Pregnancy and pathology: Picturing childbirth in eighteenth-century obstetric atlases

Art Bulletin

Volumn 87, Issue 1, 2005, Pages 73-91

  Massey, Lyle ^a  

^a NORTHWESTERN UNIVERSITY   (United States)

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[No Author keywords available]

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EID: 60950625772     PISSN: 00043079     EISSN: None     Source Type: Journal    
DOI: 10.1080/00043079.2005.10786229     Document Type: Article

References (56)

1. As Lisa Forman Cody has rightly noted, the public-private distinction breaks down when the situation of early modern midwives is taken into consideration. But, as she also points out, men-midwives succeeded in supplanting midwives by redefining pregnancy and birth as public spectacles. This article expands on Cody's thesis by examining one of the primary means through which parturition became spectacularized. See Lisa Forman Cody, "The Politics of Reproduction: From Midwives' Alternative Public Sphere to the Public Spectacle of Man Midwifery," Eighteenth-Century Studies 32, no. 4 (1999): 477-05
2. Michel Foucault, The Birth of the Clinic: An Archaeology of Medical Perception, trans. A. M. Sheridan Smith (reprint; New York: Vintage Books, 1975)
3. Many of her initial findings have been updated, expanded, and complicated in Robbie E. Davis-Floyd and Carolyn F. Sargent, eds., Childbirth and Authoritative Knowledge: Cross-Cultural Perspectives (Berkeley: University of California Press, 1997)
4. For a detailed discussion of how class and ethnicity figure in American practices of childbirth Ellen Lazarus, "What Do Women Want? Issues of Choice, Control, and Class in American Pregnancy and Childbirth," in Davis-Floyd and Sargent, Childbirth and Authoritative Knowledge, chap. 5
5. A National Center for Health Statistics (NCHS) 1999 report for the Center for Disease Control stated that the rate of midwives attending births either at home or in the hospital in the United States slowly increased throughout the 1990s. By 1997, 7 percent of all births in the United States were attended by midwives. Sally C. Curtin and Melissa M. Park, "Trends in the Attendant, Place and Timing of Births, and in the Use of Obstetric Interventions: United States, 1989-97," 1999, NCHS, http://www.cdc.gov/nchs. However, in 2002, the National Center for Health Statistics reported that the performance of cesarean sections in the United States had reached a record high of 26.1 percent of all births. NCHS, http:/www.cdc.gov/nchs/releases/03news/lowbirth. htm. This report has stirred controversy, and there has been a flurry of articles in international newspapers and medical journals over "elective" cesareans and the physicians who may or may not provide them
6. See Adrian Wilson, The Making of Man-Midwifery: Childbirth in England, 1660-1770 (Cambridge, Mass.: Harvard University Press, 1995), 50-53
7. In 1733 Edmund Chapman published in London the first description of forceps and provided information as to their use in Essay on the Improvement of Midwifery, Chiefly with Regard to the Operation. He included illustrations in an expanded edition in 1735. Forceps were invented and had been used nearly a century earlier by the Chamberlens, a family of surgeons and physicians. Members of this family claimed they had possession of a "secret" method to deliver difficult births. In 1687 Hugh Chamberlen I petitioned the College of Physicians in London to receive a patent for an unspecified aid related to midwifery. It is likely that the patent was for forceps. It was not until 1732, after the family had died out, that the forceps was finally described in print and became widely available. However, there is evidence that all the instruments invented by the Chamberlens, including the forceps, were sold by the family to other male practitioners long before the Chamberlens died out. In addition, the Chamberlens seem to have sold the forceps and other instruments to some French surgeons between 1710 and 1720. The French had instituted a salle des accouchements in the Hôtel-Dieu in Paris in which surgeons and midwives were trained. The forceps was introduced in this setting and students trained there to use it. In fact, a number of later English and Scottish practioners were trained at the Hôtel-Dieu and learned forceps methods there. See Wilson, Making of Man-Midwifery, 54-56
8. For an example of this type of argument W. Radcliffe, Milestones in Midwifery (Bristol: Wright, 1967), 30
9. Wilson's statistics are based on diaries kept by men-midwives such as William Smellie and William Giffard in urban and rural England. These accounts focus largely on problematic births, but Wilson then contrasts them to a 1781 publication by Robert Bland, "Some Calculations . . . Taken from the Midwifery Reports of Westminster General Dispensory," Philosophical Transactions of the Royal Society 71, part 1, no. 22 (1781): 35-72. Bland gave a detailed analysis of 1,897 births at the Westminster General Dispensary, most delivered by midwives, and his cases offer a cross section of normal and pathological births
