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.