Whoever considers the absolute necessity of the art of midwifery, will readily allow it a place among the capital ones in the primeval times of the world. All the other arts are no further necessary to man, than to procure him the conveniencies or luxuries of life; that of midwifery is of indispensable necessity to his living at all, imploring as he does its aid for his introduction into life. Without this art the earth itself must soon become dispeopled and a desert, whereas by means of it men have been multiplied, with inconceivable rapidity.

In conformity to its claim of importance, this art appeared in all its lustre among the Jews, the Egyptians, the Athenians and Romans, and indeed in all nations during thousands of ages. Nor was the confinement of the exercise of it to women deemed any derogation to it. It even gave honor to its professors of that sex. Socrates, so ennobled by his character of being the greatest philosopher in all antiquity, did not disdain to boast himself the son of a very able midwife Phanarete, as may be seen in Plato’s book on science, in Diogenes Laertius and others.

Among the Egyptians and the Greeks it cannot be hard to conceive what emulation, what ardor it must have excited among the women of that profession, the custom of distributing prizes to those of the greatest merit in it, in the face of the people. No one is ignorant of the power of honors and distinction to bring arts to perfection.

But from the instant the midwives sunk into dis-esteem, and wherever that has happened, it will be found by woeful experience, that not only the art itself has suffered in the very midst of the most falsely boasted improvements, but that human-kind itself has much and very justly to complain of the change.

The native inconstancy and levity of the French nation opened the first inlet, in these modern-times, to men-practitioners. In antient history we meet with but one feeble attempt of that sort, which however soon gave way to the united powers of modesty and common sense. In France, and may it not be the same case soon here! the women of a competent class of life and education, begin to decline forming themselves for this profession, as beneath them, considering the slight put upon those women who exercise it.

Nor has this injustice remained unpunished. Many women have found, by severe experience, their having been enemies to themselves, in abandoning or slighting those of their own sex, from whom, at their greatest need, they used to receive the most effectual service, and who alone are capable of discharging their duty by them, with that sympathy for their pains, that tender affectionate concern, which may so naturally be expected from those who have been, are, or may be subject to the same infirmities.

Many out of a distrust inspired them of midwives, have thrown themselves into the hands of men, who have promised them infinitely more than they were able to perform; and who behind all the tender alluring words, of superior skill and safety in the employing of them, conceal the ideas with which they are full, of cutting, hacking, plucking out piece-meal, or tearing limb from limb.

The murder of so many children, the fruits of their bowels, might, one would imagine, have induced mothers to consider this point a little more carefully. Yet, through the prevalence of groundless fears, and of imaginary dangers they have run into real ones, and have sometimes found their death precisely where they sought their life; and not seldom where nature has even favored them enough in their labor, for them not to need any extraordinary ministry of art, the men have put them to cruel and dangerous tortures.

Notwithstanding some examples, and many violent presumptions of such mal-treatment, too many women have been so miserably misled by fashion, as to prefer the betraying the cause of their own sex, and the subjecting themselves to those who deceive them with false hopes, to the entrusting their preservation to those of their own sex, in the hands of which the care of it has been for so many ages, with so much reason, and such little cause of complaint.

Yet we do not see that any of these men-midwifes have been capable of forming a good midwife. On the contrary, we see, that in order to remedy the abuses, or rather to prevent the fatal accidents which every day occur in the practice of a profession so necessary to the preservation of the human species, they were in France obliged to have recourse to one of the ablest midwives in that kingdom, who was placed at the head of the practice in the HÔtel Dieu at Paris, to preside over the lyings-in there, and to found and cultivate that inexhaustible seminary of excellent female practitioners, who have actually restored the art to its antient degree of esteem, with all fair judges. These worthy proficients have been so public-spirited, as to communicate their talents and knowledge to a number of surgeons, who never had any reason to be ashamed of the lessons they assiduously took from the midwives, unless indeed for themselves not being able to come up to them in the practice, so true it is, that the business is not at all natural to them.

Yet have even many of those very men-practitioners, influenced by that self-interest which has such a power in all human affairs, revolted against their mistresses in the art, and their benefactresses. They have, at various times, commenced lawsuits, about the HÔtel Dieu at Paris, in order to get the lyings-in there committed to them: but the administrators, the persons of a just sense of things, together with the parliament of that town, ever attentive to decency, without excluding the due regard to the preservation of the subjects, have constantly opposed and frustrated the pretentions of these innovators. These again thus disappointed, were forced to content themselves with practising upon some women of quality, under the favor and protection of some of the old ladies of the court of Lewis XIV. who had their reasons for propagating this fashion. And now these innovators, not without a due proportion of ingratitude to the injustice, began to run down the midwives, and exalt themselves. The novelty prevailed, and the contagion of example soon communicated itself to the provinces, and thence into neighbouring nations. A few men perhaps of real abilities, but governed by the most sordid interest, associated to their party a number of the most ignorant and unexpert practitioners, but who served to fill up the cry, and made a common cause against the midwives, whose pretended insufficiency was now to be pleaded in favor of themselves being admitted to supplant them. Nor was the concurrent attestation in their favor, of so many ages, during which the practice was entirely in female hands, to weigh any thing against the boasts of their own superior ability. They picked up and sounded loud a few real instances perhaps, and undoubtedly many false ones of faults of practice in women: though were the numbers of human creatures, who have barbarously perished by the unskilfulness of the practitioners, to be fairly liquidated, it would appear that fewer have been the victims of female ignorance, than of the presumption and indexterity of the men. The women are undoubtedly liable to error: there have even been monsters of iniquity among them, but certainly in no number to form a general prejudice against them: but as to the men they are all of them, as will be more fully demonstrated hereafter, naturally incapable of the exercise of this profession. A history of their murders might even be collected out of the books written by them to establish their superiority over the women. From Deventer, Mauriceau, and the most celebrated of their writers, amongst many excellent observations in the way of the chirurgical art, many of the grossest absurdities have escaped, where they transgress its bounds and go into that of midwifery. Some of those absurdities too are so glaring, that they have not even been overlooked by themselves.

Many persons in Holland, having set up for men-midwives, without being duly qualified, the government thought proper to interfere, and consequently there was an ordinance issued on the 31st of January, 1747, by which it was enjoined, that no one should practise in the quality of man-midwife, or exercise this art, unless he were especially authorized for this function, by a certificate of his having undergone a sufficient examination before capable and intelligent judges for that purpose appointed.

It will appear, in the sequel of this work, that it were to be wished, for the sake of the good that would redound from it, to the preservation of the human species, both in parent and child, that those who are entrusted with the public welfare, would establish the same regulation in the British dominions, to expel and exclude from the art all the ignorant pretenders of either sex, who are, in fact worse than the Herods of society. The cruelty of Herod extended to no more than to the infants; not to the mothers; that of such pretenders to both.

If their conduct was to be examined with attention, how many fatal mistakes would be discovered in the practitioners of both sexes? But I dare aver it more in the men than in the women-practitioners. With what horror would not there in these be remarked, tearings, rendings, and tortures of no use to which they put both the mother and the child? One, upon some most learnedly erroneous hypothesis, pulls and hauls the arm of an innocent infant yet living, so that he plucks it off; or repels it with such violence, that he breaks it: another unmercifully opens the infant’s head, and takes the brain out: some bring the whole away piece-meal: operations often to be defended only by hard words and harder hearts.

Nor need this procedure astonish. Every thing is at the disposal, I had almost said, at the mercy of these executioners: but have they any? all their handy-work is transacted in private, and remains buried in the tomb of oblivion. The parents suspecting nothing, think every thing has been done, according to art, that is to say, very right. The operator thinks he has done nothing but his duty, and is highly satisfied with himself, after he has ordered some draughts for his patient. The magistrate knows no injury done to the subject, or is insensible to the consequences from the same spirit of confidence. In the mean time, a husband loses a fine child, or a beloved wife, perhaps both; children, a tender mother, and if they are of the same sex, have the same fate to dread for themselves. The man-midwife is clear, for only saying, that he has done all for the best. But this is probably true too, as to the intention; but as to the fact, it shall be shewn that there is often great reason to doubt it.

Be this observed, without offence to the few able men-midwives who are masters enough of the business, not to deserve the reproaches due to by much the greater number of rash and ignorant pretenders to it: whose practice, well examined, would bring to light such terrible truths, as would alarm even the legislature to provide a remedy against the danger.

In contradiction to this, it may be urged, that the practice by women is susceptible upon that account, of superior objections. That remains now to be examined. The chief object of this work being a fair discussion, which of the two sexes is the most appropriated by nature and art, to the exercise of this function.

To this end, I shall present, in a candid view, the two opinions which, on this point, divide the English yet more than they do the French. Most of the surgeons, all the men-midwives, no doubt, many apothecaries, a number of women and nurses maintain, that midwifery is the business of the men: whilst on the other hand, the best part of the able physicians, with many other persons of both sexes, defend the contrary side of the question, and insist on this art being, for many invincible reasons, solely the province of female practitioners.

Not to lose sight of the fundamental arguments and proofs brought to support respectively these two opinions, I shall place them in parallel with one another, in form of objections and answers. The objections made to women-practitioners precede the answers. If the men-midwives, or their partizans, shall think I have omitted any thing that makes for them, or against us, or have any stronger or more essential arguments to oppose, I shall endeavour to satisfy them.

Regard ought to be paid to prior possession. The art of midwifery being a branch of the art of physic, must have been originally in the hands of man, the inventor of all arts.

ANSWER.

The just deference so universally paid to holy writ will, I presume, allow no prejudice to be found against my availing myself of those inferences and decisions to be drawn from it, which are so agreeable to the eternal laws of common sense.

If the arts and sciences, acquired by experience, and by acts often repeated, had, as they certainly were not invented by men only, that could not at least be said of those acts of the human life, which are indispensably necessary to its preservation. Such faculties may with more propriety be termed instinctive, than invented ones. The faculties of eating, of drinking, of lying down to rest, common to both sexes, are not perhaps more natural, more matter of instinct, than the faculty of one woman assisting another in her labor-pains being appropriated to the female sex.

There is no occasion to give one’s imagination the torture to account for Eve’s delivering herself of her first children. There is no reason to establish it as an absolute necessity that Adam should have assisted Eve in her first lyings-in; whose labor-pains might not only be less severe, than they afterwards became in accomplishment for the curse pronounced on the human race for the sin of those first parents, but also more consonant to piety, to believe that God, being the best of fathers, infused into Eve knowledge sufficient of the manner of delivering herself; a manner more natural and more conformable to the ideas of that decency imprinted with his own hand in the human heart, in no point more strongly, nor more universally, than in this matter of the women lying-in, when both men and women have an equal repugnance to the interposition of any assistance, but that of the female sex, to which the faculty of ministering in that case seems innate.

But admitting even that Adam, for the want of females for that function, before the daughters of Eve were grown up to a capacity of it, actually did assist Eve, in the seasons of her delivery; that would establish no inference of right for the future: since we know that their children and descendents in time following did not make use of men to lay the women.

In Genesis, chap. xxxv. ver. 17. there is mention made of Rachel’s midwife. In the same book, chap. xxxviii. ver. 27, and 28. we see they were intelligent midwives. Thamar being with child. “It came to pass in the time of her travail, that behold, twins were in her womb.”

Ver. 28. “And it came to pass that when she travailed, that the one put out his hand, and the Midwife took and bound upon his hand a scarlet thread, saying, this came out first.”

And here I intreat the reader not to impute to me any idea so absurd as that of meaning to defend an erroneous practice solely from the antiquity of it; I intend nothing further by this citation, than to prove the antiquity itself, which if not decisive in favor of the practice by women, can at least be no prejudice against it.

Objection the Second.

The art of midwifery being equally noble for its subject as for its end, since it is the only one which enjoys the prerogative of saving, at one operation of the hand, more than one individual at once; ought the less noble sex to dispute pre-eminence in it with the men? On tracing things back to the remotest distance of times, it must be allowed, that if the women, through a mistaken modesty, in those times of ignorance and simplicity, commonly made use of midwives, it may be presumed there were also men-practitioners employed in difficult cases.

Readily granting that the art is a noble one; noble in its subject and ends: all that I am surprised at is, that the men did not find it out sooner. Probably the nobility of this art is only begun to be sounded so high by the men, till they discovered the possibility of making it a lucrative one to themselves. Then indeed the ignorance and incapacity of the poor women for it, came all of a sudden to be doubted and despised. The art with all its nobility was for so many ages thought beneath the exercise of the noble sex: it was held unmanly, indecent, and they might safely have added impracticable for them. But had even any of the medical profession not thought so, there is great reason to think the rest of mankind would have viewed their interested endeavors to usurp this province from the female sex, in the light they deserve. It was only for the eternal fondness which prevails among the French for novelties, that paved the way for the admission of so dangerous and indecent an one, as that of men making a common practice of midwifery, and taking it out of the women’s hands, to which it was so much more natural.

I am here far from wishing to enter into a contest with the men, on the superiority and excellence they assume over the women; though not quite so indisputable perhaps as is commonly imagined. All that I contend for, to the purpose of the present question, is, that there are certain employments and vocations, which are generally and naturally more proper for one sex than for another. A woman would seem to aim at something above her sex, that would set up an academy for teaching to fence, or ride the great horse: but a man sinks beneath his sex, who interferes in the female province. It is not with quite so good a grace as a woman that he would spin, make beds, pickle and preserve, or officiate as a midwife. Be this observed without impeachment of the superiority of men.

Open books, sacred and profane, you will find that the Egyptians were not so simple as Dr. Smellie would give us to understand they were; when in the beginning of his introduction, pages 1st and 2d, he grants us, out of his special grace and favor, “that in the first ages the practice of the art of midwifery was altogether in the hands of women, and that men were never employed but in the utmost extremity: indeed (says he) it is natural to suppose, that while the simplicity of the early ages remained, women would have recourse to none but persons of their own sex, in diseases peculiar to it: accordingly we find that in Egypt midwifery was practised by women.”

According to scripture, however, the sorcerers of Egypt were not so very simple neither, since they had art enough to imitate some of the miracles of Moses, in transforming their rods into serpents, blood into water, and covering the land with frogs^[1]. All this did not favor of simplicity.

The Egyptians^[2] have ever passed for the most intelligent and enlightened of all the other nations of the earth, who respected them as oracles of wisdom and sound philosophy. They are the first people who established systematically rules of good government. This profound and serious nation saw early the true end of human policy; and virtue being the principal foundation and cement of all society, they industriously cultivated it. At the head of all virtues they placed that of gratitude. The honor attributed to them of being the most grateful of men, shews that they were also the most social. They had an inventive genius: their Mercuries, who filled Egypt with surprizing discoveries, scarce left any thing wanting to the perfection of their understanding, or to the convenience and happiness of life. The first people among whom libraries were known to exist, is that of Egypt. In short, so far from being simple or ignorant, they excelled in all the sciences. There were indeed among them no men-midwives; but to make up for this deficiency, they had, it seems, excellent midwives.

Besides it is even ridiculous to confine the practice of midwifery by females only to early ages. Who does not know, that it was so in all ages, and in all countries, till just the present one, in which the innovation has crept into something of a fashion into two or three countries. The exceptions before, or any where else, to the general rule, are so few, that they are scarce worth mentioning.

But to return to the so simple Egyptians. We read in Exodus, chap. i. v. 15. and following, that Pharaoh said to the midwives, “When ye do the office of midwife to the Hebrew women, and set them upon the stools, if it be a son then ye shall kill him, but if it be a daughter she shall live.

“17. But the midwives feared God, and did not as the king of Egypt commanded them, but saved the men-children alive.”

The king reproached them, as may be seen in the same place.

Why did not Pharaoh give the same order to the men-midwives, if there had been any such employed in difficult or extraordinary pains? (as Mr. Smellie supposes.) Or rather, if the king had not thought it too unnatural for women to be delivered by men, he certainly would not have failed to have commanded it, especially on perceiving that the midwives had deceived him. This would have been a fine occasion to have forbidden them their function, and for the men-practitioners to have come into vogue. The men would certainly have been of the two not the improperest to have executed the intentions of the tyrant: as tender-heartedness is surely not more the character of their sex, than of the women. Besides, their instruments would have served admirably to have thinned the species, without distinction of the sexes. They might also have concealed the barbarity of the murders by such instruments, under the pretext of their necessity from hard-labors, as the midwives excused their disobedience under that of easy ones, which had rendered their aid superfluous.

Objection the Third.

So many authors as have wrote on the art of midwifery, from the age in which Hippocrates florished, whom we look on as the first and father of the men-midwives, with the disciples whom he formed, and their successors, do not they satisfactorily prove the antiquity of man-midwives?

ANSWER.

As for satisfactorily, no. It can only be concluded from this objection, that the ignorance of the pretended men-midwives is very antient: and yet posterior by much to the function of the midwives, since that is coeval with the world itself, embraces all times, extends through all parts of the earth, whereas we hear nothing of the other till the times of Hippocrates.

Nevertheless I greatly respect Hippocrates, and all the authors who have treated of this art. Some thanks are due to them, though but from those whom they have set to work in our days. Consider but the most celebrated authors among them down to our times, there may be found in them great progresses by degrees, especially in our modern writers on this subject. Yet the most intelligent of them feel and confess that the matter is yet far from exhausted. For after having studied all the treatises we have upon it, there may, there must be perceived an aberration and emptiness with which the understanding remains unsatisfied, and feels that much is yet wanting to the requisite perfection.

Notwithstanding likewise the veneration confessedly due to Hippocrates, I cannot dispense myself from saying the truth; he might be and doubtless was an excellent physician: he has wrote upon all the female disorders, and on the means of delivering them; he may have been consulted in his time, but he can never pass for an able man-midwife. His writings contain some violent remedies and strange prescriptions for women in labor, which must be the produce of the most dangerous ignorance of what is proper for them in that condition.

This author was also evidently ignorant of what concerns preternatural deliveries, as indeed were his successors till the beginning of the last century.

To prove what I advance, there needs no recourse back to very remote times: it will be sufficient to peruse the treatises of Ambrose ParÆus, Jacques Guillemeau, Peter-Paul Bienassis, printed 1602, and even that of De la Motte, who is of this century, to own, that the practice of the men-midwives was far from having attained any degree of perfection.

