b.25 July 1890 d.3 April 1986
MedLicStockholm(1918) MD(1927) *FRCP(1970)
Nanna Svartz was born in Vasteras, a provincial city west of Stockholm. At that time this city made no provision for educating girls to university entrance standard. However, young Nanna had made up her mind to study medicine and she went to Stockholm (later her family followed in order to support her), where she passed her university entrance examination in 1910 and immediately began her medical studies at the Karolinska Institute. She qualified in 1918 and commenced her hospital career in internal medicine at the Seraphimer Hospital, the old University Hospital in downtown Stockholm. After gaining her MD in 1927 she was appointed assistant professor of medicine. Ten years later she became a full professor of internal medicine at the Karolinska Institute, and chairman of the department of medicine at the Seraphimer Hospital. In 1940 she was transfered to the new Karolinska Hospital, where she was chairman of medicine until her retirement in 1957.
During the latter period she created a new department of rheumatology at the hospital and contributed in a major way to the establishment of the King Gustav Vth Research Institute, built within the grounds of the Karolinska Hospital with money collected in Sweden to celebrate the King’s 80th birthday. Nanna was appointed the first head of the Institute - a position she held for some time after her official retirement from the academic chair. She continued to work in her laboratory until a few years before her death; up to 25 years after her retirement.
At an early stage in her career, two apparently unrelated areas of medicine caught her interest and remained major fields of activity throughout her long life: ulcerative colitis and rheumatoid arthritis. Her MD thesis had dealt with intestinal bacteria and had stimulated her interest in ulcerative colitis. She early understood the importance of good nutrition for patients suffering from this condition; on arrival in hospital they were often found to be suffering from near starvation. And in rheumatology she began to define and purify the rheumatoid factor; by surprisingly simple methods, such as euglobulin precipitation in distilled water, she achieved a major step in the process of purification. She also developed a sheep cell agglutination test for the determination of the factor in patient sera.
Perhaps her most important contribution was the creation of a link between her two fields of research: the sulphonamides had been introduced towards the end of the 1930s and Nanna Svartz decided to try and combine a sulphonamide with acetylsalicylic acid which, until that time, had been almost the only effective drug against rheumatic disease. The result was azulfidine (‘Salazopyrin’): sulphapyridine linked to acetylsalicylic acid by an azo bond. Nanna had planned this new drug specifically for the treatment of rheumatoid arthritis ( at that time called primary chronic polyarthritis), but she found that the granulated tissue in ulcerative colitis had definite similarities to that in rheumatoid arthritis and decided to try the drug on patients with ulcerative colitis - with immediate effect. This was before the steroid era and Nanna Svartz used ‘Salazopyrin’ for treatment of the active stage of the disease. Almost 50 years later it is being used all over the world, mainly to prevent recurrence of the colitis, with excellent results. But the link has not been broken, there is renewed interest in ‘Salazopyrin’ as an immunosupressive drug also in rheumatoid arthritis - especially in the UK.
Nanna combined her hospital work with private practice; she took very good care of all her patients and they all loved her. She also received very substantial financial support for her continuing research.
Nanna was an excellent clinician. I trained with her during my first years in hospital medicine and learned much; a knowledge that many years later I tried to pass on to my students when I myself became chairman of medicine at the Karolinska. She loved to travel and even in old age she liked to take part in international meetings as an active participant, often submitting papers. She was also active in the creation of the International Society for Internal Medicine.
Nanna was not the first woman doctor in Sweden; when she began her career there were a score already in practice. But she was the first woman within any university faculty to be appointed a full professor - after evaluation by an official Faculty Committee, according to the Swedish system, followed by appointment by the King. She was very proud of this fact, and rightly so. Nowadays there are many women professors within medicine but even today there are very few women who head large departments of internal medicine.
Nanna Svartz loved her work - and she loved working. She published a very large number of scientific papers. I well remember how she used to arrive at the hospital in the morning with a bunch of official documents under her arm, stating that she had read them all in bed during the night. She repeatedly said that she knew nothing better than work; that science, which reveals the truth step by step, was more exciting than the theatre, and that clinical work was always an adventure.
Nanna’s long and very active life is now over; her contribution to medicine was made so long ago that there are many today who do not know who she was. Those who had the good fortune to work with her will always remember her with gratitude and admiration.
Sir Gordon Wolstenholme
(Volume VIII, page 488)
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