Asto those who, from a principle of œconomy, prefer a man-midwife to a midwife for conducting a lying-in, with respect to the remedies and prescriptions which may be necessary on those occasions, Œconomy is doubtless a laudable consideration, but I am much afraid, that those who on this occasion make it a reason of preference, much mis-calculate things. This man-midwife you prefer is either an eminent or an ordinary one. If he is an eminent one, you are not always sure ofhaving him in the greatest need; for besides their being so rare, they cannot be every where at one time. But admitting that you are fortunate enough to fall into the hands of a man-midwife of the greatest name in the profession, can you imagine that you will have a very cheap bargain of him? These gentlemen expect no small fees, and will not attend without them. You would besides be ashamed of not doing honor to the footing on which they give themselves out. Whereas the same gratitude is not always shewn to a midwife, however skilful in her profession, and whatever trouble she may give herself both before and after the lying-in of her patients; notwithstanding too the assiduous attendance and visits she bestows upon them till they are out of danger; notwithstanding these tender attentions she has for the children, which are so seldom regarded by the men-midwives; there are who imagine they cannot give a midwife of this sort too little, and that for no other reason on earth, but because she is not a man.
Ifon the contrary, and what the most frequently happens, you fall into the hands of one of the common men-midwives, either of that multitude of disciples of Dr. Smellie, trained up at the feet of his artificial doll, or in short of those self-constituted men-midwives made out of broken barbers, tailors, or even pork-butchers (I know myself one of this last trade, who, after passing half his life in stuffing sausages, is turned an intrepid physician and man-midwife) must not, I say, practitioners of this stamp be admirably fitted, as well for the manual operation, as for the prescriptions? If then it is from thrift they are employed, by way of sparing fees to a real physician, I own, I think this is pushing savingness too far; as I should be almost as much afraid of the prescriptions of these mock-doctors as of their operation. I should have more confidence in the advice of a discreet matron, or of a skilful midwife, who, by habit and a long experience of seeing ladies in their lyings-in attended by the best physicians, is in the most common cases of the labor-pains,more able to advise the sick person to innocent remedies, where there is no complication in the disorder, than those half-bred or ignorant pretenders: but if there is a complication, then there must absolutely be a good physician called in, the expence of which should not be regretted, since life is at stake.
Nowin such cases, a midwife, though never so skilful, will neither be ashamed nor backward to require such aid: whereas a man-midwife, the more ignorant he is, will be but the more careful of concealing that ignorance, and from the most false prejudice that both the faculties of physic and surgery are implicit ingraftments on the profession of midwifery in a man, will rather let mother and child perish, than call in that assistance, of which he will be ashamed to confess his standing in any need. He will then rashly do the best he can for his patient: but what will that best most probably be? Torture and death; and that with perfect impunity. I say most probably, for not even the most credulous, or the most zealous for the appropriationof this profession to the male-sex, can hardly carry the blindness of credulity and obstinacy the length of assenting in earnest, that in the common run of men-practitioners you are to find at once the man-midwife, the physician, and the surgeon. Whereas women, fully sufficient for all cases but the very extraordinary ones indeed, are ever ready to call for proper help, on the first alarm of danger, of which too their apprehension is much more quick and just than that of the men.
Theignorance of the women is the cause of the little confidence there is reposed in them.
Ifthis objection was fairly stated, it should be said, that the ignorance of the women in the art of destroying mother and child, occasions their not being trusted so much as they deserve with the office of saving both. In that art indeed of perpetrating double murder with perfect impunity,under the sanction of the public credulity, imposed upon by a vain parade of learning, I readily confess the men superior to the women. I do more than confess it, I will prove it; and how? even from their own writings and confession, not extorted from them by the spirit of candor, but from an interested desire of decrying or supplanting one another, in order to self-recommendation.
Infact, whoever will, with a competent degree of knowledge of the subject, and of due impartiality, peruse the practical treatises of midwifery, written by the most celebrated practitioners, some of whom have so vainly pretended to the triple union of the characters of man-midwife, surgeon and physician in one person, and it will be found, that all their boasted superiority of erudition, has only led them into the greater errors of practice, and the most barbarous violences to nature.
Butperhaps I exaggerate. Let the reader judge for himself, and pronounceas his own reason shall dictate to him. Let him if he can read without shuddering, the following quotation from one of the most celebratedmen-midwives of the age, Levret, p. 199. “Mauriceau had invented a newtire-tête, which was to be introduced into that part (the uterus). Peu or Pugh, likemanyothers, made use of different hooks (crochets) and La Motte opening the head with scissors, scooped out the brain, &c. We read, with horror, inallthese authors, that they have extracted children, who, tho’ muchmaimedormutilated, have yetlivedseveral hours.”
Uponthis many reflections will naturally occur. These children thus destroyed, owed most probably their death neither to nature, nor to the difficulties of the passage through which the launch is made into our world, but to the labor being prematurely forced, and the delivery effectuated by those torturous instruments, which at once kill the child, and not seldom irreparably wound the mother in the tender contexture of these parts. A midwife, with less learning and more patiencethan those gentlemen, and well acquainted with the power and custom of Nature to operate in some subjects, sometimes more slowly, and in all ever more safely and gently than art, would have left to nature, not without her tenderest assistance of that nature, the expulsion of the child. A proper predisposal of the passage, and direction of the posture, with an unremitting attention to employ the fingers, so as not to lapse the critical moment of operation, often never to be recovered with safety to mother and child, would have, I repeat it, and appeal to common sense for the probability thereof, saved the lives of those innocents, which thus fell the victims of thoselearnedexperiments, with instruments, which, by the way, be it remarked, none are so forward to use, as those who are the loudest in exclaiming against the employ of them. And reason good, if they exclaim against them, it is evidently in order to cover their practice with them, against which the minds of their patients must so naturally be revolted. But that exclaiming does not evidently hinder their being used, when, the truth is, that if due care was previously taken withthe patients, those execrable substitutes to the fingers need never be used at all.
Butif these instrumentarians were called to account for their so justly presumable massacres, what would be their defence? Most certainly not the truth. One would not own, that in order to attend a richer patient, or perhaps to return to his bottle, he had recourse to his fatal instruments, to make the quicker riddance oreffectualdispatch; another would not confess, that he employed them purely because his fund ofpatiencewas exhausted; some would not care to allow, that they used them purely on the scheme of trying experiments; and none of them would, you may be sure, plead guilty of ignorance of better and more salutary methods. No! their wilful error, or that want of skill, they would be sure to conceal under the cloud of hard words and scientific jargon, in which they would dress up their respective cases, and insult the ignorance of those silly good women, whoknownobetterthan to deliver those of their own sex with the help of their fingers and hands, and who are so undextrous, as to have nonotion of putting them to such unnecessary tortures and risks, as are inseparable from the use of those iron and steel instruments. Instruments which rarely fail of destroying the child, or at least cruelly wounding it, and never but injure the mother, not only in those exquisitely tender-textured parts, where they are so blindly and ungovernably introduced; but in the often irrecoverable dilatations of the external orifice, the vagina, and especially thefourchetteorfrænum labiorum, all which, in general, they considerably damage: and always originally without necessity. For if through carelessness, if through an impatience, so much more natural to men than to women, in a case and position of this nature; if through ignorance of the critical minute of extraction, the occasion of operating with the fingers hasnotbeenlapsed, any recourse to instruments is perfectly unnecessary, and they will hardly ever succeed where the subject is inaccessible to the fingers, without having the worst of consequences to dread from them both to mother and child. Nothing then can be worse for a man-midwife, than to be tempted to any negligence, to any precipitation,to any ostentation, in short, of expedition or of superiority of skill to that of the women, by his having those instruments at hands, the doing without which is at once so much better and safer, even by the confession of those who use them nevertheless.