The manner in which the antients proceeded, when the child presented in an untoward situation, is a fully convincing proof thereof; since they obstinately, in such cases, continued their efforts to reduce it to its natural situation, in spite of a thousand difficulties and dangers, instead of bringing it away footling, as is now done by all who understand the right practice.

Hippocrates is the first who discovered that wonderful secret of killing the child, and bringing it away piece-meal from the mother’s womb. He advises it, in the manner taken notice of by Dr. Smellie, in his introduction, (page 10. & seq.) I do not know whether it is from that branch of practice that he adopts him for “the father of midwifery” (p. 4.) but, what is certain is, that Galen, and all the successors of Hippocrates, till towards the end of the last century, exactly followed his method of not delivering women in hard labors, but by the means of murderous instruments. I shall not here detain myself with rehearsing the long legend Mr. Smellie gives us of all the authors who have written on this subject to the time of Ambrose ParÆus; time when to the progresses made by the midwives of the HÔtel Dieu at Paris in the art of midwifery, it was owing, that the surgeons, guided by their superior lights, made some greater progress towards perfection.

That the reader however may not suspect me of exaggeration, or over-straining points, I request of him to suspend his judgment, to have the patience to hear me out to the end, and he will find, that I have here advanced nothing but what in the sequel stands clearly and manifestly proved.

Objection the Fourth.

In a word, the manual operation of midwifery is an art, a science, and as such consequently more competently to be professed by men, than by women. It is making the art cheap, say the moderns, to allow the practice of it to women.

I agree with you in the first part of your objection: but I absolutely deny the consequences.

There are women, who, besides the gifts received from nature, are improved by study, by reading, and experience, who succeed much more easily than men in the practice. To say the truth, nature has, in this point, been even lavish to the women, for this art is a gift innate to them.

I will however own, that not all women indistinctly are proper for this business; that there must be natural dispositions cultivated by art; that a purely speculative knowledge is not sufficient; that there are required good intellects, memory, strength of body and mind, sentiments, some taste, and practice joined to theory; so that when I say that the women are born with dispositions for this art; this can only be understood in general, and relatively to the men, among whom those dispositions are more rare, because they are less natural to them in this branch.

Would it not be a sort of blasphemy against the divine providence to maintain, that what God has placed and left in possession of the women, was fitter for the men? the attentive, beneficent, and tender manner with which he governed his people elect, obliges us to believe that he omitted nothing of what was necessary or advantageous to it; since he regarded that people as his own particular dominion and appendage; honoring it with his presence, like a master in his dwelling-house, or a father in his family. He had taken pleasure in the forming and instructing it from its infancy. He put the women in possession of the art of midwifery, he blessed, approved, and recompenced the midwives. It is but just, that men should hear and keep silence where God speaks. They may think themselves happy, to learn from him the true secrets of nature, and not from those pretended doctors who abandon the rules of truth to cleave to themselves; who, instead of her, present us with a phantom of their own creation, who, in short, would make us the worshippers of their dreams and imaginations.

The women have for them the authority of God, who has declared himself in their favor; they have for them the authority of men from one pole to the other, who have in all ages made use of the female ministry in this art. Such a plurality of votes has surely some claim to prevalence, especially, since it is founded upon the natural order of things, upon truth and reason supported by experience. This experience we have on our side: none can deny it, without denying self-evidence.

One would think there is a kind of curse attends the operations of men-practitioners, as I dare aver it for a truth, that difficult and fatal labors have never been so rife, or so frequent, as since the intermeddling of the men. Whereas, God has ever so blessed the work of the midwives, that never were lyings-in so happily conducted, nor so successful, as when the practice was entirely in their hands.

Open the book of Numbers, you will observe, that God having ordered Moses to number his people: out of seventy individuals of the family of Jacob, who had come to dwell in Egypt, two hundred and forty years before, there had issued above six hundred thousand men fit to carry arms, without taking into the account an almost infinite multitude of children, of youths under twenty years of age, of women, of old men, besides a whole tribe, that of Levi, which was entirely set apart for the divine worship.

Objection the Fifth.

There is no such thing as being a good practitioner of midwifery without understanding anatomy: now this science is the province of a man, of a physician, or surgeon, not of a woman.

ANSWER.

It is sufficient that a woman understands and knows the structure and mechanical disposition of the internal parts which more particularly distinguish her sex; that she can discern the container from the contents, what belongs to the mother from what belongs to the child, as well as what is foreign to both. In short, she ought to be skilled enough to give full satisfaction to all questions that the most able anatomist could put to her, in respect to that part purely necessary to the art of midwifery, and to its operations with mastery and safety.

Now the midwife, especially one instructed in hospitals, ought to be well acquainted with all that is essential and necessary to that effect; and she cannot but be so, unless she is of herself incapable, or that those who are charged with the instruction of pupils, wrong the confidence of the public.

I myself know more than one midwife, so well educated as to be able to give demonstrations on this subject, to analyze things by their names, either upon drawings of them, upon skeletons, or upon the originals themselves. It is true, that these poor midwives do not understand anatomy enough to make dissections; but I fancy that the ladies who want assistence in their lyings-in, are not very curious of having one that can dissect instead of delivering them.

Prophane history has preserved to us the names and talents of a number of illustrious women who have distinguished themselves in all kinds of arts. Cleopatra queen of Egypt, is one of the first ladies that have written on the art of midwifery. Mr. Smellie, in his introduction, endeavours to render doubtful this quality of queen and princess, with a design, probably to weaken the credit of it, or rather out of contempt to the women; but as all those who have made collections of antient history, assure us, that notwithstanding the wars in which this princess was engaged, she did not neglect an assiduous application to physic, I had rather adhere to their authority, than to that of Mr. Smellie.

In Greece, Aspasia, and a number of other celebrated women, quoted by various authors, have applied themselves to our profession, and have left behind them valuable works on the method of delivering women, and of managing them both before and after their lying-in.

Madam Justin, midwife to the Electress of Brandenbourg, has also given us a very good treatise. Several professed midwives appointed to form the apprentices of the HÔtel Dieu at Paris, have written very clearly on the same subject, without however being mistresses of any more anatomy, than what was sufficient for their business.

Objection the Sixth.

The different instruments which the men have invented in aid of, and supplement to the deficiency of nature, and of which they are frequently obliged to make use in different labors, ought not to be put into the hands of midwives: and were it but for this reason alone, they ought to be excluded from the practice of this art. As, why multiply attendants unnecessarily? A man-midwife, with his instruments which he ought always to have about him, is enough for every thing: whereas a midwife, if the case requires instruments, will be obliged to have recourse to a man: consequently double embarrassment, double expence.

ANSWER.

The keen instrumentarians bring an argument they imagine capable of banishing or exterminating all the midwives. The men, they say, enjoy alone the glorious privilege of using instruments, in order, as they pretend, to assist nature. But let them, I intreat of them, answer, whether if the question could be decided by votes, where is the kingdom, where is the nation, where is the town, where, in short, is the person that would prefer iron and steel to a hand of flesh, tender, soft, duly supple, dextrous, and trusting to its own feelings for what it is about: a hand that has no need of recourse to such an extremity as the use of instruments, always blind, dangerous, and especially for ever useless?

What has engaged men to invent and bequeath to their successors so many wonderful productions, for such they imagine them? Is it not the thirst of fame and money? These gentry have judged, that they ought to spare no lucubrations, no labor of the head, no efforts of the tongue and pen to procure themselves a strange reputation, supported by these horrible instruments. But these lucubrations, this labor of the head, would have been much better employed in seeking for the means of absolutely doing without them, as our good female practitioners have ever done, and as those of them still do, who are instructed in the right practice.

We are no longer in the times of the Pharaohs and the Herods, who mercilessly massacred the innocents; we are no longer in the times of those pure Arabs, who were the inventors of a number of cruel operations, and of several instruments, which often cause more apprehension and terror to a woman in labor, though concealed from her light, but never from her imagination, than the actual presence of all the apparatus of the rack, where that torture is in use.

It were to be wished, that all the men-midwives, who had wrote on this matter, had suppressed the mention of their instruments; for as their books often fall into the hands of women, so deeply interested as the sex is in that subject, it is not to be imagined what bad effects they have. Their variations among themselves would be sufficient to frighten the women: you meet with authors condemning in the morning the over-night’s sentiment. I can observe them losing their way in systematical errors, which explain nothing to me, and in which nothing can be discovered but disagreement with one another, and with themselves. The wisest and most able of them, after having well examined all the kinds of instruments hitherto invented, have doubtless seen and been convinced of their ridiculousness and usefulness, but all of them have not hitherto dared to speak out and say as much.

The most interested of them would fain persuade us, that, in their display of a whole armory of instruments, they have discovered the philosopher’s stone of midwifery, in virtue of which they have a right to wrest out of the women’s hands, the practice of an art, which nature has appropriated to them. But certainly the point, and the whole point is, to find an expert dexterous hand, the sex is out of the question, provided it is but a human hand, and provided the work is done to the satisfaction of society, it seems to me that nothing more need be required.

Objection the Seventh.

It is only for the ignorant to be so rash as to raise an out-cry against the use of all instruments; people who do not know the absolute necessity there is for employing them on certain occasions. This clamor must proceed “from the interested views of some low, obscure and illiterate practitioners, both male and female, who think that they find their account in decrying the practice of their neighbours.” Such is the objection in the words of Dr. Smellie, in his Treatise on Midwifery (page 241.) and for this panegyric, he prepares us in his Introduction (page 55.) where, speaking of the midwives of the HÔtel Dieu of Paris, he first indeed tells us, that the surgeons had, in that hospital, perfected themselves in the art of midwifery; but then for fear that from thence occasion might be taken of saying, that to women it was they were beholden for that perfection; he takes care immediately after to add, that what “got the better of those ridiculous prejudices which the fair sex had used to entertain,” was, that the women or midwives of this hospital “had recourse to the assistance of men in all difficult cases of midwifery.”

ANSWER.

These gentlemen will permit me to tell them that they make great pretentions, and prove little or rather nothing. Calling hard names with a disdainful tone, and with airs of triumph, are not overwhelming reasons.

But to the point. Those who reject instruments, say you, do not know what they are: they reject them from ignorance. This is soon said. Nevertheless a number of authors, much more experienced and versed in the matter than Dr. Smellie, are of this opinion. Deventer exclaims against instruments; Viardel does the same; Levret admits none but those of his own invention, and rejects universally all others; and well might he except his own, since he wrote only to recommend them. Delamotte was not very fond of instruments: he tells us in his preface, that in a course of thirty years practice, he had not twice made use of the crotchet, though he had an extent of country forty leagues round, in which he regularly exercised his profession, insomuch as to have four lyings-in in a day under his management.

I have very exactly read almost all the modern authors who have written on this art; and have been surprized to observe that whilst, on one hand, they agree, they own, that in England, France, and Holland, people are much come off, or undeceived, as to all those dangerous or mortal instruments of which the antients made use, such as the short broad-bladed knife, (call it, if you please, a pen-knife) the bistory, the crotchets, &c. especially since the invention of the new forceps, or tire-tÊte: on the other hand, these same doctors tell you, that recourse must be had to crotchets, or to the CÆsarean operation, when the new forceps will not do. A comfortable resource this, in an instrument so boasted as the best discovery that has been made since the creation of the world, and for which we are indebted to the moderns!

I have also scrupulously examined all that authors have been pleased to say of great, wonderful and magnificent, with regard to the new forceps of Palfin, as it now stands after infinite corrections, as well in foreign countries, as in this one, which have dignified it with the name of the English forceps; and I find all these great elogiums reduced, at the most, to no more than the proving, as clear as the sun, that it is allowable for an operator, extremely able and extremely prudent, to make use of it, when the business might be perfectly well done without it.

From thence I deduce my demonstration directly opposite to the pretentions of Dr. Smellie and of his followers. According to the instrumentarians, and according to certain doctors, there are certain occasions, certain cases, in which there is an absolute necessity for employing the forceps. If we will hearken to and follow other doctors of more celebrity and credit, it is not right to make use of it, but when one may very well do without it: for example, after the having obviated all the obstacles which retard the delivery, after having, with the hands only, dis-engaged the head or the shoulders of the child, without which (say these same writers) the instrument would be found insufficient or useless; this palpably implies the being able to do without it. Now since it is not allowable, in good practice, to make use of it, but when it is perfectly needless to use it at all, there is then no absolute necessity for it; as surely, what can be done without, is not absolutely necessary. Be this only transiently remarked. For I reserve most convincingly to prove this proposition in the second part of this work. There I shall treat of all the instruments of our antients and our moderns, and besides an enumeration of them shall demonstrate their danger and uselessness. In the mean time, it must be owned, that either Mr. Smellie has been much misinformed of what passes at the HÔtel Dieu of Paris, in the ward of the lying-in women, or else, which I the least believe, is not sincere in the account he gives us, that the women of that hospital “had recourse to the assistence of men, in all the difficult cases of midwifery;” which, he observes, “got the better of those ridiculous prejudices the fair sex had been used to entertain.” That is to say, in preference of midwives to men-practitioners.

I frequented this HÔtel Dieu two whole years, before being received an apprentice-midwife, which I accomplished with great difficulty, on account of being born a subject of England, and consequently a foreigner there: my admission, however, I gained at length, through the favor, protection, and special recommendation of his royal highness the duke of Orleans. Now, I dare aver, that in all the time before, and after I was admitted there, I never but once saw Mr. Boudou, surgeon-major called, who did nothing more than to make us, one after another, touch the patient, about whom we had been embarrassed; and as he interrogated, he made us discover an uterus full of schirrous callosities, which joined to its obliquities, impeded the palpation of it properly with the hand, the orifice being very difficult to come at. Every thing, however, was done without his help, and very successfully. And most certainly we should have spared him the trouble of coming at all into our ward, if the head-midwife, who was a little capricious in her temper, had not taken it into her head to keep us in our perplexity, which engaged us to send for Mr. Boudou without her knowledge, and for which she was afterwards heartily angry with us.

I never once saw an occasion in which there was any necessity for using instruments, though in my time we had, at least, five or six hundred women a month to deliver.

Very far then are the midwives from having often occasion of recourse to the assistence of the men, in difficult cases; and indeed to those prejudiced in favor of men-practitioners, it may, though true, appear strange, that in a place where there are every year so many thousand women delivered, and consequently many difficult labors amongst them, and even cases of monsters, there is no recourse to the surgeon-major but in the last occurence, which falls out very rarely.

About eighteen or twenty years ago, Madam Poor, head-midwife of this hospital, delivered a woman of a monster with two heads, with no help but only her fingers and a young prentice. Not an instrument was employed: no man assisted her. The child was christened, and died presently after. The mother remained some months upon recovery, and did perfectly well. This fact requires no proofs, being of such public notoriety. The monster was carried to St. Cosmo’s, where any surgeon may see it. I served my time with this same mistress some years after this kind of prodigy had happened.

As to what I have advanced concerning the procedure in the wards of the lying-in women, should my testimony appear in the least suspicious, I appeal to the justice and veracity of all the doctors in England, who have been at the HÔtel Dieu at Paris, who cannot but confirm what I have said. In the mean time Mr. De la Motte, who passes for an author of credit may certify, the same. Here follows what he says in his preface to his observations, page 2.

“One would think (says this author) from reading the books of Messieurs Mauriceau and Peu, that it was impossible to succeed in the practice of midwifery, without having operated at Paris in the lying-in ward of the HÔtel Dieu. It is true, that this hospital is the best school in Europe, and that I would have ardently wished to have been admitted to the operations of midwifery during the five years I staid in that hospital: but as there is no more than one surgeon only, who is in charge to attend when he is called to consultation with the midwives, and that it is a place which goes only by favor, I was forced to content myself with following in quality of topical surgeon, to the physicians who performed their visits there. So that I followed only, for six months, three physicians in their rounds there, during which time I applied myself to examine the conduct observed by those gentlemen, to preserve the women after their lying-in from the accidents which follow thereon. By this means I made myself amends for my want of recommendation; but I can safely say, that during the six months I was admitted in the above-mentioned quality, there was no more than one extraordinary labor, which was that of a child engaged in the passage, where the presence of a surgeon was required, and which however was terminated without any other help than that of patience. And yet there were (so far back as then) from three hundred and fifty, to four hundred pregnant women, who were all delivered by the apprentices and rarely by the Dame De la Marche, at that time, head midwife of the hospital: so that I am persuaded, that those who boast of having lain a great many women there, exaggerate furiously.”

For me, I dare yet go farther, and will maintain it, that those persons impose upon the public in such boasts: since the naturalized surgeons, those of the nation, those of Paris itself, have no right to come into our ward. There is no one admitted but the surgeon-major, whose place is a place of favor, and rather matter of form than any thing else. Much more then are strangers excluded, and the truth is, that they never did, nor ever do operate there.

As to the reproach which Mr. Smellie makes to us of being interested, I can, for myself, prove that I have delivered gratuitously, and in pure charity, above nine hundred women. I doubt much, whether our critic can say as much, unless he reckons it for a charity, that which he exercised on his automaton or machine, which served him for a model of instruction to his pupils. This was a wooden statue, representing a woman with child, whose belly was of leather, in which a bladder full, perhaps, of small beer, represented the uterus. This bladder was stopped with a cork, to which was fastened a string of packthread to tap it, occasionally, and demonstrate in a palpable manner the flowing of the red-colored waters. In short, in the middle of the bladder was a wax-doll, to which were given various positions.

By this admirably ingenious piece of machinery, were formed and started up an innumerable and formidable swarm of men-midwives, spread over the town and country. By his own confession, he has made in less than ten years nine hundred pupils, without taking into the account the number of midwives whom he has trained up, and formed in so miraculous a manner. See the preface of this author. He speaks of his machine in the first page, and p. 5, of the number of his pupils.

Now as to these worthy pupils, must not they be finely enabled to judge of the situation of women with child, and of that of their foetus? Must not they be deeply skilled in that branch of anatomy? Must not they acquire a habit of the touch exquisitely nice, exquisitely just, for discerning the proportion and analogy between a mere wooden machine, and a body, sensible, delicate, animated, and well organized?

I hope too that it is an injustice done to that doctor, by those who say that his pupils have too often a way of hurrying out the waters, which can only serve to render the labor more dry, consequently more laborious, and by that means furnish a handle for setting their instruments to work. If this should be so, as once more I hope it is not, may not the bad habit they will have contracted during their pupilship, of drawing the small-beer out of their wooden-woman, have contributed to this method of practice?

