Embracing Digital History: How Medicine Became Modern

It’s #FutureMW for Museum Week! Where do we hope to go in the future? The Dittrick Medical History Center and Museum, in collaboration with design partners and funded by the National Endowment for the Humanities, presents: How Medicine Became Modern, an innovative new way to explore the artifacts, people, and stories behind the great innovations of our age!

What was it like to be sick 50 years ago? 150 years ago?
What medical innovations most changed American lives?
How did Cleveland rise to importance as a medical city?
In other words:
How did we get here?

Museums nationally and internationally are reaching new audiences—while retaining and engaging present ones—through the medium of digital technology. The Philadelphia Museum of Art presented inter-actives for Treasures of Korea; the Field Museum of Chicago showcased a 3D exhibit about Tyrannosaurus bones; the British Museum of London installed 3D touch-activated Explorer Tables allowing virtual autopsy of a mummy. More locally, the Cleveland Museum of Art opened the award-winning Gallery One.

Now, the Dittrick Museum embarks on a project to make history come to life through a 10ft by 4ft interactive digital wall–a place where visitors can “handle” artifacts (rotating BC-Logo_LGand zooming), and more importantly, a place to engage with the human stories behind them. Partnering with Zenith Systems and Bluecadet, and supported by NEH’s Museums Libraries & Cultural Organizations grant, How Medicine Became Modern will go live in 2017!

Exhibit Details:

  • 6Free-standing 10ftx4ft wall in the main gallery
  • Ability to zoom, rotate, interact with artifacts
  • Links to the stories behind artifacts/Access to interactive game-play
  • Four lenses into medical history:

HMBM

 Want to hear more?

How would something like this work? Why would a museum want to take part in digital mediums? The 225th anniversary of the College of Physicians of Philadelphia Historical Medical Library (also the parent body of the Mütter Museum) asked these very questions in 2013. The answer? Museums and libraries must see new ways of engaging the public–and of building community. As I say in an essay for H-Sci-Med-Tech, History—far from being lost in the past—is by these means coming out to meet new friends. The story of medicine’s past offers something valuable to medicine’s future, a new way of interfacing between worlds that is both physical and digital, then and now. We enter the story through these public spaces, and through digital mediums, medical collections around the world are beginning to reach beyond them as well. What we see is a convergence of exhibit, interaction, and digital outreach.


A Practical Example from the Project:

L0057592 Fowler's phrenological head, Staffordshire, England, 1879-18 Credit: Science Museum, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org Lorenzo Niles Fowler’s (1811-96) detailed system of phrenology is shown on this phrenological head. Phrenologists believed that the shape and size of various areas of the brain (and therefore the overlying skull) determined personality. For instance, the area under the right eye relates to language and verbal memory; the desire for foods and liquids was thought to be located in front of the right ear. Fowler’s system, based on his thirty years of research throughout the world, was just one of many. He was an American phrenologist who led a revival in phrenology after its decline in the 1850s. In 1860, Fowler emigrated with his family to the United Kingdom and set upon an ambitious lecture tour. In 1887, Fowler set up the British Phrenological Society, which finally disbanded in 1967. maker: Unknown maker Place made: Staffordshire, England, United Kingdom made: 1879-1896 Published: - Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/
Fowler’s phrenological head, Staffordshire, England, 1879-18
 Science Museum, London.

The history of medicine offers much more than static displays or old tech. Each object, from a cast of Joseph Lister’s hand to a full-scale working x-ray machine, tells a tale of personal tragedy and triumph, of success and failure, of hopes and dreams.

Take, for instance, the phrenology bust. Sleek, smooth–replicas are attractive enough to show up on end-tables and mantle pieces. But what’s the story? It’s about Diagnosing by the Bump!

Franz-Joseph Gall (1758-1828), proposed that different functions, such as memory, language, emotion, and ability, were situated in specific “organs” of the brain. These portions of the brain would grow or shrink with use, and the changes would appear as bumps or depressions on the skull. Called Phrenology, the practice of “reading” the bumps supposedly allowed a practitioner to assess different abilities and personality traits. Does that make sense? What might our own phrenological assessment look like? The digital display allows the viewer to see a chart with interactive sections of the brain. Why not do your own “reading”?

