Image from the National Library of Medicine.
William Smellie was a Scottish obstetrician famous for his use of forceps, for which he received training in both London and France. From 1740 onward, he resided in London and worked as a teacher. He was willing to treat poor patients if they allowed his treatments to be observed, which allowed him to demonstrate his techniques for his students.
In 1760 Smellie came under attack by the midwife Elizabeth Nihell, who saw forceps as a brutal instrument that could not stand in for human hands. While Smellie was not always successful in their use, he was able to discover how forceps could assist a fetus’ head rotate through the birth canal.
Smellie’s illustrated obstetric atlas, A Sett of Anatomical Tables, was published in 1754 and served as a cross between an illustrated atlas and a manual of midwifery. The engravings by Dutch artist Jan van Riemsdyk include depictions of deformities that could cause difficulty in delivery, how to position the forceps in the birth canal, and the stages of human gestation.
Portrait of Hunter by Alan Ramsay. The University of Glasgow.
William Hunter was a contemporary of Smellie, who also hailed from Scotland and worked in London during the mid 18th century. Unlike Smellie, he worked for the higher classes and served as physician to Queen Charlotte. He also differed in his approach to midwifery. While Smellie was an advocate of the forceps, Hunter believed in noninterventionist approach, and was in many ways a traditional midwife who favored natural labor above all else.
His great work Anatomia uteri humani gravidi was published in 1774. He did not feature any illustrations showing the birth in progress, as Smellie did, but instead focused primarily on the uterus and the fetus as they appear at full term.
Soranus of Ephesus was a Greek gynecologist and obstetrician who lived in the 2nd century CE. His work Gynecology was considered to be an authority on women’s diseases and pregnancy up until the 16th century.
Portrait of Siegemund from The Court Midwife.
Justine Siegemund is known for her work Die Kgl. Preußische und Chur-Brandenburgische Hof-Wehemutter (the Court Midwife), which was first published in 1690 and went through a total of seven editions, establishing her as the most famous German midwife of the late 17th and early 18th centuries. Unusually for the profession, Siegemund never had children of her own. She defended herself by pointing out that physicians were not required to experience every disease they were called upon to treat; by the same logic it was perfectly acceptable for her to practice as a midwife.
The book itself takes the form of a dialogue between an experienced midwife and her young counterpart. She emphasizes the importance of finger palpations of the cerbix and understanding what the midwives' hands tell them, and decries the use of the speculum as causing unncessary pain. There is a sense of competition with male practitioners in her work, but she also sought the approval of male medical faculty at Frankfurt on the Oder, Lepizg, and Jena prior to publication. Siegemund's work is significant for being written and published by a female practitioner instead of a male, but still illustrates the tension between the two.
Pen sketch of Semmelweis by Jenő Dopy.
Ignaz Semmelweis was a German-Hungarian physician most famous for his discoveries about infection and puerpural fever. While working at the obstetric clinic in Vienna during the mid 18th century, he noticed that the death rate from puerpural fever was two or three times higher in the student teaching ward than in the midwives' ward. He theorized that students carried the infection from the dissecting room to the healthy patients, and ordered that students wash their hands in a mixture of chlorinated lime before examining each new patient. After this, mortality rates dropped sharply.
While younger physicians toke note of his discovery, the existing medical establishment remained skeptical. He eventually took a position as professor of obstetrics at the University of Pest, where his ideas were accepted. Vienna continued to decry his handwash as foolish, and the continued cirticism eventually caused him to have a breakdown in 1865. He died of an infection of a wound in his right hand.
1907 photograph of Kelly as a youg man. Penn University Archives.
Howard A. Kelly was recruited by William Osler to Johns Hopkins Hospital in 1889, where he served on the hospital staff and as the professor of gynecology and obstetrics. He is credited with establishing gynecology as a medical specialty, and focused on developing new surgical treatments for female diseases.
His Operative Gynecology is a two-volume work that covers a variety of female illness and medical procedures, and includes several black and white and color illustrations, which were done by Max Brödel, Hermann Becker, and August Horn.