In the mean time, does it become a doctor to call us interested, who himself, for three guineas in nine lessons, made you a man-midwife, or a female one, by means of this most curious machine, this mock-woman?

Objection the Eighth.

But you who come so late (it will be said) What new discoveries do you bring us? Can you imagine you will, with one dash of the pen, cancel the impression of so many excellent works as have appeared before you? Do you believe a woman can have more ability than so many men of letters, who have labored all their life-time in perfecting the art, and who so strongly recommend the use of instruments, as the most expeditious method of extricating one self, in all the cases they specify, and where there is a necessity for recourse to extremities? Can you think, that these personages have all spent their time in vain?

ANSWER.

Almost all the sciences and arts attain to perfection, in process of time, through the experience and assiduous attention of those who cultivate them. We owe the most of our rare and precious inventions to the ages of barbarism, in which as yet reigned that brutality and ignorance which the irruption of the northern swarms had diffused over all Europe. This invention and perfection of arts cannot be attributed to merely human industry; but, with more probability, to a particular over-ruling providence, which commonly concealing itself under what seems to us the weakest, and under occurrences which appear to us the effect of chance, have guided men to wonderful discoveries. Do not we owe to a fair Circassian the art of inoculating children? And surely the art of midwifery, perhaps more than any other, stands the fairest chance of being improved by women.

For my part, I dare maintain it, that the surgeons, in form of men-midwives, have been the death of more children, with their speculum matricis, their crotchets, their extractors or forceps, their tire-tÊtes, &c. than they have preserved. If in killing the children, they have saved the lives of some mothers, they have hurt and damaged, not to say murdered, a number of others. Their faults ought to set us upon searching out for a better way of going to work; a more easy, a more safe one. This fatal operation by instruments might even be pronounced absolutely useless in the profession. There is no inveighing severely enough against so dangerous a doctrine as that which recommends them. Even common humanity requires an endeavour to open the eyes of those, who imagine they cannot do better than blindly to assent, in every point, to authors recommendable, it is true, by a number of good things, but whose authenticity in those points procures them but the more dangerously credit in erroneous ones. Good sense does not dictate undistinguishingly receiving all that is advanced even by the best authors. As they may have been themselves deceived, they may also deceive us. The sacrifice of our reason is what we owe to nothing but to revelation. Books written by men have no title to it. As their understanding is not above the impositions of others, or errors of their own, they may adopt falsities, through ignorance, through prejudice, for want of examination, or of right reasoning. Their heart may also have been byassed or corrupted by views of interest or of ambition. I may therefore, without over-presumption aver, that with regard to instruments, it is wrong to lay any stress on the authority of others. For, with all the respect due to some illustrious writers in these modern times, who defend the party opposed to ours, it may be assuredly said, that either they have not known the art of midwifery, or that they have formed their judgment of it by nothing but the abuses of the antients, who practiced it without knowing it. Is it not a crying shame, that operators, who in their life-time massacred such numbers of human creatures, should still retain, after death, credit enough to assassinate common sense? Faith is given to unskilful authors, who have deceived their cotemporaries, posterity, and perhaps themselves: ignorance admires, enthusiasm protects them. But what a cruel and mean policy must be that of supposing, that the knowledge of truth ought not to have a clearer title to dominion than the illusions of imposture? I hope however, that, when the eyes of the public shall, in this point, come to be opened, and opened they will be, if true physicians will give themselves the trouble to enlighten it, that public will at length see, that an approbation, unpreceded by a due examination, does it as little honor as service.

Lying-in women principally require an early assistence. For unless they are pregnant of a monster with two heads (a case so rare, that in the practice of a thousand surgeons, in their whole life, it may not twice, nor perhaps once fall in their way) there need never be an occasion of recourse to a surgeon: for in this case, of a monster, it must be the affair of a most profoundly skilled operator and not of merely a common man-midwife.

Run over all the authors who have written on this matter, and you will find that the men-midwives, for want of right, and of true knowledge of the profession, have introduced themselves by force and violence, as one may say, sword in hand, with those murderous instruments: read the ancients, it will appear, that they cut their way in, with iron and steel, forerunners of murders. Our moderns to palliate these violences and injustices, agree on one hand, that the common and gentlest methods are to be preferred: but, on the other hand, when you tell them, that the common and gentlest methods are the hands of women, who ought therefore to be preferred to the men, and to be restored to their antient and rightful possession; then you will see the whole pack open in full cry: to arms! to arms! is the word: and what are those arms by which they maintain themselves, but those instruments, those weapons of death! would not one imagine, that the art of midwifery was an art-military?

As for we women, we can but in our weakness groan under this tyranny. Our protest, joined to that of reason and experience, avails little. Our wise innovators have a great deal more wit than we have; but it is not a wit of which we would be ambitious: for it serves them no better, than under the pretence of saving to be paid for destroying: at least it is not unfrequently so.

Objection the Ninth.

Opinion often makes a stronger impression on us than truth. Whatever you may say to the contrary, the imagination will prevail of life, being safer in the hands of a man than of a woman. For, in short, of what importance can a woman be, who, after all, is but a woman? This is so true, that most of our women now a-days will have a man-midwife, some through prejudice, others through good oeconomy, because if there are any prescriptions necessary for the patient, the man-midwife, who is also stiled the doctor, will write for them; whereas, if there is a midwife, a physician may moreover be requisite: this is an additional charge.

ANSWER.

A happiness founded on opinion only, is rather too slightly founded, especially in a point where not less than life is at stake. I know there are women so obstinately wedded to their opinion of certain pretended doctors, that they would not look upon it to be a good office done them, though certainly it would be one, to undeceive them. I also know that the title of doctor is so common in this country, that it ought to be very cheap.

Most of the women in labor, (you say) will have men to assist them, as thinking their life more in safety with them, than in the hands of women. May be so. But what does that prove but the deplorable blindness, the weakness of the human understanding, and the silly prejudices in favor of novelty? Is it then the instruments of these men-midwives that give this confidence or this security? As if a king, a queen, or princess dangerously ill, could be defended from death, by doubling their guards.

The women have on this occasion the delicacy not to suffer even their husband to assist at their labor, and this out of decency. This is very well for those who are contented with midwives; but as for those who will be attended by men to lay them, it is very wrong in them not even to insist on their husband to stay by them. For this preference of men to deliver them, comes either from a greater inclination to the men, or from a greater confidence in them than in the women, or, in short, from the pure necessity they imagine themselves under to employ a man. If it is from inclination, or from necessity, it will be always proper for the husband to stay, to contain the man-midwife, as much as possible, within the bounds of modesty. If the man-practitioner is preferred by them, out of the great confidence they have in men: in what man can they place more confidence than in a tender husband: who more than he can interest himself in the man-midwife’s acquitting himself duly of his office?

I wonder that this great confidence which is reposed in the male sex should be limited to the man-midwife only. I promise the women, that they may with equal justice imagine a greater handiness about them in men-attendants than in women; they may just as well have men-nurses as men-midwives: the convenience will be as much greater in the one, as the safety will be in the other. Away then with all the women, who croud round to comfort and relieve a woman in labor: away with your mothers, sisters, aunts or female acquaintance: in consequence to the preference due to the male-sex, let the patient’s labor be attended by fathers, brothers, uncles, or men-acquaintance.

But let common opinion lower women as much as it will, so much is certainly and experimentally true, that, notwithstanding the prejudice and superiority of the men, the judgments and decisions of the women are often more shrewd, more exact than theirs. Women have a certain delicacy of mind, which, not being spoilt by undigested studies, renders their taste much more quick, and more to be depended on, than that of the half-learned.

The distribution of merit and talents is entirely in the hands of divine providence, that gives what and to whom it pleases, without respect to the quality of persons; forming out of the assemblage of sciences of all sorts, a sort of empire, which, generally speaking, embraces all ages, and all countries, without distinction of age, sex, condition or climate. The rightful claim to solid praise in this empire, is for every one to be contented with his place, without bearing envy to the glory of others. These he ought to look on as his colleagues, destined as well as himself to enrich society, and become its benefactors. As this providence places kings on the throne for nothing but the good of the people, neither does it distribute different talents to men but for the public utility. But, as in states it has been seen, that tirants and usurpers have sometimes got the upper-hand, so, amongst men of talents there may, if I dare so express myself, creep in a sort of tyranny, which, in the present case for example, consists in looking on the women with a jealous eye, especially those who from an eminence of talents might dispute precedence with them. Thence it is that they are, as it were, hurt by their successes, and by their reputation, and that they endeavour to depreciate their merit, in order to establish the sole dominion in themselves. A hateful defect this, and entirely contrary to the good of society.

This is nevertheless the defect of most of our young men-midwives. But when I consider the mercenary interest by which they are guided, I am far from wondering at their inveteracy against those midwives, especially who are distinguished for their merit and science. The objects of this malignity of theirs are principally those, who have a reputation they fear may enable them to be their competitors in practice. From this mean jealousy of profession, they warmly inveigh against its being trusted in our sex. This is a doctrine they spread every where, and the stale burthen of their abuse is ever, “What is a woman? What effectual service can be expected from a woman?” And thus, by dint of this repetition and of clamor, they come at length to accomplish the persuading an over-credulous public. The common people have in all ages been easily seducible, open to imposition, and when once an error has got full possession of them, it is a miracle if it does not maintain itself in it. They love novelty, are readily taken with striking objects, and stop at the surface of things, which they eagerly seize. Singularity especially moves them. Reason alone, and divested of chimeras, appears too naked to them. They must have something that borders upon the marvellous. Is it not from thence that the dreams of the poets found faith among the Heathens, or that the fables of the Coran pass for so many truths among the Mahometans? To the same weakness in favor of every thing that will make one stare, is owing that silly credulity, which so often leads men to the swallowing the grossest absurdities. One would think fictions had peculiar charms for them.

Nothing however can be more pitiful, than the injustice of running down a sex, which has, in this very matter of midwifery, served the whole earth through all ages, till just the present one, that a small part of the world, becomes in imagination, all of a sudden a land of Goshen, or the only enlightened spot, and takes the ignis fatuus of a mercenary presumption for the sun-shine of sound reason. But after this injustice, where will the men stop? What profession will they leave to the women? It will at last be discovered, that the men can spin, raise paste, cut out caps, pickle and preserve better than we do. After all, is it not even ridiculous to see a custom, established for above five thousand years, universally approved by great and little, fall into disgrace, I will not say by the opinion, but by the whim of a handful of people, most of whom too are, most probably, perfectly sensible of the nonsense and absurdity of that whim, but defend it from a spirit that can hardly not be suspected of interestedness, which indeed will make men defend any thing?

And after all, even common decency and common gratitude might engage the men-midwives to speak less slightingly of the women of that profession; since of whom is it, that the most famous of our present master-men-midwives of London have learned their science but of the women? Do not even the principal ones of them make it their boast to have served a kind of apprenticeship under those midwives, who had served theirs in the HÔtel Dieu at Paris?

But surely the reader will not think it here impertinent to observe, that the wise administrators of that famous hospital, would hardly have failed establishing men-midwives in it, if the safety of the subject had had any thing to fear in the hands of women. But women alone it is that preside at all the lyings-in there, be they never so extraordinary or laborious. The men-midwives have never yet been able to extend their footing within that place. Their emissaries can gain no admission, nor are any proficients trained up there but women only. Notwithstanding which, all the women who are there delivered are satisfactorily and skilfully assisted. Vexatious accidents are less frequent there, in proportion to the numbers, than elsewhere, under the eyes and operation of the men-midwives. Mother and child are both more in safety under the hands of those dextrous matrons, than in those of the most renowned men-practitioners^[3].

To those then, who with a contemptuous tone ask what is a woman but a woman? I shall with equal modesty and truth answer, that generally speaking women are inferior to men in most public services. They are scarcely so fit to head armies, to navigate ships, break horses, or the like manly employs: but there are certainly domestic branches, in which they rather make a better figure than the men. Midwifery seems their appropriate lot: and rather a gift than an acquisition. They hold from nature herself, in this matter, a certain expertness and dexterity, to which not all the more abstruse refinement of art can ever conduct the men. Nor will the operation of iron and steel instruments ever equal the suppleness, safety and effectual ministry of the fingers of an expert midwife, who understands her business.

Let me then be permitted to ask retortingly in my turn, What is, at the best, a man-midwife? Is not he one of a new set of operators unknown to our ancestors? A creature in short hard to be defined? In no original or primitive language is there so much as a word to express one of this profession. The common word for him in the English language is a contradiction in terms, a monstrous incongruity; a MAN-mid-WIFE. Sensible of the ridiculous sound of this expression, scarcely less so than that of a woman-coach-man, they have, by way of remedy, borrowed the term of accoucheur from that nation whence the fashion was unhappily borrowed, among many other fashions, so many of which are however rather ridiculous, than like this one big with danger, added to the ridicule of it. But even that affected French word accoucheur is of a very recent date in France. No French authors employ it, who are not themselves of a more modern date than the word itself, which has not above the antiquity of a century to boast. The name and vocation of a midwife are found in the most primitive languages, being, in fact, coeval with mankind itself.

As to those who, from a principle of oeconomy, prefer a man-midwife to a midwife for conducting a lying-in, with respect to the remedies and prescriptions which may be necessary on those occasions, Œconomy is doubtless a laudable consideration, but I am much afraid, that those who on this occasion make it a reason of preference, much mis-calculate things. This man-midwife you prefer is either an eminent or an ordinary one. If he is an eminent one, you are not always sure of having him in the greatest need; for besides their being so rare, they cannot be every where at one time. But admitting that you are fortunate enough to fall into the hands of a man-midwife of the greatest name in the profession, can you imagine that you will have a very cheap bargain of him? These gentlemen expect no small fees, and will not attend without them. You would besides be ashamed of not doing honor to the footing on which they give themselves out. Whereas the same gratitude is not always shewn to a midwife, however skilful in her profession, and whatever trouble she may give herself both before and after the lying-in of her patients; notwithstanding too the assiduous attendance and visits she bestows upon them till they are out of danger; notwithstanding these tender attentions she has for the children, which are so seldom regarded by the men-midwives; there are who imagine they cannot give a midwife of this sort too little, and that for no other reason on earth, but because she is not a man.

If on the contrary, and what the most frequently happens, you fall into the hands of one of the common men-midwives, either of that multitude of disciples of Dr. Smellie, trained up at the feet of his artificial doll, or in short of those self-constituted men-midwives made out of broken barbers, tailors, or even pork-butchers (I know myself one of this last trade, who, after passing half his life in stuffing sausages, is turned an intrepid physician and man-midwife) must not, I say, practitioners of this stamp be admirably fitted, as well for the manual operation, as for the prescriptions? If then it is from thrift they are employed, by way of sparing fees to a real physician, I own, I think this is pushing savingness too far; as I should be almost as much afraid of the prescriptions of these mock-doctors as of their operation. I should have more confidence in the advice of a discreet matron, or of a skilful midwife, who, by habit and a long experience of seeing ladies in their lyings-in attended by the best physicians, is in the most common cases of the labor-pains, more able to advise the sick person to innocent remedies, where there is no complication in the disorder, than those half-bred or ignorant pretenders: but if there is a complication, then there must absolutely be a good physician called in, the expence of which should not be regretted, since life is at stake.

Now in such cases, a midwife, though never so skilful, will neither be ashamed nor backward to require such aid: whereas a man-midwife, the more ignorant he is, will be but the more careful of concealing that ignorance, and from the most false prejudice that both the faculties of physic and surgery are implicit ingraftments on the profession of midwifery in a man, will rather let mother and child perish, than call in that assistance, of which he will be ashamed to confess his standing in any need. He will then rashly do the best he can for his patient: but what will that best most probably be? Torture and death; and that with perfect impunity. I say most probably, for not even the most credulous, or the most zealous for the appropriation of this profession to the male-sex, can hardly carry the blindness of credulity and obstinacy the length of assenting in earnest, that in the common run of men-practitioners you are to find at once the man-midwife, the physician, and the surgeon. Whereas women, fully sufficient for all cases but the very extraordinary ones indeed, are ever ready to call for proper help, on the first alarm of danger, of which too their apprehension is much more quick and just than that of the men.

Objection the Tenth.

The ignorance of the women is the cause of the little confidence there is reposed in them.

ANSWER.

If this objection was fairly stated, it should be said, that the ignorance of the women in the art of destroying mother and child, occasions their not being trusted so much as they deserve with the office of saving both. In that art indeed of perpetrating double murder with perfect impunity, under the sanction of the public credulity, imposed upon by a vain parade of learning, I readily confess the men superior to the women. I do more than confess it, I will prove it; and how? even from their own writings and confession, not extorted from them by the spirit of candor, but from an interested desire of decrying or supplanting one another, in order to self-recommendation.

In fact, whoever will, with a competent degree of knowledge of the subject, and of due impartiality, peruse the practical treatises of midwifery, written by the most celebrated practitioners, some of whom have so vainly pretended to the triple union of the characters of man-midwife, surgeon and physician in one person, and it will be found, that all their boasted superiority of erudition, has only led them into the greater errors of practice, and the most barbarous violences to nature.

But perhaps I exaggerate. Let the reader judge for himself, and pronounce as his own reason shall dictate to him. Let him if he can read without shuddering, the following quotation from one of the most celebrated men-midwives of the age, Levret, p. 199. “Mauriceau had invented a new tire-tÊte, which was to be introduced into that part (the uterus). Peu or Pugh, like many others, made use of different hooks (crochets) and La Motte opening the head with scissors, scooped out the brain, &c. We read, with horror, in all these authors, that they have extracted children, who, tho’ much maimed or mutilated, have yet lived several hours.”