Howgreatly then is the ignorance of the midwives preferable tosuchan use, as the male-practitioners commonly make of that deep learning of theirs, which only misleads them, at the expence of humanity! How over-compensated is that want of theoretical knowledge, so unjustly reproached to women, since they profess a sufficiency even of that knowledge; how over-compensated, I say, is that supposed want, by that instinctive keenness of apprehension, and ready dexterity of theirs in the manual operation, which in them is a pure gift of nature, and to which not the utmost efforts of art or experience can ever make the men arrive, for reasons which will be made clearly appear in the two following considerations.
First, It will hardly be denied, that the art of midwifery requires a regular training or education for it. The season of that education can only be that of youth. And surely in that season precisely, the very nature of the study excludes those of the male-sex, at the same time, that there is nothing in it indecent or improper for the females destined to that profession. This proposition will be more clearly illustrated, by an appeal to the reader’s own sense and reason upon what passes, and must necessarily pass in those hospitals for the reception of lying-in women, where those of the male-sex are allowed to attend for the sake of learning the profession.
ThisCharity is indeed founded upon specious motives, but the conduct of it would make humanity shudder, even where no violence is expressly intended to humanity; and without the least forced or uncharitable conclusion, may serve to demonstrate the impropriety of attempting to throw the practical part of midwifery into the hands of male-practitioners,the implicit consequence of which must be the exclusion of the midwives, without any direct and formal exclusion of them, but purely from the discouragement that will hinder any good and able ones being formed in future. And that no thoroughgood men-midwives, except perhaps two or three extraordinary men in a whole nation, can ever be formed, the procedure at the lying-in hospitals, open to men-pupils, such as it must of all necessity be from the nature of the thing itself, without any the least reproach herein meant to the worthy managers, will convince all who will make an unprejudiced use of their judgment.
Wewill then suppose a lying-in hospital, in which, for the sake of training upmento the profession of midwives, there are young pupils of the male-sex admitted to attend and learn the practical and manual part of the business. To obtain this end, we will not say that women of virtue and character are subjected to the inspection and palpation of a set of youths, who perhaps pay largely for their privilege of attendance; but we will grant,that the objects of this charity are entirely women, who, though they may have unfortunately forfeited their right to virtue, cannot however have lost their claim to the protection of that humanity, which, besides the great and most political attention due to population, pays especially a tender regard to the innocent burthen, though of a guilty mother. Yet among these wretched victims, there may be not a few who, if they were not even to deserve more compassion than blame, for particular circumstances of their ruin, in which the villainy of men has often a much greater share than female frailty itself, cannot surely deserve that all traces of modesty, or natural remains of regard for it, should be utterly eradicated by that hard necessity of theirs to accept of a charity, by which they must be abandoned up to the researches of a set of young men, to whose approaches their age and sex must alone give an air of petulance and wantonness not to be explained away, to the satisfaction of the poor passive sufferer, by the goodness of the intention. Every one must be sensible of the dreadful effects such a treatment must have on the mindof a poor creature in that condition, when the imagination is known to be the most weak, and susceptible of the most dangerous impressions. At that critical time, amidst all the terrors and apprehensions inseparable from her situation, she is moreover exposed to the greatest indignity that can be well imagined, that of serving for a pillar of manage to break young men into the exercise of that most unmanly profession. Nay, that very circumstance of the use she is put to, which she is in fact to consider as a kind of valuable consideration by her paid for the relief afforded her, and which in that light can scarce be called a charity; that very circumstance, I say, of her submission, at all calls, and upon all pretences of the pupils, being accounted for to her by the good intention of it, will yet hardly pass on a wretched, frightened, harrassed woman, who, whatever may be said to procure her tame acquiescence, can scarcely, if she has a spark of female modesty left in her, be reconciled to the grossness of such usage, whether she considers herself as the butt of wantonness, or the victim of experiments, or perhaps of both the one and the other.It is well if she is defended by her ignorance from any idea of those dreadful instruments, of the having practices tried upon her with which, her circumstances might but too reasonably render her apprehensive, since a needless resort to them may be too often presumed in the course of practice, where the men are even paid for their assistence. These the men-midwives may possibly indeed conceal from the sight of their patients, but I defy him to conceal them from their wounded imagination, if they are not wholly ignorant or can think at all.
Yetin pure justice to all parties it should be observed, that, besides many other points to be learned only by ocular inspection and manual palpation, of which no theory by book or precepts can convey satisfactory or adequate notions, that great and essential point in our profession, a skill in what we call theTouching, is not to be acquired without a frequent habit of recourse to the sexual parts whence the indications are taken. And in this nothing but personal experience can perfect the practitioner. But this admitted, onlyproves the more clearly the utter impropriety of men addicting themselves to this occupation. For, once more, most certainly the season of acquiring the nicety of that faculty ofTouching, besides other requisites in the art, is for obvious reasons that of youth. Now let any one figure to himself boys or young men, running at every hour, and exercising a kind of cruel assault on those bodies of the unfortunate females, upon which they are to learn their practice. But will they learn it by this means? It is much to be doubted. It may perhaps be granted, that men of a certain age, men past the slippery season of youth, may claim the benefit of exemption from impressions of sensuality, by objects to which custom has familiarized them. But, in good faith, can this be hoped or expected in the ungovernable fervor of youth? Can such a stoic insensibility be imagined in a boy or young man, as that he can direct such his researches by pawing and grabbling to the end of instruction only? Must not those researches, humanly speaking, be made in such a disorder of the senses, as to exclude the cool spirit of learning and improvement? Mayhe not lose himself, and yet not find what was the occasion of losing himself? In short, granted, though it is surely hard to grant, that the wretched women, admitted to this so falsely called Charity, may not deserve much tender consideration; but in what can the poor young pupils have deserved so ill of their parents or guardians, as to be thus exposed to temptations so shockingly indecent? What father, what mother, what considerate relation can paint to himself a child, or charge of his, at an age so incapable of resisting the power of sensual objects, as is that of youth, employed in exploring such arcanums, and exploring them too in vain? It is surely easier to guess the natural consequences, than to defend either the subjecting youths to them, or the hoping any good from the subjecting them. In short, even Dr. Smellie’s doll is a more laudable method of instruction.
