Des maladies des femmes grosses et accouchées. Avec la bonne et veritable méthode de les bien aider en leurs accouchemens naturels, & les moyens de remedier à tous ceux qui sont contre-nature, & aux indspositions des enfans nouveau-nés.

Paris: Chez Jean Henault, Jean d'Houry, Robert de Ninville, Jean Baptiste Coignard, 1668.

The Dedication Copy of the first edition of this groundbreaking medical work which “established obstetrics as a science” (G&M). This is a superb copy in a presentation binding of contemporary red morocco stamped with the name of the dedicatees—Les Maistres Chirurgiens Jurez de Paris—and with three signed inscriptions by the author at the end of the printed dedication, announcing the publication of his work’s later 17th century revised editions. “This book was without question the most practical, explicit and accurate of the then known treatises on midwifery” (Cutter & Viets, A Short History of Midwifery, p. 51). Mauriceau was “the first to write on tubal pregnancy, epidemic puerperal fever, and the complications that arise in labor from misplacement of the umbilical cord’’ (Le Fanu, Notable Medical Books from the Lilly Library, p. 85). Mauriceau popularised the idea of delivery in bed rather than on a birth stool, and while recommending the reading of other learned authors, cautioned that “the most part of them, having never practised the art they undertake to teach, resemble…those geographers who give us the description of many countries which they never saw”. “While much in Mauriceau’s treatise echoed the teachings of his predecessors, the work also included several important new features, such as Mauriceau’s detailed analysis of the mechanism of labor, his introduction of the practice of delivering women in bed rather than in the obstetric chair, the earliest account of the prevention of congenital syphilis by antisyphilitic treatment during pregnancy, and the rebuttal of Paré’s erroneous account of pubic separation during birth” (Norman). For more than seventy years and through numerous translations and editions, Des maladies des femmes grosses contributed to the spread of good obstetric practice throughout Europe.

Provenance: The present copy’s presentation binding testifies directly to Mauriceau’s practical training in obstetrics and importance in the Parisian medical community: its covers declare its owner to be a member of Les Maîtres Chirurgiens Jurés (also known as the Confraternity of Saint-Come), the venerated guild of Paris surgeons established in the 13th century. Mauriceau’s printed dedication, similarly addressed to “Mes chers Confrères,” has manuscript addenda in this copy: Three inscriptions written by the author and signed with his cipher, the first noting the publication of the corrected and augmented second edition of Des maladies des femmes in 1675, the second the publication of the third French and the first Latin editions in 1681, and the third noting the publication of the revised fourth edition “bien plus parfaite que toutes les précédentes.” It seems probable that after Mauriceau originally presented this copy to the library of the Confraternity he continued to revisit the copy on their shelves and documented, in this dedication copy of the first edition, the fact that he had continued to make improvements to his text in later editions.

“François Mauriceau had an extensive practice in midwifery in Paris, both private and in the Hotel Dieu, which was at that time the leading establishment for lying in women in

Europe. In 1668, when only 31, he published his great work Traité des Maladies des Femmes Grosses et Accouchies, ‘which, according to Andre Levret drew from the cradle’ the art of midwifery. Two years later Mauriceau received a visit from Hugh Chamberlen, a member of the British family that possessed the secret of the obstetric forceps, who then translated his text, making it available to the English-speaking world. The influence of this work on many aspects of midwifery was immense, and Mauriceau is still remembered eponymously for his description of delivery of the after coming head in breech presentation. Mauriceau’s book also contains a section entitled ‘Of children newborn and their ordinary Distempers, together with necessary directions to chuse a Nurse'. Among the 18 chapters are ones on ‘Of cutting the Tongue when Tongue-ty’d’ and ‘How to cure the Venereal Lues in infants.’ Perhaps, though, in retrospect, his greatest impact was in the influence his advice had on the position that women should adopt during delivery. From earliest times women throughout the world had usually assumed an upright posture during parturition. In Europe, the birthing chair was particularly popular. As Atwood has written, ‘The first major obstetrical change in the position of the parturient occurred when François Mauriceau substituted the bed for the birth stool. The time honoured ‘position’ assumed in an obstetric chair was replaced with the recumbent position to facilitate examinations and obstetric operations for the obstetrician.’

