Midwifery and Medicine in Boston: Walter Channing, M.D., 1786-1876 (review)

Though Amalie M. Kass in her new book examines the development of midwifery through the life and career of Walter Channing, she has by no means written just a history of midwifery or a Channing biography. Rather, this is a fine example of using one practitioner's career as the lens through which to view a particular subject (an emerging medical specialty) in its larger context (the practice of medicine in general). Kass informs us at the outset why the story is worth telling: "For more than fifty years, Walter Channing was the unnamed presence in the lives of countless Boston women. . . . Channing's story reveals more than the practice of obstetrics or the reproductive lives of nineteenth-century women" (pp. 3-4).

Insights into the medical, social, educational, and economic history of nineteenth-century Boston and Cambridge enliven the text. Somewhat less clear is why Channing's story has been hitherto neglected. Today, when childbirth is so frequently straightforward, it is easy to forget how much was still unknown in Channing's time. Kass reminds us that the "fundamentals of obstetrics could not change until bacteriology revolutionized the understanding, treatment, and prevention of infection; endocrinology began to explain the development and workings of the reproductive system; embryology shed light on fetal development; and radiology permitted the physician to view the interior of the body" (pp. 91-92).

Kass is sometimes a little too brisk—for instance, in describing the differences between American and European medical education when Channing was studying (pp. 26-28)—and she occasionally oversimplifies. It is misleading to imply that all civic leaders in the early nineteenth century understood "that hospitals were essential to the progress of medical education and medical science" (p. 57); not even all physicians did. Nonetheless, throughout, she skillfully weaves together the strands of her general and particular stories. Chapter 2, "Medical Studies," for example, nicely balances an overall history of medical education with an account of Walter Channing's own medical studies. Similarly, chapter 7, "The Middle Years," opens with the cultural and political context for the central period of Channing's career.

In chapters 10 and 11, particularly, Kass brings us face to face with the kind of person he was. "Throughout the delivery, Channing paid minute attention to his patient's respiration, color, and pulse as well as her emotional response to the anesthesia. For several days afterward he continued to monitor her condition . . ." (p. 174). This is emblematic. Although Channing may have exhibited "extravagant enthusiasm" (p. 183) when it came to the benefits of anesthesia in obstetrics, Kass insists that his early "advocacy of anesthesia is his most important contribution to the practice of obstetrics" (p. 186). She is not afraid to criticize her subject, however. "Channing was a compassionate physician, but he was not a scientist, and much of this discussion makes little sense in the light of subsequent developments in our understanding of physiology" (p. 179). Channing's "paper on anemia shows [him] at his best" (p. 224); his poems "have little literary value and are noteworthy only because they demonstrate another facet of his personality" (p. 228).

Midwifery and Medicine in Boston splendidly demonstrates the congenial companionship of narrative and scholarship. Many of the more than twelve hundred footnotes include discussions, well worth reading in their own right, and there is frequent evidence of Kass's dogged detective work. If at times one wishes she had said more—she failed to note that the "female physiological societies" of the mid-nineteenth century (p. 254) were a kind of prelude to the Boston Women's Health Collective that published Our Bodies, Ourselves a century later—on balance there is much to praise and little to which one might object in this fine book.