THESE gentlemen will permit me to tell them that they make great
pretentions, and prove little or rather nothing. Calling hard names with
a disdainful tone, and with airs of triumph, are not overwhelming
reasons.
BUT to the point. Those who reject instruments, say you, do not know
what they are: they reject them from ignorance. This is soon said.
Nevertheless a number of authors, much more experienced and versed in
the matter than Dr. Smellie, are of this opinion. Deventer exclaims
against instruments; Viardel does the same; Levret admits none but those
of his own invention, and rejects universally all others; and well might
he except his own, since he wrote only to recommend them. Delamotte was
not very fond of instruments: he tells us in his preface, that in a
course of thirty years practice, he had not twice made use of the
crotchet, though he had an extent of country forty leagues round, in
which he regularly exercised his profession, insomuch as to have four
lyings-in in a day under his management.
I HAVE very exactly read almost all the modern authors who have written
on this art; and have been surprized to observe that whilst, on one
hand, they agree, they own, that in England, France, and Holland, people
are much come off, or undeceived, as to all those dangerous or mortal
instruments of which the antients made use, such as the short
broad-bladed knife, (call it, if you please, a pen-knife) the bistory,
the crotchets, &c. especially since the invention of the new forceps, or
tire-tête: on the other hand, these same doctors tell you, that recourse
must be had to crotchets, or to the Cæsarean operation, when the new
forceps will not do. A comfortable resource this, in an instrument so
boasted as the best discovery that has been made since the creation of
the world, and for which we are indebted to the moderns!
I HAVE also scrupulously examined all that authors have been pleased to
say of great, wonderful and magnificent, with regard to the new forceps
of Palfin, as it now stands after infinite corrections, as well in
foreign countries, as in this one, which have dignified it with the name
of the English forceps; and I find all these great elogiums reduced, at
the most, to no more than the proving, as clear as the sun, that it is
allowable for an operator, extremely able and extremely prudent, to make
use of it, when the business might be perfectly well done without it.
FROM thence I deduce my demonstration directly opposite to the
pretentions of Dr. Smellie and of his followers. According to the
instrumentarians, and according to certain doctors, there are certain
occasions, certain cases, in which there is an absolute necessity for
employing the forceps. If we will hearken to and follow other doctors of
more celebrity and credit, it is not right to make use of it, but when
one may very well do without it: for example, after the having obviated
all the obstacles which retard the delivery, after having, with the
hands only, dis-engaged the head or the shoulders of the child, without
which (say these same writers) the instrument would be found
insufficient or useless; this palpably implies the being able to do
without it. Now since it is not allowable, in good practice, to make use
of it, but when it is perfectly needless to use it at all, there is then
no absolute necessity for it; as surely, what can be done without, is
not absolutely necessary. Be this only transiently remarked. For I
reserve most convincingly to prove this proposition in the second part
of this work. There I shall treat of all the instruments of our antients
and our moderns, and besides an enumeration of them shall demonstrate
their danger and uselessness. In the mean time, it must be owned, that
either Mr. Smellie has been much misinformed of what passes at the Hôtel
Dieu of Paris, in the ward of the lying-in women, or else, which I the
least believe, is not sincere in the account he gives us, that the women
of that hospital “had recourse to the assistence of men, in all the
difficult cases of midwifery;” which, he observes, “got the better of
those ridiculous prejudices the fair sex had been used to entertain.”
That is to say, in preference of midwives to men-practitioners.
I FREQUENTED this Hôtel Dieu two whole years, before being received an
apprentice-midwife, which I accomplished with great difficulty, on
account of being born a subject of England, and consequently a foreigner
there: my admission, however, I gained at length, through the favor,
protection, and special recommendation of his royal highness the duke of
Orleans. Now, I dare aver, that in all the time before, and after I was
admitted there, I never but once saw Mr. Boudou, surgeon-major called,
who did nothing more than to make us, one after another, _touch_ the
patient, about whom we had been embarrassed; and as he interrogated, he
made us discover an _uterus_ full of schirrous callosities, which joined
to its obliquities, impeded the palpation of it properly with the hand,
the orifice being very difficult to come at. Every thing, however, was
done without his help, and very successfully. And most certainly we
should have spared him the trouble of coming at all into our ward, if
the head-midwife, who was a little capricious in her temper, had not
taken it into her head to keep us in our perplexity, which engaged us to
send for Mr. Boudou without her knowledge, and for which she was
afterwards heartily angry with us.
I NEVER once saw an occasion in which there was any necessity for using
instruments, though in my time we had, at least, five or six hundred
women a month to deliver.
VERY far then are the midwives from having often occasion of recourse to
the assistence of the men, in difficult cases; and indeed to those
prejudiced in favor of men-practitioners, it may, though true, appear
strange, that in a place where there are every year so many thousand
women delivered, and consequently many difficult labors amongst them,
and even cases of monsters, there is no recourse to the surgeon-major
but in the last occurence, which falls out very rarely.
