Part 12

HERE you have from an unsuspected authority a certainly not over-rated importance of the expedience of preliminary TOUCHING. Now granting, only for argument’s sake, what is assuredly false, that a man-practitioner can be equal (superior he would not in this point, at least, have the impudence to pretend himself) to a midwife; let a husband, let a wife, but reflect on the difference, every thing else being equal, there must be as to _modesty_, between the function of _touching_ being performed by a man or by a woman. Let a husband, I say, for an instant figure to himself what a figure he must make, what a figure his wife must make, under such a ceremony performed by a lusty HE-MIDWIFE, exploring those arcana of the female fabric, and especially to so little purpose, with his natural disqualifications for so much as knowing what he is about. Will the husband be present? What must be the wife’s confusion during so nauseous and so gross a scene? Will he _modestly_ withdraw while his wife is so _served_? What must be his wife’s danger from one of those rummagers, if she should be handsome enough to deserve his attention, or a compliment from him on such a visitation of her secret charms, the more flattering from _him_, not only as he must be supposed so good a judge from the frequency of his occasions of comparison, but as it must imply a superior corporal merit in the woman so visited, as could overcome that satiety which a fastidious plenty of patients might so naturally be imagined to create in a man-midwife? Will any one say, that these suppositions are over-strained, or out of Nature? I fancy, that if the secret histories of many families were ransacked, of the practice on which the men-midwives were in possession, it would not be always found, that those preliminary visitations were not turned to some account of interest or seduction. And yet an omission of that _touching_ might be dangerous. How kind is it then in Nature, to have of herself so far consulted the good and tranquility of society, in palpably bestowing upon women a faculty, which she has as palpably refused to the men, in whom the exercise of it would for obvious reasons be big with so many inconveniences? Is there any breach of charity in the taking for granted the existence of such inconveniences, unless indeed, all of a sudden, in favor of this lucre-begotten sect, the men were ceased to be men, and the women women?

BUT allowing that nothing was to pass between a man-midwife and his patient, in this _act_ of _touching_, beyond the necessity of the practice, or in a merely technical sense, that in short no such libertine impression should make itself be felt in the course of such _touches_, as should discompose the good _Doctor_’s DIGNITY, and endanger the patient’s honor, by present or future attempts derived from such a strange privity; is it not to be feared, that a designing or interested person may take other advantages besides that of gratifying sensuality? May not a woman, the more attached she is to her modesty, the greater sacrifice she has made of it, in her innocence of intention, only imagine herself but the more subjected to a man, to whom she has submitted in the manner she must do to a man-midwife, and let him take an ascendant over her and her family, of which a midwife would not so much as dream, from her office being so much in course, and too little extraordinary for her to have any extraordinary pretentions or designs? On the contrary, a man-midwife need scarce set any bounds to his. In any differences in a family, especially between man and wife, must not a man-practitioner, from such a familiarity with the wife’s person, have such a footing in the confidence of the wife, as may enable him to dispose of her will almost in any thing? He may be her apothecary, physician, surgeon, privy-councellor, what not? What can a woman refuse a man, to whom she is so deluded as to think she owes her own life, or that of a darling child, all his merit, in which I have before explained? What can a woman in short refuse a man, to whom nothing of that has been refused, in which consist all the preliminaries of granting every thing? She may indeed refuse him the sacrifice of her virtue, if he should think it worth designing upon, but how few things else could she refuse him? Once more the greater value she put on the sacrifice of so much of her modesty, the less would she be able to deny him any thing else, as any thing else must comparatively appear so inconsiderable.

BUT hitherto I have spoke only of those outrages and dangers to modesty from the preparatory attendance of the man-midwife as occasion may require, during the pregnancy. But as to his officiating in the crisis of the labor-pains and delivery, there are two very essential points of consideration.

