the women who joined this spiritual family and pursued the calling of a deaconess? Information concerning these women can be found in the application documents, particularly the autobiographies (lefnadsbeteckningar) required in the admissions process. This information is unfortunately incomplete, since application documents were preserved only for those eventually consecrated as deaconesses, and even in these cases there are some missing documents. Enough material exists to provide a general profile in terms of social class, educational, and occupational backgrounds. This material also sheds light on why these women chose to pursue this calling in the first place. Gunnel Elmund has examined in detail the archival material for the formative period and into the beginning of the transitional period (– ). She notes that of the fifty-three women who became deaconesses in this period, twenty-one came from the middle class, with fathers holding occupations primarily as craftsmen and tradesmen. Twenty came from the peasantry, with fathers working primarily as freeholders and crofters. Only seven deaconesses came from working-class families. The social-class backgrounds of five deaconesses from this period are unknown.109 It is more difficult to conduct a similar examination of social-class backgrounds for the later periods due to a larger number of missing

109

Elmund, Den kvinnliga diakonin, .


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application documents and the number of documents with no explicit reference to social-class background. But it appears that even in these later periods there were no significant changes in the social-class backgrounds of those entering the institution, leading Bring to complain as late as the s about a certain contempt among the higher social classes for the deaconess vocation. In the autobiographies from these later periods, numerous applicants continued to identify their parents as farmers and freeholders. By the s, there was a slight increase in the number of applicants whose fathers or guardians worked in occupations not well represented in the formative or transitional periods, such as the teaching profession. Even so, the number of applicants who came from families with teachers, clergy, or even military professionals was quite small in comparison to the much higher proportion of those who came from farming or artisan families.110 Deaconesses in the formative period often had little formal education. This is not surprising, given the fact that elementary schools and teachers were in short supply in the s and s, particularly in rural areas. Fortunately for those seeking admission, requirements for prior formal education were low. Applicants could be admitted if they were able to demonstrate a rudimentary ability to read from a book, write, and do arithmetic, regardless of how much schooling they received in their childhood. These basic educational prerequisites did not change much throughout the late nineteenth century. What did change was the number of applicants with formal educational backgrounds. By the s, many of the applicants had attended all grades of elementary school and, in some cases, beyond. The occupational experience of the applicants reflected their educational backgrounds. Elmund’s examination of applicants from the first decade reveals that twenty-four of the fifty-three women who became deaconesses by  had worked as maids or servants. Many of these came originally from the peasantry or working classes. The small amount 110 Ernst Lönegren attempted to categorize the occupations of the fathers/parents of the applicants from  to . Of the  women who became deaconesses over the course of the first fifty years, information on occupations for the parents/guardians of  of these was lacking. But for the  applicants who did make note of these occupations, Lönegren stated that  of them identified their fathers or guardians as freeholders, while  came from artisan families,  from crofters or working-class families, and  from the families of tradesmen, factory owners, etc. The remaining  applicants came from clergy, civil service, and military families. See Lönegren, Svenska Diakonissanstaltens femtioårsjublieum, .

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of formal education, combined with the difficult financial circumstances of their families of origin, explains why so many deaconesses from this period had supported themselves as maids or servants. Other previous occupations from this period include positions as teachers and seamstresses. Fourteen of the deaconesses from this period had no prior occupation but rather had lived at home with parents or relatives before entering the institution.111 As was the case with social-class background, the number of missing application documents also makes it more difficult to conduct an analysis of prior employment experience for the remainder of the nineteenth century. From what has been preserved, it appears that there were no significant changes. Many who became deaconesses beyond the formative period also had work experience as maids or servants. A much smaller number worked in professions such as teaching or health care, and others lived with their parents or relatives prior to entering the institution. The autobiographies provide some indication of why these women chose to pursue the deaconess calling. One reason was that it offered a viable solution to difficult financial circumstances, particularly given their unmarried status. Many women, particularly those from the peasantry, came from families under great financial stress. In some cases, the father and/or mother had died during an applicant’s childhood, forcing her to seek employment in order to support herself. In other cases, there were too many siblings for the parents to support the applicant adequately. For others, the family members simply had trouble making ends meet, particularly if they were farmers. The deaconess vocation was thus an attractive option for women from these backgrounds, particularly in the s and early s, when there were still limited educational and occupational opportunities for women. Many of these women would have experienced the calling of a deaconess as a step up the socioeconomic ladder from the work of a maid or servant.112 An applicant might also pursue the deaconess calling for psychological reasons. Given the fact that many applicants came from homes in which one or both parents had died, often resulting in the dissolution of the home and the separation of siblings, the deaconess institution provided a surrogate family to replace the one that had been lost. The same was true even for women who had been sent from the parents’ home because

111 112

Elmund, Den kvinnliga diakonin, . Ibid., .




of strained finances.113 At the institution, their fellow deaconesses would be their new siblings, while the director and/or housemother would care for them and their needs as their birth parents would have, including seeing to it that they had a place to live, food to eat, clothing to wear, and a home that would care for them if they became sick or incapacitated. The psychological motivation is difficult for the historian to access, and the applicants do not explicitly state in their autobiographies that they were looking to the deaconessate to fulfill their need for a family. But the prominence given in some of these documents to the death of one or more parents, as well as the instances in which applicants note the difficulty of having to leave home at a young age in order to support themselves, suggests that many applicants may have seen in the deaconess vocation an opportunity to become part of a family once more. There are also instances in which applicants express gratitude for a God who is a parent to the parentless, or who protects those who are forced to leave the comforts of home at an early age. Such statements suggest a longing for family and home that the motherhouse and spiritual sisterhood of the deaconessate could fulfill. Whatever the economic or psychological reasons for pursuing the calling of a deaconess, the most commonly stated reason for choosing this vocation was religious. The admission requirements stated that an applicant must articulate an experience of being convicted through the grace of God of her sins and accepting the atoning death of Jesus Christ for her salvation.114 This requirement reflected the neo-evangelical revivalist orientation of the Swedish Deaconess Society and the administrative board of the mid-nineteenth century. Applicants consistently attempted to conform to this requirement by articulating stories in their autobiographies of their personal conversion experiences and by appealing to these experiences as ways of authenticating their calling to serve God and their fellow human beings.

113 Catherine M. Prelinger makes a similar argument about the nineteenth-century German deaconessate, maintaining that the family model adopted at Kaiserswerth was crucial in attracting women who had suffered the loss of one or both parents, or whose families of origin could no longer support them financially. See Prelinger, “The Nineteenth-Century Deaconessate in Germany: The Efficacy of a Family Model,” in German Women in the Eighteenth and Nineteenth Centuries: A Social and Literary History, eds. Ruth-Ellen B. Joeres and Mary Jo Maynes (Bloomington: Indiana University Press, ), –. 114 SDSFU Berättelse och redovisning –, .

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Many of the conversion narratives contained common elements. First, the applicant typically expressed a prior condition in which she had not been convicted of the severity of her sinful condition and her need for salvation. Sometimes the applicant explained that this condition was a result of her willful disobedience. Maria Svensson believed that even though her “loving Savior called me both in my childhood years and throughout my entire life . . . I unfortunately did not listen to His voice but rather stood against Him” until she finally was able to become convinced of the depths of her sinfulness and her need for salvation.115 Olivia Paulsson wrote that “[a]lready in my childhood years, the Lord worked upon my heart with His spirit,” but she “through disobedience hindered this work.”116 This condition was often explained as resulting from ignorance of what God was doing or had done prior to the conversion experience. Mathilda Westerberg explained that “[f]or  years, I lived without knowing what Jesus had done for my soul” before realizing that she was a lost sinner.117 Hilda Öberg noted that “the works of grace from God’s Spirit have been with me since my early childhood years,” though she would not receive the grace that leads to salvation until she was twentyseven.118 After articulating a condition of being lost to the power of sin, it was common for an applicant to relate a conversion experience in which she had been convicted of her sinfulness and brought to salvation through an act of God’s grace. Sometimes the occasion for conversion arose from a trying life experience. Oliva Paulsson recounted how God’s grace awoke her at the age of twelve while she was bedridden due to a serious illness. Through the illness, she “was able to experience the justifying and bornagain grace of the Lord” that led her ever since on the path to eternal life.119 In many cases, the conversion experience was connected to hearing revivalist preaching. Maria Svensson recalled how God once sent a “faithful teacher” to the town of Helsingborg where she lived. Through his preaching, God’s grace enabled her to realize that it “was not well between her and her God.” Eventually, God, who was at work in this preacher, illuminated the truth for her that “Jesus had suffered and died for my sake,

115 116 117 118 119

Maria Svensson’s Lefnadsbeteckning,  September , E Va  (no. ), EDA. Olivia Paulsson’s Lefnadsbeteckning,  April , E Va  (no. ), EDA. Mathilda Westerberg’s Lefnadsbeteckning, , E Va  (no. ), EDA. Hilda Öberg’s Lefnadsbeteckning,  March , E Va  (no. ), EDA. Olivia Paulsson’s Lefnadsbeteckning,  April , E Va  (no. ), EDA.


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and that He had paid for all of my debts and now wanted to forgive all of my sins.”120 For Mathilda Westerberg, it was one sermon in particular that was the catalyst for conversion. On a Sunday evening in June , the preacher in question delivered a sermon on the seventh chapter of Matthew in which he stressed that the path to eternal life was narrow and few were willing to take it. Upon hearing the sermon, Westerberg came to realize that she was “a lost sinner” who “had never been on the path” that led to eternal life.121 Toward the end of the century, some applicants even connected their conversion experiences to confirmation. While going through confirmation instruction in the Klara parish in Stockholm, Alma Castelli explained that “the Lord opened my eyes, that Jesus was the only way and the only one who could satisfy my soul’s longing.”122 Anna Åström likewise expressed her belief that it was primarily through her preparations for confirmation in the parish of Nederluleå that she “came to experience through faith in Jesus Christ the peace [that comes from] the forgiveness of sins and God’s great love for sinners.”123 After relating her conversion experience, an applicant sometimes would connect it to her sense of calling to pursue the deaconess vocation. Applicants making such a connection typically expressed a desire to offer their lives to serve Christ and their fellow human beings as an act of gratitude for the forgiveness and salvation they had experienced. Hilda Öberg wanted to become a deaconess because “of Him who has called me from darkness to His wonderful light.”124 Emelie Toll expressed that her desire “to serve the poor, sick and vulnerable” was a result of wanting “to show my love and gratitude to my dear Savior, [though] not as some payment or replacement for what he has done for me.”125 Emma Gustafsson noted that ever since the Lord “saved me by grace for Christ’s sake, I have begun to think of how I would best be able to serve him who has given his life for me.”126 A final element commonly found in these conversion narratives was a statement of unworthiness and/or inability to carry out the duties of a deaconess, and indeed the duties of a Christian, apart from God’s 120 121 122 123 124 125 126

Maria Svensson’s Lefnadsbeteckning,  September , E Va  (no. ), EDA. Mathilda Westerberg’s Lefnadsbeteckning, , E Va  (no. ), EDA. Alma Castelli’s Lefnadsbeteckning,  May , E Va  (no. ), EDA. Anna Åström’s Lefnadsbeteckning, , E Va  (no. ), EDA. Hilda Öberg’s Lefnadsbeteckning,  March , E Va  (no. ), EDA. Emelie Toll’s Lefnadsbeteckning,  September , E Va  (no. ), EDA. Emma Gustafsson’s Lefnadsbeteckning, , E Va  (no. ), EDA.

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grace. Augusta Ketscher believed that it was only “God’s mercy [that] has allowed me to see that I am a weak and evil thing who is unable to do anything good” apart from grace.127 Carin Jönsdotter maintained that “I do not feel that I have the ability on my own to carry out” the deaconess calling, and for this reason, she believed that she would have to depend on the power of God to perform her deaconess duties.128 Mimmi Sethlin likewise explained that while she felt called to “serve my sick and suffering fellow human being,” she confessed that “on my own, I am not capable of [this calling].” Nevertheless, she believed that “the Lord helps his weak children” to carry out this work.129 It is not necessary to argue that one of the above-mentioned motivations—economic, psychological, or religious—is more important than the others when determining why women chose to become deaconesses. But for those who chose this vocation, religious motivations played a prominent role in the decision to apply to the institution. It was noted in the first chapter that some sociologists maintain that even in those cases in which private religious convictions motivate religious professionals to carry out social functions in the modern era, there is little in the actual performance of these functions that distinguishes them from secular providers. But I will argue in subsequent chapters that deaconesses did not push aside or suppress the “private” religious motivations discussed above when they performed their duties as teachers, nurses, and poor relief workers. Their work bore the unmistakable signs of their religious convictions.

E. Deaconess Education A woman did not automatically become a deaconess simply because she believed she was called to serve the poor, the sick, and others in need. Whatever her motivations for wanting to devote her life to diaconal work, including the desire to show gratitude to Christ for the forgiveness of sins and the promise of eternal life, a woman wishing to pursue the deaconess vocation first had to apply to the institutional board of the deaconess institution, and if accepted by this board, she had to undergo a period of training that could take as long as three years. 127 128 129

Augusta Ketscher’s Lefnadsbeteckning,  April , E Va  (no. ), EDA. Carin Jönsdotter’s Lefnadsbeteckning,  March , E Va  (no. ), EDA. Mimmi Sethlin’s Lefnadsbeteckning,  Februrary , E Va  (no. ), EDA.


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Throughout the late nineteenth century, the prerequisites for admission to the institution were basically the same. An applicant had to be between the ages of twenty and forty. She should be able to read from a book fairly well, as well as write and do arithmetic, though she need not be as proficient in the latter two. She should have basic competency in performing everyday household tasks, such as cooking, sewing, cleaning, etc. She was expected to have a good knowledge of the Christian faith, particularly as expressed in prominent biblical passages. As for her motivation, she was expected to have the desire to become a deaconess primarily because Christ’s love compelled her to do so.130 Much of the above could be attested to in the autobiographies that applicants were required to submit. As discussed earlier, these autobiographies also included faith narratives and information concerning parentage, upbringing, and previous occupations. In addition to her autobiography, an applicant had to include five other pieces of information or documentation in her application. First, written approval from either her parents or guardians had to be provided, since “[a] deaconess must be free of [those] connections [of marriage, family obligations, etc.] in order that her work may not be hindered.” Second, a doctor had to give her a certificate of good health. The board felt that since the physical demands of diaconal work were fairly strenuous, “[s]ick, weak, or melancholy persons may . . . see in this a sign that the Lord has not called them to the work of a deaconess.” Third, she had to include a certificate from her parish priest indicating her standing and residence in that parish.131 Fourth, in order to demonstrate to the institution that she has “a quiet, humble spirit . . . and has proven this through obedience to parents, masters, etc.,” an applicant must include a letter of recommendation from anyone for whom she had previously worked. Finally, if for some reason an applicant who was admitted to the institution was later deemed unsuitable for the deaconess calling, or if she herself chose to sever her connection with the institution, the board required her to include the

130

“Några upplysningar för dem som vilja bliwfa diakonissor,” Olivebladet  (),

–. 131 While the designation of “pastor” for a member of the Protestant clergy is common in the context of American religious history, in Sweden, the word “priest” (präst) has typically been used to refer to a member of the Lutheran clergy. Clergy in free church traditions are typically referred to as “pastors,” though this designation was sometimes given to Lutheran clergy as well.

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written attestation of someone (parent, relative, etc.) promising to take the applicant into his or her home.132 If the institutional board accepted the applicant, she was admitted as an inquirer. This was the first of two preparatory stages in becoming a deaconess. Implemented at the institution’s opening in , it signaled a departure from the practice at Kaiserswerth, where, at least until , all entering students automatically became probationary sisters before becoming deaconesses.133 At the Stockholm institution, a student remained in the inquiry stage typically from six months to one year, during which time the leadership determined whether she demonstrated the gifts and calling of a deaconess. Inquirers did not receive a salary, nor did they wear the uniform. Inquirers also did not take educational or occupational coursework but instead participated in the various household duties at the institution, such as cooking, sewing, and laundry. Inquirers did receive basic religious instruction as well as weekly lessons on the calling of a deaconess. After six months to one year, inquirers were eligible to be promoted to the probationary stage, under the condition that both the institutional board and the other sisters (deaconesses and probationary sisters) approved. If this approval was not given, the inquirer remained in the first stage for a longer period, though the institutional board might decide that she did not possess the qualities needed for a deaconess and thereby terminate her relationship with the institution.134 After an inquirer was promoted to a probationary sister, she began her formal coursework and occupational training over the course of one to three years, depending on her prior educational and occupational experience.135 In addition to weekly instruction in biblical studies and the

132 “Några upplysningar för dem som vilja bliwfa diakonissor,” Olivebladet  (), –. Many of these requirements can be found as early as , before the first students were accepted. See “Fordringar af blifande sjukvårds diakonissor,”  November , AA (vol. ), EDA. 133 Gunnel Elmund believes it is likely that Marie Cederschiöld was influenced by the deaconess institution at Strasbourg in adding this inquiry stage. Cederschiöld was indeed critical of the length of education and training at Kaiserswerth, feeling that it was too short. Elmund, Den kvinnliga diakonin, . 134 “Diakonisshuset såsom bildningsanstalt och hem för systrarne,” Olivebladet  (), –; “Om diakonissanstalten i Stockholm,” Olivebladet  (), –; Lönegren, Svenska Diakonissanstaltens femtioårsjublieum, . 135 The trend throughout the late nineteenth century was toward a longer probationary period within this time frame.


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Lutheran catechisms,136 a probationary sister took courses on subjects taught in the elementary schools, including arithmetic, writing, grammar, biblical history, church history, Swedish history, and geography.137 The probationary period also marked the beginning of her theory-based coursework in health care, after which she received practical health care training either in the deaconess hospital or in another hospital in Stockholm.138 Once probationary sisters completed these requirements, they were assigned to various positions either within or outside of the institution, under the supervision of experienced deaconesses. In this way, the institution’s leadership was able to discern in which area of work a probationary sister was particularly gifted.139 Once a probationary sister completed coursework and worked in various capacities in the service of the institution, she became eligible for promotion to a deaconess. Those deaconesses who knew the probationary sister would then vote on whether to promote her, though again the final decision remained in the hands of the institutional board, particularly the director.140 If a probationary sister was promoted, she vowed to remain in the service of the deaconess institution for at least five years.141 This educational process for deaconesses was extensive and at times rigorous, and many students dropped out along the way, particularly in the inquiry phase. Nevertheless, the institution played an important role in helping women wield more direct influence in the public sphere than had previously been possible. It provided women with both generalized education and specialized training as teachers, nurses, and poor relief workers, among other professions. In doing so, it gave these women the

136

Catechetical instruction was irregular in the formative period, since there was not a regular clergy presence at the institution. Once Bring took over as director, this instruction became integral to the religious education of deaconesses. Elmund, Den kvinnliga diakonin, . 137 Elmund, Den kvinnliga diakonin, . Toward the end of the nineteenth century, inquirers might be required to take some preliminary education courses if there were significant gaps in their prior schooling. Lönegren, Svenska Diakonissanstaltens femtioårsjublieum, . These courses were initially intended to help prepare those sisters who were interested in serving as teachers. Once the institution abandoned the training of teachers in , all sisters underwent general coursework simply to improve their overall educational foundation. Lönegren, Svenska Diakonissanstaltens femtioårsjublieum, . 138 The health care component of the curriculum remained obligatory for all sisters until the mid-twentieth century. Iverson, En bok om Ersta, . 139 Lönegren, Svenska Diakonissanstaltens femtioårsjublieum, –. 140 Lönegren, Svenska Diakonissanstaltens femtioårsjublieum, . 141 SDSFU Stadgar för Diakonissorna , II , AA (vol. ), EDA.

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skills and qualifications that would make them attractive to potential employers and thereby enable them to carry out essential social functions in the public sphere. The household duties that all students had to gain competence in also made it clear that in training to become deaconesses, the women at the institution were pursuing a calling appropriate to their sphere and gender. Finally, in a period in which a growing number of non-religious professionals and specialists were performing social functions, such as education and poor relief, the deaconess institution, through its religious instruction, trained and educated a group of religious professionals to carry out these same social functions in a manner that addressed the temporal and spiritual needs of Swedish society.

F. The Work of Deaconesses Once a student had undergone enough coursework and practical training at the probationary stage, she was assigned a work station, as were all sisters who had become deaconesses. Work stations were located either in one of the divisions of the deaconess institution in Stockholm (internal work stations) or outside the institution with an employing organization or institution (external work stations). The majority of deaconesses were assigned to external work stations. Because sisters assigned to these stations were usually outside the direct supervision of another deaconess or the institution’s personnel, their working conditions were governed by a hiring contract established between the institutional board and the employing organization or institution.142 Most contracts contained four common elements. First, the employer was required to pay the institution a fixed fee for the services of the deaconess in question. The institution would use this fee to pay the deaconess’s salary.143 Employers were not to pay her salary directly, nor were they allowed to give her

142 This contract system was used at Kaiserswerth. Fliedner got the idea for this system from the Sisters of Charity. Elmund, Den kvinnliga diakonin, . 143 Both probationary sisters and deaconesses received a cash salary in addition to other benefits, such as room and board, medical coverage, etc. For this reason, it is difficult to compare a deaconess’s salary with the salaries of other social service providers. According to Gunnel Elmund, if one calculates a deaconess’s salary based on all of the benefits she received beyond the cash salary, she earned an income that was slightly higher than most maids and was on the same level as the lowest-paid elementary school teachers in the rural


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gifts. Second, the employer was to arrange free room and board for the deaconess. The room was to be furnished, and the deaconess was also to be provided wood and light. Third, in case of illness, the employer was to provide for the deaconess’s medical care and medicine, and in case of death, the employer was to cover her funeral expenses and arrangements. Finally, the employer was reminded that the deaconess institution ultimately reserved the right to reassign deaconesses as it saw fit.144 Most internal and external work stations fell within one of four major spheres of work carried out by the deaconessate in the late nineteenth century: education, health care, poor relief, and child welfare. More will obviously be said about the first three of these areas in subsequent chapters, but a brief sketch of all four areas is provided here. In the area of education, a deaconess might be assigned to the institution’s own school for poor children in Stockholm. Otherwise, she was assigned externally to a rural school out in the provinces that was typically operated by an Inner Mission society or a wealthy individual influenced by the evangelical revival. As stated earlier, in  the institution formally shut down its school for poor children and ceased its training of deaconesses as teachers, though it would not be until  that the last teaching station was terminated. Sisters assigned a health care position at the institution could work either at the institution’s own hospital or at one of the other health care divisions that came to be added at the institution over the course of the nineteenth century, such as the nursing home or the polyclinic. The health care stations outside the institution were mainly hospitals in other cities, though for much of the period deaconesses also provided health care in private homes in Stockholm. In the area of poor relief, all assignments were outside the institution. Most of these from the s onward were as parish deaconesses, though a smaller number of deaconesses were assigned to poorhouses, poor farms, and workhouses. As for child welfare, the

provinces. Elmund, Den kvinnliga diakonin, . On the other hand, the nurses trained at the Sophia Home received not only the same benefits as deaconesses but a higher cash salary. Elmund, Det kvinnliga diakonatet som kall, . 144 In , the deaconess institution in Stockholm abolished the contract system and the system of assigning deaconesses to work stations. Deaconesses were free to search for positions on their own once they completed their education. Iverson, En bok om Ersta, –.

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institution had several internal divisions in this field, including an orphanage, a household school, and a rescue home for delinquent girls. Deaconesses could also be assigned to orphanages, shelters, or nurseries outside the institution. These were the four primary areas of specialization in the late nineteenth century. Education was the main focus in the first two decades, whereas health care and poor relief became the dominant fields of work from the s to the turn of the century. Child welfare never dominated the work of deaconesses as did these other three areas, but the diaconate maintained a consistent involvement in this field throughout the fifty years being studied here. It should also be noted that there was considerable overlap with these stations when it came to the kinds of duties deaconesses were expected to perform. For example, a sister assigned to a poorhouse or parish was often expected to carry out nursing tasks, whereas some schools also doubled as orphanages. There were other areas besides these four to which a deaconess might be assigned, even if the number of sisters assigned to them was much smaller. These stations included rescue homes for prostitutes, prisons, and, toward the end of the period, the mission field. The social functions performed by deaconesses in the late nineteenth century were therefore extensive, and the potential for wielding influence in the public sphere through these functions was great.

G. The Difficulties of Recruiting and Retaining Deaconesses Even though female diaconal work covered many important social functions, the institution’s leadership repeatedly expressed its frustration that the deaconessate was not living up to its full potential in terms of influence in the public sphere. Demand for diaconal services was relatively high, but time after time the leadership had to deny requests from employing institutions and organizations for deaconesses because there were not enough to send. The number of deaconesses certainly grew considerably in the course of fifty years, but this growth did not keep up with demand, and for this reason, annual reports and the Olivebladet frequently addressed the challenges faced by the institution in recruiting, and to some degree in retaining enough deaconesses to meet the demand for diaconal services. But what were these challenges, and what do they tell us about the social significance of deaconesses in the late nineteenth century?


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One of the main purposes of the Olivebladet was to serve as a recruiting tool both by making female diaconal work better known among potential recruits in the country and by clarifying misunderstandings and misconceptions about this work.145 Through this and other publications, the leadership consistently complained that female diaconate work remained unknown in Sweden. But given the fact that deaconess services were in relatively high demand, such statements should not be taken at face value. Potential employers certainly knew of the work of deaconesses, as did the recipients of their services (patients, paupers, etc.). Complaints about unfamiliarity with diaconal work, rather, were directed at “Christian-minded people.” Many of the frustrations were directed at the clergy and the church leadership. The institution’s leaders believed that some of the best potential recruits, the daughters of the clergy, were the ones who knew the least about diaconal work. The leadership repeatedly renewed its calls for daughters of the clergy to consider the calling of a deaconess.146 The leadership also enjoined the clergy to make female diaconate work better known among its parishioners by teaching children and youth about the vocation and by promoting it in other venues or public-speaking occasions. Even the church hierarchy was asked to do its part by better educating clergy candidates at the universities about the significance of diaconal work. The deaconess institution certainly understood that the novelty of female diaconate work in Sweden also explained its unfamiliarity among potential recruits, but on the fiftieth anniversary of the female diaconate, the leadership was still complaining that unfamiliarity with diaconal work was creating problems for recruitment.147 Problems with recruitment cannot simply be traced to a lack of knowledge concerning female diaconal work. The growing number of parishes employing deaconesses in the last quarter of the nineteenth century suggests that there must have been more familiarity with female diaconal 145 J.C. Bring, “Anmälan,” Olivebladet (), . The institution’s annual Christmas publication, Febe, can also be viewed in part as a recruiting tool. In its first edition from , Febe also addressed the need to make the work of the deaconessate better known in Sweden so as to attract more recruits. See “Om diakonissanstaltens uppgift,” Febe (), . 146 “Hwad är diakonissanstalten?,” Olivebladet  (), ; “Till wåra prestdötrrar,” Olivebladet  (), –; “Huru skall kyrkan bäst tillgodose de andliga behofwen hos de lekamliga nödstälda?,” Olivebladet  (), . 147 SDSFU Årsberättelse , Olivebladet  (), ; “Hvad kunna diakonissanstalten och diakonissakens vänner göra för att draga allt flere goda krafter till barmhärtighetens tjänst,” Olivebladet  (), –.

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work among “Christian-minded” (i.e., Lutheran) circles than the deaconess publications indicated. The institution’s leadership also realized that its problems with recruitment could not be attributed to unfamiliarity with female diaconal work alone, even if the leadership believed this was the primary obstacle. For this reason, the Olivebladet and other deaconess publications devoted significant attention to clarifying misunderstandings concerning the purpose and work of the deaconessate, misunderstandings the leadership felt also adversely affected recruitment. One set of misunderstandings pertained to the educational purpose of the deaconess institution. Some women applied because they felt it was an opportunity to receive an education that would help them support themselves or find better work opportunities. The answer given by the leadership in these circumstances was that the deaconess institution did not accept students simply because they needed somewhere to go in order make a better life for themselves financially or because they no longer had a family to support them. An applicant must be perceived as having a particular calling to the deaconess vocation, and this calling must be driven first and foremost by her desire to serve Christ and to provide physical and spiritual assistance to those in need.148 Other women applied because they believed they could receive training for a much more specific profession, such as teaching.149 Confusing the deaconess institution with a teaching seminary was particularly common in the first two decades of the institution’s existence. The autobiographies of applicants reveal that some women primarily saw in the institution an opportunity to become teachers. For its part, the leadership insisted that while deaconesses did work as teachers, and while someone entering the institution might eventually be sent out to work as a teacher, the deaconess institution was not a school for training women for the teaching profession. The deaconess institution trained women as deaconesses, and those applicants who wanted to be educated as teachers were reminded that deaconesses must be prepared to work wherever and however they were needed. If a prospective student was not willing

148 “Hwad är diakonissanstalten?,” Olivebladet  (), , ; “Diakoniss-saken såsom en Christi församlings sak,” Olivebladet  (), . 149 Identifying the deaconess institution with a nursing school was a misperception that the institution’s leadership faced during the last quarter of the nineteenth century. See “Om diakonissanstaltens uppgift,” Febe (), .


