A Treatise on the Art of Midwifery / Setting Forth Various Abuses Therein, Especially as to the Practice With Instruments: the Whole Serving to Put All Rational Inquirers in a Fair Way of Very Safely Forming Their Own Judgement Upon the Question; Which It Is Best to Employ, in Cases of Pregnancy and Lying-in, a Man-midwife; Or, a Midwife

by Elizabeth Nihell

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.