The Hippocratic Oath

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Marie-Anne Boivin

Marie-Anne GILLAIN was born in 1773 in Montreuil, near Versailles.

She was sent to boarding school with the Sisters of the Visitation.

During the Revolution, she took refuge in Etampes, staying with a relative who was the mother superior of the Hospitalières de l’Hôtel-Dieu.

There she attended the surgeon’s lectures and served for two and a half years, from 1793 to 1796, as a hospital volunteer—that is, as a layperson who offered her services to the poor and sick on a voluntary basis.

In 1797, she returned to Versailles to marry Louis Boivin, deputy head of the National Domains office.

She became pregnant early on, but in 1798, at the age of 25, she was suddenly widowed, left penniless, and with a young daughter to raise.

She then decided to put the skills she had learned from the surgeon at the Hôtel-Dieu in Étampes to good use and enrolled in the Midwifery School at the Maternity Hospital in 1799.

In 1800, she graduated and moved to Versailles to be reunited with her daughter and pursue her career.

In 1801, following the death of her daughter, she obtained permission from Marie-Louise Lachapelle to return to the Maternity Hospice

In 1803, she was appointed head supervisor of the breastfeeding unit. She held this position for eleven years, until 1814. During this long tenure, she took the opportunity to attend the lectures of her patron, the surgeons at the Maternity Hospital (Baudelocque, then Dubois), and the chief physicians (Andry, and especially Chaussier), from whom she gathered observations and lessons.

In 1812, she wrote and published *A Treatise on the Art of Childbirth*. The work was approved by the Ministry of the Interior, which included it among the textbooks given to graduates of the Maternity School.

In 1814, the position of supervisor that she held was eliminated, and she was dismissed with a severance payment equal to her annual salary, amounting to 360 francs.

In October, she was appointed storekeeper and steward at the Poissy General Hospital, a position she held until January 1819, when the General Hospital was converted into a prison.

Little is known about this period of her life: did she continue her obstetric practice despite her new, more administrative duties? Did she do so within the general hospital? Or with a private clientele? In any case, for a time she appears to have received a comfortable annual salary of 1,200 francs—almost as much as the head midwife at the Maternity Hospital.

In 1818, she entered the Paris Medical Society’s competition anonymously, submitting a paper on internal uterine hemorrhages. She was awarded the medal.

On February¹, 1819, she joined the Maison Royale de Santé in Paris as chief midwife, with a modest salary of 350 francs a year.

In 1821, an opportunity for promotion arose following the death of Marie-Louise Lachapelle.

According to procedure, the General Council of the Hospices must submit to the Minister of the Interior a list of five candidates to succeed the renowned midwife.

On November 14, 1821, the Council voted to approve a list with Marie-Anne Boivin at the top; she received 12 out of 12 votes in the first round of voting to select the top candidate.

A month and a half later, the Minister of the Interior endorsed the Council’s decision.

But the winner declined the position (or rather resigned), forcing the board to propose another list. Why the refusal? All contemporary biographers attribute this decision to a public promise Marie-Anne Boivin is said to have made to her former patroness never to replace her, even after her death. If this is the case, she kept her word, and another midwife, Madeleine Catherine Legrand, was appointed in 1822.

Marie-Anne Boivin therefore continued to practice at the Maison Royale de Santé, where she amassed observations, publications, and honors.

In 1828, she submitted a thesis on spontaneous abortions, which was awarded a prize by the Bordeaux Medical Society.

In September 1835, at the age of 62, worn out and exhausted, she retired and urged the board of the hospices to grant her a pension. Finally, after a first stroke that left her hemiplegic, she died in May 1841.

In 1902, one of the rooms in the renovated maternity ward was named after Marie-Anne Boivin.

Louise BOURGEOIS

She was born in 1563 on Boulevard Saint-Germain or in Mons to a family of doctors.

She married Martin BOURSIER, a master surgeon and student of Ambroise PARÉ, in 1594.

She finds herself destitute when her husband is enlisted in the king's army.

She quickly gained a reputation among the ladies of the court and delivered the queen's children on six occasions.

She is paid 500 crowns for the birth of a boy and 300 for the birth of a girl.

It lost its prestige following the death of Marie de Bourbon-Montpensier, wife of Gaston d’Orléans, at the time of the birth of the Grande Mademoiselle.

According to the surgeons who performed the autopsy on the woman who had given birth, her death was attributed to the presence of retained placental tissue in the uterus, and Louise Bourgeois was subsequently accused of negligence.

At that time, there were few male obstetricians practicing, and they were trying to gain the upper hand over the midwives' guild.

Louise questions their competence by harshly criticizing the autopsy findings and the skills of the obstetricians; however, her response has the opposite effect of what she intended, as it ends up giving them publicity.

