G66 PARTURITION. 
of fmall forceps, and cut with a (harp knife ; then the per¬ 
foration may be dilated with the fingers, fo as to effedl a 
fufficient opening for the paffage of the child. 
The next confiderable author on this fubjedf, is Paulus 
Algineta, whom Le Clerc fuppofes to have lived in the 
latter end of the fourth century ; though Dr. Freind brings 
him down to the feventh ; he was the laft of the old 
Greek medical writers. His method of practice is much 
the fame with that of ALtius and Philumenus, as above 
defcribed; and, though not fo full as they, he is very 
diltinft and particular. He tells us in his preface, that 
he had colledied from others; and, although he was the 
firft who had the name of man-midwife from the Arabians, 
the writings of ^SEtius plainly fhow, that there had been 
many male practitioners before him. In the feventy-fixth 
chapter of his third book, which treats of difficult births, 
lie gives the appellation of natural to all thofe in which 
the head or feet prefent; and all other pofitions he deems 
prseternatural. Paulus is fuppofed to have ftudied at 
Alexandria : for, long before his time, the Roman empire 
in the weft had been overrun and ruined by the Goths and 
Vandals; and, foon after this period, learning began to 
decline in the eaft; the fchools of Alexandria were re¬ 
moved to Antioch and Haran by the Saracens, who fub- 
dued Egypt, and deftroyed the Roman empire in Alia, 
and then the Greek phyficians were t ran (la ted into the 
Syriac and Arabic: at leaft, the Arabians copied front 
them. This fubjedt is fully difcuffed by Dr. Freind, in 
his Hiftory of Phyfic. 
Serapion, one of the firft Arabian writers, in his Trac- 
tatus Quintus has feveral chapters on the difeafes of preg¬ 
nant women, with the method of cure. 
The next author of any note, belonging to this coun¬ 
try, was Rhazes ; who, in the latter end of the ninth cen¬ 
tury, lived at Bagdat. Like other fyftematic writers in 
phyfic, he hath treated of the difeafes of women ; and 
written one book exprefsly on the difeafes of children. 
In the laft chapter of his Liber Divifionum, he orders the 
membranes, when they are too tough, to be pierced with 
the nail of the finger, or with a little knife-: and, if the 
waters are difcharged a long time before delivery, fo 
that the parts remain dry, he diredts us to anoint them 
with oily cerates. 
Avicenna lived at Ifpahan about the year 1000 ; and 
was fo famous for his writings all oyer Alia and Europe, 
that no other doctrine was taught in the fchools of phy¬ 
fic, till the reftoration of learning. He is a voluminous 
author, treats largely of every part of midwifery, fo far 
as it was known in his time ; copying from thofe that 
went before him : the operation for the dead child he 
takes from Paulus ; the extraction of the fecundines 
from Philumenus; and the ufe of the fillet from his 
countryman Rhazes. He is very full on all the difeafes 
of women, relating to the menfes, uterine geftation, and 
delivery. In all preternatural cafes, he fays, the head 
ought to be reduced into the natural pofition ; but, fhould 
this be found impracticable, he advifes us to deliver by 
the feet. He alleges, that the head is the only natural 
way of prefenting, and that all other pofitions are pre¬ 
ternatural ; though of thefe, the eafieft is when the fcetus 
prefents with the feet. 
The next Arabian medical writer is Albucafis, who, 
in the eleventh or twelfth century, lived at Cyropolis, a 
city of Media, on the Cafpian Sea; and it appears from 
an Arabian manufcript, in the Bodleian library, that 
this is the fame perfon who was all’o known by the name 
of Alfaharavius. He has written on natural labours in 
the fame way with his predeceffors, adviling us to afiift 
the birth with fomentations and ointments, and by re¬ 
ducing the child into the natural pofition, when any 
other part than the head prefents. His operation for ex¬ 
tracting the dead child is literally the fame with that de¬ 
fcribed by 4£tius ; but whether he copied it from that 
author, or from other Arabians his predeceffors, is un¬ 
certain. 