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to participate in all areas of diaconal work, then the deaconess institution was not the place for her.150 Another misunderstanding pertained to the appropriateness of women carrying out diaconal work. In some cases, parents or guardians of women who wanted to become deaconesses refused to give their permission because they felt that such work would bring disgrace or shame upon the family.151 It was noted earlier how the deaconess institution attempted in its publications and in the manner in which it organized its work to reconcile the calling of a deaconess with that of a woman. Particularly under Bring’s directorship, the institution’s leadership interpreted and organized its work in accordance with the Lutheran doctrine of a woman’s calling because it wanted to alleviate potential gender-based concerns among the clergy or church hierarchy in order to establish better financial and organizational ties with the church. These efforts also appear to have been aimed at those families that refused to grant permission for one of their own to enter the institution because of the belief that the public nature of diaconal work rendered it inappropriate for respectable Christian women. The institution also had to combat the perception that its work and organization were too Catholic. Many outside observers felt that the institution resembled a convent because of the special uniforms deaconesses had to wear, the “vows” of chastity, and the familial designations given at the institution. The leadership sought to address these concerns by arguing that deaconess oaths were not unconditional and that deaconesses could leave the service of the institution at any time to marry or to return to their family of origin to care for parents or relatives. And whereas Catholics believed that the life of a nun was holier and had more merit than other callings, deaconesses did their work not to gain merit but, in the spirit of Luther’s Reformation, in response to the freedom of the Gospel and to demonstrate gratitude for what Christ had done for them.152 The leadership went even further by warning its readers of the dangers of Catholic female religious work in Sweden. It argued that the health care work of the St Elizabeth Sisters in particular, while appearing to be similar 150 151

“Hwad är diakonissanstalten?,” Olivebladet  (), . “En bön,” Olivebladet  (), ; “Om diakonissanstaltens uppgift,” Febe (),

. 152 “Om Diakoniss-verksamheten,” Olivebladet  (), –; “Hwad är diakonissanstalten?,” Olivebladet  (), –; SDSFU Berättelse och Redovisning –, ; “Om diakonissanstaltens uppgift,” Febe (), .

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to that of the deaconessate, in fact threatened the religious truths and principles upon which Sweden was established.153 According to Bring, the real purpose of this work was to spread Catholic propaganda and to bring Sweden back into the Roman Catholic fold. In this assessment, he was in agreement with many of the Lutheran clergy in Stockholm, including the pastor primarius of the city, Fredrik Fehr.154 Sweden’s foremost representative of Ritschlianism and the highest-ranking clergyman in Stockholm, Fehr called a gathering of Stockholm clergymen in  to address the Catholic threat. He argued that the work of the St Elizabeth Sisters was meant to prepare the way for Jesuits and Catholic priests to persuade the Swedish people to embrace Catholicism. Bring was in attendance, and he was among the clergymen who overwhelmingly approved a resolution condemning the Catholic propaganda spread by the St Elizabeth Sisters and encouraging members of the Church of Sweden to give their support to evangelical women who carried out health care work.155 The attention given by deaconess publications to combating Catholic interpretations of diaconal work reflects the leadership’s concern with how these misconceptions affected recruitment. The female diaconate may have encountered more outright objections to its work based on its similarities to Catholic religious orders than it did based on gender. Nevertheless, neither gender-based objections nor affinities with Catholic female religious orders were considered by the leadership to be the main reasons for the lack of women entering the institution. The most commonly cited reason was the lack of familiarity with or 153 The St Elizabeth Sisters first came to Sweden in  in order to oversee the household of a Catholic priest and to operate a boys’ home in the Södermalm region of Stockholm. But from the beginning, they devoted themselves to nursing. At first, they cared primarily for other Catholics, but they eventually began caring for non-Catholics as well. Throughout the late nineteenth century, the St Elizabeth Sisters established themselves in other Swedish cities: Malmö (), Gävle (), and Gothenburg (). Yvonne Maria Werner, Världsvid men främmande. Den katolska kyrkan i Sverige –  (Uppsala: Katolska Bokförlaget, ), –. 154 The city of Stockholm did not belong to a particular diocese in the nineteenth century. The parish churches in the city were governed by a consistory led by the pastor primarius, that is, the priest of the Great Cathedral. The diocese of Stockholm was created in . 155 “Ett gif akt,” Olivebladet  (), –. The clergy meeting called by Fehr in  was in response to a bazaar being held in Stockholm in order to raise money to support the work of the St Elizabeth Sisters. Even though Fehr’s resolution was passed almost unanimously, the bazaar raised a considerable sum, , crowns, over the course of three days. The condemnation of the Stockholm clergy still may have had some effect on the bazaar, as the amount raised was , crowns less than the money raised at a similar bazaar seven years earlier. See Werner, Den katolska kyrkan i Sverige, –.


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knowledge of diaconal work. The institution was certainly right to view this as a major challenge for recruitment, but it should be noted that other likely obstacles, beyond the ones already mentioned in this section, received little attention, including the strict rules that deaconesses had to follow, the relatively low pay they received in comparison with elementary school teachers or other nursing professionals later in the century, and the increased educational and occupational alternatives that existed for women by the last quarter of the nineteenth century.156 The deaconess institution struggled to meet the growing demand for its services not only due to challenges with recruitment but, to a lesser degree, due to difficulties in retaining students. On the occasion of the institution’s fiftieth anniversary, Ernst Lönegren, the director, wrote a history of the female diaconate in which he discussed retention rates. Between  and ,  women entered the institution for deaconess education. Of these,  at some point left the service of the institution. Approximately  percent of these left during the inquiry stage. A smaller percentage,  percent, left during the probationary period, and  percent left after they had become full deaconesses. Lönegren noted that a lower percentage of women left the institution’s service in the second twenty-five years of its existence than in the first quarter century.157 What is clear from this is that retention was primarily a problem in the first year of service. Once a student was promoted to the probationary level, and particularly to full deaconess status, retention was actually quite good. Lönegren listed several categories to indicate why women left the institution’s service. Accordingly,  women left because they were “not suited for the calling,”  “for relatives or on their own request,”  due to illness,  for “no stated reason,”  because they got engaged, and  “according to an agreement” with institution’s leadership.158 156 According to some periodical articles, one reason why some women either did not pursue the deaconess vocation or chose to leave the institution during their training was a desire for the freedom that was characteristic of the age. This observation certainly suggests that some potential candidates for the deaconessate harbored reservations about the strict rules and codes of conduct that they would have to follow at the institution. See SDSFU Berättelse och Redovisning –, –; “Diakonissanstaltens årsfest,” Olivebladet  (), . On occasion, Bring did try to defend the institution against accusations that deaconess salaries were too low, though he did not appear to view in these accusations the possibility that the salaries of deaconesses posed a significant obstacle to recruiting, particularly among middle- and upper-class women. See “Diakonisshemmet, d.ä. diakonissanstalten såsom Hem,” Olivebladet  (), . 157 Lönegren, Svenska Diakonissanstaltens femtioårsjublieum, . 158 Ibid., .

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Some of these categories are self-evident and need little elaboration, such as those who left the institution in order to help aging or sick parents and relatives, or those who left because of illness. That some women left because they got engaged is also self-evident, though this reason at times appears to have bothered Bring and other leaders of the institution. Bring had nothing against marriage as such. After all, when Bring remarried after his first wife’s death, he married a deaconess. But he felt that deaconesses who were considering marriage should hold off on their engagements as long as possible. In doing so, they would not only be able to test the idea and the new relationship that they were about to enter, but they could also continue to carry out their diaconal duties while taking the time to fully consider whether marriage was the step they were being called to take.159 The other categories are too vague to provide a clear picture of what motivated so many to leave. Studying both the board minutes and the published materials of the institution adds a little clarity to this picture, though not much. These materials suggest several likely reasons for the retention rates noted above. First, some found the work more difficult or strenuous than they expected. For this reason, deaconess publications occasionally reminded prospective candidates that because diaconal work was difficult, women should think about what it was that really inspired them to pursue it.160 Second, despite the attempts of the institutional board to weed out applicants who misunderstood the kind of education or occupational training they would receive, some women still entered the institution to receive a general education to supplement their previous schooling or to train for a specific occupation, like teaching.161 When some of these women realized that a deaconess education or vocation did not conform to their expectations, they left the institution.162 Third, some left because they found the institution’s rules too 159

JCBRB,  December, B I  (no. ), EDA. See, for example, untitled, Olivebladet  (), –; “Beriktigande,” Olivebladet  (), . 161 In some cases, women entered the institution simply to receive an education. The institution’s director of pedagogical training from –, Betty Ehrenborg, was in fact dismissed from her post because she saw to it that some students were accepted who had no intention of becoming deaconesses. Both Cederschiöld and the administrative board found this practice unacceptable, though during Bring’s tenure, there was more openness to women entering the institution to explore the deaconess vocation even if they were not sure they wanted to be deaconesses. See Iverson, En bok om Ersta, . 162 A number of sisters left the institution in the early s. It appears that they did so in response to the decision of the institution’s leadership to terminate its training 160


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strict. In some cases, women were dismissed from the institution’s service because they broke one or more of the rules. In other cases, deaconesses left on their own initiative. Related to this third reason was the fact that some women left the deaconessate because they had broken the rule concerning participation in non-Lutheran religious meetings or groups. While there were not many instances of sisters leaving the deaconessate for this reason, when this did happen, it typically received considerable attention in the meetings of the administrative board and, to a lesser extent, in deaconess publications. In , four sisters left to join the Baptist movement.163 One of these was Carin Wiman, a deaconess stationed at the hospital in Åmmeberg in the province of Närke. Early in , Wiman informed Cederschiöld that she and a probationary sister also stationed at Åmmeberg were joining the Baptist movement. Cederschiöld wrote to Wiman in an attempt to convince her that the Baptist movement was heretical. Wiman responded that she was determined to join the movement and that it “was not heretical, it is in accordance with God’s Word.”164 The institutional board recalled Wiman to the institution, subsequently dismissing her. A few weeks later, the other probationary sister at Åmmeberg was also dismissed. A much more publicized case of a deaconess going over to a “heretical” movement came in –. Johanna Östling, stationed at a nursery in Ladugårdslands parish in Stockholm, was reported by the parish priest to Bring because she had been attending meetings of the Salvation Army. Bring wrote to her and gave her a choice—she could either stop attending Salvation Army meetings altogether, or she could leave the service of the institution.165 Östling responded that “I cannot force my conscience to obey Pastor Bring’s command to cease from receiving nourishment for my individual spiritual life from those places where I most clearly hear God’s voice.” She believed that by placing the ultimatum before her, Bring had “indirectly dismissed” her from the institution. Östling maintained that if this were the case, she needed to be compensated with an annual stipend, since the dismissal was made against her wishes and

of deaconesses as teachers. Obviously, the association of the deaconess vocation with the teaching profession was strong even in the minds of some who had become full deaconesses. Ibid., . 163 Elmund, Den kvinnliga diakonin, –. 164 Carin Wiman to Marie Cederschiöld,  March , E Va  (no. ), EDA. 165 J.C. Bring to Johanna Östling,  April , AA (vol. ), EDA.

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without her having committed any wrongdoing in carrying out her duties at the nursery.166 Bring and the administrative board found her request unfounded, but they did not dismiss her immediately, perhaps because she had served the deaconessate for twenty-five years.167 She was given one year to decide whether or not to abide by the original directive.168 Östling ultimately chose to leave the institution in order to maintain her affiliation with the Salvation Army.169 While decisions like Östling’s created anxiety among the leadership, it does not appear that there were many cases resembling hers.170 The minutes and periodicals contain few accounts of such departures. It is possible that more sisters left the institution due to free church influences than the records indicate, particularly given the vague categories used to describe reasons for leaving.171 It is also possible that some sisters left for this reason without being forthright with the leadership about why they were leaving. Despite these challenges in recruitment, and to a lesser degree retention, the female diaconate did grow in the course of the late nineteenth century, and it more than doubled its numbers between  and  (see Table ). But in a period in which so many unmarried women were in need of an occupation, the question still remains as to why the institution’s leadership did not succeed in building up an even larger corps of deaconesses. One underlying explanation involves the priority Bring placed on establishing closer financial and organizational ties with the Church of Sweden. He strove to make the female diaconate conform as closely as possible to the Bible and the Lutheran construction of gender. His efforts paid dividends in that opportunities for deaconess participation in the public sphere, particularly in parish poor relief, opened up as 166

Johanna Östling to SDSFU,  November , AA (vol. ), EDA. Although the administrative board rejected Östling’s request for an annual stipend upon leaving the institution for the Salvation Army, the board did grant another sister who left to join the Salvation Army, Charlotta Svensson, a one-time stipend of  crowns. It is likely that she was given this stipend both because she had served the institution for a long time (twenty-two years), and because she suffered from rheumatism. SDSFU minutes,  May, , § , AA (vol. ), EDA. 168 SDSFU minutes,  December , § , AA (vol. ), EDA. 169 SDSFU minutes,  May , § , AA (vol. ), EDA. 170 Elmund describes a few other cases of sisters leaving for free church movements. See Elmund, Den kvinnliga diakonin, –; Det kvinnliga diakonatet som kall, –. 171 The case of Charlotta Svensson illustrates this possibility. She left to join the Salvation Army in , but the institution indicated that she left “according to an agreement.” SDSFU minutes,  May , § , AA (vol. ), EDA; SDSFU Årsberättelse , Olivebladet  (), . 167


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a result. But these efforts also hampered the deaconessate’s ability to be more competitive in terms of recruitment. One example that illustrates the more detrimental effects of Bring’s push for closer ties to the Church of Sweden concerns salaries. Despite complaints by some critics concerning the low salaries of deaconesses, Bring repeatedly defended the level of compensation by reference to the Lutheran construction of gender. As women, deaconesses did not work to earn a living as men did, because their work was an extension of the household sphere.172 Bring saw no need to compete with other social service providers in terms of compensation because deaconesses were not employees as such, but rather members of a spiritual household. But the lower salaries almost certainly would have made the female diaconate less appealing for unmarried women than those institutions or professions that carried out similar tasks but paid better salaries. For example, both elementary school teachers and the nurses associated with the Sophia Home (Sophiahemmet), an institution established in  to train nurses, were better compensated than deaconesses. To be sure, teachers and nurses also had to contend with the reality of prevailing gender expectations. The Sophia Home adopted the motherhouse model of the deaconessate, incorporating its nurses into a surrogate family and requiring them to wear a uniform, in order to connect them more clearly to the household sphere. And pretty much all nurses and female elementary school teachers were prohibited from getting married. Nevertheless, the teaching and nursing professions offered freedoms that the female diaconate did not. Teachers could negotiate their salaries directly with school boards, and they could apply for the positions they wished. Nurses at the Sophia Home did not have to worry about being reassigned to a Magdalene Home or orphanage; wherever their assignment, it would be in their chosen profession—nursing. These freedoms could not be found in the deaconessate. Bring did not want to abandon the practice of negotiating contracts with employers on behalf of deaconesses because he felt it would violate the Lutheran doctrine of a woman’s calling in the household sphere. He refused to allow deaconesses to specialize in only one profession, like nursing, because he needed to make the deaconessate conform to the biblical and early church model in which deaconesses were called to help all in need. In

172 LHA –, “Hwad är betydelsen af en Diakonissanstalt?,” Ö III b, EDA; “Hwarföre mottaga diakonissorna inga gåfwor?,” Olivebladet  (), .

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both cases, Bring had a vested interest in maintaining an organization that would be acceptable to the Church of Sweden, particularly its more traditionalist elements. Because he was so beholden to the institutional church, competition for recruits was often secondary to church loyalty, and for this reason, the female diaconate struggled to meet its full potential, particularly when it came to recruitment.173 Whatever the challenges faced by the female diaconate in building a larger corps of deaconesses, its services were still in high demand. One of the most common refrains found in the Olivebladet and annual reports is the complaint that while many institutions and organizations were requesting deaconesses, the institution had “no one to send” due to “the lack of personal resources.” It was noted in the first chapter that some sociological defenders of the secularization thesis maintain that with lower numbers of religious professionals comes a corresponding lower degree of social significance. It is difficult to deny that there is a connection between the two. The fact that there were not enough deaconesses to meet the demand for their services certainly placed limits on the extent of their influence in the public sphere. On the other hand, too much can be made of the connection between the low supply of a group of religious professionals, such as deaconesses, and secularization. Low supply does not necessarily mean that there is a lack of demand for the services of religious professionals, and it has been noted that deaconesses were very much in demand. If the secularization thesis ultimately has to do with demand for religion, including the demand for the services of religious professionals, then the fact that deaconesses were in demand indicates that they were considered significant by numerous individuals, institutions, and organizations. More importantly, the social significance of religious professionals cannot be easily quantified. The Finnish historian Pirjo Markkola rightly points out that while the deaconess movement in Sweden (and Finland) never became a mass movement, the influence of deaconesses in these coun173 Even with its recruitment challenges, the Swedish Deaconess Institution was still one of the largest deaconess institutions in Europe throughout the period of study. In , with  sisters, it ranked fifth out of about forty deaconess institutions in Europe. Only Kaiserswerth, Berlin, Neuendetteslau, and Strassburg hosted institutions with larger numbers. By , the Stockholm institution had dropped to twenty-fourth place out of seventy-five deaconess institutions, though with  sisters, it still ranked in the top onethird of all institutions. See “Om diakoniss-sakens tillwext de  sista åren (–),” Olivelbadet  (), , –; “Meddelanden från diakonissanstalten,” Olivebladet  (), –.




tries extended well beyond their numbers.174 One deaconess often had responsibility for many patients, poor families, school children, or orphans in her particular work station. In the following chapters, I will argue that Swedish deaconesses made a significant and sometimes lifechanging difference in the lives of many people who benefited from their teaching, nursing, and poor relief work.

H. Conclusion The nineteenth-century Swedish deaconessate never comprised a large number of women, but this chapter has demonstrated that it was nevertheless a socially significant group of religious professionals. The Swedish Deaconess Institution in Stockholm was the first institution at which women could receive occupational and nursing education. The number of sisters in its service grew steadily over the second half of the nineteenth century, as did the number of external work stations. The divisions at the institution also expanded. From initially hosting only a small hospital, the institution grew to include a school for poor children, an orphanage, a rescue home, a household school, a Magdalene Home, a polyclinic, and a nursing home, among other divisions. In expanding its work in the public sphere, the deaconess institution and its sisters did not abandon their religious profile in order to compete with the other specialized institutions and professionals arising at the time. The women who entered the institution articulated a strong sense of God’s presence in their lives. In many cases, they expressed a desire to pursue the deaconess vocation in order to demonstrate gratitude for Christ’s atoning work and the promise of salvation they had been given. The education they received at the institution also reinforced the religious identity of their vocation as they learned the biblical, confessional, and theological justifications for their work. The female diaconate had recourse to these religious justifications as it faced a potentially significant obstacle to its work in the public sphere— gender. The Lutheran construction of gender was still quite influential for much of the nineteenth century. Women were expected to fulfill their callings as wives and mothers in the household sphere. The calling of a deaconess dictated that deaconesses serve the poor, the sick, and the suffering in society, meaning that much of their work would take place 174 Pirjo Markkola, “Promoting Faith and Welfare. The Deaconess Movement in Finland and Sweden, –,” Scandinavian Journal of History  (), .

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in public spaces and among people to whom they were not related. The institution’s leadership sought to address potential concerns, especially in church circles, that the deaconess vocation contradicted the Lutheran understanding of a woman’s calling. The leadership did so by professing its allegiance to this doctrine. The institution also organized female diaconal work according to the motherhouse system, and in doing so, it was able to reinforce the connection of deaconesses to the household sphere. Another significant obstacle for the deaconessate was recruitment and retention. While the number of deaconesses at the Swedish Deaconess Institution was comparably high in relation to other European deaconess institutions in the late nineteenth century, the leadership consistently complained that it could not keep up with demand for the services of deaconesses because there were not enough women choosing to pursue the deaconess vocation. The low supply of deaconesses obviously limited the range of influence that the deaconessate could wield in the public sphere. But the diaconate’s influence extended well beyond its numbers. The deaconessate was a socially significant group whose services were valued and sought after by those in need (the poor, the sick, etc.) and by private and government-based institutions and organizations. In the following three chapters, I will demonstrate just how socially significant deaconesses were in carrying out three specific social functions in the late nineteenth century.

chapter three EDUCATION

The female diaconate concentrated its work initially on education. In this chapter, I will examine the social significance of deaconesses as teachers in primary and elementary schools in the nineteenth century. The first two sections will address the development of popular education in Europe and Sweden from the early modern period through the nineteenth century. Particular attention will be given to the role that religious institutions and professionals historically played in providing popular education. The extent to which functional differentiation affected the influence of religious institutions and professionals in popular education will also be discussed. The remaining sections will analyze the role that deaconesses played in popular education. Because of a very limited supply of teachers in the decades following the elementary school legislation of , deaconesses helped to meet the educational needs of a number of rural parishes and communities by working as elementary school teachers in the s and s. The deaconess institution’s own school in Stockholm also provided much-needed education to poor children in one of the city’s parishes in these decades, not to mention that this school also doubled as the first teaching college for women in Sweden. By the late s, the diaconate was abandoning its involvement in education, despite the fact that there was still a demand for its services. This was due in part to the feeling among the institution’s leadership that the diaconate could not effectively compete in the future with the larger supply of teachers educated at teaching colleges. More importantly, the decision to discontinue teaching reflected the leadership’s lack of commitment to and interest in education. J.C. Bring in particular had much more interest in refocusing diaconal work on nursing and poor relief than in continuing his predecessor’s dream of producing a new generation of teachers. To the extent that functional differentiation contributed at all to the diaconate’s eventual termination of its educational work, it did so only indirectly.

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chapter three A. Popular Education in Medieval and Early Modern Europe

Most of the formal schooling available in medieval Europe was provided by ecclesiastical institutions. Charlemagne took the initiative to improve literacy among clerics and monks by establishing schools in connection with monasteries and diocesan sees in the late eighth century. Monastic and cathedral schools in the early medieval period were thus intended for those pursuing a religious vocation. The latter continued to serve as important educational centers in the high Middle Ages, and a growing number of them focused on the study of the liberal arts and philosophy. The thirteenth century witnessed not only the beginnings of universities, where theology was the most prestigious discipline, but also an increasing number of schools dedicated to teaching the laity reading and writing. Nevertheless, formal schooling was not an option for the majority. The education that most children received was occupational (learning a trade or agricultural skills) and religious. The latter was conducted in the family and by clergy, and it did not include instruction in reading and writing.1 Schools providing elementary education for children became more widely available in early modern Europe, ranging from parish elementary schools to charity schools to girls’ schools. There was no coordinated educational system as such. Early modern schools might complement or overlap with one another in terms of the content of the instruction they offered. Most elementary schools concentrated on teaching literacy and religious knowledge, and for the vast majority of children who did attend school, formal schooling did not go beyond elementary school.2 Secondary schooling was largely the preserve of children from wealthier families and those who had an interest in entering the clergy or civil service. Children at the elementary school level might be taught by people who were formally connected to the church, such as those who had a theology degree but who chose to work as teachers while waiting for a more 1 C. Stephen Jaeger, The Envy of Angels: Cathedral Schools and Social Ideals in Medieval Europe, – (Philadelphia: University of Pennsylvania Press, ), –, – ; Helen M. Jewell, Education in Early Modern England (New York: St. Martin’s Press, ), ; James Thompson, The Literacy of the Laity in the Middle Ages (New York: Burt Franklin, ); Evelyn Birge Vitz, “Liturgy as Education in the Middle Ages,” in Medieval Education, eds. Ronald B. Begley and Joseph W. Koterski (New York: Fordham University Press, ), –. 2 R.A. Houston, Literacy in Early Modern Europe: Culture and Education – (London: Longman, ), –, –.

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promising position in a parish. But not all teachers were religious professionals. In many cases, teachers worked in other professions or trades and taught school on the side as a means of earning additional income. The quality of these teachers could vary significantly, with some having little formal education themselves. Even when teachers were not religious professionals, they were still considered a type of “junior partner” to the local clergyman, since their job was first and foremost to provide religious and moral education.3 The eighteenth century witnessed attempts by many Western European countries to expand the provision of schools for elementary education. Even with a greater number of schools, the percentage of school-age children who attended school varied considerably. The average attendance rates in the second half of the eighteenth century ranged anywhere from one-fifth to one-third of school-age children, depending on the region. In some areas, this percentage could reach fifty percent or more, such as in Brandenburg-Prussia, England, and northeastern France. In other areas, this percentage could dip below ten percent, as in many parts of eastern and southern Europe.4 For those who did not attend school, whatever education they may have received would have been acquired in the home and/or church. Among the Nordic countries, the provision of popular education via schools also varied considerably. Whereas Denmark and Norway increasingly came to depend on schools for popular education in the early modern period, Sweden, Finland, and Iceland relied much less on them. All five of the Nordic countries witnessed high literacy rates in this period, but schools were more important in achieving these rates in Denmark and Norway than in the other Nordic countries.5 Schooling was not uncommon in certain regions of Sweden in the early modern period, but the availability of schools was confined largely to cities or to the more populated regions in the south. Both extensive poverty and the sparse population in most of the country meant that 3 Houston, Literacy in Early Modern Europe, ; Mary Jo Maynes, Schooling in Western Europe: A Social History (Albany: State University of New York Press, ), . 4 Houston, Literacy in Early Modern Europe, , –; Maynes, Schooling in Western Europe, –; Richard S. Tompson, “English and English Education in the Eighteenth Century,” in Studies on Voltaire and the Eighteenth Century: Facets of Education in the Eighteenth Century, ed. James A. Leith (Oxford: The Voltaire Foundation at the Taylor Institution, ), , –. 5 Loftur Guttormsson, “The Development of Popular Religious Literacy in the Seventeenth and Eighteenth Centuries,” Scandinavian Journal of History  (), –.

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chapter three

the provision of schools for the vast majority of rural parishes was often untenable before the nineteenth century. As a result, popular education in Sweden relied much more on cooperation between the heads of households on the one hand and church functionaries, such as parish priests or clerks, on the other.6 The Lutheran church served as a catalyst in the widespread provision of popular education through its attempts to create a literate population that could read basic religious texts, particularly Luther’s Small Catechism. Legislation in the late seventeenth and early eighteenth centuries stipulated that the religious instruction of children was to be conducted primarily in the household but with the assistance of local church authorities. Children were to be taught by their parents or guardians how to read familiar religious texts, such as the catechism. Parish priests would examine the reading and religious knowledge of children and parents/adults alike at annual “house examinations” (husförhör). The parish priest would record the reading ability of each parishioner in a register, and if this ability was shown to be inadequate, it was incumbent upon the priest to arrange for auxiliary instruction for the person(s) in question. He could arrange for this instruction to be carried out by the parish clerk, if the latter was capable. Otherwise, arrangements could be made with a schoolmaster or other literate person in the parish to provide this instruction.7 These examination records indicate that despite the lack of availability of schools for most Swedes in the early modern period, by the end of the seventeenth century, Sweden was the most literate Nordic country, and by the end of the eighteenth century, it was one of the most literate countries in all of Europe. Of course, such a judgment depends on how literacy is defined. If the ability to write or sign one’s name is excluded in measuring literacy, then Swedes were far more literate than most other 6

In , approximately  percent of all rural parishes had an elementary school of some sort. H. Arnold Barton, “Popular Education in Sweden: Theory and Practice,” in Facets of Education in the Eighteenth Century, ; Houston, Literacy in Early Modern Europe, . 7 Barton, “Popular Education in Sweden,” –; Gösta W. Berglund, “Hemmet och skolan,” in Ett folk börjar skolan. Folkskolan  år, –, ed. Gunnar Richardson (Stockholm: Allmänna Förlaget, ), ; Houston, Literacy in Early Modern Europe, , ; Åke Isling, “Arbetsformer och arbetssätt,” Folkskolan  år, ; Gunnar Richardson, Svensk utbildningshistoria. Skola och samhälle förr och nu (Lund: Studentlitteratur, ), –, –, –; Bengt Sandin, Hemmet, gatan, fabriken eller skolan. Folkundervisning och barnuppfostran i svenska städer – (Lund: Arkiv, ), – .

education



Europeans, at least in terms of their ability to read and pronounce words from a written text.8 What is important for our purposes is that the two institutions of the church and the household played a vital role in providing basic education to the vast majority of Swedes in the early modern period, and in comparison to the popular education that existed in other parts of Europe, these institutions carried out this social function quite proficiently.

