This study is regionally demarcated to two West Swedish islands, examining how state-employed district physicians, along with pharmacists and trained midwives, became established in rural Sweden in the nineteenth century. Up until the early nineteenth century state physicians, pharmacies, and midwives had only been found in the towns. When doctors, along with pharmacists and midwives, were stationed in the countryside, they had to bring about a cultural change. This meant that they had to gain the confidence of the rural population and replace the unqualified folk healers, or initially at least provide an alternative to them. It is this process of cultural adaptation that this essay concentrates on. It is a study of encounters between qualified and unqualified healers. An important question is how the rural population handled and perceived different illness situations. This requires studying both those who had the task of delivering health care, whether they were trained or not, and those who received the care, that is, the country people. The development was thus that what doctors called quackery was widespread in the middle of the nineteenth century but had almost ceased by the end of the 1890s. That is how long it took for the doctors to gain the confidence of the common people through their efforts and their enlightenment. They could then be consulted as a rule in cases of illness, thus largely taking the place of folk healers. This radical cultural change had parallels in Norway.
Keywords: public health care, folk healing, qualified midwives, cultural adaptation, district physicians, pharmacy, epidemics