William Cowper. 1737. The anatomy of humane bodies
William Cowper. 1737. The anatomy of humane bodies

But that’s not the only story. Phrenology resonated with the American Dream. Johann Kaspar Spurzheim (1776-1832) arrived to begin a speaking tour, and found a very willing audience. Why? It fit the “American Dream” idea of rising from nothing, emphasizing the ability to train the mind and attain social mobility. In other words, despite the bumps you were born with, we could all get better, a kind of rags-to-riches idea very popular even today. One of Cleveland’s own doctors had his “head examined”—Jared Potter Kirtland. On the other hand, phrenology and it’s sister pseudoscience physiognomy had a dark side; they privileged one race, one class, and one sex. Not exactly a “dream” of equality. (And for the record, Kirtland did not apparently agree with the reading; the booklet has his marginal notes!) The digital display offers the visitor a window in time; they can see the images and texts (and hand written notes!) while learning about larger ethical dilemmas.

Phrenology was later abandoned and its practitioners were attacked as charlatans and fakes. Even so, phrenology helped to move psychological understanding forward in two important ways: 1. it suggested that different parts of the brain did different things and 2. It demonstrated that individual effort could be just as, if not more, important than biological inheritance. The take-away? Through digital means, the visitor doesn’t just see the bust in a cabinet. Instead, he or she can look at it closely, from all angles, and then walk through time.

Johann Heinrich Oesterreicher. 1879. Atlas of human anatomy
Johann Heinrich Oesterreicher. 1879. Atlas of human anatomy

Better yet, the visitor can walk through the body—through anatomies and flip books of fugitive sheets (where each layer reveals more of the anatomy underneath). So much of our fragile history remains out of reach for visitors–but digital humanities/history projects can do much more than show the item itself. It can open up that artifact as a window into another time, another place.

We look forward with great anticipation to bringing this digital history/digital humanities project to life–the human story behind medical history: “How Medicine Became Modern.”

ABOUT THE BLOGGER
Brandy Schillace, PhD, works as Research Associate and Public Engagement Fellow for Dittrick Museum. She is also a freelance fiction and non-fiction writer, lecturer, blogger, and the managing editor of a medical anthropology journal, Culture, Medicine, and Psychiatry. View her recent TEDx talk on the history of medicine and “steampunk,” featuring artifacts from the museum!

Recent Acquisition! Tea-cups, Princess Charlotte, and the History of Birth

IMG_7448Recent acquisition! This cup and saucer set c. 1818 commemorates the death of Princess Charlotte after giving birth. The heir to the throne of England labored for 50 hours without intervention before delivering a large, stillborn son in 1817. Charlotte’s physicians came from the non-interventionist school of #obstetrics, meaning they used no forceps to assist or hasten the child’s stalled birth. Further, no destructive instruments (those that would have sacrificed the child to spare Charlotte) would have been used because of infant’s royal status. In fact, physicians attempted to resuscitate the stillborn baby, thinking he was in a state of “suspended animation” before attending to Charlotte’s delayed delivery of the placenta. This event forever changed the course of birth and delivery methods.

V0048368 Queen Caroline and George Prince of Wales
Queen Caroline and George, Prince of Wales

Who Decides, Who Delivers?

Prior to the 18th century in Britain, babies were delivered by midwives, women practitioners who had apprenticed under other women–or sometimes just an elder matron who had given birth many times herself. Then, suddenly, things began to shift. In a relatively short space of time, midwifery developed from the rare intervention of surgeons to a robust and nearly exclusive male practice. A confluence of events led to this shift, including changes in the “bodily and social event” of childbirth with the advent of lying-in hospitals, as well as changes in fashion, politics, and social structure.[i]  Medical technology was the male calling card, so to speak. With the invention of the forceps, skilled surgeons (who were always men), could deliver children even in difficult or near-hopeless cases:

