Part 21

IT cannot however have escaped observation, that while I am, with the utmost regard to truth, endeavouring to recommend the preference of the hands to instruments, there is nothing I mean so little, as that some deliveries may not be accomplished by instruments, and especially by that divine invention of the forceps. What I presume to exclaim against, is the needless torture to the mother, the needless increase of danger to which she and her child both are exposed, for the sake of that practice being tried upon them, with those instruments, when the bare hands would be so much more safe and effectual. I could myself, no doubt, in many cases, if I could be inhuman and wicked enough to dally with any thing so sacred as the health or life of a woman and child, in some measure, entrusted to me, give myself the learned air of delivering with a CURVE FORCEPS. But in the very same cases, though at the hazard of being called ignorant for my pains, I would always be sure to do it more cleverly, less dangerously, less hurtfully, with only my hands. So that, without straining any comparison, the forceps may deliver indeed, but how? Why just as a man may, if he chuses it, hobble round St. James’s Park, on a pair of those _artificial legs_[41] called stilts, when one would imagine, that the mock-elevation from them could scarce atone for their uncouth totteringness, and that he might full as well deign to use his own _natural_ legs.

IN the slighter cases then, that is to say, in those cases, where it is a jest to doubt of the hands not being the preferable instrument, since they may be truly averred to be so even in the most difficult ones, instrumentarians commonly go to work, _only_ (please to mind that _only_) with the forceps. So that it is _only_ in those slighter cases, where, once more nothing is more certain than that no instrument is wanted at all, that they find matter of triumph over their predecessors in theory and practice, over common sense, and especially over humanity. And this is that amazing, that FORTUNATE IMPROVEMENT, the superhuman invention of the forceps, the philosopher’s stone of the modern art of midwifery, found out by the male-practitioners. Yet, after all it plainly appears, that even themselves do not rely on it in the more difficult cases. They are then obliged to return to the _old_ crotchet, or the like methods, which bad, very bad, and very inferior to the hands as they are, never however are supposed to be resorted to, without an appearance of extremities to afford some color, some plea of humanity to employ them, in a kind of dernier resort, to prevent a greater evil by a less one. Whereas, when the forceps is used, the cruelty of that torture it cannot but create, must be greatly aggravated by the consideration of its being perfectly needless. But in the case of using either crotchet or forceps, or indeed any instruments at all, the truth is, that besides the increase of danger and pain they bring, to the already too much afflicted patients, they defraud them of the more efficacious, less painful, and especially more safe help of the hands alone.

THE instrumentarians all then agree on that insufficiency of this precious forceps, which occasionally compels their recourse to the crotchet so detested even by themselves. Levret, for example, confesses this, p. 24, of the appendix to his observations.

“THE crotchets (says he) are, generally speaking, instruments, the very sight of which shocks and terrifies: but notwithstanding the repugnance which all _good_ men-midwives ought to have to the using of them, there are cases in which there is no doing without them.”

NOW in these cases, that of the monster with two heads[42], is not meant to be included, as Levret himself afterwards explains himself. If then there are such cases as necessitate a recourse to crotchets, it will, I presume, be allowed me, that they can be no other than those which render the delivery the most laborious. What those cases are, I have, from after the instrumentarians themselves reduced to the four capital ones, I have above set forth, without reckoning the pendulous belly. At least I know of no other situations than those, that can produce the very severe labors, nor do I believe that the instrumentarians know any other, or they would tell us so. Now if, in the more difficult of those cases, there is no doing without the crotchet, what becomes of the prodigious merit of the forceps, so insignificant in cases of the greatest need, and so superfluous in those others, where there being no occasion at all for it, it must be the most inhuman wantonness to employ it?

