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[EN] In the Eighteenth century, there were some strong 'tensions' about birth care, a scene of medical practice affected by dramatic changes, which were consolidated with local variations all over Europe in the period. Female midwives' traditional hegemony was questioned by the religious, medical, and political powers systematically, and it was replaced step by step by a surgeon midwives' new hegemony. Eventually, the 'art of midwifery' became an obstetrical surgery which was configurated as a male, technical, and medical knowledge. This article tries to show the development of this topic during the Eighteenth century in Spain throughout different points of view according to the discussions kept by surgeons, physicians, and clergymen. ; [ES] La Europa del siglo XVIII conoce la aparición de tensiones en tomo a la asistencia al parto, un escenario de la práctica médica que registra importantes cambios que, en mayor o menor medida según los diversos contextos locales, se consolidaron en todo el continente. La tradicional hegemonía de las parteras fue puesta en cuestión sistemáticamente desde el poder político, médico y religioso y sustituida de forma progresiva por la de los cirujanos comadrones. El "arte de la partería" dejará paso a una cirugía obstétrica técnicamente configurada de acuerdo con el saber masculino, médico y quirúrgico, de la época. El artículo trata de ofrecer un panorama sobre el desarrollo de esta cuestión en la España del siglo XVIII, a través de lo que cirujanos, médicos y clérigos debatieron al respecto. ; Este trabajo se ha realizado en el marco del proyecto de la DGESIC PB98-0406-C02-02. ; Peer reviewed

(ES) La Europa del siglo XVIII conoce la aparición de tensiones en torno a la asistencia al parto, un escenario de la práctica médica que registra importantes cambios que, en mayor o menor medida según los diversos contextos locales, se consolidaron en todo el continente. La tradicional hegemonía de las parteras fue puesta en cuestión sistemáticamente desde el poder político, médico y religioso y sustituida de forma progresiva por la de los cirujanos comadrones. El "arte de la partería" dejará paso a una cirugía obstétrica técnicamente configurada de acuerdo con el saber masculino, médico y quirúrgico, de la época. El artículo trata de ofrecer un panorama sobre el desarrollo de esta cuestión en la España del siglo XVIII, a través de lo que cirujanos, médicos y clérigos debatieron al respecto. ; (EN) In the Eighteenth century, there were some strong 'tensions' about birth care, a scene of medical practice affected by dramatic changes, which were consolidated with local variations all over Eurape in the period. Female midwives' traditional hegemony was questioned by the religious, medical, and political powers systematically, and it was replaced step by step by a surgeon midwives' new hegemony. Eventually, the 'art of midwifery' became an obstetrical surgery which was conftgurated as a male, technical, and medical knowledge. This arlicle tries to show the development ofthis tapie during the Eighteenth century in Spain throughout different points of view according to the discussions kept by surgeons, physicians, and clergymen. ; Peer reviewed

By 'medical catalanism' we understand the intellectual and professional movement featuring a significant group of doctors, pharmacists and veterinary surgeons of the first third of the XX Century, closely connected to political catalanism which sought, and indeed achieved at some points, higher levels of self-government for Catalonia. It is, therefore, an excellent example of the intermingling of political, professional and intellectual interests. Medical catalanism considered that in order to understand and manage health care in an appropriate and modern way it was necessary to transform the political arena, and to do things differently than in the rest of Spain. Medical catalanism acted, basically, through the 'Acadèmia i Laboratorio de Ciències Médiques'. This society was launched in 1878 as a result of the merger of two previous associations set up a few years before to overcome the difficulties arising from the opposition of the university world to the introduction to experimental medicine. The Academy has survived over the years in difficult and changing circumstances and has encouraged long term initiatives. At the turn of the XX Century the Academy took shape as the main expression of the union of the intellectual and political interests of catalanism. From the intellectual point of view the Academy made a firm commitment to the use of Catalan as a scientific language, drawing up a medical dictionary, the distribution of which was cut short by the outbreak of the Civil War. Between 1907 and 1937 the Academy published the journal "Annals de Medicina" the main mouthpiece of the movement. It also encouraged the establishment of other societies in order to achieve the scientific and professional goals of doctors and other health professionals: the 'Associació de Metges i Biòlegs de Llengua Catalana', the 'Sindicat de Metges de Catalunya', the 'Mutual Mèdica' and the 'Cooperativa de Consum', among others. Moreover the Acadèmia was the institutional platform that helped the development of medical specialities, a process that radically changed medical practice, the profession and the relations between doctors and patients. Another fundamental aim was the achievement of university self-government as a way to offer training in line with to the requirements of European science that overcame the traditional paralysis of the Spanish University as a whole. From the political point of view, many doctors belonging to the Acadèmia took part as active members in the organization of political parties and institutions that changed the distribution of political power both in Catalonia and the rest of Spain. A first practical outcome of their work occurred between 1914 and 1923, the period of the Mancomunitat de Catalunya that developed a sanitary policy different from the rest of Spain in key questions related to public health such as the fight against infectious diseases and the health and welfare policies like the management of institutions for the mentally ill. The first dictatorship that Spain suffered in the XX Century (1923-1930) put an end to these initiatives. After 1931 with the arrival of II Republic and self-government for Catalonia (1932), it was possible to undertake a process which sought to implement new sanitary policies with the significant contribution from the Sindicat de Metges. The social unrest of the republican years and the outbreak of Civil War in July 1936 prevented many initiatives from being put into practice. As a whole, therefore, medical catalanism has many fascinating ramifications and allows us to study in detail a series of overlapping areas among political, ideological and scientific interests. ; Peer reviewed