The more it was known [the surgeon] could deliver a living child, the less women would fear him; the less they feared him, the earlier they would call him; the earlier they called him, the more often he could deliver the child alive; and the more other this was so, the further it would be realized that he could achieve this.[ii]

Birth became a subject of medical science and of medical men, and by 1764, Queen Charlotte made William Hunter her royal obstetrician. The new age of obstetrics did not put an end to the birthing debate, however! Instead, two schools of thought arose–one that favored intervention by the obstetrician with the forceps, and one that favored non-intervention (letting nature take its course). Like Queen Charlotte, Princess Charlotte (her granddaughter) also had a physician obstetrician overseeing her pregnancy and birth–Sir Richard Croft. Unfortunately for Charlotte, Croft followed non-intervention methods and Charlotte and the baby both died.

Princess Charlotte
Princess Charlotte

Croft committed suicide, feeling that he had been responsible for two deaths (and royal deaths at that). Charolotte’s funeral attracted enormous crowds of mourners–and some have compared it to the national grief that followed the death of Princess Diana.[iii].  The tragedy and its response ushered in a new age of “rational intervention” including the use of stimuli (for contractions), blood transfusion, and anesthesia.[iii] For a period of time following, no one would have criticized a princess for preferring an obstetrician and the most advanced of medical tools!

Commemoration and Change

The death of Princess Charlotte was commemorated through the sale of inexpensive transfer-wear porcelain tea cups and saucers. It may seem morbid to us, but these pieces were popular and widely used, meaning the message was also widely transmitted. If you look close, this set features a weeping #Britannia, symbolizing how the country mourned the heir’s passing. In response to her death, physicians moved toward interventionist approaches to childbirth in attempt to prevent such mortality. Texts including David Davis’s Elements of Operative #Midwifery (1825) served as important guides on the use of instruments to expedite labor.

 

[i] Wilson, Adrian. The Making of Man-Midwifery. (Cambridge: Harvard University Press, 1995): 6.

[ii] Wilson, Adrian. The Making of Man-Midwifery. (Cambridge: Harvard University Press, 1995): 97.

[iii] “Triple Tragedy” by Vic, Jane Austen’s World

About the blogger

Brandy Schillace is a medical humanist, literary scholar and writer of Gothic fiction. She is the Managing Editor for Culture, Medicine, and Psychiatry, a guest curator for Dittrick Museum, and a SAGES fellow for Case Western Reserve University (she has also worked as an assistant professor of literature at Winona State). She runs the Fiction Reboot and Daily Dose blogs, leads interdisciplinary conferences abroad for IDnet, and spends a lot of her time in museums and medical libraries.

Event and Gallery Opening! From Ether to Epidural by Jacqueline Wolf

IMG_5115Anesthesia: it calls to mind surgeries, treatment of shock–the rendering of a patient unconscious and free (temporarily) from pain.  But anesthesia has played an enormous role in the shifting ideas surrounding labor and birth in America generally–and right here in Cleveland. It’s more than a knock-out; it’s an ever-changing history!

On Thursday, November 19th at 6:00pm, Dittrick will share this fascinating story through a gallery opening (Childbirth in America, 1840-1940) and a talk by celebrated author and historian Jacqueline Wolf. Reproduction, birth, and women’s health in the 19th century shaped the way we practice obstetrics today. One of the biggest changes since then has been the use of obstetric anesthesia… From ether and chloroform in the 1890s, to barbiturates and narcotics in the 1950s, to the “natural” childbirth movement of the 1970s, each generation of American women has faced a very different birth experience! In this opening lecture, Jackie Wolf will explain how and why women’s obstetrician’s views of labor pain and its appropriate treatment changed over time. Dr. Wolf has explored this topic in her evocative Deliver me from Pain (2009), and will share her more recent insights.

IMG_5116The lecture is free, the gallery will be open late, and a reception will be provided in the museum space itself. We hope you will join us for the opening–to see the new permanent exhibit and the birth-chair platform (a generous gift from the Cleveland Medical Library Association), and to hear from a leading researcher in the field!