. What is moft particular in this author is, the defcrip- 
tions and figures of the inftruments then ufed in mid¬ 
wifery : namely, a vertigo for opening the matrix, which 
feems to be much of the fame contrivance with that 
which Rhazes calls the torculum volvens: he likewife 
exhibits the figures of two other inftruments for the 
fame purpofe ; but not one of the three in the leaft re- 
fembles the fpeculum matricis, defcribed in later writers : 
an impellens, to keep up the body of the child while the 
operator endeavours to reduce the head into the natural 
pofition : two kinds of forceps, of a circular form, fur- 
niftied with teeth on the infide, to fqueeze and cruftt the 
head, when it is of an extraordinary bignefs ; the larger 
he calls almifdach, the other mifdach; and two different 
kinds of crotchets. 
After the twelfth century, phyfic began to decline in 
Alia. Theodore Gaza brought the Greek manufcripts 
from Conftantinople, after that city was taken in the 
year 14.53 ; and about this time, the art of printing being 
found out, all the knowledge of the ancients was foon 
difperfed over Europe. In the next century, the prac¬ 
tice of phyfic began to be encouraged in England. Li- 
nacre, born at Canterbury, and chofen fellow of All¬ 
fouls, in Oxford, in the year 14.84, was a man of learn¬ 
ing, and projedied the foundation of the college of phy¬ 
ficians in London; for which he obtained a patent from 
king Henry VIII. and was himfelf prefident of it till the 
day of his death. 
But the ftudy of the art of parturition, though it now 
began to be cultivated with fome fuccefs, continued in 
a very rude ftate till the 17th century; and, even after 
phyfic and furgery had become diftindt profeftions, it 
remained almoft totally uncultivated. 
“ It is a curious fail, (fays the editor of the Encyclo¬ 
pedia Britannica,) that in the empire of China the very 
reverfe of this has taken place. In that empire, accord¬ 
ing to the lateft accounts, both phyfic and furgery are 
ftill in a ftate of the utmoft degradation, even more fo 
than among the favages of America; but for fome hun¬ 
dred years the art of midwifery has been pradlifed by a 
fet of men deftined to the purpofe by order of govern¬ 
ment. Thefe men, who hold in fociety the fame rank 
which lithotomifts did in this country about the be¬ 
ginning of laft century, are called in whenever a woman 
has been above a certain number of hours in labour, and 
employ a mechanical contrivance for completing the de¬ 
livery without injury to the infant. A certain number 
of fuch individuals is allotted to each diftridt of a certain 
population. 
“ Both fir George Staunton and Mr. Barrow were 
ignorant of this fadt; and the latter in particular ex¬ 
prefsly mentions, that there are no men-midwives in 
China. But the writer of this article had his informa¬ 
tion from a more authentic fource than the works of 
gentlemen who were only a few months in that coun¬ 
try, and were in a great meafure treated as ftate-pri- 
foners. He has it, through the medium of a friend, 
from a gentleman who relided upwards of twenty years 
as furgeon to the Britilh fadtory at Canton, and who 
had both the ability and the inclination to learn, during 
the courfe of fo long a refidence, all the cuftoms and pre¬ 
judices of the natives relating to the prefervation of 
human health.” 
Towards the end of the 16th century, the fame caufes 
which had fo long before led to the cultivation of mid¬ 
wifery in China produced the fame effedts in Europe. 
The dangers to which women are fometimes expofed 
during labour excited the compaflion of the benevolent; 
fo that a confiderable part of the firft hofpital which was 
eftabliflied for the reception of the indigent fick, the 
Hotel Dieu of Paris, was appropriated to lying-in women. 
The opportunities of pradtice which that hofpital 
afforded, diredted the attention of medical men to the 
numerous accidents which happen during labour, and to 
the various difeafes which occur after delivery. Public 
teaching 
