Book Reviews: Caesarean Birth: The Work of Francois Rousset in Renaissance France: A New Treatise on Hysterotomokotie or Caesarian Childbirth.

When the French surgeon Francois Rousset published his treatise on Caesarean birth on living women in 1581, he was not hailed as the great innovator he hoped to be but was criticised by some of his colleagues, such as Ambroise Pare, for, among other things, not taking seriously enough the danger of a fatal haemorrhage. The Parisian master surgeon Jacques Marchant vilified Rousset as the creator of a plague that was sweeping Europe: Caesarean birth that, Marchant claimed, should have been named after Tarquinius, and not one of the Caesars, because Tarquinius delighted in the blood and death of women. What was Rousset’s crime? Describing and advocating the performance of the surgical extraction of a living foetus from a living woman. Ronald M. Cyr and Thomas F. Baskett, both of them members of departments of obstetrics and gynaecology, do a real service to medical historians and practitioners by translating, annotating, and contextualising this important and controversial treatise. The illustrations depict title pages of some of the early editions as well as images of surgeons performing the operation. Before Rousset, Caesarean birth had been treated in surgical texts and religious contexts, such as Church Councils, with the assumption that it was strictly a post-mortem procedure, to be attempted in order to save the foetus if the mother died during the birth. Rousset wanted to change both the practice and the theoretical thinking about the operation with his treatise. He published it in French (though there was also a German version, published by Bernard Jobin in 1583, and a Latin translation, published in 1586 by Caspar Bauhin) so that practitioners could profit from his advice. Cyr and Baskett offer a very readable translation of the treatise, complemented by a concise introduction and a few historical appendices on Rousset’s patrons and the historical situation in sixteenth-century France. There are also ample notes of both an historical and medical nature that allow the reader to juxtapose Rousset’s ideas, not only to those of his contemporaries but also to modern medical practice. Of the 228 pages of Rousset’s original treatise, only eighteen are devoted to case histories of successful Caesareans, and sixteen to a ‘clinical guide’. The bulk of the text deals with ideas on expanding the use of the operation, with the optimistic premise that a woman can survive not only one but several Caesareans, and that there is no risk to her fertility from the operation. His tone is passionate and polemical: a rhetorical analysis of this text is not part of Cyr’s and Baskett’s project but would have yielded some interesting insights into the nature of Renaissance scientific discourse. Rousset’s detailed descriptions of numerous surgical interventions related to Caesarean section will be of great interest to anyone wishing to understand the scope of Renaissance medicine. With Caesarean section on living women, an area of obstetrics was inaugurated that moved childbirth away from midwifery and slowly but inexorably into the realm of learned men. Rousset’s text was soon eclipsed by Scipione Mercurio’s Commare o raccoglitrice of 1596. Inspired by Rousset, Mercurio had also travelled widely to interview survivors of Caesarean sections and believed, like Rousset, that the operation was possible with a good outcome for mother and child. But Rousset’s treatise, considered a masterpiece by some, a ‘plague’ by others, was still the first to open up this new surgical field. It is the great merit of Cyr and Baskett to have brought this text to the attention of a modern audience through this very good translation and the study of the operation’s feasibility in different time periods contained in the notes.