Butbesides this reason taken from the moral impossibility of laying a timely foundation of practical knowledge in the male-sex, for preferring women under the falsecharge of ignorance, to the so unconsequentially boasted learning of the men, there remains a yet stronger argument against the male-practitioners: an argument furnished by nature herself, and of the which, every impartial reader’s own feelings will in course render himself the judge.
Naturehas to all animals, from the man down to the lowest insect, to all vegetables, from the cedar to the hyssop, to all created beings, in short gives what is respectfully necessary for them. Nor can it without the grossest absurdity be imagined, that this tender universal parent, or call her by a yet more sacred name, the divine providence, would have failed women in a point of so great importance to them, as that of the ability to assist one another, in lying-in, at the same time, that she has given them so strong and so reasonable a sympathy for those of their sex in that condition? Can it be thought that nature, so vigilant, so attentive, to the production of fresh generations, through all beings, should have been deficient or indifferent as to women, her favourite work, the friend,the ornament of human kind? And so she must have been, if she had left her in the necessity of recourse to others than those of her own sex, in whom there exists so sensibly a superior aptitude for tending, nursing, comforting and relieving the sick, that even the men themselves, in their exigences of infirmities, can hardly do without them. But to say the truth, and as I have before remarked, nature has been even liberal in her accomplishments of those of the female sex for this office. Not content with giving them a heart strong imprinted with a particular sympathy for their own sex, on this occasion, a sympathy, which for its tenderness, has some resemblance or affinity to the instinctive love orstorgethat parents have for their children; she has also bestowed on them a particular talent, both for the manual function in the delivery of women, and for all the concomitant requisites of their aid during the time of their lying-in: a talent in short, which may even be felt, without the necessity of definition or proof, to be superior to any possible attainment of the men in that art, though they should have sacrificed hecatombs of pregnant rabbits,or have brooded over thousands of coveys of eggs in their search of excellence in it. To say nothing of a certain softness, flexibility, and dexterity of hand, palpably denied to the men, there is, both in the management of the manual operation, and in the attendance due on those occasions, a quality in which the women, generally speaking, excel the men, and that is, patience, a quality more essential, more indispensable than can well be imagined. For on patience it is, that the salvation of both mother and child often depend; whether that patience is considered in the so needful point of predisposing the passages, or of waiting, without however over-waiting, the critical efforts of nature in the expulsion of her burden. Now nothing is more certain, than that nature, who to woman has in general given all that vivacity and quickness of spirit, which seems incompatible with the phlegmatic quality of patience, has, as if she had purposely meant an exception favourable to her darling end, the propagation of beings, especially the human one, bestowed on the female sex, such a remarkable assiduity and diligence in aid of women’s labors, as arerarely to be seen in men, and when seen, appear rather forced than naturally constitutional to them. Women, in those cases, have more bowels for women: they feel for those of their own sex so much, that that feeling operates in them like an irresistible instinct, both in favor of the pregnant mother and of the child. Thence it is, that a woman-practitioner will employ, without stint, or remission, all that is necessary to predispose the passages, for the least pain, and the greater safety; she will patiently, even to sixteen, to eighteen hours, where an extraordinary case requires so extraordinary a length of time, keep her hands fixedly employed in reducing and preserving the uterus in a due position, so as that she may not lapse the critical favorable moment of extraction, or of assisting the expulsive effort of nature: and what man is there, can it be imagined, would have endurance enough to remain so long in a posture, the very image of which, in one of his sex, is so nauseating and so revolting, to say nothing of the want of that pliability and dexterity of management of the fingers, on those occasions, so necessary, and so uncommon inthe men, especially in that very age, when their practice should be supposed the greatest.
Itis then in those cases where nature is slow, as she sometimes is, in her operation, and often so, for the greater good of the patient, so conformed perhaps, that a quicker expulsion would only destroy her, that the midwife, not only uses all patience consistent with safety of life to the mother especially, but inculcates patience to her suffering charge. Whereasthe men, from their natural impatience, or from whatever other motives their precipitation may arise, having those infernal iron and steel instruments at hand, are but too often tempted to make use of them, not only without necessity, but against all the indications of nature, pleading for a just indulgence to her of her own time in her own work. In vain then do too many of them declaim as loudly as can be wished, or as the thing deserves, against all recourse to instruments, but in extremities which, they pretend, justify them. In the first place, those extremities are often the fault of deficientand unskilful practice. The precious moments of the assistence due to nature have been lapsed, or there has been some failure of preliminary treatment; or what is worse yet, extremities are rashly taken for granted when they are not existing.
Here, in the history of one single woman, I give the history probably of thousands.
A healthywoman, about twenty five years of age, and remarkably robust, was in labor of her second child. Her first had come in that natural smooth way, as had given the same man-midwife, who was now to lay her again, not the least trouble, as often happens. In this second labor, however, the head of the child stuck in the passage; and was so far advanced, that the Doctor told her, whether in jest or earnest I cannot say, that he could discern the color of its hair. Her pain, though extremely great, had not however hindered her observing the Doctor rummaging for his instruments; her frightful apprehension, of which, she had all the reasonto imagine, did not a little contribute to retard her throws. She taxed him with his intention to use them, and he did not deny it. Upon this she used the most moving fervorous entreaties for a respite of execution; but all in vain; he told her, with a resolute tone, that he knew surely better what was for her good than she did, that he had even already waited longer than he could justify; and that her life was absolutely desperate if the child was not instantly extracted, of the which being dead, he was sure from many incontestable symptoms. Her thorough confidence in a man, whom she had often heard declaim vehemently against the use of instruments unless in extremities, and which she understood in the most literal sense, without considering, or perhaps knowing that, on too many occasions, nothing is so different as words and actions; her thorough confidence in him, I say, joined to a natural love of life, and to her present feelings of exquisite pain, determined her to an acquiescence. The fatal instrument was struck into the brain-pan of the child, who at the instant gave the lie to the first part of the Doctor’s asseveration as to its death,by such a strong kick inwards as had almost killed her, and convinced her not only of its being alive but lively. This did not, you may be sure, add to her belief of the second part of his averment, that waiting any longer for the operation of nature, would infallibly have been her death. It might be so: yet surely there are strong reasons for concluding, that a little more patience might have saved a fine boy, and yet not have destroyed, or even hazarded the destroying the mother, whose life is certainly the preferable object. But how cruel to state the dreadful alternative where it does not exist! And how easy, in the presumption of that alternative, to extort the dreadful consent from a weak woman, yet more weakened by her condition, and naturally determined by her present feelings, to embrace the appearance of an immediate relief, presented to her in the form of salvation of life! However, scenes similar or a-kin to this, may, without breach of charity, be presumed too frequent, especially under those superficial men-midwives, whom the facility of forming, in the manner they are generally formed,renders so suspicious as to their ability, and who for so many reasons, both of nature and interest, are but too liable to the murderous want of that patience, for which the women are but the more remarkable in this case, for their not being perhaps so capable of it in any other. But here their duty is even their nature; as if in so capital a point, she would trust it to nothing but herself.
