Part 2
WHEN _the_ HEAD _of the fœtus presents itself foremost but sticks in the passage_, 289. _Objections to instruments more at large included under the title to this section_, 389. _Mauriceau’s_ tire-tête, 395. _Palfin’s_ FORCEPS, _with the improvements of various practitioners_, 398. _A waggon load of instruments insufficient, and why_, 401. _A curious nostrum of an instrument_, 406. _Mr. Freke’s ingenious invention of a_ FORCEPS _and_ CROTCHET _all in one_, 416. _Dr. Smellie’s improvement of the forceps_, 417. _The curve forceps of Levret_, 419.
_Case of a_ PENDULOUS BELLY, 445.
_Triumph of the moderns over Hippocrates and the antients in the invention of the forceps_, 452. _Inhumanity and folly of the general conspiracy against children_, 458.
CONCLUSION _of the_ SECOND PART, 466.
A TREATISE ON MIDWIFERY.
WHOEVER considers the absolute necessity of the art of midwifery, will readily allow it a place among the capital ones in the primeval times of the world. All the other arts are no further necessary to man, than to procure him the conveniencies or luxuries of life; that of midwifery is of indispensable necessity to his living at all, imploring as he does its aid for his introduction into life. Without this art the earth itself must soon become dispeopled and a desert, whereas by means of it men have been multiplied, with inconceivable rapidity.
IN conformity to its claim of importance, this art appeared in all its lustre among the Jews, the Egyptians, the Athenians and Romans, and indeed in all nations during thousands of ages. Nor was the confinement of the exercise of it to women deemed any derogation to it. It even gave honor to its professors of that sex. Socrates, so ennobled by his character of being the greatest philosopher in all antiquity, did not disdain to boast himself the son of a very able midwife Phanarete, as may be seen in Plato’s book on science, in Diogenes Laertius and others.
AMONG the Egyptians and the Greeks it cannot be hard to conceive what emulation, what ardor it must have excited among the women of that profession, the custom of distributing prizes to those of the greatest merit in it, in the face of the people. No one is ignorant of the power of honors and distinction to bring arts to perfection.
BUT from the instant the midwives sunk into dis-esteem, and wherever that has happened, it will be found by woeful experience, that not only the art itself has suffered in the very midst of the most falsely boasted improvements, but that human-kind itself has much and very justly to complain of the change.
THE native inconstancy and levity of the French nation opened the first inlet, in these modern-times, to men-practitioners. In antient history we meet with but one feeble attempt of that sort, which however soon gave way to the united powers of modesty and common sense. In France, and may it not be the same case soon here! the women of a competent class of life and education, begin to decline forming themselves for this profession, as beneath them, considering the slight put upon those women who exercise it.
NOR has this injustice remained unpunished. Many women have found, by severe experience, their having been enemies to themselves, in abandoning or slighting those of their own sex, from whom, at their greatest need, they used to receive the most effectual service, and who alone are capable of discharging their duty by them, with that sympathy for their pains, that tender affectionate concern, which may so naturally be expected from those who have been, are, or may be subject to the same infirmities.
MANY out of a distrust inspired them of midwives, have thrown themselves into the hands of men, who have promised them infinitely more than they were able to perform; and who behind all the tender alluring words, of superior skill and safety in the employing of them, conceal the ideas with which they are full, of cutting, hacking, plucking out piece-meal, or tearing limb from limb.
THE murder of so many children, the fruits of their bowels, might, one would imagine, have induced mothers to consider this point a little more carefully. Yet, through the prevalence of groundless fears, and of imaginary dangers they have run into real ones, and have sometimes found their death precisely where they sought their life; and not seldom where nature has even favored them enough in their labor, for them not to need any extraordinary ministry of art, the men have put them to cruel and dangerous tortures.
NOTWITHSTANDING some examples, and many violent presumptions of such mal-treatment, too many women have been so miserably misled by fashion, as to prefer the betraying the cause of their own sex, and the subjecting themselves to those who deceive them with false hopes, to the entrusting their preservation to those of their own sex, in the hands of which the care of it has been for so many ages, with so much reason, and such little cause of complaint.
YET we do not see that any of these men-midwifes have been capable of forming a good midwife. On the contrary, we see, that in order to remedy the abuses, or rather to prevent the fatal accidents which every day occur in the practice of a profession so necessary to the preservation of the human species, they were in France obliged to have recourse to one of the ablest midwives in that kingdom, who was placed at the head of the practice in the Hôtel Dieu at Paris, to preside over the lyings-in there, and to found and cultivate that inexhaustible seminary of excellent female practitioners, who have actually restored the art to its antient degree of esteem, with all fair judges. These worthy proficients have been so public-spirited, as to communicate their talents and knowledge to a number of surgeons, who never had any reason to be ashamed of the lessons they assiduously took from the midwives, unless indeed for themselves not being able to come up to them in the practice, so true it is, that the business is not at all natural to them.
