AFFECTION, respect and mutual concern are immediately discernible in letters between José Rizal and his beloved sisters. He brought them news of his activities and travels in Europe and they kept him in tune with the rhythms of family life. More intimately, they related to him their private health and medical concerns, a gesture that indicated their trust in him. Here, Rizal had a striking opportunity to influence and educate the women closest to him on fundamental issues concerning all women in general—female reproductive health and birth control.
Rizal told his family that his first lectures at the Hospital Clinico San Carlos were on obstetrics. For a time his sisters might even have thought their brother was developing a special interest in gynaecology and obstetrics. His professor in obstetrics, he told them, was the flamboyant Andres López Busto, whom Rizal knew by his title ‘Marquis de Busto’.
When he was in Paris, Rizal visited the Laennec Hospital with the esteemed Filipino obstetrician Felipe Zamora and noted that its facilities were far superior to those found in Madrid. Again in Paris, he accompanied Felix Pardo de Tavera, who was studying gynecology, to examine women’s illnesses at the Lariboisiere Hospital. Writing to his sister Saturnina, Rizal told her about the use of water as an effective treatment for women’s diseases.
Encouraged by these reports of his activities, Rizal’s sisters made it clear to their brother that women’s reproductive health was crucially important to them. Writing in Tagalog, his eldest sister Saturnina firmly told her younger brother:
‘I am sending you news that I now have two children, the eldest is Alfredo, next is Adela, and now I am eight months pregnant. Study well how you may be of assistance to our situation, certainly with so many of us there will always be someone suffering the hardships of this sickness.’
Having nine sisters, of whom only two, Joséfa and Trinidad, remained unmarried, Rizal was well aware of his sisters’ fecundity. The news Rizal regularly received from home was riddled with announcements of pregnancies, new births, children who were sick or had died, and the health of mothers. At the end of 1883, Rizal’s mother Teodora Alonso sent a letter to her son in which she listed the names and arrival dates of her newest ‘debts to Our Lord’, six new grandchildren within a period of less than 12 months, born to four daughters who, as she noted, were undeterred by the high rates of maternal death, the ravages of a cholera epidemic, beri-beri and the destructive violence of typhoons.
Writing in 1886 to inform him about his sister Narcisa’s miscarriage and other miseries, Lucia pointedly told Rizal that ‘We have no other treatment for our hardships other than the Spanish word for pasiencia (patience). If you have better medicine than this then don’t forget to bring it with you.’ Narcisa only narrowly survived a serious bout of puerperal fever that struck her down three days after childbirth. In 1887 the family mourned the death of Olimpia, the third eldest sister, who had survived two difficult deliveries and the birth of a stillborn but then died in the course of another labor.
Rizal was in Europe during a period when modern contraception was veritably exploding into the public consciousness amidst debates on Malthusian projections of a population explosion. Tampons or vaginal sponges were a popular and respectable contraceptive in nineteenth century Europe, as was douching using vaginal syringes. Popular in Germany since the 1870s, the standard device was known as the ‘irrigator’, an apparatus that squirted a douching solution consisting of water, vinegar and carbolic acid into the vagina through a thin nozzle that immobilized and flushed out spermatozoa. A more convenient model, the Ebell irrigator, was fitted with a bulb to collect the solution, thus permitting douching to be done in bed.
And surely, too, Rizal would have heard of the mechanical contraceptive enthusiastically launched by Dr Wilhelm Mensinga in Leipzig in 1882, called the ‘diaphragm’. Mensinga and the thousands of doctors who advocated the use of the diaphragm viewed therapeutic contraception as being as moral as therapeutic abortion but much safer. The cervical cap had already been promoted since the 1830s, and in the mid-1880s the London pharmacist Rendell began eagerly marketing chemical contraception in the form of tablet suppositories. Finally, by the 1890s, spermicidical powders constituting boric, citric and tannic acids in a gum base had become available throughout Europe, a popular brand being Dr. Huter’s vaginal powder which sprayed directly into the vagina to coat the surface.
Rizal finally, could also have let his sisters know how high-powered douches and other forms of hydrotherapy were being used to treat women’s illnesses in European spa resorts, or he might have mentioned a new instrument known as the electro-mechanical vibrator that physicians employed to relieve a host of hysteroneurasthenic disorders in women. Involving genital massage, the treatment was intended to induce female orgasm, a state defined under clinical conditions as the crisis of an illness, or ‘hysterical paroxysm’. Whether attained by mechanized technology such as the ‘water-cure’, or by the traditional use of fingers (properly dipped in fragrant oils and scented waters) as performed by a doctor, massage of the genitals to orgasm was considered a legitimate medical therapy that only fashionable women could afford.
In relating their illnesses to Rizal, his sisters held some anticipation of a response, an expectation that informed advice would be offered. Craving information, Rizal’s sisters would surely have benefited from knowing, even in the simplest terms, what medical treatments were being administered to European women.
However, evidence suggests that Rizal’s attitude towards his sisters’ medical concerns was ambivalent. He professed a general interest in obstetrics but did not accede to their request that he specialize in that field and did not offer them the practical advice they urgently sought.