Ifit should be here to this objected that the women may, through that very spirit of patience, wait too long, or overstay the time of saving the patients life, for want of calling in proper assistence; I have already implicitly obviated this objection, by remarking before, that a true thorough midwife, from her quickness of apprehension, and knowledge of the danger, will ever be readier to call in the assistence and advice of a physician, than the common men-midwives, who are ever in proportion to their ignorance the more rash, the more fearless, and consequently averse to calling in that help, of which they will be ashamed to confess their want, andthus cruelly, though with impunity, lose the opportunity of others endeavouring at least to repair those damages, of which themselves are oftenest the authors. Now a midwife has no such shame; she pretends to no extraordinary skill in physic or surgery; she knows her art, and will not presume to transgress its bounds; she would think herself accountable if she did: and even that very tenderness and sensibility, upon which nature has founded her patience, will make her cautious how she pushes that patience too far. She may easily see, feel and discern those cases in which nature calls the physician in aid to the midwife; nature, who seems to have placed such boundaries between those professions, as nothing but interest, presumption, or ignorance of nature, could ever render their union in one person supposable: tho’ the quality of physician may not indeed exclude that of the surgeon, but rather implies, at least, the theory of surgery. For I presume anatomy is the great basis of true rational physic, though it can very little assist practical midwifery, which depends so much upon purely manual operation,and needs only a sufficient general idea of the structure of the sexual parts in woman, the conceptacle, and passages of the delivery.
Thisis so true, that any impartial observer of the male and female practitioners in midwifery, will easily distinguish the characteristic difference of the sexes, in their respective manner of operation.
Inthe men, with all their boasted erudition, you cannot but discern a certain, clumsy untowardly stiffness, an unaffectionate perfunctory air, an ungainly management, that plainly prove it to be an acquisition of art, or rather the rickety production of interest begot upon art.
Inwomen, with all their supposed ignorance, you may observe a certain shrewd vivacity, a grace of ease, a handiness of performance, and especially a kind of unction of the heart, that all evidently demonstrate this talent in them to be a genuine gift of nature, which more than compensates what she is supposed to haverefused them, in depth of study, though even of that they are not so unsusceptible, as some men detractingly think; and in midwifery, most certainly they attain all that they need of learning to perfect them, with a facility the greater for nature, having collaterally endowed them with an organization of head, heart and hand, obviously adapting them to this her most capital mystery. This will be denied by none who have any regard for truth, and who do them justice, as to the keenness of their apprehension, as to that simpathizing sensibility which supplies them with the needful fund of patience, and tender attention; and as to that peculiar suppleness of the fingers, as well as slight of hand, in a function which rather exacts a kind of knack or dexterity, than mere strength, of which they have also a competency. Nor can it be quite without weight, that the midwives, besides their personal experience, being sometimes themselves the mothers of children, have a kind of intuitive guide within themselves, the original organ of conception, itself pregnant, in more cases than that, with a strong instinctive influence on the mind and actionsof the sex; an influence not the less certainly existing, for its being undefinable and unaccountable, even to the greatest anatomists[4].
Themen, it will be said, have many or all of these qualifications, except indeed the last. Granted that they have: but how very few are there of the men that possess the most essential ones to a degree comparable to that of the women: or rather not so imperfectly, as that all their boasted skill in literary theory and anatomy, cannot supplement or atone for the deficiency? Nor theory, nor all the books that ever were written on that subject from the divine Hippocrates, who understood so much of physic, and so little of midwifery, down to Dr. Smellie, who is so great a man in both, will ever amount to so much as the practical experience of a regular bred midwife.
Asto that superior skill of the men in anatomy which is sounded so high, against the women, I shall not imitate the men in their want of candor towards the female-sex in their availing themselves of false arguments. I will not then take the benefit of the slight opinion which Celsus and Galen had of the depths of anatomy; theywho contented themselves with a gross superficial notion of the principal viscera. I will not even desire to countenance that contempt by the example of that great philosopher Mr. Lock, the intimate friend, and even the counsellor of the British Esculapius Sydenham, who paid a great deference to his physical knowledge; and yet this very Mr. Lock wrote an ingenious treatise (though not published by him) upon the insignificance of the refinements of anatomy in the practice of physic. Neither will I here insist on the absurdities into which even the greatest anatomists have fallen; as for example,Pecquet, the famous discoverer of the thoracic duct in the human body, who nevertheless adopted so extravagant a notion, as that digestion of food ought not to be promoted by exercise, but by drinking spirituous liquors, a practice to which himself fell a victim, dying suddenly at the anatomical theatre. It is only for those who have a false cause to defend to shut their eyes against those truths which seem against them. Those on the contrary who defend purely the truth, know that one truth cannot hurt or exclude another truth, andthat all truths may very well coexist. It may be true that anatomy, though it does not give the nature of the elementary composition of parts intrinsic and too minute for the human sense, since a new incision only presents a new surface, much conduces however to ground the student in mechanical principles of great assistence to him in practice, of which they are doubtless the most solid foundation: yet that truth is not incompatible with another quite as much a truth, that midwifery can have no occasion but for a general notion of the configuration of those parts upon which it is exercised. A midwife, for example, may be a very safe and a very good one, without knowing whether the uterus is a hollow muscle, or purely a tissue of membranes, arteries and veins: but if that ascertainment is necessary, she must wait for it till the anatomists have settled among them that point, which, like many other capital points of anatomy, is not however yet done. In short, once more, a woman in labor requires a midwife to lay her, not an anatomist to dissect her, or read lectures over the corpse, he will bemost likely to make of her, if he depends more on the refinements of anatomy, than on the dexterity of hand, and the suggestions of practical experience and common sense.
Ifthen, there are who can examine things fairly and with a sincere desire of determining according to the preponderance of reason, they cannot but on their own sense of nature, on their own feelings, in short, discern that no ignorance, of which the women are undistinguishingly taxed, can be an argument for the men’s supplanting them in the practice of midwifery, on the strength of that superiority of their learning, so rarely not perfectly superfluous, and often dangerous, if not even destructive both to mother and child. Consult nature, and her but too much despised oracle common sense; consult even the writings of the men-midwives themselves, and the resulting decision will be, that great reason there is to believe, that the operation of the men-practitioners and instrumentarians puts more women and infants to cruel and torturous deaths, in the few countries where they are received, than the ignorance of the midwivesin all those countries put together where the men-practitioners are not yet admitted, and where, for the good of mankind, it is to be hoped they never will.