YET have even many of those very men-practitioners, influenced by that self-interest which has such a power in all human affairs, revolted against their mistresses in the art, and their benefactresses. They have, at various times, commenced lawsuits, about the Hôtel Dieu at Paris, in order to get the lyings-in there committed to them: but the administrators, the persons of a just sense of things, together with the parliament of that town, ever attentive to decency, without excluding the due regard to the preservation of the subjects, have constantly opposed and frustrated the pretentions of these innovators. These again thus disappointed, were forced to content themselves with practising upon some women of quality, under the favor and protection of some of the old ladies of the court of Lewis XIV. who had their reasons for propagating this fashion. And now these innovators, not without a due proportion of ingratitude to the injustice, began to run down the midwives, and exalt themselves. The novelty prevailed, and the contagion of example soon communicated itself to the provinces, and thence into neighbouring nations. A few men perhaps of real abilities, but governed by the most sordid interest, associated to their party a number of the most ignorant and unexpert practitioners, but who served to fill up the cry, and made a common cause against the midwives, whose pretended insufficiency was now to be pleaded in favor of themselves being admitted to supplant them. Nor was the concurrent attestation in their favor, of so many ages, during which the practice was entirely in female hands, to weigh any thing against the boasts of their own superior ability. They picked up and sounded loud a few real instances perhaps, and undoubtedly many false ones of faults of practice in women: though were the numbers of human creatures, who have barbarously perished by the unskilfulness of the practitioners, to be fairly liquidated, it would appear that fewer have been the victims of female ignorance, than of the presumption and indexterity of the men. The women are undoubtedly liable to error: there have even been monsters of iniquity among them, but certainly in no number to form a general prejudice against them: but as to the men they are all of them, as will be more fully demonstrated hereafter, naturally incapable of the exercise of this profession. A history of their murders might even be collected out of the books written by them to establish their superiority over the women. From Deventer, Mauriceau, and the most celebrated of their writers, amongst many excellent observations in the way of the chirurgical art, many of the grossest absurdities have escaped, where they transgress its bounds and go into that of midwifery. Some of those absurdities too are so glaring, that they have not even been overlooked by themselves.
MANY persons in Holland, having set up for men-midwives, without being duly qualified, the government thought proper to interfere, and consequently there was an ordinance issued on the 31st of January, 1747, by which it was enjoined, that no one should practise in the quality of man-midwife, or exercise this art, unless he were especially authorized for this function, by a certificate of his having undergone a sufficient examination before capable and intelligent judges for that purpose appointed.
IT will appear, in the sequel of this work, that it were to be wished, for the sake of the good that would redound from it, to the preservation of the human species, both in parent and child, that those who are entrusted with the public welfare, would establish the same regulation in the British dominions, to expel and exclude from the art all the ignorant pretenders of either sex, who are, in fact worse than the Herods of society. The cruelty of Herod extended to no more than to the infants; not to the mothers; that of such pretenders to both.
IF their conduct was to be examined with attention, how many fatal mistakes would be discovered in the practitioners of both sexes? But I dare aver it more in the men than in the women-practitioners. With what horror would not there in these be remarked, tearings, rendings, and tortures of no use to which they put both the mother and the child? One, upon some most learnedly erroneous hypothesis, pulls and hauls the arm of an innocent infant yet living, so that he plucks it off; or repels it with such violence, that he breaks it: another unmercifully opens the infant’s head, and takes the brain out: some bring the whole away piece-meal: operations often to be defended only by hard words and harder hearts.
NOR need this procedure astonish. Every thing is at the disposal, I had almost said, at the mercy of these executioners: but have they any? all their handy-work is transacted in private, and remains buried in the tomb of oblivion. The parents suspecting nothing, think every thing has been done, according to art, that is to say, very right. The operator thinks he has done nothing but his duty, and is highly satisfied with himself, after he has ordered some draughts for his patient. The magistrate knows no injury done to the subject, or is insensible to the consequences from the same spirit of confidence. In the mean time, a husband loses a fine child, or a beloved wife, perhaps both; children, a tender mother, and if they are of the same sex, have the same fate to dread for themselves. The man-midwife is clear, for only saying, that he has done all for the best. But this is probably true too, as to the intention; but as to the fact, it shall be shewn that there is often great reason to doubt it.
