Image from George Spratt’s Obstetric Tables, 1833.[i]
A Medical Book Beyond its Time
By BreShae Stewart
One of the greatest contributions to the study of obstetrics is the book, The Science and Art of Obstetrics, written by Theophilus Parvin. Published in 1886, this book details the journey of pregnancy and all its components from the anatomy of female sexual organs to illnesses and diseases experienced by women after delivery of a child. Not only is it a remarkable text because of the knowledge imparted and writing style, but also for its unique way of teaching a proper practice of medicine. Parvin, who was a medical teacher, wrote this book with the intention of it serving as a useful aid to students and practitioners. The book contains several illustrations of obstetric techniques, some of which were original and had never been seen in any other obstetrical book or journal.[1] A copy of this book can be found in the Leo J. McCarthy, MD, History of Medicine Room and Collection at the Ruth Lilly Medical Library.
Obstetrics and gynecology was a relatively a new field of study under medicine. Prior to the 18th and 19th centuries, midwifery had been well established, but obstetrics had not been. In the 18th century, more medical professionals began to finally understand the anatomy of the uterus. The popular invention of the forceps was also developed during this time period. It wasn’t until the late 19th century that obstetrics was recognized as a medical specialty.[2]
In the 19th century, some gynecologists viewed women’s puberty and menstruation as a sign of weakness or uncleanliness. They held false beliefs “that conception was most likely when intercourse occurred during the monthly flow, but intercourse at such times was dangerous and forbidden because the menstrual blood was the source of male gonorrhea.”[3] Moreover, physicians believed nervous stimulation triggered menstruation, therefore they were against the emancipation of women. The process and timing of ovulation wasn’t fully understood until the 20th century.[4] Parvin’s work was a major contribution in this regard. He allots a chapter of The Science and Art of Obstetrics to the scientific observation of ovulation and menstruation, which he learned of after conducting a study of one hundred cases of menstruation at the Indiana Reformatory for Women and Girls. His results led to the conclusion of the average age of the first menstruation and the duration of the flow.[5] Having a mindset greater than his contemporaries, Parvin highlights the characteristics of menstruation, duration of the flow, causes affecting it, and the reasons why it happens.
Additionally, Parvin appeared to have better bedside manner than other physicians of his time. During the mid-to-late 19th century, physicians were accused of disregarding the pain and symptoms of women patients, as male doctors deliberately enforced their professional authority. One such example was the common use of forceps during delivery, which could be painful for both the woman and the child. By contrast, Parvin notes that forceps should only be used when the life of the mother or child requires immediate delivery. In The Science and Art of Obstetrics there are more than enough illustrations, scenarios, definitions, and directions given to readers, medical students and practitioners, of how and when to use surgical instruments. When describing the effects of labor, Parvin gives detailed analysis of the physiological phenomena of labor such as the characteristics of uterine contractions, abdominal contractions, and dilation of the uterus. However, Parvin also goes as far as to describe the characteristics of the pains. He notes that patients may become more restless or irritable as the intensity of contractions occur. He even suggests a practitioner will learn to know a patient’s cry and be able to tell if she is in the first or second stage of labor.
Parvin’s understanding and the knowledge of a woman’s body was far greater than one might expected a physician’s to be in the 1880s, especially when it came to female anatomy. His knowledge almost appears to be that of a person who has personally experienced the pain and difficulties of child labor, but rather he is a physician that has had much experience with women and child bearing. He is one of the greatest contributors to obstetrics and far unmatched in his time.
This post was written for the course HIST H364/H546 The History of Medicine and Public Health (Instructor: Elizabeth Nelson, IUPUI School of Liberal Arts).
References:
[1] Theophilus Parvin. The Science and Art of Obstetrics. (Philadelphia: Lea Brothers & Company, 1886), v.
[2] Deirdre Cooper Owens. “The Birth of American Gynecology,” in Medical Bondage: Race, Gender, and the Origins of American Gynecology, Athens: University of Georgia Press, 2017, 18-19.
[3] Vern Bullough and Martha Voght. “Women, Menstruation, and Nineteenth-Century Medicine,” Bulletin of the History of Medicine 47, no 1 (2000): 67.
[4] Bullough and Voght, 68.
[5] Isaac Hays and I. Minis Hays, “American Intelligence,” The American Journal of the Medical Sciences, Philadelphia: Henry C. Lea, 1878, 293.
[i] Susan Isaac. “Art and Science Meet: George Spratt (1784-1840) – Obstetric Tables, Comprising Graphic Illustrations.” Royal College of Surgeons (November 24, 2017). Online: https://www.rcseng.ac.uk/library-and-publications/library/blog/art-and-science-meet-george-spratt-obstetric-tables/.
