ALL due honor be to the original author of this sublime invention of the

forceps, whoever was the happy mortal! happy, I say, according to Dr.

Smellie, who calls it a “_fortunate contrivance_”[36]; though perhaps by

fortunate, he rather means its having been so to himself. For hitherto,

in all truth, I must own, that I do not find, even by the most

exagerated accounts of the learned men-midwives, that those poor

instruments of God’s making, the women’s fingers, would not much better,

and much safer, do every thing that is pretended to be done by that same

boasted instrument, or that can be done by any other human means.

BUT let us suppose for an instant, what both my love and knowledge of

the truth would hinder me from granting, that instruments are at some

times, and in some sort necessary: in what case is it that they are

necessary? this is what hitherto I do not know. And which instrument is

it that a man-midwife must use? that is what I yet know less: nor do I

believe there is any practitioner so presumptuously silly, as to admit

any particular one, as the only one universally received and approved.

It will perhaps be said, that according to the circumstances, each

practitioner will, out of his bag of hard-ware, pick out that which will

be fit for the occasion. But then, a waggon would not carry their whole

armory, to calculate not only according to the various alterations made,

if but in the forceps, by whim, desire of getting a name, or of

increasing practice, but according to the various exigencies and

circumstances to which the form of the instrument ought to be peculiarly

adjusted. And upon every occasion, there is not the time for inventing,

directing, or making a new instrument. But if it is said, that for want

of such exactness, the general make of an instrument must do, in _all_

cases: that general make is not at least to be looked for in any of the

kinds I have already quoted, by which such numbers of women and children

must have been tortured or sacrificed, before they were exploded and

given up, as good for nothing or insufficient, even by the

men-practitioners themselves, who however substituted no others to them

but what were rarely less exceptionable. They were only newer. Let us

then now proceed to pass in a summary review the later and pretended

improvements of this prodigious invention of the forceps, and candidly

examine the validity of their claim over the women’s hands.

MR. Rathlaw, a famous surgeon of Holland, in his dissertation on the

means, or secret of Roger Roonhuysen, which was transmitted to his

heirs, for extracting (as was said) in a very little time, a child,

whose head should be embarrassed in the neck of the uterus, says thus,

“TO me it appeared impossible, to establish an instrument, whose use

should be so certain, so general, so necessary, that one could not be a

man-midwife without having a knowledge of it.”

THE same Mr. Rathlaw, in the same piece, exclaiming against the use of

the crotchets has this remark.

“NO one (says he) can be ignorant of it’s being no longer the practice

in France, or in England, to employ crotchets, or murderous tire-têtes

(_would this were truth!_) in the deliveries, unless for a monstrous or

hydrocephalous head, when the bulk of it is so enormous, that there is

no possibility of getting it out whole, and especially if the child

should be dead.... In my time, (adds this author) every eminent

man-midwife had invented different means of extricating himself out of

the plunge of such a case, and their reputation grew in proportion to

their respective success. Yet, hitherto, I do not know, that either at

Paris or at London, they have got such a length, as to take any

particular instrument under their protection. Nine years ago, (Mr.

Rathlaw continues) I had made a forceps almost wholly of my own

invention to extract the fœtus by the head, and it often succeeded well

with me. It was, as to its make, a good deal resembling that which

Butter describes in the Edinburgh-acts, volume III. art. 20. But mine

(proceeds he) seem to possess better proportions, and is certainly of a

more handy use, than those which have hitherto appeared.”

PLEASE to observe, that this forceps of Mr. Rathlaw is the same as

Palfin’s, or rather as that of Gilles le Doux, excepting only the

semilunar hollow cuts in the claws, which Monsieur Duffé, a surgeon of

Paris, had contrived in them. The author says, it had _often_ succeeded

well with him: he does not say _always_, and why? most probably because,

when he did so _often_ find it of service, that was, only whenever there

was no sort of occasion for using it at all. Do not let it here be

imagined, that I force an inference. I give my reason. Supposing that

such an instrument was necessary to every practitioner, the case for his

using it cannot but rarely occur. Now those rare cases where Rathlaw

judged his forceps necessary, and in which it failed him, were in all

likelihood the true tests of its merit: whereas those other cases, in

which he _often_ succeeded, may very well be taken for such as, with

hands and patience, might have afforded a better account of them, than

the silly superfluous quackery of employing a forceps, unless indeed his

hands were too clumsy to attempt it. Otherwise the using instruments,

where they sometimes do the work with so much more pain and danger, when

the bare hands well conducted would do so much better, remind me

naturally enough of what I have seen a pretty master do with a

steel-instrument called a zig-zag or fruit-tongs, when, to display it,

or out of wantonness, he has catched up fruit with it, that lay fully

within the reach of his hand. In this piece of childishness there is

however no mischief; whereas the man-midwife, for considerations of

lucre, dallies with two lives to pluck at a fruit that is never, I

repeat it, never, out of reach of the hand, where that steel-instrument

of his, a forceps, can bring it away.

MR. Rathlaw also tells us of another instrument, of which he gives us an

account. He had got the secret from one Velsen, a physician at the

Hague. This Velsen had it of Vanderswam, who had been a pupil of

Roonhuysen, the inventor of this pretended nostrum, with which he always

helped the women in labor, snug under the bed-cloaths, the better to

conceal his miraculous secret. He had long promised his pupil to

discover it to him.

“IN short (says Mr. Rathlaw) one day that Roonhuysen was returning from

laying a woman, a burgomaster of Amsterdam came to speak with him: in

the hurry Roonhuysen was to receive him, he hid his nostrum-instrument

in some apartment. His curious pupil (Vanderswam) who had for several

years been watching such an occasion with great eagerness, found it, and

took a draught of it. This instrument was in a case with two long steel

crotchets, and a piece of whalebone, in the shape of a pipe for

smoaking, only shorter, and at one of the ends of which was a piece of

steel, of the shape of an acorn, and there was no other instrument in

this case.”

IF Mr. Velsen is to be believed, it seems, on the one hand, that

Roonhuysen made the whole science of midwifery consist in the knowledge

and use of this his instrument, since it is there said, that Roonhuysen

had promised this pupil of his to teach him the art of midwifery, but

taught him nothing of it; and indeed it does not appear, that he had

hidden any thing from Vanderswam but this wonderful instrument, with

which he used, under the bed-cloaths, to smuggle the child through the

difficult passage[37].

ON the other hand again, it may be judged, that this pretended

marvellous instrument was not of effectual enough service to its

inventor, unless in those cases where he might as well have done without

them, since this very same Roonhuysen made use of crotchets, doubtless,

when he found his instrument fail him. O women! women! thus it is that

your pretious lives, and that of your children (to say nothing of the

additional tortures you are put to, as if those of Nature’s own ordering

were not already enough) are trifled with, in practices being tried upon

you with such instruments, for which you are besides to pay

exorbitantly; and all for what? To increase the practice of some quack,

who raises into notice his worthless name, or perhaps swells some work

of his, published by way of advertising himself, with the rare boast of

having delivered you with an instrument, that has only, not murdered

some of you, though it may sometimes perhaps have done you irreparable

damage, and will have always occasioned you an unnecessary increase of

pain and danger. Is it possible to inculcate this truth too often or too

strongly to you?

“THERE are many people, (adds Mr. Rathlaw) who make a doubt whether this

instrument is not the same as that with which the three Chamberlains,

brothers, acquired in Ireland and other countries the reputation of

being the most eminent men-midwives in the world. In those circumstances

in which others employed crotchets, they could, by their manual

operation, and with less labor, hasten the delivery of the women in less

time, and without the least danger to mother and child.”

I AM not unwilling to believe that the three brothers, the Chamberlains,

might pass for the most eminent men-midwives in the world, especially in

Ireland, where before there never had, as I understand, been seen any

practitioners of midwifery but women. As to other countries, these

brothers might very easily surpass in skill those, who knew no gentler

way of terminating a delivery than by the means of crotchets. Therefore

it is that our author adds, that the Chamberlains only made use of the

manual operation; he does not add of other instruments. It is a great

pity however, that the surgeons of all countries have not yet got hold

of, and adopted this marvellous secret of Roonhuysen’s, which would

extricate them so gloriously, in their attendance on such difficult

labors. They would thereby greatly reduce their armory, from its complex

state at present of variety of crotchets, tire-tête, forceps, spoons,

blunt hooks, pinchers, fillets, lacs, scissors, incision-knives, and the

rest of their tremendous apparatus.

ACCORDING then to Mr. Rathlaw, the forceps of Roonhuysen was the same as

that of the Chamberlains. How he got the secret from them matters not.

He only changed the figure of the blade-parts. In short, our author

adds, that to him it seems probable, that this instrument has been

brought to perfection by the continual experience of men-midwives, who

have successively employed it. He pretends himself to have made some

alterations in it for the better, but what they are he is not pleased to

tells us.

THE illustrious Janckius, a great practitioner, mentions another

corrected forceps in his dissertation upon the forceps and pinchers,

instruments invented by Bingius, a surgeon of Copenhagen, and of their

use in difficult labors, printed at Leipsic, 1750, page 211. This

forceps resembles mostly that which the celebrated Monsieur Gregoire,

senior, first imagined upon the model of Palfin’s tire-tête.

“Janckius, in the same dissertation, tell us, that it would be of

service to have spoons or blades of the forceps of various curvatures,

and of different lengths, for the shorter the arching, and more crooked

the blades or spoons are, the more difficult and dangerous will the

application be, according to Chapman and Boëhmer.”

