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See Anesthesia and Bloodletting in Obstetrics on next page

Civil War Era Birthing Bed
Birthing Bed and Speculum Table
Circa 1860s
     The necessity for a pelvic evaluation led to the development of the examination table.  The first furniture  for this purpose  was called "Speculum Table" (1839), where speculum vaginal examinations were performed.  A simple and cheap portable table for delivery and operations. It is equipped with a sliding stirrups and a sliding platform to catch secretions. This delivery table was believed to be owned by doctor in Alabama during the Civil War era.  A similar table is illustrated on James V. Ricci, MD, 1949 book: The Development of Gynaecological Surgery and Instruments, pg 496. Chap X.

Cesarean Section
Surgical Knife
Circa 1860

     The first Cesarean operations were done to extract a dead fetus from a dead mother.  Numa Pompilius (715 - 672 BCE), a legendary king of Rome forbids burying a dead woman until her baby was taken out of her.  Early Christians believed that: "He who does not bury the baby causes the promise of life to perish with the mother!"  No one survived the operation in Paris between 1787 to 1876 when the procedure was done on 24 living patients.  The surgical knife shown is unplated steel with ivory handle used around 1860.
 

Cesarean Section

     The operation's name probably goes back to the eight Century BCE.  Numa Pompilius (715 - 672 BCE), a king of Rome forbids the burial of a pregnant woman before the young has been excised.  The law continued under the Caesars when it acquired the name Lex Caesare.  Some scholars believed that the name was derived from the Latin word Caedere, meaning to cut.  In 1867, there were 54% maternal deaths out of 1,605 operations done in the United States.
     The photo is a scalpel made of unplated steel with smooth ebony handle used circa 1860.


The First Stethoscope
 The First Stethoscope
c 1816


 Since the time of Hippocrates, 5th Century BCE, doctors usually placed their ears on a patient's chest to listen to the heartbeat and lung sounds.  Faced with breasty woman, Dr Rene Laennec modestly insisted on using a rooled-up sheets of paper as shown on picture.  Thus, in 1816, the first stethoscope was conceived. 

 
  A replica of the wooden monaural stethoscope made by Rene Laennec in 1819.  A solid wood cylinder with a drilled center.  It could be shortened by pulling the other half of the stethoscope for closer listening.
The larger opening in the chest end is for listening to the lungs.  To listen to the heart , the plug is inserted.
Three separate pieces that fit together to form a 33 cm long, 3 cm diameter instrument was made by Sharp & Dome Co. circa 1955.

Early Blood Transfusion in Midwifery

The first blood transfusion was done from animals like sheep or calf to man.  James Blundell (1790-1878) have done the first sucsessful human to human blood transfusion.  It was done on patients who would have exanguinated from post-partum bleeding.  In 1849, nineteen cases were successfully transfused;  however, five ended in death.  This was a remarkable accomplishment considering that blood grouping was unknown until 1900, and blood banking until 1936
To overcome the clotting problem, blood transfusion was done directly from donor to patient. Circa 1850s.

Below:
A cased blood transfusion set with tubings, syringes, and needles dated 1913.


19th C bl trans
19th Century Blood Transfusion Set

A rare antique blood transfusion syringe from the 19th Century.  The syringe is placed in the original silk lined leather box.


German trans set 1

German Bl trans set 2
Bl trans instr 1
blood trans instr 2
                                     German Antique Blood Transfusion Set
                                                  
Complete with illustrations and instructions.

Ergot of rye was introduced by John Stearns (1770-1848) in 1807 for postpartum hemorrhage and for prevention of anticipated bleeding.  It was of little help on patients who already have lost significant blood volume.

Fluid Extract Ergot

Pregnancy Votive Medal
Circa 19th Century
     A silver plaque depicting a pregnant belly.  It was used as an offering to St. Gerard Majella, after the woman's prayers about her pregnancy have been fulfilled.  19th Century, Sicily. (11 x 9.5 cm.)

Maunder's Mouth Wedge
Circa 1860's
Ebony mouth gag.  6 cm length, 3 cm widest diameter.
1280 Council of Cologne
A woman's mouth was to be kept open with a mouth wedge in order for her child in her womb to breath air while it was being removed by operation. 

Chinese Medical Doll
Circa. 19th Century
Tradition and extreme modesty prohibit Chinese doctors from examining female patients.  This solid ivory figurine serves as a devise used by women to indicate to the doctor the part of the body in which ailment was present. Physicians carry it with them to the bedside, or at times the patient brings it with her ( Ming Period 1368-1644).  The nude lady is ornately carved, 14 cm in length, 4 cm wide, on a mahogany stand.

Birthing Postures
There were various birth postures practiced throught the centuries. Childbirth during the medieval times took place on a stool or in the lap of another woman. Others have it kneeling or squatting. In Taunton England, standing up was the choice.  Mauriceau of France made a daring innovation when he started to deliver his patients in bed.
Birthing Postures

Childbirth during the medieval times took place on a stool or in the lap of another woman. 

