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Paul Ferdinand Gachet was a general practitioner with a training in mental ailments. His thesis (1858) entitled Étude sur la Mélancholia contained principles for the moral treatment of the insane. Gachet’s system of therapy for melancholies was based on three principles, admission to hospital, therapeutic activities, and psychological support. For physical therapy Gachet allowed the use of warm baths to calm anxious patients. He strongly condemned the prevalent use of phlebotomy and purgation.
Gachet looked after Van Gogh during the painter’s last two months of life in Auvers-sur-Oise in 1880.1 He was an early supporter of the impressionists and a painter and engraver of considerable talents himself. He was intrigued by the creative mind. His campaign for the establishment of a Society for Mutual Autopsy in which artists would leave their brains for postmortem study to evaluate artistic ability and elucidate the process for creativity met with little enthusiasm. Renoir was one who resisted that invitation. Paul Gachet’s medical records pertaining to Van Gogh have not been found. Gachet had spoken with Theo Van Gogh before seeing Vincent. Theo, in a letter to Vincent, relayed the news that “When I told him how your crisis came about he said to me that he didn’t believe it had anything to do with madness and that if it was what he thought he could guarantee your recovery, but that it was necessary to see you and to speak with you in order to make a more definitive statement”.
There is anecdotal evidence that Gachet considered that Van Gogh had been overexposed to turpentine vapour, and that painting for long hours in the sun contributed to his illness. There are many views on the nature of Van Gogh’s illness. Gachet seems to have considered it as more akin to epilepsy without convulsions complicated by periods of depression. He was not convinced that Vincent had pure insanity. Two months after becoming a patient of Dr Gachet, in the late Sunday afternoon of 27 July 1890, Van Gogh shot himself in the chest with a revolver. Dr Gachet found that the bullet had been deflected by the fifth rib. He died on 28 July about 1 30 am. Gachet persuaded the village priest to make an exception and allow this victim of suicide to be buried in the cemetery, not far from the artist’s “vast fields of wheat”. Dr Gachet had firm views about psychiatric illness. In a letter to the editor of Le Figaro (18 August 1859) Gachet condemned a previous article claiming mental illness to be contagious pointing out the obvious that if this was true, an epidemic of insanity should have occurred years earlier among the employees of the Salpetiere. In 1875 through the pages of a popular health annual read by a large audience, Dr Gachet proclaimed, contrary to widely held opinion, that insanity was curable. He attacked the law of 1838 which allowed almost unregulated confinement of the mentally ill and concluded by suggesting that the public should divest themselves of the idea that mental illness “is an exaggeration or a deviation of intelligence and that people who are taxed with originality are monomaniacs and are insane”.
In 1990 Antigua published a set of stamps to commemorate the centenary of the death of Vincent van Gogh. Among these is Van Gogh’s portrait of Dr Gachet (Stanley Gibbons 1517, Scott 1426) painted in two days in June 1880. The painting hangs in the Musee D’Orsay in Paris.
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