Exhibit: Childbirth in America 1840-1940, curated by Catherine Osborn in collaboration with Jim Edmonson and Anna Claspy.

Talk: Ether to Epidural: Obstetric Anesthesia in Historic, Medical, and Social Context, Jacqueline Wolf, PhD

Location: Dittrick Medical History Center and Museum, 3rd floor Allen Memorial Medical Library.

RSVP: Jennifer Nieves at 216-368-3648 or email jks4@case.edu

Embracing Digital History: How Medicine Became Modern

Brandy L. Schillace

What was it like to be sick 50 years ago? 150 years ago?
What medical innovations most changed American lives?
How did Cleveland rise to importance as a medical city?
In other words:
How did we get here?

The Dittrick Medical History Center and Museum, in collaboration with design partners and funded by the National Endowment for the Humanities, presents: How Medicine Became Modern, an innovative new way to explore the artifacts, people, and stories behind the great innovations of our age!

Museums nationally and internationally are reaching new audiences—while retaining and engaging present ones—through the medium of digital technology. The Philadelphia Museum of Art presented inter-actives for Treasures of Korea; the Field Museum of Chicago showcased a 3D exhibit about Tyrannosaurus bones; the British Museum of London installed 3D touch-activated Explorer Tables allowing virtual autopsy of a mummy. More locally, the Cleveland Museum of Art opened the award-winning Gallery One.

Now, the Dittrick Museum embarks on a project to make history come to life through a 10ft by 4ft interactive digital wall–a place where visitors can “handle” artifacts (rotating BC-Logo_LGand zooming), and more importantly, a place to engage with the human stories behind them. Partnering with Zenith Systems and Bluecadet, and supported by NEH’s Museums Libraries & Cultural Organizations grant, How Medicine Became Modern will go live in 2017!

Exhibit Details:

  • 6Free-standing 10ftx4ft wall in the main gallery
  • Ability to zoom, rotate, interact with artifacts
  • Links to the stories behind artifacts/Access to interactive game-play
  • Four lenses into medical history:

HMBM

 Want to hear more?

How would something like this work? Why would a museum want to take part in digital mediums? The 225th anniversary of the College of Physicians of Philadelphia Historical Medical Library (also the parent body of the Mütter Museum) asked these very questions in 2013. The answer? Museums and libraries must see new ways of engaging the public–and of building community. As I say in an essay for H-Sci-Med-Tech, History—far from being lost in the past—is by these means coming out to meet new friends. The story of medicine’s past offers something valuable to medicine’s future, a new way of interfacing between worlds that is both physical and digital, then and now. We enter the story through these public spaces, and through digital mediums, medical collections around the world are beginning to reach beyond them as well. What we see is a convergence of exhibit, interaction, and digital outreach.


A Practical Example from the Project:

L0057592 Fowler's phrenological head, Staffordshire, England, 1879-18 Credit: Science Museum, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org Lorenzo Niles Fowler’s (1811-96) detailed system of phrenology is shown on this phrenological head. Phrenologists believed that the shape and size of various areas of the brain (and therefore the overlying skull) determined personality. For instance, the area under the right eye relates to language and verbal memory; the desire for foods and liquids was thought to be located in front of the right ear.  Fowler’s system, based on his thirty years of research throughout the world, was just one of many. He was an American phrenologist who led a revival in phrenology after its decline in the 1850s. In 1860, Fowler emigrated with his family to the United Kingdom and set upon an ambitious lecture tour. In 1887, Fowler set up the British Phrenological Society, which finally disbanded in 1967. maker: Unknown maker Place made: Staffordshire, England, United Kingdom made: 1879-1896 Published:  -  Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/
Fowler’s phrenological head, Staffordshire, England, 1879-18
 Science Museum, London.

The history of medicine offers much more than static displays or old tech. Each object, from a cast of Joseph Lister’s hand to a full-scale working x-ray machine, tells a tale of personal tragedy and triumph, of success and failure, of hopes and dreams.

Take, for instance, the phrenology bust. Sleek, smooth–replicas are attractive enough to show up on end-tables and mantle pieces. But what’s the story? It’s about Diagnosing by the Bump!

