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"It would be absurd to suppose that the cases of sudden death from chloroform const.i.tute the full measure of the mortality. How few even of these are generally known or reported. Hardly any in private practice; and now, even in hospitals, they are concealed. It is well known to the frequenters of the London hospitals, that, in the same week in which the recent death from chloroform at St. Thomas's occurred, another took place in another hospital, but which did not become the subject of judicial inquiry. Humanity, and the character of the profession, demand that the whole subject should be investigated anew."--_Medical Times and Gazette._
[36] Roussel, page 177, de la Grossesse.
[37] Maladies des Femmes, t. v., p. 375.
[38] Roussel, de l'Accouchement Naturel, page 208.
[39] "It is a common notion, that the brute enjoys great advantages, compared with woman, in the act of parturition, from the position and configuration of its pelvis. Is not this groundless? In the first place it is said that the oblique axis of the brim, in woman, is less favourable to the descent of the foetal head than the axis of the brim in the brute, which is parallel with the spine. But the physiologist knows, that ordinarily in woman, just before the commencement of the labour pains, the uterus slowly, and without pain, descends by a mechanism, which Sir C.
Bell has so beautifully described in his memoir on the muscularity of that organ; and that thus a small segment of the foetal head becomes engaged in the brim, and in the position most favourable for pa.s.sing, before the uterine pains commence. The truth is, the obliquity of the axis of the brim is, in general, _no disadvantage or impediment whatever_. In the second place, it is urged, that the great size of the human foetal head occasions incomparably more difficulty than the sharp-pointed, small head of the brute foetus. For this there is equally no foundation. The size and figure of the human brim are as well fitted to give pa.s.sage to the large head of the child, as the brim of the brute pelvis to allow the entrance of the comparatively smaller head of the foetal brute, &c., &c.
Still looking at the figure of the human foetus, and comparing it with that of the foetal brute, some may be inclined to imagine, notwithstanding what has been said, that the brute will pa.s.s with far greater facility than the child; such was my own opinion till I subjected the point to the test of experiment. We are not to think, but to try, as John Hunter advises," &c.--_Roberton, Physiology, &c._, p. 247.
[40] _L'Histoire General des Voyages._
[41] "During pregnancy the squaw continues her usual avocations, and, even in its most advanced state, she neither bears a lighter burthen on her back, nor walks a shorter distance in a day, than she otherwise would. If on a march she feels the pains of parturition, she retires to the bushes, throws her burthen from her back, and, without any aid, brings the infant into the world. After was.h.i.+ng in water, if at hand, or in melted snow, both herself and the infant, she immediately replaces the burthen upon her back (weighing, perhaps, between sixty and one hundred pounds), secures her child upon the top of it, protected from the cold by an envelope of bison robe, and thus hurries on to overtake her companions."--_James'
Narrative of Expedition from Pittsburgh to the Rocky Mountains._
[42] "The Samoides are a tawny, squat, miserable race of pagan savages, subjects of the Russian empire. They are found along the Frozen Sea, on the European side of the Jugorian Mountains, east of these on the River Oby, and elsewhere on the vast sh.o.r.es of Siberia. According to Tooke, they are mature at a very early age," &c.--_Roberton_, quoting _Tooke's Russian Empire_, vol. ii. p. 286.
[43] "The truth is, that when the pregnant will submit to prepare themselves for what is before them, will be temperate in their eating, regular in their hours for sleep, and for exercise daily in the open air, a considerable proportion may secure benign labours. It is the sedentary and luxurious who oftenest suffer severely in parturition," &c.
&c.--_Roberton's Notes on Pregnancy_, p. 460.
[44] Roberton has a remark to the same effect.
[45] "The beasts ca't manipulated."--_Shepherd on the Phrenologists, Noctes Ambrosianiae_, vol. ii. p. 21.
[46] "The calling of 'accoucheur' does not appertain to men. It is with them nothing but a usurpation, or a rash experiment, founded upon the timidity of women, who believe that, by this unworthy submission, they insure their lives; and upon the credulity of husbands, who, by this dangerous condescension, imagine that they more surely preserve their wives."--_Hecquet, De l'Indecence aux Hommes d'accoucher les Femmes_, page 9.
[47]
"Ubi non est mulier, ibi ingemiscit aeger."
Where woman is not, there the sick man groans.
