The winter of 1851 was not a good time for the new doctor in Vemdalen, Johan Ellmin. He did not only have to adjust to life in a new environment, he also found his sleep disturbed. One night during Easter, he heard noise from the yard at the farm where he rented a room. A group of youngsters were trying to convince the young farm maid to leave the farm and come with them, and Ellmin soon found himself in a dispute with the intruders. This was neither the first nor the last time this happened, nor was it the only problem the doctor had to face. Placed in an unfamiliar and unfriendly environment, far away from family, friends and colleagues, it was perhaps not surprising that he was often ill at ease.

This article uses the experiences of Dr Johan Ellmin in the district of Härjedalen, Sweden, to shed light on some major themes of nineteenth-century medicine. By discussing how the health-care system was spread throughout Sweden, as well as outlining the obligations of provinsialläkare (district medical officers),1 this text relates the activities of one doctor serving in a remote area to the development of medicine and medical organization in a significant historical period. The main sources used here are the reports that Ellmin sent to the Sundhetskollegium (National Board of Health) from 1851 to 1859.