Franz-Joseph Gall (1758-1828), proposed that different functions, such as memory, language, emotion, and ability, were situated in specific “organs” of the brain. These portions of the brain would grow or shrink with use, and the changes would appear as bumps or depressions on the skull. Called Phrenology, the practice of “reading” the bumps supposedly allowed a practitioner to assess different abilities and personality traits. Does that make sense? What might our own phrenological assessment look like? The digital display allows the viewer to see a chart with interactive sections of the brain. Why not do your own “reading”?

William Cowper. 1737. The anatomy of humane bodies
William Cowper. 1737. The anatomy of humane bodies

But that’s not the only story. Phrenology resonated with the American Dream. Johann Kaspar Spurzheim (1776-1832) arrived to begin a speaking tour, and found a very willing audience. Why? It fit the “American Dream” idea of rising from nothing, emphasizing the ability to train the mind and attain social mobility. In other words, despite the bumps you were born with, we could all get better, a kind of rags-to-riches idea very popular even today. One of Cleveland’s own doctors had his “head examined”—Jared Potter Kirtland. On the other hand, phrenology and it’s sister pseudoscience physiognomy had a dark side; they privileged one race, one class, and one sex. Not exactly a “dream” of equality. (And for the record, Kirtland did not apparently agree with the reading; the booklet has his marginal notes!) The digital display offers the visitor a window in time; they can see the images and texts (and hand written notes!) while learning about larger ethical dilemmas.

Phrenology was later abandoned and its practitioners were attacked as charlatans and fakes. Even so, phrenology helped to move psychological understanding forward in two important ways: 1. it suggested that different parts of the brain did different things and 2. It demonstrated that individual effort could be just as, if not more, important than biological inheritance. The take-away? Through digital means, the visitor doesn’t just see the bust in a cabinet. Instead, he or she can look at it closely, from all angles, and then walk through time.

Johann Heinrich Oesterreicher. 1879. Atlas of human anatomy
Johann Heinrich Oesterreicher. 1879. Atlas of human anatomy

Better yet, the visitor can walk through the body—through anatomies and flip books of fugitive sheets (where each layer reveals more of the anatomy underneath). So much of our fragile history remains out of reach for visitors–but digital humanities/history projects can do much more than show the item itself. It can open up that artifact as a window into another time, another place.

We look forward with great anticipation to bringing this digital history/digital humanities project to life–the human story behind medical history: “How Medicine Became Modern.”

ABOUT THE BLOGGER
Brandy Schillace, PhD, works as Research Associate and Public Engagement Fellow for Dittrick Museum. She is also a freelance fiction and non-fiction writer, lecturer, blogger, and the managing editor of a medical anthropology journal, Culture, Medicine, and Psychiatry. View her recent TEDx talk on the history of medicine and “steampunk,” featuring artifacts from the museum!

Living (and Breathing) Museum Research

What is it? Does this inhaler featured in this 1875 trade card reside in the Dittrick’s collections?

When the museum receives donations from the community, sometimes little surprises find their way into unexpected collections. Frequently, we classify artifacts based on the donor’s description and our expectations. Until we dig into their stories for an exhibit, these unexplored artifacts sit on shelves among surgical sets, microscopes, and pharmaceuticals, waiting to be discovered. One such specimen found its way into our work space as we pulled items for a recent installation on Obstetrical Anesthesia from 1850 to 1890.

We were familiar with the Bennett Inhaler (Fig. 1), a handheld device intended to be filled with chloroform for laboring women to self-administer anesthetic. During childbirth, women using this inhaler would lose the ability to hold the item close to their face, their hand would drop, and they were less likely to experience a chloroform overdose. Although we were delighted by this object, there was one problem — it was patented in 1910, outside of our desired time period.

Fig. 1. Bennett Inhaler from the Dittrick Museum Collections.
Fig. 1.: Bennett Inhaler from the Dittrick Museum Collections.
Fig. 2: Bennett Inhaler Ad from the American Journal of Clinical Medicine, 1910.
Fig. 2: Bennett Inhaler Ad in the American Journal of Clinical Medicine, 1910.

