Ärztliche Praxis (Medical Practice) grew out of Dr Marion Baschin’s doctoral research, and is No. 52 in a series of treatises on ‘Medicine, Society and History’ issued by the Institute for the History of Medicine at the Robert Bosch Stiftung (Institute) in Stuttgart. Dr Baschin seeks to document and contextualise the everyday practice of a homeopathic physician in the northwestern German city of Münster during the latter years of the nineteenth century. Dr Bönninghausen left behind close to 7,000 patient records, now located in the library of the Bosch Stiftung, a major centre for research on the history of homeopathy. Baschin’s analysis of this material is supplemented by background on Bönninghausen’s place within the homeopathic tradition and the relation of his practice to the pluralistic medical world of Münster. Homeopathy arose as a critique of the mainstream medicine (‘Schulmedizin’) of its day. Samuel Hahnemann (1755–1843), the founder of the movement, believed the sources of illness to lie in dynamic imbalances within the body–mind system, to restore which he applied the principle ‘similia similibus curantur’—that disorder can be addressed with highly diluted doses of natural medicinals that, in full strength, produce symptoms akin to those of the disease itself. Hahnemann’s approach was empirical, experimental, holistic and patient-centred. Bönninghausen’s father, Clemens, was a lay homeopath in that tradition. At university, Friedrich first read Law, but changed over to Medicine and received a regular medical degree in 1862; but he returned to homeopathy upon taking over his father’s practice in 1864, and for a time had that market all to himself. He was not socially prominent and, save for a dissertation on diabetes preparatory to receiving his medical degree, left little of a paper trail save his case records themselves; nor was he active in local medical organisations or the homeopathic Central Verein (Union). Bönninghausen’s frustrating invisibility as a person is counterbalanced by the sociological and historical background that Baschin provides. She believes that Friedrich was guided by his father’s methods for recording data and tracking the progress of his patients by means of a journal. Following Hahnemann, Clemens Bönninghausen believed a journal to be indispensible ‘for every true homeopathic physician’ (p.53); only by this means can the total picture be grasped and appropriate treatment provided over the course of the illness. Although he left no journal as such, Friedrich’s summary notes allow Baschin to extract information on his patients that she analyses in terms of sex, age, position in the family, class, profession, etc. She examines what brought Bönninghausen’s patients to him, who they were, what they complained of, where they lived, what they sought from him in comparison to the other available options, and what he did about it. This trove of material is so considerable that she isolated several periods on which to focus her attention, beginning with the 1864–67 series and concluding with 1879–82. Her analysis is accompanied by summary graphs in the text and fuller data in the appendices. Baschin shows that Münster was well supplied with hospitals, physicians, surgeons, midwives, apothecaries, bonesetters and a variety of lay-healers, but, then as now, self-medication was often the first recourse. Bönninghausen was officially qualified to treat wounds and assist in childbirth; nevertheless, given the crowded nature of the local ‘medical marketplace’, homeopathy was Friedrich’s distinctive niche and he stuck to it. His patients were self-referred and approximately 60 per cent female. For both sexes the ages of the majority of his clients fell approximately between 20 and 55 years. Perhaps they were already aware of the homeopathic critique of mainstream medicine, but it seems that they turned to it more as a complementary than an alternative practice. Women were more likely to make return visits than men. These patients were of the middling sort; farmers, tradespeople and industrial workers were well represented. Likewise it was possible to follow the medical histories of specific patients from their first encounter with Bönninghausen to their disappearance from his records. Beyond a few general categories, symptoms did not vary widely among patients and neither did the still familiar homeopathic medicines prescribed to treat them—substances such as belladonna (deadly nightshade) for coughs, ‘nux vomica’ for gastric and other upsets (from a strychnine-containing nut), and pulsatilla (from the pasque flower) for a wide range of conditions. Baschin has thus situated her findings in relation to the homeopathic tradition, the history of Münster, its social structure and the activities of other local practitioners. Like other works in this series, her goal is not to document the extraordinary but to recover the everyday realities of medical practice at the time. © The Author(s) 2018. Published by Oxford University Press on behalf of the Society for the Social History of Medicine. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices)
Social History of Medicine – Oxford University Press
Published: Aug 1, 2018
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