Part 11

INOCULATION was not long since a novelty in this nation. The lady who introduced it, for any thing I know to the contrary, still lives to enjoy the honor of having procured so great a benefit to mankind. But then this benefit would bear the fairest of all trials, that of calculation: for what is reason itself but another word for calculation? The procuring then the small-pox by inoculation, in a body duly prepared, and especially at an eligible age, affords, according to the doctrine of chances, so much a fairer prospect of safety, than in the case of a spontaneous or accidental infection, that nothing scarcely could be imagined more friendly to Nature than such a rational prevention of her danger, from a distemper too rarely escaped, for the possibility of that escape to be employed as an argument against such a method of prevention. Here then the seeming violence offered to Nature, appeals for its justification to Nature, Reason and Experience.

CONSULT Nature as to this innovation in the employing men-practitioners preferably to the midwives, who have been for ages, and so universally considered as the properest for that function. Nature will tell you, that it is injuring her to suspect her of being so cruel a mother-in-law, as to deny her tenderest production the female sex sufficient succors within herself, or leave women under a necessity of recurring to men for aid in their greatest need of it, during those sufferings, to which it has pleased the great master of Nature to subject peculiarly the women. If Nature then is but another name for his Fiat through all his works, never was his will more plainly signified than by her voice in this point: a repugnance in both sexes to that office being administered by a man. A repugnance which is not even one of Nature’s least remarkable signs of abhorrence from this innovation, and is only to be surmounted in the men by interest, and in the women by their false fear, or what is weaker yet, by their rage in following that bell-weather Fashion, though it should lead them like sheep to the slaughter. The uncouthness and inaptitude of the men, so ill compensated by their miserable inventions of iron and steel instruments, form another loud protest of Nature against this important function being committed to men-operators.

CONSULT reason, and reason founded upon those dictates of Nature, to which time only gives the more strength, will tell you, in contempt of fashion, that the men-midwives will never do any thing in a matter rather too universal for any excellence in it to depend upon Greek, Latin, or Arabic; that they are, in short, only hatching of wind-eggs, in the study of an art, which no incubation on it will ever sufficiently naturalize to them.

IF to experience you appeal, I have already furnished unrefutable arguments of that’s being against the men-midwives. But let them remember my confession, that the number which I have quoted of women happily delivered is taken from the course of practice of good midwives. I am not here an advocate for bad ones, nor would I wish to authorize them if I could. All that I shall say, and dare aver is, that the very worst of them, unless their hands are cut off, or at least deserve to be cut off, can hardly be worse than the best of the men-operators.

BUT while it is to the tribunal of Nature, of Reason, and of Experience, that I presume to wish that this same Fashion might be brought; I readily acknowledge its force though not its justice. I feel the power of it, with pain, for the sake of humanity[21]! My opposition then to this fashion is rather founded in duty than in hope. The weakness of it will probably furnish fashion only a new matter of triumph, not indeed over me who am too low for it, but over the welfare of mankind, which it has often, in more points than this, the pleasure to see sacrificed to it, though in not one perhaps more palpably than in this one.

IN the mean time it might be worth the while of even those who not being themselves men-midwives, nor having any personal interest in patronizing them, owe their favorable notion of them to their own fair judgment; it would, I say, even be worth their while to consider that there may possibly be a time, when they may themselves see reason to change that judgment of theirs. They may possibly discover the illusions of interest, under the old stale mask of service to the public. They may find out the folly of fashion. But will not it be too late, when that fury of fashion shall, like a pestilence, have either swept away the good midwives, or at least have so thinned their numbers, as not to leave enough for the demand of the service? They must in time become, to all intents and purposes, like an old obsolete law, as effectually abolished by disuse, as if abrogated by a formal repeal. “The matter would not be much if they were,” an instrumentarian will probably say, but I doubt much, whatever he might gain by it, whether mankind or population would profit much by that extermination, even though the men-midwives with their tire-têtes, crotchets, and forceps, were to succeed to their business.

AND that such an extermination is far from improbable, will appear no strained inference to those who consider the power of Fashion, which establishes its tyranny, much as the first Roman emperors did theirs over that commonwealth, by leaving a semblance of liberty without the substance; whence the baneful effects do not the less follow, or rather the more surely follow. Thus there is indeed as yet no act of parliament for the preference of men-practitioners or the extinction of the midwives, but the statutes of fashion are not only more forcible than any act of a human legislature, but, in this matter even than the laws of Nature herself tho’ inculcating their observance, under pain of death, or at the least of severe corporal punishment; such as being torn with cold pinchers, or cut or punctured with instruments, or put to more pain than necessary.