A little digging in an artifact box entitled “Inhalers” turned up this item: a small, hard rubber device with two nozzles, a center cork, and a lid (Fig. 3). Other than being marked “Patented in 1873,” we had little else to go on, except the hope that it was used far earlier than the Bennett Inhaler in obstetrical cases, and could fit in our exhibit.

Fig. 3: Mystery Inhaler from Dittrick Museum Collections.
Fig. 3: Mystery Inhaler from Dittrick Museum Collections.

The first step was looking through lists of inventions from 1873, published in the Official Gazette of the U.S. Patent Office (1874)– a task made significantly easier with digitized records. We searched individual patents for all of the the objects listed as “inhaler,” “respirator,” or “anesthesia,” and compared the drawn plans to our item. Only one stood out as a possibility (Fig. 4).

1873 Patent Illustration for Crumb's Inhaler
Fig. 4: 1873 Patent Illustration for Crumb’s Inhaler
Fig. 5: 1873 Crumb's Inhaler Ad
Fig. 5: 1873 Crumb’s Inhaler Ad

William R. Crumb of Buffalo, NY patented an inhaler of a similar shape to the Bennett Inhaler used, not for anesthesia, but as a general means of treating any and all respiratory ailments. An ad in the Gem of the West and Soldier’s Friend journal in 1873 claimed the inhaler instantaneously improved catarrh (excessive mucous), bronchitis, asthma, and colds if used in tandem with Crumb’s other product — “Carbolated Chloride of Iodine” as an inhalant (Fig. 5).

As a proprietary medicine salesman, Crumb fashioned himself as an “MD,” to assure customers of his credibility. However, in 1881 the Buffalo Medical College of Physicians revoked his recent degree on the grounds of plagiarism, “having been proven upon examination that the thesis upon which the degree was conferred was written by a Dr. Walton.”

Fig. 6: 1886 Crumb's Inhaler Ad
Fig. 6: 1886 Crumb’s Inhaler Ad

Despite this news (and a move to Ontario), Crumb continued to improve his inhalers and advertised their popularity in later ads showing a model of the inhaler similar to our’s. It featured a lid so customers could easily carry the inhaler in their pocket and sleeker medication chamber (Fig. 6). At this point in our search, we felt more confident that the object in question was one of the 500,000 products W.R. Crumb had peddled by 1886.

Although we couldn’t use the inhaler in our childbirth exhibit, we reunited this object with its story and made our archivist, and future researchers, very happy.

References:

[1] Mattison, Richard V., ed. 1881. The Monthly Review of Pharmacy and Medicine 9(6): 180.
[2] Crumb, W.R. Improvement in Inhalers. U.S. Patent 134858. January 14, 1873.
[3] United States Patent Office. 1874. Official Gazette of the United States Patent Office, Vol. 5. p. 665.
[4] Crumbs Pocket Inhaler. Haviland, C. A. and Mrs. C. A. Haviland, eds. 1873. Gem of the West and Soldier’s Friend 7(12): 522.
[5] Crumb’s Rubber Pocket Inhaler. 1886. Hall’s Journal of Health 33(12): ix.

About the Authors:

Catherine Osborn, MA is a Research Assistant at the Dittrick Museum of Medical History and the Editorial Associate of Culture, Medicine, and Psychiatry. She enjoys pursuing historical tangents and proving she can find any source online.

Anna Claspy is a summer intern at the Dittrick Museum and a student of history at the College of Wooster. She enjoys causing trouble on social media.

Madame du Coudray: A Midwife in a Man’s World?

Coudray-plate-XV
From Madame du Coudray’s book, plate XV

Here on the Dittrick Blog, we’ve begun a series on body-snatching for the purpose of anatomy… but today, we’d like to interrupt that history with another, equally fascinating but focused on the other end of the life spectrum. It’s National Midwifery Week, and today we present the history of a “woman in a man’s world,” the midwife Madame du Coudray.