I havehere said few countries have hitherto countenanced men-midwives. That I presume is too notorious to require proof: for even those Saracen or Arabian physicians, Avicen, Rhazes, &c. who, by the by, are little more than servile translators or copists of the Grecian ones, wrote only theoretically in quality of physicians; for it does not appear that they ever practised midwifery themselves, nor ever got the practice of it by men introduced into their countries. Among the Orientals there is no such being known as a man-midwife; that refinement of real barbarism, under the specious pretext of humanity, is happily unknown to them. But if it should be said, that the jealousy so constitutional to the inhabitants of the warmer climes, has a share in the exclusion of men-practitioners; the women have, at least in that point, a weakness to thank for its production to them of so great a good, as the greater safety of theirpersons and children, in that capital emergency of their lying-in. For, after all, the art of midwifery is, in the hands of men, like certain plants, which, by dint of a forcing culture, exhibit more of florish, or a broader expansion; but besides ever retaining a certain exotic appearance, they never come up to the virtue of those spontaneously growing in the full vigor of a soil of nature’s own choice for them. Art may often indeed improve nature, but can never be a supplement to her, where she is essentially wanting. Deep learning may, in very extraordinary cases perhaps, repair the errors, or assist the deficiencies of the manual function, but the deepest learning will never bestow the manual function, nor indeed can in the same person exist, but at the expence of the manual function, which must have been in some measure neglected for it. And yet the greatest practical skill that any man can with the utmost labor and experience acquire, will hardly ever equal the excellence in it of the women, Great Nature’s chosen instruments for this work: an excellence by them attained with scarce any learning atall, or at least of that abstruse theoretical sort, on which the men make their superiority principally depend.
Butthat I may not herein be taxed of maintaining any thing that has only the air of a paradox, or of begging the question, I shall implicitly, in the course of my answer to the following objection, endeavor to remove any remaining doubt on this head.
Inlike manner, as there are particular parts of the human body which have their appropriate undertakers or protectors under their proper distinctive names, as oculists, dentists, and corn-cutters, who by making respectively one part their particular care and study, arrive at a greater perfection, at least in the practical operations on it, than regular physicians or surgeons, whose object is the whole fabric; Why, by parity of reasoning, should not the men-practitioners in midwifery be preferable to the midwives, since a man hasto his manual function superadded a theory superior to that of the women, who, it is confessed, stand sometime in need of calling in the physician to their assistence? As a man then will have laid in a stock of medical knowledge, peculiarly adapted to the exigencies and disorders incident to women during their pregnancy and lying-in, he must consequently excel the midwife, or the physician singly considered; he who with so much greater convenience will have united in one person both their faculties, besides that of the surgeon.
Thatcertain parts of the human body enjoy the protection of practitioners, who respectively devote themselves to their service, I confess. Such appropriations may also be beneficial, at least, to the practitioners. I can even conceive, that a professed dentist may clean, scale, and draw teeth, or an oculist couch a cataract, better than either a physician or surgeon. These may in their respective practice be excelled by those partial artists. But Imuch doubt, even as to these, whether their trusting too much to that partial excellence, does not sometimes do more mischief than good, for want of duly consulting the relation of such parts to the universal fabric, of which physicians and surgeons must be so much better judges. Galen does not appear in contradiction to common sense, where he observes, that to rectify a disorder of the eye, the head must be rectified, which cannot well be done without rectifying the whole body. In confirmation of which, I once myself knew a gentleman, whom a professed oculist, at Paris, assured of the loss of his eyes being infallible; and who upon his despondingly consulting a regular physician, was by him as positively assured, that those very condemned eyes might be saved by a proper regimen. The gentleman happily believed him, and his eye-sight was not only saved, but perfectly restored.
Anotherinstance of the like nature occurs to me, which seems applicable to the dentist, and which I quote here from a translation of the learned and ingeniousDr. Huxham’s observations on the constitution of the air.
“Manyyears ago I knew a gentleman of a hale, robust habit of body, who, from being too much addicted to the drinking of brandy, fell into a violent jaundice, from which however he would have recovered well enough, would he have conformed himself to the advice of hisphysicians: but he on the contrary, because hisgumswere very apt to bleed, and histeethstunk from thescorbutic taint, put himself into the hands of an ignorantpretender to physic for the cure of these inconveniencies. This fellow immediately set aboutscaling his teeth, andrubbing his gumswithhis famous teeth-powder, till at last, by perpetually fretting and irritating the loose texture, he brought on such a hemorrhage, that baffled all the stiptics that could be invented by the most expert surgeons, and continuing to spout forth in small streams from the little arteries of the gums, which were now every where divided: in the space ofsixteen hoursthe poor mandiedthrough mere loss of blood.”
Theseinstances are however only adduced to justify that doubt which I expressed of these partial artists beingalwaysto be beneficially consulted in those local affections, to which their talent is supposed exclusively appropriated.
Corn-cutteris indeed a homely plain English term, but if the teeth give from the Latin the appellation of dentist, as the eye that of oculist, what name, taking it from thepartin question, will remain for that language, to give the men-practitioners of midwifery, in substitution to that hermaphrodite appellation, that absurd contradictory one in terms, ofman-midwife, or to that new-fangled wordaccoucheur, which is so rank and barefaced a gallicism? But let what name soever be given them, it can hardly be too burlesque an one, considering the gross revolting impropriety of men, addicting themselves to a profession naturally so little made for them.
Paintto yourself one of these sage deep-learnedCotts, dressed for proceedingto officiate[5], and presenting himself with his pocket-nightgown, or loose washing wrapper, a waistcoat without sleeves, and those of his shirt pinned up to the breasts of his waistcoat; add to this,[6]fingers, if which not the nicest paring the nailswill ever cure the stiffness and clumsiness; and you will hardly deny its being somewhat puzzling, the giving a name to such an heteroclite figure? Or rather can a too ludicrous one be assignedit?
Thosehowever who will consider this grave Doctor in his margery field-uniform, this ridiculous piece of mummery, in a light of seriousness, such as the matter perhaps more justly deserves, especially combining with all the rest, the idea of his crotchets, forceps, and the rest of his bag of instruments, may think he less resembles a priestess of Lucina, than the sacrificer, in a surplice, with his slaughtering-knife, to one of those heathen deities whose horrid worship required human victims, which the poor lying-in women but too nearly resemble.
Butwhether or not, in imitation of the dentist, or oculist, he receives his title from the particular part he has taken under his protection, so much is certain, that the same arguments, which militate for those partial artists claiming their respectivedepartments of the human body, will not avail the man-midwife. An oculist, a dentist, a corn-cutter, have no operations to perform but those of which disorders equally incident to both sexes are the object. There is nothing in their practice repugnant to the nature of the male-sex, nor to that reasonable decency, which only requires that no sacrifices of it should be made in vain, or at least not made to no better a purpose than to increase at once the danger and the pain of both mother and child, in whose favor it is sacrificed, as it may be clearly proved to be oftenest the case. But of the chirurgical part of the man-midwife’s pretention, I reserve to treat after considering him in the capacity of a physician; in which a man may indeed be wanted, but in that of surgeon never, or at least so very rarely, as not to atone for the dangers which attend the men forming themselves into a set under the name of men-midwives.