HERE can you be with too much insistence desired to observe the solemn banter, in such a matter of life and death too, of these kind, tender-hearted modern instrumentarians! they are so transported with stark love and compassion to the poor women and children, that they do not know what they are about; they fall into the most palpable contradictions, and would have even Hippocrates, and the antients, appear as so many bloody-minded Cannibals compared to them. Hippocrates, it seems, and the antients, according to the best of their apprehension, in points of midwifery, prescribed the crotchet, in no case however but where the child was certainly dead, which, by the by, is next to the not prescribing it at all, since the ascertainment of that death is scarce not impossible. So because they recommended this practice in the last necessity, the ingeniousness of the modern instrumentarians was “[43]stimulated to contrive some _gentler_ method of bringing along the head” —— without any necessity at all; that is to say, in the minor difficulties, for the crotchet of the old practice is, to this instant, even with them, left in possession of the greater ones. Thus was produced the forceps, that prodigiously bright refinement upon the dull antients, and goes on improving without end under the wise heads of our gentlemen-midwives. But if the modern Genius of arts and sciences has no better improvement than this to boast over Hippocrates and the antients, may the instinct of self-preservation defend mothers, and, in them, their children, from being the trophy-posts of their victorious atchievements! may the midwives continue in their happy ignorance of their curious devices! may they ever preserve a due aversion from indeed all instruments whatever! for they are all needless and pernicious substitutes to the hands. May none of them, especially in any labors committed to their conduct, prove so criminally false to their sacred trust, as through negligence, or through an interested designing reliance upon instruments, to repair their failures or mispractice, slacken their attention to their duty, or afford, by their defective performance, an excuse, though a fallacious one, for resorting to instruments, when skilful hands are incomparably more fit for a remedy or retrieval!

I CANNOT then too ardently wish, for the women not to be so cruel to themselves, and to their so naturally dear children within them, as inconsistently to suffer their aim at superior safety, to be the very snare that betrays them into the greater danger, and often worst of consequences, from those male-practitioners, to whom that aim drives them for recourse; while that examination they owe to so interesting a point would issue, or deserve to issue, in rescuing them from such a shameful subjection of body and spirit to a band of mercenaries, who palm themselves upon them, under cover of their crotchets, knives, scissors, spoons, pinchers, fillets, _terebra occulta_, _speculum matricis_, all which, and especially their _tire-têtes_, or _forceps_, whether Flemish, Dutch, Irish, French or English, bare or covered, long or short, strait or crooked, flat or rounding, windowed or not windowed, are totally useless, or rather worse than good for nothing, being never but dangerous, and often destructive.

NATURE, if her expulsive efforts are but, in due time, and when requisite, gently and skilfully seconded by the hands alone, will do more, and with less pain than all the art of the instrumentarians, with their whole armory of deadly weapons. The original and best instrument, as well as the antientest, is the natural hand. As yet no human invention comes near it, much less excells it: and in that part it is that the women have incomparably and evidently the advantage over the men for the operations of midwifery, in which dexterity is ever so much more efficacious than downright strength.

AND, indeed, let every requisite faculty for the assistence of lying-in women be well considered, and the resulting determination cannot but be, that in the common labors, where the men themselves are either simple by-standers or receivers of the child, or operate with the hand only, they are the very best of them, not comparable to a common midwife, and in those cases, in which they pretend the use of instruments necessary, hardly better than the worst one. So that, not less than justly speaking, they are not receivable, either as substitutes, or even as supplements to midwives.

THE art of midwifery then, in its management by women, carries with it, in the recommendation of order, modesty, propriety, ease, diminution of pain and danger, all the marks of the providential care of Nature. It is imaged by the incubation of a brood-hen, assiduously watching over her charge, and tenderly hatching it with her genial heat. Whereas the function of this art, officiated by men, has ever something barbarously uncouth, indecent, mean, nauseous, shockingly unmanly and out of character: and, above all, of lame or imperfect in it. It strongly suggests the idea of the chicken-ovens in Egypt, kept by a particular set of people, who make a livelihood of the secret, which they, it seems, ingross of that curious art of hatching of eggs by a forced artificial heat: a practice, which, like the other refinements of dungbeds for the same purpose, or that of committing the rearing or education of the chickens to[44]“_cocks_, to _capons_, or to _artificial wooden mothers_,” may sound indeed vastly ingenious; but besides the numbers that perish the victims of those experiments, many of the productions of such methods of hatching are observed to be maimed, wanting a leg or a wing, or some way damaged or defective. The comparison breaks indeed in that, at least, the grown hens themselves escape damage, which is not often the case of mothers under those heteroclite beings the men-midwives; or, if they do escape, it is no thanks to those operators, but to the prevalence of Nature over their pragmatical intervention, so fit only to disturb, thwart, or oppose her effects, and in every sense to deprive the unhappy women that trust them of her common benefit.

BUT while superior considerations of humanity so justly intercede for the mothers, while I strenuously contend for the preference to be, without hesitation, due to the mother over the child, especially in that dreadful dilemma, where one must be sacrificed to the safety of the other; supposing such a dreadful alternative ever to exist, which I much doubt, or at least, not to exist so often as it is rashly taken for granted, and even then, where the effects do not always follow the resolution taken thereon, since, though the child is always certainly lost, the mother is far from always saved, when, by a judicious preventiveness in practice, neither of them might perhaps have been so much as in jeopardy; while, I say, I plead for the preferable attention to the mothers, I hope no mothers will think me the worse intentioned towards them, for giving the lives of their children the second place in my tender concern for the safety of both.

