Nils Rosén von Rosenstein and neonatal jaundice in the 18th century

Abstract Background: Nils Rosén von Rosenstein (1706–1773) was a Swedish nobleman and a professor at Uppsala University. His series of lectures on children's diseases and their treatment was published in 1764 under the title Underrättelser om Barn‐Sjukdomar och Deras Bote‐Medel . Materials and methods: Rosén von Rosenstein's book was translated into several languages. The present paper deals with the opinions and advice proffered on the jaundiced neonate in chapter 25 of the Danish edition from 1769. Results: The distinction between jaundice in the neonate and jaundice in older children is not clear everywhere in the chapter, and much of Rosén von Rosenstein's advice on therapy appears to be intended for all age groups. Rosén von Rosenstein believed that neonatal jaundice was less common in Sweden than elsewhere, and ascribed this to the common practice of purging newborns with a manna sugar laxative. The principal cause of jaundice, according to Rosén von Rosenstein, was bile stasis. When milk curdled in the stomach, the curds could plug the common bile duct, and bile would be forced into the lymphatics and from there into the blood. Thus, the bile was carried around the body and caused the skin and the sclera, as well as other organs, to become yellow. Cure was usually easy—a laxative in the form of puréed manna with powdered rhubarb was what Rosén von Rosenstein recommended. Conclusion: Rosén von Rosenstein's opinions and advice concerning neonatal jaundice were not original, and did not differ from those found in other medical texts from the 18th and 19th centuries. The bile stasis explanation for all kinds of jaundice, including neonatal jaundice, was widely held in the 18th century, and continued to predominate in paediatric texts until the end of the 19th century. Similarly, laxatives and enemas as the cure‐all for many ailments held sway until the late 1800s.