Angelique Marguerite Le Boursier du Coudray (1712-1790) was the “King’s Midwife” in France. And yet, Madame du Coudray left no journal and few personal papers, meaning that while her deeds are well-recorded, her life is still somewhat mysterious. She remained unmarried, though took on the title of Madame, appropriate to her work as a sage femme (literally “wise woman,” but also the French term for a midwife).

Mission and Machine: “Saving Babies for France”

“Th[e] paradox of the singular, idiosyncratic woman who follows a ‘quest plot’ instead of a ‘marriage plot”

–Nina Gelbart, The King’s Midwife, 13

angelique-marguerite-le-boursier-du-coudrayAfter ten years as a midwife in Paris, Madame du Coudray was hired by King Louis XV to travel across France to better train rural midwives. There were political motivations for this; Louis wanted to boost a “declining” population, and more subjects also meant more capable soldiers. Unlike Queen Charlotte of England who chose William Hunter as the royal obstetrician, Louis appointed du Coudray, a woman, to train women. Madame du Coudray became the national midwife in 1759, earning 8,000 livres a year (equal to that of a decorated military general).[i]

Madame du Coudray’s accomplishments are remarkable even by our own standards, but this is especially true considering the time period. After all, in Britain, midwives had been replaced by man-midwives (or surgeon/obstetricians) by the middle of the eighteenth-century. What led to so radical a shift? And why was du Coudray so successful, even in a “man’s world”?

L0018481 Carciature of a man-midwife as a split figureMan-Midwives

Adrian Wilson traces the English history of male practitioners to Percival Willughby of Derby, who served in “the midwife’s bed” from 1630 to 1670[ii]. This phrase, which comes from Willughby’s Observations, suggests a clandestine affair, a blushing sneak, almost unmentionable. In fact, most early male practitioners were called surgeons, which, as Wilson points out, “tends to conceal their obstetric practice.”[iii] Surgeons attended at the behest of the midwife, and Willughby himself only served in place of the midwife for three expecting mothers over the course of many years.[iv] Male involvement was unusual, but by the eighteenth century, midwives like Elizabeth Nihell could accuse man-midwives like William Smellie of releasing “swarms” of male midwives into practice.  A variety of things contributed to this change–so many, that we probably can’t point to a single event.  The advent of lying-in hospitals, as well as changes in fashion, politics, and social structure in England were part of the shift.[v]  It is also true that cases like the “Rabbit Breeder of Godalming” brought midwifery to embarrassing public notice in England.

‘Breeding Rabbits’ and the Power of Instruments

Wellcome Image: Toft
Wellcome Image: Toft

In 1727, Mary Toft mimicked birth pangs and contractions and fooled many into believing she had given birth to a brood of baby rabbits. The case was finally overturned by surgeon Sir Richard Manningham, who threatened to cut her open in a live vivisection. Toft confessed to the hoax–(who wouldn’t?) While Manningham’s threat was probably an empty one, it is useful case study for two reasons; first, Toft—as an uneducated woman—was thought incapable of fooling the medical men (who presumably “knew” more about birth than she).[vi] Second, Manningham’s threats were of a particularly surgical kind. The mystery of female anatomy would be rendered plain through the surgeon’s instruments. Instrumentation had been one of the ways in which male surgeons protected their interests, for only a surgeon could wield instruments, and only those wielding instruments could be considered surgeons. The fact that only man-midwives could use forceps helped to build their practice. The rise of the man-midwife and the rise of forceps tend to go together. So–given that all of this occurred around the same time du Coudray was practicing in France–how did she gain such a powerful position? Why wasn’t a surgeon obstetrician chosen as the national midwife?

