Obstetrics and Gynecology: A History and Iconography
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《新英格兰医药杂志》
Obstetrics and Gynecology: A History and Iconography is the third revised edition of Iconographia Gyniatrica, a comprehensive attempt to tell the history of obstetrics and gynecology through pictures. With more than 1000 illustrations on female anatomy, embryology, midwifery, labor, cesarean delivery, obstetrical instruments, breast-feeding, contraception, and obstetric and gynecologic books, it provides a spectacular report on the medical history of obstetrics and gynecology that could hardly be told just verbally. Every page of this book has something interesting to say and to show.
(Figure)
An Ancient Roman Relief of a Midwife Attending a Woman Giving Birth.
Wellcome Library, London.
Obstetrics in its broadest sense encompasses the entire life cycle, from the creation of a new person to his or her birth. Today the diagnosis of pregnancy is simple and straightforward. However, this was not always the case, as shown in chapter 2: "If the veins within her arm beat against thy hand, thou shalt say: she is pregnant (Brugsh Papyrus, 1350 B.C.)." We travel in time from this Egyptian method of pregnancy diagnosis to the medieval introduction of uroscopy, to the 19th-century French usage of a test called the Kyesteine pellicle, and to the method, announced in 1928, devised by Aschheim and Zondek.
Until the 19th century, medicine was divided into three parts — medicine, surgery, and obstetrics — with obstetrics being perhaps the oldest branch. That is why it is not surprising to find representations of birth in the crude cave drawings of the ice age (chapter 4). The illustrations of scenes of birth from various nations throughout the centuries are perhaps the most impressive part of the book. Many ancient myths and legends are associated with obstetrics and gynecology. The birth of many heroes and gods are related to the "unnatural" form of birth by cesarean section. This is because the outcome of cesarean section was so poor in ancient and medieval times that if a newborn sustained the operation, it was believed that the gods must have intended an outstanding future for this person. Some examples of such persons in the book are Asclepius (the Greek god of medicine), Julius Caesar, Buddha, Adonis (a Greek hero), and Rustan (a legendary Persian hero). In chapter 11, there are stories and reproductions of many miniatures, woodcuts, reliefs, and paintings depicting these events.
Deviations from normal human forms at birth intrigued scientists, artists, and ordinary people for centuries. In chapter 14, there are stories about and illustrations of cyclopia (one eye), sympodia (fusion of the lower limbs), janiceps (conjoined faces), acormia (a head without a trunk), phocomelia (absence of the proximal segments of the limbs), and other birth defects. Many fascinating ancient and historical gynecologic instruments are presented in chapter 17. It is humbling to discover that many of the procedures and instruments that we believe to have been invented in recent decades were actually described centuries ago.
In the 1967 edition of Encyclopaedia Britannica, under the history of medicine and surgery, is this description: "The history of medicine is not a branch of medicine; it is medicine itself. Here is no mere antiquarian pursuit or hobby for elderly or retired doctors. Medical history . . . and its study enables one to recapture in some degree the broad outlook of the early days, when a physician was also a philosopher [, and] . . . reinstate the patient to the position he ought to hold; i.e., that of the central figure. Thus, properly viewed, the history of medicine becomes the very basis of medical education." I sincerely believe that this is precisely why Obstetrics and Gynecology should find its place on the shelf of every modern obstetrician and gynecologist, as well as with anyone interested in the medical or cultural history of women's health.
Samuel Lurie, M.D.
Edith Wolfson Medical Center
58100 Holon, Israel
drslurie@hotmail.com(Revised Third Edition of )
(Figure)
An Ancient Roman Relief of a Midwife Attending a Woman Giving Birth.
Wellcome Library, London.
Obstetrics in its broadest sense encompasses the entire life cycle, from the creation of a new person to his or her birth. Today the diagnosis of pregnancy is simple and straightforward. However, this was not always the case, as shown in chapter 2: "If the veins within her arm beat against thy hand, thou shalt say: she is pregnant (Brugsh Papyrus, 1350 B.C.)." We travel in time from this Egyptian method of pregnancy diagnosis to the medieval introduction of uroscopy, to the 19th-century French usage of a test called the Kyesteine pellicle, and to the method, announced in 1928, devised by Aschheim and Zondek.
Until the 19th century, medicine was divided into three parts — medicine, surgery, and obstetrics — with obstetrics being perhaps the oldest branch. That is why it is not surprising to find representations of birth in the crude cave drawings of the ice age (chapter 4). The illustrations of scenes of birth from various nations throughout the centuries are perhaps the most impressive part of the book. Many ancient myths and legends are associated with obstetrics and gynecology. The birth of many heroes and gods are related to the "unnatural" form of birth by cesarean section. This is because the outcome of cesarean section was so poor in ancient and medieval times that if a newborn sustained the operation, it was believed that the gods must have intended an outstanding future for this person. Some examples of such persons in the book are Asclepius (the Greek god of medicine), Julius Caesar, Buddha, Adonis (a Greek hero), and Rustan (a legendary Persian hero). In chapter 11, there are stories and reproductions of many miniatures, woodcuts, reliefs, and paintings depicting these events.
Deviations from normal human forms at birth intrigued scientists, artists, and ordinary people for centuries. In chapter 14, there are stories about and illustrations of cyclopia (one eye), sympodia (fusion of the lower limbs), janiceps (conjoined faces), acormia (a head without a trunk), phocomelia (absence of the proximal segments of the limbs), and other birth defects. Many fascinating ancient and historical gynecologic instruments are presented in chapter 17. It is humbling to discover that many of the procedures and instruments that we believe to have been invented in recent decades were actually described centuries ago.
In the 1967 edition of Encyclopaedia Britannica, under the history of medicine and surgery, is this description: "The history of medicine is not a branch of medicine; it is medicine itself. Here is no mere antiquarian pursuit or hobby for elderly or retired doctors. Medical history . . . and its study enables one to recapture in some degree the broad outlook of the early days, when a physician was also a philosopher [, and] . . . reinstate the patient to the position he ought to hold; i.e., that of the central figure. Thus, properly viewed, the history of medicine becomes the very basis of medical education." I sincerely believe that this is precisely why Obstetrics and Gynecology should find its place on the shelf of every modern obstetrician and gynecologist, as well as with anyone interested in the medical or cultural history of women's health.
Samuel Lurie, M.D.
Edith Wolfson Medical Center
58100 Holon, Israel
drslurie@hotmail.com(Revised Third Edition of )