[48] "At the time when this work was published, there had appeared a catechism, in which M. Dufot, a physician, who was the author of it, proposed to himself to instruct the midwives in the country, and he set forth in a manner clear, exact, and perspicuous, the principles of the art of midwifery. It would be desirable that these ideas, which are sufficient for their purpose, should be disseminated; they would prepare the public to do without the help of men in an office where their agency seems necessarily to compromise morals. This object, to which some men only gave the attention which it deserved, is doubtless the one which has urged some intendants to occupy themselves in the instruction of midwives. We learn from the _Gazette de France_, of 25th September, 1776, that the dame Ducoudrai, commissioned and pensioned by his Majesty, had, by the care of M. Fontette, chief magistrate (intendant) of Caen, organized more than a hundred and fifty midwives in two public courts which she had held. That example, without doubt, will not be lost on the provinces; whatever the price of knowledge may be, it is in such close contiguity to the temptation to abuse it, that I dare hardly put up any prayers for my country. In all the County of Foix, where I was born, deliveries are intrusted to women of the lower order, who never have the least idea of anatomy, and with whom the whole art is reduced to some practical and traditionary customs. But they display zeal, patience, and uprightness, while the others apply themselves to nothing but the glitter of a scientific phantom, and the former cannot but succeed the best. I remember to have seen but one woman perish, in my little town, from the consequences of labour. It is true that, contrary to custom, she had been delivered by a man. The event was so distressing, that they had every cause to believe that nature reprobated such a fatal innovation."
[49] Here let us ill.u.s.trate the truth of Roussel's observations, by a statement of facts which have occurred in our own day:--The _Portafoglio Maltese_ (October, 1856), in describing the frightful effects of a late earthquake in Candia, gives the following:--"In one case a woman was discovered alive under the fallen ruins. She had been miraculously preserved by a beam falling in such a manner as to leave a small s.p.a.ce, where she remained eight days without food before being discovered. During this time she gave birth to a child, which was also alive. Another woman was being delivered when the earthquake commenced; the husband and three women who were attending her fled. On the husband returning after the panic was over, on removing the ruins of his house, he found his wife with her child in her arms alive in a corner of one of the rooms, which had only partly fallen in. During the awful moment she had been safely delivered."
[50] "While such are the prominent vices and defects of the poor, vices and defects of a different kind, but no less offensive to morality, are found among the rich. Sensuality and excess, selfishness, evil speaking, want of charity and kindness abound. All these are obstacles to moral and philosophical progress. Upon what can we rely to counteract them? Upon the force of civilization? Twice have its powers been tried and found wanting.
In the days of Augustus Caesar, when order had been established and prosperity revived, when Virgil and Horace flourished at Rome, and the vast provinces of the Roman Empire were blest with peace and tranquillity, everything seemed to promise a long duration of happiness. But the Christian Apostle and the Pagan Satirist alike prove all was hollow and delusive. Vice increased, knowledge decayed, power vanished, and soon everything portended the decline and fall of the Roman Empire. Again, in the eighteenth century of our era, civilization had reached a very high point. That century, enlightened above all its predecessors, which enjoyed the literature of the age of Louis XIV. in France, and of Queen Anne in England, when Racine, Moliere, Boileau, La Fontaine, Dryden, Pope, Addison, and Swift were read and admired; when Newton's philosophy was established; when La Voisier, and Black, and Cavendish had advanced chemistry to a science, and Watt had, by his improvement of the steam engine, rivalled the invention of the printing press, seemed, in its course, tending to the happiness of nations. But before that century ended, revolutions tearing up the foundations of society, wars desolating all the nations of Europe, bore sad testimony to the mistake that had been made. What was that mistake? The nature of man is so p.r.o.ne to evil that a strong restraint is required to keep down his bad pa.s.sions, and subdue his vicious inclinations. He requires, likewise, some special incentive to good. The legislators of antiquity sought that restraint upon evil, and that incentive to good, in powerful inst.i.tutions guarded by sanct.i.ty of manners. It was thus that Sparta and Rome were led to virtue. But these inst.i.tutions perished when manners no longer supported them."--_Lord John Russell._ Lecture delivered at Exeter Hall, on the Obstacles which have r.e.t.a.r.ded Moral and Political Progress, November, 1855.
[51] "I know that our philosophy, always abounding in singular maxims, pretends, contrary to the experience of all ages, that luxury forms the glory of states; but after having forgotten the necessity of sumptuary laws, will she yet dare to deny that good manners are essential to the duration of empires, and that luxury is diametrically opposed to good manners?"--_Rousseau Discours_, p. 67.
