Read Dr. Soucasaux on the colposcope, used
to examine the vulva, vagina and cervix of the uterus.
 
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Touch but don't look:
"The Touch" and the shame of physical examination,
part 2 (part 1)
Examining a bed-ridden woman followed the same procedure. In the illustration
right below, the physician looks the woman in the eye to give the impression
he's not thinking about the region his hand is touching.
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From "Lying-In: A History of Childbirth in America" by
Wertz and Wertz, Yale, 1989
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Bilz shows (below) a woman not uncovering the patient's abdomen while
examining her, although she looks at the area she touches. The picture dates
from the last decade of the 19th century and probably more latitude was
allowed - and the examiner was a woman.
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"Method of examination lying down according to Thure
Brandt"
From Friedrich Eduard Bilz's "Das Neue Naturheilverfahren," about
1890
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In the 1840s the American physician Marion Sims successfully repaired
damage to the walls of the vagina, bladder and rectum of some American slaves
he had bought for this purpose. Such damaged tissue often prevented women
from enjoying social life as the leaking of feces and urine caused constant
soiling and repellent odor. The slaves, of course, occupied the lowest status
and had little choice but to let Sims attempt, again and again over years,
to surgically fix the terrible wounds caused by childbirth - using no anesthesia.
But once Sims had repaired the tears and mastered the procedure he opened
probably the first hospital for women, in New York, and traveled the world
helping similarly afflicted women, including European royalty. It was a
huge breakthrough in gynecology and demonstrated the power of actually looking
at the genitals of a patient in order to help her. The so-called Sims posture,
or position, below, used by Sims to access the woman's perineum, became
useful to other doctors in examinations because the woman could not see
the physician, thus maintaining the emotional distance achieved by "sightless"
examination procedures that were now becoming obsolete.
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Drawing (1903) from Dr. Howard Kelly's "Gynecology,"
1928, showing Sims position.
See a Sims speculum in the museum
collection.
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Drawing from Dr. Howard Kelly's Gynecology, 1928, showing
Sims position.
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Dr. Howard Kelly, above, first professor of gynecology at Johns Hopkins
medical school, was very religious, a characteristic prized by the 19th-century
medical establishment because it helped inoculate a physician against suspicion
that he might be interested in more than a woman's illness. But some of
his famous colleagues at Johns Hopkins found his piousness off-putting although
they respected his enormous influence and talent. (See more drawings from
Kelly's book and read about the founder of the
first university department of medical illustration in America, Max Brödel,
at Hopkins, the place these illustrations originated.)
It's striking that vision should be the
offending sense here; touch is by definition physically on
the patient - but was tolerable. Vision's power in medicine might be comparable
to that of the Evil Eye in many parts of the world, both demonstrating the
strange hold of eyesight. I wonder if part of the problem resided in the
doctor's facial expression. Sometimes patients were covered with sheets
in such a way as to block their view of the physician's face.
Several of the facts and insights on these two pages I gleaned from
"Lying-In: A History of Childbirth in America," by Wertz and Wertz,
Yale, 1989.
See the Sim's speculum in the
museum's collection. Read Dr. Soucasaux on the colposcope,
used to examine the vulva, vagina and cervix of the uterus.
©2004 Harry Finley. It is illegal to reproduce
or distribute work on this Web site in any manner or medium without written
permission of the author. Please report suspected violations to hfinley@mum.org
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