Upon this many reflections will naturally occur. These children thus destroyed, owed most probably their death neither to nature, nor to the difficulties of the passage through which the launch is made into our world, but to the labor being prematurely forced, and the delivery effectuated by those torturous instruments, which at once kill the child, and not seldom irreparably wound the mother in the tender contexture of these parts. A midwife, with less learning and more patience than those gentlemen, and well acquainted with the power and custom of Nature to operate in some subjects, sometimes more slowly, and in all ever more safely and gently than art, would have left to nature, not without her tenderest assistance of that nature, the expulsion of the child. A proper predisposal of the passage, and direction of the posture, with an unremitting attention to employ the fingers, so as not to lapse the critical moment of operation, often never to be recovered with safety to mother and child, would have, I repeat it, and appeal to common sense for the probability thereof, saved the lives of those innocents, which thus fell the victims of those learned experiments, with instruments, which, by the way, be it remarked, none are so forward to use, as those who are the loudest in exclaiming against the employ of them. And reason good, if they exclaim against them, it is evidently in order to cover their practice with them, against which the minds of their patients must so naturally be revolted. But that exclaiming does not evidently hinder their being used, when, the truth is, that if due care was previously taken with the patients, those execrable substitutes to the fingers need never be used at all.

But if these instrumentarians were called to account for their so justly presumable massacres, what would be their defence? Most certainly not the truth. One would not own, that in order to attend a richer patient, or perhaps to return to his bottle, he had recourse to his fatal instruments, to make the quicker riddance or effectual dispatch; another would not confess, that he employed them purely because his fund of patience was exhausted; some would not care to allow, that they used them purely on the scheme of trying experiments; and none of them would, you may be sure, plead guilty of ignorance of better and more salutary methods. No! their wilful error, or that want of skill, they would be sure to conceal under the cloud of hard words and scientific jargon, in which they would dress up their respective cases, and insult the ignorance of those silly good women, who know no better than to deliver those of their own sex with the help of their fingers and hands, and who are so undextrous, as to have no notion of putting them to such unnecessary tortures and risks, as are inseparable from the use of those iron and steel instruments. Instruments which rarely fail of destroying the child, or at least cruelly wounding it, and never but injure the mother, not only in those exquisitely tender-textured parts, where they are so blindly and ungovernably introduced; but in the often irrecoverable dilatations of the external orifice, the vagina, and especially the fourchette or frÆnum labiorum, all which, in general, they considerably damage: and always originally without necessity. For if through carelessness, if through an impatience, so much more natural to men than to women, in a case and position of this nature; if through ignorance of the critical minute of extraction, the occasion of operating with the fingers has not been lapsed, any recourse to instruments is perfectly unnecessary, and they will hardly ever succeed where the subject is inaccessible to the fingers, without having the worst of consequences to dread from them both to mother and child. Nothing then can be worse for a man-midwife, than to be tempted to any negligence, to any precipitation, to any ostentation, in short, of expedition or of superiority of skill to that of the women, by his having those instruments at hands, the doing without which is at once so much better and safer, even by the confession of those who use them nevertheless.

How greatly then is the ignorance of the midwives preferable to such an use, as the male-practitioners commonly make of that deep learning of theirs, which only misleads them, at the expence of humanity! How over-compensated is that want of theoretical knowledge, so unjustly reproached to women, since they profess a sufficiency even of that knowledge; how over-compensated, I say, is that supposed want, by that instinctive keenness of apprehension, and ready dexterity of theirs in the manual operation, which in them is a pure gift of nature, and to which not the utmost efforts of art or experience can ever make the men arrive, for reasons which will be made clearly appear in the two following considerations.

First, It will hardly be denied, that the art of midwifery requires a regular training or education for it. The season of that education can only be that of youth. And surely in that season precisely, the very nature of the study excludes those of the male-sex, at the same time, that there is nothing in it indecent or improper for the females destined to that profession. This proposition will be more clearly illustrated, by an appeal to the reader’s own sense and reason upon what passes, and must necessarily pass in those hospitals for the reception of lying-in women, where those of the male-sex are allowed to attend for the sake of learning the profession.

This Charity is indeed founded upon specious motives, but the conduct of it would make humanity shudder, even where no violence is expressly intended to humanity; and without the least forced or uncharitable conclusion, may serve to demonstrate the impropriety of attempting to throw the practical part of midwifery into the hands of male-practitioners, the implicit consequence of which must be the exclusion of the midwives, without any direct and formal exclusion of them, but purely from the discouragement that will hinder any good and able ones being formed in future. And that no thoroughgood men-midwives, except perhaps two or three extraordinary men in a whole nation, can ever be formed, the procedure at the lying-in hospitals, open to men-pupils, such as it must of all necessity be from the nature of the thing itself, without any the least reproach herein meant to the worthy managers, will convince all who will make an unprejudiced use of their judgment.

We will then suppose a lying-in hospital, in which, for the sake of training up men to the profession of midwives, there are young pupils of the male-sex admitted to attend and learn the practical and manual part of the business. To obtain this end, we will not say that women of virtue and character are subjected to the inspection and palpation of a set of youths, who perhaps pay largely for their privilege of attendance; but we will grant, that the objects of this charity are entirely women, who, though they may have unfortunately forfeited their right to virtue, cannot however have lost their claim to the protection of that humanity, which, besides the great and most political attention due to population, pays especially a tender regard to the innocent burthen, though of a guilty mother. Yet among these wretched victims, there may be not a few who, if they were not even to deserve more compassion than blame, for particular circumstances of their ruin, in which the villainy of men has often a much greater share than female frailty itself, cannot surely deserve that all traces of modesty, or natural remains of regard for it, should be utterly eradicated by that hard necessity of theirs to accept of a charity, by which they must be abandoned up to the researches of a set of young men, to whose approaches their age and sex must alone give an air of petulance and wantonness not to be explained away, to the satisfaction of the poor passive sufferer, by the goodness of the intention. Every one must be sensible of the dreadful effects such a treatment must have on the mind of a poor creature in that condition, when the imagination is known to be the most weak, and susceptible of the most dangerous impressions. At that critical time, amidst all the terrors and apprehensions inseparable from her situation, she is moreover exposed to the greatest indignity that can be well imagined, that of serving for a pillar of manage to break young men into the exercise of that most unmanly profession. Nay, that very circumstance of the use she is put to, which she is in fact to consider as a kind of valuable consideration by her paid for the relief afforded her, and which in that light can scarce be called a charity; that very circumstance, I say, of her submission, at all calls, and upon all pretences of the pupils, being accounted for to her by the good intention of it, will yet hardly pass on a wretched, frightened, harrassed woman, who, whatever may be said to procure her tame acquiescence, can scarcely, if she has a spark of female modesty left in her, be reconciled to the grossness of such usage, whether she considers herself as the butt of wantonness, or the victim of experiments, or perhaps of both the one and the other. It is well if she is defended by her ignorance from any idea of those dreadful instruments, of the having practices tried upon her with which, her circumstances might but too reasonably render her apprehensive, since a needless resort to them may be too often presumed in the course of practice, where the men are even paid for their assistence. These the men-midwives may possibly indeed conceal from the sight of their patients, but I defy him to conceal them from their wounded imagination, if they are not wholly ignorant or can think at all.

Yet in pure justice to all parties it should be observed, that, besides many other points to be learned only by ocular inspection and manual palpation, of which no theory by book or precepts can convey satisfactory or adequate notions, that great and essential point in our profession, a skill in what we call the Touching, is not to be acquired without a frequent habit of recourse to the sexual parts whence the indications are taken. And in this nothing but personal experience can perfect the practitioner. But this admitted, only proves the more clearly the utter impropriety of men addicting themselves to this occupation. For, once more, most certainly the season of acquiring the nicety of that faculty of Touching, besides other requisites in the art, is for obvious reasons that of youth. Now let any one figure to himself boys or young men, running at every hour, and exercising a kind of cruel assault on those bodies of the unfortunate females, upon which they are to learn their practice. But will they learn it by this means? It is much to be doubted. It may perhaps be granted, that men of a certain age, men past the slippery season of youth, may claim the benefit of exemption from impressions of sensuality, by objects to which custom has familiarized them. But, in good faith, can this be hoped or expected in the ungovernable fervor of youth? Can such a stoic insensibility be imagined in a boy or young man, as that he can direct such his researches by pawing and grabbling to the end of instruction only? Must not those researches, humanly speaking, be made in such a disorder of the senses, as to exclude the cool spirit of learning and improvement? May he not lose himself, and yet not find what was the occasion of losing himself? In short, granted, though it is surely hard to grant, that the wretched women, admitted to this so falsely called Charity, may not deserve much tender consideration; but in what can the poor young pupils have deserved so ill of their parents or guardians, as to be thus exposed to temptations so shockingly indecent? What father, what mother, what considerate relation can paint to himself a child, or charge of his, at an age so incapable of resisting the power of sensual objects, as is that of youth, employed in exploring such arcanums, and exploring them too in vain? It is surely easier to guess the natural consequences, than to defend either the subjecting youths to them, or the hoping any good from the subjecting them. In short, even Dr. Smellie’s doll is a more laudable method of instruction.

But besides this reason taken from the moral impossibility of laying a timely foundation of practical knowledge in the male-sex, for preferring women under the false charge of ignorance, to the so unconsequentially boasted learning of the men, there remains a yet stronger argument against the male-practitioners: an argument furnished by nature herself, and of the which, every impartial reader’s own feelings will in course render himself the judge.

Nature has to all animals, from the man down to the lowest insect, to all vegetables, from the cedar to the hyssop, to all created beings, in short gives what is respectfully necessary for them. Nor can it without the grossest absurdity be imagined, that this tender universal parent, or call her by a yet more sacred name, the divine providence, would have failed women in a point of so great importance to them, as that of the ability to assist one another, in lying-in, at the same time, that she has given them so strong and so reasonable a sympathy for those of their sex in that condition? Can it be thought that nature, so vigilant, so attentive, to the production of fresh generations, through all beings, should have been deficient or indifferent as to women, her favourite work, the friend, the ornament of human kind? And so she must have been, if she had left her in the necessity of recourse to others than those of her own sex, in whom there exists so sensibly a superior aptitude for tending, nursing, comforting and relieving the sick, that even the men themselves, in their exigences of infirmities, can hardly do without them. But to say the truth, and as I have before remarked, nature has been even liberal in her accomplishments of those of the female sex for this office. Not content with giving them a heart strong imprinted with a particular sympathy for their own sex, on this occasion, a sympathy, which for its tenderness, has some resemblance or affinity to the instinctive love or storge that parents have for their children; she has also bestowed on them a particular talent, both for the manual function in the delivery of women, and for all the concomitant requisites of their aid during the time of their lying-in: a talent in short, which may even be felt, without the necessity of definition or proof, to be superior to any possible attainment of the men in that art, though they should have sacrificed hecatombs of pregnant rabbits, or have brooded over thousands of coveys of eggs in their search of excellence in it. To say nothing of a certain softness, flexibility, and dexterity of hand, palpably denied to the men, there is, both in the management of the manual operation, and in the attendance due on those occasions, a quality in which the women, generally speaking, excel the men, and that is, patience, a quality more essential, more indispensable than can well be imagined. For on patience it is, that the salvation of both mother and child often depend; whether that patience is considered in the so needful point of predisposing the passages, or of waiting, without however over-waiting, the critical efforts of nature in the expulsion of her burden. Now nothing is more certain, than that nature, who to woman has in general given all that vivacity and quickness of spirit, which seems incompatible with the phlegmatic quality of patience, has, as if she had purposely meant an exception favourable to her darling end, the propagation of beings, especially the human one, bestowed on the female sex, such a remarkable assiduity and diligence in aid of women’s labors, as are rarely to be seen in men, and when seen, appear rather forced than naturally constitutional to them. Women, in those cases, have more bowels for women: they feel for those of their own sex so much, that that feeling operates in them like an irresistible instinct, both in favor of the pregnant mother and of the child. Thence it is, that a woman-practitioner will employ, without stint, or remission, all that is necessary to predispose the passages, for the least pain, and the greater safety; she will patiently, even to sixteen, to eighteen hours, where an extraordinary case requires so extraordinary a length of time, keep her hands fixedly employed in reducing and preserving the uterus in a due position, so as that she may not lapse the critical favorable moment of extraction, or of assisting the expulsive effort of nature: and what man is there, can it be imagined, would have endurance enough to remain so long in a posture, the very image of which, in one of his sex, is so nauseating and so revolting, to say nothing of the want of that pliability and dexterity of management of the fingers, on those occasions, so necessary, and so uncommon in the men, especially in that very age, when their practice should be supposed the greatest.

It is then in those cases where nature is slow, as she sometimes is, in her operation, and often so, for the greater good of the patient, so conformed perhaps, that a quicker expulsion would only destroy her, that the midwife, not only uses all patience consistent with safety of life to the mother especially, but inculcates patience to her suffering charge. Whereas the men, from their natural impatience, or from whatever other motives their precipitation may arise, having those infernal iron and steel instruments at hand, are but too often tempted to make use of them, not only without necessity, but against all the indications of nature, pleading for a just indulgence to her of her own time in her own work. In vain then do too many of them declaim as loudly as can be wished, or as the thing deserves, against all recourse to instruments, but in extremities which, they pretend, justify them. In the first place, those extremities are often the fault of deficient and unskilful practice. The precious moments of the assistence due to nature have been lapsed, or there has been some failure of preliminary treatment; or what is worse yet, extremities are rashly taken for granted when they are not existing.

Here, in the history of one single woman, I give the history probably of thousands.

A healthy woman, about twenty five years of age, and remarkably robust, was in labor of her second child. Her first had come in that natural smooth way, as had given the same man-midwife, who was now to lay her again, not the least trouble, as often happens. In this second labor, however, the head of the child stuck in the passage; and was so far advanced, that the Doctor told her, whether in jest or earnest I cannot say, that he could discern the color of its hair. Her pain, though extremely great, had not however hindered her observing the Doctor rummaging for his instruments; her frightful apprehension, of which, she had all the reason to imagine, did not a little contribute to retard her throws. She taxed him with his intention to use them, and he did not deny it. Upon this she used the most moving fervorous entreaties for a respite of execution; but all in vain; he told her, with a resolute tone, that he knew surely better what was for her good than she did, that he had even already waited longer than he could justify; and that her life was absolutely desperate if the child was not instantly extracted, of the which being dead, he was sure from many incontestable symptoms. Her thorough confidence in a man, whom she had often heard declaim vehemently against the use of instruments unless in extremities, and which she understood in the most literal sense, without considering, or perhaps knowing that, on too many occasions, nothing is so different as words and actions; her thorough confidence in him, I say, joined to a natural love of life, and to her present feelings of exquisite pain, determined her to an acquiescence. The fatal instrument was struck into the brain-pan of the child, who at the instant gave the lie to the first part of the Doctor’s asseveration as to its death, by such a strong kick inwards as had almost killed her, and convinced her not only of its being alive but lively. This did not, you may be sure, add to her belief of the second part of his averment, that waiting any longer for the operation of nature, would infallibly have been her death. It might be so: yet surely there are strong reasons for concluding, that a little more patience might have saved a fine boy, and yet not have destroyed, or even hazarded the destroying the mother, whose life is certainly the preferable object. But how cruel to state the dreadful alternative where it does not exist! And how easy, in the presumption of that alternative, to extort the dreadful consent from a weak woman, yet more weakened by her condition, and naturally determined by her present feelings, to embrace the appearance of an immediate relief, presented to her in the form of salvation of life! However, scenes similar or a-kin to this, may, without breach of charity, be presumed too frequent, especially under those superficial men-midwives, whom the facility of forming, in the manner they are generally formed, renders so suspicious as to their ability, and who for so many reasons, both of nature and interest, are but too liable to the murderous want of that patience, for which the women are but the more remarkable in this case, for their not being perhaps so capable of it in any other. But here their duty is even their nature; as if in so capital a point, she would trust it to nothing but herself.

If it should be here to this objected that the women may, through that very spirit of patience, wait too long, or overstay the time of saving the patients life, for want of calling in proper assistence; I have already implicitly obviated this objection, by remarking before, that a true thorough midwife, from her quickness of apprehension, and knowledge of the danger, will ever be readier to call in the assistence and advice of a physician, than the common men-midwives, who are ever in proportion to their ignorance the more rash, the more fearless, and consequently averse to calling in that help, of which they will be ashamed to confess their want, and thus cruelly, though with impunity, lose the opportunity of others endeavouring at least to repair those damages, of which themselves are oftenest the authors. Now a midwife has no such shame; she pretends to no extraordinary skill in physic or surgery; she knows her art, and will not presume to transgress its bounds; she would think herself accountable if she did: and even that very tenderness and sensibility, upon which nature has founded her patience, will make her cautious how she pushes that patience too far. She may easily see, feel and discern those cases in which nature calls the physician in aid to the midwife; nature, who seems to have placed such boundaries between those professions, as nothing but interest, presumption, or ignorance of nature, could ever render their union in one person supposable: tho’ the quality of physician may not indeed exclude that of the surgeon, but rather implies, at least, the theory of surgery. For I presume anatomy is the great basis of true rational physic, though it can very little assist practical midwifery, which depends so much upon purely manual operation, and needs only a sufficient general idea of the structure of the sexual parts in woman, the conceptacle, and passages of the delivery.

This is so true, that any impartial observer of the male and female practitioners in midwifery, will easily distinguish the characteristic difference of the sexes, in their respective manner of operation.

In the men, with all their boasted erudition, you cannot but discern a certain, clumsy untowardly stiffness, an unaffectionate perfunctory air, an ungainly management, that plainly prove it to be an acquisition of art, or rather the rickety production of interest begot upon art.

In women, with all their supposed ignorance, you may observe a certain shrewd vivacity, a grace of ease, a handiness of performance, and especially a kind of unction of the heart, that all evidently demonstrate this talent in them to be a genuine gift of nature, which more than compensates what she is supposed to have refused them, in depth of study, though even of that they are not so unsusceptible, as some men detractingly think; and in midwifery, most certainly they attain all that they need of learning to perfect them, with a facility the greater for nature, having collaterally endowed them with an organization of head, heart and hand, obviously adapting them to this her most capital mystery. This will be denied by none who have any regard for truth, and who do them justice, as to the keenness of their apprehension, as to that simpathizing sensibility which supplies them with the needful fund of patience, and tender attention; and as to that peculiar suppleness of the fingers, as well as slight of hand, in a function which rather exacts a kind of knack or dexterity, than mere strength, of which they have also a competency. Nor can it be quite without weight, that the midwives, besides their personal experience, being sometimes themselves the mothers of children, have a kind of intuitive guide within themselves, the original organ of conception, itself pregnant, in more cases than that, with a strong instinctive influence on the mind and actions of the sex; an influence not the less certainly existing, for its being undefinable and unaccountable, even to the greatest anatomists^[4].