Birthing Bed
Mauriceau of France on the 17th Century made a daring innovation when he started to deliver his patients in bed!

Wet Nurse
If mothers could not breastfeed their newborn themselves, the well to do hires a wet nurse.  Mothers who cannot afford to employ a wet nurse would ask a close kin to do the task.  Midwives or the physicians often times were asked to select a breast to do the job adequately.
wn

 
Amputation Cased Set
C 1895 - 1900
Small leather cased amputation kit by Otto Helmond, Pitt. Pa.  All metal handle on the amputation saw denoting post 1880 sterilization concerns.

During the Civil War 1861- 1865, medicine barely rosed up  from its medieval period.  Amputation was the only reasoned  treatment for gun shot wound, severe laceration, severly infected limb, or fracture .  Amputation accounted for 75 % of all the surgeries done during the civil war.  Records showed more or less 30, 000 amputations were  performed on the Union side  with more than 25 % mortality.  Few doctors knew how to administer ether or chloroform although available and  the principle of antisepsis was unknown.  Surgery was performed with bare unwashed hands in the open fields.  The surgeons used the same amputation kits,  rubbing them between cases  with  a piece of dirty rags.

 
Boxed Pessaries with inserter.
Circa.  Early 1900's
 Y  shaped pessary made of gold
Mushroom shaped Pessary
IUD's Sold as Pessaries

Medical instruments from the end of the 19th century through early 1900's, include descriptions of "pessaries" that resemble modern IUD (Intrauterine device).  The existence of Comstock laws that prohibit the use of the mails for contraceptive devices may have been the reason for the false advertisement.
Anthony Comstock was an anti-sin crusader whose activities resulted in the passage of the 1873 federal postal law prohibiting the propagation of birth control information and contraceptive devices through the U.S. mail.  He labeled contraceptive methods  as "lewd, lascivious, and obscene," that he burned  tons and tons of contraceptive materials.  In 1930, a U.S. federal court declared  the Comstock law unconstitutional.


The Forerunner of Modern Day IUDs
Intrauterine Wishbones & Stem Plugs

It was illegal to sell or promote any form of contaceptives during early 1900s.  These birth control devices were sold and advertised as pessaries.  They were place in the cervix with the stem inside the uterine cavity.  These pessaries were the forerunners of the modern day IUDs.

 
Clinical Thermometer
Circa 1860

     Clinical thermometer was introduced in the mid 19th Century.  This underarm bent thermometer is clumsy, heavy, and inaccurate.  Its scale etched on an ivory could read only if in place.  If removed before recording, the mercury column drops in the process.  It was superior to the hand on the forehead  method .  The thermometer is 17.5  x  5  cm.  Glass and ivory in brown leather case.


 Baunscheidt's Lebenswecker
Circa 1880

      Lebenswecker, a German word for life awakener.   A counter irritant device.  The sharp needles in the tip of the instrument were dipped in a mixture of menthol, camphor, turpentine, and vegetable oil.  The head of the device was placed on the area of ailment.  The toggle was drawn back to cock the spring then released driving the needles into the patient's skin (ouch!), and presumably curing numerous illnesses.  Seemed to work, most patient never came back for a second treatment!  The hollow ebony tube contained a handle with coiled spring attached.  Measures 27 x 3 cm.


Warning!  Warning!  Warning!  Warning!  Warning!
Medications mentioned on this web are intended for historical information only.  Do not attempt to take or apply any of the medicine to yourself or to others.  It will cause irreparable damage to your health and to others.
Treatment For Venereal Disease
Pre-Penicillin Era

     Treatment for female Gonorrhea:  Cleanse vagina, cervix and urethra with saturated solution of boric acid. Dry with pledget cotton, held by a uterine forceps.  Soak pledget in a 1% aqueous Methylene blue solution and apply  it up to the cervical canal, vagina, and urethral opening.  Treat 2x weekly.

Glass Vaginal Syringes
 
Circa 1890s

Syringes for injecting medicine to the vagina.
Varying lengths: 14, 20, 22 cm.

French Secret for Venereal Prophylactic

             Boric acid powder,
             Burnt alum powder,
             Quinine hydrochloride.

     Dissolve 1 dram in pint warm water, wash and inject into vagina immediately after sexual intercourse.

 
castor
Induction of Labor

Castor oil was commonly used medication to prime labor.  Two table spoons of castor oil was given followed by ten grains of quinine. This regimen was repeated if labor does not start in one hour.  An enema was also given in conjuction with the above mediccations if labor does not ensue. See other uses of enema below.  (Warning: Do not attempt to use the above medications.  It will do irreparable damage to you and your unborn child.)