ALREADY has fashion driven numbers of women out of their livelihood to make way for the encroachments of the men on the female provinces of industry, though there never was a time, in which it was not a just complaint that there were rather much too few means of employment for women. Fashion has determined it otherwise, and many callings formerly appropriated to females are now exercised by men.

BUT as to this profession of midwifery, even the total extinction of the real midwives, would not be perhaps so bad as giving that name to those poor creatures in training under the men-practitioners, who independently of their own incapacity of practice, consequently of forming good practitioners, have a palpable interest not to suffer their women-pupils to gain any eminence in the profession that might give umbrage to themselves[22]. The midwives whom these men-practitioners would perhaps gratiously allow to subsist, might to their own insufficiency add the dangerous circumstance of creating, or at least of not preventing, by duly exerting themselves in the predisposing part, the necessity of calling in their protectors, especially where recommended by them. Not that I imagine even these mock-midwives would wilfully be guilty of such prevarication in their duty. For them not to deserve such a suspicion, it is enough that they are women, consequently tender-hearted. But that does not exclude the idea of weakness. But where so fair a virtue as gratitude may disguise even from themselves the fouler motive of interest lurking at bottom, if that tenderness is not even destroyed, it may not impossibly be made a tool of, and join in persuading them, that things had really better be left to the men-practitioners, whose creatures and devotees they are. Thence a negligence superadded to their defect of skill. Such subalterns then would, at least, not be dis-inclined to the “FINDING” _themselves_ “AT A LOSS”, or yet worse for the patient, have by their omissions, if not commissions, bred the occasion of “_finding_” themselves “_at that loss_”, even mechanically, and without the direct design of paying their court to their recommending “_accoucheur_, _their man of honor_ and _real friend_,” in a _candid_ recourse to him. Pity it were indeed that so charming a harmony should not subsist between _the accoucheurs_ and such _midwives_, for the “MUTUAL ADVANTAGE” of both! A harmony, which however could hardly be established but at the expence of the sacrificed patients.

AND here I appeal to the reader’s own fair judgment, whether I over-strain the consequence against such wretched creatures as they cannot but be who must, for bread, be so subservient to the men-midwives, and be what the French call, their _âmes damnées_ (souls sold). Can any thing be more probable than that these _good women_ dignified by the men-practitioners, out of their special grace and favor with the title of midwives, will on all occasion consult the “_advantage_” of their kind _patrons_ and “_real friends_”. And how can that advantage be better consulted than by bungling their work so as to make it _appear_ necessary to have a _candid recourse_ to the good Doctor, who recommended and warranted them? can it, in short, be imagined, that they will be less mere machines than Dr. Smellie’s Dolls, or indeed furnish less occasion, than the education under those Dolls, for the _iron_ and _steel instruments_, which are the most part understood to be indispensably necessary where the midwife shall have failed. And as to such midwives as have been formed or recommended by the men-practitioners, their _not_ failing would indeed be the wonder!

THUS the name of a midwife may subsist after the reality shall have perished, and the world so often deceived by mere names, may not perhaps discover this annihilation till long after it is effectuated, or till it is too late to repair the damages, which will hardly fail of discovering it to them. Of good midwives there never were too many; but they are now much too few; though still not more rare in proportion than those of the men-midwives, who may be called good, comparatively to so many of them as are dangerously superficial. Discouragement has already greatly hindered the places of the good female-practitioners who are gone off the stage, from being duly supplied. Proper subjects decline taking up a profession, in which they must have to dread the prevalence of so false a prejudice against them, as that which determines the preference of the male-operators. It is easier to destroy, than to create a-new; and perhaps when the need of good midwives shall be at the greatest, the difficulty of finding such, will make the employing of men-practitioners, with all the so just objections to them, even a necessity. Things are not at present perhaps far from that point, and an alarming consideration that would be to all women, if they were but to reflect on the increase of pain and danger to themselves in the hours already too big with both, of their increase, I say, by the most aukward and violent aid of the men, compared to the so much more effectual and gentle methods so natural to the women-assistents.

IF the parties then principally concerned in the decision of this question, and especially the women who are the patients, and their tender relations of husband, father, or brother, &c. were but to consult their own feelings, their reason, and even that instinct which, in this point, is itself so strong a reason from its being the voice of Nature never unhearkened to with impunity, they would soon, to your objection drawn from a fashion scarce less ridiculous than pernicious, allow no more weight than, in fact, it deserves.