The men, it will be said, have many or all of these qualifications, except indeed the last. Granted that they have: but how very few are there of the men that possess the most essential ones to a degree comparable to that of the women: or rather not so imperfectly, as that all their boasted skill in literary theory and anatomy, cannot supplement or atone for the deficiency? Nor theory, nor all the books that ever were written on that subject from the divine Hippocrates, who understood so much of physic, and so little of midwifery, down to Dr. Smellie, who is so great a man in both, will ever amount to so much as the practical experience of a regular bred midwife.

As to that superior skill of the men in anatomy which is sounded so high, against the women, I shall not imitate the men in their want of candor towards the female-sex in their availing themselves of false arguments. I will not then take the benefit of the slight opinion which Celsus and Galen had of the depths of anatomy; they who contented themselves with a gross superficial notion of the principal viscera. I will not even desire to countenance that contempt by the example of that great philosopher Mr. Lock, the intimate friend, and even the counsellor of the British Esculapius Sydenham, who paid a great deference to his physical knowledge; and yet this very Mr. Lock wrote an ingenious treatise (though not published by him) upon the insignificance of the refinements of anatomy in the practice of physic. Neither will I here insist on the absurdities into which even the greatest anatomists have fallen; as for example, Pecquet, the famous discoverer of the thoracic duct in the human body, who nevertheless adopted so extravagant a notion, as that digestion of food ought not to be promoted by exercise, but by drinking spirituous liquors, a practice to which himself fell a victim, dying suddenly at the anatomical theatre. It is only for those who have a false cause to defend to shut their eyes against those truths which seem against them. Those on the contrary who defend purely the truth, know that one truth cannot hurt or exclude another truth, and that all truths may very well coexist. It may be true that anatomy, though it does not give the nature of the elementary composition of parts intrinsic and too minute for the human sense, since a new incision only presents a new surface, much conduces however to ground the student in mechanical principles of great assistence to him in practice, of which they are doubtless the most solid foundation: yet that truth is not incompatible with another quite as much a truth, that midwifery can have no occasion but for a general notion of the configuration of those parts upon which it is exercised. A midwife, for example, may be a very safe and a very good one, without knowing whether the uterus is a hollow muscle, or purely a tissue of membranes, arteries and veins: but if that ascertainment is necessary, she must wait for it till the anatomists have settled among them that point, which, like many other capital points of anatomy, is not however yet done. In short, once more, a woman in labor requires a midwife to lay her, not an anatomist to dissect her, or read lectures over the corpse, he will be most likely to make of her, if he depends more on the refinements of anatomy, than on the dexterity of hand, and the suggestions of practical experience and common sense.

If then, there are who can examine things fairly and with a sincere desire of determining according to the preponderance of reason, they cannot but on their own sense of nature, on their own feelings, in short, discern that no ignorance, of which the women are undistinguishingly taxed, can be an argument for the men’s supplanting them in the practice of midwifery, on the strength of that superiority of their learning, so rarely not perfectly superfluous, and often dangerous, if not even destructive both to mother and child. Consult nature, and her but too much despised oracle common sense; consult even the writings of the men-midwives themselves, and the resulting decision will be, that great reason there is to believe, that the operation of the men-practitioners and instrumentarians puts more women and infants to cruel and torturous deaths, in the few countries where they are received, than the ignorance of the midwives in all those countries put together where the men-practitioners are not yet admitted, and where, for the good of mankind, it is to be hoped they never will.

I have here said few countries have hitherto countenanced men-midwives. That I presume is too notorious to require proof: for even those Saracen or Arabian physicians, Avicen, Rhazes, &c. who, by the by, are little more than servile translators or copists of the Grecian ones, wrote only theoretically in quality of physicians; for it does not appear that they ever practised midwifery themselves, nor ever got the practice of it by men introduced into their countries. Among the Orientals there is no such being known as a man-midwife; that refinement of real barbarism, under the specious pretext of humanity, is happily unknown to them. But if it should be said, that the jealousy so constitutional to the inhabitants of the warmer climes, has a share in the exclusion of men-practitioners; the women have, at least in that point, a weakness to thank for its production to them of so great a good, as the greater safety of their persons and children, in that capital emergency of their lying-in. For, after all, the art of midwifery is, in the hands of men, like certain plants, which, by dint of a forcing culture, exhibit more of florish, or a broader expansion; but besides ever retaining a certain exotic appearance, they never come up to the virtue of those spontaneously growing in the full vigor of a soil of nature’s own choice for them. Art may often indeed improve nature, but can never be a supplement to her, where she is essentially wanting. Deep learning may, in very extraordinary cases perhaps, repair the errors, or assist the deficiencies of the manual function, but the deepest learning will never bestow the manual function, nor indeed can in the same person exist, but at the expence of the manual function, which must have been in some measure neglected for it. And yet the greatest practical skill that any man can with the utmost labor and experience acquire, will hardly ever equal the excellence in it of the women, Great Nature’s chosen instruments for this work: an excellence by them attained with scarce any learning at all, or at least of that abstruse theoretical sort, on which the men make their superiority principally depend.

But that I may not herein be taxed of maintaining any thing that has only the air of a paradox, or of begging the question, I shall implicitly, in the course of my answer to the following objection, endeavor to remove any remaining doubt on this head.

Objection the Eleventh.

In like manner, as there are particular parts of the human body which have their appropriate undertakers or protectors under their proper distinctive names, as oculists, dentists, and corn-cutters, who by making respectively one part their particular care and study, arrive at a greater perfection, at least in the practical operations on it, than regular physicians or surgeons, whose object is the whole fabric; Why, by parity of reasoning, should not the men-practitioners in midwifery be preferable to the midwives, since a man has to his manual function superadded a theory superior to that of the women, who, it is confessed, stand sometime in need of calling in the physician to their assistence? As a man then will have laid in a stock of medical knowledge, peculiarly adapted to the exigencies and disorders incident to women during their pregnancy and lying-in, he must consequently excel the midwife, or the physician singly considered; he who with so much greater convenience will have united in one person both their faculties, besides that of the surgeon.

ANSWER.

That certain parts of the human body enjoy the protection of practitioners, who respectively devote themselves to their service, I confess. Such appropriations may also be beneficial, at least, to the practitioners. I can even conceive, that a professed dentist may clean, scale, and draw teeth, or an oculist couch a cataract, better than either a physician or surgeon. These may in their respective practice be excelled by those partial artists. But I much doubt, even as to these, whether their trusting too much to that partial excellence, does not sometimes do more mischief than good, for want of duly consulting the relation of such parts to the universal fabric, of which physicians and surgeons must be so much better judges. Galen does not appear in contradiction to common sense, where he observes, that to rectify a disorder of the eye, the head must be rectified, which cannot well be done without rectifying the whole body. In confirmation of which, I once myself knew a gentleman, whom a professed oculist, at Paris, assured of the loss of his eyes being infallible; and who upon his despondingly consulting a regular physician, was by him as positively assured, that those very condemned eyes might be saved by a proper regimen. The gentleman happily believed him, and his eye-sight was not only saved, but perfectly restored.

Another instance of the like nature occurs to me, which seems applicable to the dentist, and which I quote here from a translation of the learned and ingenious Dr. Huxham’s observations on the constitution of the air.

“Many years ago I knew a gentleman of a hale, robust habit of body, who, from being too much addicted to the drinking of brandy, fell into a violent jaundice, from which however he would have recovered well enough, would he have conformed himself to the advice of his physicians: but he on the contrary, because his gums were very apt to bleed, and his teeth stunk from the scorbutic taint, put himself into the hands of an ignorant pretender to physic for the cure of these inconveniencies. This fellow immediately set about scaling his teeth, and rubbing his gums with his famous teeth-powder, till at last, by perpetually fretting and irritating the loose texture, he brought on such a hemorrhage, that baffled all the stiptics that could be invented by the most expert surgeons, and continuing to spout forth in small streams from the little arteries of the gums, which were now every where divided: in the space of sixteen hours the poor man died through mere loss of blood.”

These instances are however only adduced to justify that doubt which I expressed of these partial artists being always to be beneficially consulted in those local affections, to which their talent is supposed exclusively appropriated.

Corn-cutter is indeed a homely plain English term, but if the teeth give from the Latin the appellation of dentist, as the eye that of oculist, what name, taking it from the part in question, will remain for that language, to give the men-practitioners of midwifery, in substitution to that hermaphrodite appellation, that absurd contradictory one in terms, of man-midwife, or to that new-fangled word accoucheur, which is so rank and barefaced a gallicism? But let what name soever be given them, it can hardly be too burlesque an one, considering the gross revolting impropriety of men, addicting themselves to a profession naturally so little made for them.

Paint to yourself one of these sage deep-learned Cotts, dressed for proceeding to officiate^[5], and presenting himself with his pocket-nightgown, or loose washing wrapper, a waistcoat without sleeves, and those of his shirt pinned up to the breasts of his waistcoat; add to this,^[6]fingers, if which not the nicest paring the nails will ever cure the stiffness and clumsiness; and you will hardly deny its being somewhat puzzling, the giving a name to such an heteroclite figure? Or rather can a too ludicrous one be assigned it?

Those however who will consider this grave Doctor in his margery field-uniform, this ridiculous piece of mummery, in a light of seriousness, such as the matter perhaps more justly deserves, especially combining with all the rest, the idea of his crotchets, forceps, and the rest of his bag of instruments, may think he less resembles a priestess of Lucina, than the sacrificer, in a surplice, with his slaughtering-knife, to one of those heathen deities whose horrid worship required human victims, which the poor lying-in women but too nearly resemble.

But whether or not, in imitation of the dentist, or oculist, he receives his title from the particular part he has taken under his protection, so much is certain, that the same arguments, which militate for those partial artists claiming their respective departments of the human body, will not avail the man-midwife. An oculist, a dentist, a corn-cutter, have no operations to perform but those of which disorders equally incident to both sexes are the object. There is nothing in their practice repugnant to the nature of the male-sex, nor to that reasonable decency, which only requires that no sacrifices of it should be made in vain, or at least not made to no better a purpose than to increase at once the danger and the pain of both mother and child, in whose favor it is sacrificed, as it may be clearly proved to be oftenest the case. But of the chirurgical part of the man-midwife’s pretention, I reserve to treat after considering him in the capacity of a physician; in which a man may indeed be wanted, but in that of surgeon never, or at least so very rarely, as not to atone for the dangers which attend the men forming themselves into a set under the name of men-midwives.

Where there is no complication of any collateral disorder with the gestation and parturition of women, it is even a jest for men to pretend the necessity of any study or practice to which women may not arrive, and even much excel them.

But where there exists the case of a singular constitution, or of symptoms declarative of other help being necessary than just the common one, that quickness of discernment, that peculiar shrewdness of the women, in distinguishing what is relative to their art from what is foreign from it, gives them the alarm in time, and if they have a just sense of their duty, or but common sense, they must know that such disorders cannot be partial, cannot therefore be considered as they are by the man-midwife, as subordinate to his particular province, relative as they are to the whole fabric or system. All partial practice then is here absolutely out of the question, and now what help can, consistently with good sense, be expected from a man-midwife, who, under a natural impossibility of ever acquiring the female dexterity in the manual operation, cannot however, be supposed to attain even that imperfect degree of skill, without sacrificing to the endeavours at it the time and pains in study and practice, which are requisite to form the able physician?

But, in fact, the men, that is to say, those of that sex who have the best understood all the refinements of anatomy, all the variety of female distempers, never that I can learn, attempted to invade the practical province of midwifery. The immortal Harvey, Sydenham, the great Boerhave, Haller, and numbers of others who have written so usefully upon all the objects of midwifery, have never pretended or dropped a hint of the expedience of substituting men-midwives to the female ones. They contented themselves with lamenting the ignorance of some midwives, from which has been drawn a very just inference of the necessity of their being better instructed; but even those great men never chose the character of practitioners themselves, nor probably would have thought it any detraction from their merit to have it said, they might make a bad figure in the function of delivering a woman.

Whoever then will consider but how the common run of men-midwives actually are and must be formed, and assuredly the number of exceptions to the general insufficiency cannot oppose the inference, must allow that, where a woman has distempers collateral to her pregnancy, with which they must also become dangerously complicated, she must expose herself to the utmost hazard, in any confidence she may place in a man-midwife.

The truth is, that most of the dangerous lyings-in are so far from being likely to be relieved by a man-midwife, that it is often to the having relied upon his medical judgment, and especially to his manual skill they are owing. But of the first only it is we are now here speaking.

The women captivated by that assiduity of the men-midwives, of which they only fail when they are not paid or likely to be paid, in some form or other, up to the value they set upon themselves, lightly take for granted, that, as men, they are also capable physicians. It is enough, in short, for these practitioners not to be women; for the women to think they can prescribe for them in all disorders. A mistake this, often big with the utmost danger to them.

The men-midwives, in general, have never, at the most, carried their studies beyond the disorders commonly incident to pregnant women: the knowledge of all the other possibly collateral ones, is what even the least modest of them will hardly claim, unless to the profoundly ignorant, and is in fact scarce less than impossible to one who has applied himself essentially to the manual function. In such cases the ignorance of a midwife can hardly be greater than that of the men-practitioners, and must be less dangerous from her less of pretention. Her consciousness of her own want of sufficient light, will engage her readily to state the exigency to some able and experienced physician, whom she must allow, in such cases, to be her superior judge: whereas the other, the man-midwife, acknowledges no greater authority than that with which he is pleased to invest himself. He stands, in virtue of a distinct business, and a business for which he never was made, of a sudden the self-constituted sovereign dictator and inspector-general of all female disorders whatsoever, where the woman is with child, that is to say, where the case is only thereby rendered much the more nice and difficult, and, not rarely, does he continue under the same pretext, to extend his practice to where there is no pregnancy at all in the case. And yet ask him for his titles, they are all implicitly dependent on or subordinate to that same midwifery, for which he is so naturally unqualified, even if a due study and exercise of it would permit those avocations, that would contribute to accomplish him in the so necessary general knowledge of physic. But indeed why need he acquire it, since it is so commonly taken for granted, or that he is believed upon his own word, especially if he is backed with a diploma, for form’s sake, that may have cost him little or nothing of medical study, or indeed of any thing but the amount of the fees for it?

Yet how serious, how important is it for women, if they tender their own lives, and that of the precious burthen of which they are the depositaries, to make that distinction between the physician and the midwife, which they seem so little to make! How little do they consider, what nevertheless is strictly true, that a man can never at the best be but an indifferent practitioner of midwifery, though he may be an excellent one in physic; but that as bad a midwife as he can be, he must be yet, if possible, a worse physician, if he attempts to throw both professions into one, and exercise them jointly! They are incompatible, from the justly presumable impossibility of one man doing justice to the practice of the one, unless at the expence of the study of the other: by which other, to obviate cavils, I repeat it, I mean the general practice of physic, which comprehends the speculative part of midwifery, as well as all other branches understood to be the province of the physician. This distinction then I make, because, as to the diseases purely incident to pregnant women, experimental practice will rather assist the medical study of them: and it is in that part only the men-midwives can make any figure at all, and that not a superior one to midwives who are regularly bred, and who have, in their favor, their excellence in the manual function besides.

Once more, in complicated cases, the most dreadful mistakes are to be dreaded from those common-men-midwives, who so groundlessly erect themselves into physicians on those occasions. A purge, a venesection, or any other prescription injudiciously ordered, may be the occasion proximate or remote of death to both mother and child; yet a woman, at least, ought not to expect better from one of these practitioners who, for the most part, has neither study nor experience in general physic; nor more than a smattering of anatomy, joined to the index-learning of dispensatories. Such a man-midwife can never have thoroughly made himself master of the course of the fluids, nor of the order of their circulation. Their relation to the solids, and the efficacy of medicines upon both, can hardly be sufficiently known to a man, who must have been too much employed in trying to form a hand never to be formed, and in attendances on the practice of his midwifery, to acquire those collateral requisites for the effectual multiplication of his professions.

Yet this man void of knowledge, experience, observation, and, in consequence, of physical ability, shall boldly decide on the expedience of an internal remedy, of which he does not know the power or operation; of a venesection, of which he can but guess at the consequence; and of a narcotic, of which he is unaware of the danger. In all which, observe, he may possibly sometimes be tolerably right, in cases where there is no complication; that is to say, in cases when a midwife, duly bred, is as sufficient as the best man-practitioner. But then she is moreover not only quicker of apprehension, as to danger, where the case appears complicated, but readier to call in proper help where she discerns it to be above her reach, and consequently above that of the man-midwife, who must be equally or rather more at a loss, because his boasted theory will serve only to puzzle him, or what is worse yet, since a shew must be made of doing something, will most probably determine him improperly, if not fatally, to random prescriptions, in points out of his sphere of knowledge, or rote of practice.

Many a man who to-day undertakes prescribing for a fever, for a fit, a convulsion in a lying-in woman, only because he appears in the character of a man-midwife, would have been ashamed the day before he had taken up that business to give himself out for a physician. He would have been afraid of ordering any thing for her if she was not his patient, as to lying-in, and would not, even after assuming the profession of midwifery, perhaps order any thing for the same woman, out of the time in which his office is supposed necessary. This plainly proves, that many of those gentlemen are weak enough to imagine, that the man-midwife implies the physician, though the greatest physicians that ever were never dreamt of such an absurdity, as that the physician implied the midwife, whose master and instructor he rather is, in points highly useful indeed at times to her profession, but in which that profession does not consist.

I do not however charge all the men-midwives with so much modesty, as to confine their striking out of midwifery into physic, to the women lying-in, or to the time of their lying-in, since there have not been wanting some who, with equal ignorance, but superior effrontery, have intrepidly hoisted, the standard of a general knowledge of physic, and having originally insinuated themselves into families in the character of men-midwives, have easily maintained their ground in them afterwards on the foot of physicians. A circumstance not much to be wondered at, considering the endearment of such an office as that of a man-midwife, and the ascendant it must serve to give them over the heads of families, even in points where a midwife can have no shadow of pretention, for interfering. In the mean time, let any one of sense or common humanity consider but the consequences of this dangerous admission of the sufficiency of a man-midwife in those complicated cases, which require the consultation of a regular physician; to say nothing, for the present, of the other objections already mentioned, or which I shall hereafter more at large discuss, and the result must be, to allow that the medical pretentions, or indeed any pretentions, of these men-practitioners, cannot be too much discouraged, nor confidence more misplaced than in them. For once that they may hit the mark by chance, they will often take the part of the distemper instead of that of the patient; they will do what they have only a gross guess of being the right, not what they know to be so: and physic, at best, but a conjectural science, must in them want even the common grounds of conjecture.

