- The History of Obstetrics and Gynaecology
As the title indicates, this is an ambitious work, and the authors understandably suggest that they have provided us with a definitive volume. The book totals around seven hundred pages and offers readers forty-five short chapters describing illnesses and procedures. Each chapter has a chronology and bibliography; many have illustrations.
The authors, both practicing medical men, have had the courage to do that which intimidates many professional historians: they attempt an international sweep, advance a variety of syntheses, and supplement their specific studies with broad historical generalizations. Analysis, as in so many instances, pays rent to the landlord of synthesis, and in this case the rent is high. It is a rare historian—Philip Curtin, for instance—who can successfully adopt a truly global perspective without losing the depth and texture that are intrinsic to the best scholarly histories.
Even at a more micro-level, there are some obvious problems with the work at hand. The historical sketches and bibliographies are rather inconsistent. Granted, O’Dowd and Philipp have amassed a tremendous amount of useful material; but they have also left some surprising gaps. Ornella Moscucci’s book The Science of Woman (1990), which offers a valuable historical perspective on nineteenth-century [End Page 185] gynecology, is not even cited. As this indicates, the bibliographies vary considerably in their extent and reach. In the chapter on hormones and the menstrual cycle, for instance, there are 370 references; in the preceding chapter on antibiotics, there are 26. Clearly, this does not accurately represent the available literature. Perhaps these differences more accurately reflect the authors’ interests, a conclusion supported by other aspects of the volume.
Despite these problems, the book contains much material that will interest historians of medicine. The authors have enhanced their survey with vignettes and details that help to keep the reader engaged. Some of these may have been vaguely known, but the essays jog them back into focus and provide useful information for teaching purposes. In the 1940s, for example, excessive benign menstrual bleeding was sometimes treated by X-rays and radium—a therapy that not surprisingly resulted in vastly higher rates of endometrial and cervical cancer (p. 301). This is the type of story that can be used to launch discussions about historical relativism, medicine for women, and the development and application of new technologies in health care.
The chapter on cesarean section illustrates the strengths as well as the weaknesses of the book. The authors survey the standard histories of the subject and provide a useful, well-researched, chronological narrative, with some worldwide perspectives. Anyone beginning a study of the history of this operation would do well to read their essay. Unfortunately, scholars in the field will nevertheless be disappointed to find that the chapter is relatively shallow: it fails to address or even mention some of the most recent literature in the field, and thus fails to provide the kind of analysis desirable in graduate education. There are other signs that the book is behind the front edge of historical interpretation in this field. Menopause, for instance, is addressed within the framework of illness; the authors seem unaware of the literature dealing with menopause as a natural and normal life-cycle event.
While these are serious problems, they will not prevent historians, physicians, and nurse-practitioners from making good use of this compendium. Many will be pleased to find that the authors are not mere apologists for heroic medicine: they acknowledge the importance of midwives historically and contemporarily; they describe aspects of non-Western medicine and discuss some elements of “alternative” practice in Western society (e.g., using evening primrose oil to ameliorate PMS). Their book—because of its breadth and bibliographies—will be a useful addition to reference libraries and to medical schools’ Ob/Gyn libraries. It will also be found on the shelves of historians of medicine interested in obstetrics and gynecology. Beginning instructors, who will find valuable the chronologies, bibliographies, and brief histories, will also...