Jakob Rüff, The Expert Midwife or An Excellent and most necessary Treatise of the generation and birth of Man (London, 1637), title page.
Swiss surgeon and physician Jakob Rüff (1500-1558) originally published The Expert Midwife in Latin in 1554, attempting to expand on the famed midwifery manual Der schwangern Frauwen und Hebammen Roszgarten (A Garden of Roses for Pregnant Women and Midwives) by Eucharius Rösslin (d.1526). Rösslin’s text is often referenced as the precursor to the obstetric studies that Rüff created. Rüff was passionate about the education of rural midwives and allegedly distributed manuals to be read aloud in the countryside. This 1637 English translation, from the personal collection of John Worth (1648-1688), Edward Worth’s father, focuses on maladies that affect women throughout their lives, not only just in childbirth. Rüff was a keen advocate of anatomy and is known for his anatomical treatises.
In the beginning of the sixteenth century, any and all women’s health concerns were undertaken by the local midwives. It was thought that midwives understood the female body in ways male physicians could not fully comprehend. On the first page, Rüff dedicates the volume:
“To all grave and modest Matrons, especially to such as have to do with women in that great danger of child-birth, as also, to all young practitioners in sick and surgery whom these matters may concern, Grace, Peace, and good success, in their undertakings, heartily wished.”
Jakob Rüff, The Expert Midwife or An Excellent and most necessary Treatise of the generation and birth of Man (London, 1637), Sig A2r.
These women were in a unique position of authority on the subject of women’s bodies. The foundations of society revolved around religious taboos with doctors often told to mind the modesty of the patient. Genital health was almost impossible for a physician to inspect without jeopardizing his dignity. The midwives were called on to breach this gap. Rüff notes that though some might find the subject to be vulgar, it was better to be educated on the matter than for physicians to not be able to aid those in need.
The work is split into six short “books”, each covering different types of maladies. However, they fall under three unofficial but similar sections. The first two are similar in fashion, and describe fetuses, uteri, and their changes and development throughout pregnancy. These are accompanied with drawings that show development of the “seed”, a term used for the ovum, and diagrams of the organs. The understanding of both subjects was rather basic as female anatomical dissections had yet to become widespread. These anatomical drawings created greater knowledge for those who had no access to cadavers, e.g. midwives with no formal training. Although the accuracy of these figures is questionable (as they draw on many antiquated ideas of anatomy), the concept of bringing this information to lay-people was a radical move by Rüff.
Jakob Rüff, The Expert Midwife or An Excellent and most necessary Treatise of the generation and birth of Man (London, 1637), p. 93.
The following chapters suggest both routines and rudimentary medicines that can aid sickness. Rüff discusses difficulties during pregnancy: ranging from miscarriages, inducing labor, and other problematic births. Rüff himself was trained in midwifery and gives a myriad of physical and medicinal solutions for expecting mothers. Many of these cures are very indicative of the time of the sixteenth century, entailing herbs steeped in wine and the placement of cloths on affected areas. In Book Four, there are drawings and demonstrations of obstetric instruments, which assist in the removal of afterbirth or fetuses. There is a brief mention of chloroform as an anaesthetic in dire situations; however, the sixteenth century predominately had natural births. The only exceptions were when the mother or child was no longer alive.
Jakob Rüff, The Expert Midwife or An Excellent and most necessary Treatise of the generation and birth of Man (London, 1637), p. 105.
The last two “books” contribute theories of conception. These predominately focused on how humors and spirits affect the womb. Since there had been very little research undertaken on this topic, Rüff, like his contemporary Rösslin, relied on the sciences of ancient Greece and Rome.
Rüff is most well known for his anatomical work that was years ahead of the field of obstetrics at the time. Contemporary literature was filled with ancient studies from Hippocrates and Aristotle rather than moving forward in scientific literature. It was almost a radical idea at the time to display the anatomy in such an explicit manner; however, it quickly became a wide-ranging success across the continent. The reading of his work to those who had experience but no formal education created a field of obstetrics in a place where it did not exist as a science. While the instruction remained rudimentary for many decades after publishing, Rüff’s work moved childbirth into the modern era of scientific inquiry.
Jakob Rüff, The Expert Midwife or An Excellent and most necessary Treatise of the generation and birth of Man (London, 1637), p. 107.
Longo, Lawrence D., and Lawrence P. Reynolds. Wombs with a View Illustrations of the Gravid Uterus from the Renaissance through the Nineteenth Century. Cham: Springer International Publishing, 2016.
ODowd, Michael J., and Elliot Elias Philipp. The history of obstetrics and gynaecology. New York: Informa Healthcare, 2011.
Text: Ms. Mallory McFall (University of Kansas, 2017)