*<Arch Dis Child Fetal Neonatal Ed* 2000;*82**:*F255-F256 ( May ) Perinatal
lessons from the past

Laurent Joubert of Montpellier (1529-82) and his Erreurs Populaires*Peter M
Dunn*

Laurent Joubert was born on 16 December 1529 in the old province of Dauphiné
in south-central France. He was the tenth of 20 children born to Le
Chevalier Joubert and his wife, Catherine de Genas, between 1519 and 1541. .
. . . . .Catherine de Medici . . appointed him her personal physician. . . .
. . .

Joubert wrote a number of medical books in French as well as in Latin, of
which undoubtedly the most important was his *Popular Errors*, the first
part of which was published in 1577. Recently it has been translated and
annotated by Professor de Rocher of Alabama. In this book Joubert . . . . .
 attempted to correct current misconceptions  . . . . . . .

Although some of Joubert's explanations of false popular beliefs were
themselves incorrect, his book contains many fascinating insights into
medical attitudes in the sixteenth century and not a little wise advice
relevant to our own times, as the following extracts reveal.


On multiple pregnancy

"A woman has only two mammae and can thus carry only two children ordinarily
and nourish the same number. For if she has three or four at a time ... they
will not live communally; ill nourished in their mother's belly, and thus
unable even to endure the strain of coming out, they (may) die in the birth
passage or soon afterward ... such children are borne only for a period of
seven months ... This is because the womb had slightly stretched ...
it is enough
that they are well formed and have all the parts needed by the nutritive
faculty. They recover well from their fasting and abstinence if they find
proper nurses who give them lots of milk. They make more progress in eight
days than others who are born well nourished do in three weeks. Everyday we
see very small ones born, all withered and wrinkled like an old apple, who
in almost no time become marvellously big and fat."


  On posture in childbirth

"It is now necessary to consider various postures during the act of
childbirth. Some wish to be standing, held up, others, seated on a sawed-out
chair that is also open in the front; still others, lying down. I let those
who have tried everything choose the manner they find the easiest. I only
warn that they be certain that the crupper is free and unimpeded, so that it
is able to flex down freely. This would be aided tremendously if the
standing method were used at just the right time, when the child starts coming
out, without tiring the poor woman or causing her useless pain. For besides
the fact that the crupper (as it is called) has great freedom of movement in
such a posture, the child, because of its own weight, descends better and
aids its delivery ... It is a thing of great importance to have the woman
deliver comfortably ..."


On breastfeeding and bonding

"Only an unnatural, imperfect, and halfhearted mother would have a child and
then suddenly reject it and send it away. What sort of woman would nourish
in her womb with her very blood a being she could not see and then not nurse
with her milk one she could see, alive and expecting its mother to do her
duty? Do you think nature gave women nipples on their breasts to serve as
pretty little buttons for embellishment rather than for the nursing of their
children? Are these women not prodigal when they work at stopping and drying
up these most sacred fountains of the body, wellsprings of the human species
... as if it disfigured the marks of their beauty? ... mothers who thus
abandon and turn out their children, giving them to others to be nursed,
sever the bond and tie of love, by which nature joins fathers and mothers to
their children, or at least loosen and weaken this link ... One of a woman's
greatest desires is to find herself pregnant and then graced with a
beautiful birth. How can she suddenly be so inconstant and fickle that,
scarcely does the child see the light of day, she rids herself of it,
sending it away to be nursed by a strange woman? ... Without a doubt, the
love and the pleasure are double with mothers who nurse their children ..."


On cracked nipples

"*Tandrieres* are little fissures in the ... nipples of the breasts, when
they crack and split because of the first milk, especially in those who
nurse, because as the child sucks and pulls on them they split all the more
... Now, in order to avoid them, especially right from the first child,
women apply diverse remedies, all of which tend toward exsiccation, thinking
that by correcting the softness one will prevent such little splits,
inasmuch as the nipple that is already hardened is not going to be so
subject to them ... And all these do nothing but make the nipples much worse,
for the harder and stiffer the nipples are, the more they will split. The
very opposite is what must be done: soften them and make them supple before
the milk arrives. For if they are soft, they will definitely give enough and
will not split ... This is why those who are better informed will apply to
their nipples some new wax thinned with some soft oil a few months
before delivering
in order to avoid *tandrieres*. But it is better yet, as I prescribe, to
grease them often with cool bacon fat, which softens them nicely and
gently."



On fixed times for feeding babies

          "Women are of the opinion that in order to give a child proper
care it must be regulated according to fixed hours, both for nursing
          as well as for changing its breechcloth to keep it clean ... whoever
would seek to limit the feedings of all children to the same
          times cannot fail upsetting nearly all of them ... the child that
is fed on an individual basis will be far healthier ... And so it seems it
          would be better to make another rule: namely, that the child not
have any fixed and limited timetable, but that the nurse give it her
          breast constantly. For if it is hungry, it will suck; it not, it
will abstain ..."


On relactation

"A poor woman died, leaving her five- or six-month-old child without a
nurse. Her niece, verily a young girl and a virgin, a plump child and in
good health, tried a few times to calm the child (which was dying of hunger)
by offering it her breasts as if there were milk in them. The child so
pulled and drew on them that it made some bloodied humour come out, which
the poor girl endured patiently in order to please her little cousin
on whom she
had pity. This went on so much that the red turned to white and became milk,
with which she eventually nursed the child for more than a year ...">


Having been the 10th of twenty children, he probably started medical school
with a lot of insight!


Jean
*****************
K. Jean Cotterman RNC, IBCLC
Dayton, OH USA

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