Wherethere is no complication of any collateral disorder with the gestation and parturition of women, it is even a jest for men to pretend the necessity of anystudy or practice to which women may not arrive, and even much excel them.
Butwhere there exists the case of a singular constitution, or of symptoms declarative of other help being necessary than just the common one, that quickness of discernment, that peculiar shrewdness of the women, in distinguishing what is relative to their art from what is foreign from it, gives them the alarm in time, and if they have a just sense of their duty, or but common sense, they must know that such disorders cannot bepartial, cannot therefore be considered as they are by the man-midwife, as subordinate to his particular province, relative as they are to the whole fabric or system. Allpartialpractice then is here absolutely out of the question, and now what help can, consistently with good sense, be expected from a man-midwife, who, under a natural impossibility of ever acquiring the female dexterity in the manual operation, cannot however, be supposed to attain even that imperfect degree of skill, without sacrificing to the endeavours at it the time and pains instudy and practice, which are requisite to form the able physician?
But, in fact, the men, that is to say, those of that sex who have the best understood all the refinements of anatomy, all the variety of female distempers, never that I can learn, attempted to invade the practical province of midwifery. The immortalHarvey,Sydenham, the greatBoerhave,Haller, and numbers of others who have written so usefully upon all the objects of midwifery, have never pretended or dropped a hint of the expedience of substituting men-midwives to the female ones. They contented themselves with lamenting the ignorance of some midwives, from which has been drawn a very just inference of the necessity of their being better instructed; but even those great men never chose the character of practitioners themselves, nor probably would have thought it any detraction from their merit to have it said, they might make a bad figure in the function of delivering a woman.
Whoeverthen will consider but how the common run of men-midwives actually are and must be formed, and assuredly the number of exceptions to the general insufficiency cannot oppose the inference, must allow that, where a woman has distempers collateral to her pregnancy, with which they must also become dangerously complicated, she must expose herself to the utmost hazard, in any confidence she may place in a man-midwife.
Thetruth is, that most of the dangerous lyings-in are so far from being likely to be relieved by a man-midwife, that it is often to the having relied upon his medical judgment, and especially to his manual skill they are owing. But of the first only it is we are now here speaking.
Thewomen captivated by that assiduity of the men-midwives, of which they only fail when they are not paid or likely to be paid, in some form or other, up to the value they set upon themselves, lightly take for granted, that, as men, they are alsocapable physicians. It is enough, in short, for these practitioners not to be women; for the women to think they can prescribe for them in all disorders. A mistake this, often big with the utmost danger to them.
Themen-midwives, in general, have never, at the most, carried their studies beyond the disorders commonly incident to pregnant women: the knowledge of all the other possibly collateral ones, is what even the least modest of them will hardly claim, unless to the profoundly ignorant, and is in fact scarce less than impossible to one who has applied himself essentially to the manual function. In such cases the ignorance of a midwife can hardly be greater than that of the men-practitioners, and must be less dangerous from her less of pretention. Her consciousness of her own want of sufficient light, will engage her readily to state the exigency to some able and experienced physician, whom she must allow, in such cases, to be her superior judge: whereas the other, the man-midwife, acknowledges no greater authority than that with which he is pleasedto invest himself. He stands, in virtue of a distinct business, and a business for which he never was made, of a sudden the self-constituted sovereign dictator and inspector-general of all female disorders whatsoever, where the woman is with child, that is to say, where the case is only thereby rendered much the more nice and difficult, and, not rarely, does he continue under the same pretext, to extend his practice to where there is no pregnancy at all in the case. And yet ask him for his titles, they are all implicitly dependent on or subordinate to that same midwifery, for which he is so naturally unqualified, even if a due study and exercise of it would permit those avocations, that would contribute to accomplish him in the so necessary general knowledge of physic. But indeed why need he acquire it, since it is so commonly taken for granted, or that he is believed upon his own word, especially if he is backed with a diploma, for form’s sake, that may have cost him little or nothing of medical study, or indeed of any thing but the amount of the fees for it?
Yethow serious, how important is it for women, if they tender their own lives, and that of the precious burthen of which they are the depositaries, to make that distinction between the physician and the midwife, which they seem so little to make! How little do they consider, what nevertheless is strictly true, that a man can never at the best be but an indifferent practitioner of midwifery, though he may be an excellent one in physic; but that as bad a midwife as he can be, he must be yet, if possible, a worse physician, if he attempts to throw both professions into one, and exercise them jointly! They are incompatible, from the justly presumable impossibility of one man doing justice to the practice of the one, unless at the expence of the study of the other: by which other, to obviate cavils, I repeat it, I mean the general practice of physic, which comprehends the speculative part of midwifery, as well as all other branches understood to be the province of the physician. This distinction then I make, because, as to the diseases purely incident topregnant women, experimental practice will rather assist the medical study of them: and it is in that part only the men-midwives can make any figure at all, and that not a superior one to midwives who are regularly bred, and who have, in their favor, their excellence in the manual function besides.
Oncemore, in complicated cases, the most dreadful mistakes are to be dreaded from those common-men-midwives, who so groundlessly erect themselves into physicians on those occasions. A purge, a venesection, or any other prescription injudiciously ordered, may be the occasion proximate or remote of death to both mother and child; yet a woman, at least,oughtnot to expect better from one of these practitioners who, for the most part, has neither study nor experience in general physic; nor more than a smattering of anatomy, joined to the index-learning of dispensatories. Such a man-midwife can never have thoroughly made himself master of the course of the fluids, nor of the order of their circulation. Their relationto the solids, and the efficacy of medicines upon both, can hardly be sufficiently known to a man, who must have been too much employed in trying to form a hand never to be formed, and in attendances on the practice of his midwifery, to acquire those collateral requisites for the effectual multiplication of his professions.
Yetthis man void of knowledge, experience, observation, and, in consequence, of physical ability, shall boldly decide on the expedience of an internal remedy, of which he does not know the power or operation; of a venesection, of which he can but guess at the consequence; and of a narcotic, of which he is unaware of the danger. In all which, observe, he may possibly sometimes be tolerably right, in cases where there isnocomplication; that is to say, in cases when a midwife, duly bred, is as sufficient as the best man-practitioner. But then she is moreover not only quicker of apprehension, as to danger, where the case appears complicated, but readier to call in proper help where she discerns it to be above her reach, and consequently above that of the man-midwife,who must be equally or rather more at a loss, because his boasted theory will serve only to puzzle him, or what is worse yet, since a shew must be made of doing something,willmost probably determine him improperly, if not fatally, to random prescriptions, in points out of his sphere of knowledge, or rote of practice.
