The first of the three books mentioned passed through five editions during Mauriceau’s lifetime, and there were two reprintings after his death. A noticeable feature of the work, says von Siebold, is the care which the author takes to preface all his lectures with a detailed exposition of the anatomical relations of the region concerning which he is about to speak; and this custom, which he was the first to introduce, has since then been followed by the great majority of those who have written on the subject of midwifery.
In the book which hears the title “Observations sur la grossesse, etc.,” Mauriceau gives an account of his first and only interview with the English obstetrician, Hugh Chamberlen, to whom is commonly accorded the credit of having invented the first pattern of the obstetric forceps. From this account it appears that on August 19, 1670, Mauriceau was called to see a primiparous woman, thirty-eight years old, who had already been in labor for several days, but who had not yet been able, owing to the extreme narrowness of her pelvis, to give birth to her child. (The case was one of head presentation.) As Mauriceau was not at all willing to perform a Caesarian section,—which alone, as he believed, promised a way out of the difficulty,—Chamberlen, who happened to be in Paris at that moment, was asked to see the patient. He came at once, made a hasty examination, and declared that he needed only six or seven minutes for effecting, by means of the method which he had invented, the delivery. The patient was placed under his charge and he proceeded to apply his method. Instead of a few minutes, he spent three hours in the attempt to accomplish this purpose, but without success; and then admitted that it was impossible, in this particular case, to effect delivery. At the end of twenty-four hours the woman was dead. A postmortem examination revealed the fact that the uterus was torn in several places and perforated at one spot, all of which lesions had evidently been produced by the instrument or instruments employed by Chamberlen. “To complete this story,” adds Mauriceau, “it should be remembered that, six months before the occurrence of the events just narrated, this physician had come to Paris from England, and boasted that he possessed a secret method by means of which he could, even in the most desperate cases of labor, promptly effect the delivery of the child, and had told the King’s Physician-in-Ordinary that he would sell the knowledge of this secret for the sum of 10,000 Thalers (about $7500).”
One naturally hesitates about giving any measure of credit to a physician whose professional conduct, as revealed in his relations to Mauriceau’s patient, is clearly that of a charlatan. At the same time we are obliged to bear in mind that in 1670 it was still possible for a physician or surgeon to own a secret method of treatment and yet not forfeit all consideration on the part of his professional brethren. But at no time in the history of medicine has such conduct as that attributed to Hugh Chamberlen (apart from the question of ownership of a secret process) been considered otherwise than reprehensible. However, as there does not appear to have been an earlier claimant for the honor of having invented the obstetric forceps,—crude as it must have been in its first form,—it seems only fair that Chamberlen should be granted undisputed possession of this honor. During the eighteenth century—a period with which the present volume has no concern—the obstetric forceps underwent many alterations, and finally was given, by Levret and Baudelocque in France, by Smellie in England, and possibly also by Palfyn in Holland, practically the form which it possesses to-day.
Before I finally dismiss the allied topics of obstetrics and gynaecology, it seems desirable that I should add a few remarks concerning two French surgeons who attained considerable eminence in this special field, viz., Portal and Dionis.
Paul Portal.—Paul Portal, a native of Montpellier, France, was a contemporary of Mauriceau and an excellent obstetrician. He received his training under the best teachers at Paris, and more particularly under the guidance of René Moreau, Dean of the Paris Faculty of Medicine (1630 and 1631) and Royal Professor of Medicine and Surgery. He died in 1703. In the treatise which he published at Paris in 1685 (“La pratique des accouchements, etc.”) he lays down very strongly the maxim that the surgeon or the midwife who has charge of a case of labor should make no attempt to accelerate the efforts of Nature until it becomes plainly evident that artificial assistance is absolutely necessary. Portal cultivated the art of digital exploration to a very high degree of excellence. In Chapter VI., according to von Siebold, he expounds with great clearness the dangers which result from a prolapse of the umbilical cord. When this condition is discovered, no time should be lost in delivering the child. “In narrating some of his most remarkable cases Portal uses very simple and clear language, and he puts on record many things which in later years have been published as entirely new discoveries. But, unfortunately, his immediate successors were not disposed to profit from Portal’s admirable teachings.” (Von Siebold.) The only translations of his treatise into foreign languages that have been published are one in Dutch (1690) and another in Swedish by Van Hoorn (1723).