BE this observed, without offence to the few able men-midwives who are masters enough of the business, not to deserve the reproaches due to by much the greater number of rash and ignorant pretenders to it: whose practice, well examined, would bring to light such terrible truths, as would alarm even the legislature to provide a remedy against the danger.
IN contradiction to this, it may be urged, that the practice by women is susceptible upon that account, of superior objections. That remains now to be examined. The chief object of this work being a fair discussion, which of the two sexes is the most appropriated by nature and art, to the exercise of this function.
TO this end, I shall present, in a candid view, the two opinions which, on this point, divide the English yet more than they do the French. Most of the surgeons, all the men-midwives, no doubt, many apothecaries, a number of women and nurses maintain, that midwifery is the business of the men: whilst on the other hand, the best part of the able physicians, with many other persons of both sexes, defend the contrary side of the question, and insist on this art being, for many invincible reasons, solely the province of female practitioners.
NOT to lose sight of the fundamental arguments and proofs brought to support respectively these two opinions, I shall place them in parallel with one another, in form of objections and answers. The objections made to women-practitioners precede the answers. If the men-midwives, or their partizans, shall think I have omitted any thing that makes for them, or against us, or have any stronger or more essential arguments to oppose, I shall endeavour to satisfy them.
OBJECTION the First.
REGARD ought to be paid to prior possession. The art of midwifery being a branch of the art of physic, must have been originally in the hands of man, the inventor of all arts.
ANSWER.
THE just deference so universally paid to holy writ will, I presume, allow no prejudice to be found against my availing myself of those inferences and decisions to be drawn from it, which are so agreeable to the eternal laws of common sense.
IF the arts and sciences, acquired by experience, and by acts often repeated, had, as they certainly were not invented by men only, that could not at least be said of those acts of the human life, which are indispensably necessary to its preservation. Such faculties may with more propriety be termed instinctive, than invented ones. The faculties of eating, of drinking, of lying down to rest, common to both sexes, are not perhaps more natural, more matter of instinct, than the faculty of one woman assisting another in her labor-pains being appropriated to the female sex.
THERE is no occasion to give one’s imagination the torture to account for Eve’s delivering herself of her first children. There is no reason to establish it as an absolute necessity that Adam should have assisted Eve in her first lyings-in; whose labor-pains might not only be less severe, than they afterwards became in accomplishment for the curse pronounced on the human race for the sin of those first parents, but also more consonant to piety, to believe that God, being the best of fathers, infused into Eve knowledge sufficient of the manner of delivering herself; a manner more natural and more conformable to the ideas of that decency imprinted with his own hand in the human heart, in no point more strongly, nor more universally, than in this matter of the women lying-in, when both men and women have an equal repugnance to the interposition of any assistance, but that of the female sex, to which the faculty of ministering in that case seems innate.
BUT admitting even that Adam, for the want of females for that function, before the daughters of Eve were grown up to a capacity of it, actually did assist Eve, in the seasons of her delivery; that would establish no inference of right for the future: since we know that their children and descendents in time following did not make use of men to lay the women.
IN Genesis, chap. xxxv. ver. 17. there is mention made of Rachel’s midwife. In the same book, chap. xxxviii. ver. 27, and 28. we see they were intelligent midwives. Thamar being with child. “It came to pass in the time of her travail, that behold, twins were in her womb.”
VER. 28. “And it came to pass that when she travailed, that the one put out his hand, and the _Midwife_ took and bound upon his hand a scarlet thread, saying, this came out first.”
AND here I intreat the reader not to impute to me any idea so absurd as that of meaning to defend an erroneous practice solely from the antiquity of it; I intend nothing further by this citation, than to prove the antiquity itself, which if not decisive in favor of the practice by women, can at least be no prejudice against it.
OBJECTION the Second.
THE art of midwifery being equally noble for its subject as for its end, since it is the only one which enjoys the prerogative of saving, at one operation of the hand, more than one individual at once; ought the less noble sex to dispute pre-eminence in it with the men? On tracing things back to the remotest distance of times, it must be allowed, that if the women, through a mistaken modesty, in those times of ignorance and simplicity, commonly made use of midwives, it may be presumed there were also men-practitioners employed in difficult cases.
ANSWER.
READILY granting that the art is a noble one; noble in its subject and ends: all that I am surprised at is, that the men did not find it out sooner. Probably the nobility of this art is only begun to be sounded so high by the men, till they discovered the possibility of making it a lucrative one to themselves. Then indeed the ignorance and incapacity of the poor women for it, came all of a sudden to be doubted and despised. The art with all its nobility was for so many ages thought beneath the exercise of the noble sex: it was held unmanly, indecent, and they might safely have added impracticable for them. But had even any of the medical profession not thought so, there is great reason to think the rest of mankind would have viewed their interested endeavors to usurp this province from the female sex, in the light they deserve. It was only for the eternal fondness which prevails among the French for novelties, that paved the way for the admission of so dangerous and indecent an one, as that of men making a common practice of midwifery, and taking it out of the women’s hands, to which it was so much more natural.