10. Manningham was knighted in 1721. Thirteen years earlier, David Hamilton had been the first man knighted for midwifery. See Judith Schneid Lewis, In the Family Way: Childbearing in the British Aristocracy, 1760-1860 (New Brunswick, N.J.: Rutgers University Press, 1986), 87
11. M. C. Versluysen, "Midwives, Medical Men, and 'Poor Women Labouring with Child': Lying-in Hospitals in Eighteenth Century London," in Women, Health and Reproduction, ed. H. Roberts (London: Routledge, 1981), 18-49. The forceps thesis also does not account for why the situation on the Continent, especially in France, was very different from that in Britain. In France, there had already been a long tradition of very public, celebrated midwives who were recognized as authorities and who published highly regarded treatises on midwifery. For instance, Louise Bourgeois (1564-1636) was royal midwife to Marie de Médicis and authored an important manual on midwifery. In 1759 Louis XV appointed Mme du Coudray to provide instruction for midwives all over France, which she did for more than twenty years (from 1760 to 1783). She also published an obstetric manual for midwives. Before the turn of the nineteenth century, midwives had more public authority in France than they did in England, in part because they received royal recognition but also because they were appointed to serve in visible, public capacities
12. Specialization, rather than general practice in medicine, carried the mark of low status in early Renaissance Europe. This was particularly true of midwifery or obstetrics, although gynecology was often included among the skills offered by physicians of higher status. See Nancy Siraisi, Medieval and Early Renaissance Medicine (Chicago: University of Chicago Press, 1990), 38
13. Anthony Carlisle, Lancet, March 17, 1827, 768-69. Carlisle was responding to the newly formed Obstetric Society
14. Schneid Lewis, In the Family Way, 87
15. Francis Foster, Thoughts on the Times, but Chiefly on the Profligacy of Our Women, and it's causes. . . . (London, 1779), 79. Foster condemned man-midwifery on moral grounds, but he did not condemn the practice of calling in surgeons for extremely problematic cases. He seemed intent on rebutting the growing practice of having men-midwives attend normal births. Nevertheless, he also attacked the brutality of surgeons, citing William Smellie's detailed case studies as examples of the violence that the surgeon's tools (that is, forceps) do to women in labor
16. Although it is beyond the scope of the present essay to discuss Vesalius's frontispiece, it is of particular salience because the cadaver he dissects is female. Katharine Park argues that Vesalius chose to show himself with a female corpse because as an anatomist he claimed a better understanding of women's secrets than the tradition of books written about women and midwifery, and because the dissection of the female body was an analogy for the anatomist giving birth to the new science of anatomy. Park, "Dissecting the Female Body," in Crossing Boundaries: Attending to Early Modern Women, ed. Jane Donaworth and Adele Seeff (Newark, Del.: University of Delaware Press, 2000), 39-40
17. The clearest version of Moschion is found in a ninth-century manuscript, MS 3714, in the Royal Library, Brussels. For discussions of Moschion's version of Soranus Owsei Temkin's introduction to Soranus' Gynecology, trans. Temkin (Baltimore: Johns Hopkins University Press, 1956)
18. Ludwig Choulant, History and Bibliography of Anatomical Illustration, trans. Mortimer Frank (1852; New York: Schuman, 1945), 73-75
19. and K. B. Roberts and J. D. W. Tomlinson, The Fabric of the Body: European Traditions of Anatomical Illustration (Oxford: Clarendon Press, 1992), 15
20. Eucharis Rösslin, When Midwifery Became the Male Physician's Province: The Sixteenth Century Handbook "The Rose Garden for Pregnant Women and Midwives," Newly Englished, trans. Wendy Arons (Jefferson, N.C.: McFarland, 1994), 2-3
21. Arons, When Midwifery Became the Male Physician's Province, 4, cites Ricarda Sherzer and Merry Wiesner as feminist historians who have argued that late medieval midwifery was a highly evolved and valued skill, particularly in parts of Germany
22. See E. Ingerslev, "Rösslin's 'Rosegarten': Its Relation to the Past (the Muscio Manuscripts and Soranos), Particularly with Regard to the Podalic Version," Journal of Obstetrics and Gynaecology of the British Empire 15, no. 1 (January 1909): 23-25
23. Jacob Rueff, De conceptu et generatione hominis. . . . (Zurich, 1554), 10: ". . . I wish to bring out this figure of the feminine body from the Anatomy book of the most famous and learned Andreas Vesalius, with the womb and other parts of the uterus so that whoever is performing services for pregnant women may make good use of it as a mirror [or speculum] [. . . hanc ex celeberrimi doctossimique Andreae Vesalij Anatome foeminei corporis figuram cum matrice & alijs uteri partibus proferre voluimus, ut hac ceu speculo quotquot praegnantibus inserviunt utantur utiliter]." I extend my gratitude to Dan Garrison for his help in translating this passage and for his assurance that, indeed, Rucff's image appears to be based on Vesalius
