A Mandrágora [Com Notas] (Portuguese Edition)
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Principe, O - Livro de Bolso. Da Arte da Guerra. Provide feedback about this page. There's a problem loading this menu right now. Get fast, free shipping with Amazon Prime. Get to Know Us. English Choose a language for shopping. Amazon Music Stream millions of songs. Amazon Advertising Find, attract, and engage customers. Rather than considering childbirth pain as a taken-for-granted physical phenomenon, its materialization within the specific biomedical and historical context of Portugal at the turn of the 20 th century is analysed.
It is an omen for a quick delivery, a wish for labour to be short, hinting at its pain without actually mentioning it. At antenatal classes and in pregnancy booklets distributed in health centres, pain is invariably evoked by describing the onset of labour in terms of discomfort; uterine contractions are depicted as similar to menstrual cramps, but stronger in intensity.
In the clinical context, pain is considered a troublesome side-effect of the physiology of labour, and addressed exclusively in terms of the techniques available to relieve it. The pain associated with labour is subject to different apprehensions, depending on how childbirth is understood and managed. For Arcidiacono both configurations tend towards a denial of the hardship of labour, of that strenuous work of parturition to which the etymology of the word labour refers: These seemingly polar approaches to pain at some point intersected, hence recourse to pharmacological relief is included today within technologies of the pregnant self that also incorporate meticulous attendance to the body and the relishing of the birthing experience Foucault ; Lupton Genealogy, describes Foucault, is situated within the articulation of the body and history.
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Specifically, I analyse the constitution of childbirth pain that emerged from the clinical encounter following the discovery of anaesthesia. Most of the medical theses and articles analysed were based on the trials carried out in the infirmary related to the application of anaesthesia during childbirth.
Today these documents are scattered across various locations in the city of Lisbon. This definition was situated within an agenda that sought to promote the use of hospitals nationwide as part of the modernization project and deliberately disregarded the universe of informal assistance in childbirth provided by parteiras , comadres and curiosas , 12 that reproduced an empirical and oral tradition relatively disentangled from the medical domain.
The transformation of the birthing scene — and the associated roles of those who attended it — depleted the social and symbolic meanings that had been reproduced through traditional midwifery practices around labour. In the next section, through an analysis of oral histories and ethnographies of fertility rituals and childbirth in Portugal, I attempt to articulate the holistic understanding of pain that homebirths had sustained. Assistance in labour mainly depended on the proximity — social, affective, physical, residential — of the attendants; care of the birthing woman would be limited to the delivery and immediate post-partum periods or could extend to overall support to her household Silva ; Gionelli In this context of homebirth unsanctioned by the medical profession, childbirth unfolded through a series of corporeal and symbolic practices that, rather than focusing on relieving pain, were aimed at hastening labour.
In contrast with this gendered and engendering understanding of pain as a landscape within which home birth practices were performed and transmitted, the obstetrical practice of administrating ether or chloroform in labour — both in the home and in the hospital setting — would generate a collapse not only of the values traditionally ascribed to pain, but also of the relationships of proximity established through childbirth attendance.
In October dentist William T. Simpson administered ether on a parturient with a pelvic deformity, and later discovered and experimented with chloroform in a normal as in non-instrumental delivery, anaesthetizing more than women in the following three years and publishing numerous articles that conferred on him international fame Caton ; Wolf While the administration of anaesthesia, especially in childbirth, generated animated debates within the medical milieu, it also gave rise to international disputes over who had implemented it first; medical professionals were immediately aware that they were faced with a revolutionary discovery Carneiro ; Caton ; Sacadura a; Wolf Such competitive efforts to associate themselves with the pioneering use of anaesthetics reveal how, in the international debate between critics and supporters of anaesthesia in childbirth Caton , the Portuguese obstetrical community leant towards the latter camp.
