Hardcover
1591 · Basel
by OBSTETRICS. GYNECOLOGY. Rousset, François (ca. 1535-ca. 1590); Bauhin, Caspar (1560-1624)
Basel: Apud Conradum Waldkirch, 1591. SECOND EDITION of Bauhin’s Latin translation, with his commentary and additions, including a new case study. The book first appeared in French in 1581. Hardcover. Fine. A fine copy. Bound in contemporary bind-stamped pigskin (soiled, lacking ties), the boards paneled and decorated in blind, with a large decorative lozenge at the center and with the initials ZPD and the date 1592 tooled on the uppers board. All edges red. A few leaves lightly browned. With woodcuts of instruments in the text on pages 369-372 and a smaller woodcut on p. 218. The folding woodcut image shows a woman in a chair, her abdomen opened to reveal her womb. Next to her, on soft cushions, are two images of the delivered infant, the first of which has been extracted from the mother together with part of the womb. Provenance: Carl Christian Krause, given by him to the Bibliotheca Paulina in Leipzig in 1760; signatures of two members of the Van der Hoven family, 1865 and 1900, whose collection was sold at Sotheby’s in 1984.
The first book on Caesarian section, written by the first physician to champion the use of the procedure on living women. François Rousset, who was the first to use the term ‘Caesarean’ in connection with abdominal birth, recommended the operation against opposition from other eminent physicians, including Paré and Guillemeau. The book contains accounts of 15 case studies of the procedure.
“[A]n ardent proponent of Caesareans on living women… It was François Rousset who was responsible for the permanent entrenchment of the term ‘Caesarean section’ in medical terminology… Rousset was aware of the novelty of his ideas. ‘Something unheard of, never written about, hardly credible to those who see it’ is how he describes his subject in the prefatory epistle… Only now, in the twentieth century, has medicine fulfilled what Rousset hoped for: routine Caesareans in which both mother and child survive….”(Blumenfeld-Kosinski)
“The book was a masterpiece… In the first part of his book, Rousset pointed out the usefulness and necessity of the operation where there was imminent danger to both mother and child and delivery by the natural passage was impossible. Next, he established the possibility of the success of the operation [by presenting 15 case studies] that proved that wounds caused during the operation are not necessarily fatal. Lastly, he entered into a detailed account of several obstetrical complications which were incomparably more terrible than the operation he proposed… Finally he proved by several examples that a further pregnancy may follow the operation.” (Young)
“The subtitle of Rousset's work indicates the revolutionary nature of his remarks:
‘The extraction of the child through a lateral incision of the abdomen and uterus of a pregnant woman who cannot otherwise give birth. And that without endangering the life of the one or the other and without preventing subsequent maternal fertility’.
“The text begins with a definition of a Caesarean (extraction of a child either alive or dead through the side of the mother by incision of the epigastrum and the uterus) and a refusal to speak of postmortem Caesareans (known already to the ancients)… Rousset then lists the indications for a Caesarean section: if the child is too large or malformed or dead (in that case it may too bloated to be extracted by natural means); in the case of twins or of problematic presentation. Other indications concern the mother: if, through reasons of extreme youth or old age, she is too narrow or ‘hard,’ that is, not elastic enough.
“In the next section Rousset takes on the age-old tension between theory and practice as well as between the representatives of school medicine and those of rural practice. Since none of the ancients has written on the subject of Caesareans, learned doctors and surgeons give no credit to the practice, although operations of this kind have been and are being performed by rural barbers, if very rarely. Therefore… three means will be used to persuade the skeptics: experience (through case histories); pertinent reasons (through discussion of medical points); sufficient authority (discussion of possible analogies, wounds of a character similar to a Caesarean incision that have indeed been dealt with by the ancient authorities).
“As a preface to his case histories, Rousset describes his method of gathering evidence. He basically relies on the testimonies of ‘gens fideles’ (trustworthy people) and of ‘personnages non suspects.’ In other words, Rousset never performed the operation himself and was not even present at most of the cases he describes.
