Reviewed by: Oefening en bespiegeling: Het verloskunde onderwijs van M. S. du Pui (1754–1834) te Leiden Harold J. Cook M. M. Lamens-van Malenstein. Oefening en bespiegeling: Het verloskunde onderwijs van M. S. du Pui (1754–1834) te Leiden. Pantaleon Reeks, no. 26. Rotterdam: Erasmus Publishing, 1997. 477 pp. Ill. Hfl. 97.50. A thorough study of the life and teachings of Meinard Simon du Pui, Lamens-van Malenstein’s book will be of interest to those who wish to learn more about the [End Page 331] development of university instruction in obstetrics at the turn of the nineteenth century. After beginning his medical studies at Groningen and Leiden, du Pui traveled to London and Paris for further work; returned to take his M.D. at Leiden in 1780; obtained the post of lecturer in anatomy, surgery, and obstetrics at the city of Kampen and then Alkmaar; and in 1791 finally returned to Leiden as a professor extraordinarius in surgery and obstetrics (gaining the post of professor in 1795). He established a university clinic in 1799 to add formal teaching in the practice of childbirth and surgery to his lecturing, while he also supervised his students as they gained additional experience by helping poor women during childbirth at home. Du Pui’s teachings on obstetrics, which took account of the best recent work in England, France, and Germany, became the most respected in the Netherlands, and several of his students went on to gain academic posts at other universities, where they passed on his views and methods. Lamens-van Malenstein conveys all this topically. After a brief but thorough biography of du Pui, he examines contemporary surgical and obstetrical teachings in England, France, and Germany; investigates du Pui’s library; discusses the municipal ordinances and institutions governing midwifery in Leiden; presents the views on practice and theory advocated by du Pui; and accounts for his students. A summary in English of several pages concludes the book, making a sketch of the author’s discussion available to those who do not read Dutch. Appendices also make many of du Pui’s works (originally in Latin) available in a facing-page translation into Dutch. Du Pui was an interesting as well as influential instructor. He gave special importance to a thorough study of the pelvis, since deformations of it were so often the reason for calling in a surgeon or male midwife. He taught the cautious use of forceps and levers, following English practice, and in cases where the life of the baby or the mother had to be sacrificed, he believed in using methods for saving the life of the mother (although he did convey to his students the procedures for cesarean section, almost always fatal to the mother). Du Pui also taught symphysiotomy (splitting open the pubic cartilage), which was used in his day as a way of trying to increase the pelvic opening, as an alternative to the use of the hook or the knife on the child; but he taught that the use of this method was indicated only in exceptional cases, and he himself never used it. He also advocated patience in waiting for the afterbirth to be ejected by nature, rather than pulling it out quickly after the child emerged. These and other teachings of du Pui illustrate the growing influence of the “expectant” orientation of medicine at the turn of the century, in which the physician preferred to wait for nature to take its course, helping as needed. Lamens-van Malenstein does not question whether this basic orientation of du Pui’s was representative or unusual, or whether it reflected an attitude that had more general effects on medical practice or was confined to obstetrics. The book is therefore not as significant a contribution to the general study of medicine in the period as it might have been. But it will be of much value to anyone who [End Page 332] wishes to compare the important obstetrical teachings of this Leiden professor with those in other parts of northwestern Europe at the same time. Harold J. Cook University of Wisconsin-Madison Copyright © 1998 The Johns Hopkins University Press
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