AND surely never was a time, when children more required the intercession of humanity in their favor. Mothers can speak for themselves. But the poor infants, so often precluded, by violence, from the pity-moving faculty of their own cry, have nothing but the cry of Nature to plead for them. A cry, the listening to which is prevented by those vain imaginary terrors, inspired by designing Art in the service of Interest, through which Nature is seduced to act against herself, and deliver herself up to her greatest enemies.

IN short, one would imagine, that all the rage of cruelty was unchained, and let loose against especially those tender innocents, born or unborn.

AMONG the poor, particularly as to those infants cast upon the public charity, a barbarously premature ablactation, under a pretext so easily foreknown to be as false as it is fatal, of bringing them up by hand for cheapness-sake, has destroyed incredible numbers.

AMONG the rich, or those able enough to pay for the learned murder of their offspring, how many of their children, even before they have well got hold of life, in this, literally speaking as to them, iron age, encounter their death or wounds, stuck in the brain by a crotchet, or crushed by a forceps, to say nothing of their being now and then ingeniously strangled in the noose of a fillet!

AND those horrors proceed unchecked and unexploded, and in what a nation? a nation, that values herself upon the distinction of profound thinking: a nation that, besides that interest she has in common with all other well-governed nations, to protect and promote population, stands, be it said, in that true spirit of justice, which as much disdains to pay a fulsome compliment, as good sense ever will to receive it, moreover eminently distinguished above them all, for producing a race of natives, one would think could hardly be too numerous, since they are the most remarkable in the known world for courage, for personal beauty, and for many other liberal gifts of Nature, among which surely not the least is, that inborn spirit of liberty, to which they owe the honorable acquisition of so many additional advantages.

CAN it then be too strongly recommended to the women especially, at least, to examine whether their notion of superior safety under the hands of a man, in their lying-in, bears upon the solid foundation of Nature, or merely on the treacherously weak one of a delusive opinion? an opinion that owes its existence to fears cruelly played upon, and turned to account by designing Interest. If those then of them who are under the force of prejudice, or governed by habit, or by both at once, would, on a point that concerns themselves and children so nearly, assume liberty enough of mind to shake off the dangerous yoke, they would undoubtedly find it better and safer to listen to that salutary instinct of Nature so authorized by reason, which inspires them with that repugnance to submit themselves in the manner they must do that submit themselves to men-midwives, who have the impudence to call that repugnance a “_false modesty_:” as if that Modesty could not be a true one, a foolish one I am sure it could not be, that should murmur at being so cruelly sacrificed to such a bubble’s bargain as it is, by those innocents, who, over-persuaded by a deceitful promise of more effectual aid, too often embrace a torturous and a shameful death, for which, to add ridicule to horror, they are expected to pay their executioners larger fees than to one of their own sex for a more decent, a more safe, and always a less painful delivery.

MAY the women then, for their own sakes, for the sake of their children, cease to be the dupes, sure as they are to be in some measure the victims of that scientific jargon, employed to throw its learned dust in their eyes, and to blind them to their danger or perdition! may they, in short, see through that cloud of hard words used by pedants, whose interest it is to impose themselves upon them: a cloud, which is oftener the cover-shame of ignorance, than the vehicle of true knowledge, and perhaps oftener yet the mask of mercenary quackery, than a proof of medical ability!

AS to the writings of the men-midwives especially, I dare aver, that, though there may be here and there some very just theoretic notions, borrowed from able physicians and surgeons, nothing is more contemptible than most of their practical rules; what is tolerable in them being most probably got from midwives, but so disfigured with their own absurd sophistications, that I should heartily pity any woman, subjected to have her labor governed by such, as should have no better guidance than their ridiculous instructions.

THEN it is that a sensible woman would, in defence of her own life, or of any life that she holds dear to her, in the case of needing the aid of midwifery, view with equal disdain, with equal horror, either the rough manly[45] he-midwife, that in the midst of his boisterous operation, in a mistimed barbarous attempt at waggery or wit, will ask a woman, in a hoarse voice, “if she has a mind to be rid of her burthen,” or the pretty lady-like gentleman-midwife, that with a quaint formal air, and a gratious smirk, primming up his mouth, in a soft fluted tone, assures her, and lies all the while like a tooth-drawer, that his instruments will neither hurt nor mark herself nor child but a little, or perhaps not at all. (See p. 448.)

