238 



MIDWIFERY. 



History, in ancient and modern language the appellation of the 

 "'~i~* " practitioner is always feminine, with the exception of 

 the French term accoucheur. 



By the Roman law, midwives were recognised as a 

 distinct class in society, and partook of certain immu- 

 nities and advantages in common with medical practi- 

 tioners. At the present time, in several continental 

 countries, no one can practice midwifery without a li- 

 cense ; but in Britain it is otherwise, as every one who 

 chooses to run the risk incurred by common law for 

 the fruits of ignorance, may practice as a midwife. 

 With regard to accoucheurs, they stand in this pecu- 

 liar state, that they sometimes are considered as belong- 

 ing to medicine, and sometimes to surgery. With the 

 exception of a temporary measure adopted by the Col- 

 lege of Physicians in London, no public body has issued 

 distinct licenses to male practitioners. In some Ger- 

 man universities, it is explicitly attached to the united 

 degree of doctor of medicine and surgery. In others, 

 it seems indifferently to belong to the doctor of medi- 

 cine or master of surgery. In the university of Glas- 

 gow, the only one in Britain which confers surgical de- 

 grees, the right to practice midwifery is included in 

 the degree of magister chirurgise. 



Historical Sketch of the Progress of Midwifery. 



History of I* would be quite impossible, in a work of this kind, 

 midwifery, to trace the history of midwifery minutely through 

 every individual who has written on the subject, from 

 Hippocrates downwards. Even to a medical reader, 

 this would ba more a matter of curiosity than utility. 

 It appears from the early writers whose works we pos- 

 sess, that in natural labour the patient was placed on a 

 particular kind of seat or stool, and the process of deli- 

 very conducted altogether by the midwife, who, we 

 may presume, from little being said of her duty, had no 

 very difficult office to perform. It was only in cases of 

 protracted labour, or in those where the child could 

 not be born, either on account of its position, or size 

 compared with the pelvis, that the male practitioner 

 was called ; and at this place it may be observed, that 

 Paulus Paulus jEgineta, in the 7th century, seems to be the 

 jEgineta. first who was styled a man midwife. The practice 

 adopted in such cases, no doubt varied a little at differ- 

 ent times, and in different hands ; but the general 

 principles of conduct were not much diversified, and 

 may be learned by consulting the works of ^Etius, Al- 

 bucasis, and Avicenna. In tedious labour, the effect of 

 concussion was sometimes tried to promote delivery ; 

 but it was more common to employ means for produ- 

 cing relaxation, such as emollient applications, and even 

 the warm bath. Blood-letting, so useful in many cases 

 of tedious labour, was strongly recommended by Hip- 

 pocrates ; and it is much to be regretted, that his au- 

 thority in this respect has been so long slighted by 

 the moderns. Those, on the other hand, who seemed 

 to be too much enfeebled, were ordered to be sprinkled 

 with vinegar, or to sit over vapours supposed to have 

 a strengthening quality. 



In preternatural positions, the presentation ivas either 

 pushed back, and the head made to come forward ; or 

 the protruding member was twisted off, and the child 

 pulled away piecemeal. When the head was large, or 

 the pelvis small, various modes were adopted. The 

 head, by some, was pushed back, if not impacted, and 

 the child turned, so as to allow the practitioner to de- 

 liver by the feet. This continued long to be the re- 

 source in all cases where it was practicable, as there 

 was thus a possibility of saving the child. But if the 



obstacle were considerable, the infant always perished, History, 

 and, in many cases, the body wasactually torn awayfrom' * *~*~** 

 the head. This accident in aftertimes gave rise to diffe- 

 rent contrivances for extricating the head which thus re- 

 mained in the uterus. Other practitioners, at a very early 

 date, endeavoured to deliver the child by fixing a fillet or 

 band around the head, thereby becoming able to pull 

 it down. In a greater number of instances, however, 

 they accomplished delivery by opening the head, or 

 fixing a hook or crotchet into it, or squeezing it in for- 

 ceps furnished with teeth. 



From the seventh down to the sixteenth century, va- 

 rious writers are to be met with, but little improvement 

 is to be found in the art. The most popular work in 

 the sixteenth century, was published originally in Ger- 

 man by Eucharius Roesslin, commonly called Rhodion. 

 This, which was entitled the Garden of Lying-in Wo- 

 men and Midnives, was translated into Latin and all 

 the modern languages, and became the code of instruc- 

 tion for midwives. It was not pos&ible for rapid im- 

 provement to be made, the women could not go be- 

 yond their teachers, and their teachers had few means 

 of instructing themselves by actual practice. Dr. Veit, 

 in 1522, was publicly branded in Hamburgh, for hav- 

 ing been present at a delivery under the, disguise of a 

 midwife. 



In the sixteenth century, when little originality was Ambrose 

 to be met with, Ambrose Pare formed an exception to Pare, 

 the general character of the age ; and it is this circum- 

 stance which has made him stand higher in public esti- 

 mation than his real merits deserve. Yet it is far from 

 the intention of the writer of this article to detract from 

 his claim ; for surely the man, who, in an age of dark- 

 ness and servitude, can to any degree desert the beaten 

 path for a better way, is entitled to more praise than th 

 author of a brilliant system in a period enlightened by 

 science and philosophy. Pare was the best surgeon of 

 his day, and his book, in many respects, bears the same 

 relation to medical details that Froissart's chronicle does 

 to a dry history. His obstetrical directions are to be 

 found in his general work, but came again before the 

 public in a separate form by his pupil Guillimeau. This g u j]][. 

 contained a view of all that was known at the time ; nreau. 

 but its chief merit, and the ground of Pare's obstetric 

 reputation, is the rule, which he rendered nearly abso- 

 lute, in all preternatural labours to turn the child, and 

 deliver by the feet. This work was succeeded, in 1G6'8, 

 by a system of F. Mauriceau, who not only had much Mauriceau. 

 private experience, but opportunity of improvement in 

 the Hotel Dieu, part of which by tin's time had been 

 appropriated to lying-in women, and is to be consider- 

 ed the first establishment of the kind in Europe. His 

 book is not only worthy of notice from its merit, con- 

 sidering the time when it appeared, but also from the 

 English translation by Dr. Chamberlain, containing an Chamber- 

 intimation in the preface that his father, himself, and lain, 

 his brother, possessed a mean of delivering women in 

 difficult labour in a way compatible with the safety of 

 the child. How long his father or the family had pos- 

 sessed the secret is not known, but the first public in- 

 timation is given in the preface alluded to, which ap- 

 peared in 1672. Before this he had gone over to Paris 

 with the intention of selling his secret, but imprudent- 

 ly boasted that he could deliver safely a woman whom 

 Mauriceau had declared could not be saved otherwise 

 than by the Cesarean operation. The result of his 

 trial, in this case, was such as might have been expect- 

 ed, and, instead of selling his secret, he, by promising 

 too much, lost his reputation, and with empty pockets 

 returned to England. Next he went to Holland, where 



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