She was the first midwife to write a book on obstetrics, *Various Observations on Infertility, Miscarriage, Fertility, Childbirth, and Diseases of Women and Newborns*, published in 1609.

In this book, she points out that infertility in a couple may be due to male factors, even though, like doctors of that era, she confuses the ability to procreate with sexual vigor.

She identified the role of malnutrition in fetal health, and she was the first to prescribe iron supplements to treat anemia.

She emphasizes the importance of anatomical knowledge for midwives and urges doctors to allow them to attend lectures and dissection sessions.

In 1636, Parisian midwives submitted a petition to the Faculty of Medicine requesting that Louise Bourgeois be permitted to teach them obstetrics, but their request was denied.

Subsequently, however, one of her students, Marguerite du Tertre de la Marche, was appointed head of the midwives at the Hôtel-Dieu and succeeded in overhauling their training program.

She died on December 20, 1636, on Boulevard Saint-Germain at the age of 73.

Jean-Louis BAUDELOCQUE

He was born on November 30, 1745, in Heilly, Picardy.

He was the son of Jean Baptiste BAUDELOCQUE, a surgeon, and Anne Marguerite LEVASSEUR. His brothers Félix Honoré (1744–1794) and Jean Baptiste (1749–1800) were both doctors. He was the third of ten children.

It was his father who introduced him to surgery in the countryside of Picardy.

He completed his studies in Paris at the Hôpital de la Charité, where a renowned professor of obstetrics, Solayrès de Renhac (1737–1772), was in charge.

In 1772, following Solayrès’s untimely death at the age of 35, he collected the manuscripts of his lectures and succeeded him as professor of obstetrics at the Hôpital de la Charité. Thanks to Baudelocque, Solayrès’s work was saved from oblivion.

In 1775, at the initiative of the surgeon Augier du FOT, a demonstration instructor in obstetrics in Soissons, he published—drawing on manuscripts bequeathed by Solayrès de RENHAC—the first edition of a manual intended for the training of midwives. This work was later republished under his name alone, under the title“Principles on the Art of Childbirth: Questions and Answers for Student Midwives.” It underwent three reprints during Baudelocque’s lifetime and three more posthumously.

In 1776, following the defense of his thesis on symphysotomy, titled“An in partu propter angustiam pelvis impossibili, symphysis ossium secanda?”, he was appointed surgeon at the Hôpital de la Charité in Paris and was awarded the title of Master of Surgery by the Paris College of Surgery.

On April 5 or 6, 1777, in Paris, he married Andrée DERULLIER (née de Vulier, de Voulier, de Rullie, or de Rouillier), whose family made mannequins of pregnant women for demonstrations in childbirth classes; she died on January 4, 1787, without children.

In 1781 and 1789, he published the first two editions of his scholarly treatise*The Art of Childbirth* in two volumes. He became famous for his forceps, his practice of cesarean sections, and the invention of the pelvimeter, which measures the external anteroposterior diameter to identify patients who might experience difficulties during childbirth.

On September 14, 1788, in Amiens, he married Marie Catherine Rose Laurent; the couple had five children (three daughters and two sons).

During the French Revolution, the guilds and faculties were abolished. Hospitals lost some of their staff and funding. Baudelocque nevertheless managed to build a reputation as an obstetrician thanks to a clientele in the city and private obstetrics lessons.

In 1794, the former Faculty of Medicine was replaced by the École centrale de Santé de Paris, where he was responsible for teaching medical students and midwives.

In October 1795, the Maternity Hospice began taking in poor women and unwed mothers to assist them during childbirth and provided clinical training for midwives and doctors from the School of Health.

In addition, this facility also takes in abandoned children.

In 1798, Baudelocque, in addition to his position as professor of obstetrics at the Paris School of Health, became chief surgeon at the Maternity Hospital.

In 1802, the school at the Hospice de la Maternité was established, where Baudelocque put his teaching skills to use, employing mannequins to allow students to practice examinations and obstetric procedures. He emphasized observation over intervention, preferring to let nature take its course and using instruments as little as possible.

Busy with his many responsibilities, he delegated some of his authority to the head midwife of the Maternity Ward, Marie-Louise Lachapelle (1769–1821), who took on part of the training of the midwifery students and was authorized to use forceps on her own in cases of difficult childbirth.

He was involved in a high-profile lawsuit brought against him by an obstetrician, Jean François Sacombe, a fierce opponent of cesarean sections and a defender of traditional midwifery practices. Sacombe, who had set himself up as a defender of midwives and accused Baudelocque of infanticide, ultimately lost his case in 1804 and, in the process, any sense of proportion.

In 1806, Napoleon appointed Jean-Louis Baudelocque to the chair of obstetrics, the first medical specialty chair in France.

He became the personal obstetrician to the queens of Spain, Holland, and Naples, as well as to all the ladies of the court.

