The princess, it is said, had some scruples in regard to employing Clement. As she desired it might be kept a profound secret, she sent for him, he being a surgeon of great reputation; and he was conducted with the greatest secrecy into a house where the lady was, with her head covered with a hood. The same surgeon was employed in subsequent labors of the same lady, and the princesses made use of surgeons on similar occasions; and as soon as it became fashionable, the name of accoucheur was invented to signify that class of surgeons. Foreign countries soon adopted the custom, and likewise the name of accoucheurs, for they had no such term in their own language; but in Great Britain they have more generally been termed midwives.
Dr. William Shippen, of Philadelphia, a very worthy citizen and exemplary man, had the honor of being the first teacher of midwifery in the United States. In London he enjoyed the advantages of the instructions of the celebrated Dr. William Hunter, and on his return to his native country he was chosen professor of anatomy in the earliest of its medical schools, the University of Pennsylvania. His lectures on obstetrics, like those upon anatomy and surgery, are said to have evinced great ability and command over his auditory. His first course on midwifery was delivered in 1762, and was attended by only ten pupils. He, however, lived to give instructions to a class of two hundred and fifty. This leads me to the reflection, will those who now advocate the employment of females principally in midwifery, even when the country has grown many times larger in numbers than it then was, meet with one half the success that Dr. Shippen did? If so, may it be, and Heaven speed the right.
In the year 1767 the first medical school of New York was founded, under the auspices of Kings, now Columbia College. Among the appointments to that institution was Dr. John V. B. Tennant as professor of obstetrics. It is said that he was a very worthy man and of good reputation. He died at an early age, of the yellow fever, in the West Indies, where he had gone for his health. Since the time of Drs. Shippen and Tennant, midwifery has been taught as an important part of medical education in all of the medical colleges in the United States.
In China the practice of midwifery is regulated in a very good way certainly; and on the whole, the Chinese custom is to be regarded as a safe one. It, however, recognizes the superiority of man’s intellect, nerve, mechanical skill, to that of woman’s, in scenes of trial and danger. The custom is this: Female midwives attend in all ordinary cases; but there is a class of obstetric surgeons which is devoted exclusively to this department, is perfectly skilled in the use of instruments, and the management of every possible difficulty. One of these is located in each particular district, having a given number of inhabitants, and after a woman has been a certain number of hours in labor, the child not being yet born, the midwife is required by law to call in the obstetric surgeon. Thus it is, I repeat, that man’s superiority over woman’s, in ability to perform great and difficult operations, is recognized even in China. Nor is it to be supposed that it is in the most difficult cases only that the male practitioner is called in that country, because many a woman has, on the whole, a safe labor which is yet a good deal protracted.
It is said that in Russia the obstetric branch of the medical art is practiced for the most part by females. They are educated at the government’s expense, and are said to be very skillful in their art. We are not, however, in the habit of looking to Russia as a country eminent in civilization and the arts.
It is admitted that a great majority of the human family, from the beginning of the world down, have been born by the aid of female midwives only, or without there being any assistant whatever at the birth, as is still the case with some of the savage tribes. At the present day even, of all births that take place in the world at large, probably not one out of twenty is superintended by a male practitioner. But all of this proves nothing in regard to the question, as to whether it is better for men or women to be employed in such practice. It proves to us the competency of nature to do, as a general thing, her own work. But to say that it proves that males should never practice midwifery, would be as absurd as to affirm that railroads, steamships, and magnetic telegraphs ought never to be brought into use. But I have already spoken on this subject in my introductory letter, and need not here enlarge upon it.
The question regarding the extent to which the pains and perils of childbirth may be modified by the voluntary habits of individuals and nations, and by the appliances of art, is one of the greatest importance to society, a subject which has been probably more neglected than any other in both medical and scholastic lore.
To prove that the evils and dangers attending child birth, even among the most civilized and enlightened portions of the human family, may be brought to a great extent within the range of man’s control, is the object of the following remarks.
Let us look first at the habits and condition of the aborigines of our own country.
The state of society among the Indians necessarily excludes the influence of many of those passions which are known to cause bodily derangement. If an Indian becomes angry, the turbulent effects of his passion are hushed in deep and lasting resentment. Envy and ambition also are, for the most part, excluded by the equality of savage life. “The weakness of love,” says Dr. Adam Smith, “which is so much indulged in ages of humanity and politeness, is regarded among savages as the most unpardonable effeminacy. A young man would think himself disgraced forever if he showed the least preference of one woman above another, or did not express the most complete indifference, both about the time when, and the person to whom he was to be married.” Thus the savage state, although being in many respects far from a truly natural one, exempts the individuals of both sexes from those violent and lasting diseases which are well known to arise from excesses in matters pertaining to the sexual and marital relations.