“The first case concerns a woman named Anne Godart who gave birth by Caesarean six times in a row. At the seventh birth she died because her surgeon, Nicolas Guillet, had died some time before and no other surgeon was willing to perform the operation. In the second case, Rousset wanted to go and see the woman, who had delivered three times by Caesarean, but she died of the plague before he could get his first-hand testimony. The next two cases all concern multiple successful Caesareans, news of which was transmitted to Rousset by letter. Now a break occurs in the narrative. The next section is headed ‘Histoires oculaires’ (Eyewitness stories)… The next two stories involve Rousset directly. In the first, he examined a woman with a ventral hernia who explained that the long scar on her left side was the trace of a successful Caesarean performed seven years earlier by an old barber of her village. Rousset had intended to contact this barber but was, ‘through the difficulty of the times,’ unable to find the piece of paper on which he had written his name. Rousset's wish to ‘gather from him practical details gained from experience’ remained unfulfilled. In the next case, Rousset actually witnessed the performance of the operation that he himself had advised for a woman in prolonged labor. Since the experienced surgeon Ambroise le Noir could not be found, a young barber (‘le premier trouve’) performed the operation. Here we learn the exact date (Easter 1556) and the way the incision was made: on the right side about one finger down from the navel. The barber was so skillful that little blood was shed, and he managed to pull out the living child and the afterbirth. He then closed the wound with five stitches (he did not suture the uterus) and after forty days' bed rest the woman was well again. She later gave birth to a daughter naturally.
“The next cases concern the excision of dead fetuses. Here Rousset accuses several midwives who through their incompetence ‘broke up’ a poor woman in such a way that, despite the successful removal of the fetus, she was ill for seven months. Similar remarks appear in the story of one Jeanne Michel, who was tormented by midwives without any result until, in the tenth month of pregnancy, she was finally delivered of a dead fetus.
“Of the 228 pages of Rousset's treatise only 17 are devoted to case histories of successful Caesareans. One of the most dramatic stories of a successful Caesarean is not in Rousset's work proper but in the appendix to Bauhin's Latin translation of Rousset. It is that of Jacob Nufer, a Swiss pig gelder who, in the year 1500, delivered his wife surgically after she had been in labor for several days. Great drama accompanied this operation, for Nufer first had to get the permission of the authorities, and courageous midwives had to be found (only two out of the thirteen he approached finally decided to assist this determined man). With a single deep cut he opened the uterus ‘as if operating on a pig’) and extracted the child at the first try. He then sewed up his wife in the same manner he used for his animals, and it was only then that the eleven timid midwives were allowed back into the room. The following year his wife supposedly gave birth to twins (without a Caesarean) . Should this story be true it would indeed be remarkable. It is unlikely that Nufer sutured the uterus. In fact, Rousset specifies in several stories that surgeons did not suture the uterus. Some historians have doubted that Nufer performed a Caesarean at all and assert that his wife's pregnancy must have been extrauterine. Two factors argue against this, however, according to Pietro Gall: the mother's extended labor and the good health of the child. In the absence of asepsis and anaesthetics in this period the mother's survival in this as in all of Rousset's stories must be seen as a fortunate accident.
“The second and third parts of Rousset's treatise contain an operating manual (where, for example, he compares a Caesarean with the operation to remove bladder stones), while the fourth part speaks of the dangerous alternatives to a Caesarean in complications such as a retained and putrid fetus, abcesses of the uterus or the hypogastrium (through extrauterine pregnancies). His point here is that in every case an extraction by incision poses the smallest risk. Here again, Rousset uses numerous case histories, some of them in letters addressed to him, to buttress his arguments. He defends himself repeatedly against allegations that his cases took place far away; to counter certain attacks he tells some stories that happened closer to Paris, as if this geographical proximity guaranteed the stories' veracity. Part 5 deals with experimental surgery (specifically the removal of the uterus in animals without any adverse effect), and part 6 explains that a Caesarean does not impede a woman's fertility.
“Rousset's treatise is remarkable for its passionate tone and polemical stance. Acerbic remarks on the incompetency of midwives stand side by side with accusations against the cowardly passivity of many surgeons. Radical innovation and active intervention in childbirth are his tenets, which did not endear him to the established medical community. According to Young, Rousset's work ‘was a masterpiece, and he appears to be the first writer who had the courage to advise the performance of the operation upon a living woman.’ Pundel also lauds Rousset for his theoretical descriptions (many of which are still true today), although he doubts that under sixteenth-century conditions Rousset's recommendations could have ensured the success of the operation…
“As a consequence of Rousset's work a bitter controversy erupted about the advisability of Caesareans on living women. In the 1590s Rousset became the target of vitriolic attacks by Jacques Marchant and of somewhat more temperate attacks by [Jacques] Guillemeau.”(Renate Blumenfeld-Kosinski, Caeserian Birth In Medical Thought, in “Not of Woman Born. Representations of Caesarean Birth in Medieval and Renaissance Culture”, Ch. 1, pp. 7-47, esp. pp. 38-47: “François Rousset and the Controversy over Caesareans in Living Women.”)
See also: Young, Caesarean Section: “The History and Development of The Operation from Earliest Times”, pp. 23–24, and Gall, “Il taglio cesareo addominale” (Bologna, 1922). Ricci, “The genealogy of gynaecology”, pp. 306–309 [p. 253 ff.]: “…marked the beginning of operative gynaecology.”