THENCE this consequence seems derivable, that to obviate these

difficulties and dangers, it would be requisite to have as many crooked

spoons as there are particular cases, as well as to take measure of the

heads that are stuck, which still would imply the introduction of the

hand, and, of course, the uselessness of instruments.

MR. Levret, in his notes, p. 377, makes us observe, that the branches of

the forceps of Bingius, which are solid, being considerably more crooked

than the windowed forceps, the expansion of their middle part must be

too wide not to risque, in the extraction, the _tearing_ the perinæum,

which it is no such _indifferent_ matter as not to be remarked.

THIS Janckius had, it seems, that bad habit of employing too _soon_ the

instrument of Bingius, which is extremely dangerous. This however, is

not seldom the case, when Monsieur l’Accoucheur is in a hurry.

BOËHMER, in a dissertation on this subject, thus expresses himself, as

to the instrument of Levret, and the forceps of Bingius.

“I shall only observe (says that learned physician) what Mr. Levret has

himself very justly remarked, that the application of the forceps is

dangerous, unless the head should have already descended low enough into

the pelvis for the orifice of the uterus to be effaced, and to make but

one and the same cavity with the vagina. This counsel is essential for

two reasons;

“FIRST, for fear of hurting the orifice of the uterus which might easily

happen without this precaution.

“SECONDLY, on account of the instrument itself, the blades of which

could not embrace more than a part, and not the whole of the head, which

remaining too high, they could not consequently compress it equally, nor

extract it. It is for the same reasons (continues he) that I rather

differ in opinion from the celebrated Janckius, who, as soon as the

waters are discharged, and he perceives that the head does not pass, has

instantly recourse to the instrument.... Some time (says he) should be

indulged to the action of Nature.... There is often more success

obtained by temporising, than by too early a recourse to instruments.”

LITTLE by little the truth will come out. Little by little, even the

men-practitioners themselves, will be forced to allow, that the very

least imperfect of the instruments are prejudicial and dangerous: though

perhaps they will not speak out the whole truth, and confess that total

uselessness, which would, in so great a measure, imply their own. But

common-sense will inform whoever consults the light of it within

himself, that these instruments are of a nature so heterogeneous, from

the service expected from them, so impossible to be adapted to the

infinitely tender texture of the organ of gestation, that the very best

of them must occasion lacerations, especially by the opening of the

branches, the strain of which bears upon the mother’s body, and can

never but hurt the child, in crushing it’s head; as they make that to be

done precipitately, about which Nature has, for taking her own longer

time, no doubt a very good reason, if there was no more than that one of

gradually dilating the passage; but there are probably many others.

ART should aim at imitating Nature: now Nature proceeds leisurely,

instead of which the forceps goes too quick to work. The action of it

depends on an artificial compression, which begins by moulding, or

rather crushing the child’s head, adaptingly to the figure of the

pelvis, to facilitate its extraction; and though the divine providence

has in its wisdom provided for the preservation of the human species, by

means of what is called the duramater, and by the void of the sutures in

the cranium of children, the manual compression of the instrument is

either too strong or too weak. If too strong, the child is lost; the

head being so compressed by the instrument, that the brain escapes

through the occipital cavity: if it is too weak, so that the head has

not been sufficiently compressed, nor it’s bulk competently diminished,

in attempting the extraction, not only the uterus can scarce escape the

being wounded, but the perinæum and the bladder the being torn: and

indeed in either case they hardly escape, the instruments occasioning

various inflammations and contusions, of the worst consequence, both in

the internal and external parts, besides the great danger of the blades

slipping and violently hurting the mother, not to mention the painful

divarications and shocking attitudes in order to the introduction.

THE instrument used by Mr. Giffard, man-midwife, is supposed by Levret

and others to be nothing more than the windowed forceps, of which the

use had been long before known. But that appears as unsatisfactory as

others. Mr. Freke too, it seems, furnished a new kind of corrected

forceps, the chief merit pretended of which was, that the extremity of

one of the blades was curved in form of a crotchet, and that this

extremity might be _concealed_ when not employed as a crotchet, and

consequently helped to avoid the having a multiplicity of instruments,

as this new-fangled one might, upon an occasion, serve either for

crotchet or forceps.—What a prodigious strain of sublime invention is

this of death and wounds in various shapes!

I FIND too that Chapman is blamed, for that, in his essay on the art of

midwifery, he very frankly condemns all the tire-têtes he had seen

employed till his time by all other practitioners, but he has not, it

seems, given a description of the one he himself used, nor doubtless the

method of using it, the one necessarily depending on the other. Nor

where that author speaks of passing a ribbon over the head of a child,

is he so good as to tell you how he managed to get it over.

I MUST not here omit some mention of the forceps, pretended to be

improved by Dr. Smellie. Upon which, however, I shall spare the reader a

tedious minute discussion of its form, and of its advantages and

disadvantages, comparatively to other forceps calculated for the same

use. Levret may to the curious furnish sufficient satisfaction on that

head. He has examined it with great exactness and seeming candor, even

though he prefers his own to it. Nothing can be plainer, than its being

just as insignificant and foolish a gimcrack as any of the rest. But

there is one particularity, of which Levret takes notice, that I cannot

well omit mentioning. The Dr. has, it seems, whether to spare the women

the shock of the gleam from a polished steel instrument, or, whether to

defend them from the injury of that metalline chill, which is not well

to be cured by any warming at the fire, covered his instrument with

leather spirally wound round it. Levret upon this concludes his remarks

with the following one. “The ledges or roughness which the leather must,

_besides increasing its bulk_, create by those its spiral

circumvolutions, cannot but be such an obstacle to the introduction of

the instrument, as to let it be serviceable only in those cases where

(N. B.)—one may do _very well without it_. For it is well known, than in

those cases where recourse to it is requisite, the most polished, the

most smooth instrument often finds such great difficulties in its

intromission, that nothing but a hand, _consummately_ expert in the use

of this instrument[38] can, without damage, remove the impediments.”

DR. Smellie has, however, himself salved one of Levret’s objections to

his instrument, as to any offensive smell or infection that might be

contracted by the use of it. (Treatise of Mid. p. 291.) “The blades of

the forceps ought to be _new covered_ with stripes of _washed_ leather,

after they shall have been used, especially in delivering a woman

suspected of having an _infectious_ distemper.” Certainly, certainly,

not only the Doctor’s nine hundred pupils, but all other practitioners,

that use this famous instrument, will do well to observe this

injunction. It is the very best thing they can do, next to never using

it at all.

I COME now to the boasted instrument of Levret; who is the last, at

least that I know of, who has invented a new make of a tire-tête, or

forceps corrected, over all that have appeared since Palfin. He gives

us, in a book written on purpose to recommend it, a minute analysis of

it, and an ingenious delineation in some pretty prints of it. The work

is intitled, _Observations sur les causes et les accidens de plusieurs

accouchemens laborieux_.

BUT to make use of the instrument or instruments which Levret

recommends, requires not only a hand consummately dextrous and skilful

in the art, but an infinite number of perplexing precautions, as may be

seen, p. 106, and seq. of his observations.

I WILL not here undertake a circumstantial account, I shall content

myself with mentioning some of them.

“There is here (says our author) a very important remark to be made,

when you are for using this forceps. It is absolutely necessary that the

orifice of the uterus should be, as it were, totally effaced or erased,

that is to say, that the vagina and the uterus should, in a manner, no

longer form other than one and the same cavity, from a sort of

uninterrupted continuity, because, without that, there would be a danger

of getting hold of the orifice of the uterus between the head of the

child and the instrument, which would be extremely hurtful.

“I OUGHT (continues he) to add, that great attention should be given to

the attenuation of that orifice, for before it’s intirely disappearing,

it becomes sometimes so thin, and so exactly close fitted to the child’s

head, that, without a most scrupulous examination, one might commit a

mistake.”

BESIDES the measures, observations and remarks this practitioner urges

in that place, which require infinite attentions, he adds to them the

following ones.

“FIRST, when you introduce the instrument you are never sure of being in

the uterus, but, when, besides the precaution I have above recommended,

you feel that the axis of the instrument, or the extremity of the

branches, is in a kind of vacuum. This sign would I own be a very

equivocal one, for a person that should use this forceps without having

practised surgery[39]; but so it will not be for him, whose sense of the

touch is habituated to the feeling of instruments of different sorts, as

they enter into empty cavities of vessels or of hollow organs, or in

short of any cavity.

“SECONDLY, when by drawing towards yourself the instrument, you are

assured of the preceding sign, you will feel a small resistence to a

certain degree.

“THIRDLY, the blades of the instrument should suffer themselves to be

opened out with some sort of ease, and what is opened out should not

make resistence enough for the blades to return with any violence to the

place whence the opening out began.

“FOURTHLY, the blades in the instrument should, as they open wider and

wider, rather tend to augment the diameter of the void of the instrument

than diminish it.

“FIFTHLY, these same blades should, in their expansion, go a little

depth in the vagina.

“IF the man-midwife, (says Levret) perceive, that _any_ of these

favorable signs should be _wanting_, he ought to _mistrust_ the

_success_, and to have recourse to his _sagacity_ for the remedying it.”

THUS far as to the handling this forceps of Levret’s, to whom the

defectiveness of the English and French forceps had inspired an idea of

providing such a supplement to it, from the richness of his own

invention.

