Jean René Sigault

Jean-René Sigault studied surgery at the Collège de Saint-Côme in Paris and received his mastership in 1770. He studied at the École de médecine from 1772 and obtained his medical doctorate in 1776. In 1768, in a communication to the Royal Academy of Surgery, Sigault presented a treatise that proposed substituting the section of the symphysis of the pubis for caesarean section. The master surgeons promptly rejected his proposal, with little discussion.

However, Sigault was resolved to try it anyway. Specialising in midwifery, he established his medical practice in Paris. Finally in October 1777, he created a sensation when he performed a successful symphysiotomy to deliver the infant of Madame Souchot, whose pelvic deformities prevented vaginal delivery. She was about forty years of age and deformed from rickets. She had already lost four babies, and the consensus of medical opinion was that she had no chance of bearing live children without a caesarean section. Sigault, assisted by Alphonse Louis Vincent Leroy (1742-1816), performed instead a section of the pubic symphysis, and mother and child both survived the operation.

The Paris faculty of medicine took special pride in this surgical achievement because of Sigault's prior rejection by the Academy, because he had quietly joined their institution, and because the innovation appeared to be a triumph for the faculty in a field traditionally dominated by surgeons. During the ensuing controversy the College of Surgery discredited the operation for a second time. However, the Sigault affair demonstrated the medical faculty's willingness to encourage surgery within its own ranks.

Symphysiotomy had been advocated in 1597 by Severin Pineau (ca. 1550-1619) after his description of a diastasis of the pubis on a hanged pregnant woman and Ambroise Pare (1510-1590) approved Pineau. The operation was performed many times after Sigault's report but was opposed by the famous French obstetrician Jean-Louis Baudelocque (1745-1810). The discussion was so bitter that the Parisian physicians became divided in two groups, cesareans and symphyseans. Symphyseotomy, as a result of poor technic and its use in unsuitable cases, soon fell into disrepute and was forgotten until 1863 when Ottavio Morisani (1834-1917), in Italy, performed it again. The procedure was reintroduced in France in 1891 by Adolphe Pinard (1844-1934).

Works by others:
• Severin Pineau:
  Opusculum physiologicum, anatomicum vere admirandum librisque duobus distinctum; tractans analytice notas primo integratialis et corruptionis virginum, deinde gravitatem et partum naturalem mulierum in quo ossa pubis et ilium distrahi, dilucide docteur.
  Parisiis, E Typographis Steph. Prevosteau, 1598. Frankfurt 1599, 1650; Frankfurt and Leipzig 1690, Leiden 1610, 1634, 1639, 1640, 1641, 1650, 1660; Amsterdam 1663. In German: Frankfurt 1717; Leipzig 1724; Erfurt 1727, 1759.
  Title also given as: Opusculum physiologicum & anatomicum in duos libellos distinctum. In quibus primum. De integratis & corruptionis virginium notis. Paris, Steph. Prevosteau, 1597.
• Alphonse Louis Vincent Leroy:
  Recherches historiques et pratiques sur la section de la symphyse du pubis.
  Paris, 1778. In this work, Leroy advocates symphysiotomy.
• Ottavio Morisani:
  Sulla simfisiotomia. 1883.
• Adolphe Pinard:
  Documents pour servir à l’histoire de la grossesse extrautérine. Paris, 1892. Works by Sigault: His three doctoral dissertations:
  
• An a conceptu ad puerperium genus nervosum sensibilius?
  
• An in praegnantibus, parturientibus et puerperis diaeta?
  
• An placentae solutio naturae committenda?
• An in partu contra naturam sectio symphyseos ossium sectione caesarea promptior et tuitor? Angers, 1772.
• Discours sur les avantages de la section de la symphyse dans les accouchements laborieux. Paris, 1779.
• Précis de ce qui s’est passé à la Faculté de médecine de Paris au sujet de la section de la symphyse des os pubis practiquée sur la femme Souchot. Paris, 1777. Biographical:
• August Hirsch, publisher:
  Biographisches Lexikon der hervorragenden Ärzte aller Zeiten und Völker.
  2nd edition. Berlin, Urban & Schwarzenberg, 1929.
  First published in 6 volumes 1884-1888. 3rd edition, München 1962.
• M. Dumont:
  La longue et laborieuse naissance de la symphyséotomie ou de Séverin Pineau à Jean-René Sigault.
  [The long and difficult birth of symphysiotomy or from Severin Pineau to Jean-Rene Sigault]
  Journal de Gynécologie Obstetrique et Biologie de la Reproduction, Paris, 1989, 18 (1): 11-21.
• Ira M. Rutkow:
  Surgery – an Illustrated History. Mosby-Year Book, Inc. 1993.
• M. Thiery:
  Jean-René Sigault (1740-?) en de operatie van Sigault.
  Tijdschrift voor Geneeskunde, Louvain, 2004, 60 (1): 55-58.