He had been chosen and selected in advance to deliver the heir awaited by Napoleon and Empress Marie-Louise of Austria. But, struck down by a cerebral hemorrhage, he would not live to see the birth of the King of Rome.

He died on May 2 or 3, 1810, at 16 Rue Jacob in Paris (^{6th arrondissement}), where he lived, at the age of 65.

He was buried at the Vaugirard West Cemetery, then exhumed due to land acquisition for the construction of what is now Boulevard Pasteur.

He was then buried on August 17, 1839, at Père-Lachaise Cemetery (^45thdivision).

He was the most famous obstetrician of his time.

A physician at the Hôpital des Enfants Malades, he would lend his name to the Baudelocque Clinic in 1890.

The Port-Royal Maternity Hospital was built in 1966. The two facilities merged in 1993 (^{14th arrondissement of} Paris).

There is now a midwifery school on Avenue Denfert-Rochereau that bears her name.

François CHAUSSIER

He was born on July 2, 1746, in Dijon, in the parish of Saint Pierre.

His father was a master glazier.

After completing his training at the Dijon Hospital, his mother sent him to Paris to continue his medical studies, and he enrolled at the Royal College of Surgery, where he attended classes regularly from 1765 to 1767; there he took anatomy courses taught by Raphaël SABATIER and Jean-Joseph SUE.

At the same time, he began training in surgery at Lafaye’s clinics and, in the afternoons, at those of Isaac GOURSAUD.

His years of surgical training came to an end in 1768, when he was awarded the title of Master of Surgery; he then settled in Dijon as a surgeon

He married Jeanne CARRE, the daughter and granddaughter of a Master Surgeon, on July 27, 1767, in Quetigny, Côte d’Or. Together they had a son, Bernard François Hector (1769–1837).

In 1769, he began teaching a free course in human and comparative anatomy, which was attended by many students for over ten years.

In 1774, the Estates of Burgundy established a chemistry program with Louis-Bernard GUYTON de MORVEAU as the full professor and Hugues MARET and François CHAUSSIER as assistant professors. Upon MARET’s death in 1786, he was promoted to associate professor of chemistry.

In Dijon, his professional skills earned him the favor of his patients, and his reputation quickly spread beyond Burgundy; he distinguished himself at the Academy of Surgery through several presentations, and as a result, he was awarded the Academy’s Gold Medal at the public session on April 10, 1777.

He received his Doctor of Medicine degree from the University of Besançon on January 14, 1780, and in 1784, he became a corresponding member of the Royal Society of Medicine. That same year, he was admitted to the Academy of Sciences, Arts, and Letters in Dijon, where he became secretary-general following the retirement of Guyton de Morveau.

In 1785, at the request of the Estates of Burgundy, he published a popular guide on the treatment of bites from rabid animals: “Method for Treating Bites from Rabid Animals and Vipers; Followed by a Summary on the Malignant Pustule” (with Joseph Enaux, 1726–1798).

In 1789, he published a study on the muscles of the human body, in which he proposed a more rational classification than the one previously taught: “A Brief Overview of the Muscles of the Human Body According to the Methodical Classification and Nomenclature Adopted in the Public Anatomy Course at Dijon”; this work was reprinted in 1797.

On December 20, 1789, he read a paper titled “Surgical-Legal Observations on an Important Point of Criminal Jurisprudence” at the Academy of Dijon, in which he demonstrated the role that physicians could play in assisting the justice system; this work attracted attention, and the following year he launched a course in forensic medicine in Dijon.

On 3 Nivôse, Year III (December 23, 1794), he married Angélique LABOREY in Dijon (Crébillon district); they also had a son, Franck Bernard Simon (1804–1866).

In 1794, Antoine-François Fourcroy was tasked by the National Convention with reorganizing medical education and sought out a figure capable of providing him with the details of this reorganization. Claude-Antoine Prieur-Duvernois, from Côte-d’Or, who headed the Committee of Public Safety’s Department of Science and Arts Education, recommended François Chaussier, who thus joined the Committee of Public Instruction: he drafted a report and a draft decree, which he read from the rostrum of the Convention on 7 Frimaire, Year III (November 27, 1794); In it, he proposed the creation of a single “Central School of Health” in Paris; the members of the Convention, who were largely open to decentralization, requested the creation of other similar schools in Montpellier and Strasbourg, and it was on this basis that the report was adopted on 14 Frimaire (December 4).

Chaussier returned to Dijon, where he resumed his teaching and studies as well as the duties entrusted to him: he had been appointed physician to the Hospices of Dijon in April 1793 and Surgeon to the Prisons; he did not remain there long, however, as he was recalled to Paris to occupy the chair of anatomy and physiology at the School of Health. Chaussier was, in the words of Joseph-Henri Réveillé-Parise, the most famous professor of physiology at the Paris School: he argued that vitalism was the foundation of all studies in physiology.