I DO not wonder however at no instrument pleasing Mr. Levret so well as

his own. Nothing is more common among the instrumentarians, than their

disagreement about the make of their instruments. Some will have their

forceps long, others short, some strait and flat, others curve: in

short, there is no adapting the mechanism of it to their various

fancies, so apt too as they are to change. Levret complains bitterly of

the inability or injustice of the instrument-makers; but by what I

believe of them, very unjustly. The gift of the fault is not in the

instrument; it is in the use to which they are so often put of

attempting impossibilities.

BUT now let us examine, what surely very competent judges have thought

of this famous new forceps of Mr. Levret, which he calls _his_

instrument.

WHEN the book and instrument were presented the Royal Society at London,

it appears by a quotation inserted by Mr. Levret himself, that his

instrument was allowed to be ingenious enough, but that “there was

_nothing extraordinary in it_.”

PAGE the 10th of his preface, he has the candor to own, that he does not

absolutely pretend that success will always attend its application, even

in the cases he points out.

PAGE the 36th, and seq. of his observations, after having exploded the

forceps, and other instruments of the authors who have preceded him; and

after having described the alterations and corrections made in the

English and French tire-têtes, he gives us indeed the better opinion of

his, by a fair confession of the insufficiency of them all without

exception, and even of his own: by which, however, it is plain, he can

mean no more than that, imperfect as they are, they all are still

preferable to the hands alone; but the question of this superiority is

as constantly as it is shamelessly begged by him, and all his fraternity

of instrumentarians.

THUS however he expresses himself as to his own instruments. “This

instrument is actually, to all appearance, now at the very utmost degree

of perfection, to which it is possible for it to arrive, without however

having all the perfection that might be wished, for the most expert

practitioners in the use of it, agree in the opinion.

“FIRST, of the difficulty of its introduction in certain cases.

“SECONDLY, of its stubbornness as to the crossing of the blades.

“THIRDLY, of its contributing to _tear_ the _fourchette_, or _frænum

labiorum_.”

[OUR author is very angry, that Boëhmer, who, in his critical

objections, opposes those his own words to him, has not added the

subsequent lines.]

“THE correction I have made in this instrument (continues Levret) by

means of the shifting axis, has rendered the difficulty of crossing the

blades _less_ considerable, and the two following reflexions may serve

_greatly_ to overcome the other two inconveniences.”

BUT should it be granted to Levret, that the shifting axis somewhat

lessens the difficulty of crossing the blades of this instrument, it

would still remain too great an one, for all that correction. The

reflexions he adds, for the overcoming the other two inconveniences,

carry no conviction with them; and indeed he himself seems to think so,

by his adding afterwards (p. 99.)

“TO obviate this inconvenience of tearing the _fourchette_, or the

perinæum, I caused to be made a _curve_ forceps, as to any thing else

not differing, in its dimensions, from the first. I took the idea of it

from the curve pinchers used in the operations of lithotomy. It will be

easier to conceive, than for me to describe the advantage it must gain

by it. That was not however the only end I proposed by it, as all the

good practitioners at present agree on the _small_ efficacy of the

common forceps, in the case of a head stuck in the passage when the face

is turned upwards.”

IT is in consequence of this opinion that Levret, in the sequel to his

observations, p. 301, tells us.

“I COULD (says he) answer Mr. Boëhmer, that all the most eminent

men-midwives are convinced, that when the child presents with the face

upwards, or turned forwards, that is to say, towards the os pubis, and

that in this position, the head sticks, the forceps commonly used can be

of _no_ service: I do not (adds he) even except the one I have had made

with a shifting axis. The defectiveness of these instruments, in these

particular cases, sufficiently proves, I should think on one hand, that

the English forceps is not so good as Mr. Boëhmer seems to believe; and

on the other, I presume, he will be convinced, that I am not more

servilely attached to my own productions, than those of others.”

THIS insufficiency then of the common forceps has given rise to the

curve forceps of our author. Here follows what he further adds to what I

have above (p. 427) quoted from page 99 of his work.

“THE form I have given to my forceps, renders it then very useful,

since, by means of the curve, it lays holds of the head with all the

efficaciousness that can be found in the use of the common forceps,

employed on the most advantageous position that the head can be

imagined.... Notwithstanding all the corrections made in the English and

French forceps (continues the other practitioners) if my instrument is

compared to all the other forceps it will appear;

“FIRST, that it has none of their faults.

“SECONDLY, that it is very feasible with it to extract the head of a

child separated from the body and remaining in the uterus. This is so

possible, that all those who have seen my instrument, are unanimously of

opinion, that no other forceps can do as much.

“THIRDLY, with my instrument it appears to me possible to assist

powerfully the getting out the head of a child that shall have remained

in the uterus, the body being entirely come out, but of which a part is

still in the vagina.

“FOURTHLY, my instrument has this in common with the ordinary forceps,

that it can extract a child by the head, when this part shall be stuck

in the passage.”

IT may well be said here, that Mr. Levret attributes such excellent

qualities, and marvellous properties, to that same new forceps of his,

as ought to immortalize his memory, and render his forceps universal

over the whole earth,—if they were but proved. Ay! there lies the

difficulty. Messieurs Rathlaw, Boëhmer, Janckius, and the most notable

practitioners in England, do not believe a syllable of the matter. Even

Dr. Smellie, though I think he approves the crooked part of the forceps,

speaks slightly enough of it, and has even dared to falsify the

inventor’s assertion of the ne-plus-ultra of it, by altering the form,

as he tells us, p. 370. “in a manner that renders it more simple, more

convenient, and less expensive.” Mr. Levret cannot then expect we shall

take these advantages for granted upon his own bare assertion, in the

blind enthusiasm he manifests for this rare production of his genius. I

do not so much as believe, that he was even himself, at times, clearly

persuaded of its excellence. At least he, in several places, appears to

contradict himself. As it is then greatly of use to show into what a

maze of errors these are capable of falling, who neglecting the guidance

of judgment in the road of truth, wander into the wilds of imagination,

I shall just point out here some of Levret’s, at least, to me, seeming

inconsistencies with himself, but especially with plain reason and

common-sense. The reader will find the notice I take of them far from

digressive, serving as they do even for connexion, as well as

enforcement of my arguments.

MR. Levret, p. 161, concludes the first part of his observation thus.

“NOTA, some very intelligent persons have been pleased to charge me with

an opinion, which I have never had as to CURVE FORCEPS: they think, that

I believe it capable of going into the uterus in search of the child’s

head when it is not ingaged in the orifice: and yet I do not advise the

use of it, unless in those cases where the other (the common forceps) is

employed, over which it has essential advantages.”

HERE the reader will please to observe, that all the wonders, just

before quoted from himself, are reduced only to the cases in which it

may be advantageously substituted to the common forceps. This, by the

by, is reducing it to less than nothing. But how is this consistent with

those same marvellous excellencies he displayed to us a little before,

to wit? “_It is very feasible with it to extract the head of a child

separate from the body, and remaining in the uterus._”——And again,

“_with my instrument it appears to me possible, to assist powerfully the

getting out the head of a child that shall have remained in the uterus,

the body being entirely come out, but of which a part is still in the

vagina_.”

NOW these two cases clearly imply, that Mr. Levret’s curve forceps is

capable of going into the uterus in search of the child’s head, even

when it is not engaged in the orifice: for here the case meant, is

either that of a head remaining detachedly in the uterus, after having

been severed or torn away from its body: or of a head not separated, but

remaining in the uterus after the body shall have come out, and part of

it is still in the vagina.

IF therefore Mr. Levret’s forceps had the advantage over the common

forceps, confessedly insignificant in these cases, of being able to lay

hold of these heads, he might be somewhat in the right to exalt it as he

has done. But at present he must be wrong, which ever side he takes. The

dilemma is self-evident. He is in the wrong to deny what he had

certainly said. He is in the wrong to complain of being taxed with an

opinion, which his own allegations prove he had entertained. I therefore

refer Mr. Levret from himself to himself. If he did not believe, that

his curve forceps had over all the rest the properties he sets forth,

why has he so confidently affirmed them? and after affirming them, why

would he hinder us from thinking that he believed what he affirmed?

I AM here to observe, that if I have made use of the terms of “a head

not _separated but remaining in the uterus after the body shall have

come out, and part of it is still in the vagina_,” it is purely because

I would not change any thing in the expression of this celebrated

instrumentarian. It is this exactness of quotation, that has made me

conform myself to his manner of speaking, in my answer upon this

difficulty. Otherwise, I own, I do not apprehend the propriety of his

description of the case. It surprized me too the more, in so intelligent

a writer as Mr. Levret, that he should represent to us a body come out

of the uterus, and yet remaining in the vagina; as if, on such an

occasion, the vagina could be distinguished from the orifice of the

uterus. It is even stranger to me yet in Mr. Levret, for that he

himself, in a note, p. 106, of his observations (by me before quoted)

expressly says, that “when you are for using this forceps, it is

absolutely necessary that the orifice of the uterus should be, as it

were, totally erased or defaced;” so that the vagina and orifice should

be laid into one. (See p. 420.)

HERE follows a much more material contradiction, rather however to

common sense than to Levret himself, to which I intreat the reader’s

particular attention.

OBSERVATIONS, part the 2d, p. 160. Levret gives us the following

preliminary general precept.

“THERE is, says he, a general precept by which it is established, that a

surgeon ought never to thrust instruments into deep places, without

guiding or conducting them with the hand, or with the extremity of the

fingers of that hand that does not hold the instrument.”