B. Educational Reforms in Nineteenth-Century Sweden Significant growth in the number of schools available in much of Sweden took place in the first half of the nineteenth century. In particular, between  and , many schools were established according to the Lancastrian model that had been started in England. This model enabled one teacher to instruct up to several hundred children at once through the assistance of more advanced students working as monitors. The Lancastrian method was first introduced in Sweden in . In , there were  Lancastrian schools in Sweden, and by , the year of the Elementary School Law, there were .9 These Lancastrian schools, added to the already existing elementary schools of various sorts throughout Sweden, meant that Sweden was becoming a more schooled society even before the  elementary school statute. Even so, at the end of the s, almost one-half of Sweden’s parishes still lacked an elementary school, meaning that in many regions, popular education continued to be primarily a matter of the home.10 Two explanations are generally put forth by historians as to why the king and the parliamentary estates decided to pass legislation on compulsory elementary education in . Some historians maintain that politicians were responding to the growing democratization of society and changes in the agrarian economy. Liberal politicians in particular felt that 8

Harvey J. Graff, The Legacies of Literacy: Continuities and Contradictions in Western Culture and Society (Bloomington: Indiana University Press, ), ; Guttormsson, “The Development of Popular Religious Literacy in the Seventeenth and Eighteenth Centuries,” Scandinavian Journal of History  (), . 9 Klas Aquilonius, Svensk folkskolans historia. Det svenska folkundervisningsväsendet –, vol.  (Stockholm: Albert Bonniers, ), –; K.G. Lindqvist, “Pionjärtidens skolor,” Folkskolan  år, ; Sixten Marklund, “Läraren i skolan. Utbildning och yrkesambitioner,” Folkskolan  år, . 10 Egil Johansson, “Folkundervisningen före folkskolan,” Folkskolan  år, ; Petterson, “Fyller verkligen folkskolan  år?,” .

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chapter three

mass education was needed to provide people with the knowledge necessary to adapt to these changes. Other historians insist that politicians implemented mass education in response to the rapid population growth and the proletarianization of the country. More conservative politicians saw in a compulsory elementary school a means of social control through which the existing social order would be reinforced and legitimized. Most likely, both sets of concerns enabled various factions within parliament to come to a general agreement on the need for universal elementary school education.11 In the debates leading up to the passing of the  Elementary School Law, all four parliamentary estates expressed concern that the state allow local municipalities to have a great deal of freedom in organizing and overseeing elementary schools. Other concerns raised in parliamentary debates pertained to the long distances that children in larger parishes would have to walk to reach the school and the desire to value the continued role of home instruction in education. Despite these concerns, all four estates agreed that the state needed to create a means to provide elementary school education throughout the country.12 On June , , the Elementary School Law officially took effect. Each parish in the country was to establish an elementary school and to hire a certified teacher to teach in it. The state took on the responsibility for educating teachers, although organizationally, teacher-training colleges would fall under the immediate authority and supervision of the cathedral chapters. In those cases in which a parish was too poor to bear the full financial burden of establishing an elementary school, the state would subsidize the costs. Otherwise, the parishes themselves would be responsible for all of the costs of building a school and hiring a teacher. Parishes had to hire a teacher and establish a permanent elementary school within five years, although allowances were made for the creation of ambulatory schools if difficult financial circumstances or other local conditions made it unfeasible to set up a permanent school. The statute also allowed for private schools to be set up under the supervision of the parish school board.

11 Tomas Englund, “Tidsanda och skolkunskap,” Folkskolan  år, ; Christina Florin, Kampen om katedern. Feminiserings- och professionaliseringsprocessen inom den svenska folkskolans lärakår (Stockholm: Almqvist & Wiksell, ), –. 12 Gunnar Richardson, “ års folkskolestadga,” Folkskolan  år, –.

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While the state bore some of the responsibility for implementing the new elementary school statute, religious institutions and professionals clearly had an important role in the organization and operation of the schools. Cathedral chapters had oversight of teacher training colleges. At the local level, parish priests served as ex-officio chairmen of the parish school boards. The school boards in turn made many of the decisions concerning the operation of the school, including teaching methods, discipline, the age at which children should begin school, and the length of the school year. Moreover, instruction in Christianity was the foundation of the curriculum, though children would also be instructed in basic subjects like reading, writing, and arithmetic. The clergy had particular oversight of the instruction of Christianity.13 The  law marked a change in the manner of large-scale educational provision for children in Sweden, but it is important to note that the church and the clergy continued to have a dominant role in overseeing and organizing popular education. The statute shifted the primary locus of popular education from the household to the school, but this transition did not mark the end of significant religious influence in education. Even given the fact that the statute signaled a move toward the creation of a teaching profession separate from the body of religious professionals traditionally associated with popular education, such as parish priests and clerks, teachers were still under the authority and supervision of the local clergy via the school boards. All of this is to say that while the  law signaled increased functional differentiation in popular education in Sweden through its efforts to establish both an elementary school in every parish and a separate body of teaching professionals, the law did not initially lead to any significant decline in the influence of religious institutions and professionals. In fact, the same law that led to increased functional differentiation also generated a demand for education that could not be adequately met by the new teaching professionals, and this opened the door for deaconesses to find a small but important niche as teachers in the s and s. It soon became clear that the  law was far too optimistic with its five-year timeline. By , only about half of all school-age children attended elementary schools, and just over one-third continued 13 For an overview of the role that the Church of Sweden and its representatives played in compulsory education in the late nineteenth century, see Todd Green, “The Partnering of Church and School in Nineteenth-Century Sweden,” Journal of Church and State  (), –.

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to receive their education through household instruction.14 For several decades following the passing of the statute, there were significant problems in carrying out its basic provisions. First, the statute created a huge and immediate demand for certified, educated teachers throughout the country, yet it took several decades for the teaching colleges to produce enough teachers to meet much of this demand.15 Second, economic resources were lacking. Many poor parishes had difficulty, even with state aid, in building a school and hiring a teacher, while many parents struggled to provide their children with adequate clothing and shoes needed for school.16 Third, in the more sparsely populated areas, the distances between some homes and the parish school were often too long, and the roads to these schools were typically in poor condition.17 Finally, in a number of communities, parental interest in the elementary school was low. The tradition of household instruction still held sway in many areas, not to mention that parents often needed their children to help with work at home for much of the year.18 One decade after the passing of the statute, the state began to deal with some of the obstacles that prevented the realization of universal elementary school education. It addressed the issue of the long distances to schools in some areas by giving the local school boards in  the right to establish lower elementary schools (mindre folkskolor). Five years later, the state extended its recognition of approved schools to include grammar schools (småskolor).19 Lower elementary schools were intended to provide schools for those who lived too far from elementary schools, and as such, they functioned as provisional elementary schools. Grammar schools were intended to help with large class sizes and the wide spectrum of knowledge and ability found in the classrooms by

14 Gunnar Richardson, “Folkskolan tar form—de första decennierna,” Folkskolan  år, . 15 Richardson, “Folkskolan tar form,” Folkskolan  år, ; Johan Wallner, Folkskolans organisation och förvaltning i Sverige under perioden – (Lund: Håkan Ohlssons Boktryckeri, ), . 16 Richardson, “Folkskolan tar form,” Folkskolan  år, , . 17 Marklund, “Läraren i skolan,” Folkskolan  år, –; Richardson, “Folkskolan tar form,” Folkskolan  år, , , . 18 Berglund, “Hemmet och skolan,” ; Richardson, “Folkskolan tar form,” Folkskolan  år, –, , . 19 Richardson, “Folkskolan tar form,” Folkskolan  år, ; Ingela Schånberg, De dubbla budskapen. Kvinnors bildning och utbildning i Sverige under - och -talen (Lund: Studentlitteratur, ), .

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creating separate schools for the very young and/or for beginners.20 In some instances, grammar schools functioned as substitute elementary schools, while in other cases they served as a preparatory stage for elementary schools.21 In any event, the lower elementary schools and grammar schools not only addressed the need for more school locales and smaller class sizes, they also helped with the teacher shortage as the state gave school boards the right to hire uncertified teachers at these schools.22 The state also alleviated the severe shortage in teachers by allowing women to teach at lower elementary schools and grammar schools in  and , respectively. In , women were allowed to teach in elementary schools, and in , women were permitted to attend teaching colleges. Women became attractive candidates as teachers in part because they were cheap labor in comparison to male teachers. Their gender also qualified them, since historically women had played a significant role in the education of children in the household.23 In this way, women could enter a profession that literally took them out of the household but that ideologically could be justified because the instruction and nurturing of children was an extension of the traditional duties of a woman in the household.24 For their part, many women found the teaching profession attractive because of the difficulties unmarried women faced in the mid-nineteenth century in terms of supporting themselves. The state continued to become more involved in elementary school education at the local and regional levels in the second half of the century. In , the office of school inspector was created. Inspectors were assigned the task of visiting schools in their respective districts and learning about the conditions and needs of these schools. They were then to report their findings to higher governing bodies, including the cathedral chapter.25 In this way, educational policies could be developed at the regional and national levels that better reflected the local realities described by the school inspectors. In , the state approved a standard curriculum for use throughout the country, and in , the length of the 20

Marklund, “Läraren i skolan,” Folkskolan  år, –. Richardson, “Folkskolan tar form,” Folkskolan  år, . 22 Marklund, “Läraren i skolan,” Folkskolan  år, . 23 Aquilonius, Det svenska folkundervisningsväsendet, ; Schånberg, De dubbla budskapen, , . 24 Florin, Kampen om katedern, . 25 Richardson, “Folkskolan tar form,” Folkskolan  år, . 21

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school year was set for all schools, as was the organizational structure of elementary school education that would characterize the system well into the twentieth century.26 This increasing functional differentiation in the second half of the century would ultimately come at the expense of the influence of the church and the local clergy on the operation of the schools and even on the curriculum, but the decline in religious influence did not become marked until the twentieth century.27 In the initial phase of functional differentiation, the local parishes and their clergy exerted considerable influence in the local schools. The provision that all parishes employ a qualified teacher ultimately generated such a huge demand for teachers that the door was opened for non-certified teachers to help meet some of this demand. This opening gave the deaconessate the opportunity to make significant contributions as teachers during the s and s.

C. The Deaconess School for Poor Children The  statutes for the Society for the Preparation of a Deaconess Institution in Stockholm stated that the intention of the future institution would be to educate nurses.28 The  statutes reaffirmed this commitment to caring primarily for the sick and others in need.29 Yet one year after its opening, the institution had taken on a branch of diaconal work not explicitly mentioned in the statutes—teaching. The administrative board had already discussed during the first year the possibility of opening a school primarily for the sick children cared for at the deaconess hospital, though healthy children would also be allowed to attend. No deci-

26

Englund, “Tidsanda och skolkunskap,” Folkskolan  år, ; Richardson, “Folkskolan tar form,” Folkskolan  år, . 27 For a brief discussion of the secularization of the religious curriculum in elementary schools in the twentieth century, see Sven Enlund, Svenska kyrkan och folkskoleseminarierna –. Med särskild hänsyn till seminarierna i Uppsala, Härnösand, och Göteborg (Uppsala: Föreningen för Svensk Undervisningshistoria, ), –; see also Green, “The Partnering of Church and School in Nineteenth-Century Sweden,” Journal of Church and State  (), –. For a treatment of the dissolution of the administrative connection between the church/clergy and the local elementary schools at the turn of the twentieth century, see Lennart Tegborg, Folkskolans sekularisering –. Upplösning av det administrativa sambandet mellan folkskolan och kyrka i Sverige (Stockholm: Almqvist & Wiksell, ). 28 SDSFU Minutes,  April , § , AA (vol. ), EDA. 29 Stadgar för Svenska Diakoniss-Sällskapet,  June , § , AA (vol. ), EDA.

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sion had been reached on the matter when Marie Cederschiöld opened a school for poor children living in Katarina parish in Stockholm on  July .30 The school was organized on the basis of paragraph twelve in the  statute allowing individuals and organizations to establish private schools. Just over a week after Cederschiöld opened the school, she reported her decision to the institutional board, while Oscar CarlheimGyllenskjöld communicated Cederschiöld’s actions to the administrative board in September.31 Cederschiöld’s decision created some controversy. While the minutes from both boards do not reflect it, Cederschiöld’s diary does. She noted that at a meeting of the institutional board in August, “a little nagging took place” concerning the school.32 After an administrative board meeting in October, she wrote how some board members described the new school as “an outgrowth, a parasite, an enterprise only by me, for my recreation.” When she offered to close down the school, the board declined, insisting only that rules be established for its operation.33 One likely reason why some board members were upset was that Cederschiöld had opened the school without authorization from the governing boards. Since the statutes indicated that the administrative board was the highest authority, Cederschiöld’s actions may very well have been interpreted as an attempt to circumvent the board. It is also possible that a few board members were upset because the teaching of children was not in accordance with the original intention of the Swedish Deaconess Society to train deaconesses as nurses, even if the society was aware that education was a branch of diaconal work at similar institutions on the continent.34 After these initial reservations, there are no other recorded instances of discontent with the school in Cederschiöld’s diary or in the board minutes. But Cederschiöld remained sensitive to the perception that the school was not in accordance with the original intention of diaconal work. For this reason, she wrote in the – annual report that 30 Katarina parish was one of the poorest parishes in Stockholm in the mid-nineteenth century. See Johan Söderberg, Ulf Jonsson, and Christer Persson, A Stagnating Metropolis: The Economy and Demography of Stockholm, – (Cambridge: Cambridge University Press, ), –. 31 Gunnel Elmund, Den kvinnliga diakonin i Sverige –. Uppgift och utformning (Lund: CWK Gleerups, ), . 32 MCD,  August , FX, EDA. 33 MCD,  October , FX, EDA. 34 “Anmälan,”  April , AA (vol. ), EDA.

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“[t]hrough the opening of the school, the primary purpose of the institution is not being overlooked but rather comes closer to its realization.” She added that it was already becoming clear that not all probationary sisters had the constitution or skills for nursing, but they were still called to serve the Lord.35 The school thus was a good outlet for those women who possessed the general calling to serve God and their fellow human being but who were not cut out for nursing. Seven children were initially registered at the school when it opened, but within a year that number had jumped to twenty-seven, and the school was moved into the deaconess house during the winter of – .36 By , approximately fifty-eight children were attending the school, and four years later the number had increased to between seventy and eighty.37 Over the course of the next decade, registration would average between seventy and eighty. While it is unknown how many private schools there were in Stockholm in the s and s, it is estimated that attendance at such schools would have averaged twenty to thirty students.38 The deaconess school was thus large compared to other private schools in the city. Probationary sisters who were preparing to specialize as teachers carried out the teaching at the school. They did so under the supervision of an experienced teacher. The first supervisor of the teacher-training program at the school was not a deaconess but was a fervent supporter of diaconal work. In the winter of –, Betty Ehrenborg had traveled to England, where she observed several kinds of educational institutions using different teaching methods. It is unclear which pedagogical approach Ehrenborg used when she began working at the deaconess institution in the fall of , but we do know that her experience in England led her to become quite critical of the Lancaster method.39 Ehrenborg directed teacher training at the school until . In that year, the institution’s leadership had voiced its criticism of Ehrenborg for training women as teachers who had no intention of becoming deaconesses. She was asked to cease taking on student teachers of this kind. Ehren35

SDSFU Berättelse och redovisning –, . SDSFU Berättelse och redovisning –, –. 37 SDSFU Berättelse och redovisning –, –; SDSFU Berättelse och redovisning –, –. 38 Einar Ekman, Diakonien och folkskolan. En minnesvärd insats i svenskt folkbildningsarbete under förra seklet (Stockholm: Föreningen för svensk undervisningshistoria, ), –. 39 Ibid., . 36

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borg resigned her post that year, and one year later she opened a separate teaching college for women.40 She continued to be a supporter of the Swedish Deaconess Society even after her departure, while in her place, various experienced deaconesses oversaw the training of teachers. In the first few years, the institution wanted to focus only on teaching older children, those who had already learned some of the basics of reading and spelling.41 But younger children were also accepted in these early years, meaning that children of different abilities and levels of preparation received instruction at the school. The heart of the curriculum was instruction in Christianity. The –  annual reported stated that “we hope very much that . . . the Bible knowledge that the children receive . . . will be sufficient for the awakening of the spiritual life.”42 Children were regularly tested on their knowledge of the principles of the Christian faith acquired through studying the Bible and learning the catechism. In addition to religious knowledge, the children were instructed in most of the subjects taught in the statemandated elementary schools: reading, writing, spelling, arithmetic, history, and geography. Besides these subjects, girls were given additional instruction in household tasks, such as sewing and knitting. The institution’s leadership viewed the school’s work with girls as primarily that of educating future wives and mothers, even if the girls received instruction in many of the same subjects as boys. When annual reports commended the progress of the students, boys were praised for their achievements in subjects such as arithmetic and writing, while girls were complimented on their performance in household tasks, such as needlework.43 Moreover, the number of girls accepted at the school consistently exceeded the number of boys, suggesting a clear preference for teaching girls. Statistics concerning the female-to-male ratio were not typically given in the annual reports, but when they were, the imbalance was evident. In , the annual report stated that of the eighty-eight children registered, fifty-four were girls, and this ratio appeared much more balanced when compared to earlier years.44 By focusing more on the education of girls, deaconesses were 40

Ibid., –. SDSFU Berättelse och redovisning –, . 42 SDSFU Berättelse och redovisning –, . 43 SDSFU Berättelse och redovisning –, . 44 SDSFU Berättelse och redovisning –, . By comparison, in  there were fifty-eight children registered. The annual report indicates that only “a few” were boys. See SDSFU Berättelse och redovisning –, –. 41

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better able to reinforce their own connection to the domestic sphere by carrying out the responsibilities of mothers in teaching younger girls household tasks, tasks at which deaconesses would have been deemed naturally gifted due to their gender. Of course, even in the instruction of boys, deaconesses extended the responsibilities of a woman in the domestic sphere into a public setting, since basic education of children of both genders had historically been a responsibility of mothers in the household. It is difficult to assess how individual deaconesses who trained or taught in the school felt about their work, since, unlike diaconal teaching in provincial schools, there are no surviving documents written by deaconesses that reflect on this work. The annual reports contain assessments about the successes and frustrations of this work, but how much this reflects the sentiment of deaconesses as a whole is difficult to know. Some reports note that children responded positively to the evangelistic efforts of the sisters by demonstrating a desire to hear God’s Word.45 As noted above, the reports also contain some positive evaluations of the progress the children were generally making in their schoolwork. The challenges faced by the deaconesses at the school appear to have been of two kinds. First, it was difficult to teach children who came from impoverished conditions and who thus were exposed to what was perceived as immorality outside the school. The – annual report states how amazed some of the deaconesses were that the children were not more disobedient and immoral than they already were, given that “these small, poor children hear and see evil in all its hideous forms” in their homes.46 Several years later, another report indicates how much the religious instruction of the children was undermined due to the immoral conditions under which the children lived in their parents’ homes.47 Specific examples of immoral conditions are not given, but what is clear in the annual reports is that poverty and immorality were closely linked in the perspective of the institution’s leadership. The other challenge that deaconesses faced involved irregular school attendance among their pupils. There were complaints that children did not come to school as often as they should, in part because parents needed them at home to help with work, and in part because poor families had to move from one location in the city to another quite 45 46 47

SDSFU Berättelse och redovisning –, . SDSFU Berättelse och redovisning –, –. SDSFU Berättelse och redovisning –, .

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frequently. It was therefore difficult for some children to make progress because of sporadic attendance.48 Even with these challenges, annual reports consistently indicate that their school was in demand among many parents in Katarina parish. As early as , the school was turning down requests for a place at the school due to cramped conditions.49 The lack of space still forced the school to turn away children several years later, even though in doing so, the school had “to deny many mothers who insistently beg us to accept their children.”50 The rapid increase in enrollment in the course of the s, and the fact that the average number of registered students remained in the seventy to eighty range and at times came close to one hundred also reflected a demand for the education provided by the deaconess school. Much of the demand certainly stemmed from the fact that for some decades after the  statute, there were too few schools and teachers in proportion to the number of school-age children in the country. The school at the deaconess institution therefore fulfilled a necessary function by providing education to children who may have had difficulty getting an adequate education elsewhere in the city. An article in Febe many years later reinforces this view, noting that the institution made significant contributions to the education of children in its first two decades because of the paucity of schools at the time.51 The need for basic educational provision was great in the s and into the s, and the institution’s school was in demand in large part because it helped to meet this need in one of Stockholm’s poorest parishes.

D. Deaconesses as Teachers in Provincial Sweden It was noted earlier that the  Elementary School Law was particularly difficult to implement in rural areas due to widespread poverty, the long distances to schools, and a strong tradition of household instruction. The severe shortage of teachers also made it difficult for many rural communities to meet the basic provisions of the new statute. The

48

SDSFU Berättelse och redovisning –, . SDSFU Berättelse och redovisning –, . 50 SDSFU Berättelse och redovisning –, . 51 “Några drag ur Svenska Diakonissanstaltens historia, dess uppkomst och utvekling,” Febe (), . 49

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rise of the female diaconate in the s came at an opportune time because it provided a potential pool of teachers for some of the communities that had the greatest difficulty in fulfilling the provisions of the statute. Like the school for poor children in Stockholm, the provincial schools at which deaconesses taught from the mid-s onward were mostly organized according to paragraph twelve of the  law, which enabled individuals and organizations to establish private schools in a given district under the authority of the school board. Teachers at private schools did not have to be certified, though their competency and knowledge were subject to examination by the parish school board. The overall percentage of children instructed in private schools in the years immediately following the  law was not high. In , approximately four percent of children received their primary elementary school education in this way. Considering that in the same year just over fifty percent of children received their education in elementary schools,52 it is clear that many communities continued to lack access either to schools or to teachers, though certainly there were families who did not send their children to schools for reasons having little to do with accessibility issues. Under these circumstances, private schools were the only schools in some rural districts available to children in the decades following the statute’s implementation. Some of the private schools at which deaconesses taught were estate schools, established by an individual on his or her estate. In most instances, the individuals in question were members of the nobility who had some sort of connection to the neo-evangelical revivals. Many other schools at which deaconesses taught were established by missionary societies, also connected to revivalism. This was particularly the case in the province of Gotland, an island off the east coast of Sweden. Until the late s, estate and mission schools made up at least fifty percent, and often more, of the types of schools at which deaconesses taught. Other kinds of private schools at which deaconesses were stationed included orphanage schools, church schools, and mill/factory schools.53 Many were located in the south, with four provinces hosting over half of these schools: Gotland, Västergötland, Uppland, and Småland.54 Altogether, the deaconess institution stationed sisters at sixty-two provincial schools 52 53 54

Richardson, “Folkskolan tar form,” Folkskolan  år, . Ekman, Diakonien och folkskolan, . Ibid., –.

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between , when the first deaconess was assigned, and , the year the last school station was discontinued.55 The number of children registered at these schools varied considerably. For example, in , twenty-two provincial schools employed deaconesses. The number of students registered at these schools is estimated to be between  and  children. The average number of students per school therefore would have been between thirty-four and thirty-seven students. The fewest number was at Österåker School, with seventeen students, while the highest number was sixty-five at Köhlbäck School in Östergötland.56 A survey of other annual reports indicates that the number of children at a given school could surpass one hundred. In , two schools met or exceeded this mark, both in Värmland and each staffed by one probationary sister: Väse School, with  registered students, and Sjönnebol School, with .57 The deaconess institution did not keep records on attendance rates, though it is clear from deaconess correspondence that these rates could vary considerably. As for the responsibilities that deaconesses were expected to carry out, a survey of the few hiring contracts that have been preserved, combined with some of the letters deaconesses wrote back to the institution, provide a general picture of a deaconess’s job responsibilities. In addition to leading Sunday School, sisters were expected to teach many of the same subjects found in the state-mandated elementary schools, including reading, writing, arithmetic, church music, biblical history, and the catechism. They were also to teach household skills, such as sewing and knitting, to girls.58 Instructing girls in household skills sometimes took place while boys were getting additional practice in the basic elementary school subjects.59 If it were a girls’ school, the elementary school subjects might be taught in the morning and household skills in the afternoon.60

55

The – annual report states that a probationary sister was actually sent to a school station in Västmanland, though it appears that this was a temporary assignment. How much time the sister in question worked at this school is unclear. SDSFU Berättelse och redovisning –, . 56 SDSFU Berättelse och redovisning –, . 57 SDSFU Berättelse och redovisning –, . Beginning with the – annual report, the deaconess institution did not provide information concerning the number of children registered at the different provincial schools. 58 Contract between SDAS and Eskelhem Parish School Board,  June , Ä Ia  (no. ), EDA. 59 H. Öberg to M. Cederschiöld, May , E Va  (no. ), EDA. 60 C. Kindberg to M. Cederschiöld,  June , E Va  (no. ), EDA.

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Deaconesses would have been attractive candidates for some private girls’ schools as well as for other private religious schools with girls registered. The instruction of young girls in traditional domestic skills was after all the responsibility of wives and mothers, and as women who belonged to the domestic sphere, deaconesses would have been viewed as perfectly qualified to carry out the duties assigned to wives and mothers in a school setting. This would have been particularly true among more traditional religious individuals or communities, such as those that typically sought to hire deaconesses as teachers. Even in the instruction of boys, deaconesses were carrying out their gender-specific responsibilities of nurturing young children and providing them with a basic education. Through their role as teachers, deaconesses reinforced their connection to the household sphere by extending the traditional educational duties of wives and mothers into a public setting. Deaconesses assigned as teachers in provincial schools were often expected to carry out duties not related to teaching. For example, the school at Göksholm in the province of Närke was joined to a small orphanage, and the deaconess assigned to this school had responsibility for the orphans as well.61 In the estate schools of Agnestad and Viken in Västergötland, Emma Salton had responsibility for instructing the children in basic health and hygiene. Salton also visited the poor and the sick in their homes.62 It was even possible for the school to be a secondary assignment for some deaconesses. This was the case in Åmmeberg in Närke, where in  two deaconesses were assigned primarily to work as nurses in a hospital owned by a Belgian mining company. When the company opened a school for the children of its workers in , the deaconesses also worked as teachers there.63 Through a survey of the letters written by deaconesses that have been preserved from the s and s, combined with other accounts published in the annual reports, it is possible to get some sense of how satisfied deaconesses were in their roles as teachers. Some of the deaconesses reflected quite positively on their teaching experiences. An excerpt from a letter written in  by Johanna Svensson, stationed

61

SDSFU Berättelse och redovisning –, ; Ekman, Diakonien och folkskolan,

. 62 SDSFU Berättelse och redovisning –, ; SDSFU Berättelse och redovisning –, –; Elmund, Den kvinnliga diakonin, –; Ekman, Diakonien och folkskolan, –. 63 Ibid., –.