A decree dated 7 Vendémiaire, Year III (September 28, 1794), which officially established the École Centrale des Travaux Publics, the future École Polytechnique, the Board of Directors proposed, less than a month after the school opened, to establish an infirmary there and to appoint a “health officer” (the revolutionary term for doctors) to treat sick students and also to give lessons on “the art of preventing and alleviating diseases.” The roster of École Polytechnique staff for the following year lists him as an assistant to Claude Louis Berthollet, “concurrently responsible for the courses in Zootechnics and Public Health, and School Physician”: in fact, he taught Berthollet’s course during the latter’s absence in Italy in 1796–1797. After the formalization of chemistry instruction, Chaussier appears to have abandoned teaching this science and confined himself almost entirely to his duties as a physician.

In 1799, *Les tables synoptiques* was published to great acclaim. It provides a summary of the physiology, pathology, and treatment of the various anatomical systems of the human body.

On May 9, 1804, he was appointed Physician to the Maternity Hospitals and was entrusted with the chairmanship of the medical examination boards for the exams to become a Public Health Officer, Pharmacist, and Midwife for the district of the Paris Faculty of Medicine.

He was a member of the commission appointed by the Minister of the Interior in October 1810 to study “secret remedies”; there he worked alongside André Marie Constant Duméril, Jean-Joseph Menuret, and Nicolas Deyeux.

In 1815, following the fall of the First Empire, he was replaced as physician at the École Polytechnique, but he retained his chair at the Faculty until November 21, 1822, when the Restoration reorganized the Faculty: he was appointed honorary professor and his chair was revoked. He felt great bitterness over this, and the next day, he suffered a stroke that temporarily left him unable to speak or walk. He recovered, however, though he remained hemiplegic, which did not prevent him from continuing his work at the Maternity Hospital.

On May 6, 1823, he was elected tothe Academy of Sciences.

Between 1824 and 1827, he published several works on forensic medicine: *Forensic Manual of Poisons, Preceded by Considerations on Poisoning*¹⁴, “Collection of Papers, Consultations, and Reports on Various Topics in Forensic Medicine”¹⁵, “Forensic Medical Paper on the Viability of the Newborn Child, Presented to^{His Excellency} the Keeper of the Seals, Minister of Justice”¹⁶

François Chaussier died at his home in Paris on June 19, 1828, at the age of 81, from a stroke.

He was buried at Père-Lachaise Cemetery (^18th division) on June 21: Nicolas-Philibert Adelon delivered a speech on behalf of the Academy; Marie-Alexandre Désormaux, representing the Faculty, did the same; and Duméril, on behalf of the Royal Academy of Sciences, read a lengthy eulogy.

The^second son, Franck CHAUSSIER, followed in his father’s footsteps and defended his doctoral dissertation in 1827 in Montpellier.

He is a French physician, a professor at the Paris Faculty of Medicine, and a member of the Royal Academy of Medicine and the Academy of Sciences.

Chaussier was the chief editor of the articles on pharmacy inthe *Encyclopédie méthodique*¹³.

Angélique Marguerite Le Boursier du Couday

She was born in 1712 in Clermont-Ferrand to a family of doctors.

She first studied under Anne BAIRSIN, a midwife, for three years.

On September 26, 1739, she received her diploma and shortly thereafter became a licensed midwife.

She worked as a midwife at the Châtelet in Paris for sixteen years.

In 1752, to put theory into practice, she published a book titled *A Summary of the Art of Childbirth*.

In 1754, she returned to Auvergne and began giving free lessons.

In 1758, she designed her famous demonstration “machine” (made of wood, cardboard, fabric, and cotton), which was approved on December¹ by the Academy of Surgery.

During the two-month training course, the students were encouraged to practice on the mannequin.

In 1759 (or 1757 or 1767), Louis XV granted her a pension and issued her a royal charter authorizing her to teach throughout the kingdom; she embarked on a 25-year obstetric tour of France that continued until 1783, during the reign of Louis XVI, and trained more than 5,000 women and surgeons.
In 1768, she enlisted the help of her niece, Marguerite GUILLOMANCE.
In 1769, a^second edition of her book was published, which she had illustrated with 26 charming color engravings.
In 1770, she hired a young surgeon in Bordeaux, Mr. COUTANCEAU, who married her niece shortly thereafter.
In 1789, she was staying with her niece.

She died on April 16, 1794, at the age of 79 in Bordeaux, in poverty and solitude, with her niece and her husband absent. There is a Rue Angélique du Coudray in Thorigné-Fouillard and also a Rue Madame-du-Coudray in Clermont-Ferrand, her hometown. The maternity ward at the hospital in Melun (77) also bears her name.

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