670 
PARTURITION. 
a ward or ftnall hofpital in the parochial infirmary of St. 
James, Weftminfter, for the reception of parturient wo¬ 
men, which was the firft thing of the kind in the Britifh 
dominions. At this ward, which was fupported by pub¬ 
lic fubfcription, he gave lectures, and the ftudents had 
opportunities of being qualified for practice. He pub- 
lifhed a Compendium Artis obftetriciae ; a Treatife on the 
Febricula; on the Ufe and Abufe of Phyfick; Aphorif- 
mata Medica; and many other eflays, relating chiefly to 
the practice of midwifery. Sir Richard Manningham was 
a man of much learning and information, eminent and 
fuccefsful in practice, and very humane in the exercife of 
his art. He died about the year 1750. 
Heifler, profeflor at Helmftadt, a little town in the 
dukedom of Brunfwick, in the year 1739 publifhed at 
Amlterdam a Treatife on Surgery; in which we find a 
very concifeand diftinCt account of the practice of mid¬ 
wifery, as well as of the Casfarian operation. 
Sir Fielding Ould, furgeon in Dublin, in the year 
1742 publifhed a Treatife on the Practice of Midwifery, 
in which there are two good obfervations : one relating to 
a cafe in which the head prefents ; and the other fpecify- 
ing what is to be done, when delivery is retarded by the 
tvvifting of the funis round the neck of the child. He 
prefers his terebra occulta to the fciflors, probably be- 
caufehe did not know the proper dimenfions of this laft 
inftrument. The very next year, Monf. Mefnard pub¬ 
lished, at Paris, a book on the fame fubjeCl, by way of 
queftion and anfwer; and is the firft who contrived the 
curved in lieu of the ftraight crotchet, which is a real 
improvement. 
Practitioners in the art being now poflefled of fuch 
powerful afliftants as the forceps and crotchet, it was to 
be feared they might be induced to have recourfe to them 
for the purpofe of accelerating the labour in cafes where 
there were only fuch obftacles as in a moderate fpace of 
time would be overcome by the pains. Cautions againft 
this fafcinating practice are found in all the late treatifes 
on the art. Smellie, who had a larger fhare of practice, 
and who inftruCted a greater number of pupils, than any 
other profeflor in his time, is frequent in his admonitions 
againli uling art, other than in aid of nature, where (he 
is abfolutely and decidedly incompetent to the comple¬ 
tion of the labour. How feldom alfo this happens, he is 
careful to inform them. He very much Amplified the 
form of the forceps ; and, that they might not be ufed 
before the head of the child had defcended fufliciently 
low in the pelvis, he confiderably reduced them in length ; 
he alfo contrived a method of locking them, much more 
convenient than had been before ufed. Before he re¬ 
tired from the pra&ice, in which he introduced feveral 
valuable improvements, he publifhed, in 1752, “ A 
Treatife on the Theory and Practice of Midwifery,” 
which contained the fubftance of every thing that was 
xtfeful, that had been printed on the fubjeCl, as well as 
the refult of his own extenfive practice. This was fol¬ 
lowed by a fet of plates, in large folio, correctly drawn 
and well engraved, illuftrating his pra&ice. Soon after 
he publifhed two volumes of cafes, arranged in clafl'es, 
referring to his treatife, and (flowing the e’fficacy of the 
rules he had there inculcated. The advice with which 
he concludes the Introduction to his Treatife on Mid¬ 
wifery, is very much to our prelent purpofe. 
“That the young practitioner may not be milled by 
the ufelefs theories and uncertain conjectures of both 
ancient and modern writers, it is neceffary to obferve in 
general, that all the hypothefes hitherto efpoufed are 
liable to many material objections; and that almoft every 
fyfl.em hath been overthrown by that which followed it. 
This will probably be always the cafe; and indeed, 
as theory is of but little fervice towards afcertaining the 
diagnoftics and cure of difeafes, or improving the prac¬ 
tice of midwifery, fuch enquiries are the lefs material. 
