See the museum's Sims' speculum.
Read Dr. Soucasaux on the colposcope, used to examine the vulva, vagina and cervix of the uterus.
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Touch but don't look:
"The Touch" and the shame of physical examination,
part 2 (part 1)

Examining a bed-ridden woman followed the same procedure. In the illustration right below, the physician looks the woman in the eye to give the impression he's not thinking about the region his hand is touching.

From "Lying-In: A History of Childbirth in America" by Wertz and Wertz, Yale, 1989

Bilz shows (below) a woman not uncovering the patient's abdomen while examining her, although she looks at the area she touches. The picture dates from the last decade of the 19th century and probably more latitude was allowed - and the examiner was a woman.


"Method of examination lying down according to Thure Brandt"
From Friedrich Eduard Bilz's "Das Neue Naturheilverfahren," about 1890

In the 1840s the American physician Marion Sims successfully repaired damage to the walls of the vagina, bladder and rectum of some American slaves he had bought for this purpose. Such damaged tissue often prevented women from enjoying social life as the leaking of feces and urine caused constant soiling and repellent odor. The slaves, of course, occupied the lowest status and had little choice but to let Sims attempt, again and again over years, to surgically fix the terrible wounds caused by childbirth - using no anesthesia. But once Sims had repaired the tears and mastered the procedure he opened probably the first hospital for women, in New York, and traveled the world helping similarly afflicted women, including European royalty. It was a huge breakthrough in gynecology and demonstrated the power of actually looking at the genitals of a patient in order to help her. The so-called Sims posture, or position, below, used by Sims to access the woman's perineum, became useful to other doctors in examinations because the woman could not see the physician, thus maintaining the emotional distance achieved by "sightless" examination procedures that were now becoming obsolete.


Drawing (1903) from Dr. Howard Kelly's "Gynecology," 1928, showing Sims position.
See a Sims speculum in the museum collection.


Drawing from Dr. Howard Kelly's Gynecology, 1928, showing Sims position.

Dr. Howard Kelly, above, first professor of gynecology at Johns Hopkins medical school, was very religious, a characteristic prized by the 19th-century medical establishment because it helped inoculate a physician against suspicion that he might be interested in more than a woman's illness. But some of his famous colleagues at Johns Hopkins found his piousness off-putting although they respected his enormous influence and talent. (See more drawings from Kelly's book and read about the founder of the first university department of medical illustration in America, Max Brödel, at Hopkins, the place these illustrations originated.)

It's striking that vision should be the offending sense here; touch is by definition physically on the patient - but was tolerable. Vision's power in medicine might be comparable to that of the Evil Eye in many parts of the world, both demonstrating the strange hold of eyesight. I wonder if part of the problem resided in the doctor's facial expression. Sometimes patients were covered with sheets in such a way as to block their view of the physician's face.

Several of the facts and insights on these two pages I gleaned from "Lying-In: A History of Childbirth in America," by Wertz and Wertz, Yale, 1989.
See the Sim's speculum in the museum's collection. Read Dr. Soucasaux on the colposcope, used to examine the vulva, vagina and cervix of the uterus.

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