Pubiotomy
     A surgical procedure to divide the pubic bone to accomplish delivery of the fetus on difficult labor.  It was first performed by J.R. Sigault in 1777. (Sometimes called the Sigaultian Operation).   Reintroduced by Morisani of Naples in 1866, in France by Spinelli in 1891.  Introduced in America in 1892.

symphysisknife

Symphysiotomy Knife
Circa Early 1900
      Symphysiotomy Operation

       Too firm a union of the pubic bone was mistakenly regarded as a cause of difficult labor.  The surgical separation of the pubic bone called symphysiotomy was in fashion one time and in competition with Cesarean section in the mid 1800 through early 1900.  Although the United States abandoned the procedure because of the mutilation it did to the mother, European and South American accoucheurs continued to perform these horrible operation up to the mid 20th Century.   

                                                                      Art work by Aimee Gapultos


Chain Saw 
c 1890s
     The string saw developed by Leonardo Gigli (1863-1908) for dividing the pubic bone.  It was believed that cutting the segment of the pelvis made it moveable, and yield to the pressure of the uterus to accomplish delivery of the child.  The operation is also called Hebotomy or Hebosteotomy.
     Ebony handles, 6cm.  The length of the chain saw and handles measure 45 cm.  Comes with a large curved unplated steel symphysiotomy needle, 9cm

Ecraseur (Uterine Guillotine)
Circa 1865
      An awesome unplated steel instrument used to amputate the cervix to eradicate cancer of the cervix, or to treat uterine prolapse.  It has a chain loop mechanism that is tightened by turning the handle clockwise until the cervix is crushed.  This technique was introduced by Gustav Simon in 1850.  Hysterectomy was out of the question because it was fatal.  (L 36 cm)

Ecraseur
Circa 1870
The cervical stump in abdominal hysterectomy was amputated by a chain ecraseur in the late 19th Century.  The chain was placed around the cervix and was tightened so as to strangulate and lacerate the cervix, thus lessening the chance of hemorrhage.  (L 31 cm)

Wire Ecraseur
Late 19th Century
The wire ecraseur was passed around the base of uterine polyp or tumor.  The handle was turned to tighten the noose until the tumor came off.  (L 15 cm)

Facts About Hysterectomy

Levi Lane, in 1878 performed the first hysterectomy vaginally.  Palmer Dudley found no cases of vaginal hysterectomy  before 1878
LAVH (Laparoscopic Assisted Vaginal Hysterectomy) Concept in 1810?
Maxentius Gutberlet introduced the new technique of cutting the uterine attachments by abdominal approach and then resorting to removal of the uterus from the vagina as early as 1810.
                         Ref: James Ricci, M.D.
                         The Dev of Gyn Surg   
                          and Instr. pg 387
                          Norman Publishing, 1990

Facts About Episiotomy
Fielding Ould (1710-1789) in 1742, he first suggest episiotomy to avoid perineal injury.
Paul Dubois (1795-1871) introduced mediolateral episiotomy.
Carl Braun Ritter von Fernwald (1822-1891)  gave the name episiotomy.
                             Ref: James Ricci, M.D.
                             Norman Publishing, 1990

Metrotome
Circa 1860
 Cervical stenosis, uterine malposition like retroflexion were attributed to several women's complaints.  Among them were painful menstrual cramps, and infertility.  It is a scissor-like instrument for dividing the cervix (inset on right).  The opening of the sharp edge was adjusted with a screw inside the handle.  James Young Simpson introduced the metrodome in 1860. 

cordclamp1a

cordclamp1b


Birthing Scissors
Circa 19th Century
A brass stork cord scissors.  Beak surfaces are flat and were used to compress the fetal cord until it could be tied off with string and cut.  Note the image of an infant on the stork's belly.  Midwives in mid 1700 often debated about how long a fetal cord should be cut.  They believe to cut the cords longer on the male so "they would be well provided for the encounter of Venus!" On the other hand, the cords were cut shorter on the female because "they would be modest and their privities narrower to make them more acceptable to their sexual partner!" (9 x 4.5 cm)

enema 2

Enema

 During the  rule of King Louis XIV, aristocrat women resorted to enemas as often as 4 times a day to improve their complexion and retain thier youthful appearance. Cloyster of opium were given to relax an irritable colon . 





William's ob book
J. Whitridge William's Obstetrics
1903
First Edition
First Printing

The gold standard textbook in Obstetrics in the world.  On its 21st edition 2001.

The classic texbook used by medical students and practioners alike for 100 years. On Chapter XV, Conduct of Labor, it states:
"The physician should direct the nurse not to send for him if the labor commences at night, between 11 P.M. and 7 A.M., unless it seems necessary that he should see the patient at once. On the other hand, when the pains begin between 7 A.M. and 11 P.M., the physician should be notified immediately, so that he may make his plans accordingly."  Hmmm, the good old days huh!!

John Whitridge Williams (1886-1931), a Professor of Obstetrics in John Hopkins University and author of Americas's most popular obstetric text, first published in 1903.



See Anesthesia and Bloodletting in Obstetrics on next pageAnesthesia

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All statements in this web page regarding date, age, and origin are statements of opinion.  All photos and materials on this web page are protected by copyright laws.  Please obtain direct  permission fromF.C. Gapultos, Jr.to use any and all materials on this site, including photographs and drawings.