THE FIRST. The modesty of the women, unaccustomed to the approaches of other men than a husband, must be in great sufferance in the moments of their labor-pains. All Nature agonizes in them. They are at once weakened in the flesh and in the spirit. The bare presence of a man to officiate at such a time, may excite in them a revolution capable of stopping the labor-pains caused by the expulsive efforts of delivery, which thus becomes dangerously retarded, and may so overpower them, as to put them in the greatest peril of their lives. This is what has often happened. You may see frequent examples of this revolt of Nature against the ministry of men-midwives in Dr. La Motte himself, a man-midwife. If Nature then suffers so much in women at that juncture, when a person, nay even of the same sex, offers her aid, in certain indispensable occasions, to which humanity is subjected; how greatly must the presence of a man increase their constraint and embarrassment, and rob them still more of that so necessary freedom in the animal functions! But how greatly ought the women to thank that their instinctive repugnance of Nature to such a prostitution of their persons, if they consider those tortures, which, by the listening to that same repugnance, may at once be saved to their modesty, and to their personal feeling. Let them paint themselves the following posture prescribed by a man-midwife. “_The patient must be commodiously placed, that is to say, on the bed-side, her thighs raised and expanded, her feet drawn up to her posteriors, and kept steady in that posture by some trusty helpers._”[25] Levret, p. 161. _On the use of the new crooked forceps._ Here it may be said; “why there is nothing in this attitude, however shockingly indecent, but what may be sanctified by the extremities of necessity”. Very well. But what must a husband, what must a wife think at her being _spread out_ in this manner, under the hands and eyes of a man-practitioner, with his helpers, perhaps his trusty apprentices, only for the experiment of a _forceps_ of a new invention, the merit of which too is a so contested an one, that Levret himself is forced to own that, “that same FORCEPS _would be[26] an instrument of pure_ SPECULATION, _and not of_ PRACTICE, IF (N. B. that IF) _a certain general precept should be true_,” which, by the by, is most certainly so! So that, in this case, for example, you see how a woman may be treated, only to ascertain the merit of some new-fangled gimcrack of an instrument. But to how many occasions of as little, or even less necessity than this, for putting a woman into postures of this sort, might not wantonness, interest, or other motives give birth? Or can pretexts for such insults to modesty be wanting to designingness?

THE SECOND consideration is this. Those moments of weakness of spirit, and infirmity to which the labor-pains subject the women may, in some of naturally the weakest of them be, liable to leave impressions in favor of a man-midwife, the less suspected of harm, and consequently the more dangerous for their being suggested by that gratitude for his imaginary[27] contribution to their deliverance, which is itself a virtue, though the object of it is so miserably mistaken by them. Let any one image to himself what must often happen in Nature, a woman sinking under her pains, her mind all softened and overpowered with her present feelings, and looking up for _relief_ to the _man_, employed, as she imagines, to procure it her, though the real fact oftenest is, that he will not have enough prevented her pain, or perhaps greatly occasioned its increase. Of this however she knowing nothing, sees him in the amiable light of her deliverer from her actual and intolerable state of pain. In the mean time, those aukward uncouth endeavours of his to relieve and deliver her, even though they should aggravate her torture, pass upon her for master-pieces of art or skill. “Who would be without a man-midwife?” At length, Nature sometimes, even in spite of all his omissions, or bungled operation, proceeds in her favorite task of delivery, that is to say, if he has not hurried or made tragic work of it, with his mispractice or his instruments. The patient then is rid of her burthen, and what are then her feelings? Those of exquisite delight, from the comparison with what she was induring but the instant before. It is a transport of joy, not unmingled with gratitude, to the person to whom she fancies herself in any measure obliged for it. The ugliest wretch on earth, so he could but be imagined the cause of such a delivery, would, in those instants, assume in her eyes the form of Loveliness itself. Even with the greatest innocence of heart she could hug, she could kiss him in the ebullitions of her joy and gratitude. Let no one imagine these expressions are over-strained. Such a rapture of felicity, in the sudden case of being taken as it were down from a rack, is not of a Nature to know any bounds of moderation, nor can be conceived but by those who have felt it. Her gratitude would even extend to inanimate things, much more to the dear Doctor, to whom she conceives she owes so much. She eyes him with all the intense eagerness of a gratitude so fond, that its transiency into a passion of another nature would not appear such a prodigy, to those who consider how apt passions of tenderness are to confound motives and run into one another. The melting-softness of those moments of infirmity and weakness of spirit, affords a susceptibility of impressions, which may not afterwards be so soon worn out, and of which the usual affection from the difference of sexes, in the parties, may sooner or later come in for its share. Dr. Smellie has, as I have before observed, implicitly allowed the possibility of a temptation to men, and shall I not follow his laudable example of candor, and confess that there may also be weak women?

IT is indeed true that in cases of extremities, such as most certainly are not the frequentest ones, any thought of immodesty may be intirely out of the question. The sad and suffering state of a woman agonizing with pain, at the gates one may say of death, leaves little room for licentious temptations. But, once more, those cases are much the rarest: and even in those, the greater the danger will have been, the greater must the gratitude afterwards be for the imaginary service, that will be supposed to have accomplished the deliverance. Let a midwife have really rendered that service, the gratitude will scarce be so quick, so lively or so lasting, only because she is not a man.