24. In it she explains obstetric anatomy and recommends that midwives read Smellie's case studies. In addition, she seems to have advocated that midwives use forceps in exceptional cases. See Roberts and Tomlinson, Fabric of the Body, 449
25. and Jean Towler and Joan Bramall, Midwives in History and Society (London: Croom Helm, 1986), 123-25
26. This was probably with the help of Peter Camper (Camper became an anatomist, naturalist, and artist who contributed drawings for some minor plates in Hunter's atlas), who visited England several times and enrolled in Smellie's midwifery course in 1749. See John L. Thornton, Jan van Rymsdyk: Medical Artist of the Eighteenth Century (Cambridge: Oleander Press, 1982), 16
27. For a detailed discussion of Leonardo's many inventive representational techniques Martin Kemp, "The Mark of Truth: Looking and Learning in Some Anatomical Illustrations from the Renaissance and Eighteenth Century," in Medicine and the Five Senses, ed. W. F. Bynum and Roy Porter (Cambridge: Cambridge University Press, 1993), 85-121
28. Hunter's social ties and influence in London clearly contributed to his ultimately successful bid to gain admittance to the Royal College of Physicians. In the hierarchy of medical practitioners in eighteenth-century London, men-midwives were generally relegated to the Company of Surgeons and denied admittance to the Royal College of Physicians. Hunter was a member of the Company of Surgeons from 1747 until 1756, when he became licensed by the College of Physicians. See Helen Brock, "The Many Facets of Dr. William Hunter (1718-83)," History of Science 32, part 4 (1994): 387
29. Hunter, like most of his contemporaries, was not averse to manipulating normal births. He did not employ forceps, but he did use his fingers on occasion to stretch the cervix. See Edward Shorter, "The Management of Normal Deliveries," in William Hunter and the Eighteenth-Century Medical World, ed. W. F. Bynum and Roy Porter (Cambridge: Cambridge University Press, 1985), 374
30. William was involved in a dispute with his brother John Hunter, who himself became a famous surgeon, over who had priority in discovering the relation between fetal and maternal blood circulation in the placenta. Evidence supports William's claim. See Brock, "Many Facets of Dr. William Hunter," 389
31. In his eulogy, Samuel Foart Simmons mentions that in his atlas, Hunter's scientific contributions consisted of identifying the retroverted uterus and the membrana deciduas reflexa, "or that part of the spongy chorion which is reflected over the foetus." Simmons and John Hunter, William Hunter 1718-1783: A Memoir, ed. Helen Brock (Glasgow: University of Glasgow Press, 1983), 21. In a footnote to this memoir (38 n. 56), Brock also observes that a set of notes taken by Charles White during Hunter's 1752 anatomy lectures proves that Hunter had described the role of the lymphatic system before Alexander Monro, secundus, who claimed sole proprietorship over the discovery
32. As Martin Kemp, "Mark of Truth," 118, points out, "The unadorned realism of Hunter's great book, far from being aimed at an audience of students and general members of the midwifery profession, was not less regal in purpose than Cheselden's production. Its sheer size, which makes it mightily inconvenient to use, and its presentation make it clear that it is consciously planned as a super-prestige publication." William Cheselden was an eighteenth-century anatomist who was famous for two atlases, The Anatomy of the Human Body of 1713 and Osteographia, or the Anatomy of the Bones of 1733
33. The only other medical publication produced by Baskerville is Joseph Dalby's Virtues of Cinnabar and Musk, Against the Bite of a Mad Dog, 1762, but it has no illustrations
34. Most of Baskerville's editions were in octavo and quarto and were very limited in illustrations. Toward the end of his life, however, Baskerville seems to have taken on more involved projects involving more lavish copperplate engravings. His 1773 quarto edition of Ludovico Ariosto's Orlando furioso, commissioned by the Molini brothers, booksellers with branches in London, Paris, and Florence, included a copperplate-engraved frontispiece after Titian's portrait of Ariosto and forty-six more plates drawn by artists such as Giovanni Battista Cipriani and Jean-Baptiste Greuze. See Ralph Straus and Robert K. Dent, John Baskerville: A Memoir (Cambridge: Printed at the University Press for Chatto and Windus, 1907), 61
35. For further information on Baskerville F. E. Pardoe, John Baskerville of Birmingham: letter-Founder and Printer (London: F. Muller, 1975)