Pierre Dionis.—Pierre Dionis, who was born at Paris in the early part of the seventeenth century, was in some degree related to Mauriceau, the famous Parisian accoucheur. In 1673 he was appointed Royal Demonstrator of Anatomy and Surgery at the institution known as the “Jardin-du-Roi,” and from this date onward, up to the year 1680, he gave instruction regularly in these branches of medical knowledge to large classes of students. He was particularly distinguished for the clear and methodical manner in which he handled the subjects upon which he lectured. In the year last mentioned he was called to Vienna to fill the position of Physician-in-Ordinary to Maria Theresa, Empress of Austria, but von Siebold, who is my authority for the present sketch, does not say for what length of time he continued to hold this position. His death occurred in 1718.
The earliest work published by Dionis bears the title: “Histoire anatomique d’une matrice extraordinaire,” Paris, 1685. (Description of a case of extra-uterine pregnancy.) Five years later he published the treatise on human anatomy (“L’anatomie de l’homme, etc.,” Paris, 1690) upon which his celebrity largely rests. This book passed through numerous editions and was translated into Latin, Dutch and English (1723), and also Chinese; this last piece of work being done by the Jesuit missionary, Father Parrenin, at the request of Cam-Hi, Emperor of China, who died in 1723. Another treatise, which perhaps contributed, even more than did his Anatomy, to render Dionis celebrated, is that which bears the title: “Cours d’opérations de chirurgie démontrées au Jardin-du-Roi,” Paris, 1707; and later translations into German, Dutch and English. This book covers the entire field of operative surgery, and its subject-matter is most methodically arranged. It contains a large number of precepts which are as sound to-day as they were two hundred years ago. From the frequent mention which Dionis makes of the diseases to which the teeth are liable, and from his descriptions of the operations that may be performed for the cure or relief of these disorders, one is justified in drawing the conclusion that, at that early period, this branch of surgery was not, as many suppose, abandoned entirely to charlatans.
CHAPTER XLIII
THE FIRST APPEARANCE OF SYPHILIS IN EUROPE AS AN EPIDEMIC DISEASE.—MEDICAL JOURNALISM.—THE BEGINNINGS OF A MODERN PHARMACOPOEIA.—ITINERANT LITHOTOMISTS
Toward the end of the fifteenth and during the early part of the sixteenth centuries accounts concerning syphilis began to be published in the medical literature of Spain, Italy and France. The word “syphilis,” it is true, does not appear in any of these records, for it had not yet been coined; but the accounts themselves leave no room for doubt that this was the disease to which the authors of these records referred. The prevailing views with regard to the origin and nature of syphilis differed somewhat in the three countries named. In Spain, for example, it was a common belief that the disease originated in an unfavorable conjunction of the stars[100] and yet at the same time it was generally admitted that it was a disease which belonged in the category of luxuries and might be avoided if one were careful not to have intercourse with dissolute women. For a brief period of time there were physicians in all three of the Latin countries who maintained that syphilis had been imported, in the first instance, from America by the men who made the voyage with Columbus and by the earliest Spanish explorers of South America; but it was soon shown that this theory was not compatible with certain known facts—such, for example, as the published reports made by the Spanish physicians Pintor and Torrella,[101] who describe cases of syphilis which they had treated prior to 1493 (the year in which the first discoverers returned from America). In Italy, according to Giovanni da Vigo, the author of an excellent treatise on surgery (“Practica in arte chirurgica copiosa,” Rome, 1514), the disease was first observed in Europe in December, 1494, soon after the arrival of Charles the Eighth’s (France) army at Naples; and only a short time elapsed before there developed, as a result of this great accession of French soldiers, a veritable epidemic of what then began to be known quite generally as “morbus gallicus” or “the French disease.” The King himself, it is stated, was among the number of those who contracted the infection.
So far as I am able to discover, the term “syphilis” was first introduced into medical literature by Fracastoro, the distinguished physician of Verona, who published in 1530 a Latin poem bearing the title: “Syphilis sive morbus gallicus.” These verses were received everywhere with great favor, were translated into several modern languages, and speedily put an end forever to the employment of the insulting term “morbus gallicus.”