IT is then to this general axiom strongly dictated by reason, and surely

in no case more obviously so, than where the exquisitely tender texture

of the uterus protests against committing its safety from the cruellest

injuries, to the necessarily blind random agency of an iron or steel

instrument, so palpably ungovernable in so remote, intricate, and

slippery a place by even the most skilful hand[40]; it is, I say, in

exception to this so salutary general precept, that Mr. Levret will have

it that there are exceptions, and in favor of what, do you think, not

surely of the poor woman who, is to be the subject, or rather the victim

of the experiment, but of——his most egregiously silly CURVE FORCEPS!

Yes; it is by way of trying practices with that same instrument, that

the patient is liable to be _spread out_, in that delicate attitude

which I have above, (p. 237) described from Levret, to the perusal of

whom, for a thorough conviction of the perfect insignificance of that

instrument, or indeed of any of that sort, I would recommend even the

most sanguine in favor of instruments, if they would but grant, to their

own reason, its just prerogative of a previous suspence of prejudice.

IN these cases, however, for the which being exceptions to that

excellent general rule, Levret contends; and, to do him justice,

contends so auckwardly, that he rather provokes pity than indignation,

at his endeavouring to establish even so pernicious an error; let the

reader consider within himself the part into which this forceps is to be

thus blindly thrust, at the risque of so many almost inevitable dangers.

And for what?——In those cases it is either possible or not possible to

introduce the fingers. Where they absolutely cannot be insinuated, the

introduction of those instruments is in all human probability big with

the worst of mischiefs, where neither hand nor fingers can controul the

effects of the iron or steel: which, consequently, endanger more than

they can help, and are therefore not to be used. But if the hand or the

fingers can be insinuated, the hand or the fingers well conducted will

do the work without the help of instruments, which in this second

supposition become also useless.

THIS brings me to this case particularly, the title of which is prefixed

to this section, that of a head stuck in the passage, which the

gentlemen-midwives may perhaps second Levret, in maintaining to be an

exception to that admirable axiom above quoted, and maintain it purely,

in evasion of the conclusion against their miserable instruments, which

I aver need never be resorted to, nor never are, but for want of

sufficient skill in the manual function to terminate such labors without

them.

I ANSWER then to these instrumentarians, that an instrument, even, no

more dangerous than a probe, would in so tender a place as I am treating

of, not perhaps be quite enough exempt from a possibility of doing

mischief, to deserve an exception: but as to those instruments, which

are so palpably likely to hurt both mother and child, to injure, in

short, or even to destroy both the mould and the cast, they are all of

them within the case of exception, or rather exclusion. It is then, in

knowing what to do, and in the faculty of operating with the hand

according to that knowledge, that the art of midwifery principally

consists. If instruments are deemed ingenious, the doing without them is

surely not less so.

NOW as to the case proposed in this section, that of a child’s head

stuck in the passage, I aver, that it is not absolutely impossible to

terminate this delivery by the hand.

I AM even ready to demonstrate this before any competent judges. I speak

by experience. I have hitherto executed with all desirable success this

operation without any aid but that of the hand, with a little patience

and proper assiduity. I have many and many a time seen it practised at

the Hôtel Dieu, and elsewhere. I never in my whole course of practice

saw sufficient reason for attempting so hazardous an extraction, as that

which is executed by means of a tire-tête. Why then those needless

terrors, those superfluous tortures with instruments, to women already

in too much pain and anguish? care enough could not be taken to spare

those of the weaker-nerved sex in that condition such horrors, the very

idea of which, to say no more, is enough to put them into imminent peril

of their lives. All the forceps, and the rest of the chirurgical

apparatus, especially the more complex instruments, very justly frighten

the women, and their friends and assistents for them. Their introduction

requires at once a painful, a shocking, and a needless devarication. The

patients are put into attitudes capable of making them die with

apprehension, if not with shame, from that native modesty of theirs,

which, in these cases, may however be pronounced rather a wise instinct

than a virtue.

HOW much preferable is the true midwife’s practice, who will have

oftenest prevented, by her knowledge and skill, this very situation!

That is to say, if she has been called in time. She knows how to

predispose the passages, and by gentle reductions to restore Nature to

her right road, where she has been through mispractice driven out of it,

or through negligence suffered to deviate from it, or not preventively

watched.

I HAVE never but seen, with respect to the uterus in this case, that it

was possible to insinuate first one finger, then another, and little by

little the whole hand, not indeed a hard hand, as big as a shoulder of

mutton, the hand of some lusty he-midwife, but of a midwife, such as it

is commonly seen.

WHEN Nature does not proceed as could be wished in her labor-pains, the

point is then to husband well the strength of the patient, to restore it

where it fails, by giving her good broths and corroboratives, that do

not heat, or cooling things, where heating ones have been injudiciously

administered. She is then to lie as composed and tranquil as possible;

to be cherished, comforted, inheartened. There is, humanly speaking, no

fear but her strength will return; her pains must not be irritated, nor

herself harrassed with ineffectual interference. Nature will come to

herself again: the situation will, by her benign energy, change for the

better, and become favorable enough, for the midwife to be able to

assist her in the due time with a manual operation, that will terminate

happily her delivery. It is at least, with this success, that I have

delivered many, who, by the unskilfulness of those who had attended

them, at the beginning of their pains, had been reduced to a deplorable

condition, by their labor lingering some for upwards of six days.

IN short, it is extremely rare that this case of a head stuck in the

passage ever happens, unless under the hands of unskilful practitioners,

or of over-dilatory or neglectful midwives, who will not have duly

attended to the prognostics of this event; who will not have watched and

taken the benefit of the favorable critical moment; who give the head

time to engage itself, or get fast jammed, for want of their removing

the impediments to Nature’s doing the rest, or when help has been called

or come too late. It may also be owing to those who hasten too much, who

precipitate the women’s labor by forcing draughts, that heat, burn them

up, exhaust their strength, and prematurate the coming on of the

labor-pains. Some practitioners fatigue them, with making them walk, or

keep them up too much.

BUT when the membranes are not too soon pierced and the waters let out,

when the pains are not provoked, when time is given to Nature to form to

herself a passage, not omitting the precautions I have summarily

intimated; when due care is taken to procure all possible ease of body

and mind to the patient; who may vary her posture, sometimes lying

along, sometimes sitting up, or well supported when she walks: little by

little the head will frank itself a passage with the weight of the body

acting by an innate energy, and with a little due assistence of the

midwife’s art: and with this practical advertence, that, in these

arduous cases, much may be safely left to Nature, but not every thing.

There are times in which she cannot bear neglect, but there are none in

which she can bear extreme violence.

HERE the reader will not expect I should in a treatise, purely

calculated to expose the abuses of midwifery, attempt to particularize

either all the contingent cases, or all the modes of operation in them.

That would require a work a-part. I shall only then, to the four

principal cases, in which instruments are so falsely supposed necessary,

add a summary account of that of a _pendulous belly_, which is not

without its difficulty.

AS to a PENDULOUS BELLY, madam Justine, midwife to the Electress of

Brandenbourg, remarks, in her Treatise of the Art, that she knows, by

experience, that some children turn upon their heads with their feet

upwards, in women who have a large and prominent abdomen; because, says

she, they are pitched too much into the fore-part of the belly, that is

become pendulous. But she does not explain the consequence of this

situation, which however does not fail of causing a severe and

troublesome labor; in that the uterus being fallen into the capacity of

the hypogastrium, and the child being got above the os pubis, there it

sticks, and the labor-pains are ineffectual, if proper assistence is not

given to Nature.

THE practice which my success on experience encourages me to propose is,

to have the patient lye on her back, the belly to be braced upwards with

a large linnen-fold or roller, to reduce the uterus and fœtus to its

better position in the capacity of the pelvis; but if, notwithstanding

that help, the head of the child continues to rest on the os pubis, the

finger must be insinuated between those bones and the head, in order to

make, it, little by little, retrograde into the pelvis towards the

coccyx.

IN every case then that can be imagined, so far as my own experience and

observation have reached, I am authorized to aver, that the gentleness

of the manual assistence to women is at once more agreeable to Nature,

and more salutary than the violence of the instrumental practice; which

not only conveys the idea, but the very reality of a butchery. While its

being sheltered under the plausible pretext of tenderness and pious

regard to the safety of the poor women and children, cannot but provoke

the greater indignation, at seeing vile interest trifling thus wantonly

with their lives, and add to the cruel outrages on the human person, the

greatest of insults on the human understanding.

IT cannot however have escaped observation, that while I am, with the

utmost regard to truth, endeavouring to recommend the preference of the

hands to instruments, there is nothing I mean so little, as that some

deliveries may not be accomplished by instruments, and especially by

that divine invention of the forceps. What I presume to exclaim against,

is the needless torture to the mother, the needless increase of danger

to which she and her child both are exposed, for the sake of that

practice being tried upon them, with those instruments, when the bare

hands would be so much more safe and effectual. I could myself, no

doubt, in many cases, if I could be inhuman and wicked enough to dally

with any thing so sacred as the health or life of a woman and child, in

some measure, entrusted to me, give myself the learned air of delivering

with a CURVE FORCEPS. But in the very same cases, though at the hazard

of being called ignorant for my pains, I would always be sure to do it

more cleverly, less dangerously, less hurtfully, with only my hands. So

that, without straining any comparison, the forceps may deliver indeed,

but how? Why just as a man may, if he chuses it, hobble round St.

James’s Park, on a pair of those _artificial legs_[41] called stilts,

when one would imagine, that the mock-elevation from them could scarce

atone for their uncouth totteringness, and that he might full as well

deign to use his own _natural_ legs.