OBJECTION the Fourteenth.

YOU must allow, however, that it must be a false modesty that, in the women, which can oppose the preference of the men-practitioners to the female ones.

ANSWER.

I KNOW indeed that Dr. Smellie (page 2. of his introduction) attributes the opposition made by the Athenian women[23] to the prohibition of midwives, and to the acceptance of men-practitioners in their room to “_mistaken modesty_.” It may however with more reason and truth be averred, that the admittence of men to that function by women, would be in the women a most egregiously MISTAKEN IMMODESTY. Since, surely the virtue or grace of female modesty is not an object to be held so cheap, as to be sacrificed for worse than nothing, for nothing better, in short, than the purchase with it of danger or perdition to both the mother and child. After so valuable a sacrifice as that of modesty itself, it may perhaps sound mean to add any thing comparatively, so trifling as that of the hire not given to the person who prostitutes herself in some sort on a so much mistaken hope, but to the very person to whom she is prostituted in that hope of superior safety.

I AM not then here to assume a character, that would become me so ill, of a Casuist or Divine, by pretending to fix the degree of moral turpitude in the submission of modest women to a practice, which, I will even allow might be justified by the superior consideration of safety to two lives, if that consideration was not a question most impudently begged, with so little foundation, that the very contrary thereof is the truth.

NEITHER would I here incur the just charge of impertinence, in giving my private and insignificant opinion on an undecency so unwarranted by any necessity. That would look too like dictating to others, what they are to think of a practice, of which every one will doubtless judge for himself. The boundaries of female modesty are so well known, and so ascertained by common consent, that surely it little belongs to me to offer new lights upon that subject.

WHAT I have then to say, on this head, is purely in justification of that modesty, which the men-midwives are for obvious reasons pleased to call a false one, though so far as it pleads for excluding them, it is an ingratitude to that Nature, of which it is the peculiar gift to the female sex, not to term it even a wise virtue.

SOCIETY especially stands indebted to Nature for her suggestion of modesty in this point. If in all ages, in all civilized countries, the wife is considered as the peculiar property of a husband, insomuch, that all laws human and divine consecrate, if I may use the expression, to him alone, exclusive of all other men, the access to the reserved parts of the wife’s body, certainly such a privilege can hardly be thought lightly communicable. And what can be more so than suffering a man, mercenarily or wantonly, or perhaps both, to invade that so sacred property, under the mask of a service, for which he is by Nature so evidently disqualified? While Nature too has made so ample a provision for this very service, in fitting the women for it, with so much more propriety and safety, both to the concern of the public in the welfare of population, as well as to the domestic honor of families, which is not without some danger, at least, from the practice of midwifery being in the hands of men.

AS to this last averment of mine, the truth of it is so glaring, that it does not even need Dr. Smellie’s own implicit confession of it, in his instructions to the men-practitioners in general, or, if you please, to his more than nine hundred pupils.

“_He_ (_the_ ACCOUCHEUR) _ought to_ ACT _and_ SPEAK _with the utmost_ DELICACY _of_ DECORUM, _and_ NEVER VIOLATE _the_ TRUST _reposed in him, so as to harbour the least_ IMMORAL _or_ INDECENT _design; but demean himself in all respects suitable to the_ DIGNITY _of his_ PROFESSION,” p. 447.

HERE I confess myself so smitten with the propriety and sanctity of the precept of the good Doctor’s, and particularly with the needfulness of it, that I would advise every man-practitioner of midwifery, of a certain age that might require it, to have the said commandment wrote out in _gold letters_, and wear it about his arm, especially on his proceeding to _officiate_, by way of amulet, phylactery or preservative against any incident temptation to _violate_ his _trust_, or to fall off from the high _dignity_ of his profession. All that I fear is, that its virtue may not always be to be depended upon, against the energy planted by nature in the difference of the sexes. No one would be farther than I from the cruel injustice of drawing consequences unfavorable to any set of men, from the misconduct of any particular individual in it.[24]Errors are purely personal. If I then so much as mention the case of a man-midwife convicted of having debauched a gentleman’s wife, in consequence of his admission to the practice of his profession of midwifery upon her, it is by no means neither with a design to insult the unhappy criminals, nor to draw from thence an inference to the disfavor of the men-practitioners in this point, beyond what I am authorized by the constancy of the temptation from Nature, to all, yes, to all, who, by their age, in one sex, are not past it: I say in one sex, because in the other, the female, the very circumstances of a woman’s needing a midwife, shews that she is not past the age of, at least, causing a temptation. Further, it would even be a matter of argument on the side of the men-midwives, that so _few_ instances come to the knowledge of the public, of the ill-consequence of a practice which breaks down the capital barriers of modesty; if those ill-consequences were not, in the nature of them, not only a secret, but easy to be kept secret. Who would complain but the husband or relations of transactions between a man-midwife and his patient? But then how seldom need a third to be let into such a secret?