IF it shall be here objected, that the men-midwives ought to be above all suspicion or scandal of this sort; I shall only say, that at least it is their interest to appear so. But they themselves will not pretend to an exemption from temptation, nor can answer for themselves that such a temptation may not come into existence, as that all their virtue, fortified by the divine precept before quoted from Dr. Smellie, may not defend them from yielding to it. They are not, or at least ought not to be men in years for obvious reasons as to that manual practice of theirs which at the best is so indifferent. Let any one then consider the consequence of this worse than unnecessarily putting young women, in such manner, into the hands of men in the vigor of their age. Let any impartial person but reflect what barriers are thrown down, what a door is opened to licentiousness, by the admission of this so perfectly needless innovation. Think of an army, if but of barely Dr. Smellie’s nine-hundred pupils, constantly recruiting with the pupils of those pupils, let loose against the female sex, and of what an havock they may make of both its safety and modesty, to say nothing of the detriment to population, in the destruction of infants, and I presume, it will not appear intirely in me a suggestion of private interest to wish things, in this point, restored to the old course of practice of this art of midwifery by women. A course which Nature has so self-evidently established, in her tender regard to the female sex, and to its darling offspring, and in which she has not less consulted one of her primary ends, the Good of Society, in the greater security of the conjugal union and property, which ought to be so sacred, and especially so, for the honor of the human understanding, from the invasion of an upstart profession, sordidly mean in its motives, infamously false in its pretences, shamefully ridiculous in its practice, and yet dreadfully serious in all its consequences.

CONCLUSION of the FIRST PART.

In the foregoing part of this work I have contented myself with asserting, in general, the perfect inutility of those instruments, of which the male-practitioners themselves confess the danger, and use them not a bit the less for that confession. It is then for the following and second part, that I have reserved the entering into a more particular discussion of them. Therein will appear, upon how false and slender a foundation the gentlemen-midwives have insinuated themselves into a business so little made for them. The truth is, that the pernicious quackery of those same instruments has been artfully made the pretext, and become the sanction of an innovation set on foot by Interest, adopted by Credulity, and at length fostered by Fashion. The employing of midwives was undoubtedly not long since, in this country, the General Rule. The calling in of men-practitioners, upon very extraordinary occasions, was an Exception, and a very rare one, to that General Rule. But by a fatal inversion of the natural order of things, the Exception is recently crept into the place of the General Rule. The point is to consider, whether this palpable violence to Nature is of that benefit to society which it is pretended to be.

I HAVE already examined some of the arguments in favor of the men-practitioners. But the principal one, deduced from the incapacity, or rather aversion of the midwives, upon just grounds, from using instruments, merits an ampler scrutiny. In proof of my candor in it, I shall take most of my remarks on those instruments from what the men-practitioners themselves say, and confess of them. This, I presume, cannot be deemed unfair.

UPON the whole, those parties whom the decision may concern, will please to decide on which side the force of Reason and Truth shall appear the greatest; and so deciding, it is, in fact, in their own favor, and in one of their most capital concerns, that they will decide.

THEY will decide, in short, whether, upon the whole, the plea of the men-practitioners, founded upon the ignorance of a few midwives which, bad as it is, is more than balanced by their incompetency in the manual function, and to which a remedy might easily be found, is a valid one for driving out of the practice of midwifery a sex, to which the faculty of it is self-evidently the genuine gift of Nature herself, only to make way for a set of interested male-practitioners, whose so boasted art is oftenest signalized by the most barbarous and horrid outrages upon Nature, with this aggravation, that they are needlessly committed under the specious and plausible pretext of flying to her assistence.

The End of the FIRST PART.

A TREATISE OF MIDWIFERY. PART the SECOND.

Containing various observations on the labor and delivery of lying-in women, including a discussion of the pretended necessity for the employing instruments.

INTRODUCTION.

NOTWITHSTANDING the numerous productions of writers on the art of succoring women in labor, all that has hitherto appeared on that subject, still leaves the mind unsatisfied; not that it is so unjust as to expect perfection in any human art, but from its feeling that, in this particular one, too much is given to theory, and too little to the practical part, or manual function.

WHILE the causes of difficult labors are far from solidly or sufficiently explained, and rather obscured by a cloud of scientific jargon, than practically illustrated, they give us no tolerably sure method for preventing or remedying those difficulties. On the contrary, the whole boasted improvement of the art is reduced, to a pernicious recourse to instruments, which cut at once the knot they cannot unty.

IT is then no wonder that there should still, in all the books and observations hitherto given on this matter, exist a void lamentably unfilled; and as this void evidently consists less in the theory than the practice, the superior qualifications, and natural endowments of the women for the manual operation, point out the fitness of the greater dependence on them for the filling up what, humanly speaking, can be filled up of that void.

