“This celebrated man-midwife was called to two other women of my acquaintance, of whom the labor somewhat resembled that of this lady, but of which the consequences were very different: he had made them take his powders to no manner of purpose, when seeing that a day had passed without their producing the expected effect, he had recourse to his crotchet, with which he quickly dispatched both the deliveries.”
Observation 174, of the same Mr. De la Motte.
“A gentleman who lived upon his fortune, without professing surgery, though he had served his time to it, and had even formerly exercised it, not only in France, but in Italy, and in other foreign countries, told me, in conversation, that he had an infallible remedy to make a woman bring forth instantaneously, however lingering and difficult her labor might naturally be. Of this, he said, he had made undoubted experiments, and that he had obtained this secret from an Italian, under oath of not disclosing it to any one. He was more than a little surprized at finding me without curiosity to learn from him this pretended secret, which he imagined must concern me so much, as one who made open prefession of the obstetrical art; and still greater was his surprize at seeing me change the subject, without any sign of attention to what he had been saying on this head.”
“In process of time, he married, and his wife being pregnant was got into the time of her labor-pains towards delivery. It became now expedient for him to declare this famous secret to me, which was no other than half a drachm of borax in a glass of any innocent liquid agreeable to the palate of the patient. But as this dose happened to be administered by one who had no sort of faith in it, it had no effect: his wife lay four days and four nights in labor; the child died the moment after it was born, and the mother narrowly escaped following it.”
Observation 176, (of M. De la Motte)
“As I was at Caën, a town of Normandy, attending the lying-in of a lady there, an old stander of a practitioner of that place, and a man of good abilities, told me, that he had been lately sent for to a woman who had continued several days in labor, with slow and moderate pains. As he found the fœtus well situated, he made the patient take an infusion of three drachms of sena in the juice of a Seville orange, in order to quicken the throws and advance the delivery, which indeed came on ten or twelve hours afterwards, but the woman died, one may say, immediately after it.
“To this account (continues M. De la Motte) I opposed, for answer, that being at Bayeux, on the like occasion, an old practitioner in surgery of that place, in conjunction with whom I had been called to visit a patient, told me, in conversation, that he understood midwifery very well, that he had even, not long before terminated a delivery given over by another surgeon; that the child, one arm of which hung out, was dead, before he put his hand to it, and that the mother, though well delivered, died soon after.”
These examples may suffice to prove, that the notion of giving histeric medicines, for which the inventors did not forget to make themselves be well paid, existed in M. De la Motte’s time, who is not but a modern author: nor are they even to this hour absolutely exploded, tho’ some of the men-midwives themselves have joined Mr. de la Motte’s cry against them. It gives however those men-practitioners, who exclaim against a quackery in others, by which themselves get nothing, a good sort of an air: it serves even to render that more pernicious quackery of their instruments the less obnoxious to suspicion. Nothing is easier to give up than that by which nothing is got. If the instruments were not a plea for the very essence of such a thing as a man-midwife, they too would be given up. However, it will hardly be denied, that those same pompous histeric medicines were the invention of learned men-practitioners, and not of those poor ignorant midwives, who, with respect to women in labor, are of opinion, that there can nothing be more effectual for their well-doing, than in the first place giving Nature fair-play, and, when requisite, to assist her with the management of natural hands skilfully conducted: always observing neither to lapse nor precipitate the critical time of such assistence. In the mean time, let a humane reader but reflect how many mothers and children must have been, and perhaps still continue to be the victims of a reliance in such medicines, and he will allow, that such errors of practice, tho’ not capital in the intention, are too often deplorably so in the effect. Is it not true to say, considering the havock of the human species, so presumably made by quackery and empiricism in general, that the lives of the subject are less sacred than their property? Surely they are less guarded, either by the laws, or by common sense.
As to a fœtus that presents an arm, or any other part than the head or feet, there is rarely any thing to do but to slide the hand all along that arm, or other part it may present, to find out the feet, and terminate the delivery; without its being necessary to attempt the reduction of any part or member.
Most of the writers on midwifery often start difficulties where there are really none. They often give us emphatical accounts of a head too large, and a passage too narrow, in which they state them as difficulties that are invincible, when the case is far from being so. When the fœtus presents fair, and is in a good posture, our method of practice is, to advise the patient to remain as quiet a-bed as possible, avoiding every thing that may tend to fatigue her body, or hurry her spirits, to reserve in short her strength as much as possible. With time and patience the head of the fœtus scarcely ever fails of moulding itself to the passage, through a particular providence of Nature, which has so ordered it, that the parietal bones of the head of the fœtus, so flexile as to ride over one another, form a kind of oval figure, which facilitates the issue, and dispose it for making way for itself, through the extrusive pressure of the labor-throws. Mean while nothing should be done to irritate the pains; the membranes should not be unnecessarily or untimely burst, which loses the benefit of the waters. You can hardly, in this case, rely too much on the benevolent efforts of Nature: she is constantly at work for the patient’s delivery. Interruptions sometimes only serve to mar or retard a favorable crisis: but all abrupt force or violence is carefully to be avoided. As to bad postures of children, I shall treat of them in the sequel, and of the means to remedy them.