These hemorrhages are but too frequent, especially with those women who neglect the precautionary bleeding; and such sudden death too commonly the consequence of neglecting, or of not knowing that the most salutary practice, in these cases, is to well evacuate the uterus by the operation of the hand, where Nature appears in the least tardy or deficient.
The long experience I have of this manual help, which has never failed of success with me, warrants my averring, that there is little or no danger, in these cases, to women, provided the midwife employs herself dextrously to clear them while time serves. Their relief is instantaneous. They come to themselves presently: they are restored to a freedom of respiration: nor will they have so much as been sensible of this operation of the hand, which will nevertheless have saved their lives.
There have been men-midwives, that pass even for learned, but who from their ignorance of this so simple and easy method of relief, have been in the disagreeable circumstance of seeing many women perish under their hands, though they had to all appearance been very happily delivered.
With respect to pregnant women, there is again another point of great consequence to ascertain. Great care must be taken not to mistake the signs of delivery. This is a very essential matter. Nothing scarce can be more dangerous, than to excite a woman to the last labor-pains, which will not fail of exhausting that strength of her’s, in vain, which had so much better be reserved for the support of her in the time she will really need it. So that a midwife ought to make it her business clearly to distinguish the spurious pains from the true ones. Where a woman near her time feels pains in the belly, the loins, or even the sexual parts; they are not always to be taken for the true labor-pains. In this point, the touching will be a great guidance.
If the fœtus is still high in the uterus, and the situation of it does not indicate a readiness for extrusion; if the waters are not sufficiently prepared, or their pressure down not in due forwardness, the pains must be assuaged by some calming anodine remedies: the patient must be left to her rest, till things declare themselves more openly; and then, as she will not have been fruitlessly fatigued and tormented, the labor may proceed happily.
There have been men-practitioners so very unskilful, or at a loss for delivering women by the operation of their hands, that they tortured their heads to discover medicines to save themselves the tediousness of Nature’s taking her own time, as if she was to do her work the better for their hurrying her. Towards the atchievement of this end, they brought into play certain drugs, to which they gave the appellation of hysteric, and placed or pretended to place great confidence in them.
Even some of our modern practitioners prove, at least, by their practice, that they have faith in the virtue of such drugs, since they continue to use them. They are still suffered to make a figure in many of the Pharmacopœas, though no sure experience hitherto has verified their efficacy. On the contrary, a thousand and a thousand examples might be quoted in demonstration of their insufficiency and danger. I shall content myself with producing here the testimony of Mr. De la Motte, in the second book of his observations, and he is not the only man-midwife that does such medicines the justice of disapproving them.
Observation 174.
“A celebrated man-midwife of this town (says Mr. de la Motte) pretended to have a marvellous powder to provoke labor-pains, and accelerate parturition. This powder was composed of galbanum, myrrh, savin, rue, and other drugs, of which he made the patient take a dose, to hasten a delivery, when the labor was lingering, from half a drachm to a drachm, and after the effect of this medicine, which ended commonly in leaving the patient in a worse condition than before the taking it, he substituted the use of the crotchet, which was indeed an infallible method of putting a speedy end to the labor; and of which he as well as his fellow-practitioners made such a murderous use, the aid of the hand well conducted being unknown to them.
“The same operator (says Mr. de la Motte) was sent for to assist a lady who had continued in labour for three days, to whom he proposed a dose of his powders, to which she readily consented in the hopes of a speedy delivery. Unluckily, not most certainly for the lady, but for the honor of the powders, the operator, not having had the providence of having them about him, was forced to go home for them. The lady, in the mean while, was brought very happily to bed, just as he was re-entering the room with his dose for her. What a pity this was! What would not have been the boast of the virtue of those pretious powders, if the delivery had waited for them but half a quarter of an hour, though they would not have had the least share in it, since it would have been purely the work of Nature and Time.