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at Göksholm School, illustrates how much some deaconesses enjoyed their work: The school children are attentive, and they animate me a lot. Their childlike, funny answers often move me. It is such a gift of grace that I may talk to them . . . about God’s Word.  children are registered . . . Most are boys, all are quite kind, and [they] often talk at home about what they have learned in school. Some who were believed to be too small to begin school have astonished their parents with how well they have learned the Bible . . . The older kids learn biblical history and geography. The girls sew and crotchet quite nicely. I have now begun to hold Sunday School . . . Many of the parents go with the children.64

Positive accounts from other deaconesses noted how kind and obedient the children were, how willing the children were to learn and attend school, or even how some of the children were beginning to know the Lord. Not everyone experienced Johanna Svensson’s joys and successes. Deaconesses also encountered various difficulties and obstacles in their work as teachers, enough in some cases to discourage them from continuing as teachers or even as deaconesses. One challenge involved resistance and at times outright opposition from the local church authorities. Sofia Holmblad complained that the parish priest openly opposed her presence in the school, entering the classroom several times “as a roaring lion.”65 She also noted how on one occasion, representatives from the parish council tried to remove her, but through the Lord’s intervention, nothing came of it.66 Emma Hjerner arrived at her teaching station only to discover that the parish priest would not officially acknowledge her right to teach until she had formally submitted her credentials. The same priest later articulated his anger both to Hjerner and Cederschiöld that Hjerner’s Sunday Schools were adding to further divisions and tensions in the parish, probably because they at times took on the form of revival meetings.67 Both Holmblad and Hjerner were stationed at mission schools in the province of Gotland at the time of these encounters, and the resistance of local church authorities was no doubt related to what they perceived to be the separatist tendencies of the revival movements in the region. Most of

64 65 66 67

SDSFU Berättelse och redovisning –, . S. Holmblad to M. Cederschiöld,  October , E Va  (no. ), EDA. S. Holmblad to M. Cederschiöld,  January , E Va  (no. ), EDA. Elmund, Den kvinnliga diakonin, –.

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the instances in which deaconesses encountered resistance from church authorities occurred on Gotland.68 A second challenge concerned the difficulty of teaching large classes with wide ranges of student ability. Charlotta Wallin noted how difficult it was to teach a large number of children, with ages ranging from six to fourteen and with vastly different levels of knowledge and competency.69 Johanna Magnusson expressed similar frustrations in terms of the large class size, though in her case, the bishop intervened and had her class divided into two, with the older and younger children alternating days of the week in which they attended.70 Many elementary school teachers faced these kinds of obstacles. A third challenge pertained to the children’s behavior. Anna Lundgren expressed sentiments found in letters by a few other deaconesses when she wrote to Bring that “[m]y children are not kind, but rather very disobedient and difficult.”71 Others were not so much disillusioned with misbehavior in class as they were with the spiritual condition of the children. Karna Larsson articulated that while she was glad that so many children were attending her school, she was disappointed that “none of them have yet begun to ask the way to heaven.”72 A fourth challenge involved feelings of inadequacy and incompetency when it came to the actual task of teaching. Mathilda Westerberg expressed her frustration after an exam she had administered that “[t]he children knew more than I, I who am supposed to be their teacher.”73 Sofia Holmblad similarly complained that she was too “ill-equipped” and “unknowledgeable” for teaching, and for this reason she requested to be relieved from her assignment.74 Maria Clarin asked to be reassigned, noting that while she tried to be strict with her children, she could not gain their respect “since they see that they surpass me in almost everything.” In Clarin’s case, it got to the point that she was terrified that a parent or school board official might visit the school and discover her lack of knowledge and ability in teaching, though she suspected that

68

Ekman, Diakonien och folkskolan, . C. Wallin to M. Cederschiöld,  November , E Va  (no. ), EDA. 70 J. Magnusson to J.C. Bring,  October , E Va  (no. ), EDA. 71 A. Lundgren to J.C. Bring,  May , E Va  (no. ), EDA. 72 K. Larsson to J.C. Bring,  February , E Va  (Nn. ), EDA. 73 M. Westerberg to M. Cederschiöld,  May , E Va  (no. ), EDA. 74 S. Holmblad to M. Cederschiöld,  January , E Va  (no. ), EDA; S. Holmblad to M. Cederschiöld,  May , E Va  (no. ), EDA. 69

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the children were already telling their parents how poorly things were going in school.75 It is possible to overestimate the number of deaconesses who were dissatisfied with their work as teachers. After all, not every letter written by deaconesses to the institution has been preserved from the s and s, and even among those that have, there are many letters in which deaconesses write little about their satisfaction (or lack thereof) with their work as teachers. Nevertheless, the fact remains that the leadership of the deaconess institution heard numerous complaints from deaconesses about the difficulties and challenges of their work. Irrespective of how the deaconess themselves felt about their abilities or job performance, most indications are that deaconesses were very much in demand. The extant correspondence between provincial school authorities and the deaconess institution, combined with statements made in annual reports, demonstrate that into the late s, and even a little beyond, demand for the services of deaconesses as teachers consistently outweighed supply. Some schools had to make repeated requests, perhaps over a period of years, before they finally received a deaconess. In other cases, employers practically begged the institution not to reassign the deaconess they already had to another school or work station. In still other cases, schools received word that no deaconess could be sent, causing them, often reluctantly, to make alternate arrangements for hiring a teacher. Several reasons can be offered for this demand for the teaching services of deaconesses. First, as women connected to the household sphere, deaconesses would have been perceived as obvious candidates to nurture children and to instruct girls in such domestic skills as sewing and knitting. Second, many of the employers were either individuals or organizations strongly influenced by the neo-evangelical revival. The main qualification they sought in a teacher, according to the correspondence, was a “Christian-minded” woman who would faithfully instruct the children in the true religion and serve as a solid religious role model.76 As an organization born out of the revival, the deaconessate was thus perceived as a legitimate source for religiously qualified teachers.

75

M. Clarin to J.C. Bring,  October , E Va  (no. ), EDA. See, for example, Räfvetofta School to J.C. Bring, undated, Ä Ia  (no. ), EDA; Nahlavi School to J.C. Bring, undated, Ä Ia  (no. ), EDA. 76

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chapter three

A third reason for the demand is that deaconesses were quite affordable in comparison with many teachers.77 If one calculates a deaconess’s salary both in terms of the annual cash stipend she received and the cost of her lodging, a deaconess received approximately – riksdaler per year in the s and early s.78 By comparison, many rural elementary school teachers in the s received – riksdaler per year, though this figure does not take into account the lodging provided to them by the parish. A deaconess received a salary roughly equivalent to the lowest-paid elementary school teachers in rural Sweden.79 However, because some of the districts in which these schools were located were so impoverished, even the cost of employing a deaconess at times could be too difficult to bear. This was the case, for example, at Torpelund School in , when the school board noted its desire to renew the contract with its deaconess for another year, but expressed concern that it would not be able to pay the fee to the deaconess institution.80 A fourth explanation for deaconess demand is that there was overall satisfaction with their job performance. The institution’s – annual report stated that: [W]e have generally been spared any troublesome information concerning so many sisters employed in the provinces . . . instead, on more than one occasion, we have been encouraged by the testimonies concerning their work.81

Much of the surviving correspondence from school authorities confirms this view. A typical assessment is that of the parish school board overseeing Köhlbäck School, which was “fully pleased with the teacher Johanna Magnusson,” and added that “as long as she finds herself satisfied with her position,” it hoped to be able to keep her.82 Many other letters note more generally how satisfied school officials, parents, and even children were with the work being carried out by deaconesses. The numerous requests

77 Christina Florin notes that the rapid feminization of the teaching profession in late nineteenth-century Sweden was primarily due to the fact that women were cheaper to employ than men, and thus they were attractive candidates in many local communities. See Florin, Kampen om katedern, . 78 Riksdaler refers to the currency used in Sweden until , after which the country began to use the crown. 79 Elmund, Den kvinnliga diakonin, . 80 Torpelund School to J.C. Bring,  October , Ä Ia  (no. ), EDA. 81 SDSFU Berättelse och redovisning –, . 82 Köhlbäck School to J.C. Bring,  September , Ä Ia  (no. ), EDA. The Köhlbäck School was also known as the Emmaus School (Emausskolan).

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made by school officials for contract renewals also confirms the overall satisfaction many schools had with their deaconesses. Not all reports were glowing. Officials at Torpelund School once asked that the deaconess who had previously been stationed at their school, Edla Pettersson, be reassigned to them because the current deaconess, Maria Andersson, seemed to lack the knowledge and ability needed for teaching.83 Bring also noted in the Olivebladet in  that the institution had received some complaints, presumably from some provincial school officials, that deaconesses serving as teachers had insufficient knowledge to do the work.84 But these complains were infrequent. Perhaps the most important reason why deaconesses were in demand in these rural districts was that there was still a deficit of available teachers two decades after the  law. As mentioned previously, attempts were made in the s to address the shortage of teachers by, among other things, allowing more informal elementary or primary schools to hire uncertified teachers, including female teachers. Nevertheless, some areas continued to have difficulty in recruiting teachers. Letters from provincial schools to the deaconess institution reflect this difficulty. In the spring of , the school board overseeing Eskelhem School on Gotland expressed frustration that the “much longed-for Sister” that they had requested the previous fall had still not been sent. They were concerned that the children “had gone so long without any teacher in Christianity,” among other things.85 Apparently, the Eskelhem School did not have any other prospects for teachers at the time. A parish priest in the province of Närke urged Bring not to remove Johanna Jonsson from her teaching post at Nahlavi School, noting that “the need for teaching assistance at the School is . . . so great.”86 Örnsköldsvik School in Ångermanland had so few prospects for teachers that when it received word that its deaconess, Margaret Persson, was to be reassigned, it asked the deaconess institution to help it find another teacher, even if the institution could not do this by sending another deaconess in Persson’s place.87

83 Torpelund School to J.C. Bring,  December , Ä Ia  (no. ), EDA. Despite the reservations of school officials about Andersson, she did not leave immediately. According to the annual reports, she continued in the position until . 84 “Hwad är diakonissanstalten?,” Olivebladet  (), –. 85 L. Walldarfve to M. Cederschiöld,  March , Ä Ia  (no. ), EDA. 86 Westman to J.C. Bring,  April , Ä Ia  (no. ), EDA. 87 Örnsköldsvik School to DAS,  April , Ä Ia  (no. ), EDA.

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chapter three E. The Discontinuation of Teaching

Even though demand for the educational services of deaconesses was consistently high in Katarina parish of Stockholm and in certain rural districts, the institution’s leadership chose in the late s to phase out teaching. The leadership first announced its decision to pull back from education in . In , the institution closed its school for poor children in Stockholm, ending its training of deaconesses as teachers. With the discontinuation of the Stockholm school and the reassignment of sisters to areas such as health care and poor relief, the area of work that once dominated the diaconate’s attention faded into the background. In the year following the leadership’s first announcement that it would reduce the number of sisters assigned to schools, the number of school stations had reached its peak at thirty-three. By , this number was down to ten, and seven years later, only one school, the Torpelund School, employed a deaconess. A deaconess would continue at this school until .88 Why did the leadership discontinue the diaconate’s involvement in education, particularly at a time when there was still demand? The reason given by Bring and the leadership, at least publicly, was that statesupported teaching seminaries were effectively meeting the general demand in Sweden for teachers, and, more importantly, they were doing so with better-trained teachers.89 An article in Febe written some twenty years after the diaconate began its withdrawal from teaching described the situation this way: In the same degree that the public school system developed, the need for deaconesses serving as teachers diminished gradually. Thus it happened that one school after another was given over to teachers who had been trained at one of the training colleges. Competition with these [teaching colleges] could no longer occur unless we established our own teaching college, as is the case at some deaconess institutions abroad.90

The leadership clearly was reacting to what sociologists today call functional differentiation. The process by which college-trained teachers were 88 “Hwad är diakonissanstalten?,” Olivebladet  (), ; SDSFU Årsberättelse – , –; SDSFU Årsberättelse , Olivebladet  (), . The Torpelund station is last listed in the  annual report. SDSFU Årsberättelse , Olivebladet  (), . See also Table . 89 SDSFU Berättelse och redovisning –, –. 90 “Några drag ur Svenska Diakonissanstaltens historia, dess uppkomst och utveckling,” Febe (), .

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assuming more and more teaching positions had progressed to the point that the institution’s leadership no longer felt deaconesses could compete with these specialized professionals. The leadership’s conviction that it could not compete in the field of education was reinforced by occasional complaints both from employers and from deaconesses themselves concerning the latter’s lack of qualifications. The leadership’s response to these complaints, particularly when they came from an employer, is worth noting. Bring wrote in an  edition of the Olivebladet that the institution has “from various places heard criticisms . . . that our school teachers have too little knowledge.” He reminded these critics that the institution has never tried to portray its deaconesses as being “on a par with elementary school teachers.” He insisted that deaconesses were best suited for teaching smaller children, particularly girls, for deaconesses were very much qualified to instruct the latter in household tasks. Criticisms about the knowledge and ability of deaconesses as teachers, he argued, stemmed from unrealistic demands placed upon them in those schools in which they were expected to teach elementary school subjects and older children.91 While he felt that these criticisms were unfair, these occasional complaints, combined with the fact that some deaconesses also expressed frustration at their lack of knowledge and preparation, helped to convince him and the leadership that the diaconate was not well positioned to compete with the increasing supply of certified teachers coming out of teaching colleges. Functional differentiation therefore contributed to the leadership’s decision to withdraw deaconesses from teaching, but caution is in order when determining whether functional differentiation inevitably forced deaconesses out of education. The discontinuation of teaching was a conscious, strategic choice. Functional differentiation may have raised the stakes in terms of competition, but the leadership could have chosen to improve the educational program of the institution so that deaconesses would have possessed similar qualifications and training as those coming out of teaching colleges. This decision was not made. Moreover, given the fact that there was still demand for deaconesses as teachers in the late s, and even beyond, it would have been possible for the institution to expand its teaching work stations beyond the thirty-three it possessed in . Instead, the leadership chose to do the opposite by turning down

91

“Hwad är diakonissanstalten?,” Olivebladet  (), –.

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requests from additional schools and reassigning existing teachers to other types of stations. As for why the leadership chose not to compete with teaching colleges, or why it did not take advantage of the continuing demand in the late s by expanding its work in schools, the best explanation is that the commitment to education under Bring’s leadership was never strong. Bring noted that in withdrawing from teaching, the institution would be able to devote itself “to other areas that are closer to what we want to be doing as an Institution, namely poor relief and health care.”92 Bring’s other writings and public addresses reveal his conviction that a focus on health care and poor relief was more in line with Christ’s own earthly ministry among those in need as well as the work carried out by deacons and deaconesses in the early church.93 It must also be remembered that the Swedish Deaconess Society did not initially intend to enter into education when it opened the institution. Cederschiöld had opened the school for poor children on her own initiative, and it is understandable why her successor may not have been as committed to this branch of work as she was. The discontinuation of teaching resulted primarily from the lack of commitment on Bring’s part and only indirectly from functional differentiation. By the late s, functional differentiation had progressed to the point that it had created more competitive conditions and higher expectations in schools concerning teacher qualifications. Under these circumstances, the institution’s leadership, already convinced that health care and poor relief were more appropriate tasks for deaconesses, decided that the time was right to give up teaching altogether.

F. Conclusion The diaconate’s participation in education reveals how functional differentiation could be a two-edged sword. After the  Elementary School Law shifted the primary responsibility for teaching children from the clergy and parents to a separate body of teaching professionals, a huge demand for teachers arose almost immediately, and there were not 92

“Hwad är diakonissanstalten?,” Olivebladet  (), . “Om Diakoniss-verksamheten,” Olivebladet  (), –; “I Jesu namn,” Olivebladet  (), –; “Något som, enligt skriften, kan anbefalla diakonissverksamheten,” Olivebladet  (), –. 93

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enough teachers to meet this demand. In this way, functional differentiation initially opened the door for deaconesses to work as teachers. As functional differentiation progressed, the supply of certified teachers educated at teaching colleges increased, and this increased supply contributed to the decision to discontinue the deaconessate’s work in schools. What functional differentiation did not do was force deaconesses out of teaching by eliminating or even reducing demand for their teaching services. Demand for deaconesses as teachers was consistently strong in the s and s. However much functional differentiation had progressed in education by the late s, the fact that external school stations were at their peak in , combined with the fact that requests continued to be made for contract renewals or new deaconesses, indicates that deaconesses were as attractive as ever as teachers. The increase in college-trained teachers may have influenced the leadership’s decision to abandon teaching, but it is also clear that the diaconate left the field of education largely because its leaders felt that the diaconate’s mission was more suited to nursing and poor relief and that it could be more competitive in these spheres. On this latter point, the leadership’s confidence was not misplaced, as the next two chapters will demonstrate.

chapter four HEALTH CARE

By the late s, the female diaconate shifted its attention from education to health care. This shift represented the leadership’s desire to return to the original vision of the Swedish Deaconess Society—the training of evangelical nurses to help the sick and the suffering. In this chapter, I will examine the diaconate’s influence in nursing and health care provision in late nineteenth-century Sweden. It is important to note that health care and poor relief overlapped significantly in the diaconate’s work; a sharp distinction between the two cannot be made. I will focus on the diaconate’s involvement in institutions whose central purpose was to provide health care to patients irrespective of financial status. In the next chapter, I will discuss the diaconate’s work in poor relief institutions and parishes where the focus was on helping the poor, even though this work often included providing health care to the “poor sick.” The first section will survey the history of health care in early modern Europe and Sweden, with particular attention given to the role played by religious institutions and personnel. The second section will address the impact of female religious organizations and personnel on the development of the modern nursing profession in Sweden. The remaining sections will examine in greater detail the diaconate’s work in nursing and health care provision both at the institution and outside of it. I will argue that the professionalization of nursing in modern Swedish history began through the pioneering work of deaconesses. Nurses existed in Sweden before the nineteenth century, but deaconesses were the first women with “higher education” to work as specialized health care professionals. I will also demonstrate that the health care services of deaconesses were in fairly high demand among patients and employers, particularly in the last quarter of the nineteenth century. This demand was fueled by advances in medical knowledge, the rapid expansion of institutional health care, the opportunities for free health care that the institution gave to the poor, and overall satisfaction with deaconess job performance among employing institutions. The implications of these arguments are twofold. First, the role deaconesses played in the professionalization of nursing means that func-

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tional differentiation cannot be understood simply as a separation of the religious from the secular in the provision of essential social functions in modern history. Religious organizations and professionals were sometimes crucial agents in the creation of specialized professions, a reality that many theories of functional differentiation overlook. Second, we encounter yet another instance in which functional differentiation created opportunities for religious professionals to exercise social significance in the public sphere.

A. Health Care in Medieval and Early Modern Europe Hospitals in the West can be found already in the Frankish period, though numerous establishments of hospitals first occurred in the twelfth century. Lords, princes, and bishops took the initiative for these foundations. Because hospitals were considered religious institutions, they typically fell under the jurisdiction of bishops, though by the fourteenth century municipal governments in regions such as Germany and Italy began to assume responsibility. The architectural design of many medieval hospitals reflected their ecclesiastical connections in that they resembled churches. Hospitals were typically managed by monastic communities and occasionally staffed by nursing orders. Nurses performed duties ranging from housekeeping (emptying chamber pots, preparing food, etc.) to administering medications.1 Hospitals in the Middle Ages performed three principal functions: caring for the sick, serving as hospices for travelers and pilgrims, and sheltering the poor.2 Only one of these three corresponds to what modern people think of as a hospital’s “appropriate” task, but even in caring for the sick, it must be remembered that the purpose of hospitals was custodial rather than curative. Efforts to cure inmates did take place, but this was not a hospital’s primary function.

1 Darrel W. Amundsen, Medicine, Society, and Faith in the Ancient and Medieval Worlds (Baltimore: The Johns Hopkins University Press, ), ; Daniel Le Blévec, “Hospital, Hospice,” in Encyclopedia of the Middle Ages I, eds. Andre Vauchez, Barrie Dobson, and Michael Lapidge, trans. Adrian Walford (Chicago: Fitzroy Dearborn Publishers, ), –; Mary Lindemann, Medicine and Society in Early Modern Europe (Cambridge, Eng.: Cambridge University Press, ), . 2 Robert Jütte, Poverty and Deviance in Early Modern Europe (Cambridge: Cambridge University Press, ), .

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By the end of the Middle Ages, there were more than , hospitals in Europe, many of them in urban areas or in the vicinity of towns.3 In Sweden, it is estimated that there were some forty hospitals just prior to the Reformation.4 Even so, most people in need of healing or medical attention never set foot in one. Childbirth, illness, and death typically took place in the home, and if someone outside the family was called upon for medical assistance, this practitioner usually treated the patient at home. Patients, perhaps more accurately conceived of as patrons, had a wide range of healers to choose from, including religious personnel, such as monks, nuns, and parish priests, but also surgeons, midwives, cunning-men and cunning-women, and, most importantly, wives and mothers. While the number of university-educated physicians grew significantly from the twelfth century onward, most people never consulted one.5 The Reformation in some Protestant lands led to a severe disruption of services to the poor and sick as a result of the confiscation of ecclesiastical property and the closing of many monasteries. The most notable example of this was in England, but even there, the disruption affected institutional health care provision in some regions more than others. In London, English monarchs had already reestablished the so-called “Five Royal Hospitals” by the s and s, with each hospital receiving a staff of physicians and surgeons. In the provinces, the restoration of hospitals went much more slowly, with little improvement until the voluntary hospital movement of the eighteenth century.6 The case of England should not be universalized. Many Protestant reformers went to great lengths to provide for those in need, even with the dissolution of monasteries and religious orders. They were motivated by the desire to create a Christian commonwealth in which the poor and sick were cared for by the Christian community to express neighborly love and not to gain merit in the quest for eternal life. Johannes Bugenhagen is perhaps the most prominent reformer in this regard. The church orders he helped to implement in Denmark and northern Germany contributed to the foundation of new hospitals, particularly plague hospitals.

3

Ibid., . This figure excludes monasteries that may have practically functioned as hospitals. See Barbro Holmdahl, Sjuksköterskans historia. Från siukwakterska till omvårdnadsdoktor (Stockholm: Liber, ), –. 5 Lindemann, Medicine and Society, , . 6 Ibid., –. 4

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Bugenhagen also worked to create a form of nursing service in some town hospitals. In the Braunschweig and Hamburg church orders, he inserted a paragraph requiring all women who were maintained in a hospital and/or who received support from the parish common chest to care for the sick.7 Sweden did not experience the same degree of disruption in health care provision as had taken place in England. Despite his confiscation of ecclesiastical properties, Gustav Vasa preserved many of the kingdom’s hospitals for the care of the poor and sick. He also worked to transform some existing monasteries and convents in the cities into hospitals. In Stockholm, he was helped in these efforts by Olaus Petri, Sweden’s leading Protestant reformer. Outside of Stockholm, the local parish assumed primary responsibility for caring for the sick and poor who had no family to aid them. The  Church Law recommended that each parish establish an infirmary capable of housing four to six patients. Many parishes followed suit by setting up infirmaries in buildings adjacent to the local churches. The churches were expected to fund these infirmaries through collections. Legislation in the following century continued to emphasize the obligation of local parishes to provide health care to those residents who could not be cared for at home. Preventing relief institutions and hospitals in more populated towns from being overburdened by the poor and the sick from other parishes provided much of the impetus for this legislation.8 In Catholic lands, the post-Tridentine religious revival led to a renewed charitable impulse that inspired many prelates and princes to establish numerous hospitals. The spirit of creating new hospitals in Catholic Europe was most evident in seventeenth-century France, particularly after Louis XIV’s  decree that all towns and cities were required to establish a hôpital général.9 Seventeenth-century France also experienced the revival of hospital nursing orders through the establishment of communities such as the Daughters of Charity.10

7 Ole Peter Grell and Andrew Cunningham, “The Reformation and Changes in Welfare Provision in Early Modern Northern Europe,” in Health Care and Poor Relief in Protestant Europe, –, eds. Ole Peter Grell and Andrew Cunningham (New York: Routledge, ), ; Ole Peter Grell, “The Protestant Imperative of Christian Care and Neighbourly Love,” Health Care and Poor Relief in Protestant Europe, . 8 Åke Andrén, Sveriges kyrkohistoria . Reformationstid (Stockholm: Verbum, ), –; E.I. Kouri, “Health Care and Poor Relief in Sweden and Finland, c.–,” in Health Care and Poor Relief in Protestant Europe, , –. 9 Jütte, Poverty and Deviance, –; Lindemann, Medicine and Society, –. 10 For an overview of the Daughters of Charity and other nursing communities in

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In the eighteenth century, Enlightenment-inspired reformers made efforts to found new hospitals and to transform existing ones into institutions that focused more particularly on treating curable illnesses. The establishment of hospitals arose from both public and private initiatives, and in some cases prominent ecclesiastical institutions and clergy played an instrumental role. Historians have traditionally argued that this reform movement bore fruit at the end of the century as clinical medicine began to be practiced in many hospitals through a combination of clinical observation, statistical assessments, and bedside teaching.11 Enlightenment-inspired reform initiatives also reached Sweden in the eighteenth century as several larger hospitals were established to serve the sick and the poor beyond the confines of the local parish. The most significant one was the Seraphim Hospital in Stockholm, established in , with similar hospitals in other urban areas arising throughout the late eighteenth century. These efforts were endorsed by the king and parliament and signaled the beginnings of a shift away from institutional health care provision as a matter primarily of the local parish, though the clergy were called upon to collect the money to fund these new hospitals and to implement state-initiated health care policies at the local level.12 Many of these eighteenth-century hospitals still lacked the kind of professionalized staff that would begin to characterize hospitals later in

seventeenth- and eighteenth-century France, see Colin Jones, The Charitable Imperative: Hospitals and Nursing in Ancien Regime and Revolutionary France (London: Routledge, ). 11 Mary Lindemann nuances this interpretation, arguing that the practice of clinical medicine gradually emerged throughout the eighteenth century and did not erupt onto the scene all of the sudden at the end of the century. See Lindemann, Medicine and Society, –. For an example of the view that clinical medicine largely did not exist prior to the end of the eighteenth century, see John Frangos, From Housing the Poor to Healing the Sick: The Changing Institution of Paris Hospitals under the Old Regime and Revolution (Cranbury, NJ: Associated University Presses, ). Frangos insists that in France, it was the Revolution that led to the medicalization of hospitals. 12 Wolfran Kock, “Sjukhusväsendets utveckling i Sverige,” in Svenska Sjukhus. En översikt av det svenska sjukhusväsendets utveckling till -talets mitt. Första delen, ed. Einar Edén (Stockholm: Åhlén & Åkerlunds Boktryckeri, ), –, . Dorothy Porter argues that an important impetus behind the state’s growing involvement in health care reform in the eighteenth century was the  national census. The census revealed just how low population levels in the country were, and the state responded by improving health care in order to stimulate population growth. Dorothy Porter, “Health Care and the Construction of Citizenship in Civil Societies in the Era of the Enlightenment and Industrialisation,” in Health Care and Poor Relief in th and th Century Northern Europe, eds. Ole Peter Grell, Andrew Cunningham, and Robert Jütte (Burlington, Vt.: Ashgate, ), –.

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the nineteenth century. For example, some eighteenth-century Swedish hospitals employed nurses, but their duties were not much different from those of the medieval nursing orders. Even into the early nineteenth century, patients with minor illnesses were expected to help care for patients suffering from more serious illnesses. As Barbara Holmdahl notes, the boundary between patients and care personnel such as nurses was blurry in Swedish hospitals before the late nineteenth century.13 The growing number of hospitals in eighteenth-century Europe did not significantly shift the locus of health care from the home to the hospital. Women of the household continued to provide primary care in times of illness or childbirth. Beyond the household, the range of potential providers was as extensive as in the Middle Ages and continued to include religious personnel such as clergy (and in Protestant regions, clergy spouses). Apothecaries, midwives, surgeons, and physicians also competed for the opportunity to treat prospective patients. Midwives were the health care providers who most commonly entered homes. While the number of physicians had grown significantly by the mid-eighteenth century, most people still did not hire one because they were either too expensive or too few of them existed in a given region. Throughout the early modern period, physicians typically were not deemed more qualified to treat illnesses than other practitioners. Physicians were viewed in the popular mind as particularly, if not uniquely, qualified to provide health care only from the mid-nineteenth century onward.14 The growth of a different kind of nursing corps, one trained especially to help physicians in treating illnesses, accompanied this change in the perception of physicians. It is to these developments that we now turn.

B. Origins of the Modern Nursing Profession in Nineteenth-Century Sweden Most historians agree that the large-scale transformation of institutional health care from caring primarily for the sick poor to a medicalized system focused on curing illnesses occurred during the nineteenth century. By the end of the century, physicians had become many people’s first choice of health care providers, clinical teaching and bedside instruction had become integral to the education of physicians, and a specialized 13 14

Holmdahl, Sjuksköterskans historia, –. Lindemann, Medicine and Society, , –.

