[1] Lagerlöf was commissioned to write it by a Swedish association as a means of public education about tuberculosis ("consumption").
Edith, a young "Slum Sister" (social worker) in the service of the Salvation Army is on her death bed dying of "consumption" (tuberculosis).
A year earlier, he was the first patron of the newly opened social welfare house that Edith had founded.
After more drinking, David gets into a fight with his companions, is hit in the chest and suffers a hemorrhage (a complication of TB) and falls lifeless to the ground.
The brother regrets that he has failed to fulfill a promise he once made to a sick child to see the ocean.
Selma Lagerlöf was commissioned by a Swedish association to write an essay on tuberculosis ("consumption") and its control.
More so than in her earlier works, she deals with concrete social ills of the day – alcoholism, domestic violence.
Her experiences of social deprivation as a young teacher in the southern Swedish town of Landskrona help inform the novel.
However far from a novel of social realism, her characters take on mythic qualities, David Holm is a personification of evil.
In a letter to Sophie Elkan, Selma Lagerlöf wrote that in the evening, when she was alone in her room working on the novel, she sometimes had the feeling that only a thin curtain separated her from the other world.