Abdominal deliveries in Africa: food for thought to scholars of the history of medicine

Abstract

The purpose of this article is to show the advancement in knowledge of cesarean sections among African traditional healers before the advent of colonialism and introduction of scientific medicine (allopathy) to Africa. The case mentioned below was witnessed by Robert W. Felkin, a Scottish medical anthropologist, in Uganda in 1879. Felkin subsequently wrote a medical dissertation on his observations, which he submitted to Marburg University, Deutsche Reich (now Federal Republic of Germany), in 1885.

PIP: Robert Felkin, a Scottish medical anthropologist in Uganda in 1879, observed African medical achievements and used this information to write his medical dissertation. Caesarian sections have been performed since the reign in Rome of Numa Pompilius (715-672 B.C.), mainly on women who died late in pregnancy. The 1st Caesarian on a live patient was performed in 1610. Most patients (85%) died of hemorrhage or infection until 1882 when Sanger introduced longitudinal incision and uterine fundus sutures which greatly decreased the risk of hemorrhage. Poro introduced sterile surgical methods and decreased the risk of infection. Caesarians were performed in Africa much before colonization. A story of an abdominal delivery as performed by an African operator, is related in detail. Another incident of a black slave in America in 1869 performing abdominal surgery on herself is briefly mentioned. It is clear from the stories that medical knowledge was fairly advanced in Africa: cauterization of the bleeding points with a hot iron was used, dressing with a poultice to decrease risk of infection was standard, closing the incision with animal gut sutures, post operative suture removal, "anesthesia" with wine, and scrubbing with alcoholic beverages were all techniques used that are strikingly similar to "modern" surgical techniques.