Manya man who to-day undertakes prescribing for a fever, for a fit, a convulsion in a lying-in woman, only because he appears in the character of a man-midwife, would have been ashamed the day before he had taken up that business to give himself out for a physician. He would have been afraid of ordering any thing for her if she was not his patient, as to lying-in, and would not, even after assuming the profession of midwifery, perhaps order any thing for the same woman, out of the time in which his office is supposed necessary. This plainly proves, that many of those gentlemen are weak enough to imagine, that the man-midwife implies the physician, though the greatest physicians that ever were never dreamt of such an absurdity,as that the physician implied the midwife, whose master and instructor he rather is, in points highly useful indeed at times to her profession, but in which that profession does not consist.
I donot however chargeallthe men-midwives with so much modesty, as to confine their striking out of midwifery into physic, to the women lying-in, or to the time of their lying-in, since there have not been wanting some who, with equal ignorance, but superior effrontery, have intrepidly hoisted, the standard of a general knowledge of physic, and having originally insinuated themselves into families in the character of men-midwives, have easily maintained their ground in them afterwards on the foot of physicians. A circumstance not much to be wondered at, considering the endearment of such an office as that of a man-midwife, and the ascendant it must serve to give them over the heads of families, even in points where a midwife can have no shadow of pretention, for interfering. In the mean time, let any one of sense or common humanity consider but the consequencesof this dangerous admission of the sufficiency of a man-midwife in those complicated cases, which require the consultation of a regular physician; to say nothing, for the present, of the other objections already mentioned, or which I shall hereafter more at large discuss, and the result must be, to allow that the medical pretentions, or indeed any pretentions, of these men-practitioners, cannot be too much discouraged, nor confidence more misplaced than in them. For once that they may hit the mark by chance, they will often take the part of the distemper instead of that of the patient; they will do what they have only a gross guess of being the right, not what they know to be so: and physic, at best, but a conjectural science, must in them want even the common grounds of conjecture.
Insteadthen of the dangerous self-sufficiency of these complex smatterers, you have in a plain midwife, supposing her regularly bred, and duly qualified for her profession (for I am no more an advocate for ignorance in the women than in the men) one, who, being called in time, willduly consider, and observe the constitution of the person that wants her assistence. If nothing appears extraordinary, or out of the common-rules in her patient’s constitution and conformation, she needs only lay down for her the previous course of management, and as the hour of delivery approaches predispose her properly: a point in which the men must be grossly deficient, for want of that skill of prognostic inherent to the women, from their particular delicacy and shrewdness in thefaculty of touching; upon which more depends than can be well imagined. Wherever a case occurs to a midwife, so complicated as to be above her reach, her interest, her reputation, her duty, all conspire to prescribe to her a timely application to a regular physician. She communicates her doubts or difficulties to him, who, at the same time that he receives a just information from her of the state of things, combines it with his own knowledge of the human constitution. He does not confound, as the man-midwife does, ideas so different as those of the manual operation, and the medicinal prescription. The object of the physician, being the same as that of the midwife, the preventionor alleviation of pain to the mother, and the greatest safety to the mother and child, but preferentially that of the mother; there is this advantage to both mother and child, that all harshness of practice, all the violenter remedies will be as much corrected as can be done, consistent with the safety of mother and child, by the midwife’s tenderness, by which the physician will at the same time be above the being misled into omissions of any thing absolutely requisite. In short, on such occasions, they serve to temper one another. A truly great physician will not disdain the lights furnished him by her practical experience, and she knows the bounds of her mechanical duty and profession too well, to interfere with his superior intellectual province, in those points submitted to it. A pragmatical man-midwife, on the strength of his miserable half-learning, would think it a derogation from his character, to call in a physician in supplement to his deficiency, of which he is always ashamed, though indeed he has sometimes the excuse of himself not knowing it. Then when a fatal accident has happened, under his hands,against which, with more knowledge he might have guarded, or which with less of presumption or dependence on himself he might have prevented, by procuring previous or collateral advice; he thinks himself abundantly acquitted by laying the blame onoccult causes. Even the great man-midwife,Mauriceauhimself, has made use of that trite exploded apology[7]: where he expressly says, “that a sudden unexpected death of his patient was one of thoseFATALITIES, that not all the human prudence can prevent.”
Butthat I may not here incur the least charge of unfairness, as if I meant by this quotation any thing so absurd or unjust, as that in the labors of pregnant women, as well as in other diseases unconnected with them, there may not sometimes happen accidents impossible to be foreseen, as well under the care of the best physician, calledin by the very best midwife, as under the most ignorant assuming man-midwife, I shall here introduce another quotation from the sameLevret, that will especially shew the ladies, and all parties concerned, to what an imaginary safety, so much, and even the very point sought for, is sacrificed as is sacrificed, in preferring the men-practitioners to the midwives.[8]“M. de la Motte says, that for the fifth time he laid the wife of a glover of Valogne, the 16th of March, 1704; that the woman was but an hour in her labor-pains, and that he delivered her with all the facility imaginable; that he left her upon the couch till he had given her some broth, after which he recommended her to the care of the nurse, and wentwhere his business called him. He adds, that he had time but just to bleed two persons in the neighbourhood, before he was fetched away in haste to see the patient he had just laid, whom he founddeadupon the bed.The cause of thisdeathwas instantly manifest to him from the stream ofblood, which ran about the floor, and even penetrated to the apartment beneath, after soaking through the bed itself, in which there remained clots of blood of an extraordinary size.
“Thisauthor adds, in the reflexions at the end of this observation, that this delivery had been both more easy and more expeditious than any this woman had precedently had: and he notes, that thesemelancholic accidentsare notwithout example, since such ladies as the princess of ... and madam la Presidente de —— withnumbersofothers, have, on the like occasion, undergone the samefate, as her he here treats of. These are, according to him,proofsthat all human science and dexterityoftencannot prevent thelike misfortunes, since thesegreat ladieshad been lain by the mostcelebrated men-midwives.”
NowI might here, without much probability of being contradicted, aver, thatwhere such accidents, said to happen sofrequentlyand inevitably, should happen under the hands of midwives, there would be but one voice among the men-practitioners and their credulous adherents, to impute them to the ignorance and malpractice of the women. The plea ofoccult causeswould be hooted at in them, tho’ receivable, it seems, from the men.
Nothowever to imitate what I condemn in them, a gross want of candor to the women, of whom, by the by, the very best of the men-practitioners have learnt all the laudable part of practice, I shall allow that among those frequent examples, of sudden deaths upon delivery, some few might perhaps be of those unaccountable surprizes with which nature mocks human ignorance; but then it must be allowed too, that not all of them admit of that favorable solution. The truth is that nature, to those who have studied her course, and watched her motions with a due spirit of practical observation, hardly ever but gives warning enough to prepare proper obviative methods. It is not here the place to enter into the discussion of thosedeaths by sudden hemorrhage upon delivery, of which I shall hereafter attempt to give a more satisfactory account, as well as of the measures of prevention, than Levret. My end in the preceding quotation is to show;
First, that by the confession of the men-midwives themselves, the most fatal accidentsfrequently, andinevitablyhappen under them in spite of all theirscienceanddexterity!
