QUESTION 156 Women and procreation became an integral part of the thriving Greek medicine

QUESTION 156 Women and procreation became an integral part of the thriving Greek medicine – the “Hippocratic gynaecology” – of the fifth and fourth centuries BC. Female “seed” and blood provided vital contributions, and the child “grew like rising bread dough” in the womb. Cures for infertility and instructions for safe birthing were prominent.Philosophers including Aristotle grappled with “coming to be” in all its manifestations, along with the ideal population size for a state and how to achieve it, while farmers developed new livestock breeding techniques.As different areas of the Mediterranean world converged, so too did ideas of generation. Greece gave way to Rome, and, according to Flemming, “the imperial metropolis of the second century AD was where the physician Galen put seeds, womb and menstrual blood into their most influential arrangement”. This would hold through the religious and political changes of the next centuries. Societies were still highly patriarchal, however. Romans mapped male physiology onto female bodies, says Flemming: ovaries were women’s testicles, the uterus was a deflated scrotum and a weak female ‘sperma’ was designed to lock in male seed. “Women were viewed as inferior versions of men due to their apparent ‘mutilations’ for accommodating babies.”Lauren Kassell of Cambridge’s Department of History and Philosophy of Science oversees the medieval and early modern periods, when theories of ‘generation’ expanded. Scientific inquiry was applied to distant lands and microscopic structures, and women and artisans joined in debates.”Numerous Greek works were translated into Arabic from the eighth century. Scholars from Asia and Egypt reworked theories about the importance of the female seed and the formation of the fetus – challenging older authorities,” says Kassell.Following the devastation of the Black Death, Christian clergy were instructed to counsel parishioners about sex to encourage “fruitful marriages”. Influenced by sex-positive attitudes from Arabic texts, church law supported spousal obligations to “honour each other’s desire for sexual gratification”.Woodcut of a copulating couple as emblem of the alchemical conjunction of gold and silver. (Frankfurt: Cyriacus Jacobus, 1550), Wellcome Library, LondonLineage, paramount to social order, was threatened by women having children outside marriage, although men were free to do so – with theories of family resemblance invoked in cases of disputed paternity. While unwed women feared pregnancy, Kassell says that moral and medical advisors continued to be more interested in promoting rather than limiting fertility.”Questions about pregnancy defined early modern medical encounters. Seventeenth-century medical casebooks reveal diagnostic approaches for female fertility that are superficially familiar to modern readers, such as observing changes to a woman’s body and examining her urine, as well as the more otherworldly interpretations of the positions of the stars.”A detail from John Dee’s ‘Diary’. A table setting out planetary motions day-by-day for five decades, show December 1590. In marginal notes keyed to particular dates, he recorded a conversation with Queen Elizabeth, a trip to Chelsea for a disputation with a bishop, and when his wife Jane menstruated. Courtesy of the Bodleian Library, University of Oxford.Within households, fertility was the business of men as well as women. Some husbands charted their wives’ menstruation cycles. The book features diary sections written by the mathematician and occult philosopher John Dee, in which he recorded his wife Jane’s periods alongside notes about meetings with Elizabeth I.Hopwood guides readers into the era of ‘reproduction’: a long revolution not just in society and culture, thought and technology, but also in terminology. The word is older, but its modern use began in earnest in the 1740s, when experiments to regenerate tiny freshwater animals after cutting or sieving provided a model for reproduction in general.Mid-eighteenth century engraving promoting the City of London Lying-In Hospital. Founded in 1750, this institution accepted only married women until rules were relaxed around 1900. The horn of plenty and the breast-feeding mother symbolically linked the work of the lying-in hospital with the Enlightenment concerns of charity, fertility, infant health and economic prosperity. Wellcome Library, London.It was not until the 1870s, however, that a scientific consensus emerged on the roles of eggs and sperm in fertilization. (In 1827, the same year he discovered the mammalian egg, embryologist Karl Ernst von Baer named ‘spermatozoa’ but dismissed them as parasites.)People in industrialized countries increasingly limited the size of their families in the early 20th century, while governments initially fought contraception and abortion. Some worried that state control of reproduction would lead doctors to create humans “as farmers breed their beasts”. Others were more concerned that maternal mortality stayed stubbornly high.”As European birth-rates fell, reproduction became linked to worries about the quality as well as the quantity of populations, including nationalist fantasies of racial vigour,” says Hopwood. These would result in some of humanity’s darkest hours.The Austrian gynaecologist Hermann Knaus produced Menstrual-Cycle Calendars in the 1930s by using statistics and a formula for calculating the day of ovulation based on his endocrinological research. Knaus offered the calendar or ‘rhythm method’ to the women’s movement of the Weimar Republic and to the Nazi regime, which gave the calendars an important role in its pronatalist policies, and after the war to the Catholic church.As reproduction moved centre stage after World War II, science and medicine took ever more important roles in childbirth (now safer), contraception (now respectable), and attempts to alleviate infertility. Feminist activists campaigned against “battery births” and for “a woman’s right to choose”. Environmentalists promoted population control.Hopwood contributes a chapter on the strange history of artificial fertilization, taking in horse-semen thieves, test-tube sea urchins, experiments to produce human-orangutan hybrids, and fertility magnates promising Nobel Laureate sperm. More routinely, over five million IVF babies have now been born around the world, though assisted conception is provided through the market more than by states.6. What is “success” in your opinion? After 20 years as a physician, what kind of “success” would you hope to have achieved? Please explain7. What qualities do you look for in a physician? Can you provide an example of a physician who embodies any of these ideals? How do they do this?8. What kind of experiences have you had working with sick people? Have these experiences taught you anything that you didn’t know beforehand?9. Do you have any family members or role models who are physicians?10. What family members, friends, or other individuals have been influential in your decision to pursue a medical career?11. If you could invite four people from the past to dinner, who would they be, and why would you invite them? What would you talk about?12. Does your academic record reflect any major challenges? If so, what are they and why did they occur?13. Are you aware of any current controversies in the area of medical ethics? List and discuss some of these.14. Have you personally encountered any moral dilemmas to date? Of what nature?15. How do you feel about euthanasia or medically assisted suicide?16. What different feelings and issues might you experience with a terminally ill patient, as opposed to other patients?17. How would you feel about treating a patient who has tested positive for HIV?18. What are some of the ethical issues that our society considers in regard to teenage pregnancy?19. Assume there are limited resources available and you must make decisions in a major emergency with a wide assortment of patients from all ages, backgrounds, and degree of injury. Assume also that there is no “right answer” to this question, only considered and unconsidered responses. Who would you direct to receive the treatment first and why.  Health Science Science Nursing Share QuestionEmailCopy link Comments (0)

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