[52] "It was (says M. Astruc) at the first delivery of Mademoiselle de la Valliere, and for the safer keeping of the secret. It was feared that the presence of a midwife in the palace, where suspicion reigned already, would furnish fresh food for the malign curiosity of the courtiers; to impose on them they made use of a surgeon whose practice attached him to the court. For the rest, it cannot be denied that there have been, in every age, men who studied or taught the art of midwifery. We have treatises on midwifery of very ancient date, written by physicians.
Surgeons, while exercising themselves in other surgical operations, did not neglect that of midwifery. But the habitual and daily custom of delivery was never established as it is at present; they interfered only in difficult cases, where it was believed that an experienced operator was required."
[53] There is a work of M. Hecquet, ent.i.tled _De l' Indecence qu'il y a aux Hommes d'accoucher les Femmes_.
[54] "There are, nevertheless, women, even now, whom it would be impossible to induce to be delivered by men. We speak not of those localities where this employment is confided to women, but in towns, where men-midwives are more in vogue. There is, it is said, a great Queen in Europe who has an accoucheur of whom she never makes use. Women deliver her, and the _man-midwife_ is in the ante-chamber, as a witness of the tribute yet paid to a custom which had been renounced."
We fear that, in these "days of advance," even Majesty itself has succ.u.mbed to the prevailing fas.h.i.+on.
[55] "Sisters of Charity," page 75.
[56] "While Miss Nightingale is showing the world the great good to be achieved by ladies devoting themselves to the sick and suffering in hospitals, there is a lady in Paris who has actually worked her way to the t.i.tle of M.D. The lady in question is Dr. Emily Blackwell, daughter of the late Mr. Samuel Blackwell, of Bristol, and has, it appears, a sister practising in New York, as a regular physician, armed with the authority of a diploma. Dr. Elizabeth, like Dr. Emily, completed her medical studies in Paris. To the latter lady the Paris hospitals have been freely opened, and Dr. Emily Blackwell has followed the clinical lectures of Jobert de Lamballe, Huguier, Casenove, Guersaint, and Blanche; and on the Register of the great hospital of the Hotel Dieu may be seen the first woman's name ever entered, as a medical student, on its books. The intense earnestness with which the lady doctor labours to make herself perfect mistress of those branches of the art which chiefly concern women and children, has not only overcome prejudice, but made her a favourite with her able instructors, who have been brought to say, that there can be no more objection to the presence of ladies in hospitals, practising as physicians, than to nurses. Baron Sentin, one of the Physicians in Ordinary to the King of the Belgians, has invited Dr. Emily Blackwell to visit the great women's hospital at Brussels."--_Daily News._
[57] A respected correspondent has communicated to us the following extract from a recent paper:--"There are not far from twenty of them, and several of them are in excellent business. They confine themselves generally to midwifery, and the diseases of their own s.e.x. Their success in the former branch tends to establish them firmly in families. The number will probably be gradually on the increase, since they are beginning to be employed in the neighbouring cities of Charlestown, Cambridge, Roxbury, and adjacent towns, much more than formerly."
Among these female physicians the Misses Emily and Elizabeth Blackwell, natives of Bristol, are justly celebrated. See an interesting sketch of the life of Miss Emily Blackwell in the _Englishwoman's Review_, June, 1857.
