The history of the vaginal speculum helps us recognise some of the ways bodies have been analysed, policed, governed and understood. This instrument is designed to hold open and enable inspection of the vagina and cervix, usually in the context of medical examinations. The earliest surviving examples date from the Roman Empire, and although many historians remark that their use did not start to become widespread again until the Early Modern period, in parallel with the rise of obstetrics, specula were written about in early Islamic medical texts, for example the Andalusian Abu al-Qasim al-Zahrawi (known in Europe as Abulcasis) in his Kitab al-Tasrif of c.1000. The various uses of the specula across space and time tell us about the politics of the body, who has access to it, who views it, and under what circumstances.
The example pictured above is a ‘Fergusson’ type vaginal speculum manufactured in London in the mid-Nineteenth Century. It is made of glass with a silver mirrored interior and coated in black elastic gum, a substance from the latex sap of certain rubber trees, and as such a material dependent on colonial extraction. While the Fergusson is tubular in shape, specula took a range of forms. These included the U-shaped ‘Sims’ which originated through the experiments of the notorious gynaecologist J. Marion Sims’ (1813-83) on enslaved women in the American South. In a tribute reproduced in his memoirs, a colleague wrote ‘this instrument caused his name to flash over the medical world like a meteor in the night.’
Specula also came in the form of the expanding ‘Ricord’ or ‘Cusco’ duck-billed type which is the most widespread form still in use today globally, although versions of the Fergusson and Sims specula are still manufactured and sold.
As indicated by their names, nineteenth-century specula were often called after their ‘inventor’ who was typically a surgeon who commissioned and sometimes patented the particular instruments they used. When they were well-known, this became a selling point and the ideal of the lone genius male inventor still clings to these objects. For example, the ‘Fergusson’ speculum, is described by the Wellcome Trust as devised by Sir William Fergusson (1808-77) ‘a leading surgeon based in London during the mid-1800s’. This history is contended, and its less glamorous origins may have been with a London medical instrument dealer.
At the time of the manufacture of the Fergusson speculum in the 1860s, the use of specula in Greater Britain was most contentious due to the Contagious Diseases Acts, a set of laws first passed in 1864 and revised in 1866 and 1869. This legislation was introduced in response to the high rate of venereal disease, usually syphilis, among British soldiers and sailors as described and enumerated in a series of reports. In keeping with these military origins, the Contagious Diseases Acts generally applied to specific named towns with army bases and naval ports in Britain, Ireland and the wider British Empire including parts of India, the Cape Colony and New Zealand. Although less focussed on the military, a similar regulationist public health regime had been introduced in France in the early Nineteenth Century and extended to Algeria in the 1830s.
These Acts implicated women, particularly prostitutes, as being the reservoirs of sexually transmitted diseases, and as a threat to the virility and potency of the nation and its empire through the infection of the armed forces. Through the Acts, the British government sought to control venereal disease through the frequent compulsory inspection of women deemed to be ‘common prostitutes’. Although syphilis was often difficult to observe just by looking through the speculum, if the inspected women were suspected of being infected they were confined, often in specialist ‘Lock’ hospitals. If they refused the examination they could be imprisoned.
In evidence gathered by the extensive enquiry into the workings of the Acts in Britain, it is only the Fergusson speculum that is specifically named; the naval surgeon Thomas Pickforth testified that ‘the instruments I use are Fergusson’s glass specula and I use the two smallest sizes.’ The voices of the examinees are absent from this evidence, but it is clear that the use of the speculum was often painful and degrading. The report summarises that ‘the statement of women that they have been wounded by the examination, cannot be true of Ferguson’s glass speculum, which is of thick glass and could not break.’ Whilst many informants alleged the inspected women felt no pain, they also contradicted themselves, saying that the examinations rarely took more than three minutes and in the summary that ‘some specula, the expanding one for instance, is very liable to cut in a rapid use of it’, and, ‘if not judiciously managed, a rough introduction (of any kind of speculum) might create an abrasion of the parts.’
The use of the speculum was described in lurid terms by the well-known movement to abolish the Contagious Diseases Acts, particularly the Ladies National Association for the Repeal of the Contagious Diseases Acts (LNA). They focussed on the curtailment of women’s civil liberties, the unfairness of focussing on women rather than men as agents of disease, the acceptance of prostitution and on ‘instrumental rape’ via the speculum. The LNA leader Josephine Butler (1828-1906) published some of the letters sent to her by women subject to the Acts, detailing their sense of violation. One wrote: ‘these monstrous instruments …they pull them out and push them in, and they turn and twist them about; and if you cry out they stifle you with towels’.
In a pamphlet of 1870, the homeopathic physician and social reformer JJ Garth Wilkinson (1812-99) called on the Home Secretary to have brought before him the ‘unfeeling glass and steel’ speculum and consider the ‘violent thrust of these things’ into women. That same year, the Liberal MP Jacob Bright claimed in the House of Commons that ‘some 700 or 800 Petitions, signed by nearly 500,000 persons’ had been presented to parliament asking for a repeal of the Acts. Despite campaigns by politicians, doctors and others for their retention and even expansion to other cities such as Dublin and Liverpool, the Acts were suspended in 1883 following a parliamentary motion that focussed on the forced inspections: ‘That this House disapproves of the compulsory examination of women under the Contagious Diseases Acts’. They were finally repealed in 1886, although versions of them persisted in different jurisdictions, including Cambridge.
The speculum is associated with racialised and state-sponsored gynaecological violence through the work of Marion Sims and the Contagious Diseases Acts and through instances of compulsory inspections of incarcerated women in recent times. But, the duck billed version was also allied to liberatory politics, most distinctively in the early 1970s when feminists such as Carol Downer and Lorraine Rothman in North America, learned how to use a speculum when observing an illegal abortion clinic and brought specula and menstrual extraction kits to women’s groups. The impetus, as intimated by the Boston Women’s Health Collective’s course Women and their Bodies (1970), stemmed from the belief that ‘we have been ignorant of how our bodies function and this enables males, particularly professionals, to play upon us for money and experiments, and to intimidate us in doctor’s offices.’
Feminist health clinics and educational groups as explained in this documentary and publications such as Spare Rib, the foremost women’s liberation magazine in the UK, promoted self-examination via the speculum, torch and mirror. The speculum thus became symbolic of new self-knowledge, and its use by women to examine themselves continues to be promoted by some feminist health platforms such as the American Our Bodies Ourselves. Although such instances of consciousness raising were critiqued later for reproducing colonialist metaphors of ‘discovery’ by feminist theorist Donna Haraway, and as privileging cis gender women, others have argued that feminist health advocates were significant for women of different classes and ethnicities to realise greater bodily autonomy.
More recently, the feminist bio-hacking collective Gynepunk have distributed the means for people to make their own gynaecological instruments and diagnostic tools, including instructions for a 3-d printed speculum, an example of which has been collected by the Victoria and Albert Museum. One of the GynePunk founders, Klau, has also advocated a renaming of the parts of the female reproductive system called after the male scientists and gynaecologists who first ‘identified’ them. Instead, they propose that they be called after the three named enslaved women Sims conducted his experiments on – Anarcha, Lucy and Betsey. Through this action, scientific expertise is aligned not with professionals as in the case of the Fergusson speculum but with those who were intrinsic to the development of this knowledge, for example by their responses as examinees. This suggests that medical knowledge is co-created, and that the artefacts around us can only be understood when we take the full history of their development and use into account.