Similarly, it was argued, the obstetrician and the surgeon were now capable of sparing humanity from pain. After a night of unproductive labour, the Portuguese Queen died, allegedly of exhaustion. This silence, at a time when critics of obstetric anaesthesia in Europe and further afield earnestly proclaimed the dangers and potential lethality of chloroform, speaks volumes concerning the professional stance of Portuguese obstetricians regarding its administration. This is where the first doses of ether and chloroform in childbirth were administrated, from onwards Coutinho ; Sacadura a, b.
The theses and articles reporting these experiments rarely describe the premises where they took place, and the ward disappears behind a medical gaze Foucault  that focuses on the dosage of the composites, the appliances, the corn-shaped handkerchief, and the bodies and reactions of the labouring women observed.
The description of the maternity infrastructure evokes desolation: The ward lacked proper appliances, and parturients lay on filthy mattresses or cots arranged on the floor when service capacity was reached. From this miserable backdrop described by Alfredo da Costa certain characters emerged, women, children and visitors, providing a glimpse of a public otherwise lost to history. Wailoo which would be the flag unfurled by his successors following his death to advocate for reform in the field of obstetrics, and would mark the future direction of the profession.
By , in addition to ether and the favoured chloroform, amylene, nitric ether, aldehyde, Dutch liqueur, benzene, carbon disulphide, laudanum, morphine and chloral had also appeared Salgado ; Paiva ; Jesse As already noted, registered midwives in hospital wards were prohibited from administering anaesthesia, so their traditional task of assisting the parturient during labour was eclipsed by the function of the obstetrician overseeing the use of anaesthetic and monitoring its effects.
This focus on pain enlarged the responsibilities of the parteiro obstetrician in the birthing scene, accelerating, in turn, the process of subordination of the parteira midwife. The possibility of controlling the labouring body in the delivery room obliged obstetricians to address certain issues.
Finally, the use of anaesthetics compelled obstetricians to define what pain was, and to develop a biomedical lexicon around it. At the same time, arguments in favour of anaesthetization were propounded largely on secular grounds: The compassionate quest to nullify pain cannot be separated from parallel efforts to control and contain the emotional parturient, frequently depicted as anxious, delirious, hysterical; the liminal expression of feminine corporeality Joaquim The archive is replete with descriptions which overlap the moral duty of the obstetrician to deliver women from pain with an impulse to gain control of their labouring bodies.
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Although the appearance of narcotic gases did not in itself change the scenery of experience, it did allow the protagonists to interpret a different comedy. The surgeon no longer behaved like executioner, but like a gentleman. While some parturients reacted immediately, losing consciousness, others alternated between excitement and stupor; the majority presented a state of drowsiness occasionally interrupted by apparent expressions of alertness, coinciding with uterine contractions.
Could this be a case of what Magendie complained about?
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Coutinho, however, ruled out any possible association between childbirth whether painful or not and sexual pleasure: Analysing the effects that the cries of labouring women have on hospital attendants, historian Jaqueline Wolf describes how, in several interviews she conducted, women who experienced birth without medication reported that the transition period 29 is the most painful part to sustain, whereas the second stage of labour — birthing — was mostly described in terms of effort, of hard work , even joyful, and it was often sustained by cries. While obstetricians did not falter in their conviction that they were working for the suppression of this potential trauma, they also questioned the necessity of pain and the ambiguity of childbirth being the only painful physiological act.
The imposition of anaesthesia upon childbirth pain thereby signalled the power of obstetrics over nature, based on an ethics of compassion. Now obstetricians could govern the uterus by controlling the pain expressed through it. In the process of the development of a modern, technical lexicon around birth, pain gained the ontological status of a disembodied phenomenon which, causing trauma, needed to be acted upon. While the force that moves people to deal with these problems may be conceptualized as purely somatic […] the emotion idiom is often the central one.
With an eye on the contemporary biomedical understanding of childbirth pain in Portugal that advocates for broader national coverage of pharmacological practices in labour management, I have delved into the history of obstetrics in Lisbon to uncover how childbirth pain came to be constituted as a subject of clinical and political interest. My general aim was to discover what ideas of pain were produced and circulated at that specific socio-historical juncture, and how they mobilized obstetric agency.