IN the slighter cases then, that is to say, in those cases, where it is

a jest to doubt of the hands not being the preferable instrument, since

they may be truly averred to be so even in the most difficult ones,

instrumentarians commonly go to work, _only_ (please to mind that

_only_) with the forceps. So that it is _only_ in those slighter cases,

where, once more nothing is more certain than that no instrument is

wanted at all, that they find matter of triumph over their predecessors

in theory and practice, over common sense, and especially over humanity.

And this is that amazing, that FORTUNATE IMPROVEMENT, the superhuman

invention of the forceps, the philosopher’s stone of the modern art of

midwifery, found out by the male-practitioners. Yet, after all it

plainly appears, that even themselves do not rely on it in the more

difficult cases. They are then obliged to return to the _old_ crotchet,

or the like methods, which bad, very bad, and very inferior to the hands

as they are, never however are supposed to be resorted to, without an

appearance of extremities to afford some color, some plea of humanity to

employ them, in a kind of dernier resort, to prevent a greater evil by a

less one. Whereas, when the forceps is used, the cruelty of that torture

it cannot but create, must be greatly aggravated by the consideration of

its being perfectly needless. But in the case of using either crotchet

or forceps, or indeed any instruments at all, the truth is, that besides

the increase of danger and pain they bring, to the already too much

afflicted patients, they defraud them of the more efficacious, less

painful, and especially more safe help of the hands alone.

THE instrumentarians all then agree on that insufficiency of this

precious forceps, which occasionally compels their recourse to the

crotchet so detested even by themselves. Levret, for example, confesses

this, p. 24, of the appendix to his observations.

“THE crotchets (says he) are, generally speaking, instruments, the very

sight of which shocks and terrifies: but notwithstanding the repugnance

which all _good_ men-midwives ought to have to the using of them, there

are cases in which there is no doing without them.”

NOW in these cases, that of the monster with two heads[42], is not meant

to be included, as Levret himself afterwards explains himself. If then

there are such cases as necessitate a recourse to crotchets, it will, I

presume, be allowed me, that they can be no other than those which

render the delivery the most laborious. What those cases are, I have,

from after the instrumentarians themselves reduced to the four capital

ones, I have above set forth, without reckoning the pendulous belly. At

least I know of no other situations than those, that can produce the

very severe labors, nor do I believe that the instrumentarians know any

other, or they would tell us so. Now if, in the more difficult of those

cases, there is no doing without the crotchet, what becomes of the

prodigious merit of the forceps, so insignificant in cases of the

greatest need, and so superfluous in those others, where there being no

occasion at all for it, it must be the most inhuman wantonness to employ

it?

HERE can you be with too much insistence desired to observe the solemn

banter, in such a matter of life and death too, of these kind,

tender-hearted modern instrumentarians! they are so transported with

stark love and compassion to the poor women and children, that they do

not know what they are about; they fall into the most palpable

contradictions, and would have even Hippocrates, and the antients,

appear as so many bloody-minded Cannibals compared to them. Hippocrates,

it seems, and the antients, according to the best of their apprehension,

in points of midwifery, prescribed the crotchet, in no case however but

where the child was certainly dead, which, by the by, is next to the not

prescribing it at all, since the ascertainment of that death is scarce

not impossible. So because they recommended this practice in the last

necessity, the ingeniousness of the modern instrumentarians was

“[43]stimulated to contrive some _gentler_ method of bringing along the

head” —— without any necessity at all; that is to say, in the minor

difficulties, for the crotchet of the old practice is, to this instant,

even with them, left in possession of the greater ones. Thus was

produced the forceps, that prodigiously bright refinement upon the dull

antients, and goes on improving without end under the wise heads of our

gentlemen-midwives. But if the modern Genius of arts and sciences has no

better improvement than this to boast over Hippocrates and the antients,

may the instinct of self-preservation defend mothers, and, in them,

their children, from being the trophy-posts of their victorious

atchievements! may the midwives continue in their happy ignorance of

their curious devices! may they ever preserve a due aversion from indeed

all instruments whatever! for they are all needless and pernicious

substitutes to the hands. May none of them, especially in any labors

committed to their conduct, prove so criminally false to their sacred

trust, as through negligence, or through an interested designing

reliance upon instruments, to repair their failures or mispractice,

slacken their attention to their duty, or afford, by their defective

performance, an excuse, though a fallacious one, for resorting to

instruments, when skilful hands are incomparably more fit for a remedy

or retrieval!

I CANNOT then too ardently wish, for the women not to be so cruel to

themselves, and to their so naturally dear children within them, as

inconsistently to suffer their aim at superior safety, to be the very

snare that betrays them into the greater danger, and often worst of

consequences, from those male-practitioners, to whom that aim drives

them for recourse; while that examination they owe to so interesting a

point would issue, or deserve to issue, in rescuing them from such a

shameful subjection of body and spirit to a band of mercenaries, who

palm themselves upon them, under cover of their crotchets, knives,

scissors, spoons, pinchers, fillets, _terebra occulta_, _speculum

matricis_, all which, and especially their _tire-têtes_, or _forceps_,

whether Flemish, Dutch, Irish, French or English, bare or covered, long

or short, strait or crooked, flat or rounding, windowed or not windowed,

are totally useless, or rather worse than good for nothing, being never

but dangerous, and often destructive.

NATURE, if her expulsive efforts are but, in due time, and when

requisite, gently and skilfully seconded by the hands alone, will do

more, and with less pain than all the art of the instrumentarians, with

their whole armory of deadly weapons. The original and best instrument,

as well as the antientest, is the natural hand. As yet no human

invention comes near it, much less excells it: and in that part it is

that the women have incomparably and evidently the advantage over the

men for the operations of midwifery, in which dexterity is ever so much

more efficacious than downright strength.

AND, indeed, let every requisite faculty for the assistence of lying-in

women be well considered, and the resulting determination cannot but be,

that in the common labors, where the men themselves are either simple

by-standers or receivers of the child, or operate with the hand only,

they are the very best of them, not comparable to a common midwife, and

in those cases, in which they pretend the use of instruments necessary,

hardly better than the worst one. So that, not less than justly

speaking, they are not receivable, either as substitutes, or even as

supplements to midwives.

THE art of midwifery then, in its management by women, carries with it,

in the recommendation of order, modesty, propriety, ease, diminution of

pain and danger, all the marks of the providential care of Nature. It is

imaged by the incubation of a brood-hen, assiduously watching over her

charge, and tenderly hatching it with her genial heat. Whereas the

function of this art, officiated by men, has ever something barbarously

uncouth, indecent, mean, nauseous, shockingly unmanly and out of

character: and, above all, of lame or imperfect in it. It strongly

suggests the idea of the chicken-ovens in Egypt, kept by a particular

set of people, who make a livelihood of the secret, which they, it

seems, ingross of that curious art of hatching of eggs by a forced

artificial heat: a practice, which, like the other refinements of

dungbeds for the same purpose, or that of committing the rearing or

education of the chickens to[44]“_cocks_, to _capons_, or to _artificial

wooden mothers_,” may sound indeed vastly ingenious; but besides the

numbers that perish the victims of those experiments, many of the

productions of such methods of hatching are observed to be maimed,

wanting a leg or a wing, or some way damaged or defective. The

comparison breaks indeed in that, at least, the grown hens themselves

escape damage, which is not often the case of mothers under those

heteroclite beings the men-midwives; or, if they do escape, it is no

thanks to those operators, but to the prevalence of Nature over their

pragmatical intervention, so fit only to disturb, thwart, or oppose her

effects, and in every sense to deprive the unhappy women that trust them

of her common benefit.

BUT while superior considerations of humanity so justly intercede for

the mothers, while I strenuously contend for the preference to be,

without hesitation, due to the mother over the child, especially in that

dreadful dilemma, where one must be sacrificed to the safety of the

other; supposing such a dreadful alternative ever to exist, which I much

doubt, or at least, not to exist so often as it is rashly taken for

granted, and even then, where the effects do not always follow the

resolution taken thereon, since, though the child is always certainly

lost, the mother is far from always saved, when, by a judicious

preventiveness in practice, neither of them might perhaps have been so

much as in jeopardy; while, I say, I plead for the preferable attention

to the mothers, I hope no mothers will think me the worse intentioned

towards them, for giving the lives of their children the second place in

my tender concern for the safety of both.

AND surely never was a time, when children more required the

intercession of humanity in their favor. Mothers can speak for

themselves. But the poor infants, so often precluded, by violence, from

the pity-moving faculty of their own cry, have nothing but the cry of

Nature to plead for them. A cry, the listening to which is prevented by

those vain imaginary terrors, inspired by designing Art in the service

of Interest, through which Nature is seduced to act against herself, and

deliver herself up to her greatest enemies.

IN short, one would imagine, that all the rage of cruelty was unchained,

and let loose against especially those tender innocents, born or unborn.

AMONG the poor, particularly as to those infants cast upon the public

charity, a barbarously premature ablactation, under a pretext so easily

foreknown to be as false as it is fatal, of bringing them up by hand for

cheapness-sake, has destroyed incredible numbers.

AMONG the rich, or those able enough to pay for the learned murder of

their offspring, how many of their children, even before they have well

got hold of life, in this, literally speaking as to them, iron age,

encounter their death or wounds, stuck in the brain by a crotchet, or

crushed by a forceps, to say nothing of their being now and then

ingeniously strangled in the noose of a fillet!

