Morten A. Skydsgaard, Ole Bang og en Brydningstid i Dansk Medicin (Århus: Aarhus Universitetsforlag, 2006), pp. 333, Kr348.00, paperback, ISBN: 87-7934-228-0.

Abstract

Morten Skydsgaard’s biography of the Danish physician Ole Bang (1788–1877) is an informative and important book about a period of transition in nineteenth-century Danish medicine. Bang held several of the most significant posts available to physicians in Denmark. He was a professor at the university of Copenhagen, and he was the chief physician at the largest hospital in the capital, Frederik’s Hospital. Among the prominent patients in Bang’s lucrative private practice were the Danish and Russian royal families. Throughout his career he advocated a medicine grounded on careful observation at the bedside. He reformed medical education, putting clinical teaching into practice at the medical faculty. His methods of treatment became influential among Danish medical practitioners, and he was famous for his clinical skills. Bang was also engaged in health politics, and played an important role in the formation of a common curriculum for surgeons and physicians, thus putting an end to a long rivalry between the medical faculty and the surgical academy. During his long and active professional life (he retired in 1874, aged eighty-six), Bang was respected and recognised as one of Denmark’s leading medical figures. However, soon after his death he was branded a reactionary and accused of opposing new ideas, thereby hampering progress in Danish medicine—a view which has been generally accepted in Danish historiography until now. In this carefully researched book a more complicated picture is painted. Skydsgaard confirms that Bang remained faithful throughout his life to the Hippocratic doctrine of vis medicatrix nature, or the healing powers of nature. He believed that the organism did not accept disease passively but counteracted it by trying to rectify the disturbed equilibrium. Nature was, therefore, the best physician, but the human physician could help nature to fulfil its goal by removing obstacles to its action, thus assisting in the organism’s own attempt to recover. Bang employed traditional remedies like purgatives, emetics, diapnoic drugs, sialagogues and bloodletting. However, as Skydsgaard shows, he also participated fully in the new medical debates, and, early in his career particularly, he was a proponent of change in many areas. He introduced the stethoscope to Denmark, and studied in the French style pathological changes of the bowels during typhoid fever. He also engaged in medical meteorology, trying to generate new knowledge about epidemics based on an analysis of meteorological data. Furthermore, he advocated the use of statistics in medicine, and regularly published data on morbidity and mortality from Frederik’s Hospital. Later in life, however, he became sceptical of the increasing technicality of medicine, which, he held, distanced the physician from the patient. Consequently Bang found himself in opposition to younger colleagues, who emphasised the importance of autopsies, microscopy and animal experiments. For him, medicine was centred on the individual, carefully tailored to each patient, whereas for younger doctors objectivity and regularity took precedence over the individual. The most interesting chapter is that in which Skydsgaard analyses this period of change in Danish medicine by looking at how various physicians worked with one single disease—typhoid. He demonstrates well that new and, in retrospect, ‘correct’ ideas do not spread without friction. Also, it allows him to compare treatment methods. Bang’s younger colleagues, more favourably received in Danish historiography due to their introduction of ‘modern’ methods such as microscopy and laboratory tests, basically treated typhoid fever no differently than did Bang himself. Nevertheless, while overall this is a well-constructed and interesting piece of research work, it is not without its flaws. Perhaps most importantly, Skydsgaard’s selection of sources is too limited. He has studied published articles and books, as well as newspapers and letters from the period, but omitted hospital records. It is difficult to understand why this vital primary source of therapeutic data is ignored, and second- and third-hand descriptions of such treatment used instead. Additionally, Skydsgaard is not very comfortable or convincing when it comes to medical philosophy. His discussions of nosology and diagnostics are confusing, perhaps owing to insufficient knowledge of the important change from medical semiotics to medical diagnostics in the early nineteenth century. Finally, this is very much a book about Denmark, and, if more of Bang’s professional life had been placed in an international context, the work would have gained from a wider view. But, despite these flaws, there is no doubt that Skydsgaard has written a well-researched book about this interesting period in Danish medicine.