I WOULD not then have the men-midwives to be too forward to treat the modesty of the women on this head as a false one, or their scruples as a weakness. Modesty in this case is not only the safeguard of the lives of themselves and children, but of their own honor, which if it does not receive an actual fall in such a subjection to a man-midwife, had perhaps better not be so unnecessarily risked so near the brink of the precipice.

I AM not writing here for Italians or Spaniards, or any of the inhabitants of those countries who are so prone to jealousy, perhaps because they know their women. I am now addressing myself to Englishmen, not jealous, because, if they know theirs, they must know that, in proportion to the number, no women on the earth have more of the reality of virtue and modesty. I will not suppose then any thing so offensive, as that the chastity of the generality of them is not infinitely superior to the advantages or overtures for design afforded the men admitted to such a privacy, as that of attending them in their lying-in and delivering them. But would the honestest woman, or one however sure of herself or of her virtue, think it eligible, without a full satisfactory proof of that superior safety, which is her object in preferring men-midwives, to be herself the occasion of temptation to those people? How can she answer that she will not be it? In that so formidable army of mercenaries, actually continuing to form itself under the banners of Fashion, and headed by Interest, can she answer that the insensible stoics of it, will fall to her share? Would a woman, I will not say, of strict principles of honor, but barely of not the most abandoned ones, submit herself in the manner she must to a man-midwife, on her employing him, if she would but satisfy herself, as she easily may, that his aid cannot be more effectual than that of a woman? But what! if it is most undoubtedly a less safe one?

BUT this is far from all to be objected on the head of modesty to this practice. The opportunities, if not of temptation, if not of seduction by it, at least of offensiveness to female reserve are such, as would make even a husband, the least susceptible of jealousy, so uneasy for the outrages to which the employing of a man-midwife in the course of his wife’s pregnancy and delivery might expose her, as would make him think it no indifferent point for his judgment to settle whether such outrages might not better be spared her. It will not I presume be denied, that all female modesty is a flower, the delicacy of which cannot be too much guarded against any tendency to blast it, and that nothing can threaten more that effect, than such infringements of the unity of a husband’s privilege in the sole incommunicable possession of his wife’s body, as are implied in the course of a man-midwife’s attendance. An unity of privilege, which, when broke in one point, does not always stop at that, but may proceed to farther breach, where there is art on one side, and weakness on the other. Many women are doubtless proof against the slipperiness of such an overture: but all have not alike strength of mind.

BUT lest I should be here taxed with forging of phantoms merely for the honor of combating them, I shall only entreat all parties concerned to consider the following so probable circumstance, and then let them decide as their own judgment will direct them: a circumstance taken (can any thing be fairer?) even from a man-midwife’s own stating, as well as from the nature of things, of which none need be ignorant that will think at all about them.

IT is then to be observed, that during a woman’s pregnancy, and before the labor-pains come on, one of the principal points of midwifery is, what is called the art of _Touching_. Thence are derived the surest prognostics for preparation, and especially from the signs it affords of rectitude or obliquity of the Uterus. I have already offered reasons needless to repeat, why the men can never arrive at the excellence of skill in the women in this particular. But as to the importance of this faculty of _Touching_, hear what Dr. Smellie himself says.

P. 180. “The design of _touching_ is to be informed, whether the woman is or is not with child; to know how far she is advanced in her pregnancy; if she is in danger of a miscarriage; if the _os uteri_ be dilated; and in time of labor to form a right judgment of the case, from the opening of the _os internum_, and the pressing down of the membranes with their waters, and lastly, to distinguish what part of the child is presented.”

Again, P. 448. speaking of a _midwife_, he says, “she ought to be well skilled in the art of _touching_ pregnant women, and know in what manner the womb stretches, together with the situation of all the abdominal VISCERA: she ought to be perfectly mistress of the ART of EXAMINATION in the time of labour”.