AND those horrors proceed unchecked and unexploded, and in what a

nation? a nation, that values herself upon the distinction of profound

thinking: a nation that, besides that interest she has in common with

all other well-governed nations, to protect and promote population,

stands, be it said, in that true spirit of justice, which as much

disdains to pay a fulsome compliment, as good sense ever will to receive

it, moreover eminently distinguished above them all, for producing a

race of natives, one would think could hardly be too numerous, since

they are the most remarkable in the known world for courage, for

personal beauty, and for many other liberal gifts of Nature, among which

surely not the least is, that inborn spirit of liberty, to which they

owe the honorable acquisition of so many additional advantages.

CAN it then be too strongly recommended to the women especially, at

least, to examine whether their notion of superior safety under the

hands of a man, in their lying-in, bears upon the solid foundation of

Nature, or merely on the treacherously weak one of a delusive opinion?

an opinion that owes its existence to fears cruelly played upon, and

turned to account by designing Interest. If those then of them who are

under the force of prejudice, or governed by habit, or by both at once,

would, on a point that concerns themselves and children so nearly,

assume liberty enough of mind to shake off the dangerous yoke, they

would undoubtedly find it better and safer to listen to that salutary

instinct of Nature so authorized by reason, which inspires them with

that repugnance to submit themselves in the manner they must do that

submit themselves to men-midwives, who have the impudence to call that

repugnance a “_false modesty_:” as if that Modesty could not be a true

one, a foolish one I am sure it could not be, that should murmur at

being so cruelly sacrificed to such a bubble’s bargain as it is, by

those innocents, who, over-persuaded by a deceitful promise of more

effectual aid, too often embrace a torturous and a shameful death, for

which, to add ridicule to horror, they are expected to pay their

executioners larger fees than to one of their own sex for a more decent,

a more safe, and always a less painful delivery.

MAY the women then, for their own sakes, for the sake of their children,

cease to be the dupes, sure as they are to be in some measure the

victims of that scientific jargon, employed to throw its learned dust in

their eyes, and to blind them to their danger or perdition! may they, in

short, see through that cloud of hard words used by pedants, whose

interest it is to impose themselves upon them: a cloud, which is oftener

the cover-shame of ignorance, than the vehicle of true knowledge, and

perhaps oftener yet the mask of mercenary quackery, than a proof of

medical ability!

AS to the writings of the men-midwives especially, I dare aver, that,

though there may be here and there some very just theoretic notions,

borrowed from able physicians and surgeons, nothing is more contemptible

than most of their practical rules; what is tolerable in them being most

probably got from midwives, but so disfigured with their own absurd

sophistications, that I should heartily pity any woman, subjected to

have her labor governed by such, as should have no better guidance than

their ridiculous instructions.

THEN it is that a sensible woman would, in defence of her own life, or

of any life that she holds dear to her, in the case of needing the aid

of midwifery, view with equal disdain, with equal horror, either the

rough manly[45] he-midwife, that in the midst of his boisterous

operation, in a mistimed barbarous attempt at waggery or wit, will ask a

woman, in a hoarse voice, “if she has a mind to be rid of her burthen,”

or the pretty lady-like gentleman-midwife, that with a quaint formal

air, and a gratious smirk, primming up his mouth, in a soft fluted tone,

assures her, and lies all the while like a tooth-drawer, that his

instruments will neither hurt nor mark herself nor child but a little,

or perhaps not at all. (See p. 448.)

THIS last character, if less brutal than the other, is not perhaps the

least dangerous, since the practice being at bottom the same, pregnant

consequently with the same mischief, the gentleness of the insinuation

gives the less warning, and paves the way for the admission of a

handling not the less rough for the smoothness of the address. But is

there any such thing as polite murder? is mischief the less mischief for

being perpetrated with an air of kindness? well considered it is but the

more provoking. The male-practitioners then are not quite in the wrong,

to presume as they do upon the weakness of the women’s understanding,

since they can so grossly pass upon them their needless cruelties, under

so inconsistent and false a color as that of a tender compassion. Thus

to all the rest of the shame to which they put them, they add that of so

palpable an imposition in that flimsy cover of the mean interest, which

is so probably the real motive at bottom of their taking up a function,

to which they were never called by Nature, nor by any necessity, unless,

perhaps, of their own.

IN the mean time, the truth is, that, in vain, would the men, by way of

sparing the women the terror of their masculine figure, upon those

delicate occasions of officiating, and to appear the more natural in the

business, aim at an occasional effemination of their dress, manner and

air. They can never in essentials atone for their interested intrusion

into an office, so clearly a female one, that, if but only as to the

manual discharge of it, not even the qualifying them for the opera,

would, perhaps, sufficiently emasculate them.

CONCLUSION of the SECOND and LAST PART.

HERE, confessing my just apprehensions of not having fulfilled the

promise of my title-page; there will not, I hope, to that reproach of my

deficient powers in the performance, be added the undeserved ones of

vanity or injustice in the design or conduct of my feeble essay.

FOR as to vanity, or any presumption, on my part, of any thing so weak,

so unauthoritative as my representation, having any chance to remove the

abuses, not however the less existent for that incapacity of mine to

remove them, my knowledge of the world would alone defend me from so

ridiculously wild a thought. I am but too well aware of the

tenaciousness of especially false prejudice in most minds, where it has

once gained entrance, and with whom prepossession is ever eleven points

of the right. I have then purely had in view the discharge of that duty,

incumbent on every member of human society, to oppose such errors as

appear to be pernicious to the good of it. In that light I have beheld

the growing practice of the instrumentarians, and in that sincere belief

I have hazarded the publication of my sentiments, without surely

pretending to any authority over the opinion of others. That I

chearfully leave to every one’s reason, who is capable of reason. And to

write for others than the rational, would be only labor deservedly lost.

AS to injustice, I am, at least, clear of that of partiality to my own

sex. I grant and lament as much as any one the incompetency of but too

many of the midwives. The number of such cannot be too little. But then

would the banishing them out of the practice be preferable to the having

them better taught, especially since there is nothing but what is so

much worse to put in their room, men and instruments? What occasion too

for such a dangerous extremity? For as the deficiency is evident, so are

the causes: which are not only the want of sufficient care in the

training and education of women to this profession, but the actual

discouragement, which must grow every day greater and greater, by the

encroachments of the instrumentarians, whose plea for supplanting them

will be consequently strengthened by that alarming scarcity of capable

midwives, which themselves will have so much contributed to create.

These being then the principal causes, and well known to be so, the

remedies are not obscure, nor hard to attain.

A GOOD education especially is of great importance, to accomplish what

Nature has already gone so great a way in, by her giving in many

respects to the women such a superior aptitude for the business. Capable

midwives would much help to form good female pupils; and the lying-in

hospitals especially might be made highly useful to so desirable an end.

But surely as to the practical part of midwifery in these hospitals, it

ought not to be under the direction of men, whose interest it should be,

only to form the women so deficiently, as that themselves might be the

less unnecessary; to form them, in short, more for their own service,

than for that of the public. That temptation being removed, the

female-practitioners could not receive too respectfully from the

surgeons lectures or instructions, any lights in anatomy relative to

their theoretic proficiency. But to nothing should they be more

constantly and effectually excited, than to perfect themselves in the

manual operation; and indeed, in general, so to capacitate themselves

for their function, as to prove and establish the perfect inutility of

all instruments whatever. Nor will it be a difficult task for a woman to

acquire a superiority in her hands to the most boasted of those

unnatural substitutes. This is the true way of laudably disarming the

instrumentarians, and of thereby depriving them of the only shadow of a

pretence they have for supplanting the women, and invading the female

province, of which invasion it is so probable, that not the cause they

plead, but the pay they squint at, is the real motive.

AS to the discouragement of proper women from applying themselves to the

profession, it can only cease by the concurring of those, on whom the

choice out of either sex occasionally depends, to restore things to

their antient channel: and that will in course, for their own sakes,

follow on their ceasing to be imposed upon by the false pretences of the

men-practitioners. But this is a point upon which I am too much a party

to be heard, though even as no more than an advocate, and much less as a

judge. All I shall then presume to say is, that I very readily leave the

decision of the question to Reason, that inward oracle in every one’s

breast; an oracle, which, in a cause so interesting to human Nature, can

never return a false answer, where consulted by those who deserve to

find the truth by sincerely seeking it, with a firm design to sacrifice

to it the poor vanity of defending a prejudice, or any other interest of

the passions. And surely there can hardly exist a point of more capital

importance to Society, than the determining, what however one would

imagine not very difficult to determine, on which side in this

profession of midwifery particularly, the superiority of auxiliary power

may be expected, on that, where there is evidently a great deal of

Nature, assisted with a little but a competency of Art, or on that,

where what there is of Art is most barbarously abused, and without any

Nature at all.

The END.

[Illustration]

-----

Footnote 1:

Exod. Chap. vii. and viii.

Footnote 2:

Diod. Sic. Herodotus.

Footnote 3:

The Commentator on Boerhave’s Lectures, vol. V. p. 252. or §. 694.

says, “_At Paris women are taken into the Hôtel Dieu, fifteen days

before their lying-in, at the public expence, so that the business of

midwifery can be no where better learn’d._”

Footnote 4:

_It is evidently this universal influence of the_ Uterus _over the

whole animal system, in the female sex, that Plato has in view in that

his description of it, which Mr. Smellie (introd._ p. 15_) calls_ odd

_and_ romantic, _from his not making due allowance for the figurative

stile of that florid author. Thus the diffusion of the energy of the_

uterus, _Plato calls its_ “wandering up and down thro’ the body.” _A

power of activity which, towards conquering the otherwise natural

coldness of the female constitution, nature would hardly give to the_

uterus _merely to excite in women a desire, sanctified under due

restrictions, by her favorite end, that of propagation, if she had

not, at the same time, endowed that uterus with an instinct,

beneficial by its influence in the preservation of the issue of that_

desire. _And the real truth is, that there is something that would be

prodigious, if any thing natural could be properly termed prodigious,

in that supremely tender sensibility with which women in general are

so strongly impressed towards one another in the case of lying-in.

