Caesarean Birth: The work of François Rousset in Renaissance France
By Valerie Worth-Stylianou
As the earliest advocate of caesarean section on a living woman (in cases where no other means of delivery appeared possible), François Rousset, a 16th-century French physician, defied conventional medical wisdom. His contemporaries expected caesareans to be performed if the mother had died during the labour, in order to allow the fetus a chance of survival, but it was widely assumed that to perform a caesarean on a living woman would be to condemn her to certain death.
Hence Rousset’s treatise on the subject, published in French in 1581, and then in Latin translation from 1586, provoked almost universal scepticism, yet also exercised a marked fascination. Despite the fact that as a physician (rather than a surgeon) he had never performed the operation himself, he had witnessed some rare deliveries by caesarean, collected other case histories and reflected on analogous operations, before presenting his research in a persuasive work of some 228 pages. Surprisingly, given the importance of French obstetric texts in 17th-century England, there was never a full English translation of it (only an 18th-century version by William Cheselden, limited to the section on the comparable operation for the removal of stones). In translating Rousset’s Traitté nouveau de l’hysterotomotokie, ou enfantement caesarien into modern English, Ronald Cyr thus makes it accessible to a far wider group of readers, and his achievement is complemented by a concise but informative introduction by Thomas Baskett.
What made this text worth translating, and what kind of readers is Cyr’s and Baskett’s edition likely to appeal to? Baskett’s commentary makes clear that Rousset did not succeed in revolutionising medical practice; despite his spirited defence of his position, traditional caution held sway for another 300 years. Nor was his work anywhere near as popular in its own time as that of the Italian physician Scipio Mercurio, whose 1596 treatise on obstetrics, containing two chapters in defence of caesarean section (heavily dependent on Rousset), was republished some 40 times over the next 200 years. Nonetheless, Rousset’s treatise is an absorbing account of late 16th-century medical and surgical practices, reported by an intelligent author with a very personal commitment to his cause.
As an obstetric surgeon, Cyr is well placed to pass judgement on Rousset’s methods, and medical historians (who have sometimes asked whether the caesareans reported did indeed occur) will note his assertion that Rousset’s accounts definitely suggest the operation was performed. Equally, historians of medicine will be interested to learn that, apart from not recommending uterine sutures, Rousset’s technique is essentially the same as that which emerged in the 19th and 20th centuries. On points of detail, especially in the case histories Rousset recounts, Baskett and Cyr use footnotes to propose some modern clinical interpretations (e.g. distinguishing uterine inversion from uterine prolapse). This has the advantage of bringing Rousset’s practice closer to the modern reader’s experience, although occasionally (e.g. in discussion of superfetation) it would have been helpful to provide some additional detail on 16th-century understandings of the issue. As far as Rousset’s mentions of medicine and herbs are concerned, on the other hand, Baskett’s and Cyr’s generous notes provide very useful historical background.
How accessible is the volume to readers with little or no expertise in medical history? The tenor of the introduction and annotations to the text suggest that Cyr and Baskett assume that their work will be read above all by modern medical practitioners (and perhaps also lay readers) curious about women’s healthcare in earlier periods, rather than by specialist historians. Given that caesareans now account for a quarter or a third of deliveries in some countries, they believe the relevance of the subject needs no apology. The introduction neatly meets the needs of the reader with limited knowledge of Renaissance France, sketching Rousset’s career, the medical context in which his work arose, and the reasons for the controversy it provoked. The first appendix at the end of the volume is less obviously relevant, but to provide a ‘Summary of 16th-century French history’ in just over a page is a near-impossible task! The other two appendices, on Rousset’s illustrious protector, Renée de France, and on his patron, the Duke of Nemours, are meticulously researched, as are the historical footnotes accompanying the text itself. It is a pity, however, that the volume does not include a bibliography of either the primary or secondary works cited in the introduction and notes.
Cyr unashamedly admits his lack of expertise in either translation studies or in 16th-century as opposed to modern French, yet his understanding of Rousset is excellent, and his translation both extremely accurate and very stylish. (The latter is no mean achievement, given the often tortuous syntax of Renaissance French prose.) The RCOG Press has produced an attractive volume, and the illustrations in the introduction (from other Renaissance authors, since Rousset’s volume was not illustrated) are particularly clearly reproduced. For the relatively modest price, this volume can be warmly recommended to individuals and to libraries.
- Cyr RM (transl.), Baskett TF (ed.). Caesarean Birth: The Work of François Rousset in Renaissance France. A New Treatise on Hysterotomotokie or Caesarian Childbirth. London: RCOG Press; 2010.
Valerie Worth-Stylianou is Senior Tutor at Trinity College, Oxford.