MISS ALICE GREGORY'S PAPER 275 



comes away stunned and silenced by the unfathom- 

 able depths of her ignorance, walled in and preserved 

 inviolate as it is by the high walls of complete self- 

 satisfaction. 



I propose to-day to deal with the subject more 

 technically than is usual in a mixed audience, that 

 I may elucidate the fundamental errors in this view, 

 a very common one, of successful midwifery. 



In the first place a midwife succeeds or not in 

 proportion to the difficulties she prevents, not those 

 she attends. In a large training school one does of 

 necessity meet with many abnormalities ; patients who 

 have declined to follow out their treatment, or to 

 report themselves periodically, as desired ; patients 

 who have booked at the last moment, or who have 

 arrived as emergency cases, without booking at all ; 

 patients whose symptoms have been so masked that 

 they have escaped the trained observation of the 

 matron or house-surgeon who booked them. There 

 are, I deeply grieve to say, even yet a few training 

 schools where this observation is never exercised, 

 where the patients merely give in their names, 

 addresses, and the number of their family, to some 

 clerk or secretary, but where no details are ascertained 

 as to their health or stature. 



In such schools I do not question the pupils will 

 see a splendid lot of abnormalities, if it is indeed 

 splendid to see a mother stiff and foaming in an 

 eclamptic fit, or straining in the most hideous torture 

 to expel a large child through a distorted pelvis, and 

 to know that if she lives through it herself the chances 

 are 100 to i against the survival of the infant. 



It is of all things important that a midwife should 

 learn, both theoretically and practically, how to 

 diagnose the dangers which threaten both mother 

 and child during pregnancy. She must be taught 

 during her training, if she is to carry it out in her 

 own practice, to test for albumen in the case of every 