Secondly, to offer to the reader a reflexion for himself to judge of the validity of it, to wit, that, not only in the cases of the hemorrhage, but in many others, where there is a complication of disorders with the state of pregnancy and parturition, much of the safety of mother and child must depend on that general medical knowledge, to which the men-midwives have so little grounds of pretention. Nor indeed, for the symptoms of necessity for resorting to medical help, have they the same shrewd prognostic or acute sense as the experienced women, who muchsooner perceive the danger before it is too late, and are neither with-held by a false shame, nor by a criminal or senseless presumption, from calling in proper assistence. Such at least has been and still is their practice in all ages, and in all countries, where the matters of pregnancy and lyings-in are committed to them. The great object of the man-midwife is to impose so false a notion on his patient, as that his partial knowledge is sufficient to every thing. The consequence of which is, that if he is not too officious, too pragmatical, by way of ostentation of his art, in common cases, that is to say, where there is no complication of disorders, every thing may pass off tolerable well, till the crisis of labor-pains. And in that crisis I defy him, with all his learning, to equal the female skill and cleverness, not only for lessening the sufferings of the patient, but for facilitating the happy issue of her burden.
Butwhere there is a complicated case, dependent on the physician’s art, then the trusting to those men-dabblers in midwifery is a folly that may be fatal to bothmother and child, or, at the best, the delivery will have been rendered more painful, more laborious, more big with danger, for those precautions having been neglected, which can be so little supposed to occur to the common run of men-midwives in cases foreign from their rote of practice. Yet it is precisely in those disorders collaterally contingent to pregnancy, and no disorder does that state exclude, that the greatest skill and knowledge of physic are required. Then it is, that not only the preservation of the mother claims regard, and certainly the preferable one, but even that of the child is no indifferent point. And to save both, the state of the mothers constitution must be carefully considered. Thus the combination of the disease with the pregnancy, the due regard to the mother as well as that to the child, form a triple object that takes in a compass of comprehension to which no midwife will pretend, nor can be imagined to exist in the mere man-practitioner of midwifery. Such a nicety of observation does not seem to be the province of a manual operator, and indeed useless to him in that character. And as he will be more likelyto trust to conjectures, which no sufficient grounds of study will have justified his presuming to trust, he must oftener take the part of the disease than of the patient. It is well if sometimes, disconcerted at the excess of a danger of which he does not understand the origin or nature, he does not, in default of the head, employ the hand, and engage the mother in a premature or forced delivery of the child, to the imminent hazard of the lives of both. Now comes the chirurgical operation in play; and we shall now see, that the ingraftment of the surgeon upon the midwife, deserves equally at least reprobation with that of the physician.
Butbefore I enter on this disquisition, I am to observe, that this objection to the surgeon’s commencing midwife, does not in the least attack the merit of that respectable body of men, the surgeons. No one can honor their profession more than I do: I even readily grant, that their skill in anatomy is of service to midwifery itself, into which it throws a great light. It would be easy for me to name, if requisite, severalsurgeons, who are not only an honor to their country, from their excellence in an art so beneficial to mankind, but an ornament to society, from their extensive humanity and charity. These, I am so far from thinking, will hold themselves honored by the men-midwives attempting to make a common-cause with them, that I rather depend on their bearing witness on the part of the women in this cause, which is indeed the cause of Nature, of that Nature which they study so practically, consequently so usefully, and with which they are so conversant. I am persuaded they can even furnish me with arguments, from their superior store of knowledge, in supplement to my deficiencies. The surgeons must look on these professors of midwifery as a kind of amphibious beings, hard to define, whose claim exhibits rather the deformity of a preternatural excrescence, or wen growing out of the chirurgical art, than the becomingness of a natural member of it. Most of the first founders of this new sect of instrumentarians in this country were, or I am greatly misinformed, neglected physicians, or surgeons without practice, who in supplement to theirrespective deficiencies, greedily snatched at the occasion at that time of a prevailing whim in France, of employing men-midwives, with just such a rage of fashion, as some of the ladies there prefer valet-de-chambres to waiting maids. This novelty then appeared to practitioners despairing of business enough in their own way, an excellent scheme for eking out their scanty cloth with this bit of a border, of which by degrees they have made to themselves a whole cloak. In short novelty joined, to the much exagerated objections to perhaps a few insufficient midwives, brought in and established a remedy yet worse than the disease. Their success encouraged others; and now behold swarms of pupils pullulating, and forming on the models before-mentioned. Thus two or three maggots have produced thousands. Iron and steel are not tender: and yet it was by the pretended necessity of resorting to instruments made of these metals, that these out-casts of either profession effectuated their introduction into a business so little made for them. Then it was, that not with the least squinting view to filthy lucre, but purely out of stark love andkindness to the women, that these redressers of wrongs, armed with their crotchets, and other weapons of death, took the field on the hardy adventure of rescuing the fair sex out of the dreadful hands of the ignorant midwives. But as to the validity of that plea of theirs, of the necessity of employing instruments, I reserve to treat of it at large in its place in my second part.
HereI shall only request the reader to remember, what has been said of the indecent, superficial, and even cruel method of training up pupils in this upstart profession. But if I was to add here my having been credibly informed, that there are novices who watch the distresses of poor pregnant women, even in private lodgings, where, under a notion of learning the business, they make those poor wretches, hired for their purpose, undergo the most inhuman vexation, in a condition so fit to inspire compassion, and where those scenes must be rather a school of brutality than of art: if I was to urge, what from the great probability of the thing I firmly believe, that more than one unhappy creaturehas fallen a victim to the rudiments of these novices; that especially not long ago, one of them in a hurry and confusion of presumption and ignorance, instead of the after-birth from a woman, tore away, by mistake, her womb itself, which occasioned, of all necessity, the poor creature’s dying in unutterable agonies of torture: if I was yet to go farther and assert, that even not one of the least eminent men-midwives pulled off the arms of a child in his attempt to extract it, and very gravely laid them upon the table; what would be replied to me? It would be said I had invented these horrors, or forged such raw-head and bloody-bones stories, purely in favour of my own cause. And to this objection, while I produce no proof, and for my producing no proof other reasons may be obviously assigned, besides that of those cases being non-existent, some of which I am very certain are true, and firmly believe all the rest; to this objection then I say, I make no reply. The reader, who will have considered this matter, may easily decide within himself the degree of probability in such allegations. But what objection will stand good against authoritiesof reasonings and facts, produced from the writings of themen-midwivesthemselves? Will they be suspected of partiality or aggravation of things against themselves?