C-Sections Before Anesthesia

By Holly Tucker

C-sections were the surgery of very last resort and rarely performed until the mid-to-late eighteenth century. While they were not common, this does not mean that the procedure did not take up good-sized sections of obstetrics texts. In fact, the more difficult and horrific the procedure...the more often you'll get to read about it in early manuals.

You have here an inventory of the tools required for a caesarean section in the very early eighteenth century. This is taken from Pierre Dionis's Course on Surgical Operations [Cours d'Operation de Chirurgie], published in 1708.

Dionis (pronounced Dee-oh-nees) was an innovator in surgical instruction and ushered in a new emphasis on formal training of surgeons. He began his professional life as a surgical and anatomical demonstrator at the Jardin du Roi--now the Paris Jardin des Plantes. Open-air dissections were performed at the gardens and usually drew a large crowd of spectators.

Dionis later became a court surgeon. He documents the work he did at court and describes the demonstrations that he performed at the request of Queen Maria Theresa (Louis XIV's wife). One that sticks in my mind is the dissection that he did following the death of a pregnant woman. The Queen requested that he give her a lesson on the anatomy of the womb and specifically demanded that he bring in specimens from the newly dissected corpse.

More on early c-sections

More on the history of anesthesia

Stephanie Snow on anesthesia's dark side

Image: Wellcome Library for the History of Medicine, London

Nose Jobs

As promised, a classic illustration from Gaspare Tagiacozzi's De curtorum chirurgia per insitionem (1597, book 2). Tagliocozzi shows autografting--grafts using the patient's own skin. In addition to the ravages of syphilis, nose jobs were needed to repair injuries in battle, but also after duels.

The question that I always get is: Did they work? The problem is that we do not have a lot a data on survival rates after such surgeries. We have a good number of case histories, but often there is more information about the specifics of the surgery--rather than the post-op outcomes.

I can say that it's important to remember that antisepsis and anesthesia were 19th-century discoveries. This means that surgery had an even more complex set of potential complications than it does today. Like most of the early-modern folks, I would certainly not line up to get a nose job or breast enhancement surgery just for the heck of it. Come to think of it...I wouldn't do that now anyway!

For more on all of this, I recommend Sander Gilman's excellent Making the Body Beautiful: A Cultural History of Aesthetic Surgery. Gilman is on the faculty at Emory and a top cultural historian.

Image courtesy of: Lilly Library, Medical Collections.