LET the physicians, the surgeons instruct the midwives in so much of anatomy as is necessary to their function; let them afford them, either in writing or verbally, their guidance and direction in the consequences or occasionally in the preliminaries of management of the lying-in; all this is right, salutary, and in due course: but that men should pretend to the manual operation in these cases, it certainly neither is nor can be their business. Nor is this negation of propriety a reproach to them. Will any man think it an indignity to be told, he cannot clear-starch, hem a ruffle, or make a bed as handily as a woman? The exceptions are the shame; and in this department of art it would be truer to say, that there are no exceptions than that there are only a few.

BUT can we wonder at the insufficiency of the lights thrown into the art of midwifery by that cloud of writers who have treated of it, when so few of them having had any other view than advertising themselves, and being incapable of saying any thing to the purpose, of the art of delivering the women, have filled up their books with insignificant digressions, or things intirely foreign from the point?

IN some you see all distempers of women collateral to their pregnancy, which is certainly a very necessary and an infinitely extensive subject, while on the practical article of the deliverance they give you nothing but what is barren, jejune, or even false. Others, by way of filling up, run digressively into a discussion of the methods of treating infants. Others again have written only to recommend some pretended secrets, as powders, preparations, &c. Some have swelled their volumes with the more or less commodious structure of a couch, or the mechanism of a close-stool, or the make of different sorts of syringes for anodine injections. In others you meet with remedies for the deformities of the human body, for the contractions or stiffnesses of the muscles of the shoulders, arms, hands, legs, feet, thighs, haunches, &c. to straiten the crooked, and even, in a treatise on midwifery, to extirpate a polypus from the nose. Others, with all the parade of justly exclaiming against nostrum-mongers, the plausible writing against which serves at once to fill up, and give them an air of superiority to such trumpery, substitute however nothing better of their own than the recommendation of some instrument, which they give you for a master-piece of invention; and to establish which, they cry down every instrument of other practitioners, though not one jot inferior to it in any thing, but the not being the newest. Thus, after having perused such a multiplicity of authors, it is incredible to say how little true, or practically useful knowledge is to be picked out of the whole mass of them. You find almost every thing in them but what you are looking for.

IN the mean time, the superficial examiner of things, who sees such a number of volumes, furnished by these pretenders to the art of midwifery, cannot conceive they contain matter so little essential as they do. The scientific air diffused over them, not a little embellished with pretty prints of machines, as of a windowed forceps, a stool, or of a gravid uterus, all these contribute to throw the dust of erudition into the eyes of those, who do not penetrate beyond the surface of things. And thus the aids and appendages of the art, or what is yet worse, even the abuses of it, pass for the art itself, the main of which, as it undoubtedly consists in the expertness or dexterity of the manual practice, can be so little and so imperfectly conveyed by description. I am however far from denying the benefit which may result to midwives, from consulting all that has been written on this subject. I am far from encouraging ignorance in the women of this profession. Their skill in the manual function cannot but be improved by the addition of a sound and competent theory. But it should always be remembered, that the very basis or capital point of the art is the manual dexterity; and in that point, the most learned of the men must yield to the most ignorant of the women. A point which the men surpassing the women in every thing else can never compensate: no not with all those dreadful “artificial hands”, of which they boast so much their invention, in the room of the infinitely preferably _natural_ ones, of which the use, in this office, becomes the men as little, as their hands seem formed for it; and I might add, their heads, if they themselves can possibly think otherwise. In such an opinion the ignorance is theirs.

AS to the treatise herein offered on the art of midwifery, as the object of it is principally to attack particular abuses and dangerous innovations in it, it will not be expected that the same should furnish a compleat general course of practice. But this I dare aver that if I should be induced to attempt such a work, it will not be the worse for my consulting more the experience I have of Nature in her operations in this one of her so capital concerns, than the authorities of men, who seem or pretend to know so little of her, as to think of assisting her with instruments, formed only for her destruction, or at least for doing her more damage by their violence, than any reason to hope good from them can justify.

HERE I shall not offer any digressions on physic, anatomy, chemistry, or pharmacy; I shall confine myself entirely to the points of my business of the manual operation. Let the physician prescribe, the surgeon bleed, the chymist contribute medicines, the apothecary make them up; with none of these professions do I presume to interfere. But as to the man-midwife, who not only so often presumes in some measure to represent them all, but to join to them the exercise of an art so unnatural to his sex, I should think myself wanting to my duty in my profession, if I did not point out the mischief I apprehend to result from especially that method of practice, on which he grounds the pretence of necessity for his practising it at all; and this chiefly forms the object of this second part, in supplement to my first.

Of DELIVERIES.

WE understand, by deliveries, in general, the issue of the fœtus out of the mother’s womb.