[58] A correspondent has kindly communicated to us the following "ower true" tale of humble life:--"A poor girl, married, at the age of sixteen, to a youth not much older than, and equally poor with, herself (so impoverished are they), fell in labour of her first child. She was living with her father and mother, and he with his, for they were too poor to keep house, and her father was an old man and paralyzed, and both generations, on both sides, were as poor as was possible, consistently with living at all. Nevertheless, the wife's mother, having known better days, was ambitious of having her daughter attended by a doctor, and, during her pregnancy, had, by one device or another, sc.r.a.ped together the sum of half a guinea--the doctor's fee--which was laid up in store--an uneasy possession, in the meantime, for the poor mother, whose pressing occasions often tempted her to break in upon it. Labour, at length, coming on, late at night, as usual, the chosen doctor was sent or rather gone for, and came. The girl was in considerable pain, but the doctor, after the usual examination, declared his services to be, for the present, unnecessary. The doctor, however, was not so occupied with his patient but that he was observed, by her mother, to cast sundry glances around the forlorn and desolate apartment, as if doubtful of his fee. It is but justice to the apartment to state that it fully warranted the doctor's suspicions. The doctor, however, not being wanted, as he said, went home, leaving it to be understood that he would come again. Not coming, a long time having elapsed, and the labour becoming urgent, the mother went to the doctor's house (this was the third time that, full of trouble, she traversed a mile of windy streets at midnight). Her application to the knocker was answered from the window by the doctor's wife, who stated that her husband was in bed, and meant to stay there unless his fee was paid down. In vain the poor woman urged that the fee was ready, pleading besides her daughter's extremity. 'No,' was the reply, 'if not paid then and there the doctor would not stir.' This being simply impossible, the poor woman again sought her home, which, by this time, was a scene of pain, terror, and confusion. And now, instead of the 'usurper,' the 'true prince' was first thought of in the person of an old woman in a neighbouring court, who was well spoken of, and, by her timely aid, the long protracted labour was at length terminated for the moderate fee of five s.h.i.+llings. So the girl did well, the mother saved five s.h.i.+llings and sixpence, and the doctor remains a _respectable man_!!"
[59] Dr. Stevens mentions, that Dr. Gregory took from a gravestone in "the old burying ground" in Charlestown the following inscription:--
"Here lyes interred the body of Mrs. Elizabeth Phillips, wife to Mr. John Phillips, who was born in _Westminster_, in Great Britain, and commissioned by John, Lord Bishop of _London_, in the year 1718, to the office of a midwife, and came to this country in the year 1719, and, by the blessing of G.o.d, has brought into this world above 3,000 children."
An obituary notice in the _Boston Liberator_ of 1845, runs thus:--
"Mrs. Janet Alexander died in Boston, September 15, 1845, after an illness of nearly four months, aged 61 years. She was a native of Scotland, and was instructed in the theory and practice of midwifery by Dr. James Hamilton, the celebrated professor of Midwifery in the University of Edinburgh. She received her diploma from him in 1817. She arrived in Boston in November, 1819, and commenced the exercise of her profession on the ensuing Christmas day; and for a period of more than twenty-five years' practice among the most intelligent and respectable portion of the community, was most singularly successful, having NEVER, IN ANY INSTANCE, LOST A PATIENT."
[60] "We may, with tolerable safety, estimate the present population of the Chinese Empire as between 350,000,000, and 400,000,000 of human beings. The constant flow of emigration from China, contrasted with the complete absence of immigration into China, is striking evidence of the redundancy of the population; for though that emigration is almost wholly confined to two provinces, namely, Kw.a.n.gtung and f.o.o.kein, representing together a population of probably from 34,000,000, to 35,000,000, I am disposed to think, that a number nearer 3,000,000 than 2,000,000 from these provinces alone, is located in foreign countries. In the kingdom of Siam it is estimated that there are at least 1,500,000 Chinese, of which 200,000 are in the capital (Bankok). They crowd all the islands of the Indian Archipelago. In Java, we know by a correct census, there are 136,000. Cochin China teems with Chinese. In this colony we are seldom without one, two, or three vessels taking Chinese emigrants to California and other places. Mult.i.tudes go to Australia, to the Philippines, to the Sandwich Islands, to the Western Coast of Central and Southern America, some have made their way to British India. The emigration to the British West Indies has been considerable; to the Havannah greater still. The annual arrivals in Singapore are estimated at an average of 10,000, and 20,000 is the number that are said annually to return to China."--_Sir John Bowring._
[61] "Notwithstanding all our affectation of superior delicacy, and our reprehension of the coa.r.s.e manners of our ancestors, we suspect that they would have been shocked at the idea of the _indelicate_ and _unnecessary_ presence of a man in the sanctuary of the lying-in room."--_Plea for Physicians, Fraser's Magazine_, March, 1848.
[62] "An inst.i.tution such as I have in my mind, should be a place where women could obtain a sort of professional education under professors of the other s.e.x,--for men are the best instructors of women;--where they might be trained as hospital and village nurses, visitors of the poor, and teachers in the elementary and reformatory schools," &c.--_Mrs. Jameson's_ "_Sisters of Charity_," page 116.
[63] Roberton says, "In speaking of the small mortality in child-bed among the poor, I limit my remark to those of this community (Manchester), who have long had the advantage of being attended chiefly by midwives carefully trained and educated in connexion with our Lying-in Charity."--_Pag._ 437.