The editions:
Rousset’s book first appeared in French in 1581, and was translated into Latin by the author himself in 1590. Bauhin’s translation first appeared in 1588, with a third edition in 1601. The first leaf in the final gathering of this edition (the index), has a stray setting (paginated “p. 271”) of the final page of text of Jean d'Ailleboust’s “Foetus per annos XXIIX in utero…”, which was not included in this edition (even though it is announced on the title page) but was printed in the 1588 edition by the same printer. (Inventory #: 5227)
The first book on Caesarian section, written by the first physician to champion the use of the procedure on living women. François Rousset, who was the first to use the term ‘Caesarean’ in connection with abdominal birth, recommended the operation against opposition from other eminent physicians, including Paré and Guillemeau. The book contains accounts of 15 case studies of the procedure.
“[A]n ardent proponent of Caesareans on living women… It was François Rousset who was responsible for the permanent entrenchment of the term ‘Caesarean section’ in medical terminology… Rousset was aware of the novelty of his ideas. ‘Something unheard of, never written about, hardly credible to those who see it’ is how he describes his subject in the prefatory epistle… Only now, in the twentieth century, has medicine fulfilled what Rousset hoped for: routine Caesareans in which both mother and child survive….”(Blumenfeld-Kosinski)
“The book was a masterpiece… In the first part of his book, Rousset pointed out the usefulness and necessity of the operation where there was imminent danger to both mother and child and delivery by the natural passage was impossible. Next, he established the possibility of the success of the operation [by presenting 15 case studies] that proved that wounds caused during the operation are not necessarily fatal. Lastly, he entered into a detailed account of several obstetrical complications which were incomparably more terrible than the operation he proposed… Finally he proved by several examples that a further pregnancy may follow the operation.” (Young)
“The subtitle of Rousset's work indicates the revolutionary nature of his remarks:
‘The extraction of the child through a lateral incision of the abdomen and uterus of a pregnant woman who cannot otherwise give birth. And that without endangering the life of the one or the other and without preventing subsequent maternal fertility’.
“The text begins with a definition of a Caesarean (extraction of a child either alive or dead through the side of the mother by incision of the epigastrum and the uterus) and a refusal to speak of postmortem Caesareans (known already to the ancients)… Rousset then lists the indications for a Caesarean section: if the child is too large or malformed or dead (in that case it may too bloated to be extracted by natural means); in the case of twins or of problematic presentation. Other indications concern the mother: if, through reasons of extreme youth or old age, she is too narrow or ‘hard,’ that is, not elastic enough.
“In the next section Rousset takes on the age-old tension between theory and practice as well as between the representatives of school medicine and those of rural practice. Since none of the ancients has written on the subject of Caesareans, learned doctors and surgeons give no credit to the practice, although operations of this kind have been and are being performed by rural barbers, if very rarely. Therefore… three means will be used to persuade the skeptics: experience (through case histories); pertinent reasons (through discussion of medical points); sufficient authority (discussion of possible analogies, wounds of a character similar to a Caesarean incision that have indeed been dealt with by the ancient authorities).
“As a preface to his case histories, Rousset describes his method of gathering evidence. He basically relies on the testimonies of ‘gens fideles’ (trustworthy people) and of ‘personnages non suspects.’ In other words, Rousset never performed the operation himself and was not even present at most of the cases he describes.
“The first case concerns a woman named Anne Godart who gave birth by Caesarean six times in a row. At the seventh birth she died because her surgeon, Nicolas Guillet, had died some time before and no other surgeon was willing to perform the operation. In the second case, Rousset wanted to go and see the woman, who had delivered three times by Caesarean, but she died of the plague before he could get his first-hand testimony. The next two cases all concern multiple successful Caesareans, news of which was transmitted to Rousset by letter. Now a break occurs in the narrative. The next section is headed ‘Histoires oculaires’ (Eyewitness stories)… The next two stories involve Rousset directly. In the first, he examined a woman with a ventral hernia who explained that the long scar on her left side was the trace of a successful Caesarean performed seven years earlier by an old barber of her village. Rousset had intended to contact this barber but was, ‘through the difficulty of the times,’ unable to find the piece of paper on which he had written his name. Rousset's wish to ‘gather from him practical details gained from experience’ remained unfulfilled. In the next case, Rousset actually witnessed the performance of the operation that he himself had advised for a woman in prolonged labor. Since the experienced surgeon Ambroise le Noir could not be found, a young barber (‘le premier trouve’) performed the operation. Here we learn the exact date (Easter 1556) and the way the incision was made: on the right side about one finger down from the navel. The barber was so skillful that little blood was shed, and he managed to pull out the living child and the afterbirth. He then closed the wound with five stitches (he did not suture the uterus) and after forty days' bed rest the woman was well again. She later gave birth to a daughter naturally.