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nursing profession had arisen to work closely with physicians in treating patients. Hospitals cared not only for the very poor but people of all classes, even if the tradition of home care for the wealthy persisted. Significant advances were made in understanding how diseases were caused and spread, while the use of anesthetics and antiseptics by the end of the century led to successes in treating patients that were unimaginable a century before.15 Health care provision became more centralized in nineteenth-century Sweden. Public health commissions already existed in the eighteenth century, but with the cholera epidemics of the early nineteenth century, these commissions assumed greater authority. In , a public health board was created for Stockholm that differed from its immediate predecessors in that its concerns for public health went beyond the fight against cholera.16 Throughout the late nineteenth century, the Swedish state expanded its role in the establishment of public hospitals and in the creation of public health officers for the entire nation.17 The provision of institutional health care, in conjunction with poor relief, had largely been a matter for the local parish for much of the early modern period. From the mid-nineteenth century, it became primarily a state affair. But functional differentiation in the sphere of health care is not simply the story of the separation of the religious from the secular. The development of the modern nursing profession in Sweden is a story that cannot be told apart from the role played by a new group of religious organizations and professionals. In the late nineteenth century, the three most prominent training colleges for nurses were all institutions with religious orientations: the Swedish Deaconess Institution, the Red Cross School of Nursing, and the Sophia Home. They arose in response to the growing demand for educated nurses, a demand fed by two important developments. First, new advancements in medical knowledge created a greater need for qualified personnel to assist physicians, particularly in the area of hygienic work.18 Second, a rapid expansion in health care 15 Bengt Pernow, Sophiahemmet i sin tid. Utbildning och sjukvård under elva decennier (Stockholm: Natur och Kultur, ), –. 16 Torgny Höjer, Sockenstämmor i Stockholm fram till  (Stockholm: Almqvist & Wiksell, ), –. 17 Porter, “Health Care in the Era of the Enlightenment and Industrialisation,” Health Care and Poor Relief in th and th Century Northern Europe, . 18 Agneta Emanuelsson, Pionjärer i vitt. Professionella och fackliga strategier bland svenska sjuksköterskor och sjukvårdsbiträden, – (Stockholm: Svenska hälso- och sjukvårdens tjänstemannaförbund, ), –.

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institutions accompanied the tremendous advances in medical treatment. This is reflected in the increase in the number of hospital beds in the country from , in  to , by .19 The demand for health care professionals from private residences accompanied this institutional growth. The Swedish Deaconess Institution was the first to provide specialized training for nurses. The original vision of the Swedish Deaconess Society in  was “to create on pure Christian grounds a deaconess institution whose first and actual purpose will be to train Christian-minded women as nurses who have the predisposition and will to devote themselves to this calling in such a way that, not only the health of the body but also that of the soul can be aided with God’s blessings.”20 Influenced by the neo-evangelical revivals and the German program of Inner Mission, the society felt that existing health care lacked compassion for and neglected the spiritual needs of the sick and suffering. The society aimed to educate nurses to treat the physical needs of the sick more humanely and to tend to their spiritual needs through evangelization.21 Throughout the late nineteenth century, the leadership of the Swedish Deaconess Institution consistently maintained that deaconesses were particularly qualified for addressing the physical and spiritual needs of the sick because of their gender and faith. Caring for the sick and suffering, the leadership argued, was a task particularly suited for a woman’s temperament, for she possessed a natural disposition toward demonstrating compassion and tenderness.22 In her capacity as a nurse, a deaconess was doing nothing more than extending the caretaking responsibilities traditionally associated with women in the domestic sphere into a setting beyond the household. The leadership also maintained that in helping to alleviate physical suffering, a deaconess was in a position to bring God’s Word closer to patients, since those who suffer are more open to receiving the Gospel than might otherwise be the case.23 As women of

19

Holmdahl, Sjuksköterskans historia, . SBDAS minutes,  April , § , AA (vol. ), EDA. 21 Gunnel Elmund, Den kvinnliga diakonin i Sverige –. Uppgift och utformning (Lund: CWK Gleerups, ), –. 22 “Diakoniss-saken såsom en Christi-församlings sak,” Olivebladet  (), ; “Huru skall kyrkan bäst tillgodose de andliga behofwen hos de lekamliga nödstälda?,” Olivebladet  (), . 23 “Diakoniss-saken såsom en Christi-församlings sak,” Olivebladet  (), ; “Diakonisswerksamhetens stora uppgift att låta lefwande watten flytta ut i öknen,” Olibebladet  (), . 20

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faith, deaconesses were thus ideal candidates for realizing the society’s initial vision of bringing health to the bodies and souls of the sick and suffering. To prepare for this mission, all students at the institution took courses in basic elementary school subjects, received theoretical and practical instruction in health care, and attended weekly Bible studies and catechetical lessons. Once they completed their education and became full deaconesses, the leadership assigned the sisters to work stations in accordance with their gifts and in light of the requests received from prospective employers. A sister might never be assigned to a health care station even though she had the training of a nurse. This is because the institution was in the business of educating women for the deaconess vocation, a vocation that could be carried out in various capacities (nursing, teaching, childcare, etc). Since a sister could receive different occupational assignments throughout her career, the institution needed to prepare her to be adaptable so that she could be placed where the need was greatest. In this way, the deaconess institution differed from the Red Cross School of Nursing and the Sophia Home in that these two schools focused only on training nurses. While a basic overview of deaconess education was provided in chapter two, a closer look at the institution’s nursing education illuminates its importance in the overall training program. A deaconess’s education in health care took place during her time as a probationary sister. The probationary stage lasted anywhere from one to three years and was divided into two phases. The first phase entailed both theoretical and practical education. The theoretical component consisted of general education courses, such as Swedish, arithmetic, and geography, with only a little attention given to coursework in health care. Most of the nursing education came through the practical component. The institution employed a doctor to oversee this training. Probationary sisters accompanied the doctor on his rounds at the institution’s hospital and took notes as he instructed them on how to treat patients with various illnesses. Once per week, the doctor lectured the sisters on a specific health care topic. Probationary sisters participated in the daily nursing work of the hospital, and they learned how to compound some of the medicines that the doctor prescribed to patients. By the end of the century, the practical training alone usually lasted ten to eleven months.24 24 SDSFU Årsberättelse , Olivebladet  (), ; Yngve Iverson, Tro verksam i kärlek. En bok om Ersta (Stockholm: Verbum, ), –.

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Upon completing the theoretical and practical education, a sister entered the second phase of the probationary stage. During this period, she was assigned to a work station at or outside of the institution. If this were a health care station, she had the opportunity to deepen her knowledge and experience of nursing. After satisfactorily completing this second phase, she was eligible to become a full deaconess.25 Nursing education was clearly integral to the overall training program. The practical component of the first phase of the probationary stage consisted solely of nursing education. Theoretical instruction was less important, though deaconesses received more in this area than was the case with many hospital-based nursing programs that arose at the end of the century. Because of the central place of nursing education at the institution, Yngve Iverson rightly notes that for the first hundred years of its existence, all deaconesses were trained nurses, even if they did not always practice nursing as a full-time “occupation” in their respective work stations.26 Even when deaconesses were not assigned to hospitals, they still might be called upon to practice nursing in their work. As we will see in the next chapter, many of the sisters assigned to poorhouses or as parish deaconesses put their nursing skills to use on a regular basis. The first institution to focus solely on the training of nurses was the Red Cross School of Nursing, established in . It received its inspiration from the model of nursing education developed by Florence Nightingale in England. The school’s first director, Emmy Rappe, had traveled to St. Thomas Hospital in London one year earlier to receive her basic nursing education. Upon returning to Sweden, she opened the Red Cross School at the Uppsala Akademiska Hospital. The school moved to the Sahlgrensk Hospital in Gothenburg in  and then to the Sabbatsberg Hospital in Stockholm in . One decade later, an institutional home for Red Cross nurses opened and adopted some of the motherhouse characteristics found at the deaconess institution. During its first years, the Red Cross nursing program lasted six months and contained no theoretical instruction. The emphasis was on surgical care. After the move to Stockholm, the program included theoretical instruction in order to keep up with the rapid expansion in medical knowledge. During the s, the length of the program expanded to one year, growing to eighteen months by the turn of the century.27 25 26 27

Iverson, En bok om Ersta, –. Ibid., . Åsa Andersson, Ett högt och ädelt kall. Kalltankens betydelse för sjuksköterskeyr-

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Åsa Andersson describes the Red Cross institution as Sweden’s first secular nursing school, since its purpose was not to carry out a Christian mission to the sick and suffering but to build up a well-functioning system of nursing care detached from a particular confessional structure.28 While this is true, the importance of religious motivations for establishing the school and inspiring women to attend must not be overlooked. As Andersson herself notes, Rappe was a person of deep religious faith who saw God as the source of strength in her work and who also admired the Christian motivation behind the female diaconate’s work. The women who entered the school also possessed a strong sense of Christian calling.29 For this reason, the term “secular” can be misleading. It is more accurate to describe the school as Sweden’s first non-sectarian nursing institution. Queen Sophia was the instrumental force behind the establishment of the Sophia Home in Stockholm in . This nursing school, like the deaconess institution, utilized the motherhouse system. Sisters in its service remained celibate, received their salary from the home, and wore a common uniform. The leadership also assigned the sisters to work stations. This system remained in effect until .30 In the beginning, Sophia nursing students received their theoretical and practical training at the Sabbatsberg Hospital in Stockholm. The home established a hospital of its own in Stockholm in  so that its students could receive training there. The length of education at first was ten months, but by , it had been extended to eighteen months. At the turn of the century, the program was expanded to three years, making it the longest in the country.31 In accordance with the queen’s wishes, the school was to be guided by the motto “Everything for God’s Honor.”32 The admission requirements reflected this sense of Christian mission in the training of nurses. Applicants were required to adhere to a Protestant confession and to possess a kets formering – (Umeå: Umeå institution för historiska studier, ), ; Emanuelsson, Pionjärer i vitt, –; Holmdahl, Sjuksköterskans historia, . 28 Andersson, Ett högt och ädelt kall, . 29 Ibid., . 30 Andersson, Ett högt och ädelt kall, ; Holmdahl, Sjuksköterskans historia, –; Pernow, Sophiahemmet i sin tid, . 31 Emanuelsson, Pionjärer i vitt, . This statement must be qualified since it took students at least the same amount of time to become full deaconesses. The difference is that deaconesses received other types of instruction and practical training besides nursing. 32 Ibid., .

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strong sense of calling based on a true fear of God.33 Similar to the deaconess institution, the leadership of the Sophia Home emphasized that personal faith in Christ was essential in fulfilling one’s calling as a nurse. Even though the Sophia Home shared the religious motivations of the other two schools, it differed from them in two important ways. First, most of its nurses were recruited from higher social classes, and this undoubtedly paved the way for making the nursing profession a more respectable career choice for unmarried women by the turn of the century. Second, it placed far more emphasis on theoretical education than either of the other two institutions, and this, along with the length of the program by , made it the most rigorous nursing school in the country. Nursing education expanded rapidly at the end of the nineteenth century, and by , there were twenty schools that trained nurses. Twothirds of these were located at provincial hospitals. Hospital physicians often created these programs for the purpose of educating nurses for the needs of that particular hospital. These programs had much lower admission standards and far less theoretical instruction than the three schools discussed above. Hospital training programs were also significantly shorter, with most lasting six months to one year.34 Because these provincial programs were less rigorous and were of significantly shorter duration, they attracted more students. By the early twentieth century, the vast majority of nurses were products of these programs. Even so, the influence of the Swedish Deaconess Institution, the Red Cross School of Nursing, and the Sophia Home on the development of the modern nursing profession far exceeded the number of nurses they were producing. Graduates from these three schools frequently occupied positions of leadership in hospitals, supervising other nurses and nurses’ aides and overseeing the hygienic routines.35 In a few of the larger hospitals with training programs, they even led some of the theoretical training that nursing students received.36 These institutions also set the standards for nursing education in the first quarter of the twentieth century, particularly in terms of the more rigorous education they promoted and the necessity of theoretical instruction as part of this education. Finally, the understanding that nursing was a divine calling, central to the ethos of 33 34 35 36

Ibid., . Andersson, Ett högt och ädelt kall, ; Emanuelsson, Pionjärer i vitt, , . Andersson, Ett högt och ädelt kall, ; Emanuelsson, Pionjärer i vitt, –. Emanuelsson, Pionjärer i vitt, .

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the Swedish Deaconess Institution and the Sophia Home but also present at the Red Cross School, permeated the nursing corps as a whole as it developed at the end of the nineteenth century. As Åsa Andersson points out, this element of calling was not seriously questioned until the s.37

C. The Deaconess Hospital While the deaconess institution housed several divisions ranging from a household school to an elderly home, its primary division was the hospital. When the institution first opened in July , it rented a twostory house that served as both the deaconess house and the hospital. The facility contained beds for twelve patients.38 The hospital staff consisted of the sisters in training and one doctor. The doctor performed daily rounds and gave practical instruction in how to care for the patients.39 In the first several years, only women and children were admitted.40 The annual reports do not give reasons for this, though one possible explanation is that the leadership was concerned about the sisters coming into “intimate” contact with men who were not members of their own family. Such interaction was deemed highly inappropriate for women in the mid-nineteenth century, and the leadership may have wanted deaconesses to avoid any sort of behavior that might taint them as “public” women who were not connected to a respectable household. The lack of space at the first hospital also would have made it impossible to create a separate section for the care of male patients even had the leadership wanted to do so. When the hospital changed locations in the mid-s, it had space for thirty patients and began to admit men. In , the hospital moved to the Ersta location in the Södermalm region. The Ersta Hospital could accommodate approximately forty patients, and this capacity remained the same until after the turn of the century. By the end of the century, the hospital had one larger and three smaller wards for women and one ward for men. Children were accommodated as much as possible in these

37

Andersson, Ett högt och ädelt kall, . SDSFU Berättelse och redovisning –, . 39 Iverson, En bok om Ersta, . 40 SDSFU Berättelse och redovisning –, ; SDSFU Berättelse och redovisning –, . 38

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existing wards. There were also five private rooms for patients along with a separate private room for deaconesses requiring hospitalization.41 The hospital was staffed by deaconesses and deaconesses in training. They carried out the nursing duties and basic cleaning tasks for the hospital.42 There were also two doctors—a head physician and an assistant. The latter was added to the staff in .43 What appeared to be an adequate-sized hospital in  proved too small by the end of the century. This lack of space caused many problems for the functioning of the hospital. The hospital did not have sufficient space for carrying out operations. In fact, the hospital did not receive its first operating room until ; until then, operations were performed in the bedrooms of the deaconesses.44 The hospital also was not large enough to allow for adequate nursing training for all of the probationary sisters who needed it. Arrangements were made in  for some probationary sisters to do part of their training at the Maria Hospital in order to address this problem, though this solution proved to be temporary.45 Furthermore, the hospital did not have a separate ward for children. Only one or two children at a time could be cared for in the existing wards for women and men. Finally, the hospital could not accommodate all of the people who sought admission. Additional beds were sometimes set up in an attempt to meet this demand, but the number of people needing care was so great that many still had to be turned away.46 On its fiftieth anniversary celebration, the institution received a gift from the royal couple, Oscar II and Sophia, of , crowns.47 The 41

“Vårt sjukhus,” Olivebladet  (), . It is difficult to determine the exact number of sisters who carried out nursing duties at the hospital at any one time. In , the Olivebladet stated that there were seventynine sisters (deaconesses, probationary sisters, and inquirers) who lived and worked at the deaconess institution. Of these, twenty-one deaconesses and probationary sisters were assigned to work in the hospital, nursing home, orphanage, household school, or rescue shelter. A more detailed breakdown is not provided. Moreover, this number does not include inquirers, nor does it include deaconesses and probationary sisters who were assigned to household tasks at the hospital. See “Det nya diakonisshusets inwigning,” Olivebladet  (), . 43 “Meddelanden från Diakonissanstalten,” Olivebladet  (), . 44 SDSFU Årsberättelse , Olivebladet  (), . 45 The partnership with Maria Hospital was discontinued in October  due to problems with living accommodations for sisters and with reduced instruction time at the Ersta Hospital. SDSFU Årsberättelse , Olivebladet  (), . 46 “Vårt sjukshus,” Olivebladet  (), . 47 “Diakonissanstaltens femtioårsjubileum,” Olivebladet  (), . 42

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money was to be used to improve the hospital facilities, but the leadership decided to build a larger, more modern hospital. Fundraising continued for the next few years, and in , the new Ersta Hospital opened with room for ninety patients. The municipal government of Stockholm gave the institution , crowns toward construction costs in exchange for having forty-five beds at the hospital set aside for the city’s use. These beds were to be reserved for poor patients referred to the hospital by municipal poor relief authorities.48 Even with this gift, the hospital continued to be run as a private health care facility, but this arrangement did signal the beginning of a partnership with the municipal government that would last throughout the twentieth century. Reserving beds for the poor after the turn of the century did not signal a new direction for the hospital in terms of its clientele. Hospitals were gaining prestige in the late nineteenth century, but wealthier people still preferred to be treated at home. Most of the deaconess hospital’s patients in this period were people of little means. For example, of the  people treated in , the four largest groups of patients, excluding the institution’s personnel, were servants (), wives and children from the working class (), unmarried women (), and artisan journeymen and industrial workers ().49 These statistics also reflect the fact that far more women than men were treated. It was common for two-thirds to three-fourths of patients in a given year to be women.50 The hospital was funded through private donations and the nominal fees paid by patients rather than government subsidies, so the cost of treating so many of the poor was a perennial problem. The institution implemented two partial solutions to address this issue. First, it established “free beds” (frisängar) beginning in . These were funded by private donors to provide free care for those who otherwise could not afford treatment. Some of the beds were open to anyone without the means to pay, while others were established to provide free care for certain categories of people, such as children or people hailing from a

48

Iverson, En bok om Ersta, –. SDSFU Årsberättelse –, Olivebladet  (), . 50 Most of the patients also hailed from Stockholm, but there was a contingency from the provinces. Statistics on the city, province, or country of origin were not published in the annual reports beyond the first two decades, but from the – annual report we get a sense of the geographical background of the patients. Of the  patients treated in that year,  came from the provinces. SDSFU Berättelse och redovisning –, . 49

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particular parish. By , there were fourteen free beds.51 Second, in , the institution established so-called “free funds” (frikassa) through private donations. These covered the expenses of the poor who could not be cared for in one of the free beds either because they did not qualify or because the beds were already occupied. The free beds and free funds enabled approximately one-third of all patients throughout the late nineteenth century to receive treatment without paying.52 The hospital treated patients with a wide variety of ailments. Among the  patients admitted from May  to April , the most common afflictions were typhoid fever, consumption, anemia, pneumonia, rheumatism, gastritis, and typhus. Seventeen operations, mostly eye surgeries, were also performed.53 By , the range of diseases treated at the hospital increased significantly, though some of the most common afflictions had not changed drastically. Of the  patients cared for that year, the most numerous illnesses treated included anemia, pneumonia, gastritis, tuberculosis, bronchitis, cataracts, and neurasthenia. The number of operations also increased considerably by , due largely to the creation of a separate operating room in . A total of  patients received operations that year, with the most common operations including cataract surgery, strabismus surgery, amputations, and the removal of various tumors.54 Treating physical illnesses and carrying out operations were only part of the hospital’s mission. The annual reports repeatedly emphasized the importance of caring for the body and the soul. In the first decade, annual reports even included accounts of patient conversions such as the following from the mid-s: A man, suffering from lung disease, stayed a few weeks in our hospital. In the beginning, he was deaf to God’s Word; pleased with what reason taught him concerning God, he did not want to know more. He appeared to shelter himself from everything that he heard during moments of prayer, and [he] gave the visiting chaplain monosyllabic and unfriendly answers to questions. Toward the end of his stay in our hospital, he became milder and more communicative, [he] began to read God’s Word, and when he came home to his wife, she found him much changed. He later became 51 SDSFU Berättelse och redovisning –, ; Ernst Lönegren, Minneskrift till Svenska Diakonissanstaltens femtioårsjublieum (Stockholm, ), –. 52 Iverson, En bok om Ersta, . 53 SDSFU Årsberättelse –, Olivebladet  (), –. 54 SDSFU Årsberättelse , Olivebladet  (), –. Just six years earlier, only forty operations had been conducted. SDSFU Årsberättelse , Olivebladet  (), .

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chapter four seriously ill and wished to talk to a chaplain, for whom he gave a beautiful confession in which he expressed regret for his sins and articulated his faith in the forgiveness of sins through Jesus, soon thereafter dying in this faith.55

The annual reports from J.C. Bring’s time as director typically did not include such conversion narratives, yet he consistently stressed that the sick and suffering were much more open to the Word of God, and he lifted up the important role that deaconesses played in bringing them the Word. The sort of conversion experienced by the individual in the above narrative was thus sought after throughout Bring’s tenure as well. The hospital’s spiritual mission meant that deaconesses were not only responsible for administering medications and assisting in operations but also for providing spiritual counseling to patients. In the first decade, deaconesses read passages from the Bible and other devotional books to patients in the afternoons. This responsibility appears to have been absorbed by Bring and the various assistant chaplains from the mids onward, but throughout the remainder of the century, deaconesses continued to evangelize and pray with patients.56 What most patients thought of this evangelization is largely unknown, but it is clear that the hospital’s health services were very much in demand. Even though the forty-bed capacity of the hospital remained unchanged from  until the end of the century, a steady rise in the number of patients treated annually did take place. From May  to April ,  patients were treated.57 This number increased to  a decade later, and by , it had risen to .58 The number of people seeking treatment became so great that by the s and s, the hospital was turning away patients almost daily. Refusing treatment was clearly a last resort, and the hospital went to some extreme measures to treat as many as possible, including setting up extra beds and discharging patients before they were fully recovered.59 What accounts for this steady increase in the number of patients and the growing demand for the services of the hospital? In the last quarter of

55

SDSFU Berättelse och redovisning –, . Iverson, En bok om Ersta, –. 57 SDSFU Berättelse och redovisning –, . 58 SDSFU Årsberättelse –, Olivebladet  (), ; SDSFU Årsberättelse , Olivebladet  (), . 59 Concerning the hospital’s struggle over whether to discharge patients before full recovery, see SDSFU Årsberättelse , Olivebladet  (), . 56

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the century, significant advances had been made in medical knowledge, leading to more efficient and effective methods of treating common illnesses. As a result, patients were treated and discharged more quickly, leading to greater turnover in hospital beds. Medical advances also contributed to an increase in the prestige of many health care institutions, meaning that more people sought treatment at them. Another explanation relates particularly to the deaconess hospital and its mission to the poor. The diaconate focused on reaching out to the poor through health care and poor relief in the last quarter of the century. Through recourse to free beds and free funds, the deaconess hospital found its niche in providing health care to a segment of the population that had difficulty affording it. In the last two decades of the century, between  and  patients on average were cared for annually through free beds and free funds. The deaconess hospital was not the only Stockholm hospital to provide free treatment for those with little means, but it played a significant role in such health care provision in a time of growing need and in an area of the city with a high percentage of poor and working-class people.

D. The Nursing Home and the Polyclinic The hospital was the focal point of nursing education and health care provision at the institution, but in the course of the late nineteenth century two other important divisions developed to meet the growing demand for health care. One was a nursing home that provided longterm medical care for the chronically ill. The other was a polyclinic, an outpatient facility that performed minor and emergency operations and treated less serious ailments. Nineteenth-century hospitals were at a loss as to how to provide care for chronically ill patients. As early as , the deaconess institution was developing plans to devote a section of the hospital to care for patients with incurable diseases. In , one of the hospital rooms was dedicated to this purpose, and three patients were admitted. When these patients died several years later, the hospital discontinued its efforts to treat the chronically ill, at least for the time being. The hospital had experienced enough of an increase in demand for this sort of care by the early s that some of its supporters donated money to establish a nursing home. The nursing home was dedicated at the end of . It was connected to the hospital and had room for

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twenty patients. The home had one ward for six patients, four rooms for two patients each, and six private rooms that held one patient each.60 Chronically ill adult patients from anywhere in Sweden, with or without the means to pay, were eligible for admission.61 The number of patients cared for in a given year typically ranged from twenty-five to thirty-five, and most of them were women. Like the hospital, the nursing home had free beds and free funds to cover the expenses of those who could not afford to pay for their care, and on average, anywhere from onefourth to one-half of all patients paid no fees. While the nursing home filled an important social function by providing long-term health care, its capacity was small, and the waiting list was so long that many seeking admission had to wait several years. A much larger operation was established in —the polyclinic. Its purpose was twofold: to give sisters additional practical training in treating patients, usually under the supervision of the hospital’s assistant doctor; and to provide more accessible health care for the poor and working class people in the city.62 The polyclinic was aimed particularly at treating the poor, so the vast majority of its patients paid nothing. Many of the polyclinic’s visitors were in need of immediate treatment, oftentimes due to accidents, meaning that the clinic performed many operations. Major operations included extracting foreign objects from the cornea, amputating fingers, removing lymphatic glands, and treating ingrown toenails. More minor operations treated abscesses, carbuncles, and boils. In some cases, patients were referred directly to the hospital to receive inpatient care. Due to the large numbers of visitors, the polyclinic expanded its facilities two years after opening. By , it had taken over the bottom floor of the hospital and consisted of a waiting room, an operating room, a small apothecary, and a private room for doctors.63 In , , patients were treated, with that number rising to , by .64 These numbers demonstrate a significant demand, particularly among the poor and working class in the city’s Södermalm region, for the outpatient and emergency care provided by the polyclinic. 60 SDSFU Årsberättelse , Olivebladet  (), ; “Inwigningen af Diakonissanstaltens sjukhem,” Olivebladet  (), . 61 “Regler för sjukhemmet,” Olivebladet  (), . 62 “Meddelanden från Diakonissanstalten,” Olivebladet  (), . 63 SDSFU Årsberättelse , Olivebladet  (), . 64 SDSFU Årsberättelse , Olivebladet  (), ; SDSFU Årsberättelse , Olivebladet  (), .

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E. Private Home Care and Provincial Hospitals The shift in focus from education to health care in the diaconate’s external work stations took place in the late s. Even so, deaconesses made important contributions to health care outside the institution’s hospital before this shift. This can be seen through their work during the cholera epidemics of the s and the Danish-German War of , and in private home care. Several cholera epidemics broke out during the s in Stockholm. In the first part of the decade, a few of the sisters went into the city to provide care for victims of cholera, since the deaconess hospital at the time was too small to admit cholera patients. Deaconesses provided health care to victims of cholera and smallpox in , even though some of the sisters became infected as a result. Some of the smallpox patients in this outbreak were admitted to the hospital. During an outbreak of cholera in , sixteen deaconesses provided nursing care for victims in the city. The annual reports were quick to note that no deaconess died as a result of their work among cholera and smallpox patients.65 Deaconesses also gained recognition as nurses during the DanishGerman War of . Denmark requested Swedish assistance in caring for sick and injured prisoners during the war, and eight deaconesses from Stockholm served at a field hospital on the Danish island of Als. The king and queen of Denmark received some of these deaconesses on their way to Als and expressed gratitude for their willingness to help. In their service at Als, the deaconesses assisted with amputations and other operations as well as the day-to-day care of patients in the hospital. Their contributions gained the admiration of the Swedish Society of Medicine (Svenska Läkaresällskapet). At its meeting in , it pointed to the work of deaconesses during the war as evidence against the argument that field health care was unsuitable for women.66 Most of the health care efforts outside the institution in the s and s took place in private homes in the Stockholm area. The tradition of health care in the home was still strong in the mid-nineteenth century, and even at the end of the century, this custom persevered among

65 SDSFU Berättelse och redovisning –, –; SDSFU Berättelse och redovisning, –, ; Elmund, Den kvinnliga diakonin, ; Iverson, En bok om Ersta, . 66 SDSFU Berättelse och redovisning –, ; Anderson, Ett högt och ädelt kall, ; Iverson, En bok om Ersta, .