Madame du Coudray among the Surgeons

pelvimeter
pelvimeter

In France, there was also a contest between male and female practitioners. After all, André Levret is considered one of the  most powerful and influential figures in French obstetrics. The procedure for breech delivery, “Mauriceau-Levret manipulation,” is named after him and physician François Mauriceau. At the same time, Jean-Louis Baudelocque was working with William Smellie’s methods to “modernize” obstetrics in France–and he did so partly through instrumentation. His pelvimeter measured  pelvic dimensions (to see if the pelvis was wide enough for uncomplicated birth). These two men were critically important for turning midwifery into a science in France, and it should be noted that Baudelocque was named the first chair of obstetrics by Napoleon in 1806. The tide was turning, therefore, and yet Madame du Coudray held a prominent position well into the 1780s. How did she accomplish this?

_MG_7276_1
Madame du Coudray’s manikin in Rouen, France (images c/o James Edmonson, chief curator)

As Nina Gelbart points out in The King’s Midwife, du Coudray was not a feminist or even an advocate for other women. If anything, she de-emphasized her gender as much as possible, preferring instead to consider herself an equal to men. That means she often worked within the status quo rather than trying to change it. She wrote a medical text, amply illustrated, just as the man-midwifes had done, and as Gelbart explains, Coudray envisioned herself as a “man of action” [my emphasis]. Working within the system meant courting powerful friends–often among surgeons. Levret and an acquaintance of du Coudray, César Verdier, inspected her miraculous “machine” (or manikin) in 1756, approving of it and helping to spread her fame. This also helped to validate her practice. And what is this machine, but a kind of instrument–a piece of the mechanical and technological revolution for turning midwifery into a science? As Gelbart reminds us, even the language du Coudray uses is aimed at men–and though she taught mechanical means of birth to her female midwifery students, she also rapidly became the exception that proved the rule. She defied the marginalization of women by demanding attention, recognition, and payment for her work. Even so, she was also a vehicle for the very progress that was a distinct goal of the male physicians, obstetricians and surgeons.

_MG_7257
Fetus in placenta, Rouen, France (photo c/o James Edmonson)

Madame du Coudray was a remarkably successful woman, especially in terms of her legacy. Like Smellie, she developed a machine for teaching. Also like Smellie, she trained an enormous number of students (by 1780, two-thirds of the midwives in France were Madame du Coudray’s pupils!) Her career ended in obscurity, partly due to the revolution in France, but during her tenure and her travels, she was the most successful of all female midwives of the period.


[i] Gelbart, Nina. The king’s midwife: a history and mystery of Madame du Coudray. (University of California Press, 1999): 177

[ii] Wilson, Adrian. The Making of Man-Midwifery. (Cambridge: Harvard University Press, 1995): 6.

[iii] Ibid, 47.

[iv] Ibid, 48

[v] Wilson, Making, 6.

[vi] I do not wish to overstate this claim, but it seems apparent from the case that the surgeons felt justified upon discovering that Toft’s mother-in-law (a midwife) was behind the hoax. It did not occur to the male midwives that a woman, by virtue of being a woman alone, might know more about the workings of the female anatomy than the practitioner.


What do Medical Museums *Really* have to Offer?

JunoSometimes it is important not to let objects speak for themselves.

The Dittrick Medical History Center has the most extensive collection of 19th and early 20th century surgical instruments in the United States, the largest collection of historic contraceptives in the world, and the most comprehensive gallery of diagnostic instruments (like the earliest stethoscopes!) in North America. We also boast fascinating material on the history of birth, the history of anesthesia, the history of hospital care, WWI medicine, forensics, and much more. But objects and artifacts, as amazing as they are, don’t tell the whole story. Museums–and medical museums in particular–must do more than just present odd or interesting “old things.” They must engage us!

Here at the Dittrick, we are working towards ever-more-meaningful engagements with our visitors. We offer free public lectures and receptions, shorter gallery talks, and will be hosting some truly interesting events this coming year (including a book signing for Kate Manning, author of My Notorious Life, and a “mystery at the museum” night). We are also constantly changing and updating the gallery space. Recent additions include reconstructive surgery during WW1 and forensic crime-solving in 1916–but we aren’t finished yet! As we continue to grow and change, we welcome your input. Join us M-F 9-5, or come to a related event, Medical Mavericks and Marvels (a talk by research associate Brandy Schillace) that will take place at Happy Dog on June 10th at 7:30.