What are not their bowels on that occasion? It may not be here quite

foreign to remark, in support of the characteristic importance of the_

uterus _or the_ womb, _that in the antient Saxon language the word_

Man _or_ Mon _equally signified one of the male or female sex, as_

Homo _in Latin. But for distinction-sake the male was called_

Weapon-man, _(not however for any offensive weapon or_ instrument _in

midwifery;) and the female_ Womb-man, _or man with an_ uterus: _from

whence by contraction the word_ woman.

Footnote 5:

Smellie. Treatise of midwifery, p. 339. _where it appears, that the

above dress is reserved for a man-midwife’s masquerade-habit in

private practice, before ladies, not to frighten them; whereas to the

poor women in hospitals his looking like a butcher, is it seems

necessary, with bases and an apron; the_ steel _of course._ But if it

is not too presumptuous for me to offer so _learned_ a gentleman as

the Dr. a hint of improvement for his man-practitioner’s toilette,

upon these occasions, I would advise, for the younger ones, a

round-ear cap, with pink and silver bridles, which would greatly

soften any thing too masculine in their appearance on a function which

is so thoroughly a female one. As to the older ones, a double-clout

pinned under their chin could not but give them the air of very

venerable old women.

Footnote 6:

_If a man happens by great chance to have long taper fingers, it is a

circumstance so uncommon, that it is proverbially said of him, “He has

rare_ midwife’s _fingers.”_ Nor was it quite unhumorously observed of

one of the founders of the sect of instrumentarians in England,

remarkable for a raw-boned coarse, clumsy hand, that no forceps he

could _invent_ of iron or steel, being more likely to hurt than his

fingers, he had, at least, that excuse for recommending instruments.

Footnote 7:

_A la veritê_ Mauriceau _raporte cette mort inopineê à une_ CAUSE

OCCULTE, _puisqu’il dit expressement que_ “ce fut un de ces fortes de

malheurs de la destinée que toute la prudence humaine ne peut pas

eviter.” _C’est aussi l’opinion de_ la Motte. LEVRET, p. 272.

Footnote 8:

Levret, p. 269.

Footnote 9:

This will doubtless be laid hold of as one proof, that midwives have,

in cases where they are puzzled, been forced to have recourse to

men-practitioners: but I have no where said, there were not some

midwives unequal to their business. The sequel will shew, that this

most probably was one of them, and the case was not much mended by the

assistent she called in. A little more patience, though I confess

there is some room to think it in this so long lingering case

excusably exhausted, would have prevented the murder of the child: but

as the concomitant circumstances are not specified, I cannot pretend

to determine that point. All I shall say is, that there is not hardly

one case in a thousand, in which nature does not know her own time

best, and does not take it kindly to be hurried. It has been known,

that sometimes the quickest deliveries have been the most fatal, and

the most liable to sudden death, by consequent hemorrhages.

Footnote 10:

_Dr._ Smellie _has himself_ (p. 403.) _ranked among the causes of

sudden death to women by violent floodings after delivery the

following one; “if in separating the_ placenta _the_ accoucheur _has_

scratched _or_ tore _the inner surface or membrane of the_ womb.” _But

if unpared nails, or the rough hands of a man, may cause such a

dreadful accident, what may not be dreaded from iron and steel

instruments, blindly thrust into parts of a scarce less tender texture

than the apple of the eye? But of that more hereafter._

Footnote 11:

Levret’s words, p. 279.

Footnote 12:

_It is among the smaller mischiefs done to the mother, that I here

mention my having not unfrequently seen ruptures brought on by the

practice of men-midwives, upon patients in other lyings-in,

precedently to the one in which I attended them. These ruptures I have

sometimes been able to remedy by good management in my laying them._

Footnote 13:

“Let the _forceps_ be unlocked, and the blade _cautiously_ disposed

under the cloaths, so as not to be _discovered_”. Smellie, p. 272.

Footnote 14:

See Smellie, p. 307.

Footnote 15:

Smellie, p, 291. “When the head presents, and _cannot_ be delivered by

the labor-pains; when all the _common methods_ have been used without

success, the woman being exhausted, and all her efforts vain; and when

the child cannot be delivered without such _force_ as will _endanger_

the _life_ of the _mother_, because the head is too large, or the

_pelvis_ too narrow: it then becomes absolutely necessary to open the

head, and extract with the hand, forceps, or crotchet. Indeed this

last method formerly was the _common_ practice when the child could

not be _easily_ turned, and is still in use with _those_ who do not

know how to save the child by delivery with the _forceps_: for this

reason their chief care and study was to distinguish, whether the

_Fœtus_ was dead or alive; and as the _signs_ were _uncertain_, the

operation was often delayed until the woman was in the most imminent

danger; or when it was performed sooner, the operator was frequently

accused with _rashness_, on the supposition that the child _might_ in

time have been delivered _alive_ by the _labor-pains_: perhaps he was

sometimes conscious to himself, of the _justice_ of this _imputation_,

although what he had done was with an _upright_ intention.”—This last

indeed would be too uncharitable not to grant.

Footnote 16:

Smellie, p. 255. “In this case, we find, _by_ experience, that, unless

the woman has some VERY DANGEROUS SYMPTOM, the head will in time slide

_gradually_ down into the _pelvis_, even when it is too _large_ to be

_extracted_ with the _fillet_ or _forceps_, and the child be SAFELY

delivered by the _labor-pains_, although _slow_ and _lingering_, and

the mother seems _weak_ and _exhausted_, provided she be supported

with nourishing and strengthening cordials.” Now in this Dr. Smellie

is very right; his wrong consists in not making this conclusion more

extensive, as that of his fellow-practitioners too often does, in

fancying or exagerating _dangerous symptoms_: whereas for once that

nature really occasions them, they are incomparably oftener the

effects of the operator’s own mispractice: this observation I cannot,

for the truth and importance of it, too often repeat.

Footnote 17:

In honor to truth, be it here noted, that a few, and very few indeed

of the midwives, dazzled with that vogue into which the instruments

brought the men, to the supplanting themselves, attempted to employ

them, and though certainly they could handle them at least as

dextroussly as the men, they soon discover’d that they were at once

insignificant and dangerous substitutes to their own hands, with which

they were sure of conducting their operations both more safely, more

effectually, and with less pain to the patient.

Footnote 18:

At this day archbishop of Cambray.

Footnote 19:

By this interest, with respect to the mis-government of the infants

that fall upon the parish, I do not mean such a personal interest, as

that the super-intendants of the charity put a single farthing into

their own private pockets, out of the savings, by the with-holding or

grudging a proper provision for the children, but merely the interest

of a parish, or the public, in so false and inhuman an article of

parcimony. A consideration which, if that were possible, renders it

the more inexcusable from the temptation being so much the less.

Footnote 20:

I have somewhere read, that brutes have not been insensible of this

effect, on suckling animals, though even of so different a kind from

their own, that the most mortal enmity naturally existed between them:

such was the instance, transmitted from Pensylvania, of a cat so

softened towards a rat, by having accidentally given suck to it

amongst its own kittens, that it forbore exerting towards it its usual

hostility to that species.

Footnote 21:

The candid reader will please to observe, that in giving up so much as

I do of the argument from the prevalence of fashion, I do not give up

a little: since I might justly oppose to it the instances of our Royal

Family, in which we see so many happily living and florishing

monuments of the midwive’s capacity. _Accoucheurs_ had, I presume, no

_hand_ in delivering the greatest Lady in this kingdom. The

men-midwives will perhaps treat this as trifling. But what will they

say to so victorious a proof in favor of the female-practitioners, as

that taken from themselves, who, for the most part, were obliged to

the midwives for their ushering them into that world, of which they

are so much the light and ornament; and out of which world they are

rather not so gratefully employed in driving those, by whose function

they were helped into it?

Footnote 22:

Pray remark the following directions for the _choice_ of a midwife,

from Dr. Smellie, p. 448.

“She (the midwife) ought to _avoid_ ALL _reflections_ upon

_men-practitioners_, and when she finds herself _at a loss_, candidly

have recourse to their assistence: on the other hand, this

_confidence_ ought to be _encouraged_ by the _men_, who, when called,

instead of openly condemning her method of practice (even though it

should be _erroneous_) ought to make allowance for the weakness of the

sex, and rectify what is amiss, without exposing her mistakes. This

conduct will as effectually conduce to the welfare of the patient, and

operate as a silent rebuke upon the conviction of the midwife, who,

finding herself treated so tenderly, will be more _apt_ to _call_

necessary assistence on future occasions, and to consider the

ACCOUCHEUR as a MAN OF HONOR and a REAL FRIEND. These gentle methods

will prevent that calumny, which too often prevail among the male and

female practitioners; and redound to the ADVANTAGE of both: for no

ACCOUCHEUR is so _perfect_, but that he may err sometimes, and on such

occasions he must expect to meet with retaliations from those midwives

whom he may have roughly used.”

