Helen King's new book is a play in three acts. She traces the history of a Renaissance compendium of women's reproductive medicine through the eighteenth and nineteenth centuries. Such a project might seem antiquarian, but in King's hands, it provides a rich reinterpretation of the history of women's bodies. The book she focuses upon, the Gynaeciorum libri, or Books on the Diseases of Women, was first published in 1566 as a collection of ancient and contemporary texts and commentaries on what we would now call gynecology. It mushroomed in length until by the end of the sixteenth century it topped 1,000 pages. King explores how this book was used by William Smellie, the mid-eighteenth-century man-midwife, and then by Sir James Young Simpson, the mid-nineteenth-century pioneer of anesthesia in childbirth.
In the Renaissance, this book was a crucial carrier of Hippocratic ideas about women's reproductive functioning. The key Hippocratic text, Diseases of Women, was unknown in the Middle Ages in the Latin West. Its translation into Latin and publication in 1525, as a part of the larger Hippocratic corpus, offered Renaissance medical men a new model of the female body and a new mandate for them to take up the practice of reproductive medicine. The Diseases of Women suggested that women's bodies were fundamentally different from men's. Women's bodies were made of a looser texture, and because many women took little exercise, fluid built up, like water in a sponge. Thus, women were physiologically different from men, and doctors must attend to this difference in order to treat them successfully for any ailment. As King shows, this text was repeatedly invoked by practitioners who argued for the creation of a medical practice attentive to and focused upon the peculiarities of female bodies. The Gynaeciorum libri combined parts of the Hippocratic text with a series of pan-European medical writers' works on gynecology, influenced by the Hippocratic text, often drawing upon new anatomical and clinical studies.
King's careful explication of the significance of this Latin tome makes at least two important historiographic interventions. First, when we situate this book next to Monica Green's recent groundbreaking work, Making Women's Medicine Masculine (Oxford, 2008), we can see a very long tradition of male physicians writing about, and sometimes practicing, a medicine devoted to women's reproductive issues. These works thus offer an important refinement to the very rich scholarship on early modern midwifery. Yes, most babies in the early modern period were delivered by women, but that does not mean that all aspects of women's reproductive medicine were solely in the hands of female midwives. The much-discussed advent of the male midwife in the eighteenth century does not represent men's first incursion into reproductive health.
The other historiographic point King offers us is a more complex picture of ideas about sex difference. In particular, she shows that Thomas Laqueur's one-sex model, in which men and women are fundamentally the same, differing in the placement of their genital organs, was not the only model of sex difference available in Renaissance Europe. Indeed, it may not have been the dominant model; there may have been no dominant model but a rich tapestry of ideas available for combination and recombination. Laqueur did not consider the Hippocratic text, Diseases of Women, which does not offer a one-sex model, but rather two less significant Hippocratic works. By ignoring Diseases of Women, King suggests, Laqueur overlooked a body of evidence that would have complicated his narrative.
The next two acts of the play feature central characters well known to the history of obstetrics: William Smellie and James Young Simpson. One of the unexpected pleasures of King's book is the opportunity it affords to reflect on the changing fortunes of history within medicine. The Renaissance recovery of Hippocratic medicine was not understood as a historical exercise; humanists translated Hippocrates to improve medicine. But in the eighteenth and nineteenth centuries, Hippocratic gynecology came to serve professional purposes. William Smellie invented the role of the man-midwife in eighteenth-century London, attending normal births, rather than just intervening in those that had gone wrong, and training over 900 students. For Smellie, the Gynaeciorum offered male ancestors who specialized in female reproductive medicine. James Young Simpson pioneered the use of chloroform in childbirth and was knighted by Queen Victoria for it. His portrait was painted with the Gynaeciorum in the background, in part as a sign of his aspirations to gentility. Like Smellie, Simpson sought a historical narrative that legitimated the presence of men as midwives. He also looked to Hippocratic gynecology for historical support for his vision of gender relations and to a range of classical authorities for insights about gender and anesthesia.
This brief description does not do justice to the many topics King's focus on the Gynaeciorum enables her to address, such as the Hippocratic fascination with monstrosity, the introduction of forceps, and so forth. For scholars interested in gender and medicine, this book is a must read, full of unexpected treasures.
