The Huskvarna Drug

Recently while reading Mats Keyet's 2000 biography of Swedish beat novelist Sture Dahlström, I came across the sad story of the Huskvarna drug. It killed Dahlström's father and many others.

In 1961 Dr. Hjorton's powder was made a prescription drug. This measure was of no great consequence anywhere except in Huskvarna, a small single-company industrial town on Lake Vättern. To Americans, it's probably mostly known for the old Husqvarna motor bike brand. In the mid-1950s the company doctor realised that Dr. Hjorton's powder was not only dependency-forming but in fact caused lethal kidney damage when taken too often and for too long. Workers at the Huskvarna factory had been taking it regularly even when not ill. They were in fact chemically dependent on a lethal drug. But outside of Huskvarna, few had even heard of Dr. Hjorton or his drug. What had happened here?

The powder was no patent medicine: its composition was known and it was made at the local druggist's. The ingredients of a dose were:

• A pain killer and fever reducer: 500 mg phenacetin (Now known to cause cancer and kidney damage)
• Another pain killer and fever reducer: 500 mg phenazone
• A stimulant: 100 mg caffeine

Herman Hjorton opened his medical practice in Huskvarna in 1903, the year of his graduation and the year when the gun factory expanded into motorcycles. He was 34 and had sensed an opportunity in the expansive little town. Hjorton was the town's first doctor and he soon got a reputation for diligence, compassion and approachability, making house calls at all hours. In 1906 a drug store opened in Huskvarna and Hjorton moved his home and practice to the same building.

In 1918 the Spanish flu pandemic struck: an aggressive influenza that often caused lethal pneumonia, particularly in young and strong people. Medicine at the time had no antiviral drugs (we still don't for flu) and the first antibiotics were hard to come by after WW1, so there was not much a doctor could do for the sufferers. Except for the fever, and the muscle pain that was a common symptom of the viral infection. Dr. Hjorton could treat those. And so he came up with his formula, which actually seemed to help.

Hjorton's 50th birthday party in 1919 was a huge event for the town, whose inhabitants saw him as a hero. When he died of a heart attack four years later, the whole district was rocked by grief and he was given the biggest funeral in Huskvarna's history. He had been cycling to a patient when his heart gave out. But though the Doctor was dead, his formula lived on and the sales continued to increase.

Sales increased though the pandemic was over? People were no longer taking it as a flu remedy. They took it as a stimulant. Everybody knew about the powder after the pandemic, and since it wasn't a prescription drug no doctor needed be involved when you bought it at the drug store. Nor was there any limit to how much you could buy. Many working class families took Hjorton's powder every morning. Factory workers found that the powder made them faster, stronger, less tired and free of pain. This improved their earnings: in the 1920s performance-related pay became common. They took the powder at work, offering each other a baggie of Dr. Hjorton's like workers elsewhere would share cigarettes or snuff. The medical establishment didn't react other than to call it a bad habit. And Dr. Hjorton himself had become a silent authority.

During WW2 phenacetin became rationed and Huskvarna's inhabitants had to mail-order the powder from drug stores all around Sweden. Their use of it peaked in the 1950s, when one Huskvarna drug store sold 8000 baggies a day. The company that made the baggies was told that a million of them would only last for three months in that drug store. And for some reason, the town's workers were dying young of kidney failure.

Indirectly, the Huskvarna drug decades ended thanks to the labour union. It was making a general demand that major factories employ doctors, and so, in the early 50s when the drug use was approaching its peak, Kurt Grimlund was hired as company doctor. He came from the neighbouring town of Jönköping where he had already seen an unusual number of kidney failure cases. In 1953, Swiss researchers published a study documenting a link between phenacetin use and kidney damage. Phenacetin was a widely prescribed drug, and so the study sparked intensive international research, some of which Grimlund performed in Jönköping. As a result phenacetin became a controlled substance in Sweden in 1961, and in 1983 it was taken off the list of legal drugs entirely.

But what about the Huskvarna substance abusers after 1961? No doctor would prescribe anywhere near the amount of Dr. Hjorton's that they were used to taking. They were recommended Koffazon powder instead and seemed quite happy with it. It probably helped that Grimlund had run an information campaign about phenacetin and early death at the factory in the mid-50s. Koffazon is still an over-the-counter drug in Sweden. It's Dr. Hjorton's powder minus the phenacetin.

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This blog entry is based on C. Andersson 2009, Sippan som hjälpte mot allt. En studie runt det omfattande bruket av Dr Hjortons pulver som ägde rum i staden Huskvarna och på fabriken Husqvarna AB, BA thesis, Jönköping University College. She refers repeatedly to K. Grimlund 1963, “Phenacetin and renal damage at a Swedish factory”, Acta Medica Scandinavica, Stockholm. Andersson's maternal grandfather died young from kidney failure in Huskvarna.