“The next cases concern the excision of dead fetuses. Here Rousset accuses several midwives who through their incompetence ‘broke up’ a poor woman in such a way that, despite the successful removal of the fetus, she was ill for seven months. Similar remarks appear in the story of one Jeanne Michel, who was tormented by midwives without any result until, in the tenth month of pregnancy, she was finally delivered of a dead fetus.
“Of the 228 pages of Rousset's treatise only 17 are devoted to case histories of successful Caesareans. One of the most dramatic stories of a successful Caesarean is not in Rousset's work proper but in the appendix to Bauhin's Latin translation of Rousset. It is that of Jacob Nufer, a Swiss pig gelder who, in the year 1500, delivered his wife surgically after she had been in labor for several days. Great drama accompanied this operation, for Nufer first had to get the permission of the authorities, and courageous midwives had to be found (only two out of the thirteen he approached finally decided to assist this determined man). With a single deep cut he opened the uterus ‘as if operating on a pig’) and extracted the child at the first try. He then sewed up his wife in the same manner he used for his animals, and it was only then that the eleven timid midwives were allowed back into the room. The following year his wife supposedly gave birth to twins (without a Caesarean) . Should this story be true it would indeed be remarkable. It is unlikely that Nufer sutured the uterus. In fact, Rousset specifies in several stories that surgeons did not suture the uterus. Some historians have doubted that Nufer performed a Caesarean at all and assert that his wife's pregnancy must have been extrauterine. Two factors argue against this, however, according to Pietro Gall: the mother's extended labor and the good health of the child. In the absence of asepsis and anaesthetics in this period the mother's survival in this as in all of Rousset's stories must be seen as a fortunate accident.
“The second and third parts of Rousset's treatise contain an operating manual (where, for example, he compares a Caesarean with the operation to remove bladder stones), while the fourth part speaks of the dangerous alternatives to a Caesarean in complications such as a retained and putrid fetus, abcesses of the uterus or the hypogastrium (through extrauterine pregnancies). His point here is that in every case an extraction by incision poses the smallest risk. Here again, Rousset uses numerous case histories, some of them in letters addressed to him, to buttress his arguments. He defends himself repeatedly against allegations that his cases took place far away; to counter certain attacks he tells some stories that happened closer to Paris, as if this geographical proximity guaranteed the stories' veracity. Part 5 deals with experimental surgery (specifically the removal of the uterus in animals without any adverse effect), and part 6 explains that a Caesarean does not impede a woman's fertility.
“Rousset's treatise is remarkable for its passionate tone and polemical stance. Acerbic remarks on the incompetency of midwives stand side by side with accusations against the cowardly passivity of many surgeons. Radical innovation and active intervention in childbirth are his tenets, which did not endear him to the established medical community. According to Young, Rousset's work ‘was a masterpiece, and he appears to be the first writer who had the courage to advise the performance of the operation upon a living woman.’ Pundel also lauds Rousset for his theoretical descriptions (many of which are still true today), although he doubts that under sixteenth-century conditions Rousset's recommendations could have ensured the success of the operation…
“As a consequence of Rousset's work a bitter controversy erupted about the advisability of Caesareans on living women. In the 1590s Rousset became the target of vitriolic attacks by Jacques Marchant and of somewhat more temperate attacks by [Jacques] Guillemeau.”(Renate Blumenfeld-Kosinski, Caeserian Birth In Medical Thought, in “Not of Woman Born. Representations of Caesarean Birth in Medieval and Renaissance Culture”, Ch. 1, pp. 7-47, esp. pp. 38-47: “François Rousset and the Controversy over Caesareans in Living Women.”)
See also: Young, Caesarean Section: “The History and Development of The Operation from Earliest Times”, pp. 23–24, and Gall, “Il taglio cesareo addominale” (Bologna, 1922). Ricci, “The genealogy of gynaecology”, pp. 306–309 [p. 253 ff.]: “…marked the beginning of operative gynaecology.”
The editions:
Rousset’s book first appeared in French in 1581, and was translated into Latin by the author himself in 1590. Bauhin’s translation first appeared in 1588, with a third edition in 1601. The first leaf in the final gathering of this edition (the index), has a stray setting (paginated “p. 271”) of the final page of text of Jean d'Ailleboust’s “Foetus per annos XXIIX in utero…”, which was not included in this edition (even though it is announced on the title page) but was printed in the 1588 edition by the same printer. (Inventory #: 5227)
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