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BOOK REVIEWS The Science of Woman: Gynaecology and Gender in England, 1800-1929. By Ornella Moscucci. New York: Cambridge University Press, Pp. 200. $47.50. Dr. Moscucci has written a well-researched book tracing the development of the modern medical discipline of obstetrics and gynecology. This development is presented in the context of the role of women in British society and the desire of physicians to base their therapy on scientifically acquired knowledge. It is a fascinating journey, full of "good guys" and "bad guys," politics, intrigue, misunderstanding, philanthropy, and greed. All the ingredients for an exciting story are here. The author uses the study of the development of obstetrics/ gynecology to explore the broader question of whether women's destiny is rooted in their biology. Only women have cyclic reproductive changes. This has led to the notion that women's thoughts, beliefs, and actions are tied to the menstrual cycle. Men in general, and male physicians in particular, held the view that women's sexual organs, and problems resulting from them, have an important, perhaps overriding influence on individual women. In addition, only women can bear children. This has led to the view that women are important to society because of their ability to deliver children; children who are needed as workers, consumers, and soldiers. The major theme of the book is that the development of Obstetrics and Gynecology as a specialty was driven primarily by men's desire to control women, by the opportunities it provided men to derive income, and by the ability for successful men in this specialty to gain status in a class society. The time period of the study was chosen because science as we know it today began with the eighteenth century and the medical specialty of Obstetrics and Gynecology, with examinations and certificates, was established in 1929 as the Royal College of Obstetricians and Gynaecologists. The strengths of the book are several. The first is the fascination that readers will have when they note that the "more things change, the more they stay the same." Problems of health care delivery, overwhelming economic issues, and "turf" battles between specialties continue today as they did in past centuries. Then as now, the rich can afford to pay for health care, the indigent receive charity care, but the working poor are often left without adequate coverage. The debate continues over the role of midwives—should they be independent or be under the direction of a physician? What is the role of men in women's health care? Is the modesty of women violated? What is the role of women Permission to reprint a book review printed in this section may be obtained only from the author. Perspectives inBiology and Medkine, 34, 3 ¦ Spring 1991 463 physicians? Are they too weak physically and constitutionally to handle the demands of OB/Gyn? The issue was debated in the United States until the last decade. Women are finally accepted into the field, but must now deal with the problem ofbeing physician, wife, homemaker, and mother. It would be interesting to trace this development from "weak sister" to "superwoman" in a future book. Medical advertising was used in the nineteenth century, and condemned by some, just as it is today. The second major strength lies with the exciting story that Moscucci tells. Why did hospitals devoted to the care of women develop? Why did a medical specialty devoted exclusively to the care of women's problems flourish? The reciprocal arrangement, specialized and exclusive care of men, was not established . This book gives rational explanations for this interesting phenomenon, which tell us much about both men and women. Also tucked into the book are interesting vignettes concerning the controversies surrounding the use of the vaginal speculum and the examining table stirrups. There are some weaknesses. Greed, and the desire for power and status, are given prominent roles as motivators of men's actions. But what about the possibility that at least some physicians, and other health care workers, were compelled to action because they were appalled by the high infant and maternal mortality rates in the nineteenth and early twentieth centuries and wished to do something about it? Specialization, with...

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