Revisiting the evolution of the Hippocratic Oath in obstetrics and gynecology.

Hippocrates, an influential figure in ancient Greek medicine, is best known for his lasting contribution, the Hippocratic Oath, which includes a significant message about obstetrics and gynecology. Given the Oath's status as a widely regarded ethical code for medical practice, it requires critical evaluation. The message of the Oath, as it related to obstetrics and gynecology, is expressed in ancient Greek by the phrase "οὐδὲ γυναικὶ πεσσὸν φθόριον δώσω" which translates directly to "I will not give to any woman a harming pessary." The words fetus and abortion were not present in the original Greek text of the Oath. Yet, this message of the Hippocratic Oath has been interpreted often as a prohibition against abortion. In this article, we present a critical linguistic and historical analysis and argue against the notion that the Hippocratic Oath was prohibiting abortion. We provide evidence that the words "foetum" (fetus) and "abortu" (abortion) were inserted in the Latin translations of the Oath, which then carried on in subsequent English versions. The addition of the words "fetus" and "abortion" in the Latin translations significantly altered the Oath's original meaning. Unfortunately, these alterations in the translation of the Hippocratic Oath have been accepted over the years because of cultural, religious, and social reasons. We assert that because the original Hippocratic Oath did not contain language related to abortion, it should not be construed as prohibiting it. The interpretation of the Oath should be based on precise and rigorous translation and speculative interpretations should be avoided.

Historical Primer on Obstetrics and Gynecology Health Inequities in America: A Narrative Review of Four Events.

Four historical events provide context for racial injustices and inequities in medicine in the United States today: the invention of race as a social construct, enslavement in the Americas, the legal doctrine of Partus sequitur ventrem, and the American eugenics movement. This narrative review demonstrates how these race-based systems resulted in stereotypes, myths, and biases against Black individuals that contribute to health inequities today. Education on the effect of slavery in current health care outcomes may prevent false explanations for inequities based on stereotypes and biases. These historical events validate the need for medicine to move away from practicing race-based medicine and instead aim to understand the intersectionality of sex, race, and other social constructs in affecting the health of patients today.

History of ultrasound in obstetrics and gynaecology from 1971 to 2021 on occasion of the 50 years anniversary of EFSUMB.

Diagnostic ultrasound in obstetrics and gynaecology has experienced a fantastic evolution during the past seven decades. Initial steps with A-mode technology were followed by B-mode and B-mode real-time imaging, then by Doppler and colour Doppler ultrasound, and finally by 3D/4D ultrasound. Other evolutionary steps were the development of high-resolution transabdominal and transvaginal transducers providing high quality images in the first, second and third trimesters of pregancy, as well as in gynaecology and breast imaging.The progression from two-dimensional (2D) to three-dimensional ultrasound (3D) and 3D real-time imaging (4D) has brought new options in displaying anatomical structures. In comparison with CT or MRI, it is not a static but functional technique, cheap and safe, and applicable at any time.

The Italian gynecology at the beginnings of the twentieth century: analysis of medical records from the Institute directed by Luigi Mangiagalli.

The history of the modern Italian gynecology is closely related to the figure of an enlightened clinician and passionate master, Luigi Mangiagalli (1850-1928), who, with good reason, can be considered one of the fathers of this discipline. In 1906, Mangiagalli founded the Obstetric-Gynecological Institute in Milan, directing this structure until 1925. The aim of this paper is to describe some aspects of Italian gynecology at the beginnings of the twentieth century through the analysis of 250 original medical records, dating back to the years 1906-1912, fragments of real life of women, midwives and doctors in a pioneering era of obstetrics and gynecology.

Vindicating a traduced genius: Ignaz Philipp Semmelweis (1818-1865).

Anglophone narratives of Semmelweis's discovery of the cause and prophylaxis of childbed (puerperal) fever are based on a deficient historical record because important information about what happened to Semmelweis in Vienna, Austria, is contained in primary documents that had never been translated into English until very recently. The gaps in these narratives have been filled with invented facts and causal attributions that traduce Semmelweis by berating his character, education, and writing proficiency to hold him solely responsible for the rejection of his theory by most of his contemporaries and to explain the most puzzling aspect of his life: why he did not publish the results of his groundbreaking research in a medical journal for 11 years. This article presents the historical evidence contained in these primary documents that were missing from previous narratives and that provide very rational and understandable explanations for Semmelweis's actions. It also presents evidence that flatly contradicts the claims that have been made about Semmelweis's character, education, and writing skills and offers a more veridical portrayal of what happened to Semmelweis in Vienna that caused him to leave the city and delay publishing his results.

From Embryotomy to Cesarean: Changes in Obstetric Operatory Techniques in Nineteenth- and Twentieth-Century Urban Brazil.