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the well-to-do in Swedish society. In –, deaconesses provided private health care in thirty-two homes.67 By –, this number reached seventy-two.68 As external health care stations grew from the s onward, instances of private care decreased, rarely exceeding twenty-five in a given year.69 In some years, the number was as low as nine or ten. The leadership repeatedly lamented its inability to meet requests for private home care due to the lack of available sisters and the growing demand for deaconesses from other institutions. By the s, the leadership began to provide an additional justification for moving away from private home care by arguing that its primary mission in health care provision was to assist the poor. Even with the decline in private health care provided by deaconesses in the last quarter of the century, demand in this area remained high. This strong demand, in fact, is characteristic of the entire period under investigation here. The diaconate’s participation in health care both through its hospital and outside of it indicates that the deaconess institution was not neglecting health care in its formative period. And yet it took almost a decade before the institution assigned its first deaconesses to a provincial hospital. One of the reasons for this is clear from the previous chapter. Marie Cederschiöld’s strong interests in education, combined with the huge demand for teachers created by the  elementary school statute, led the diaconate to concentrate its efforts outside the institution on teaching in the first decade and a half. But given its other efforts in health care provision in this period, additional factors must be sought to explain the institution’s delay in establishing external health care stations. One likely factor is that physicians were initially skeptical of the idea of having educated nurses assist them. Doctors were certainly accustomed to having women working in hospitals as servants, but they were not used to working with other educated health care professionals who could 67

SDSFU Berättelse och redovisning –, –. SDSFU Berättelse och redovisning –, . 69 As the diaconate’s involvement in private home care decreased, that of the St Elizabeth Sisters increased. Bring saw Catholic female religious orders not only as competition in private health care provision but also as a threat to the true Lutheran faith. Ironically, Bring decried Catholic involvement in private home care even as he redeployed the institution’s resources away from this area. Gunnel Elmund, Det kvinnliga diakonatet som kall. Johan Christoffer Brings syn på diakonissverksamhetens uppgift och form (Skellefteå: Artos & Norma, ), –. For a summary of the work carried out by the St Elizabeth Sisters in the late nineteenth century and the Lutheran opposition to it, see Yvonne Maria Werner, Världsvid men främmande. Den katolska kyrkan i Sverige – (Uppsala: Katolska Bokförlaget, ), –. 68

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carry out some of the tasks they were accustomed to performing, such as administering medications to patients.70 It took almost two decades after the diaconate was established before this idea began to take root among physicians. Another factor is that hospitals in the s were still considered inappropriate places for women from the middle and upper classes. Åsa Andersson points out that Swedish society had yet to become accustomed to respectable women working as nurses and coming into close physical contact with men who were not family members. For this reason, hospital work could potentially be branded as “risky” or even immoral behavior, and as such, the institution was initially hesitant to send deaconesses to hospitals. When these assignments were finally made beginning in the late s, sisters were sent in pairs. Schools and orphanages, on the other hand, were considered safe, meaning that sisters could be sent to them individually.71 Assigning two or more deaconesses to hospitals remained the norm throughout the nineteenth century, even if there were exceptions already in the s, particularly at smaller hospitals. Andersson’s observations on why sisters were sent out in pairs are helpful, but I would add that this practice was also meant to protect deaconesses from unwanted sexual advances by reinforcing their connection to a spiritual household. This household became actualized in hospitals as deaconesses lived out their “sisterly” relationship through their daily interactions with one another. Patients and personnel would therefore be less likely to view them as having no household ties and would treat them with the deference afforded to any woman coming from a respectable family. All of these factors may have impeded the diaconate’s adoption of external health care stations in the beginning, but by the mid-s, the leadership focused more of its efforts on placing sisters in provincial hospitals. The institution adopted its first external health care station, Åmmeberg Hospital, in . The hospital, owned by La Vielle Montagne, a Belgian mining company, was to provide medical care for the company’s workers and their families. According to the contract, the two sisters assigned to this hospital were to care for the sick in accordance with the doctor’s instructions. They were also expected to prepare 70

Andersson, Ett högt och ädelt kall, . Ibid., –. Gunnel Elmund notes that when the institution accepted the Åmmeberg Hospital as its first external health care station in , it sent two deaconesses, even though the hospital requested only one. Elmund, Den kvinnliga diakonin, . 71

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food and do laundry for the patients.72 By the late s, a second hospital opened in the vicinity of this one, and a total of four sisters were assigned to the two hospitals. The responsibilities of the sisters expanded to include providing health care in the homes of workers.73 The number of health care stations adopted by the institution steadily increased from the mid-s onward. Ten sisters worked at six health care stations in , increasing a decade later to twenty-one and fourteen, respectively. Health care was the dominant work outside the institution for much of the s and into the early s. By , fifty-one sisters were assigned to twenty-two hospitals.74 The sizes and types of hospitals varied. In , six deaconesses were assigned to the Stockholm Public Care Institution (Stockholms Stads Allmänna Försörjningsinrättning), an institution focused on providing health care and indoor relief for the poor. Its sick ward held  patients, to which four of the deaconesses were assigned. The other two served in the convalescent ward. In fact, deaconesses served as nurses in many of the country’s largest hospitals at this time, including the Sabbatsberg Hospital in Stockholm (with nine deaconesses), the Örebro Hospital (with six), and the Norrköping Hospital (with five). Deaconesses were also assigned to smaller, more specialized hospitals. The Malmö Children’s Hospital, with room for twenty-five patients, was directed by a deaconess. The Gävle Nursing Home, with space for twenty female patients, had one deaconess serving as its housemother. Not much is known about how the deaconesses serving at these hospitals felt about their work, since letters by them to the institution have not been preserved. From the institution’s periodicals and from letters written by provincial hospital administrators, it appears that deaconesses at times felt overwhelmed by their nursing duties. For example, in , a doctor at Jönköping Hospital expressed his concern to the hospital board that the number of patients being treated was becoming so large that the two sisters were struggling with the workload.75 In the same year, Bring noted that the deaconess assigned to the Falköping Hospital, Karna Larsson, was responsible for the care of sixty to seventy patients per day, and that with the hospital’s recent expansion, she was feeling too

72 73 74 75

Contract between Åmmeberg Hospital and DAS,  June , Ä Ib  (no. ), EDA. “Några minnen från en resan,” Olivebladet  (), . See Table , p. . Jönköping Hospital to J.C. Bring,  October , Ä Ib  (no. ), EDA.

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overwhelmed to continue her work without at least some temporary help.76 A decade earlier, Bring observed that the perception of nursing as strenuous and demanding work inhibited deaconess recruitment. He sought to reassure potential recruits that deaconesses working as nurses were never assigned more patients than they could reasonably handle.77 Even with the heavy workloads and accompanying stress, the correspondence between provincial hospitals and the institution indicates a continuing demand for the nursing services of deaconesses among hospitals already under contract. When deaconesses had to be reassigned or were unable to carry out their duties due to illness, hospitals were quick to request an immediate replacement. In many cases, hospitals pleaded with the institution not to reassign a deaconess already in its service. There were also occasions when hospitals undergoing expansion were eager to add more deaconesses to their staffs. The deaconess publications reflect this high demand from potential employers. While annual reports typically did not publish statistics on the exact number of requests made for the services of deaconesses, an exception was made in the – report. Twelve requests from hospitals were received that year, though most of these could not be met due to a lack of sisters.78 Several years later, Bring noted that the institution received a request to take over a -bed hospital. It was estimated that fourteen deaconesses would be needed to staff this hospital, but since fourteen sisters were not available, it turned down the request.79 Beyond the occasional specifics, the annual reports frequently lamented that despite numerous requests for deaconesses from hospitals, it was forced to respond with the common refrain: “We have no one to send.” Two of the reasons for this demand have already been addressed in other sections of this chapter: advances in medical knowledge and treatment, and the rapid expansion of institutional health care. These factors contributed to a general increase in the demand for educated nurses, which in turn led to high demand for deaconesses at a time in which few institutions provided nursing education. A third reason is that doctors and hospital administrators were mostly pleased with how well deaconesses carried out their duties. For example, Falköping Hospital requested that the contract for Maria Clarin be renewed since 76 77 78 79

“Några minnen från en resan,” Olivebladet  (), . “Beriktigande,” Olivebladet  (), . SDSFU Årsberättelse –, Olivebladet  (), . “Meddelanden från Diakonissanstalten,” Olivebladet  (), .

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there was “overall satisfaction with how the sister has carried out her duties.”80 Upon receiving news of an increase in the fees for employing deaconesses, Jönköping Hospital responded that it was more than willing to pay the higher fees since it had been very pleased with the job performances of its sisters.81 The deaconesses’ reputation for competent nursing also spread to hospitals that employed no deaconesses but were eager to do so after hearing about them. When Söderköping Hospital learned that hospitals in Norrköping, Linköping, and Vadstena were pleased with the deaconesses in their employment, it requested that two sisters be sent (one for the position of head nurse) in order to assist in operations and provide care for about forty patients.82 The correspondence does reflect occasional displeasure with job performance. The most notable case involved Sophie Sjögren at Åmmeberg Hospital. The district doctor wrote to Bring in  requesting that Sjögren be dismissed, adding that the doctors and other personnel had been longing for her removal for some time. The district doctor described the problem as primarily a personality conflict between Sjögren and the staff. He described Sjögren as follows: S. is of a despotic, high-handed, and intolerant disposition . . . equipped with the most colossal insolence I have ever encountered in a woman— not to mention a deaconess. Politeness and common courtesy, and above all a mild disposition, are qualities that I demand and value more than anything in such a person, but with S., one finds just the opposite. Modesty is a feeling that probably has never been found in her . . ..

The doctor went on to add that she failed to show doctors due reverence and even took it upon herself at times to change a doctor’s prescriptions and instructions for patient treatment.83 In the Sjögren case, much of the problem appears to be discomfort over having a woman asserting authority and even independence in a public context. The doctors in question clearly would have been more comfortable with a nurse who conformed to the feminine ideal of modesty and submissiveness. Sjögren’s behavior was interpreted as an infringement upon male terrain and a threat to male authority. Even so, it appears that at least some if not much of the staff was also displeased with her job performance and was all too ready to be rid of her. 80 81 82 83

Falköping Hospital to J.C. Bring,  June , Ä Ib  (no. ), EDA. Jönköping Hospital to J.C. Bring,  March , Ä Ib  (no. ), EDA. Nyström (Söderköping Hospital) to J.C. Bring,  October , Ä Ib , EDA. Schröder (Åmmeberg Hospital) to J.C. Bring,  July , Ä Ib  (no. ), EDA.

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There is also evidence that doctors occasionally were not comfortable with the evangelization carried out by deaconesses. In , a doctor at the Norrköping Hospital wanted to prohibit a deaconess, Johanna Lundgren, from evangelizing to patients due to the angst one patient experienced concerning salvation after a conversation with her. Lundgren felt that she could not in good conscience follow the doctor’s prohibition since she perceived evangelization as fundamental to her calling. It is unclear how this matter was resolved.84 The extant correspondence between hospitals and the institution does not contain many such complaints. Most of the records indicate that hospitals were very appreciative of the contributions made by deaconesses in their service.

F. Conclusion The contributions made by deaconesses to health care and nursing in the late nineteenth century pose two significant challenges to the theory of functional differentiation. First, we encounter an example of a religious organization playing an integral role in the development of a modern “secular” profession. Deaconesses were the first nurses in modern Swedish history to receive both theoretical and practical training for their occupation. This model of education would inspire similar training programs in the late nineteenth century. In their roles as head nurses at many hospitals, deaconesses shaped future generations of nurses. Deaconesses were also largely responsible for injecting the notion of divine calling into the nursing profession, and this element would remain well into the twentieth century. The evolution of the modern nursing profession is a story that cannot be told apart from the important contributions made by the diaconate, and for this reason, theories of functional differentiation that uniformly portray the birth of modern specialized professions as a separation of the religious from the secular must be reconsidered. Second, the diaconate’s involvement in health care is another example of how functional differentiation created opportunities for deaconesses to wield influence in the public sphere. Two significant developments in the late nineteenth century—the advances in medical knowledge and the accompanying expansion of institutional health care—generated a 84 SDSFU minutes,  April , § , AA (vol. ), EDA; Elmund, Det kvinnliga diakonatet som kall, –.

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greater demand for educated, specialized nursing professionals, particularly in the last quarter of the century. Since few institutions trained nurses for much of the period, deaconesses were obvious candidates to serve as nurses, even if there were not enough of them to meet this growing demand. The diaconate contributed to the demand for its services because of the special attention it gave to health care for the poor and the proficiency with which the sisters carried out their nursing duties, a proficiency noted by many of their employers. This demand reinforces the argument that functional differentiation did not always have a secularizing effect in the nineteenth century.

chapter five POOR RELIEF

The female diaconate’s growing involvement in health care in the s was accompanied by increasing interest in poor relief. By the late s, poor relief assignments outside the institution exceeded all others, although, as it was demonstrated in the previous chapter, the boundary between poor relief and health care was fluid. This is understandable given the history of these social functions. In medieval and early modern Europe, health care and poor relief were two sides of the same coin. Hospitals cared predominantly for the poor, while the sick were the most likely candidates for poor relief, as they were more prone to falling into destitution in an era before welfare states and health insurance. Health care and poor relief continued to go hand-in-hand in the nineteenth century. Discussing the two separately in the context of the diaconate’s work is nevertheless possible because the deaconess institution’s leadership categorized these assignments under separate headings, and because the common denominator in all poor relief work was the intended recipients, the poor themselves. The first two sections will survey the history of poor relief in early modern and nineteenth-century Europe and Sweden, with particular attention given to the relationship between ecclesiastical and secular welfare. The remaining sections will analyze the diaconate’s contributions to and participation in poor relief in the last quarter of the nineteenth century. I will argue that demand for the diaconate’s poor relief services was not adversely affected by functional differentiation. Specialized municipal welfare boards assumed greater responsibility for poor relief in the mid-nineteenth century, but these institutions were unable and at times unwilling to meet the growing needs of those seeking assistance. The increasing demands placed on poor relief boards due to famines, combined with legislation that significantly limited the number of people qualifying for government relief, opened the door for many charitable and philanthropic organizations to partner with poor relief boards. The diaconate’s increasing involvement in poor relief paralleled these developments, and its services were very much in demand in the last quarter of the century. Municipal poor relief boards, philanthropies, and

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parish councils all recruited deaconesses to serve as nurses and relief workers in parishes. Municipal poor relief boards also employed deaconesses as nurses and relief workers in poorhouses and workhouses. The poor themselves sought out parish deaconesses in order to obtain nursing help for family members, to acquire household goods at discounted prices, and to make a case for receiving cash or in-kind relief. This demand demonstrates that deaconesses were beneficiaries and not victims of functional differentiation.

A. Poor Relief in Medieval and Early Modern Europe Ecclesiastical institutions were the primary providers of poor relief in medieval Europe. By the eleventh and twelfth centuries, the belief that giving alms to the poor conferred sanctity and salvation to the giver had taken root, and this contributed to the proliferation of charitable institutions and initiatives. Churches allocated anywhere from one-quarter to one-third of their revenues to poor relief. Monasteries were important providers of poor relief, collecting and distributing vast amounts of alms on behalf of donors.1 Guilds and confraternities, functioning as religious and charitable associations, provided for disabled, sick, or destitute members. Hospitals, under the management of monastic orders, functioned as the main indoor relief institutions by housing the poor and the sick.2 Increasing pauperism and the greater migration of beggars in the fourteenth and fifteenth centuries contributed to what some historians have called the “secularization” of charity. But Carter Lindberg warns against thinking of this process as the abandonment of the religious motives for poor relief. Civil authorities certainly assumed greater responsibility for the administration of charitable institutions and ecclesiastical resources for the poor, but this was not a reflection of rivalry between church and 1 In the history of welfare provision, a distinction is made between outdoor and indoor poor relief. The former involves providing money or in-kind assistance to the poor outside of an institution, whereas the latter pertains to assistance given within an institutional setting, such as a poorhouse or hospital. 2 Bronislaw Geremek, Poverty: A History, trans. Agnieszka Kolakowska (Oxford: Blackwell, ), , , –; Carter Lindberg, Beyond Charity: Reformation Initiatives for the Poor (Minneapolis: Fortress Press, ), –, –, ; Catharina Lis and Hugo Soly, Poverty and Capitalism in Pre-Industrial Europe (Sussex: The Harvester Press, ), .

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state but rather a sign of the latter’s growing awareness of the immense social and economic problems created by the increase in begging.3 Religious institutions and professionals continued to participate in poor relief in cooperation with government authorities. Growing numbers of beggars and itinerant poor led local governments to implement ordinances restricting begging. Greater efforts were made to discriminate between those who truly needed charity and those who had the capacity to earn a living by working. The idea that poverty could have spiritual value, represented in the monastic life, persisted even in the late Middle Ages, as did the giving of alms for salvific benefits, but the restrictive legislation on begging in urban areas reflected the growing belief that many beggars were lazy and disingenuous.4 A lively debate in recent decades has focused on the Reformation’s role in sixteenth-century poor relief reforms. The traditional view dating from the late nineteenth and early twentieth centuries held that the Reformation instigated many of the welfare reforms because of Protestant challenges to the belief that salvation could be achieved through “good works,” such as almsgiving. In Protestant regions, the rejection of the salvific benefits of helping the poor led to the laicization and “secularization” of poor relief, whereas Catholic regions continued to embrace the medieval view of almsgiving and thus did not “secularize” poor relief to the same degree. Since the s, scholars have increasingly challenged this interpretation. Robert Jütte, a leading opponent, argues that Catholic and Protestant communities shared much in common in poor relief reform, including efforts to discriminate between those truly in need and those capable of supporting themselves, attempts by theologians to encourage greater government intervention, and the centralization of charitable funds into a “common box.” These reforms, he adds, were inspired less by the Reformation and more by the social, demographic, and economic changes of the late medieval and early modern periods.5

3

Lindberg, Beyond Charity, –. Geremek, Poverty, ; Lindberg, Beyond Charity, , , . 5 Robert Jütte, Poverty and Deviance in Early Modern Europe (Cambridge, Eng.: Cambridge University Press, ). See also Brian Pullan, Rich and Poor in Renaissance Venice: The Social Institutions of a Catholic State to  (Cambridge, Mass.: Blackwell, ); and Natalie Z. Davis, “Poor Relief, Humanism, and Heresy,” in Society and Culture in Early Modern France (Stanford: Stanford University Press, ), –. 4

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Some historians, led by Ole Peter Grell, continue to champion the traditional view that without the Reformation, the centralization and “secularization” of poor relief would not have taken place. Grell insists that in Catholic regions, the emphasis on the salvific benefits of almsgiving persisted much more than was the case in Protestant lands. In northern Europe, on the other hand, the efforts of Protestant Reformers to undermine the medieval understanding of almsgiving contributed significantly to more extensive poor relief reforms and the greater involvement of secular authorities in welfare.6 Despite differences in these two positions, most historians agree on the following points. First, with a few exceptions, Catholic and Protestant lands witnessed a marked increase in state participation and intervention in both indoor and outdoor poor relief, and this trend antedates the religious upheavals of the early sixteenth century. This rise in state involvement coincided with greater efforts to distinguish between the “deserving” poor—those who could not support themselves apart from assistance (widows, orphans, the infirm, etc.)–and the “undeserving” poor— those who had the capacity to work and yet still sought relief. Second, poor relief was subject to greater bureaucratization and professionalization in much of Europe as larger towns were divided into relief districts, welfare officers were appointed, and the residents of charitable institutions were more meticulously documented. Third, the centralization of poor relief was much stronger in Protestant than in Catholic lands. Particularly in Spain and Italy, the state was much more reluctant to centralize poor relief, meaning that religious organizations such as confraternities continued to play a pivotal role. Finally, religious ideology influenced poor relief provision. Welfare throughout Europe continued to be viewed primarily as an act of Christian compassion, irrespective of which institutions were responsible for it. Poor relief reform in early modern Sweden reflected many of the patterns found elsewhere. The sixteenth and seventeenth centuries witnessed increased efforts by the national government to centralize welfare. Legislation was passed curtailing vagrancy and prohibiting the “undeserving” poor from receiving relief. Local parishes were admonished to

6 See Ole Peter Grell and Andrew Cunningham, eds., Health Care and Poor Relief in Protestant Europe, – (New York: Routledge, ). Many of the contributors to this volume share Grell’s views. For an overview of Grell’s position, see his essay “The Protestant Imperative of Christian Care and Neighbourly Love,” –.

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establish infirmaries and almshouses adjacent to parish churches for the care of the sick and poor. The “common box,” a feature in Protestant regions, was to be placed in every church porch to collect funds for poor relief, and these funds were to be administered separately from other church finances.7 Increasing state involvement and the bureaucratization and centralization of poor relief in medieval and early modern Europe reveal that functional differentiation in welfare was not new to the nineteenth century. Care must be taken not to view this process as a separation of the religious from the secular. The “secularization” of poor relief in pre-modern Europe reflected the efforts of both civil and ecclesiastical leaders to create a Christian commonwealth. In overseeing poor relief, magistrates were carrying out their Christian duty on behalf of society, and the clergy actively encouraged this role for civil authorities. It must also be emphasized that religious institutions and representatives remained involved in the poor relief systems of Protestant regions. The clergy held administrative positions in some charitable institutions and participated in the election of lay administrators in many others. At the parish level, the clergy’s personal knowledge of parishioners played a role in who was deemed qualified to receive relief. Parish clergy also exhorted the faithful to donate money to support indoor and outdoor poor relief. In many Reformed regions, such as Holland, deacons had a central role in poor relief provision, and in rural England, churchwardens strongly influenced decisions concerning poor relief. In Sweden, bishops and rural deans gave the “deserving” poor special passes that enabled them to beg legally. Finally, “common chests,” typically located in parish churches, meant that churches effectively functioned as welfare offices.8

7 E.I. Kouri, “Health Care and Poor Relief in Sweden and Finland,” in Health Care and Poor Relief in Protestant Europe, –. 8 L.A. Botelho, Old Age and the English Poor Law, – (Rochester, NY: The Boydell Press, ); Thomas Safley, “Introduction,” in The Reformation of Charity: The Secular and the Religious in Early Modern Poor Relief, ed. Thomas Safley (Boston: Brill Academic Publishers, ), ; Charles H. Parker, “Calvinism and Poor Relief in Reformation Holland,” The Reformation of Charity, –; and Kouri, “Health Care and Poor Relief in Sweden and Finland,” .

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chapter five B. Poor Relief Reform in Nineteenth-Century Sweden

Criticism of poor relief systems grew significantly toward the end of the Enlightenment. Critics insisted that poor relief was contributing to poverty because it encouraged the able-bodied poor toward idleness, itself a precondition for moral decadence. The remedy for poverty was putting the able-bodied poor to work. Enlightenment thinkers argued that to the extent that welfare was provided, the state must do it more efficiently and discriminatorily.9 Enlightenment criticisms of poor relief systems paved the way for harsher attitudes and policies toward welfare in nineteenth-century Europe. Legislation such as the  Poor Law in England reduced the state’s burden in outdoor relief. The able-bodied poor were especially targeted, making welfare assistance dependent upon their “willingness” to enter a workhouse to earn relief. Indoor relief became a more preferable form of assistance among government officials in many regions. In London, for example, the percentage of paupers residing in workhouses, hospitals, asylums, etc., increased from  percent in  to  percent by the s.10 Greater responsibility for outdoor relief fell to the growing number of religious and secular philanthropies, though many of these organizations worked in cooperation with government welfare. They adopted the view that relief was best administered in a system that fostered more intimate knowledge of potential welfare recipients in order to better discriminate between the “deserving” and the “undeserving.” To accomplish this, volunteers visited the poor in their homes, investigated their needs, provided them with moral instruction and support, and distributed money or goods to those deemed in genuine need.11 These volunteers included many middle-class women whose charitable work in the public sphere

9 Marco H.D. Van Leeuwen, The Logic of Charity: Amsterdam, –, trans. Arnold J. Pomerans (New York: St. Martin’s Press, ), ; Stuart Woolf, The Poor in Western Europe in the Eighteenth and Nineteenth Centuries (London: Methuen, ), ; Geremek, Poverty, . 10 Lynn Hollen Lees, “The Survival of the Unfit: Welfare Policies and Family Maintenance in Nineteenth-Century London,” in The Uses of Charity: The Poor on Relief in the Nineteenth-Century Metropolis, Peter Mandler, ed. (Philadelphia: University of Philadelphia Press, ), . 11 Bernard Harris, The Origins of the British Welfare State: Society, State and Social Welfare in England and Wales, – (New York: Palgrave Macmillan, ), ; Alan Kidd, State, Society and the Poor in Nineteenth-Century England (New York: St.

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was deemed acceptable in spite of an “ideology of domesticity” that sought to confine women to the household sphere. This was because these women focused on work that was viewed as an extension of their domestic responsibilities, such as helping women and children and teaching religious morals.12 The rise in the importance of charities was not a reflection of a decline in the state’s authority over poor relief. National and local governments continued to legislate and/or oversee welfare, but they did not want to bear so much of the burden of poor relief, in part because nineteenthcentury liberal political thought encouraged policies of limited and restrained government.13 But in the growing number of philanthropies and charities, governments found partners willing to shoulder some of the load. Poor relief reform in nineteenth-century Sweden reflected many of the trends in Western Europe, such as increased governmental restrictions on outdoor relief and the greater involvement of philanthropies. Many of these developments occurred much later in Sweden than in countries such as England. In fact, Sweden’s first significant poor relief legislation in  actually increased access to outdoor relief and the local government’s responsibilities in welfare provision, and it was only in the s that parliament restricted outdoor relief at the local level and embraced a policy that depended more heavily on voluntary organizations.14 It has already been noted that in early modern Sweden, local parishes had the primary responsibility for poor relief. The local institutions and authorities, including parish assemblies, parish clergy, and provincial governors, were given considerable latitude in how welfare was carried out. Welfare was funded predominantly through voluntary donations and church collections, and because these funds often were insufficient, Martin’s Press, ), –; Peter Mandler, “Poverty and Charity in the NineteenthCentury Metropolis: An Introduction,” The Poor on Relief, ; Van Leeuwen, The Logic of Charity, ; Woolf, The Poor in Western Europe, . 12 Rachel G. Fuchs and Virginia E. Thompson, Women in Nineteenth-Century Europe (New York: Palgrave Macmillan, ), –. 13 Geremek notes that the difference between political liberalism in the nineteenth and twentieth centuries is that it encouraged limited government in the former and expanded government in the latter. See Geremek, Poverty, . 14 Voluntary organizations were important partners in government poor relief before the  law. Ingrid Åberg notes that many women’s associations worked closely with municipal poor relief in the s and s. See Ingrid Åberg, “Revivalism, Philanthropy and Emancipation. Women’s Liberation and Organization in the Early Nineteenth Century,” Scandinavian Journal of History  (): –.

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begging was typically permitted. The  Poor Law reflected parliament’s desire to create greater uniformity throughout the country in welfare assistance in order better to meet the relief needs of growing segments of the population. The law spelled out the obligation of all parishes and towns to provide relief for the poor. Begging was prohibited, the poor could seek relief outside their home parish, and in locales where welfare funds were insufficient to meet the need, a poor tax was instituted. Reflecting ideas proposed a century earlier by Montesquieu, parliament endorsed through this law the notion that the poor had a right to relief and that the government had the duty to provide it.15 The law created a new set of specialized institutions, poor relief boards, to bear the responsibility of welfare provision in towns and cities.16 In addition to overseeing the affairs of local indoor relief institutions and referring the able-bodied poor to them, these boards considered requests for outdoor relief. If they denied relief to an applicant, the latter had the right to appeal the decision to a county board. Some historians interpret the creation of these boards as the end of church-based poor relief, but as we have seen, the involvement of secular authorities in welfare had characterized Sweden throughout the early modern period.17 The creation of these specialized institutions also did not preclude clergy from taking part in them, and for some decades after the law’s implementation, clergy were active participants in, and in some cases chairpersons of, these boards. In many respects, the law reaffirmed the traditional religious justification for relief as an act of Christian compassion. Caution is therefore in order when declaring that the  Poor Law signaled the beginnings of welfare as a purely secular/civil affair. Religious and secular institutions and organizations continued to work together in poor relief

15

For discussions of the  Poor Law, see Oloph Bexell, Sveriges kyrkohistoria . Folkväckelsens och kyrkoförnyelsens tid (Stockholm: Verbum, ), ; Gunnel Elmund, Det kvinnliga diakonatet som kall. Johan Christoffer Brings syn på diakonissverksamhetens uppgift och form (Skellefteå: Artos & Norma bokförlag, ), –; Göran Gellerstam, Från fattigvård till församlingsvård. Utvecklingslinjer inom fattigvård och diakoni i Sverige —omkring  (Lund, ), , –; Svante Jakobsson, Fattighushjonets värld i -talets Stockholm (Uppsala: Almqvist & Wiksell, ), –; Sverkar Oredsson, “Samhällelig eller enskild fattigvård? En linje i debatten inför  års fattigvårdslagstiftning,” Scandia  (), . 16 In Stockholm, poor relief boards already were established in each territorial parish in . 17 Göran Gellerstam notes that older church history literature in particular viewed the  Poor Law as the end of church-based poor relief. See Gellerstam, Från fattigvård till församlingsvård, .

