In Search of a Cure: The Patients of the Ghent Homoeopathic Physician Gustave A. Van den Berghe (1837–1902) (review)

Sometimes a historian gets lucky. This happened to Anne Hilde van Baal, who was offered the casebooks of the nineteenth-century homoeopathic physician Gustave Van den Berghe, who had practiced in Ghent, Belgium. The casebooks had been in the family since he died in 1902, and his great-grandson decided that they might be of value for scientific research. Van Baal gratefully decided to use the rich material for a book on patient experiences in the nineteenth century.

She begins by painting the background of medical practice in Belgium. Formally, there was a monopoly of treatment for orthodox physicians. In practice, however, there was a range of healing options, among them homoeopathy. Homoeopathy did not have an academic or legal status, but practioners tried to realize and organize by establishing a society (Société Belge d’Homoeopathie), a journal (Revue Homoeopathique Belge), and some twenty dispensaries throughout the country. Around 1856, Van den Berghe started studying medicine in Louvain, graduating in Brussels in 1863. Somewhere along the way, his “conversion” must have taken place. Shortly after settling down as a general practitioner in Ghent, he decided to devote his professional career to homoeopathy. Fully convinced of its merits, he continued experiments all his life and even published a handbook in 1881: De homoeopathie en hare tegenstrevers (Homoeopathy and Its Adversaries), the only one available in Dutch in bilingual Belgium. Between 1869 (the year of the first casebook) and 1902 (when Van den Berghe died), there were four to five homoeopaths in Ghent (a.k.a. “Manchester of the Continent”), while the number of “allopaths” in town increased from 86 to 135 (and the population from 107,000 to more than 160,000).

Although Van den Berghe played a key role in the establishment of homoeopathy in Belgium, the focus of van Baal’s book is not on homoeopathy but, rather, on patients, who happen to have left traces in the casebooks of a homoeopathic physician. The casebooks are instrumental in opening up a window on nineteenth-century medical practice in general. Van Baal decided to analyze the thousands of cases at her disposal in two complementary ways, using statistics and close reading. Thus, she was able to approach Van den Berghe’s patients both as a collective and as individuals. From her statistical analysis, it becomes clear that Van den Berghe’s clientele consisted of a cross-section of Ghent society (even though the number of female and lower-class patients increased when the century drew to an end). From the individual stories, it emerges that patients were truly “shopping around on the medical marketplace,” and that the choice of homoeopathy was hardly an ideological one (either in opposition to “orthodox” medicine or in favor of “alternative” medicine). Ghent sufferers did not opt for homoeopathy because of its supposed “holistic” qualities but simply because they wanted to try anything and everything, moving on to another healer or therapy as they saw fit. As a consequence, compliance was low, as was loyalty to Van den Berghe. The only motive to make patients stay was financial. As van Baal argues, free treatment of the poor was both a strategy for Van den Berghe to create a professional niche for himself and a motive for the poor to keep visiting him.

Apart from that, establishing motives for consultation does not seem relevant. The prevailing image is one of patient autonomy. Even around 1900, the clinical encounter remained patient dominated. This is an important amendment of the well-known thesis put forward by Nicolas Jewson, who suggested that “the disappearance of the sick from medical cosmology” took place many decades before Van den Berghe’s era.