“Let us study what Mauricaeu actually wrote on this subject”

‘The bed must be so made, that the woman being ready to be delivered, should lie on her back upon it, having her body in a convenient figure, that is, her head and breast a little raised, so that she be neither lying nor sitting; for in this manner she breathes best, and will have more strength to help her pains, than if she were otherwise, or sunk down in her bed. Being in this posture, she must spread her thighs abroad, folding her legs a little towards her buttocks … and have her feet stayed against some firm thing; besides this, let her hold some persons with her hands, that she may better stay herself during her pains … bearing them down when they take her, which she may do by holding her breath, and forcing herself, as much as she can, just as when she goeth to stool …’

“The semirecumbent delivery position described by Mauriceau became known as the ‘French’ position and its use steadily spread throughout Europe and North America in the centuries that followed. Gradually in many countries it evolved into the fully recumbent or lithotomy position. More recently, with the diffusion of Western obstetrics, the dorsal position has also been introduced into many developing countries. Though some authors have credited Mauriceau with this change in delivery position, others regard the dorsal recumbent posture to be the most mischievous intervention in modern obstetrics, causing parturition to be more drawn out, more painful for the mother, and less safe for the fetus. To be fair to Mauriceau it should be recorded that he also recommended ambulation during labour, writing:

‘… she may walk about her chamber … The patient may likewise by intervals rest herself on her bed, to regain her strength; but not too long, especially little, or short thick women, for they have always worse labours if they be much on their beds in their travail, and yet much worse of their first children, than when they are prevailed with to walk about the chamber, supporting them under their arms, if necessary; for by this means, the weight of the child, the woman being on her legs, causeth the inward orifice of the womb to dilate sooner than in bed; and her pains to be stronger and frequenter, that her labour be nothing near so long’” (Dunn).

Dunn suggests that Mauriceau took his recommendation of the dorsal recumbent position from Aristotle, who recommended it around 350 BC, although Hippocrates, Soranus of Ephesus and other classical writers all recommended an upright posture for parturition.

“Mauriceau, who was an ordinary surgeon and not a doctor of medicine, was a skilful practitioner and an acute observer, publishing his observations in an admirably clear form. Mauriceau was the first to study the conformation of the female pelvis, showing that in a woman with a large pelvis birth could take place without separation of the bones. He studied the movements of the fetus in different positions, the circulation in the pregnant uterus, and the formation of milk. He advised the bimanual extraction of the head, and was the first to describe the complication of strangulation of the newborn by the umbilical cord. He strongly condemned cephalic version, and introduced a number of technical improvements. His treatment of haemorrhage was excellent, and he gave careful rules for the treatment of placenta previa. He condemned Caesarean section, which he regarded as fatal. Contrary to the opinion of his predecessors, he recognized the puerperal flow as a secretion analogous to the suppuration of a wound” (Castiglione, A History of Medicine (1941), pp. 555-6).

It is worth noting Mauriceau’s relationship with the Confraternity to whose library the present volume was presented. The prestigious society had originally served to distinguish its members, usually academics, from “barber-surgeons” who had no university training. Yet in 1655 the two guilds had merged—in large part because the practical skills of itinerant surgeons often surpassed those of their academic competitors! In this context, Mauriceau’s hands-on apprenticeship at the Hôtel-Dieu is significant, as is the publication of his work in French instead of Latin—a fact noted by the Bibliothèque Nationale’s inclusion of the present volume in its exhibition catalogue En Français dans le texte (1990). Of interest also is Mauriceau’s advertisement of his medical practice at the foot of the engraved frontispiece, which includes his portrait. He states, admittedly in small print, that his office is on rue St. Severin at the corner of rue Zacharie, etc., etc. 6147. En français dans le texte 107. Norman 1461, Norman, One Hundred Books Famous in Medicine, no. 33; Grolier Medicine 33; Heirs of Hippocrates 604 (2nd. Edition); NLM/Krivatsy 7588; Wellcome IV, p. 85. Dunn, ‘François Mauricea (1637-1709) and maternal posture for parturition,’ Archives of Disease in Childhood 66 (1991), pp. 78-79.

4to (245 x 185 mm). [24, including engraved frontispiece by Guillaume Vallet after Antoine Paillet and letter-press title] 536 pp., including 11 full or nearly full-page, 15 half-page and 3 quarter page engravings in text. In a contemporary presentation binding of red morocco gilt, spine in 7 compartments richly tooled, covers triple-gilt-ruled with fleurons at corners, tooled in the center of the upper and lower covers: ”Ce Livre Appartient à la Compagnie / Des Maistres Chirurgiens Iurez de Paris.” Extremities and corners expertly repaired, preserved in a cloth box. Ruled in red throughout. Mauriceau’s autograph cipher at the end of the printed dedication followed by three inscriptions signed by Mauriceau’s cipher at the end of the printed dedication, dated 1675, 1681 and 1694. Correction in manuscript on p. 196. Some minor toning in extreme outer margin, but generally a broad-margined magnificent copy, in a splendid binding with an important historic association.

Item #4526

Price: $75,000.00

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