Does Sex Make a Difference? Trials and Tribulations of Late-Nineteenth-Century Gynecological Surgery

Regina Morantz-Sanchez. Conduct Unbecoming a Woman: Medicine on Trial in Turn-of-the-Century Brooklyn.New York: Oxford University Press, 1999. 320 pp. Notes and index. $30.00 (cloth); $15.95 (paper).

On the surface, Regina Morantz-Sanchez has written a richly textured, often riveting history of a highly controversial, though now largely forgotten, late-nineteenth-century female gynecological surgeon, Mary Amanda Dixon Jones. However, Conduct Unbecoming a Woman is much more than just that. A deeply contextual account that encompasses numerous aspects of late-nineteenth-century life, the book explores fundamental relationships between culture and medicine and how each informs and helps constitute the other. The specific details of why surgeons and, in particular, a maverick female physician resorted to radical gynecological surgery gives way to more substantive questions about the construction of gender, interconnections between ideology and medical practice, and the broader role of culture in what is deemed as scientific.

The end of the nineteenth century is a fertile period in which to explore these larger questions, for physicians during this era began adopting a radically new medical epistemology and, to a lesser extent, novel therapeutic practices. ¹ Moving from broadly holistic views of health and disease to more localized, reductionistic perspectives (a shift especially reinforced by the emergence of the germ theory and anatomic pathology), these physicians began forging what has become the bedrock of our contemporary vision of scientific medicine. Surgeons and their practices played a significant role in this transformation as they prodded, poked, and sliced their way into the bodies of their patients. For them, illness was rooted in localized tissues that were increasingly amenable to surgical intervention. Gynecological surgeons were at the phalanx of this new medicine, reinforcing localized approaches to disease as well as reshaping the meaning of the female body, aided particularly by new operative methods for intervening on this body. This new view of the body and disease also insinuated itself into relationships between doctors and patients in ways that one might not have predicted given the invasive and, what appears from our present perspective, reckless nature of their operations. These changes, of course, took place within a broader social and cultural world that shaped (as well as was shaped by) medical science and practices. In Morantz-Sanchez's narrative, the larger contextual factors include the growing importance of Brooklyn as a metropolitan center, the rise of the press as an instrument of cultural production, and the emerging culture of the middle class. Weaving all these themes together as she takes us through the travails of Dr. Dixon Jones, Morantz-Sanchez lays bare, with refreshing specificity, the ways in which culture constitutes and is constituted by science and medicine. ²

Mary Dixon Jones was an imposing figure. Arrogant, strong-willed, easily angered, she is an unlikely protagonist. But her virtues as well as her shortcomings--especially her transgressions of proper female conduct--give us a vivid window into late-nineteenth-century medical and social life. The scaffolding of Morantz-Sanchez's narrative is two trials that prominently displayed these strengths and weaknesses in which medicine and Dixon Jones had starring roles. In the first, she and her surgeon son (charges against him were later dropped) fought accusations of manslaughter and murder. In an effort to reclaim her soiled reputation in the wake of the first trial, Dixon Jones brought a libel suit against the newspaper that had originally raised the questions that had led to the murder charges. In the end, it turned out to be the longest libel trial up to that point in time in United States history.

One of the most determined female physicians of her generation, Dixon Jones was among the country's most accomplished gynecological surgeons of the late nineteenth century. She also had serious scientific aspirations, having published throughout her career about fifty scientific papers, consisting...