What Hippocrates has written about the form of the 
uterus, and its various motions, conception, the forma¬ 
tion of the child, the feventh and eighth months’ births, 
was believed as infallible till the laft century, when his 
doCtrine of conception, and the nutrition of the foetus, 
was overthrowm ; and many new and uncertain theories, 
on the famefubjeCt, introduced. 
“ Some of the moderns conclude, that the ancients 
never turned and brought children by the feet, becaufe 
Hippocrates direfts us in all cafes to bring the head into 
the natural fituation ; and fays that, when delivery is 
performed by the feet, both mother and child are in im¬ 
minent danger. Celfus, and all the writers till the time 
of Ambrofe Pare, adopted this practice of bringing the 
head to prefent: but, at the fame time, many of them 
obferve, that, if this be not practicable, we mull fearch 
for the feet, and deliver the fcetus in that manner. 
Celfus fays, if the feet are at hand, the child is eafily de¬ 
livered footling: and Philumenus goes dill farther, fay¬ 
ing, that if even the head fliould prefent, and the child 
cannot be delivered in that pofition, we muft turn and 
bring it by the feet. 
“ With regard to the fillets and forceps, they have been 
alleged to be late inventions; yet we find Avicenna re¬ 
commending the ufe of both : and although, by the 
figures of the forceps given by Albucafis, who reprefents 
< them furnifhed with long lharp teeth, one would imagine 
the inftrument was defigned for fqueezing the bones and 
bringing the child along at any rate, without endeavour¬ 
ing to fave its life, yet the forceps recommended by Avi¬ 
cenna is plainly intended to fave the fcetus ; for he fays, 
if it cannot be extracted by this inftrument, the head 
muft be opened, and the fame method ufed which he 
defcribes in his chapter on the delivery of dead chil¬ 
dren. 
“ To conclude, we find among the ancients feveral va¬ 
luable jewels, buried under the rubbifh of ignorance and 
fuperftition ; becaufe the affiftance of men was feldom fo- 
licited in cafes of midw’ifery, till the laft extremity : and, 
thofe difadvantages being confidered, we ought to be 
furprifed at finding fo many excellent obfervations in the 
courfe of their practice, and be afliamed of ourfelves for 
the little improvement we have made in fo many centu¬ 
ries, notwithftanding our opportunities, and the advan¬ 
tages we had from their experience.” 
While Smellie was making large ftrides toward impro¬ 
ving every part of the practice of midwifery, and bringing 
it to perfection, Levret, and various other writers on the 
continent, were exerting themfelves in a fimilar manner, 
and with perhaps equal felicity. In the mean while, 
hofpitals and other inftitutions were formed, for the re¬ 
ception of parturient women. As the management and 
care of thefe were under the immediate direction of the 
phyficians and furgeons, and the opportunity which for 
fo many ages had been wanting, of acquiring an exaCt 
knowledge of the procefs of a natural labour, and of the 
obftacles that occafionally obftruCted its progrefs and 
completion, was now obtained. To this alfo, the change 
that had been taking place, within fomething more than 
a century, in the opinions and manners of the public, 
had contributed. Several phyficians and furgeons had, 
in the courfe of that time, applied themfelves to the prac¬ 
tice of midwifery. Hence we find Mauriceau, Deventer, 
Ruyfch, Roonhuyfen, our countryman Dr. Chatnberlen, 
and others, enjoying a confiderable portion of practice in 
the art. 
The cuftom of employing men in the place of women, 
originated among the ladies of the higheft rank in France, 
and gradually defcended to the middling and lower clafles 
of the people. The advantages derived from the change, 
both in the manner of conducting the labour, and in the 
management of the woman and child after the labour, 
became fo obvious, that thepraCrice has by degrees fpread 
over all Europe. That the poor who could not, and a 
few who from prejudice (till refufed to, employ men, 
might reap the benefit of the improvements that have 
been made in the practice of the art, no women are now 
allowed 