ABOUT eighteen or twenty years ago, Madam Poor, head-midwife of this
hospital, delivered a woman of a monster with two heads, with no help
but only her fingers and a young prentice. Not an instrument was
employed: no man assisted her. The child was christened, and died
presently after. The mother remained some months upon recovery, and did
perfectly well. This fact requires no proofs, being of such public
notoriety. The monster was carried to St. Cosmo’s, where any surgeon may
see it. I served my time with this same mistress some years after this
kind of prodigy had happened.
AS to what I have advanced concerning the procedure in the wards of the
lying-in women, should my testimony appear in the least suspicious, I
appeal to the justice and veracity of all the doctors in England, who
have been at the Hôtel Dieu at Paris, who cannot but confirm what I have
said. In the mean time Mr. De la Motte, who passes for an author of
credit may certify, the same. Here follows what he says in his preface
to his observations, page 2.
“ONE would think (says this author) from reading the books of Messieurs
Mauriceau and Peu, that it was impossible to succeed in the practice of
midwifery, without having operated at Paris in the lying-in ward of the
Hôtel Dieu. It is true, that this hospital is the best school in Europe,
and that I would have ardently wished to have been admitted to the
operations of midwifery during the five years I staid in that hospital:
but as there is no more than _one_ surgeon _only_, who is in charge to
attend when he is called to consultation with the midwives, and that it
is a place which goes only by favor, I was forced to content myself with
following in quality of topical surgeon, to the physicians who performed
their visits there. So that I followed only, for six months, three
physicians in their rounds there, during which time I applied myself to
examine the conduct observed by those gentlemen, to preserve the women
after their lying-in from the accidents which follow thereon. By this
means I made myself amends for my want of recommendation; but I can
safely say, that during the six months I was admitted in the
above-mentioned quality, there was no more than one extraordinary labor,
which was that of a child engaged in the passage, where the presence of
a surgeon was required, and which however was terminated without any
other help than that of patience. And yet there were (so far back as
then) from three hundred and fifty, to four hundred pregnant women, who
were all delivered by the apprentices and rarely by the Dame De la
Marche, at that time, head midwife of the hospital: so that I am
persuaded, that those who boast of having lain a great many women there,
exaggerate furiously.”
FOR me, I dare yet go farther, and will maintain it, that those persons
impose upon the public in such boasts: since the naturalized surgeons,
those of the nation, those of Paris itself, have no right to come into
our ward. There is no one admitted but the surgeon-major, whose place is
a place of favor, and rather matter of form than any thing else. Much
more then are strangers excluded, and the truth is, that they never did,
nor ever do operate there.
AS to the reproach which Mr. Smellie makes to us of being interested, I
can, for myself, prove that I have delivered gratuitously, and in pure
charity, above nine hundred women. I doubt much, whether our critic can
say as much, unless he reckons it for a charity, that which he exercised
on his automaton or machine, which served him for a model of instruction
to his pupils. This was a wooden statue, representing a woman with
child, whose belly was of leather, in which a bladder full, perhaps, of
small beer, represented the uterus. This bladder was stopped with a
cork, to which was fastened a string of packthread to tap it,
occasionally, and demonstrate in a palpable manner the flowing of the
red-colored waters. In short, in the middle of the bladder was a
wax-doll, to which were given various positions.
BY this admirably ingenious piece of machinery, were formed and started
up an innumerable and formidable swarm of men-midwives, spread over the
town and country. By his own confession, he has made in less than ten
years nine hundred pupils, without taking into the account the number of
midwives whom he has trained up, and formed in so miraculous a manner.
See the preface of this author. He speaks of his _machine_ in the first
page, and p. 5, of the number of his pupils.
NOW as to these worthy pupils, must not they be finely enabled to judge
of the situation of women with child, and of that of their fœtus? Must
not they be deeply skilled in that branch of anatomy? Must not they
acquire a habit of the touch exquisitely nice, exquisitely just, for
discerning the proportion and analogy between a mere wooden machine, and
a body, sensible, delicate, animated, and well organized?
I HOPE too that it is an injustice done to that doctor, by those who say
that his pupils have too often a way of hurrying out the waters, which
can only serve to render the labor more dry, consequently more
laborious, and by that means furnish a handle for setting their
instruments to work. If this should be so, as once more I hope it is
not, may not the bad habit they will have contracted during their
pupilship, of drawing the small-beer out of their wooden-woman, have
contributed to this method of practice?
IN the mean time, does it become a doctor to call us interested, who
himself, for three guineas in nine lessons, made you a man-midwife, or a
female one, by means of this most curious machine, this mock-woman?
OBJECTION the Eighth.
BUT you who come so late (it will be said) What new discoveries do you
bring us? Can you imagine you will, with one dash of the pen, cancel the
impression of so many excellent works as have appeared before you? Do
you believe a woman can have more ability than so many men of letters,
who have labored all their life-time in perfecting the art, and who so
strongly recommend the use of instruments, as the most expeditious
method of extricating one self, in all the cases they specify, and where
there is a necessity for recourse to extremities? Can you think, that
these personages have all spent their time in vain?