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Des maladies des femmes grosses et accouchés. Avec la bonne et veritable méthode de le bien aider en leurs accouchmens naturels…
OBSTETRICS
CLASSIC PAGES IN AND GYNECOLOGY Lawrence D. Longo, MD
Des maladies des femmes grosses et accouchkes. Avec la bonne et veritable mkthode de les bien aider en leurs accouchemens naturels. . . Fraqois
Mauriceau
Park, Chez lean Henault.
1060
March 1995
Im$wimeries de Charles Coignard,
1668
American
Journal
of Obstetrics
and Gynecology
Volume
172, Number
Am J Obstet
Classic pages
3
1061
Gynecol
In this outstanding textbook of the time, Mauriceau (1637-1709) established obstetrics as a separate specialty and science. Perhaps the first obstetric text in the modern sense, with its numerous translations and editions, it was the dominant force in seventeenth and early eighteenth century obstetric practice. The 536page work treats the subject with logical order, clarity, and erudition. It includes 30 copper plate engravings of birth figures and obstetric instruments. Its lengthy subtitle recommends it as useful for surgeons and necessary for midwives. Much of the work was a synthesis of prior teachings. In the preface Mauriceau advised the reader: “The doctrine of books, which is one of the most wholesome effectual remedies we have to chase away ignorance, is wholly useless to mens wits, when not disposed to receive it.” Although he recommended the reading of other “learned” authors, he cautioned that “ . . the most part of them, having never practiced the art they undertake to teach, resemble those geographers, who give us the description of many countries which they have never seen.” After the introduction, which describes anatomic landmarks (see figure), the work is divided into three sections. These deal with diseases and abnormalities from conception to the end of pregnancy, normal childbirth, and the care of the mother and newborn infant, including the choice of a suitable wet nurse. The expectant mother was admonished to help shorten the duration of labor by walking about the lying-in chamber, so that the weight of the child would help dilate the cervix. Furthermore her pains would be stronger and more frequent. If the midwife perceived that the child was not presenting properly, Mauriceau cautioned her to “. . . send speedily for an expert and dextrous surgeon in the practice, and not delay, as too many of them very often do, till it be reduced to extremity.” He also admonished the midwife to reassure her patients. Among the important new features included in Mauriceau’s work were the delivery of women in bed rather than on the obstetric stool, treatment of the various gestational periods, and discussion of many difficult cases. He also discussed labor, maintaining that the uterus is the active agent with the fetus playing a passive role. He gave what is probably the earliest account of the prevention of congenital syphilis by antisyphilitic treatment during pregnancy. He was also the first to
refer to tubal pregnancy, complications of prolapse of theumbilical cord, and epidemic puerperal fever. Mauriceau practiced podalic version but condemned both cephalic version and cesarean section. He gave rules for the management of placenta previa and advanced the concept of primary repair of perineal lacerations. Mauriceau discredited the observation of Pare and others that the pubic bones separated during childbirth. He also denied that the uterus contains two cavities and that the amniotic fluid is an accumulation of menstrual blood or milk. He argued against the then common misconceptions that a child born at 7 months’ gestation had a greater chance of survival than one born at 8 months and that a woman can give birth to only two children at a time because of the presence of two breasts. In the third edition of this work (1681) he first described management of the aftercoming head in breech delivery with the aid of an index finger in the infant’s mouth, now referred to as the “MauriceauSmellie-Viet” maneuver. Mauriceau was born in Paris and practiced in the maternity wards of the Hotel Dieu. There he gained considerable experience and established a brilliant reputation for himself, becoming accoucheur-in-chief. Although not a graduate in medicine, he was a sworn master-surgeon of Saint-Come. The book also gives an account of the author’s adventure with the celebrated Hugh Chamberlen, of the Huguenot family, who succeeded in keeping their invention of an obstetric forceps a family secret for almost 200 years. Chamberlen translated the present work into English in 1673. From the third edition of 168 1, Mauriceau published a Latin edition. To the fourth edition of 1694 Mauriceau appended a collection of 283 aphorisms concerning pregnancy, delivery, and the diseases of women. German (1680), Dutch (1683), and Italian (1684) translations also appeared, and the work was widely regarded for several generations. REFERENCES
IS, Viets HR. A short history of midwifery. Philadelphia: WB Saunders, 1964:51:77-81. Robb H. The writings of Mauriceau. Bull Johns Hopkins Hosp 1895;6:51-7. Speert H. Obstetric-gynecologic eponyms. FranGois Mauriceau and his maneuver in-breech delivery. Obstet Gynecol 1957;9:371-6.