Instead then of the dangerous self-sufficiency of these complex smatterers, you have in a plain midwife, supposing her regularly bred, and duly qualified for her profession (for I am no more an advocate for ignorance in the women than in the men) one, who, being called in time, will duly consider, and observe the constitution of the person that wants her assistence. If nothing appears extraordinary, or out of the common-rules in her patient’s constitution and conformation, she needs only lay down for her the previous course of management, and as the hour of delivery approaches predispose her properly: a point in which the men must be grossly deficient, for want of that skill of prognostic inherent to the women, from their particular delicacy and shrewdness in the faculty of touching; upon which more depends than can be well imagined. Wherever a case occurs to a midwife, so complicated as to be above her reach, her interest, her reputation, her duty, all conspire to prescribe to her a timely application to a regular physician. She communicates her doubts or difficulties to him, who, at the same time that he receives a just information from her of the state of things, combines it with his own knowledge of the human constitution. He does not confound, as the man-midwife does, ideas so different as those of the manual operation, and the medicinal prescription. The object of the physician, being the same as that of the midwife, the prevention or alleviation of pain to the mother, and the greatest safety to the mother and child, but preferentially that of the mother; there is this advantage to both mother and child, that all harshness of practice, all the violenter remedies will be as much corrected as can be done, consistent with the safety of mother and child, by the midwife’s tenderness, by which the physician will at the same time be above the being misled into omissions of any thing absolutely requisite. In short, on such occasions, they serve to temper one another. A truly great physician will not disdain the lights furnished him by her practical experience, and she knows the bounds of her mechanical duty and profession too well, to interfere with his superior intellectual province, in those points submitted to it. A pragmatical man-midwife, on the strength of his miserable half-learning, would think it a derogation from his character, to call in a physician in supplement to his deficiency, of which he is always ashamed, though indeed he has sometimes the excuse of himself not knowing it. Then when a fatal accident has happened, under his hands, against which, with more knowledge he might have guarded, or which with less of presumption or dependence on himself he might have prevented, by procuring previous or collateral advice; he thinks himself abundantly acquitted by laying the blame on occult causes. Even the great man-midwife, Mauriceau himself, has made use of that trite exploded apology^[7]: where he expressly says, “that a sudden unexpected death of his patient was one of those FATALITIES, that not all the human prudence can prevent.”

But that I may not here incur the least charge of unfairness, as if I meant by this quotation any thing so absurd or unjust, as that in the labors of pregnant women, as well as in other diseases unconnected with them, there may not sometimes happen accidents impossible to be foreseen, as well under the care of the best physician, called in by the very best midwife, as under the most ignorant assuming man-midwife, I shall here introduce another quotation from the same Levret, that will especially shew the ladies, and all parties concerned, to what an imaginary safety, so much, and even the very point sought for, is sacrificed as is sacrificed, in preferring the men-practitioners to the midwives. ^[8] “M. de la Motte says, that for the fifth time he laid the wife of a glover of Valogne, the 16th of March, 1704; that the woman was but an hour in her labor-pains, and that he delivered her with all the facility imaginable; that he left her upon the couch till he had given her some broth, after which he recommended her to the care of the nurse, and went where his business called him. He adds, that he had time but just to bleed two persons in the neighbourhood, before he was fetched away in haste to see the patient he had just laid, whom he found dead upon the bed. The cause of this death was instantly manifest to him from the stream of blood, which ran about the floor, and even penetrated to the apartment beneath, after soaking through the bed itself, in which there remained clots of blood of an extraordinary size.

“This author adds, in the reflexions at the end of this observation, that this delivery had been both more easy and more expeditious than any this woman had precedently had: and he notes, that these melancholic accidents are not without example, since such ladies as the princess of ... and madam la Presidente de —— with numbers of others, have, on the like occasion, undergone the same fate, as her he here treats of. These are, according to him, proofs that all human science and dexterity often cannot prevent the like misfortunes, since these great ladies had been lain by the most celebrated men-midwives.”

Now I might here, without much probability of being contradicted, aver, that where such accidents, said to happen so frequently and inevitably, should happen under the hands of midwives, there would be but one voice among the men-practitioners and their credulous adherents, to impute them to the ignorance and malpractice of the women. The plea of occult causes would be hooted at in them, tho’ receivable, it seems, from the men.

Not however to imitate what I condemn in them, a gross want of candor to the women, of whom, by the by, the very best of the men-practitioners have learnt all the laudable part of practice, I shall allow that among those frequent examples, of sudden deaths upon delivery, some few might perhaps be of those unaccountable surprizes with which nature mocks human ignorance; but then it must be allowed too, that not all of them admit of that favorable solution. The truth is that nature, to those who have studied her course, and watched her motions with a due spirit of practical observation, hardly ever but gives warning enough to prepare proper obviative methods. It is not here the place to enter into the discussion of those deaths by sudden hemorrhage upon delivery, of which I shall hereafter attempt to give a more satisfactory account, as well as of the measures of prevention, than Levret. My end in the preceding quotation is to show;

First, that by the confession of the men-midwives themselves, the most fatal accidents frequently, and inevitably happen under them in spite of all their science and dexterity!

Secondly, to offer to the reader a reflexion for himself to judge of the validity of it, to wit, that, not only in the cases of the hemorrhage, but in many others, where there is a complication of disorders with the state of pregnancy and parturition, much of the safety of mother and child must depend on that general medical knowledge, to which the men-midwives have so little grounds of pretention. Nor indeed, for the symptoms of necessity for resorting to medical help, have they the same shrewd prognostic or acute sense as the experienced women, who much sooner perceive the danger before it is too late, and are neither with-held by a false shame, nor by a criminal or senseless presumption, from calling in proper assistence. Such at least has been and still is their practice in all ages, and in all countries, where the matters of pregnancy and lyings-in are committed to them. The great object of the man-midwife is to impose so false a notion on his patient, as that his partial knowledge is sufficient to every thing. The consequence of which is, that if he is not too officious, too pragmatical, by way of ostentation of his art, in common cases, that is to say, where there is no complication of disorders, every thing may pass off tolerable well, till the crisis of labor-pains. And in that crisis I defy him, with all his learning, to equal the female skill and cleverness, not only for lessening the sufferings of the patient, but for facilitating the happy issue of her burden.

But where there is a complicated case, dependent on the physician’s art, then the trusting to those men-dabblers in midwifery is a folly that may be fatal to both mother and child, or, at the best, the delivery will have been rendered more painful, more laborious, more big with danger, for those precautions having been neglected, which can be so little supposed to occur to the common run of men-midwives in cases foreign from their rote of practice. Yet it is precisely in those disorders collaterally contingent to pregnancy, and no disorder does that state exclude, that the greatest skill and knowledge of physic are required. Then it is, that not only the preservation of the mother claims regard, and certainly the preferable one, but even that of the child is no indifferent point. And to save both, the state of the mothers constitution must be carefully considered. Thus the combination of the disease with the pregnancy, the due regard to the mother as well as that to the child, form a triple object that takes in a compass of comprehension to which no midwife will pretend, nor can be imagined to exist in the mere man-practitioner of midwifery. Such a nicety of observation does not seem to be the province of a manual operator, and indeed useless to him in that character. And as he will be more likely to trust to conjectures, which no sufficient grounds of study will have justified his presuming to trust, he must oftener take the part of the disease than of the patient. It is well if sometimes, disconcerted at the excess of a danger of which he does not understand the origin or nature, he does not, in default of the head, employ the hand, and engage the mother in a premature or forced delivery of the child, to the imminent hazard of the lives of both. Now comes the chirurgical operation in play; and we shall now see, that the ingraftment of the surgeon upon the midwife, deserves equally at least reprobation with that of the physician.

But before I enter on this disquisition, I am to observe, that this objection to the surgeon’s commencing midwife, does not in the least attack the merit of that respectable body of men, the surgeons. No one can honor their profession more than I do: I even readily grant, that their skill in anatomy is of service to midwifery itself, into which it throws a great light. It would be easy for me to name, if requisite, several surgeons, who are not only an honor to their country, from their excellence in an art so beneficial to mankind, but an ornament to society, from their extensive humanity and charity. These, I am so far from thinking, will hold themselves honored by the men-midwives attempting to make a common-cause with them, that I rather depend on their bearing witness on the part of the women in this cause, which is indeed the cause of Nature, of that Nature which they study so practically, consequently so usefully, and with which they are so conversant. I am persuaded they can even furnish me with arguments, from their superior store of knowledge, in supplement to my deficiencies. The surgeons must look on these professors of midwifery as a kind of amphibious beings, hard to define, whose claim exhibits rather the deformity of a preternatural excrescence, or wen growing out of the chirurgical art, than the becomingness of a natural member of it. Most of the first founders of this new sect of instrumentarians in this country were, or I am greatly misinformed, neglected physicians, or surgeons without practice, who in supplement to their respective deficiencies, greedily snatched at the occasion at that time of a prevailing whim in France, of employing men-midwives, with just such a rage of fashion, as some of the ladies there prefer valet-de-chambres to waiting maids. This novelty then appeared to practitioners despairing of business enough in their own way, an excellent scheme for eking out their scanty cloth with this bit of a border, of which by degrees they have made to themselves a whole cloak. In short novelty joined, to the much exagerated objections to perhaps a few insufficient midwives, brought in and established a remedy yet worse than the disease. Their success encouraged others; and now behold swarms of pupils pullulating, and forming on the models before-mentioned. Thus two or three maggots have produced thousands. Iron and steel are not tender: and yet it was by the pretended necessity of resorting to instruments made of these metals, that these out-casts of either profession effectuated their introduction into a business so little made for them. Then it was, that not with the least squinting view to filthy lucre, but purely out of stark love and kindness to the women, that these redressers of wrongs, armed with their crotchets, and other weapons of death, took the field on the hardy adventure of rescuing the fair sex out of the dreadful hands of the ignorant midwives. But as to the validity of that plea of theirs, of the necessity of employing instruments, I reserve to treat of it at large in its place in my second part.

Here I shall only request the reader to remember, what has been said of the indecent, superficial, and even cruel method of training up pupils in this upstart profession. But if I was to add here my having been credibly informed, that there are novices who watch the distresses of poor pregnant women, even in private lodgings, where, under a notion of learning the business, they make those poor wretches, hired for their purpose, undergo the most inhuman vexation, in a condition so fit to inspire compassion, and where those scenes must be rather a school of brutality than of art: if I was to urge, what from the great probability of the thing I firmly believe, that more than one unhappy creature has fallen a victim to the rudiments of these novices; that especially not long ago, one of them in a hurry and confusion of presumption and ignorance, instead of the after-birth from a woman, tore away, by mistake, her womb itself, which occasioned, of all necessity, the poor creature’s dying in unutterable agonies of torture: if I was yet to go farther and assert, that even not one of the least eminent men-midwives pulled off the arms of a child in his attempt to extract it, and very gravely laid them upon the table; what would be replied to me? It would be said I had invented these horrors, or forged such raw-head and bloody-bones stories, purely in favour of my own cause. And to this objection, while I produce no proof, and for my producing no proof other reasons may be obviously assigned, besides that of those cases being non-existent, some of which I am very certain are true, and firmly believe all the rest; to this objection then I say, I make no reply. The reader, who will have considered this matter, may easily decide within himself the degree of probability in such allegations. But what objection will stand good against authorities of reasonings and facts, produced from the writings of the men-midwives themselves? Will they be suspected of partiality or aggravation of things against themselves?

I shall here select one of perhaps the most excusable examples from the circumstances accompanying it, or it would probably not have been produced by the author a man-midwife, to shew, by the confession of the men-midwives themselves, the insufficiency of their discernment, whether a child is dead or not.

“Edge-tools and crotchets naturally inspire horror, and though they ought not to be employed unless on a dead child, it is well known the mother is not always safe from the effect of them. Besides there are no signs of the death of a child, though he should have stuck in the passage for several days ... certain enough to authorize a recourse to a method which infallibly kills it, if it is not dead before. This is so true, that whoever will turn over the authors antient and modern, on this subject, there is not one of them that gives us satisfaction on this point. On the contrary, they all seem agreed on the insufficiency of these signs, and there are even few of them who do not bring examples to support this uncertainty.

“Here follows one taken from the observations of Saviard, p. 367. This author says, that a chirurgical operator, whose name he prudently suppresses, being sent for in aid of a midwife^[9], to extract a child that had stuck six days in the passage, and which he thought dead, from several of the signs most essential to conviction, it happened however, that having opened with his bistory the teguments and membranes which occupy the as yet unossified space, at the commissure of the parietal bones with the fontanelle, it happened (said he) that on opening this place with his bistory, introducing his crotchet at this opening, and having fixed it in one of the parietals, he drew out the child, who began to cry piercingly, all hurt as he was by so large a wound, that there came out of it more than an egg full of its brains, which made a cruel sight in the eyes of the by-standers, and a very mortifying one for the operator.

“It were to be wished that this was the only example: but I will not relate any more; it is easy to think one cannot be too circumspect in the matter of such relations. Levret, p. 77.”

Now I, who have not the same reason for circumspection in this case, as Monsieur Levret, with strict regard both to matter of fact and to candor, agree with him, in averring, that this is not the only example perhaps, by thousands, of the rash resort to the expedient of opening the head, and extracting the child with the crotchet; an expedient which, as Dr. Smellie observes, (p. 248.) “produced a GENERAL CLAMOR among the women, who observed, that when recourse was had to the assistance of a man-midwife, either the mother or child, or both were lost.” Now of not filling up the cry of those women, I must own I should be most ashamed. Especially when the good Dr. by way of curing our fears and weak apprehensions, and of shewing the nonsensicalness of them, first very gravely tells you the insufficiency of all hitherto invented instruments, and only modestly concludes, that the forceps of his own ingenious contrivance, is indeed the best, but still imperfect. His homage to truth would however not have been so imperfect as it is if he had said that instruments may be totally left out of good practice, and that no “artificial hands”, as he calls them, can, in any case, constitute a worthy supplement to the natural ones; no not even to his own, supposing iron and steel to be ever so little less tender than his fingers. ^[10] But why do these gentry then so much insist on the absolute necessity there is of sometimes having recourse to instruments?——Why? The motive for that insistence is so transparent, that not to see through it would indeed be blindness. It is the capital, and perhaps the only plea that has the least shadow of plausibility for the men to intrude themselves into the women’s business of midwifery. The women do not pretend to the art of handling those instruments, and would be very sorry to pretend to it. Nor do those midwives, who are sufficiently skilled in their art, ever need the supplemental aid of them: whatever is done with them is as well, and infinitely more safely done without them: so that the only grounds of introducing men into that female practice is essentially false. The making then the surgeons art a pandar to a sordid interest, by the incorporation of midwifery with it, is, in fact, engrafting on a noble stock, a scion of another one, both which would bear very well separate, but, thus joined, can produce nothing but a vile poisonous fruit.

If there could be such a thing as laughing in a matter of such general importance to human kind as the fixing of this point, there could hardly be any refraining from it, with regard to the conduct of the men-midwives, especially in Paris. There the novices of them, sensible of the natural defect there must be in men-practitioners, apply for improvement to the regular midwives. There is particularly, among others, one Madam Clavier, who, when I knew her, lived in the Rue de St. AndrÉ, that gave lessons, at so much a-head, to the men-students of midwifery. Yet these same men have no sooner got a smattering of all that is valuable in the profession, for beyond a practical smattering at most nature refuses them further progress; they, I say, have no sooner acquired a little useful insight from these laudably communicative midwives, but they are the first to swell the cry against them of, “oh these ignorant midwives!”——or “what can be expected from a woman?” And what is more yet, among women it is, that they can make this equally ungrateful and false clamor prevail. And women, in a point of the utmost importance to themselves, prove that the men have, in fact, not quite a wrong idea of their weakness, since they are weak enough to countenance a notion, that so unjustly dishonors them in every sense. But that is not enough. What one should imagine, women especially would consider, is that this notion received with its consequential exclusion of those of their own sex, tends to have their own pains aggravated, and the safety not only of themselves but of their so naturally dear children, yet more endangered.

For the truth of this increase of pain and danger from the practice of the instrumentarians, it is not to any representations from me only, who may be supposed too interested a party, but to reason, and even to reason’s best mistress, Nature herself, that I appeal. I appeal even to the very writings of the most celebrated men-midwives themselves, to which I would refer all who are sincere enough with themselves to be resolved to embrace truth when discovered to them. It is then even in the writings of those men-practitioners, that a lover of truth might find enough to satisfy himself, that all the mighty pretences of the men-midwives to superiority of skill and practice to the women are false and absurd. Look into Deventer, Peu, La Motte, Mauriceau, Levret, Smellie, &c. and you will find that, except their accounts of the innocent manual function, in which midwives must so much excel them; except their pernicious practical part, on which they so tediously insist, by way of recommending each some particular instrument that is to usher him into employment, and increase his profit, in which noble view he takes care to decry the instruments of all others, or at least prefer his own; except the scientific jargon of hard Latin and Greek words, so fit to throw dust in the eyes of the ignorant, and give their work an air of deep learning; except what they have pillaged from regular physicians and surgeons, who have treated upon these matters: except in short all the quacking verboseness of the various histories of their exploits and deliverances of distressed women, and you will find the merit of their whole works shrink to little or nothing, under the appraisement of common sense and true practical knowledge. The most that you will find in them, is, hard or lingering labors, oftenest precipitated fatally to the mother, or at least to the child; they hardly, you may be sure, carrying their candor so far, as always to mention when it has proved so to both; of which however the tenor of their practice with instruments gives you but too much room to presume the probability. In short those cases, of which their works are chiefly patched up, are little better than so many quack-advertisements; and their best exploits therein recounted not a whit preferable; nor indeed so practically just, as what would appear in the common daily practice of a regular well-bred midwife, that should keep a register of her deliveries. There might not indeed appear so much anatomy in her descriptions, but, I am very sure, there would be couched in them much more solid instruction. Not that I therefore have not the highest deference to the true physicians, the true surgeons. But as far as I can presume to judge, it is not in the works of the men-midwives, that the best lights in midwifery are to be looked for. They are themselves for every thing that is worth reading in their writings indebted, both to the physicians and surgeons, whose arts they have despised enough to think, they may be well enough learnt collaterally and subordinately to the mechanical operation of midwifery, as well as obliged to the midwives, to whom they ought at least to go to school, tho’ sure to rail at their ignorance the minute after being taught by them. In short, the most valuable lights thrown into this subject are undoubtedly furnished by those great men Boerhave, Haller, Heister, the great Harvey, and other the like excellent physicians and surgeons, not one of whom however, I presume, in the way of making a trade of it, ever delivered a woman in his life.