This article traces the historical processes by which Brazil became a world leader in cesarean sections. It demonstrates that physicians changed their position toward and use of different obstetric surgeries, in particular embryotomies and cesarean sections, over the course of the nineteenth and twentieth centuries. The authors demonstrate that Catholic obstetricians, building upon both advancements in cesarean section techniques and new civil legislation that gave some personhood to fetuses, began arguing that fetal life was on par with its maternal counterpart in the early twentieth century, a shift that had a lasting impact on obstetric practice for decades to come. In the second half of the twentieth century, cesarean sections proliferated in clinical practice, but abortions remained illegal. Most importantly, women remained patients to be worked on rather than active participants in their reproductive lives.

In Sickness and in Health: Expert Discussions on Abortion Indications, Risks, and Patient-Doctor Relationships in Postwar Poland.

This article analyzes expert debates relating to abortion in Poland between 1956 and 1993, a period when the procedure was legal and accessible. Through the pages of the primary Polish journal for gynecology and obstetrics, Ginekologia Polska, the author traces continuities and ruptures around three major intersecting themes: the procedure's indications, its (dis)connection to health, and the patient-doctor relationship. The journal became a forum showcasing interpretative tensions over indications for abortion and the malleability of the categories "therapeutic" and "social." In addition to these tensions, abortion was represented throughout this period as a potentially risky surgery, although this was initially nuanced with parallel representations of legal abortion combating maternal mortality. During the 1970s, abortion began to be linked to infertility, often in simplistic cause-and-effect terms. Simultaneously, opposition to abortion based on the idea of defense of the nation and fetal "life," surfaced in expert discourse.

#SayHerName: Should Obstetrics and Gynecology Reckon with the Legacy of JM Sims?

Dr. James Marion Sims has been heralded as the "father of modern gynecology" for his groundbreaking surgical technique to repair post-partum vesicovaginal fistulas (VVF); however, the ethical concerns around his inhumane practices and the contributions of the enslaved women he refined his technique on are rarely recognized. Acknowledging the personal sacrifice of the enslaved women and addressing the truth behind the immoral practices of Sims, encourages reconciliation of the race-based medical atrocities of the past and sets the tone for moral, more equitable medical care moving forward.

William Hunter's aristocratic post mortems.

William Hunter's writings, lectures and his collection of circa 1,400 pathological specimens at the University of Glasgow show that, within the scientific limitations of the 18th Century, he had a sound grasp of the significance of morbid anatomical appearances. Unlike John Hunter's collection at the Royal College of Surgeons of England, few of the Hunterian specimens at Glasgow have an accompanying case history. Within the Special Collections at the Glasgow University Library are a small number of post mortem reports, including four involving William Hunter's aristocratic patients. This article explores these patient cases, and also the only instance recorded by John Hunter of William working with him on a post mortem of an aristocrat, that of the Marquis of Rockingham, Prime Minister, who died in 1782. The study aims to better understand William Hunter's medical practice and his professional connections with other practitioners. The post mortem examinations were carried out by a surgeon/anatomist and observed by the patient's physician(s). For aristocratic post mortems, those attending were senior and well-established practitioners. The notes made were not particularly detailed. The reports show clearly that William Hunter's practice, in the 1760s at least, was not confined to midwifery.

[From Physician's Biography of Primarius Ljubica Bosner] / Iz lijecnicke biografije prim. dr. Ljubice Bosner

Previously were published well-known data on Rijeka physician, Dr Ljubica Bosner, about her work in the Ogulin, Bjelovar, Petrinja and Rijeka hospitals during her excellent surgical and gynaecological and obstetric practice. The new and now accessible archives of personal and professional items complete incomplete and unknown biographical information. After her internship, Dr Bosner worked at a public county hospital in Velika Gorica as a secondary doctor at a well-known orthopaedic ward of that hospital. Circumstances of going to the Ogulin hospital with an oath to the reigning King Peter II for fidelity, then her professional activity as a surgeon at the newly opened Foundation Hospital Rebro Zagreb, with occasional departures to the position of director of the hospital and surgeon in Petrinja and Varazdin, and after the war to new positions at the Regional People's Board in Istria, are of particular social and historical interest. Recommendations from her bosses have been found to recognise the profession of surgeon specialist that particularly emphasise her skills, clinical judgment, and performance of major surgical procedures, especially during the war. Her life and medical career went through periods of great crisis between the two world wars (during the Kingdom of Serbs, Croats and Slovenes), then World War II (during the Independent State of Croatia), and after the war and the Republic of Yugoslavia in which she acted as a surgeon. The above data in the biography of Dr Ljubica Bosner are completed by previously unknown and unpublished photographs from her personal and professional surgical life.