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A Landmark Discovery

One of the most important discoveries made in any medical specialty was the discovery of the obstetric forceps. Forceps were first used about 1000 AD in the Middle East, though the knowledge of their discovery was lost for centuries. Dr. Peter Chamberlain rediscovered this important instrument and following his report in the mid 18th century, extraction forceps played an important role in the literature and practice of Obstetrics (12,13).

The Need for Speed

In the early 19th century, adequate anesthesia was not available to allow extensive surgery in complicated pregnancies. The additional risk of puerperal fever (perinatal infection) increased the popularity of rapid abortion and thus led to the production of appropriate instruments, some of which were the most gruesome ever made (14-22).

Obstetric sets of the 19th century contained instruments that were designed for rapid delivery though could not be adequately sterilized despite the well known risks of puerperal fever (23-27). Other instruments were made for the immediate post delivery period (28-30), while emphasis on the study of women's diseases in the 19th century lead to the development of instruments designed for diagnosis (31-36), and treatment (37-44). Obstetrics finally had become a respectable profession.

12-13) Use of the Forceps

Dr Maygrier illustrates the proper use of the obstetric forceps in this fine engraving. Forceps by J. Ellis and Son (ca 1880) were called "traction forceps" because of the extra leverage they could offer the physician.

14-22) Instruments of Destruction

Some of the most gruesome medical instruments ever made were designed for early abortion. Many are pictured in "Catalogue Illustre des Instruments de Chirurgie", by Aubry (1900). Dr Aubry demonstrated the use of an OB perforator of an OB perforator while a Simpson's spring-loaded perforator is pictured. Aubry then illustrates the trepan de Leisurg et Diwisch by Thuerigl which is an OB instrument fashioned after a similar neurosurgical instrument for drilling a hole in the head of the fetus in preparation for extraction. The basilyst opens to separate the bones of the skull and a Braun's decapitating hook by Leach and Greene is also seen. An unmarked instrument with sliding blades for decapitation is pictured

23-27) Instruments of Abortion

The first two instruments are an OB hook and a cranioclast, the use of each as illustrated in "The Principles and Practice of Obstetric Medicine", 1836, by A. Davis. Next is a Tarnier's Basiotribe by Collin designed for perforation and removal of the fetus. The Cephalotribe du Dr. Bailly is similar in function to the Tarnier and is made by Klein Glitsehka Gand. The final instrument shown is the Van Huevel Forceps for bisecting the fetus in preparation for abortion. This is a fabulous one of a kind exhibition piece that had been in the Aubry family from its manufacture in the late 19th century until its recent sale.

28-30) Cased OB Set by White & Wright, (ca 1870)

This is a complete set for delivery/abortion and contains, from top to bottom: delivery forceps, scalpel, blunt hook and crochet, perforator, and craniotomy forceps. The pictured vectus replaces the hook and crochet in some sets.

31-36) Instruments for the Postpartum Period

The first instrument encountered by the newborn is the umbilical scissors. The ones shown were made by the famous French maker Collin while the silver umbilical clamp is in the form of a stork with a newborn hidden in the handles. Nursing was universally practiced prior to the bottle and was nicely illustrated by Dr. JP Maygrier. This classic breast pump was made by Maw, Son, and Thompson and is characteristic of those made in the 19th century. Constant nursing resulted in soreness at times, creating the need for protective nipple shields. The first one illustrated is made of lead and is advertised to form healing lactate of lead after combining with milk. (Of course the danger of lead toxicity was not known at that time). A fine 18th century hallmarked silver nipple shield is also shown.

37-44) Various Instruments to Treat Women's Diseases

Vaginal specula are one of the earliest manufactured medical instruments and examples from the Roman Empire remain available today. This early 19th century ivory trivalve vaginal speculum was made by Weiss and is characteristic of early models. Tiemann manufactured the more classic ebony handled bivalve variety pictured here. The ivory douche shown here was used for self-medication as well as personal hygiene. Also shown is a 19th century boxed Ferguson speculum which required a light source as did the pictured Sims trivalve uterine dilator. A repositor by Sharp & Smith was used to correct malposition of the uterus after being inserted and pulled back. The final instrument here is a chain ecraseur that was designed to strangle uterine polyps as the chain was shortened, though it was used on many other types of growths and is beautifully illustrated here by Bourgery.

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12) Forceps Delivery

15) OB Perforator

25) Tarnier's Basiotribe

26) Cephalotribe du Dr. Bailly

27) Van Huevel Forceps

29) OB Set, Open

32) Umbilical Clamp

37) Trivalve Speculum

43) Ecraseur, by Bourgery