36. For a bibliography of works printed by Baskerville Philip Gaskell, John Baskerville: A Bibliography (Cambridge: Cambridge University Press, 1959). Many thanks to Russell Malone, curator of the Charles Deering McCormick Library of Special Collections at Northwestern University, for bringing the Baskerville press output to my attention
37. William Hunter, Anatomia uteri humani gravidi tabulis illustrata / The Anatomy of the Human Gravid Uterus Exhibited in Figures (Birmingham, 1774), preface, 4
38. For a discussion of the lack of anatomical originality in Bidloo's atlas Fenwick Beekman, "Bidloo and Cowper, Anatomists," Annals of Medical History, 1935, 113-29
39. Hunter's encounter with Leonardo's drawings is explained in detail by Martin Kemp, "Dr. William Hunter on the Windsor Leonardos and His Volume of Drawings Attributed to Pietro da Cortona," Burlington Magazine 118 (1976): 144-48
40. William Hunter, Introductory Letters, quoted in ibid., 144
41. Ludmilla Jordanova, "Gender, Generation and Science," in Bynum and Porter, William Hunter and the Eighteenth-Century Medical World, 396
42. Hunter, Anatomia uteri humani gravidi, n.p.; the pages are not numbered
43. As Kemp, "Mark of Truth," 121, points out, Hunter himself saw this kind of feature as a "mark of truth," a phrase he uses in the preface to his atlas
44. Hunter, caption to pl. I
45. Riemsdyk greatly resented his exclusion, especially because on publication, the atlas was instantly celebrated for its images. In 1778, Riemsdyk published a strange catalog of the British Museum called Museum Britannicum. In it he charged a certain Mr. Ibis (a thinly disguised reference to William Hunter) with having misused him, and in a series of diatribes castigated those who had not recognized his anatomical work and lamented his exclusion from the Royal Academy. One of Riemsdyk's complaints is that "Mr. Ibis" had given a picture of an embryo in a lien's egg to Queen Charlotte without acknowledging that Riemsdyk had painted it. See Betsy Copping Corner, "Dr. Ibis and the Artists: A Sidelight upon Hunter's Atlas, the Gravid Uterus," Journal of the History of Medicine and Allied Sciences 1 (1951): 17
46. Hunter's 1770 lecture has been reconstructed by Martin Kemp, "True to Their Natures: Sir Joshua Reynolds and Dr. William Hunter at the Royal Academy of Arts," Notes and Records of the Royal Society of London 116, no. 1 (January 1992): 77-88
47. As Gary Gutting has pointed out, Foucault's great achievement in the book is to show that while modern medicine "presents itself as nothing more than fidelity to what is simply given to any naive gaze," it is, in fact, "a mode of perception based on a complexly structured interpretative grid." Thus, Foucault deconstructs the myth that when the clinic turned an "objective" gaze on the body, the result was that the medical observer simply received and absorbed the unmediated "facts" that presented themselves to vision. Gutting, Michel Foucault's Archaeology of Scientific Reason (Cambridge: Cambridge University Press, 1989), 136
48. The idea that objectivity was always a double-edged sword in early modern medicine has since been borne out by several historians of science. For instance, Londa Schiebinger, writing on Samuel Thomas von Soemmering, has argued that Soemmering's careful articulation of the differences between male and female skeletons, while meticulously observed, became ballast in the "eighteenth-century movement to define and redefine sex differences in every part of the human body." Schiebinger, "Skeletons in the Closet: The First Illustrations of the Female Skeleton in Eighteenth-Century Anatomy," Representations 14 (spring 1986): 42-43
49. Although Foucault later eschewed his own term "medical gaze [regard médical]" because he felt that it too strongly posited "the unifying or the synthesizing function of a subject," the phrase indicates what was for him primarily a perceptual rupture in the history of medicine. Foucault, The Archaeology of Knowledge, trans. A. M. Sheridan Smith (New York: Pantheon Books, 1972), 54
50. Thomas Osborne points out that Foucault disparaged his own use of the term regard médical because it seemed to project a subject who knows in the Cartesian sense, but in The Birth of the Clinic, the "gaze" seems to refer more to an "effect of a certain kind of discursive constellation" in which there are "alignments between different forms of perceptual appropriation." Osborne, "On Anti-Medicine and Clinical Reason," in Reassessing Foucault: Power, Medicine and the Body, ed. Colin Jones and Roy Porter (London: Routlege, 1994), 34-35
51. Osborne, "On Anti-Medicine and Clinical Reason," 41
52. Pierre-Jean-Georges Cabanis, Coup d'oeil sur les révolutions et la réforme de la médecine (Paris, 1804), 126
53. quoted in Foucault, Birth of the Clinic, 121
54. Jordanova, "Gender, Generation and Science," 388
55. Lorraine Daston and Peter Galison, "The Image of Objectivity," Representations 40 (fall 1992): 93
56. Foster, "Thoughts on the Times," 102-3