1. Cutter
2. 3.
CLASSIC PAGES IN AND GYNECOLOGY Lawrence D. Longo, MD
Des maladies des femmes grosses et accouchkes. Avec la bonne et veritable mkthode de les bien aider en leurs accouchemens naturels. . . Fraqois
Mauriceau
Park, Chez lean Henault.
1060
March 1995
Im$wimeries de Charles Coignard,
1668
American
Journal
of Obstetrics
and Gynecology
Volume
172, Number
Am J Obstet
Classic pages
3
1061
Gynecol
In this outstanding textbook of the time, Mauriceau (1637-1709) established obstetrics as a separate specialty and science. Perhaps the first obstetric text in the modern sense, with its numerous translations and editions, it was the dominant force in seventeenth and early eighteenth century obstetric practice. The 536page work treats the subject with logical order, clarity, and erudition. It includes 30 copper plate engravings of birth figures and obstetric instruments. Its lengthy subtitle recommends it as useful for surgeons and necessary for midwives. Much of the work was a synthesis of prior teachings. In the preface Mauriceau advised the reader: “The doctrine of books, which is one of the most wholesome effectual remedies we have to chase away ignorance, is wholly useless to mens wits, when not disposed to receive it.” Although he recommended the reading of other “learned” authors, he cautioned that “ . . the most part of them, having never practiced the art they undertake to teach, resemble those geographers, who give us the description of many countries which they have never seen.” After the introduction, which describes anatomic landmarks (see figure), the work is divided into three sections. These deal with diseases and abnormalities from conception to the end of pregnancy, normal childbirth, and the care of the mother and newborn infant, including the choice of a suitable wet nurse. The expectant mother was admonished to help shorten the duration of labor by walking about the lying-in chamber, so that the weight of the child would help dilate the cervix. Furthermore her pains would be stronger and more frequent. If the midwife perceived that the child was not presenting properly, Mauriceau cautioned her to “. . . send speedily for an expert and dextrous surgeon in the practice, and not delay, as too many of them very often do, till it be reduced to extremity.” He also admonished the midwife to reassure her patients. Among the important new features included in Mauriceau’s work were the delivery of women in bed rather than on the obstetric stool, treatment of the various gestational periods, and discussion of many difficult cases. He also discussed labor, maintaining that the uterus is the active agent with the fetus playing a passive role. He gave what is probably the earliest account of the prevention of congenital syphilis by antisyphilitic treatment during pregnancy. He was also the first to
refer to tubal pregnancy, complications of prolapse of theumbilical cord, and epidemic puerperal fever. Mauriceau practiced podalic version but condemned both cephalic version and cesarean section. He gave rules for the management of placenta previa and advanced the concept of primary repair of perineal lacerations. Mauriceau discredited the observation of Pare and others that the pubic bones separated during childbirth. He also denied that the uterus contains two cavities and that the amniotic fluid is an accumulation of menstrual blood or milk. He argued against the then common misconceptions that a child born at 7 months’ gestation had a greater chance of survival than one born at 8 months and that a woman can give birth to only two children at a time because of the presence of two breasts. In the third edition of this work (1681) he first described management of the aftercoming head in breech delivery with the aid of an index finger in the infant’s mouth, now referred to as the “MauriceauSmellie-Viet” maneuver. Mauriceau was born in Paris and practiced in the maternity wards of the Hotel Dieu. There he gained considerable experience and established a brilliant reputation for himself, becoming accoucheur-in-chief. Although not a graduate in medicine, he was a sworn master-surgeon of Saint-Come. The book also gives an account of the author’s adventure with the celebrated Hugh Chamberlen, of the Huguenot family, who succeeded in keeping their invention of an obstetric forceps a family secret for almost 200 years. Chamberlen translated the present work into English in 1673. From the third edition of 168 1, Mauriceau published a Latin edition. To the fourth edition of 1694 Mauriceau appended a collection of 283 aphorisms concerning pregnancy, delivery, and the diseases of women. German (1680), Dutch (1683), and Italian (1684) translations also appeared, and the work was widely regarded for several generations. REFERENCES
IS, Viets HR. A short history of midwifery. Philadelphia: WB Saunders, 1964:51:77-81. Robb H. The writings of Mauriceau. Bull Johns Hopkins Hosp 1895;6:51-7. Speert H. Obstetric-gynecologic eponyms. FranGois Mauriceau and his maneuver in-breech delivery. Obstet Gynecol 1957;9:371-6.
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