246 CALDERON. 



and direct the education of these ignorant women into new channels, 

 overthrowing routine customs and traditional means, many of which 

 I shall briefly discuss in this analytical study of obstetrics in the 

 Philippines. 



EARLY SUPERSTITIONS. 



During many centuries the mission of assisting in childbirth was 

 confined exclusively to niidwives, who were the oldest women of the 

 community in which they resided and who, taught by their own personal 

 experience, advised and aided the young and inexpert. A certain number 

 of precepts acquired by experience and observation, and a still larger 

 number of individual practices and superstitions, represented the whole 

 fund of knowledge employed in difficult eases. These midwives, who in 

 primitive times existed in all countries, are still known in the Philip- 

 pines by the name of hilot, a Tagalog word which has come clown to us 

 through many generations, in the same manner as the term salag, by 

 which is known the person who assists the hilot in her empirical 

 manipulations. 



The conjunction of the moon, the appearance of comets, the flow and 

 ebb of the tides, the direction of the winds and the influence of heat and 

 cold were, for the hilot and sal'ags, the etiologic agents which decided the 

 development of pregnancy, or the evolution and progress of childbirth. 



In view of such prejudices, it is not surprising that even in the most 

 aggravated cases of dystocia, the unfortunate patient was abandoned to 

 the sole efforts of nature, any rational intervention for saving her from 

 certain death being absolutely unknown. Failure was attributed by the 

 midwife to the fatal influence of the asuang, a malignant spirit which, 

 according to the common peojue, lies in wait for pregnant women and, at 

 the moment of labor, penetrates into the uterus to devour the foetus; just 

 as another spirit called patianac, in the shape of a strange animal, intro- 

 duces itself into the genitals of pregnant women in order to devour the 

 jwoduct of conception. The influence of the patianac was to the midwife 

 the logical explanation of the pathologic phenomena of pregnancy, which 

 we now know as abortion, expulsion of a macerated foetus, uterine mole, 

 placenta pravia, etc. In my opinion, these superstitions have their 

 origin in the ancient beliefs of paganism predominating in the Philippine 

 Islands before the arrival of the Spaniards, and they gained such a hold 

 on the minds of the people that thej' are still preserved latent in some 

 parts of the Archipelago, and have on some occasions given rise to 

 barbarous practices and manipulations which are an outrage to civiliza- 

 tion and which have cost the lives of many women in childbirth. 



While I was an interne in the San Juan de Dios Hospital in the 

 year 1889, I performed an autopsy on a poor woman who had died in the 

 district of Ton do because a quack had barbarously beaten her with the 