[64] We have heard that the almost incredible sum of five hundred guineas has been paid as a fee to one of the fas.h.i.+onable "ladies' doctors:" and that another caused it to be understood that he would not take a less fee than fifty guineas, whereupon the number of patients soliciting his attendance increased a hundred fold.
[65] We know a case in point, where a lady was anxious to engage a midwife who had been recommended to her as perfectly competent to perform her office without the intervention of the _man_-midwife, but the latter would not hear of this, and insisted on the subst.i.tution of one of his "own nurses." It is easy to perceive the reason of this manoeuvre. Had the original midwife attended, she would have undertaken the operation, and the importance of the _man_-midwife would have been materially lessened.
The lady's delicacy and comfort were not of sufficient weight to counterbalance this consideration. _Ex uno disce omnes._
[66] "In 1848 sixty-one mothers died to every 10,000 children born alive.
Since that year the mortality has progressively declined, as follows:--58, 55, 53, 52, 50, down to 47 in 1854. This is a gratifying result, and there can be no doubt that by further care and skill, especially by training up a cla.s.s of educated nurses, the deaths in child-birth may be largely reduced from their present high number, 3009."--_Medical Times and Gazette._
[67] So far from the presence of a _man_-midwife being a source of consolation or a.s.surance to the sufferer, as Dr. Ramsbotham alleges, we have it on the authority of a lady, the mother of many children, that on three occasions, when the "doctor" _was not present_, her labours were much easier, and in all respects more thoroughly natural and happy in their results; than on those in which the _man_-midwife officiated; and further, _that the very ring of the bell announcing the arrival of the hated accoucheur has frequently "put back" the pains of labour_.
[68] Before we laugh at this short-sighted folly and cruelty, which supposes that the interests of the two s.e.xes can possibly be antagonistic, instead of being inseparably bound up together, we must recollect that we have had some specimens of the same feeling in our own country, as, for instance, the opposition to the female school at Marlborough House, and the steady opposition of the inferior part of the medical profession to all female pract.i.tioners. That some departments of medicine are peculiarly suited to women, is beginning to strike the public mind. I know that there are enlightened and distinguished physicians both here and in France who take this view of the subject, though the medical profession as a body entertain a peculiar dread of all innovation, which they resist with as much pa.s.sive pertinacity as Boards of Guardians and London Corporations."--_Mrs. Jameson's_ "_Communion of Labour_," p. 40.
"When educated gentlemen set an example of selfishness and exclusiveness, it is only to be expected that the working cla.s.ses should follow it, and so the greed of man is the degradation of woman."--_North British Review_, No. 52, p. 837.
[69] "According to Osborne's testimony, instruments are used _dangerously_ in parturition, _one thousand one hundred and seventy-six times_ in every twelve hundred cases; and the same author, in his reprobation of Denman's culpable and inconsiderate introduction of them into practice, makes this memorable remark: 'I must believe that he must have forgotten THE MANY UNHAPPY EFFECTS which have come from their use to our mutual knowledge, even when they had been in the hands of very experienced and skilful men.'"--_The Author of_ "_The Death-blow to Man-midwifery_," quoting _Osborne's_ "_Essays_."
[70] "The conduct of medical men in all former ages proves still farther that which we would establish (that the profession of man-midwife is repugnant to nature). If they required information on the state of their female patients, it was to the midwives they applied. The midwife, therefore, pa.s.sed for the eye of the doctor, because it was through her ministration that he a.s.sured himself of what he neither committed to his own examination or to that of another man."--_Hecquet_ "_De l'Indecence aux Hommes d'accoucher les Femmes_," page 6.
[71] Albertus Magnus de Secretis Mulierum. _Ed. Amst._ 1662, p. 85.
[72] The _man_-midwife usually intimates his wish to make the examination _per v.a.g.i.n.am_, through the medium of the nurse of his own recommendation, and should the patient, struck with the daring impropriety of his request, desire to inform her husband of the infamous proposal, the nurse dissuades her by saying, that "husbands are not supposed to understand these things," and that she will probably destroy both her own life, and that of her child, by refusing to submit to it! After this the accoucheur soon triumphs, the examination is effected without further remonstrance, and the victim is irretrievably entangled in his insidious toils.
[73] Roberton, Apology, page 470.