Footnote 23:

As the story is told in Hyginus, it should seem that the practice of

midwifery at Athens, was, on a season interdicted to the women, who,

by a fixt resolution to die rather than submit to be delivered by the

men, procured from the Areopagus the repeal of that statute, and the

saving from imminent condemnation one Agnodice, who had dressed

herself in men’s cloaths, to elude the cognizance of the law. The

great practice she had obtained by this means had alarmed the

physicians, who thereon accused her as a seducer of the women: against

which she easily defended herself by a declaration of her sex. But

this brought her under the penalty of the law against women exercising

the midwife’s profession. The story imperfectly related in Hyginus, at

the same time that it does honor to the modesty of the Athenian women,

that is to say, if modesty is not, according to the men-midwives, a

false honor, gives room to suspect, that the midwives themselves had

perhaps occasioned the promulgation of so absurd a law. It is well

known, that in those antient times, there were for female disorders

women-physicians in form. Perhaps their encroachments on the province

of the men, by exercising the art of physic in general, might make a

restraint necessary, which was only so far faulty as that the remedy

was in this, as it often is in other cases, carried into extremes. I

would no more justify the women overstepping their proper sphere of

employment into that of the men, than I would the men sinking into

that of women. They are both reprehensible, both dangerous, but

assuredly, the last must be the most ridiculous.

Footnote 24:

It is from this principle, that, with so fair a field for raillery,

often not the least forcible of arguments, I have, against those who

are such advocates for the use of _anatomy_ in _midwifery_, abstained

from laying any stress on the famous imposition of the Rabbet-woman of

Godalmin, upon professors of anatomy. I am so far from attacking

anatomy, that I aver, every good midwife ought to know _enough_ of it

to assist her practice. This would not however constitute her an

anatomist, nor is it requisite that she should be one.

Footnote 25:

“Il faut d’abord placer convenablement la malade, c’est-à-dire, sur le

bord de son lit; les cuisses élevées et écartées, les pieds rapprochés

des fesses, et maintenus en cette situation par des aides dont on soit

sûr.” _Levret_, UTILITÉ DU NOUVEAU FORCEPS COURBE, p. 161.

Footnote 26:

“Si on s’arrêtoit au précepte général, le _forceps_ seroit un

instrument de pure spéculation et non de pratique.” Lev. p. 161.

Footnote 27:

The term _imaginary_ is here far from an unjust one, and why should

not the honor of a deliverance, effectuated by Nature, be as well

given to a being of flesh and blood as to a stone? The virtue of the

_ætites_, or Eagle-stone, has currently passed for abridging the pains

of labor, and accelerating parturition. A French consul in Egypt,

ordered one of those stones to be tied to his wife’s thigh, who was in

a lingering labor. The stone in this case, more innocent than probably

a man-midwife would have been, who would have used means to hurry the

birth, or perhaps have gone to work with his _forceps_ at least,

suffered Nature quietly to go her own pace. What was the consequence?

The lady was soon after happily delivered, which there is no doubt but

she would equally have been if a brick-bat had been tied to her thigh.

But Nature lost the thanks so justly due to her: the stone ran away

with all her merit; and this case was added to the catalogue of the

miraculous operations of the stone. In how many cases might it be

said, that the stone here represents the man-midwife, if to the stone

it was not so much more innocent and less dangerous to have a

recourse?

Footnote 28:

See La Motte, p. 646, of the quarto edition, Leyden.

Footnote 29:

See La Motte, p. 262. lib. v. chap. 2.

Footnote 30:

If these _best_ operators had been examined touching their opinion of

midwives; they would most probably have told you, they were a parcel

of poor insignificant ignorant creatures.

Footnote 31:

Dr. Smellie seems to countenance this practice, where he says, p. 232.

“_We have already observed_, (p. 229) _that if there is no danger from

a flooding, the woman may be allowed to rest a little, in order to

recover from the fatigue she has undergone, and that the uterus may in

contracting have time to squeeze and separate the placenta from its

inner surface._”

Footnote 32:

It is but fair to observe, that M. De la Motte, (Obs. 248) instances,

from Peu, two patients perishing by the midwife’s trusting to the pure

actings of Nature in this very case.

Footnote 33:

Dyonis in his Treatise, book III. ch. 12. Mauriceau, book II. chap.

14.

Footnote 34:

This instrument was once as much in vogue, as can be supposed of a

time, when instruments were not so common as they are now. But how

much torture in vain must it have given before it was discovered, that

“so far from answering the _supposed_ intention of it, namely, to

extend the bones of the Pelvis; it can serve no other purpose than

that of _bruising_ or _inflaming_ the parts of the woman.” SMELLIE, p.

296.

Possibly the more modern instruments, which have supplanted this now

exploded one, under the notion of improvement, will, in time be found

to be liable to as just objection. But in the mean while what lives

must be lost, what tortures endured, in the experiment! How many will

have been the victims, women and children!

Footnote 35:

Even this very Mauriceau allowed, by his brother practitioner M. De la

Motte, to have been an excellent man-midwife, is however very justly

animadverted upon by him for his weakness in giving into such

nonsense, as prescribing histeric medicines by way of hastening the

delivery. His capital receipt was the juice of a Seville orange in an

infusion of Sena. Let any one imagine, what an effect such a laxative

potion must have on a woman, commonly rather wanting to have her

strength recruited by proper restoratives, than diminished by purges,

on so senseless a view. But how many other instances might be brought

of these same most learned men-midwives, making almost as pitiful a

figure in the character of physicians, as they must for ever do in

that of manual practitioners of our art! Even the works of Daventer,

who has such glimpses of true theory, prove him not uninfected with a

spice of quackery. This is generally speaking so true of the

men-dabblers in practical midwifery, that one would imagine the

extension of that meanness of theirs, in putting their nose into such

a function, even to their collateral profession, whatever it be, of

physician, surgeon, chemist or apothecary, was the revenge of Nature,

for the outrages of their pretended art upon her.

Footnote 36:

Page 249, of his treatise of midwifery.

Footnote 37:

That is to say, if he touched the woman at all with it, and did not

sometimes, at least, _make believe_ that he delivered her with it

though Nature alone should have done the work. Sure I am that that

piece of quackery in him of pretending to hide the instrument, might

justify such a suspicion, of a less guilt however than that of really

applying an instrument insignificant to any purpose but that of

torture in vain.

Footnote 38:

How few are there such? consequently how great the danger of such

instruments, even if they were good for any thing, to be introduced

into _common_ practice?

Footnote 39:

As the practice of midwifery is, properly speaking, under no

regulation, may not this be too often the case?

Footnote 40:

If any one doubts of this, he, in order to settle his opinion, needs

but to peruse the instructions given by Levret, and other

instrumentarians, for the use especially of the forceps. He will find

such obscurity, such intrepidity of practices upon flesh not their

own, as would make one shudder. The very cautions against _locking in_

a part of the uterus between the blades of the instrument, prove the

existence of a danger no caution can scarce answer for its being able

to avoid. What do you think of young or unskilful practitioners

thrusting up instruments at RANDOM into such a place? yet Dr. Smellie,

p. 288, expressly tells you, there is a case in which “_The forceps_

MUST _be introduced at random_.” This however may give the

practitioner boldness, that whatever is his fault, the poor woman it

is that is sure to suffer for it, and how cruelly!

Footnote 41:

“The forceps may be introduced with great _ease_ and _safety_, like a

pair of _artificial hands_, by which the head is very _little_ (if at

all) _marked_, and the woman very _seldom tore_.” Smell. p. 257.

Footnote 42:

In this case of a monster of two heads, which happens so rarely as

that it might almost be reputed null or of no consideration, _once

more_, it is neither a midwife’s business, nor even of one of the

common men-practitioners of midwifery. Application should be instantly

made to one of the best and ablest surgeons procurable, for reasons

too obvious to need specification.

Footnote 43:

Smellie, p. 248.

Footnote 44:

See Reaumur’s art of hatching domestic fowls, &c.

Footnote 45:

If any of my readers imagine that I have, in my objection to the

men-midwives, exagerated matters, I intreat of them to consider the

following quotation from a _male-practitioner_, from Daventer, who

endeavoured, as much as Nature would allow him, to be a good midwife,

however he fell short of it. These are his own words translated, from

p. 11. of the French quarto edition.

“Can any thing be more shocking to the mother, and to those about her,

than to see a man in liquor, scarce knowing what he is about, divested

of all compassion, of all sentiment of humanity, his hands _armed_

with a _knife_, a _crotchet_, a _pair_ of _pinchers_, or other

_horrible_ instruments, come to the ASSISTENCE of a woman in agonies,

begin, for his first attestation of skill, by _wounding_ the _mother_,

then go on to _destroy_ the _child_, bring it away piece-meal, with

exquisite tortures to the woman, and, after all, grumble in the

notion, that he could not be PAID enough for such a fine spot of work?

had not such better at once take on to be _butchers_ or _hangmen_,

than treat thus the image of God, and render the profession odious?”

Have I any where said any thing STRONGER than this? Daventer, however,

certainly did not mean by it to insinuate, that _all_ men-midwives

answered intirely this description; no, nor I neither. But leaving the

brutality out of the question, the mischief and mercenariness of them

all differ perhaps in no very considerable degree. Please to remark in

the following quotation, the DOCTRINE and practice of that famous

_man-midwife_ Peu. “He determines himself, without much ceremony, to

the _breaking_ a child’s _arm_ or a _thigh_, when he _imagines_ this

_operation_ will facilitate the delivery, and that, on the PRINCIPLE

of its being _easy_, to repair such _damages_ of _new-born_ infants.

For the same reason the luxation of a jaw-bone gives him no scruple.”

(Translator of Daventer’s Preface.)

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