Madame du Coudray

by Allyn Bures (Vanderbilt University)

Angelique Marguerite Le Boursier du Coudray, midwife to the nation of France, holds a substantial position in the history of early modern medicine. Mme du Coudray is most famous for her revolutionary midwifery teaching techniques, including an incredibly detailed textbook and lifelike machines utilized to simulate childbirth (1).

As a practicing midwife in 18th century Paris, Mme du Coudray violated the majority of standards demanded of midwives; she had no children of her own, was not married (though possibly widowed), and believed in the organization of midwives (2).

In 1751, Mme du Coudray traveled to Auvergne, where birth survival rates were incredibly low, and was exposed to the horrors of untrained peasant midwifery. She dedicated herself to improving midwifery practices in rural France, designing child-bearing machines constructed from leather, dyed fabric, padding, and real pelvic bones, wicker, or wood to replicate deliveries (3, 4). Later models included sponges that released dyed liquids representing blood and amniotic fluid at proper moments (3).

In 1759, the same year that Mme du Coudray released the first edition of her midwifery manual Abrege de L'art des Accouchements, King Louis XV appointed her to spearhead a nationwide public health campaign educating female students and male surgeons in rural provinces (5). This campaign, the first of its kind, would counteract the low birth survival rates throughout the country and rebuild the soldier population that had been depleted in the Seven Years' War.

Mme du Coudray's teaching initiative was a huge success, lasting 30 years and educating an approximated 400,000 peasant women; in addition, a number of male surgeons taught her technique to later students. By the end of her career in the 1780s, approximately 2/3 of practicing French midwives used her techniques; success rates were reflected in the increased numbers of successful births that appeared in the 1780 and 1790 censuses (5, 6). Before her 1794 death, she ensured that her legacy was lasting by providing for her "niece" Marguerite Guillaumanche and her surgeon husband Coutanceau to continue teaching the du Coudray technique at France's first maternity hospital (5).

Image: "The Machine." Madame du Coudray's Machines. Musees en Haute Normandie.

Sources:

(1) Gelbart, Nina. "The Monarchy's Midwife who Left No Memoirs." French Historical Studies (19) 1996: 997-1023.

(2) Cody, Lisa. "Sex, Civility, and the Self: du Coudray, d'Eon, and Eighteenth Century Conceptions of Gendered, National, and Psychological Identity." French Historical Studies (24) 2001: 379-407.

(3) Riskin, Jessica. "Eighteenth Century Wetware." Representations (83) 2003: 97-125.

(4) Stanley, Autumn. Mother and Daughters of Invention. New Jersey: Rutgers UP, 1995.

(5) Marland, Hilary, ed. The Art of Midwifery: Early Modern Midwives on Europe. London: Routledge, 1993.

(6) Gelbart, Nina. The King's Midwife: A History and Mystery of Madame du Coudray. Berkeley: University of California Press, 1998.

Realism in Dissection

by Mary Coleman (Vanderbilt University)

During the scientific revolution and particularly the 17th century, anatomical dissections and representations took on a new element of "realism." Dutch anatomist Govard Bidloo's 1689 anatomical manual, Anatomia Humani Corporis, and the controversy surrounding its illustrations highlight the manner in which such realism was a product of the times.

The manual's hauntingly precise illustrations, drawn by Dutch artist Gerard de Lairesse, were central to the success of the work and proved so in later allegations of plagiarism. When William Cowper published an anatomical manual in 1698 using the same plates drawn by de Lairesse, he gave no credit to the artist or the anatomist. Although Cowper wrote an entirely original English text to accompany the plates, his status as a plagiarist remains. Author and historian William Cobb considers the importance of illustrations in 17th century medical publishing: "Precise anatomical descriptions were a key part of the scientific revolution's attempt to provide a material account of the universe" (163).

Why were such illustrations so imperative to the livelihood of 17th century anatomists? The invention and development of the microscope in the Netherlands during the early 17th century brought medical and public attention to the uncharted realm of minute structures. With the enhanced observational power of the microscope, realism and even hyperrealism became vital to the success of anatomical illustration. During the Dutch Golden Age of the 17th century, the Netherlands really was the center of scientific and artistic innovation, producing such celebrated artists as realist painter Jan Vermeer and Rembrandt, certainly a master draftsman. During this "golden" era, distinguished artists and scientists mingled in the universities and public spheres.

Medical education during the century increasingly included observation of dissection in "anatomical theatres." Professors performed dissections while dictating anatomical lessons to students, and public dissections were put on display for a fee. As interested parties became well versed in the drama of dissection and anatomical macro-structure, anatomists were pressed to deliver cutting-edge observations with precision.

Govard Bidloo's text and the controversy surrounding its publication demonstrate the beginnings of an emphasis on exacting observation that continues today in medical experimentation.

Image: Gerard de Lairesse, "Structure of Head" (1685).

Bidloo, Govard. Anatomia Humani Corporis, 1685.

Gerard van Swieten

by Julie Ann Fenstermaker (Vanderbilt University)

In 1740, when Maria Theresa inherited the Habsburg Empire, Austria was about 200 years behind its European neighbors in the medical realm. Maria Theresa acted fast and recruited knowledgeable people to her court. Gerard van Swieten was one of the most important people she brought to Vienna, Austria.

Van Swieten was educated at the Leiden University; he studied under Herman Boerhaave and became a well-respected physician. He actually compiled his notes from Boerhaave's lectures into a 15 volume set. In Austria, van Swieten was appointed as the Chief Physician, which meant he not only cared for the royal family, but he also managed the entire medical staff as well. He was also named the Director of the Imperial Library. As President of the Censorship Committee, van Swieten had access to all the new books being published. He documented the list of books that the committee read in Supplementum Librorum Prohibitorum. This record of 3,120 works, 595 of which were banned, provides insight to historians on the social and political sentiments of the time.

Van Swieten's legacy is in his reform movement. In 1749, he proposed a plan to completely reorganize the faculty of medicine. Maria Theresa agreed to this plan and provided funding to establish the Vienna School of Medicine. Van Swieten added professorships of botany, chemistry, and surgery to the university and personally taught a two year lecture series on the functioning of the human body and the pathology of diseases. He also reformed pharmacy inspections to make the apothecaries more accountable.

In his book Diseases Incident to Armies, van Swieten describes a cure for syphilis. The concoction of mercury sublimate was called Liquor Swietenii. It was not invented by van Swieten, but he was the one who administered it on a large scale; therefore it was credited to him for over 100 years.

Van Swieten's efforts of reform made a powerful impact in Austria. The Vienna School of Medicine became a highly respected institution of learning, and he was able to recruit impressive physicians and scientists to Vienna. Van Swieten was commemorated on the Euro in 2007 and can also be found on the Maria Theresa statue near the Hofburg in Vienna.

Image: Gerard van Swieten

Sources:

Brechka, Frank T. Gerard van Swieten and his World, 1700-1772. The Hague: M. Nijhoff, 1970.

Kidd, Mark, and Irvin M. Modlin. "Van Swieten and the Renaissance of the Vienna Medical School." World Journal of Surgery (25:4) 2001: 444-50.