Nay! was any accident requiring a chirurgical operation to befall a pregnant woman, I should think the application would be more safely made to a thorough regular-bred surgeon, than to one of the common run of these men-midwives; and the exceptions are so few, they are hardly worth making. The reason too for such a preference is obvious and natural. A regular surgeon probably would not only be more consummately skilful and expert in his general notions, both theoretical and practical, so far as surgery was in the question, but would not, from any thing only partial in his profession, have the same temptation of bringing into play a horrid apparatus of murderous instruments, to show the importance and utility of that anatomical midwifery of theirs, all the art of which consists in the violences it offers to Nature. What would be to be done, the true surgeon could hardly do worse than the pragmatical man-midwife, and most probably would perform it much more artistlike, except perhaps in the sole point of striking a crotchet into the brain-pan of a live-child, or needlessly tearing open, with iron and steel, parts so tender and so delicate, as hardly to bear the touch of even the softest hand, guarded with all precaution. He would not, in short, be so forward to use means destructively dangerous to both mother and child, and at the best often to ruin a woman for being a mother for ever after.

Upon the whole then, if any one will dare give his own understanding fair play, against the powers of prejudice and interested imposition, it cannot but, on a fair examination satisfy him, that that strange anomalous complex creature of the three arts, physic, surgery and midwifery, is most likely to excel in neither. It may by great chance be an indifferent physician; IT must be in this respect a dangerous surgeon, but IT can never be any thing but a despicable midwife; or if that favorite name of accoucheur, IT is so fond of assuming, should not be popular enough from its gallicism, let IT change it for the Latin one of Pudendist: a word of not one jot a more pedantic coinage than Dentist, or Oculist, but of which moreover the propriety of the sound may somewhat atone for the pitiful play of words it contains, and which can yet scarcely be more pitiful than the object of its application.

Objection the Twelfth.

It is not probable, that the men-practitioners would have come into the vogue in which we see them, if numbers of instances were not to be produced in their favor, of their having terminated happily many labors, in which they have been preferably employed, and to the exclusion of the midwives.

ANSWER.

This only proves, what none in their senses will deny, that the greater part of the cases of labor are so mild, that not even that faultiness of the men-practitioners, which is palpably owing to an incurable imperfection of Nature, not, in short, all that is bungling or deficient in their preliminary disposition and manual operation, can absolutely frustrate the kindness of that Nature, of which these intruders are not ashamed of assuming the honor. But that inference of the men in favor of themselves is as ridiculous as it is false. In those cases of labor, which are much the less frequent, and require no extraordinary assistence, the utmost of the real merit of these bunglers is only of the negative kind: that is to say, they have not destroyed the mother nor the child; and indeed, every thing considered, great is the praise to them thereof. It is not always, even in naturally easy labors, that the women who employ men to lay them have not a harder bargain of them.

But even in these propitious labors, the mischief done to a lying-in woman, by employing of a man to the exclusion of a midwife, is not a small one, if pain is an evil, and the lessening that evil a desirable good. For certainly there can hardly be a case of lying-in supposed, in which some labor-pains are not felt. The bringing forth children in pain, stands hitherto the irreversible decree of nature, from which few women can promise themselves a total exemption. But these pains, if they cannot be entirely spared, to the lying-in woman, will always admit of actual or preventive alleviation. That alleviation can be no inconsiderable object to women, who are by their nature so tender and so impatient of pain. Even then in the prospect and presence of the very gentlest labors, there are two natural points to be respectively attended to. The one is the predisposition of every thing, according to art, so as to render the expected labor-pains as moderate as possible. The second is in the manual function, at the actual crisis of the delivery. Now, in both these points, for reasons above-deduced of the superior aptitude in women derived to them from Nature herself, a woman may reasonably depend not only on a more simpathizing cherishment, but a more efficacious assistence from those of her own sex. There are a thousand little tender attentions suggested by nature, and improved by experience, that a midwife can employ both preventively and actually to the mitigation of her charge’s pain; attentions which, if even they ever entered into a man-midwife’s head, could not be accepted but with repugnance, I will not say only by a modest woman, but by any woman at all. And the truth is, that there can be few men in the world, but what, the more tender lovers they are of the women, but must be only the more disgusted, the more impatient of the midwife’s preparatory part of her office, which is however the most important one, both as to the prevention of pain, and to the safety of the delivery.

But even where those preparatory offices have been omitted, or at best perfunctorily performed by a man-midwife, and where the actual function in the crisis of labor has been deficient, or at best indifferent, the labor may still have proceeded, and the patient delivered with only more pain, than she would probably have suffered under a good midwife’s hands. What follows then? Why this; that the patient in the transport of joy at her delivery from pains which are hardly ever but great, even though much less than her fear had magnified them to her; instead of gratitude to that Nature, which can constitute to her only a vague object of the mind, her weak imagination gives to the assistent man-midwife, a more palpable being, as he is of flesh and blood, the merit of a deliverance, in which he had most probably no other share, than its being his fault that it was not yet less painful than she has found it. But this is not at all. What sounds towards a paradox, and yet is strictly true, is, that the more pain the patient has endured, through the man-midwife’s fault, the greater will her gratitude be to him. The reason is as obvious as it is natural. Herself not knowing, nor having perhaps any idea of what ought to have been done for her more perfect relief, she will have no conception that the man has omitted any thing: she will give him credit for what he has appeared to do for her; and measure her sense of acknowledgement by the pain from which she will suppose he has helped to rid her; and in her joy at her delivery would think it even an ingratitude to listen to suggestions from others, or even from herself, that should tend to diminish, explain away, or may be reduced to less than nothing, the benefit she so vainly imagines was his work.

Yet nothing is more true, nor indeed more likely to be true, than that besides the natural pains of labor not having been obviated by a due preventive method of assuagement; besides their having been unskilfully attended to in the article of the delivery, through the natural unhandiness of the men-midwives, it does not unrarely happen, that their defective practice, not only occasions to the women much greater pains, but even much greater danger than would probably have been the case, I will not say if a midwife, but even if Nature had barely been left to herself, that is to say, if nature had been neither injured by a clumsy aukward attempt to help her, nor injudiciously interrupted, nor prematurely forced or cruelly hurried. The patient is however delivered, and delivered so that, if she was better informed, or less blinded with joy, instead if thanking the operator, to whom she attributes her deliverance, she would have to impute to him all the increase of pain she had unnecessarily suffered, all the increase of danger of which this man so thanked was himself the author. Then it is, that even in a subject so serious, a judicious by-stander might give himself the comedy of observing the airs of consequence, which an operator assumes for a woman under his case not losing the life, of which but for him she would most probably not have been in the least danger. Thus a man, whose all of merit well weighed, is no more than not having been able to consummate the destruction of mother and child, in spite of the kindness of nature, shall for that negative merit be allowed the positive one of having performed wonders of art. Then it is that the mother naturally in a rapture of joy at her deliverance, in which she never remembers but with a gratitude, of which she only mistakes the object, by paying to the operator, what in fact was due to nature; then it is, I say, that the mother, father or parties concerned, for want of making due allowances in a point they are so excusable for not understanding, cordially join the self-applause of the man-midwife. Nor does it unfrequently happen, that one of these instrumentarians, after an operation, for which he deserves the severest censure, and of which, whatever necessity he had to plead was originally owing to his own unskilfulness or omission, shall strut about the room, and florishing his butcher’s steel, sing an Io Peean to himself, “for that his victorious art had saved nature as it were by enchantment”^[11]. Then it is, that in full chorus the deluded parties, in the innocence of their heads and hearts, hold up their hands to heaven, and piously exclaim, “what a narrow escape the patient had, thanks to the learned Dr. and what a mercy it was she had not been trusted to such an ignorant creature as a midwife must be.”

This folly has even sometimes gone so far, that when a woman has, through a man-midwife’s mispractice, suffered perhaps a wrong, so deep as to be disqualified for ever after for being a mother, or had a fine child, literally speaking, murdered (secundum artem indeed) he has, what with scientific jargon, through the cloud of which it was impossible for persons unversed in the matter to discern the truth, what with an air of importance, and what with especially her own weak prepossession in favor of the superiority of men to women-practitioners, known how to impose on her the most atrocious injury for so great a service as that of saving life is for ever held. The deceived patient then thinks she cannot thank him too much, nor reward him sufficiently for what he could be scarce punished enough, if proportionably to the mischief he had done; and to which his mis-representations have perhaps even made herself innocently an accomplice.

This indeed is easily to be accounted for. A pregnant woman must especially, in the moment of her labor-pains, think herself too much in the power of the operator, to whom she has trusted herself, to dispute his judgment. She may even, and that is probably oftenest the case, have too good an opinion of it, to dispute it. Her labor is severe, and, as before observed, severe, or at least the more so, very likely from some fault of his. Her deliverance lingers; Nature, from some vice of conformation, or defect of art in her assistent, appears faint, remiss, insufficient, in short, in her expulsive efforts; in the mean time, the pains of the patient grow more and more intense and intolerable: the man-midwife, either perplexed or impatient, or not knowing what better to do, has recourse to those fatal instruments, with which the odds are so great, that he will gall, bruise, or irreparably wound the child, or the mother^[12]. In some cases indeed, he may take the dreadful advantage of the mother’s agonies of pain, to use those instruments, and do her a mischief she may not just then feel, from the pain of the operation being absorbed in the greater one; to use them, I say, unobserved by her^[13].

But where the exigency appears yet greater, where, in short, the operator imagines, as he too often imagines such an extremity where it does not exist, as that either the mother or the child must perish, it is his maxim, and certainly a very just one, to consider the mother’s safety, as the preferable object. Of this preference then he makes a merit, so much the more acceptable to the mother for her own self-preservation being so palpably concerned, and so much the less disputable for her not knowing but he may be in the right, as to the reality of the fatal dilemma. In such a doubt, if nature takes the part of the child’s life, which is at stake in the decision, she also much more strongly and reasonably takes the part of the mother’s own existence in the mother’s own breast. She cannot then deny the premisses, of which she is no judge, when the inference is not only in favor of her life, but even a very just one upon the admission of those premisses. The temptation also of a quick riddance from a violent state of pain, is too great a temptation for a weak woman, overpowered with her actual feelings in that rack of nature, to resist: she acquiesces then, or perhaps her husband, her friends, equally ignorant with herself of the truth of things, and duly simpathizing with her in her impatience of her longer suffering, even virtuously, even piously acquiesce in the recourse to these instruments, which are so sure of destroying the child, and hardly ever fail of doing the mother great and sometimes irreparable mischief.

When then the child has been destroyed, the mother damaged; in satisfaction for all this tragic-work, what have you but perhaps the learned Doctor’s assertion, “^[14]that if this force had not been used, the mother must have been lost as well as the child.”

Now granting what is the utmost that candor can be expected to grant, that in but the doubt of the mother’s life, it is right to sacrifice the life of the child to that doubt, and much more to the certainty of the mother’s life not to be otherwise saved, than by these fatal instruments, I beg and entreat all fathers and mothers, or who are likely to be so, to consider with themselves whether:

In the first place, an experienced midwife is not more likely to prevent such an extremity by previous management, proper anticipations, and actual handiness during the labor-pains, than the aukward man-practitioner (as most of them evidently are) who must, naturally speaking, be so much her inferior in those points of her art, which conduce essentially to the smoothing the way for, and effectuating a delivery; and from the defect of which points that necessity which, is pleaded of a recourse to instruments, originally takes its rise. So that in fact they who are the authors of the danger, pretend to remove it, and how? by an evil only inferior to death itself, from which however those are not always safe, to whose safety so much is sacrificed in vain.

In the next place, it may well be recommended to consideration, whether, as the common methods^[15] confessedly allowed by the men-midwives to be the preferable ones, since the recourse to instruments is not even by them allowed, until the common methods are exhausted, there is not great reason, without breach of charity, to imagine that the natural unfitness of the men for the common methods does not determine especially the common men-midwives to an over-hasty recourse to the extraordinary ones, and make them see very dangerous symptoms, where they are no better than phantoms of their own creation; so that by their eagerness to embrace them for an excuse, they lose to the patient that benefit of patience in general, which Dr. Smellie himself allows in a particular case^[16]. To which patience the midwives are so much more inclined than the men, as indeed they may well be, since, should that even be exhausted, they have no instruments to fly to for the abridgment of a labor: and where they understand their business, not only every thing is best done without them, but the want of them is prevented.

But besides the common motive of impatience in the men-practitioners for resorting to that dangerous expedient of making short work, of which the women are unhappily incapable^[17], or at least which the good artists among them hold in the contempt and detestation it deserves; are there no other motives from which recourse may be had to the instruments? I have hinted at some: but as the matter is of infinite importance, from the use made of these instruments, in introducing men into the practice of an art so appropriated to the women, it cannot but be of service even to the public, to discuss the justice at least of some of those hints, and examine whether there is any farther foundation for my fears, that the precipitancy of the men in their resorting to instruments, or to the prematurely forcing a delivery, to the utmost danger if both mother and child, whether, in short, the pretence of extremities may not, in some cases, have even other causes, than a natural incapacity for the common method, an ignorance of better practice, or their impatience.

I have before remarked what I here repeat, and repeat it without the least apprehension of being justly taxed with breach of charity, that a mere sordid view of lucre, of supplementing, in short, deficiencies of success in other professions, was originally the foundation in this country of that novel sect of men-midwives, which we have in our days seen so much multiplied. If any can imagine that the instrumentarians, with their crotchets, their forceps, and the rest of their iron or steel apparatus, had more in view the relief of the distressed females, from the dangers to them in the ignorance of the midwives, than they had their own interest, in the stepping into the place of those they so injuriously decried; if any, I say, can believe that sheer humanity, and not sordid gain, was their view, I can only pity a credulity, that must proceed more from a goodness of the heart, than of the head. But to whoever will deign to consult his own reason, exercised upon facts and the nature of things, may easily satisfy himself, that interest, and interest only, inspired and actuated these intruders into a province so little made for them, of which there can hardly be a stronger presumption than the very recommendation of instruments, of which not one of them but must know the perniciousness, though they make it the capital handle of the introduction of themselves. Not one of them but rails at them, and uses them. Now, as I may safely take it for granted, that interest is at the bottom of this innovation, where that same interest is the principle, it will hardly be denied me, that it is generally speaking the leading or the governing one. It is rarely contented with acting a second part. It often exacts sacrifices, but is rarely itself one. All the actions and procedure of its votaries take the tincture of it. Humanity and all the virtuous or tender passions are either totally excluded, or exist with little or no efficacy in a heart enslaved by interest.

In virtue of this reasoning, and I should be much more glad of finding myself mistaken (knowingly I am sure I am not so) than that it should be but too much verified by matter of fact, I shall here submit a case to the reader for his own decision on the probability, and I dare swear, that among the female readers especially, I may chance to have, there will be more than one, who, on her own personal experience, could attest the existence of such a case, or at least has the strongest grounds of presumption of it.

A Woman then, lingering in a severe labor, and urged by her pains naturally to wish the speediest end of them, is yet by another superior promptership of nature desirous of meriting the sweet name of mother, and is inclined of herself not to think it over-purchased by a little more patience. In this crisis, much must depend on the judgment, and consequently on the advice of the assistent practitioner, male or female. If a midwife, besides the tenderness constitutional to her sex, her natural fears for the mother especially, not without a due share of concern for the child, where there is a possibility of saving it without too great a risk to the parent, besides the superior execution of her art in points of the manual function, she is moreover bound in all duty to see one labor come to its issue before she undertakes another; for the sake of which, she cannot well, if she would, without instruments, prematurely force a delivery by such violent, dangerous and so often destructive means. She will then in course encourage and inspirit her charge with patience, and use all the blandishments, soothing methods imaginable to comfort, relieve, and strengthen the resolution and spirit of the lying-in-woman. Now, a man-midwife, well paid, will perhaps in that cold unaffectionate manner, with which a duty that has no foundation but in interest is ever performed, exhort to endurance that patient whom his dexterity is insufficient to relieve, that patient whose pains are perhaps for the greatest part his own fault. But should he, during some lingering labor, be called elsewhere, to a more rich employer, or should one from whom he has greater expectations, require an attendance from him incompatible with his duty to his prior employer, is not here a temptation to make a quick dispatch with his instruments? A temptation to which it is at least doubtful whether a man, actuated by interest, may not be over-inclined to yield. It may even byass him, without his perceiving it himself. A man’s determining motive, when it is not of a very justifiable nature, is often skreened even from himself by a more specious one. Such, in the present case, is the saving the mother, oftenest by destroying, and sometimes by only galling, bruising, or maiming the child, when the mother rarely escapes her share of the suffering. How many mothers have pathetically interceded, and interceded in vain, for a respite of execution, when the operator has in a peremptory tone cut short their instances, by telling them in a magisterial way, that he knew best what to do, and could not answer for the patient’s life, if the operation was longer delayed! What reply has a poor woman, weak by nature, oppressed by pain, and subdued by her prepossession to oppose to such an argument of necessity, of which her own life appears to be the favored object? What husband, what friends, but must unhesitatingly subscribe to so just a preference as that of the mother and the child? Not that I would insinuate here, that such a dilemma does not sometimes though certainly very rarely exist: but is it not to be feared, that it is too often rather lightly taken for granted that it does exist? May it not be presumed, that the instruments are brought oftener into use than is necessary, for the sake of a dispatch, of which the child is almost ever the victim, and not unseldom the mother herself, who is always hurt, and sometimes irreparably damaged? May it not be justly suspected, that the abuses of Art have occasioned to many women an appearance of barrenness, from the reality of which kinder Nature had in fact exempted them?