THIS last character, if less brutal than the other, is not perhaps the least dangerous, since the practice being at bottom the same, pregnant consequently with the same mischief, the gentleness of the insinuation gives the less warning, and paves the way for the admission of a handling not the less rough for the smoothness of the address. But is there any such thing as polite murder? is mischief the less mischief for being perpetrated with an air of kindness? well considered it is but the more provoking. The male-practitioners then are not quite in the wrong, to presume as they do upon the weakness of the women’s understanding, since they can so grossly pass upon them their needless cruelties, under so inconsistent and false a color as that of a tender compassion. Thus to all the rest of the shame to which they put them, they add that of so palpable an imposition in that flimsy cover of the mean interest, which is so probably the real motive at bottom of their taking up a function, to which they were never called by Nature, nor by any necessity, unless, perhaps, of their own.

IN the mean time, the truth is, that, in vain, would the men, by way of sparing the women the terror of their masculine figure, upon those delicate occasions of officiating, and to appear the more natural in the business, aim at an occasional effemination of their dress, manner and air. They can never in essentials atone for their interested intrusion into an office, so clearly a female one, that, if but only as to the manual discharge of it, not even the qualifying them for the opera, would, perhaps, sufficiently emasculate them.

CONCLUSION of the SECOND and LAST PART.

HERE, confessing my just apprehensions of not having fulfilled the promise of my title-page; there will not, I hope, to that reproach of my deficient powers in the performance, be added the undeserved ones of vanity or injustice in the design or conduct of my feeble essay.

FOR as to vanity, or any presumption, on my part, of any thing so weak, so unauthoritative as my representation, having any chance to remove the abuses, not however the less existent for that incapacity of mine to remove them, my knowledge of the world would alone defend me from so ridiculously wild a thought. I am but too well aware of the tenaciousness of especially false prejudice in most minds, where it has once gained entrance, and with whom prepossession is ever eleven points of the right. I have then purely had in view the discharge of that duty, incumbent on every member of human society, to oppose such errors as appear to be pernicious to the good of it. In that light I have beheld the growing practice of the instrumentarians, and in that sincere belief I have hazarded the publication of my sentiments, without surely pretending to any authority over the opinion of others. That I chearfully leave to every one’s reason, who is capable of reason. And to write for others than the rational, would be only labor deservedly lost.

AS to injustice, I am, at least, clear of that of partiality to my own sex. I grant and lament as much as any one the incompetency of but too many of the midwives. The number of such cannot be too little. But then would the banishing them out of the practice be preferable to the having them better taught, especially since there is nothing but what is so much worse to put in their room, men and instruments? What occasion too for such a dangerous extremity? For as the deficiency is evident, so are the causes: which are not only the want of sufficient care in the training and education of women to this profession, but the actual discouragement, which must grow every day greater and greater, by the encroachments of the instrumentarians, whose plea for supplanting them will be consequently strengthened by that alarming scarcity of capable midwives, which themselves will have so much contributed to create. These being then the principal causes, and well known to be so, the remedies are not obscure, nor hard to attain.

A GOOD education especially is of great importance, to accomplish what Nature has already gone so great a way in, by her giving in many respects to the women such a superior aptitude for the business. Capable midwives would much help to form good female pupils; and the lying-in hospitals especially might be made highly useful to so desirable an end. But surely as to the practical part of midwifery in these hospitals, it ought not to be under the direction of men, whose interest it should be, only to form the women so deficiently, as that themselves might be the less unnecessary; to form them, in short, more for their own service, than for that of the public. That temptation being removed, the female-practitioners could not receive too respectfully from the surgeons lectures or instructions, any lights in anatomy relative to their theoretic proficiency. But to nothing should they be more constantly and effectually excited, than to perfect themselves in the manual operation; and indeed, in general, so to capacitate themselves for their function, as to prove and establish the perfect inutility of all instruments whatever. Nor will it be a difficult task for a woman to acquire a superiority in her hands to the most boasted of those unnatural substitutes. This is the true way of laudably disarming the instrumentarians, and of thereby depriving them of the only shadow of a pretence they have for supplanting the women, and invading the female province, of which invasion it is so probable, that not the cause they plead, but the pay they squint at, is the real motive.