I AM here far from wishing to enter into a contest with the men, on the superiority and excellence they assume over the women; though not quite so indisputable perhaps as is commonly imagined. All that I contend for, to the purpose of the present question, is, that there are certain employments and vocations, which are generally and naturally more proper for one sex than for another. A woman would seem to aim at something above her sex, that would set up an academy for teaching to fence, or ride the great horse: but a man sinks beneath his sex, who interferes in the female province. It is not with quite so good a grace as a woman that he would spin, make beds, pickle and preserve, or officiate as a midwife. Be this observed without impeachment of the superiority of men.
OPEN books, sacred and profane, you will find that the Egyptians were not so simple as Dr. Smellie would give us to understand they were; when in the beginning of his introduction, pages 1st and 2d, he grants us, out of his special grace and favor, “that in the first ages the practice of the art of midwifery was _altogether_ in the hands of women, and that men were never employed but in the utmost extremity: indeed (says he) it is natural to suppose, that while the _simplicity_ of the early ages remained, women would have recourse to none but persons of their own sex, in diseases _peculiar_ to it: accordingly we find that in Egypt midwifery was practised by women.”
ACCORDING to scripture, however, the sorcerers of Egypt were not so very simple neither, since they had art enough to imitate some of the miracles of Moses, in transforming their rods into serpents, blood into water, and covering the land with frogs[1]. All this did not favor of simplicity.
THE Egyptians[2] have ever passed for the most intelligent and enlightened of all the other nations of the earth, who respected them as oracles of wisdom and sound philosophy. They are the first people who established systematically rules of good government. This profound and serious nation saw early the true end of human policy; and virtue being the principal foundation and cement of all society, they industriously cultivated it. At the head of all virtues they placed that of gratitude. The honor attributed to them of being the most grateful of men, shews that they were also the most social. They had an inventive genius: their Mercuries, who filled Egypt with surprizing discoveries, scarce left any thing wanting to the perfection of their understanding, or to the convenience and happiness of life. The first people among whom libraries were known to exist, is that of Egypt. In short, so far from being simple or ignorant, they excelled in all the sciences. There were indeed among them no _men-midwives_; but to make up for this deficiency, they had, it seems, excellent midwives.
BESIDES it is even ridiculous to confine the practice of midwifery by females only to early ages. Who does not know, that it was so in all ages, and in all countries, till just the present one, in which the innovation has crept into something of a fashion into two or three countries. The exceptions before, or any where else, to the general rule, are so few, that they are scarce worth mentioning.
BUT to return to the so _simple_ Egyptians. We read in Exodus, chap. i. v. 15. and following, that Pharaoh said to the midwives, “When ye do the office of midwife to the Hebrew women, and set them upon the stools, if it be a son then ye shall kill him, but if it be a daughter she shall live.
“17. But the midwives feared God, and did not as the king of Egypt commanded them, but saved the men-children alive.”
THE king reproached them, as may be seen in the same place.
WHY did not Pharaoh give the same order to the men-midwives, if there had been any such employed in difficult or extraordinary pains? (as Mr. Smellie supposes.) Or rather, if the king had not thought it too unnatural for women to be delivered by men, he certainly would not have failed to have commanded it, especially on perceiving that the midwives had deceived him. This would have been a fine occasion to have forbidden them their function, and for the men-practitioners to have come into vogue. The men would certainly have been of the two not the improperest to have executed the intentions of the tyrant: as tender-heartedness is surely not more the character of their sex, than of the women. Besides, their instruments would have served admirably to have thinned the species, without distinction of the sexes. They might also have concealed the barbarity of the murders by such instruments, under the pretext of their necessity from hard-labors, as the midwives excused their disobedience under that of easy ones, which had rendered their aid superfluous.
OBJECTION the Third.
SO many authors as have wrote on the art of midwifery, from the age in which Hippocrates florished, whom we look on as the first and father of the men-midwives, with the disciples whom he formed, and their successors, do not they satisfactorily prove the antiquity of man-midwives?
ANSWER.
AS for satisfactorily, no. It can only be concluded from this objection, that the ignorance of the pretended men-midwives is very antient: and yet posterior by much to the function of the midwives, since that is coeval with the world itself, embraces all times, extends through all parts of the earth, whereas we hear nothing of the other till the times of Hippocrates.