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throughout the nineteenth century. But the  Poor Law did represent increasing functional differentiation in poor relief as specialized institutions assumed some of the responsibilities and authority that parish assemblies and clergy had possessed in the early modern period. The  Poor Law generated little controversy after its implementation, but opposition to it increased significantly in the late s as bad harvests and widespread famine generated huge demands on government welfare. The number of welfare recipients peaked in , and the tremendous strain on poor relief funds led to debates in parliament about reforming the  law. The result was the  Poor Law. It restricted obligatory relief to minors (under fifteen years of age), the aged, and the infirm. Outdoor relief for the able-bodied unemployed was largely abolished, and greater responsibility was placed on relatives to care for their own. The right to appeal municipal poor relief decisions to a county board was severely restricted.18 The  Poor Law reflected the liberal belief in limited government. Local municipalities were given considerable freedom to determine the parameters of welfare provision. Poor relief reverted to more of a voluntary model with a greater reliance on private contributions and philanthropic organizations as a complement to government welfare. The cooperation between government authorities, religious organizations, and secular philanthropies would strongly characterize poor relief in Sweden until World War I. Neither of the above-mentioned laws generated significant opposition among the clergy. It was not until the early s that the issue of poor relief received considerable attention in church circles. This interest was generated by several developments in society, such as industrialization and its effects on the poor, the growth of socialist movements and their attempts to engage the social question, and the increase in free churches and free church involvement in social issues. The debates among prominent theologians and clergy centered on the relationship between government and church-based poor relief. Some clergy, such as Gottfrid Billing, were strongly critical of government poor relief, insisting that it did not instill gratitude among welfare recipients.

18 Staffan Förhammar, Med känsla eller förnuft? Svensk debatt om filanropi –  (Stockholm: Almqvist & Wiksell, ), –; Elmund, Det kvinnliga diakonatet som kall, ; Gellerstam, Från fattigvård till församlingsvård, , –; Jakobsson, Fattighushjonets värld, , ; Oredsson, “Samhällelig eller enskild fattigvård? En linje i debatten inför  års fattigvårdslagstiftning,” Scandia  (), –.

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Billing argued that a church-based system, under the leadership of the clergy and with the help of specially consecrated laypeople, was the only real remedy to the deficiencies of government poor relief and the growing threats posed by socialism. Other prominent clergy, such as S.L. Bring, believed that government poor relief was a necessity, but in addition to it, a church-based system should be implemented to address those needs that municipal welfare was not obligated to meet.19 Bring shared with Billing the belief that more formally organized church-based relief was necessary because it alone could instill thankfulness among recipients and remind them that welfare was an act of Christian compassion and not a “right.” He differed from Billing in that he held a more positive view of government relief and the ways it could complement a church-based system.20 J.C. Bring was an active participant in these debates. He shared the views of many other clergy that government poor relief could not address the spiritual needs of the poor. Government relief was not firmly rooted in an understanding of welfare as a voluntary act of Christian compassion, one that was meant to invoke gratitude in the recipient. He did support the continued existence of government welfare since the needs of the poor were so great, but more church involvement and Christian compassion in poor relief were needed. Understandably, Bring’s solution to the poor relief quandary was the diaconate. He increased the deaconessate’s involvement in poor relief considerably in the s and s, in part because he believed that the female diaconate was in the best position to function as an “intermediary link” (mellanlänk) between the rich and the poor. Deaconesses could awaken Christian compassion among the rich so that they would be more willing to share their possessions with the poor, and they could distribute aid in a way that enabled the poor to experience gratitude for what they were receiving. Bring believed this reconciliatory work was all the more needed because misunderstandings and suspicions between the 19

Gottfrid Billing would eventually become a bishop, first in Västerås (–) and later in Lund (–). Sven Libert Bring was a professor of practical theology at Lund University in the late nineteenth century. He was also J.C. Bring’s brother. 20 Another important figure in this debate was Olof Holmström, professor of practical theology at Lund University. He echoed many of S.L. Bring’s sentiments concerning the need for a church-based poor relief to complement government welfare. See Olof Holmström, Kyrklig fattigvård. Ett praktiskt teologiskt inlägg i fattigvårdsfrågan (Lund, ). For a more in-depth discussion of the main positions and contributors in church debates over poor relief at the end of the nineteenth century, see Elmund, Det kvinnliga diakonatet som kall, –.

poor relief

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rich and the poor had increased significantly, and the growing socialist movements were aggravating instead of ameliorating these tensions.21 Debates in the Church of Sweden concerning the relationship between church-based and government poor relief led to other attempts to increase church involvement in welfare. One prominent effort was the implementation of the Elberfeld system in some cities at the end of the century. This was an amalgamation of municipal and church-based poor relief inspired by a German program.22 Cities were divided into districts, with overseers appointed to each district in order to visit poor families, investigate their need for relief, and distribute aid to them if needed. Church leaders actively endorsed and helped to implement this system so that poor relief would be less bureaucratic and more personal. Church donations also helped fund some of this relief. The system was utilized in several prominent cities at the end of the nineteenth and the beginning of the twentieth centuries, including Malmö, Lund, and Linköping. But the difficulty of finding suitable overseers and the preexisting government welfare infrastructure made this system untenable in the long run.23 A more lasting result of the debates was the creation of a male diaconate. Discussions concerning the establishment of a male diaconate had already begun in the mid-nineteenth century, but the clergy’s growing concern over poor relief in the s made the issue more pressing. In , Nils Lövgren, parish priest in Gävle and later bishop in Västerås, established the Swedish Deacon Society (Svenska Diakonsällskapet). An educational institution in Gävle was created that same year for the purpose of educating deacons primarily for poor relief work.24 But for the period under consideration here, the clergy’s best hope for the realization of church-based poor relief carried out in cooperation with government welfare was the same as J.C. Bring’s—the female diaconate. A growing number of parish priests and councils sought to employ parish deaconesses toward the end of the century, though they were not the only interested employers. After the  Poor Law, the 21

SDSFU Berättelse och redovisning –, ; LHA –, “Diakonissans kall,” Ö III b, EDA; “Föredrag,” Olivebladet  (), –. For an excellent discussion of J.C. Bring’s views on poor relief and the social question as expressed in his articles, sermons, and public addresses, see Elmund, Det kvinnliga diakonatet som kall, –. 22 The Elberfeld system originated in Elberfeld, present-day Wuppertal, in the s. 23 Thorsten Levenstam, Kyrklig diakoni och samhällets sociala omsorgsarbete, omkring —omkring  (Älvsjö: Skeab Verbum, ), –. For an overview of the Elberfeld system in nineteenth-century Germany, see Young-Sun Hong, Welfare, Modernity, and the Weimar State, – (Princeton: Princeton University Press, ), –. 24 Levenstam, Kyrklig diakoni, –, –.

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municipal poor relief boards were in greater need of help from charitable and voluntary organizations, and it became increasingly clear to them that deaconesses were well qualified for work among the urban poor and sick. The leadership of the deaconess institution took notice of this demand from the civil and ecclesiastical spheres, and by the late s, poor relief had become the primary focus of diaconal work outside the institution.

C. Indoor Relief Unlike education and health care, poor relief was not, strictly speaking, an internal division within the deaconess institution in Stockholm, even though Stockholmers sometimes mistook the institution for a poorhouse.25 Probationary sisters could not train for poor relief work at the institution in the same way as for teaching and nursing. Nevertheless, the leadership maintained that probationary sisters got plenty of experience working with the poor through other internal divisions, such as the school for poor children or the Magdalene Home.26 Poorhouses were the most common type of indoor relief stations adopted by the diaconate, though sisters were also assigned to workhouses and poor farms.27 Poorhouses provided shelter to many kinds of paupers, including the mentally ill, the chronically ill, the elderly, orphans, single women who had just given birth, etc. Some poorhouses also housed those capable of work who had fallen on hard times, though workhouses were also established for this purpose. Able-bodied paupers might enter a poorhouse or workhouse voluntarily or as a punish-

25

“Hwad är diakonissanstalten?,” Olivebladet  (), . SDSFU Berättelse och redovisning –, . Those in need of outdoor relief also visited the deaconess institution regularly. Their visits eventually became so common that the leadership assigned a sister to work as a parish deaconess at the institution beginning in . “Meddelanden från Diakonissanstalten,” Olivebladet  (), . 27 Categorizing indoor poor relief assignments is challenging because the annual reports list deaconesses working in the hospital divisions of poor relief institutions under the heading of “health care.” For example, in the  annual report, seven sisters are listed as assigned to poor relief institutions, but this number does not include the three sisters working in the hospital divisions of indoor relief institutions. SDSFU Årsberättelse , Olivebladet  (), –, . I have chosen to follow the institution’s categorization largely because deaconesses assigned to hospital divisions worked almost exclusively as nurses, whereas the other sisters carried out a variety of other duties in addition to nursing. 26

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ment from the municipal authorities for not repaying outdoor relief. Poor farms were indoor relief institutions in rural areas at which the poor were given food and lodging in return for working on a farm or helping with the household at the institution. Incidentally, all of these relief institutions were under the supervision of the local poor relief boards in the late nineteenth century. The first indoor relief station was a poorhouse in Falköping adopted in the early s.28 The number of deaconesses stationed at indoor institutions gradually increased in the ensuing decades, but this sphere of work was never particularly large when compared to outdoor relief work. In , three deaconesses were assigned to indoor relief institutions. This number doubled by , rising to eleven in .29 By comparison, fifty-five sisters worked in outdoor relief as parish deaconesses in .30 A periodical article from  described the instructions that the administrators of one poorhouse gave to its deaconess. It noted that this “job description” was typical of other poorhouse assignments. Many of these instructions reflected prevailing gender norms and expectations regarding the proper activities of a woman within the domestic sphere. The deaconess was to serve as a model of morality among all of the paupers, leading them in daily prayers and working to instill the “fear of God” in them. She was to have particular oversight of the children and female residents. If the children were unable to attend the parish’s local elementary school, she was to take charge of their education. She was also to perform general household tasks for all of the residents, such as mending clothes. Finally, she was to care for the sick, enlisting the help of other female residents “known for their morality” in this task.31 Because all of these duties would have been considered appropriate “feminine” tasks, the deaconess protected herself from potential objections concerning the public nature of her work, particularly at an institution that many church leaders would have considered tainted with “moral decay” and where interaction with men was unavoidable.32 28

SDSFU Berättelse och redovisning –, . SDSFU Berättelse och redovisning –, ; SDSFU Årsberättelse , Olivebladet  (), ; SDSFU Årsberättelse , Olivebladet  (),–. 30 SDSFU Årsberättelse , Olivebladet  (), –. 31 “Hwad göra diakonissorna?,” Olivebladet  (), –. 32 J.C. Bring shared the views of many other church leaders that poorhouses were “dark points” and prone to “moral decay,” though he hoped that deaconesses could brighten them by tending to the spiritual needs of the residents. “Huru skall kyrkan bäst tillgodose de andliga behofwen hos de lekamliga nödstälda?,” Olivebladet  (), . 29

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Few deaconess letters from the s onward have been preserved, meaning that little is known about what the sisters thought about their work at poorhouses. Some letters from the administrators of relief institutions show that deaconesses occasionally were overwhelmed by the work and the number of paupers for whom they had charge. Otherwise, these letters do not indicate whether the sisters found their work in poor relief institutions rewarding or frustrating. What the letters and deaconess publications do reveal is that there was some demand for deaconesses among indoor relief institutions, even if this demand was not as strong as in the areas of nursing or outdoor poor relief. In the letters, one commonly encounters pleas by these institutions not to reassign a deaconess or, if this cannot be avoided, to send a replacement as soon as possible. The quarterly and annual reports periodically note that requests from poor relief institutions cannot be adequately met due to a lack of deaconesses. Several reasons account for this demand. The first one has already been mentioned—gender. As women, deaconesses would have been considered by poor relief authorities as particularly qualified for caring for women and children. Another reason pertains to the nursing skills of deaconesses. Because most poor relief institutions contained residents in need of medical care, prospective employers appreciated the fact that deaconesses were trained nurses. In fact, many contracts with indoor relief institutions stress the need for a deaconess capable of tending to the “poor sick,” even though her duties were typically not limited to this. Finally, administrators and municipal poor relief boards were very much pleased with the job performance of deaconesses at indoor institutions. The letters preserved from these authorities on the whole attest to how successful deaconesses were in gaining the trust and confidence of the poor relief boards as well as the administrators, doctors, staff, and residents of these institutions.33

D. Outdoor Relief The deaconess institution’s leadership directed much more energy and effort to placing sisters in outdoor relief stations. One likely reason is that the  Poor Law opened up a greater need among municipal 33 See, for example, Örebro Workhouse Board to DAS,  April , Ä Ic , EDA; Lund Poor Relief Board to J.C. Bring,  September , Ä Ic , EDA.

poor relief

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poor relief boards for voluntary assistance in outdoor relief than was the case for indoor relief. This is understandable, since one of the main purposes of the law was to limit the responsibility of these government boards in outdoor relief. A second reason is Bring’s conviction that the most appropriate form of female diaconal work was that of outdoor poor relief carried out on behalf of the local congregation. He noted that the early church instituted the office of deaconess in order to serve the local congregation through helping the poor. It was unfortunate, he maintained, that the contemporary deaconessate was not connected to the local congregation as it had been in the early church. For this reason, he devoted much of his energy to re-creating this early church model by forging closer ties with urban churches, coordinating with them in instituting parish deaconess positions.34 Bring’s hope was that parish deaconesses would be hired on the initiative of parish clergy and councils, though ultimately many of the employers would be municipal poor relief boards. Even so, Bring insisted that all parish deaconesses were servants of the local congregation and were to think of themselves as assistants to the parish priest in their work.35 The diaconate’s growing interest in parish deaconess work in the s is understandable given the greater demand in society for poor relief due to the famines of the late s and the increased opportunities for voluntary assistance to government relief boards after the  Poor Law. Even before these developments, Bring had proposed the idea of assigning sisters as parish deaconesses. He first publicized this plan in an  article in which he argued that deaconesses could be of tremendous help at the parish level in visiting the sick. He noted that many clergy had difficulty visiting the sick due to their other duties. Deaconesses could help the clergy with their pastoral care responsibilities among the sick while also putting their nursing skills to use. In cases where there were not enough sick to visit, deaconesses could help local poor relief boards by visiting the poor, gathering information about their needs, and administering government relief to them when needed.36 That same year, the deaconess institution adopted its first parish deaconess station in Stockholm’s Adolf Fredrik parish. The contract was 34 “Något som, enligt skriften, kan anbefalla diakonissverksamheten,” Olivebladet  (), –; “Diakonissans kall,” Olivebladet  (), –. 35 Elmund, Det kvinnliga diakonatet som kall, –. 36 “Jag var sjuk och I sökten mig,” Olivebladet  (), –.

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established with a women’s philanthropic society that had already employed a deaconess for several years as the director of its nursery. The society requested that this same deaconess be hired to visit the poor in their homes, provide basic health care to the sick, and find alternative living arrangements for neglected children.37 It is noteworthy that it was a private philanthropic organization that first hired a parish deaconess. At the time, parish councils were legally prohibited from contracting the services of a deaconess directly, and for this reason any parish wanting to hire one had to work through an independent organization.38 This organization would also be responsible for funding the position and providing for the deaconess’s immediate needs, such as food and lodging. Private organizations continued to hire deaconesses based on the precedent established in the Adolf Fredrik parish. Municipal poor relief boards joined private organizations as the most common employers of parish deaconesses by the s, while a change in the law by this time also opened the way for parish councils to contract directly with the institution for the services of deaconesses. The famines of the late s and the corresponding need for outdoor poor relief in society did stimulate greater interest among the institution’s leadership for expanding its work in this area, but the growth in parish deaconess stations was still modest in the s. From assigning five sisters to parish deaconess stations at the beginning of the decade, the institution had only nine sisters serving in this capacity in . But after , this number would increase dramatically. In , there were twenty-one parish deaconesses. This number rose to forty-two a decade later and was at fifty-five by .39 By the end of the century, parish poor relief was the largest area of work outside the institution.40 Every parish in Stockholm employed at least one parish deaconess, as did most other urban parishes.

37 38

“Hwad är diakonissanstalten?,” Olivebladet  (), –. Yngve Iverson, Tro verksam i kärlek. En bok om Ersta (Stockholm: Verbum, ),

. 39 SDSFU Berättelse och redovisning –, ; SDSFU Årsberättelse , Olivebladet  (), ; SDSFU Årsberättelse , Olivebladet  (), –; SDSFU Årsberättelse , Olivebladet  (), –; SDSFU Årsberättelse , Olivebladet  (), –. 40 Parish deaconess work was the fastest-growing area outside the institution for most of the last two decades, but it was only in  that the number of assignments in this area exceeded the number assigned to external health care stations. See SDSFU Årsberättelse , Olivebladet  (), .

poor relief

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A wealth of information concerning the duties of parish deaconesses exists, even though few letters from them have been preserved. Bring published several lengthy articles detailing the range of work and responsibilities of these sisters. On occasion, he solicited first-hand accounts from parish deaconesses for publication. As a result, we probably know more about the life and work of parish deaconesses than sisters assigned to any other station, internal or external. One of the most significant responsibilities of parish deaconesses was providing outdoor poor relief. Because municipal poor relief boards, philanthropies, the clergy, and the institution’s leadership agreed that relief should be given in a discriminatory fashion and to those truly in need (i.e., the “deserving” poor), a parish deaconess distributed nothing without first determining the “real” needs of the poor. She devoted much time to visiting the poor in their domiciles and holding daily “office hours” in her living quarters so that the poor could visit her and tell her their needs. It was not uncommon for so many potential relief recipients to visit a parish deaconess that she did not have time to meet with all of them.41 Much of the relief distributed by a parish deaconess was in-kind. She received money from the parish councils, municipal poor relief boards, or private philanthropies, and she had considerable freedom concerning how this money was spent. She frequently bought and distributed basic provisions to poor families, such as bread, milk, potatoes, and wood. On occasion, she gave money directly to poor families on behalf of poor relief boards or private charities, though Bring discouraged relief in this form unless it was deemed absolutely necessary.42 Bring’s suspicion of distributing money directly to the poor reflected a principle held by many poor relief organizations, public or private, in the nineteenth century–“help to self-help.” If the poor were to rise above their destitution, they must acquire and utilize knowledge and skills that enabled them to support themselves. On the other hand, providing them with “no-strings-attached” money or excessive amounts of in-kind relief or charity encouraged them to rely too much on others and thus inspired 41 “En församlingsdiakonissas werksamhet i en af hufwudstadens församlingar,” Olivebladet  (), ; “Hwad göra diakonissorna?,” Olivebladet  (), . 42 “En församlingsdiakonissas werksamhet i en af hufwudstadens församlingar,” Olivebladet  (), –; “Ur ett julbref,” Olivebladet  (), . Some parish deaconesses in Stockholm directed mission houses (missionshyddor) in which meals were provided to hundreds of poor visitors on a weekly basis. “Ett drag ur arbetet för Stockholms fattiga,” Olivebladet  (), .

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them to idleness and laziness.43 Not surprisingly, some of the outdoor relief that parish deaconesses gave to the poor was a reflection of this principle. In particular, parish deaconesses often sponsored weekly or semimonthly sewing circles for poor and working-class mothers and housewives. The deaconesses “helped” these women by enabling them to buy materials at a very low price, while the women engaged in “selfhelp” by doing the actual sewing. The finished garments were sometimes intended for the families of these women, while at other times they were given to poor children in the community displaced from their homes. In some cases, the women sold these garments to supplement the family income.44 These sewing circles provided poor women with the opportunity to receive in-kind relief or money, but from the diaconate’s perspective, what was important was that these women were “earning” this assistance by relying on their own skills and industriousness. A second responsibility of most parish deaconesses was providing nursing care and health care consultations for the poor. Much of this work centered on visiting the “poor sick” in their homes and evaluating their health care needs. She determined whether they could be cared for in their homes by a local doctor, or whether their condition warranted admission to a local hospital. In the latter case, she would work with the district doctor and hospital to arrange for treatment. In addition to making referrals, a parish deaconess functioned as a social worker. For example, if the patient in question was a mother with children, it fell to the deaconess to make childcare arrangements while the mother underwent medical treatment.45 A third responsibility was evangelization. This duty was not one imposed by municipal poor relief boards but rather was embraced by the diaconate as an integral part of its calling. Bring maintained that this task was made possible by the first two responsibilities, for “if you have won the trust of the poor . . . so that they understand that you wish them well, then you can attempt to awaken in them the hunger for the bread of

43 “Till församlingsdiakonissorna!,” Olivebladet  (), ; Elmund, Det kvinnliga diakonatet som kall, . 44 “En församlingsdiakonissas werksamhet i en af hufwudstadens församlingar,” Olivebladet  (), ; “Hwad en församlingsdiakonissa uträttar,” Olivebladet  (), –. 45 “En församlingsdiakonissas werksamhet i en af hufwudstadens församlingar,” Olivebladet  (), ; “Hwad göra diakonissorna?,” Olivebladet  (), ; “Hwad en församlingsdiakonissa uträttar,” Olivebladet  (), , .

poor relief

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life and show them the way to Him who says: ‘I am the Bread of Life’ ”.46 The parish deaconess was to encourage the poor to read the Bible and to attend church. If the family in question did not have a Bible or other devotional book, she was to arrange for this literature to be placed in the home. Beyond such encouragement, the deaconess was to serve as a spiritual leader to the poor, teaching Sunday School, reading from the Bible or other spiritual work at sewing circles, personally testifying to Christ’s salvific work, and arranging for clergy to give Bible lessons and sermons at gatherings for the poor.47 This emphasis on evangelization undoubtedly gave a parish deaconess’s work a religious quality that was either much less prominent or altogether lacking in the outdoor relief work conducted by poor relief board officials and secular philanthropies. What is less clear is what the poor thought of these evangelization efforts. Periodical articles and autobiographical accounts say little about whether relief recipients embraced or rejected this proselytizing. These duties were accompanied by a host of other responsibilities, including providing moral support and at times alternative living arrangements for girls whose homes were plagued with drunkenness or sexual immorality, teaching young girls to sew, and making sure that children attended school regularly. What connected many of these tasks was their domestic nature. Parish deaconesses functioned as stand-in mothers for children whose mothers were too sick to care for them. They served as female role models for young girls at risk of becoming “fallen women.” They helped poor housewives to better provide for their families by encouraging them to make use of their domestic skills. By focusing on these and other “feminine” tasks, parish deaconesses reinforced their connection to the domestic sphere and their fidelity to the Lutheran construction of gender, thereby circumventing potential objections to their public work. In fact, their gender came to be viewed by some prominent clergy as a tremendous asset in church-based poor relief, since doors were opened for them, particularly among poor women and children, that were largely closed to men.48

46

“Till församlingsdiakonissorna!,” Olivebladet  (), . “En församlingsdiakonissas werksamhet i en af hufwudstadens församlingar,” Olivebladet  (), ; “Till församlingsdiakonissorna!,” Olivebladet  (), ; “Hwad en församlingsdiakonissa uträttar,” Olivebladet  (), –. 48 For advocates of a male diaconate, this principle could be inverted in that deaconesses were unable to intervene with lost or strayed young men in the same way as 47

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The periodical articles provide us with considerable information concerning the typical duties of parish deaconesses, but they shed only a little light on how the sisters experienced their work and whether they found it fulfilling. It is clear that the work could be overwhelming, as sisters often were so occupied with visits to and from the poor that they had little time for anything else. Certain times of year were more stressful than others. Deaconesses stationed at mission houses in Stockholm witnessed a significant increase during the winter in the number of people visiting them to receive meals.49 The weeks leading up to Christmas could be particularly taxing. One parish deaconess in Stockholm wrote how busy she became during this time due to the increasing number of people applying for municipal poor relief, the amount of money and in-kind relief to be distributed, and the amount of sewing she had to do for poor children. She noted that distributing relief to poor families was itself a monumental task, as she often visited fifty to sixty families per day.50 The overwhelming nature of the work reflected the considerable demand among the poor for the assistance of parish deaconesses, and this demand was shared by employers. The annual reports repeatedly noted by the mid-s that requests for deaconesses to work among the urban sick and poor outnumbered all others.51 While the leadership devoted more energy to fulfilling these requests than any others, it still could not keep up with demand. The fact that “[t]he demand far exceeds the supply,” as the parish priest in Gävle, Nils Lövgren, noted, meant that some prospective employers had to make repeated requests before a parish deaconess was assigned.52 Others pleaded with the institution not to reassign their parish deaconess, noting how difficult it was to replace a sister who had become so familiar with the families and conditions in their particular locale. Still others found that one parish deaconess did not suffice, and they requested that additional sisters be assigned, even though they were aware of the supply limitations. Explanations for this demand vary depending on which group was seeking the assistance of deaconesses. Poor relief applicants sought out deaconesses and conveyed their needs to them because the sisters were deacons. See David Granqwist, “Om behofwet af diakoner i wåra store stadsförsamlingar och därmed sammanhängande frågor,” Olivebladet  (), . 49 “Ett drag ur arbetet för Stockholms fattiga,” Olivebladet  (), . 50 “Ur ett julbref,” Olivebladet  (), –. 51 SDSFU Årsberättelse , Olivebladet  (), . 52 Nils Lövgren, “Diakonissors anställande för kyrklig kärlekswerksamhet,” Olivebladet  (), .

poor relief



in some cases their primary link to the municipal poor relief boards. In other words, many applicants viewed deaconesses as their spokespersons before government welfare organizations, and they wanted to influence the sisters to advocate on their behalf. Deaconesses were also granted funds by poor relief boards and private charities to use as they best saw fit, and for this reason, the poor visited parish deaconesses, at times in overwhelming numbers, in order to convince them to use these resources on their behalf. Finally, attending a gathering hosted by a deaconess, such as a sewing circle, gave poor mothers and housewives access to clothing and materials at a discounted price, and these women took advantage of this opportunity to help provide for their families. Parish deaconesses were clearly important resources to many poor families in their struggles to make ends meet. The famines of the late s and the  Poor Law created demand among many municipal poor relief boards for assistance in outdoor relief, and the diaconate eventually became an important resource for them. The drive to conduct outdoor relief more efficiently in light of greater demand for relief and limited government resources meant that these boards needed individuals to provide them with information concerning the “real” needs of the poor. The boards valued the time and energy deaconesses devoted to visiting with the poor for this purpose. Given the growing concerns of many municipalities with public health and the connection between disease and poverty in the late nineteenth century, poor relief boards also appreciated the nursing skills of deaconesses and often asked specifically that the sisters provide care for the poor and the sick. With deaconesses, poor relief boards got two services for the price of one. Debates over the social question from the s onward and the rise of socialist movements generated significant interest in church circles regarding a church-based poor relief to complement government welfare. For most of the last two decades, the best option for organized Christian (i.e., Lutheran) involvement in poor relief was the female diaconate, and growing numbers of parish clergy, particularly in urban areas, requested the services of parish deaconesses. Church officials viewed the religious characteristics and convictions of deaconesses as particularly attractive features, though gender was also considered a significant asset, as the sisters could focus their work particularly on poor women and children. A reason for high demand that holds true for all employers was satisfaction with deaconess job performance. Some employers repeatedly articulated their appreciation for how well deaconesses related to the

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poor and familiarized themselves with the conditions and needs of the parish. Växjö parish expressed disappointment that Sister Natalie Fernström was to be reassigned, noting that she “has a good way with the poor and sick” and that her knowledge of the people and the housing situation would be difficult to replace.53 Others were appreciative of the energy and zeal demonstrated by the sisters. The Hedvig Elenora poor relief board in Stockholm wrote to Albertina Claesson that “[y]ou have with unreserved energy and zeal devoted your energies to serving society and . . . to easing the burdens of those in need.”54 Most of the preserved letters reflect sentiments similar to these. The few complaints made in the correspondence were typically mild and focused mostly on the inability of a deaconess to carry out her duties due either to poor health or to the overwhelming amount of responsibilities in her work. But even in some of these cases, her efforts were praised.

E. Conclusion Functional differentiation in welfare did not first arise in the nineteenth century, but this process did increase as a result of poor relief legislation in . Specialized poor relief boards were created in municipalities to carry out welfare functions that had been overseen in part by parish clergy and councils for much of the early modern period. When the  Poor Law limited the obligations of these boards to provide outdoor relief, a growing number of voluntary philanthropies and charities partnered with government welfare to focus on helping the poor. The female diaconate’s participation in poor relief came at a time of increasing functional differentiation, but deaconesses were far from marginal in welfare provision. This was particularly true of outdoor relief, and by the end of the century, the demand for deaconesses outside the institution in this area was higher than in any other. Parish deaconesses served as links between poor families and municipal welfare authorities. Welfare applicants depended on the sisters to advocate on their behalf before poor relief boards, while municipal poor relief boards relied on them for information concerning the needs and conditions of the poor 53 Växjö Parish to J.C. Bring,  September , Ä II , EDA; Växjö Parish to J.C. Bring,  October , Ä II , EDA. 54 Hedvig Elenora Poor Relief Board to Albertina Claesson,  September , Ä II , EDA.

poor relief

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and for distributing money and in-kind relief. Parish deaconesses also referred the poor sick to hospitals and arranged for childcare in homes when the mother was unable to look after the children. The sisters carried out these and many other duties as religious professionals, evangelizing to the poor and partnering with parish clergy in pastoral care. The diaconate’s contributions in poor relief offer clear evidence of how some religious organizations not only survived but flourished as providers of essential social functions in a context of increased functional differentiation.

chapter six THE SOCIAL SIGNIFICANCE OF SWEDISH DEACONESSES

Secularization theories often presuppose that religion is the victim of inevitable modernizing forces. Science, technology, industrialization, urbanization, and functional differentiation constitute a teleological process whose end result is the marginalization of religion in the modern world. Growing numbers of historians and sociologists are countering these theories, insisting that religion has been and continues to be a resilient force in the face of modernity. These critics point to high levels of church participation and religious beliefs in the United States or the Global South as proof of this resilience. Some even argue that while religious participation in Western Europe does not match trends in the rest of the world, religious beliefs still persist, even if they no longer fit neatly in traditional “orthodox” categories. The problem with these critiques is that they are largely limited to beliefs and practices and fail to address adequately the public role of religion. Religious historians of modern Europe generally take it for granted that the growing number of specialized, secular institutions in the nineteenth and twentieth centuries stripped religious institutions of most of their societal functions and relegated their influence to a more private realm. What I am arguing is that even this aspect of the secularization thesis needs serious qualification. One outcome of functional differentiation in modern European history was secularization, but this was not the only outcome. The nineteenth century was the age of associations and philanthropies, and some of these organizations took advantage of the opportunities generated by functional differentiation and became themselves specialized providers of essential social services. In the case of religious organizations and associations, some were more successful than others, but the larger point is that it was functional differentiation that gave these organizations their raison d’être. The female diaconate in Sweden is an excellent example of a nineteenth-century religious organization that was largely successful in its efforts to specialize in three significant social functions: education, health care, and poor relief. This does not mean that the deaconess movement was an unequivocal success story. The diaconate did struggle to keep up

the social significance of swedish deaconesses



with demand through recruitment. Its work in education was also shortlived, and deaconesses had less of an impact on teaching than on the fields of health care and poor relief. But the diaconate was a religious organization whose services were in high demand throughout the late nineteenth century. Since the secularization thesis claims that modernity and modernization inevitably lead to a decline in the demand for religion, the fact that deaconesses were in such demand at the very least raises questions about whether the thesis is too narrow in its understanding of the effects of modernity on religion. What accounted for this demand for deaconesses? One important factor is the very government reform efforts that led to increased functional differentiation. While nineteenth-century legislation created more specialized institutions and professionals to carry out government-sponsored education and welfare, it also generated much greater demand for these services in society. The new specialized institutions and professionals either could not or would not meet this demand on their own, and this opened the door for religious organizations such as the female diaconate to find a niche in providing these services. In education, the  Elementary School Law marked the first attempt at compulsory public schooling. This legislation stipulated that all parishes had to establish a school and hire a certified teacher. The law stimulated increased functional differentiation, but it also created a huge demand for teachers and schools that the teaching colleges and parishes could not meet for several decades. This led provincial schools to hire teachers who had not been educated at teaching colleges, and deaconesses were among those who worked in this capacity. The deaconess institution’s school for poor children in Stockholm also served a need for many poor families in the Katrina parish who had difficulty finding schooling for their children, and the school’s enrollment was consistently so high that children had to be turned away. Even though J.C. Bring began withdrawing the diaconate from elementary education in the s, his decision was not due to a lack of demand for deaconesses as teachers. The main reason he gave for the decision was the growing number of certified teachers and the inability of deaconesses in the long run to compete with these specialized professionals educated. Functional differentiation did influence Bring’s decision to abandon teaching, but it must be stressed that he made this decision while demand appeared to be at its highest. A far more important factor driving his decision was his desire to pattern the diaconate on the early church model of diaconal work through a focus on health care and poor relief.

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In the area of poor relief, the  Poor Law created specialized institutions at the local level known as poor relief boards to oversee and carry out welfare. With this legislation, towns and parishes were now obligated to provide outdoor relief under specified conditions, and the demand for government welfare increased as a result. This demand grew even more in the late s due to famines that swept the country. But poor relief boards were unable and increasingly unwilling to meet the growing need for welfare. The strain on government resources led to the  Poor Law. This law curtailed the obligations of poor relief boards to provide outdoor relief in an effort to relieve the strain on government resources. Welfare reverted to more of a voluntary model in which government agencies cooperated with private philanthropies and religious organizations in poor relief provision. Poor relief boards were in need of greater assistance in the closing decades of the century, and they looked to deaconesses to help them carry out poor relief more efficiently and to improve public health by evaluating the needs of the “poor sick.” The nineteenth-century poor laws represent another example of legislation leading to increased functional differentiation and opportunities for religious professionals such as deaconesses to wield influence in the public sphere. A second factor explaining deaconess demand pertains to the professionalization and medicalization of health care. The nineteenth century witnessed new advances in medical knowledge and a rapid expansion in health care institutions in which the focus was on curing the sick instead of caring for the sick poor. These developments created greater demand for specialized health care professionals. Physicians became the focal point of the emerging health care system, but the need for educated nurses to assist them grew considerably. The Swedish Deaconess Institution was the first to provide specialized nursing education to meet this need for professional health care assistants. The institution served as one of the most important nursing schools in this period, and deaconesses were particularly sought after by health care officials to oversee nursing staffs, nursing education, and hygiene in the growing number of hospitals. A third factor is the overall employer satisfaction with job performance. The surviving correspondence between employers and the deaconess institution reveals high levels of appreciation and admiration for the ways that deaconesses conducted their work. The fact that so many of these letters included requests for contract renewals and pleas for the institution not to reassign sisters indicates how much employers valued deaconesses.




A fourth reason is the diaconate’s focus on serving the poor, a group whose education, health care, and/or welfare needs were not always adequately met or addressed by other institutions. The deaconess school for poor children in Stockholm provided children from poor and workingclass backgrounds with an education at a time in which there was still a limited number of schools. The deaconess hospital instituted “free beds” and raised money for “free funds” in order to cover the expenses of those unable to afford medical treatment. The institution’s polyclinic also provided free outpatient health care to large numbers of poor and workingclass individuals. Parish deaconesses served as important links between welfare applicants and government welfare boards. Deaconesses were clearly providers of essential social functions to many poor people who were struggling to survive and to find a place in a rapidly changing society. Another basis for deaconess demand involves the diaconate’s religious profile. The vocation of a deaconess was first and foremost a religious one. Conversion experiences were prerequisites for admission to the institution, and the concept of a calling was integral to the identity of a deaconess. In all three areas I have considered, deaconesses conducted their work in an overt religious manner. They proselytized and prayed with students, patients, and the poor. They led Sunday School in parishes and taught the Bible and the Lutheran confessions to children. Some employers hired deaconesses because the sisters incorporated these religious tasks into their teaching, nursing, or poor relief work. This was particularly true of religious organizations that ran provincial schools or charitable relief work, though there is evidence that even secular institutions, such as some municipal poor relief boards, valued this aspect of the diaconate’s work. A final important element explaining demand pertains to gender. I have devoted significant attention to how the diaconate sought to address and overcome gender-based objections to its activities in the public sphere by interpreting, organizing, and conducting its work so as to reconcile it with the Lutheran construction of gender. Their success at doing this was in many ways the necessary precondition for gaining access to the public sphere and for being in a position to be “in demand” by employers. The diaconate organized itself in accordance with the motherhouse system in order to reinforce the sisters’ connection to a respectable household. Deaconesses also carried out “feminine” tasks, including arranging childcare for children of sick parents and teaching sewing skills to girls, in order to present their work as domestic work. On

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the whole, the diaconate succeeded in reconciling its public work with the understanding of a woman’s calling to the household sphere. Particularly in church circles, potential objections to the diaconate’s work were largely alleviated, and the door was open for deaconesses to compete with other specialized institutions and professionals. I have argued that gender was not only an obstacle to be overcome; some employers considered it a valuable asset. Leading sewing circles for poor housewives and mothers, serving as role models for girls in danger of becoming “fallen women,” teaching household skills to girls in elementary schools—employers hired deaconesses to carry out these and similar tasks because this was understood as women’s work. Men would not have been considered qualified to perform these responsibilities, nor would they have been able to work in close proximity with women and young girls in the same way as deaconesses. This overall demand for deaconesses clearly demonstrates that they were not at the mercy of impersonal, secularizing forces. The female diaconate took charge of its own destiny and found ways to become and remain competitive in a context of increasing functional differentiation. It utilized its strengths in appealing to prospective employers, it took advantage of opportunities created by political or social developments, and it found niches in the public sphere not adequately covered by other institutions. The story of the nineteenth-century deaconess movement was therefore largely a success story. But did this success last? Was the twentiethcentury diaconate as adept in adapting to functional differentiation? Or did functional differentiation take its toll on the diaconate in the long run through the rise of the modern welfare state and the state’s wide security net that sought to cover the social needs of all citizens? Functional differentiation did cause more significant problems for the diaconate in the twentieth century than was the case in the nineteenth, but these problems arose primarily in the postwar era. In the first three decades of the century, the diaconate continued to expand its sphere of work and influence. A larger deaconess hospital was built in Stockholm, an affiliate deaconess institution was opened in the Norrland province, and pioneering work among the blind and epileptics was inaugurated. The diaconate increased its involvement in health care and poor relief, and it expanded its social work among prostitutes and troubled youth. Significant challenges to diaconal work, female and male, began with the rise of the Social Democrats and the development of the modern Swedish welfare state in the decades following World War II. For many




leaders in the Social Democratic Party, the diaconate represented the old class society that they believed to be a thing of the past. The party increasingly criticized the participation of religious organizations in nursing and social work and argued that such work was best carried out under government auspices. Some government officials came to the defense of diaconal participation in areas such as welfare, but gone was the much broader support that deaconesses had received from government institutions in the nineteenth century. Functional differentiation at last appeared to be taking its toll as deaconesses found their work in social services, poor relief, and health care increasingly regulated and in some cases taken over by the welfare state. Social Democratic attempts to push religious organizations out of these areas created uncertainty within the diaconate concerning its role in a welfare society, but it managed nonetheless to maintain its involvement in health care and social work. It also modernized its structure and operations to make deaconesses more competitive in the professional marketplace. In the s, the deaconess institution ended its practices of assigning deaconesses to work stations. The sisters were allowed to enter into employment on their own initiative and on terms agreed upon with employers. The institution also abolished the motherhouse system and lifted its restrictions on marriage. These and other measures made diaconal work more attractive, and by the s, applications for admission rose and even exceeded available slots. Today, the Ersta Diaconate Society, the successor of the Swedish Deaconess Society, continues the work of its nineteenth-century predecessors. Ersta Sköndal University College, comprising approximately , students, provides education in the areas of nursing and health care, social work, and church-related disciplines such as theology and church music. Ersta Hospital continues to work in cooperation with the Stockholm municipal government as a major health care provider. The diaconate also operates shelters for abused women and girls, a treatment facility for homeless persons with somatic and psychological illnesses, a nursing home, and a home for persons suffering from dementia. Even in a country with one of the world’s most extensive welfare systems, religious organizations such as the diaconate continue to find ways to perform essential social functions. This is not to minimize the impact of the welfare state on the diaconate in the last fifty years. The diaconate’s involvement in some areas, most prominently in welfare, has largely disappeared. But the diaconate still provides important services in the fields of health care and social work, and it does so in cooperation

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with a variety of civil and ecclesiastical organizations. The welfare state has not eliminated religion’s public role altogether, even if some Social Democrats in the mid-twentieth century hoped this would happen. In the face of the supposedly inevitable, secularizing forces of modernity, the diaconate’s story has been and continues to be one of adaptation, resilience, and survival.

BIBLIOGRAPHY

Primary Sources—Unpublished Ersta Diaconate Society’s Archives Minutes (A) Administrative Board Minutes (AA) Outgoing Correspondence (B) J.C. Bring’s Circular Letters (B ) Application Documents for Deaconess Education (E Va) Documents Arranged by Subject (F) Documents Concerning Ersta’s History (FX) Marie Cedershiöld’s Diary (FX) Miscellaneous Documents (Ö) Preserved Deaconess Documents (Ö III b) Louise Heimbürger’s Notes (Ö III b) Hiring Contracts (Ä) Institutions (Ä I) Childcare (Ä Ia) Health Care (Ä Ib) Social Care (Ä Ic) Parishes and Poor Relief (Ä II) Primary Sources—Published Bring, J.C. “Anmälan.” Olivebladet (), –. ———. “Föredrag.” Olivebladet  (), –. ———. “I Jesu namn.” Olivebladet  (), –. ———. “Något som, enligt skriften, kan anbefalla diakonissverksamheten.” Olivebladet  (), –. Bring, S.L. “Den swenska qwinnans ställning till de andliga rörelserna i wår kyrka.” Olivebladet  (), –. Granqwist, David. “Om behofwet af diakoner i wåra store stadsförsamlingar och därmed sammanhängande frågor.” Olivebladet  (), –. Lövgren, Nils. “Diakonissors anställande för kyrklig kärlekswerksamhet.” Olivebladet  (), –. SDSFU Årsberättelse, –. SDSFU Berättelse och Redovisning, –. Unsigned. “Beriktigande.” Olivebladet  (), –. ———. “Det nya diakonisshusets inwigning.” Olivebladet  (), –.

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———. “Diakonissans kall.” Olivebladet  (), –. ———. “Diakonissanstaltens årsfest.” Olivebladet  (), –. ———. “Diakonissanstaltens femtioårsjubileum.” Olivebladet  (), – . ———. “Diakonisshemmet, d.ä. diakonissanstalten såsom Hem.” Olivebladet  (), –. ———. “Diakonisshuset såsom bildningsanstalt och hem för systrarne.” Olivebladet  (), –. ———. “Diakoniss-saken såsom en Christi församlings sak.” Olivebladet  (), –. ———. “Diakonisswerksamhetens stora uppgift att låta lefwande watten flytta ut i öknen.” Olibebladet  (), –. ———. “En bön.” Olivebladet  (), –. ———. “En församlingsdiakonissas werksamhet i en af hufwudstadens församlingar.” Olivebladet  (), –. ———. “Ett drag ur arbetet för Stockholms fattiga.” Olivebladet  (), –. ———. “Ett gif akt.” Olivebladet  (), –. ———. “Fröken Marie Cederschiöld.” Olivebladet  (), –. ———. “Huru skall kyrkan bäst tillgodose de andliga behofwen hos de lekamliga nödstälda.” Olivebladet  (), –. ———. “Hvad kunna diakonissanstalten och diakonissakens vänner göra för att draga allt flere goda krafter till barmhärtighetens tjänst.” Olivebladet  (), –. ———. “Hwad är diakonissanstalten?” Olivebladet  (), –, –. ———. “Hwad en församlingsdiakonissa uträttar.” Olivebladet  (), –. ———. “Hwad en församlingsdiakonissa uträttar.” Olivebladet  (), –, –. ———. “Hwad göra diakonissorna?” Olivebladet  (), –, –. ———. “Hwarföre mottaga diakonissorna inga gåfwor?” Olivebladet  (), – . ———. “Inwigningen af Diakonissanstaltens sjukhem.” Olivebladet  (), –. ———. “Jag var sjuk och I sökten mig.” Olivebladet  (), –. ———. “Kyrklig fattigwård.” Olivebladet  (), –, –. ———. “Meddelanden från Diakonissanstalten.” Olivebladet  (), –. ———. “Meddelanden från Diakonissanstalten.” Olivebladet  (), –. ———. “Meddelanden från Diakonissanstalten.” Olivebladet  (), –. ———. “Meddelanden från Diakonissanstalten.” Olivebladet  (), –. ———. “Något som, enligt skriften, kan anbefalla diakonissverksamheten.” Olivebladet  (), –. ———. “Några drag ur Svenska Diakonissanstaltens historia, dess uppkomst och utveckling.” Febe (), –. ———. “Några minnen från en resan.” Olivebladet  (), –. ———. “Några upplysningar för dem som vilja bliwfa diakonissor.” Olivebladet  (), –. ———. “Öfversikt öfver de evangeliska diakonissanstalternas utveckling och närvarande ståndpunkt.” Olivebladet  (), –.

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———. “Om det heliga och tjenandet. VI. Diakonissans tjenande.” Olivebladet  (), –. ———. “Om diakonissanstalten i Stockholm.” Olivebladet  (), –. ———. “Om diakonissanstaltens uppgift.” Febe (), –. ———. “Om diakoniss-sakens tillwext de  sista åren (–).” Olivelbadet  (), –. ———. “Om Diakoniss-verksamheten.” Olivebladet  (), –. ———. “Regler för sjukhemmet.” Olivebladet  (), –. ———. “Till församlingsdiakonissorna!” Olivebladet  (), –. ———. “Till wåra prestdötrrar.” Olivebladet  (), –. ———. Untitled. Olivebladet  (), –. ———. Untitled. Olivebladet  (), –. ———. “Ur ett julbref.” Olivebladet  (), –. ———. “Vårt sjukhus.” Olivebladet  (), –. Secondary Sources Åberg, Ingrid. “Revivalism, Philanthropy and Emancipation. Women’s Liberation and Organisation in the Early Nineteenth Century.” Scandinavian Journal of History  (), –. Amundsen, Darrel W. Medicine, Society, and Faith in the Ancient and Medieval Worlds. Baltimore: The Johns Hopkins University Press, . Andersson, Åsa. Ett högt och ädelt kall. Kalltankens betydelse för sjuksköterskeyrkets formering –. Umeå: Institution för historiska studier, . Andrén, Åke. Sveriges kyrkohistoria . Reformationstid. Stockholm: Verbum, . Aquilonius, Klas. Svensk folkskolans historia. Det svenska folkundervisningsväsendet –, vol. . Stockholm: Albert Bonniers, . Åsbrink, Eva. Studier i den svenska kyrkans syn på kvinnans ställning in samhället åren –. Uppsala: Almqvist & Wiksell, . Bäckström, Anders, Jonas Bromander, Anders Carlwe, Peter Forsberg, Helena Särndahl Densloe. För att tjäna. En studie av diakoniuppfattningar hos kyrkliga befattningshavare. Uppsala: Diakonistiftelsen Samariterhemmet, . Barker, Eileen, James A. Beckford, and Karel Dobbelaere, eds. Secularization, Rationalism and Sectarianism: Essays in Honour of Bryan R. Wilson. Oxford: Clarendon Press, . Barton, H. Arnold. “Popular Education in Sweden: Theory and Practice.” In Studies on Voltaire and the Eighteenth Century: Facets of Education in the Eighteenth Century, ed. James A. Leith, –. Oxford: The Voltaire Foundation at the Taylor Institution, . Baumann, Ursula. Protestantismus und Frauenemanzipation in Deutschland  bis . Frankfurt: Campus Verlag, . Berger, Peter. “The Desecularization of the World: A Global Overview.” In The Desecularization of the World: Resurgent Religion and World Politics, ed. Peter Berger, –. Grand Rapids, Mich.: Eerdmans, .

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INDEX Agnestad School,  Åmmeberg Hospital, , –,  Andersson, Åsa, , , ,  Andersson, Maria,  Åström, Anna,  baptism, ,  Baptists, ,  Berger, Peter, ,  Billing, Gottfrid, – Bring, Johan Christoffer (J.C.), , , –, –, , , , – , , , , , , , – views concerning calling of a deaconess, –, –, , – Catholic female religious orders, ,  church-based poor relief, , ,  deaconess participation in non-Lutheran communities, – marriage,  teaching, diaconal involvement in, , –, ,  Bring, Sven Libert (S.L.), ,  Brown, Callum, , – Bruce, Steve, , , – Bugenhagen, Johannes,  Carlheim-Gyllenskjöld, Oscar, , –, ,  Casanova, José, , ,  Castelli, Alma,  Catholicism, , , , –, , n.  See also Saint Elizabeth Sisters Cederschiöld, Marie, –, , , –, , , 

and the Deaconess School for Poor Children, controversy concerning, , –,  Kaiserswerth’s deaconess institution, work at, – celibacy, –, – Chalmers, Thomas,  Charlemagne,  churching,  Claesson, Albertina,  Clarin, Maria, , – Cox, Jeffrey, , –, –, – Danish-German War of ,  Daughters of Charity,  Davie, Grace, – deacon. See Swedish Deacon Society Deaconess School for Poor Children (Stockholm), , , , , , –, , , , ,  Durkheim, Émilie, – Eckerström, Clara, , ,  Ehrenborg, Betty, – elderly home,  Elberfeld system. See poor relief, Elberfeld system Elementary School Law of , , –, –, , –, ,  Elmblad, Emilia, , ,  Elmblad, Per Magnus, ,  Elmund, Gunnel, –, ,  Ersta Diaconate Society. See Swedish Deaconess Society Ersta Hospital, –, ,  Ersta Sköndal University College,  Eskelhem School,  Eucharist, 



index

Falköping Hospital, , – Febe (Phoebe), , ,  Fehr, Fredrik,  Finke, Roger,  Fjellstedt, Peter, ,  Fliedner, Friederike, – Fliedner, Karoline, ,  Fliedner, Theodor, –, , ,  free beds (frisänger), –, ,  French Revolution,  Fry, Elizabeth,  functional differentiation definition of,  funeral,  Gävle Nursing Home,  Gelfgren, Stefan, – General Conference (of deaconess motherhouses),  Göksholm School, ,  Grell, Ole Peter,  Gustafsson, Emma,  Gustav Vasa, King of Sweden,  Gustavsson, Anders,  Hammar, Inger, – Heimbürger, Louise, ,  Hjerner, Emma,  Holmblad, Sofia, ,  Holmdahl, Barbara,  house examinations (husförhör),  household school, , ,  inquirer stage,  Iannaccone, Laurence R.,  Inner Mission, , , , ,  Iverson, Yngve,  Jansdotter, Anna, ,  Jönköping Hospital, ,  Jönsdotter, Carin,  Jonsson, Johanna,  Jütte, Robert,  Kaiserswerth deaconess institution, , –, –, , , 

Ketscher, Augusta,  Köhlbäck School, ,  Kselman, Thomas, , –,  Lambert, Yves,  Lancastrian schools, ,  Larsson, Karna, ,  Larsson, Olle, – Lind, Jenny,  Lindberg, Carter,  literacy, – Ljungberg, Charlotte,  Lönegren, Ernst, –,  Lövgren, Nils, ,  Louis XIV,  Lundgren, Anna,  Lundgren, Johanna,  Luther, Martin, –, ,  Magnusson, Johanna, ,  Malmö Children’s Hospital,  Maria Hospital,  marriage,  Markkola, Pirjo, , ,  Martling, Carl Henrik, –,  McLeod, Hugh, , , , –, ,  Methodists,  motherhouse system overview of, – Nahlavi School,  Napoleonic wars, ,  neo-evangelical revivalism, –, –, , –,  Nightingale, Florence,  Nobel family,  Norrköping Hospital, , ,  nursing and health care in early modern Europe, – and health care in early modern Sweden, –

index deaconess assignments Danish-German War of ,  Ersta Hospital, , , –  hospitals outside the institution, – number of external work stations,  (Table ) nursing home, – polyclinic, ,  private homes, – education in nineteenth-century Sweden, –,  at the Swedish Deaconess Institution, , , – , , ,  See also Red Cross School of Nursing, The; Sophia Home, The. nursing home, , , – Öberg, Hilda, ,  Olivebladet (The Olive Leaf), , , , , , ,  Örebro Hospital,  Örnsköldsvik School,  orphanages, , , , ,  Oscar II, King of Sweden,  Österåker School,  Östling, Johanna, – outpatient clinic. See polyclinic Owen, Robert,  parish deaconesses. See also poor relief, deaconess assignments, outdoor relief. responsibilities of, , –, – Paulsson, Olivia,  Persson, Margaret,  Petersen, Emilie, – Petersen, Johan,  Petersson, Kjell,  Petri, Olaus,  Pettersson, Edla,  polyclinic, , , , , 



poorhouses. See poor relief, deaconess assignments, indoor relief. poor farms. See poor relief, deaconess assignments, indoor relief. poor relief deaconess assignments indoor relief stations, , –  number of external work stations,  (Table ) outdoor relief stations, , – Elberfeld system,  in medieval and early modern Europe, – in medieval and early modern Sweden, – law of , , –, ,  law of , , , –, –, , ,  reform in nineteenth-century Sweden, – probationary stage, – Rappe, Emmy, – rational choice theory,  Roman Catholicism. See Catholicism; Saint Elizabeth Sisters recruitment of deaconesses, –,  Red Cross School of Nursing, The, , , – Reformation, The, , , , , – retention of deaconesses, –,  Roper, Lyndal,  Rosenius, C.O., ,  Ruether, Rosemary Radford,  Sabbatsberg Hospital, , ,  Sahlgrensk Hospital,  Saint Elizabeth Sisters, –, n. 

 Sanders, Hanne, –,  Salton, Emma,  Salvation Army, – secularization definition of, – theory or thesis (overview), – Seraphim Hospital,  Sethlin, Mimmi,  Sieveking, Amalie,  Sisters of Charity,  Sjögren, Sophie,  Sjönnebol School,  Social Democrats, –,  Society for the Preparation of a Deaconess Institution in Stockholm. See Swedish Deaconess Society Söderköping Hospital,  Sommerville, C.J., ,  Sophia Home, The, , , , – Sophia, Queen of Sweden, ,  Stark, Rodney,  Stockholm Public Care Institution,  supply-side theory, see rational choice theory Svensson, Johanna, – Swedish Deacon Society, 

index Swedish Deaconess Society, , – , –, –, , –, , ,  Swedish Mission Covenanters,  Svensson, Maria,  Toll, Emelie,  Torpelund School, ,  uniforms, – Uppsala Akademiska Hospital,  Väse School,  vicarious religion,  Viken School,  Wallin, Charlotta,  Weber, Max,  Westerberg, Mathilda, ,  Wichern, Johannes, , ,  Wiman, Carin,  Wilson, Bryan, , ,  Woodhead, Linda, – workhouses. See poor relief, deaconess assignments, indoor relief. World War II,  Zetterström, Ebba, 

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Responding to Secularization: The Deaconess Movement in Nineteenth-Century Sweden

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Adventure Guide to Sweden

The Secularization of the European Mind in the Nineteenth Century

What went wrong in Sweden?

Responding To Gangs: Evaluation And Research

Understanding and Responding to Multiple Environmental Stresses

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Secularization and Its Discontents

The Symbolist Movement in Literature

The Environmental Movement in Ireland

The Naxalite Movement in India

The Workers' Movement in Russia

Responding to Money Laundering: International Perspectives

Responding to Diversity in Schools: An Inquiry-Based Approach

Responding to International Crime (International Studies in Human Rights)

The Secularization of the European Mind in the Nineteenth Century

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