But as if ignorance, inability, impatience, interestedness, were not all of them sufficient motives for the forcing use of these instruments, Dr. Smellie has unmeaningly added another, which alone must, to the greatest number of the men-practitioners, prove a greater excitement than all the others put together, if it be true, that Vanity has so great a predominancy over the human heart as it is generally imagined to have. But let us first quote him: the inference will follow.

“(P. 265.) at any rate, as women are commonly frightened at the very name of an instrument, it is adviseable to conceal them as much as possible, untill (mind pray that UNTILL) the character of the operator is established.”

(P. 273.) “Though the forceps are covered with leather, and appear so simple and innocent, I have given directions for concealing them, that young practitioners BEFORE their characters are fully established, may avoid the calumnies and mis-representations of those people who are apt to prejudice the ignorant and weak-minded against the use of any instrument, though never so necessary, in this profession; and who taking the advantage of unforeseen accidents which may afterwards happen to the patient, charge the whole misfortune to the INNOCENT OPERATOR.”

Here I appeal to every reader of common-sense, to every reader who knows any thing of the human heart, whether it can be imagined that any man-midwife, who is called in to the aid of a lying-in woman, will choose to appear in the character of a young practitioner, or of such an one, as that his character is not enough established to dare to use instruments, for fear of after-reflexions. Is not there, if but in this lesson of the Doctor’s, couched a strong temptation for a man-practitioner not indeed to produce openly and barefacedly his apparatus of instruments, but to be very uncautious of concealing them? Since the reason for concealing them, that of the women being apt to be frightened at them, stands coupled with another reason, the fittest in the world to work a contrary effect to both; by piquing the vanity of the operator to suffer them to be seen, and what is worse yet, to the using them only that they might be seen, especially if to this motive of ostentation you add, that if these instruments being the very grand and capital point of their imaginary superiority to the women-practitioners; over whom every occasion of using them seems to the men a kind of triumph.

But while it is to the novices in the art, that Dr. Smellie recommends more especially the concealment of these same terrifying instruments, the good Dr. does not seem aware, that an advice much more honest and humane might be given to the women, for whose benefit the instruments are supposed to be invented, which is, not to employ young practitioners or novices, not in short to employ those whose character was not fully established, since they might, in order to pass for adepts, or at least for no novices, be too apt to embrace occasions of florishing those same instruments with less necessity, if possible, than the great men themselves of the profession.

In the mean time, this curious injunction to the young practitioners, while the old ones are by that distinction implicitly allowed more openness in using the instruments, reminds me of the caution of the Regent-duke of Orleans, who taking monsieur de St. Albin^[18], a natural son of his, that was in priest’s orders, to task, for some irregularities, of which certain bishops had complained, said to him in their presence, “Sirrah, could not you stay till you were a bishop?”

But whatever may be the motives of recourse to instruments, and there are other possible ones which I have omitted, certain it is, that in this nation they are more frequently employed than even in France, where that pernicious fashion first took birth. And yet in this very nation it is, that the men-practitioners themselves own, that the less they are used the better. Now will they, to solve this contradiction of their practice to their doctrine, plead that the labors of the women here are, in general, more difficult than they are in France? Common sense and truth will however furnish a juster solution: men-midwives are more employed here than in France, where the women-practitioners are still respected, and less driven out of practice, consequently instruments are less frequently used. For I will not pay the men-operators of this country so ill a compliment, as to excuse them, by saying they are less dexterous at the manual function than those of France, and therefore the more obliged to have recourse to those instruments, of which they themselves have so ill an opinion, though indeed not a so thoroughly bad one as they deserve.

In the mean while they may well proceed triumphing in their career, notwithstanding all the fatal trips they make in it, while, if they did not even run it in the dark, they have so much learned dust ready to throw into the peoples eyes whom it is so much their interest to blind. No wonder then, that since, in the more severe cases, in the preternatural labors, they so often receive from well-meaning employers both pay and thanks for the greatest mischiefs, owing to their errors both of omission and commission, they should, in the less difficult, and which are by much the most frequent ones, where no tragic accidents have happened, have credit given them for a merit, to which their pretentions are so little examined. For this they are indebted to the overflow of a gratitude at a loss for a living object and from an impatience of doubt mistaking that object so grosly, as well as to that same prepossession’s continuing, from which they were preferably employed. Hence it is, that one might often hear women, who had not even suffered a little by their practice, from the want of knowing, that by their practice it was they did not suffer less, very sincerely say, “Dr. such an one attended me in my lying-in —— He delivered me very well.” —— Or, “I have been lain for four or more children by a man-midwife, and never had room to complain.” All which proves no more than what may very well have happened, that Nature has been too favorable to them, for even the untoward assistence of a man, in the office of a midwife, entirely to frustrate her beneficence. I do not here add the weight that fashion throws into the scale of prejudice, reserving to treat of that separately.

But to that conclusion in favor of the men-midwives, from the supposed superiority of their success to that of the women-practitioners, contained in the objection I am now answering, I have further to oppose an argument drawn from matter of fact, to which I should imagine it difficult to find a satisfactory reply. This argument then consists in a fair appeal to Experience herself.

I have before observed, that in the HÔtel-Dieu at Paris, there are no men-practitioners suffered, for I do not include the surgeon-major, who is absolutely no more than an officer for the form-sake. Consequently there are no instruments ever employed in the delivery of the women admitted to that hospital. It is true they are extremely well taken care of; all necessaries are found them by that noble charity; but yet it cannot be thought, that the same abundance of ease and conveniences can be afforded, as by those persons, generally speaking, who employ men-midwives. This distinction I mention for the sake of the allowance justly to be made in the calculate I am about to propose. Notwithstanding however the superiority in this point on the side of men-midwives practice, notwithstanding the grief of mind from various causes, as well as the bad constitution of the bodies of many of those indigent wretches, prior to the reception into that hospital, notwithstanding other easily conceivable disadvantages; notwithstanding all these, I say, take any given number of patients, delivered purely by the midwives of that hospital, without the intervention of one man-practitioner, and especially without instruments, and to that given number, oppose an equal one of women attended from the first of their labor to their delivery by the men-midwives, and see on the side of which sex, in the operators, there will be found the greater number of those who shall have done well, or suffered least.

I am the more emboldened to propose such an experiment from my own certain knowledge. I have seen more than two thousand women delivered under my eyes, at the HÔtel-Dieu at Paris, some of whose cases must be readily imagined to have been severe or preternatural ones. Yet all of them were delivered by our midwives and apprentices without the aid of a man-practitioner; nor an instrument so much as thought of. And in all this number I can safely aver, there were but four who died upon their lying-in; and that not from any fault of the midwife’s art; but one from the complication of a dropsy, the other three, who were daughters to honest tradesmen, sunk under the shock of grief and shame at the being deserted by the men who had brought them into that condition. They died, in short, of their desire to die. Yet the children all did well.

This is a fact that does not require the being believed upon my word. The known practice at that hospital, and the registers regularly kept, will attest the truth of this computation. And here, I appeal to every intelligent reader’s own sense, to his own knowledge of things, whether it is unfairly presumed, that in the same number of two thousand women, delivered by the men-practitioners, they could show a roll so innocent, so free from fatal mischief or damage to their patients, to mother and to child. Let any parents, or who may hope to be parents, or are concerned but for the interest of mankind in population, weigh but the force of this argument, purely drawn from a matter of fact, of which there can be so few who are not, in some measures, judges enough to decide upon their own knowledge, or at least on strong grounds of belief or conjecture. In such a number as two thousand women delivered by the men-operators, how many, by what I know, and by what many others must know as well as I, must have perished, or been torn, ruptured, grievously hurt, or irreparably damaged! How many innocent infants must have lost their little lives, in proof of that superiority of practice in the men to the women! Or rather, in proof of that infatuate credulity, which has prevailed in favour of an innovation so unauthorized by nature, by common sense, or by experience!

Say what you will, the fashion will predominate. It is now the fashion to prefer men-practitioners of midwifery to midwives. You will oppose the torrent in vain.

ANSWER.

The conclusion against me that I shall oppose the torrent in vain, is a very just one. As to myself, I ought to expect that I should oppose it in vain, if the decision of the public was to turn upon any thing of so little authority as my private opinion, especially in a point where it is so justly liable to the suspicion of its being byassed, both by private interest, and partiality to my own sex. I readily then grant that my own opinion should go for nothing. But what ought to go for a great deal is my reader’s own judgment, formed upon his own reason and knowledge. But that is not all. I have some dependence on Nature and common sense recovering their rights, from this preference of the men-midwives which shocks both, being, in truth, nothing more than a fashion, not even of the growth of this country, but transplanted from a neighbouring one, whose follies are unhappily so contagious, though for the most part so despicable. How a few interested men, for want of business in their own professions, transplanted this baneful exotic here, where it has met with such undue cherishment has already been touched upon.

But then as this unnatural preference has all the folly and whim of fashion in it, it may be hoped, that it will also have all the instability and transitoriness of one. Time that confirms the dictates of Nature destroys the fictions of opinion. But in points where Nature is herself attacked or injured, inconveniencies and damages never fail of following thereon, enough to oppose the duration of them. The numbers of lying-in women (thanks to beneficent Nature) rather not destroyed than duly assisted by the men-operators, can neither atone for those who perish, sometimes the mother, sometimes the child, sometimes both, while none of them are but sufferers in some degree; nor long blind a public, that has so much interest not to be imposed upon in a matter so essential to it, by false pretences, or by an injurious and interested degradation of the midwives, who at the worst can hardly be so bad as the very best of the men, in the capital point of their business, the manual function. The oftenest greater danger, and always the greater pain, under men-operators than under the midwives hands will, sooner or later, determine the parties concerned to open their eyes on their greatest interest, in a point of such infinite importance to them.

Granting then to Fashion all the power it really has, and a greater one it is, than for the honor of human kind, can well be imagined, still, it not only has its limits of extension, but duration. It is only for the truth of Nature to be universal and eternal.

Fashion, it is true, may not only govern people in indifferent matters, such as dress, furniture, equipage, or so forth, but even in essential, even in capital ones, such, for example, as is this point of option between the men-operators and the midwives: it may, in short, exert its tyranny in many things, one would rather think left better to the determination of Reason. But then this tyranny cannot well be long-lived. The evils which such a fashion begets destroy at length their own parent. No opinion then, as I have before observed, can be permanent that is not founded on the truth of Nature: but where the consequences of such an opinion are detrimental to the good of society, which is the darling object of Nature; that spirit of self-preservation which she has so manifestly diffused thro’ human kind, will hardly suffer errors pernicious to it long to subsist. There is no fashion can, under such objections, long hold out against victorious Nature, who is sure to revenge the violences offered her.

And here I even officiously seize on an occasion that rises to me out of the very bowels, I may say, of my subject, of selecting for one proof of the danger of adopting innovations offensive to Nature, a point of such near analogy to midwifery, as that of nursing children, the care of whom, next to that of the mothers, is the true midwife’s tender province.

I wish then that those, who too readily admit that this so recent a fashion of employing men-midwives preferable to female ones, is an improvement receivable on the foot of its supposed advantage to human kind, would consider a little the actual consequences of having flown in the face of Nature with respect to the bringing up young children, in a way scarce more foreign from her dictates, than that of men delivering women. That women are by Nature herself formed for the office of aiding women in their lying-in; that they are also formed to bring up children by the breast, are two parts of their destination by Nature, which in all ages, and in all countries seem to have born little or no controversy. Interest has lately invaded both these provinces. With this difference, that as to the first, that of women supplanted in their business of delivering women, an active interest has prevailed; as in that of denying the female breast to children, it is a purely passive one^[19]; and we shall soon see what a dreadful effect this sacrifice of Nature to interest has produced.

As to the mischief produced by the other, of the implicitly excluding the women from midwifery, by the power of prejudice and fashion, it is not, as yet, of a Nature for obvious reasons quite so susceptible of proof, though most certainly not the less therefore existent. And that mischief is palpably owing to the gain which the men-midwives find or presume in the exercise of that profession. This is the active interest: that end to which the means give so justly the construction of base and sordid. The rich are the object of this wretched imposition, which will probably last so much the longer, for the interest to be found in imposing upon them.

But for the denying the female breast to children; it has not indeed passed hitherto into a tenet, that children may as well be reared by the spoon as by the breast, because there is not that prospect of the place of a dry-nurse being as lucrative as that of a man-midwife. If it was so, I should not dispair of seeing a great he-fellow florishing a pap-spoon as well as a forceps, or of the public being enlightened by learned tracts and disputations, stuffed full of Greek and Latin technical terms, to prove, that water-gruel or scotch-porridge was a much more healthy aliment for new-born infants than the milk of the female breast, and that is was safer for a man to dandle a baby than for an insignificant woman.

As this unnatural treatment then of children is almost entirely as yet confined to the very poor, that is to say, to new-born babes thrown upon the public CHARITY for their SUSTENANCE, the rearing by the spoon is not yet regularly established as a general doctrine, it is only admitted in Practice! As proper wet-nurses, from the difficulty in procuring them, might be dearer than dry ones; the cheapest method is preferred, and forms a kind of passive interest or saving oeconomy.

But what are the consequences of this violation of Nature, in the grudging her peculiarly appointed aliment to these poor little candidates for life? What follows the substituting, for cheapness-sake, such food as is meant to be afforded them, and is perhaps sometimes even not given them? Death. Death with all that cruelty of torture that attends atrophy or inanition. Thus perish these miserable victims to the false opinion, that the course of Nature can be changed with impunity. I have said here false opinion only, because, with all the obduracy of heart that the spirit of interest so notoriously creates, with all the crimes it so often produces, I cannot think, that such an horror, as the murder of so many innocents, can be entirely imputed to interest without ignorance coming in for its share, though interest has doubtless contributed to the so long continuance of it.

If that maxim is not a false one, that he who knowingly suffers an innocent person to perish, and can help it, is actually guilty of murder: and I prefer here the term of guilty to that of accessary; because I am told, that where there is guilt of murder, all are in the eye of equity and law, principals. Ignorance then, of the sure murder of these innocents by their method of treatment, can be the only plea for those to whom the national charity had committed the care of them. I should think too, that even I myself sinned against charity, if I did not believe, that there is none of those trustees of the poor children, that would not shudder at the thought, of himself taking an infant up by the leg and dashing its brains out against the wall. And yet that would be balmy mercy, the dispatch considered, compared to the lingering tortures, in which those poor little creatures must expire, in the common way of parish-nursing. What is certain however is, that Death would scarce more assuredly be the consequence of the child’s brains being at once beat out, than of that impropriety of aliment, which in the mildest construction is owing to an error in opinion or belief, that any aliment could be salutarily substituted to the one dictated by Nature.

I have here mentioned barely impropriety, or sometimes negation of aliment, without allowance for other causes of destruction to those infants, such as cold, bad air, uncleanliness, neglect of due attendence, or deficiency, in short, of requisites, which are not to be expected from the very poorer sort of the people, to whom the rearing of those infants is generally committed. But that omission of mine is neither undesigned nor unfair. I presume I shall have the greatest physicians on my side, in averring, that even new-born babes are endowed with a surprizing hardiness. Their little seemingly so delicate bodies bear cold to a degree scarcely credible, but from the commonness of both observation and practice, that they only thrive the better for immersions in cold water. Cleanliness, a good air, and attendence, have doubtless indeed some share in the well-doing of children of that age: but all together are in no degree of comparison to the importance of bestowing on children their appropriate aliment. The physical disquisitions into the reason of this do not belong to me here: nor are a few instances of infants reared by the spoon any valid justification for breaking the general rule of Nature, assigning to the female breast the nutrition of children: of which too there is this salutary consequence, that in the very act of lactation there is, by Nature, generated such an indearment of the suckled child to the nurse^[20], as that she who began it perhaps only for hire, finds herself engaged by a growing affection to supply in some measure the place of the mother to the orphan or deserted babe. The rearing by the spoon is so far from inspiring any such dearness, that the innocent infant is considered only as an embarrassment, of which the quicker the riddance, in the death of the brat, so much the better.

The opinion, however, that this one of the greatest institutes of Nature for the preservation of the species, for which she has so admirably organized the female breast, could be dispensed with in favor of a most sordid savingness, has alone caused more human sacrifices, to that black Demon of Interest, than probably were ever made to the “grim idol of” Moloch in the valley of Hinnom, while the cries of the poor children could not be heard by ears closely stopped up in honor of that infernal spirit.

But if any reader should imagine that I here invent any thing, or that, in favor of my inference of danger from the case of revolting against the unalterable institutes of Nature, I have exagerated matters, nothing will be more easy, nor probably at the same more shocking, than the procuring himself a proof of the scarce not actual murders I have mentioned.

The parish-registers of this great metropolis are, I presume, open for inspection. There needs but to examine them, to discover the red-letter catalogue of the armies of innocents that have been put to death under the management of the charity destined to preserve their life. There will be found not one but many, even of the most populous parishes, where for fourteen, twenty, or more years, not one poor babe of the thousands taken in have escaped the general destruction, and sacrifice to that inhuman fiend of Hell, Interest. Here with what propriety might Nature borrow from one of her most dutiful children and darling, the following exclamation,

This is so rigidly true of some parishes, that if I am not misinformed, the verification was not long ago made, as to one of them before a court of justice, of not a single infant having been brought up in the term of fourteen years. And I could name another, in which, during the course of above twenty years, ALL, ALL the new-born children that fell under the administration of the Parish-Charity, perished, except one boy, of whom it is recorded as a prodigy, that he lived till he was five years of age, when he filled up the number, and died like the rest. Will any one here say, that this TOTAL mortality was purely accidental?

But this can be no wonder to those who know there is such an expression, even proverbially in use, as that of children being a BURTHEN to the parish. An expression of which it is hard to pronounce whether it is more execrable or more silly. But what is so inconsequential as the spirit, or rather the no-spirit of interest? Children may indeed be a burthen to private families; and yet for the sweetness of it, how chearfully is it oftenest born, or with very few extraordinary exceptions to the general rule? But to a nation, or what is the same thing, to the lawful representative of the nation, a parish, what can be on earth a falser light to view children in, than that of a burthen? What could be so intolerable in the sum to be added to that actually paid for their being worse than murdered out of hand, to save their little lives, and bring them up to that age, in which the national wisdom should have established for them, at once, the means of earning their likelihood, and of earning it with such beneficial retribution to their truly mother-country, as should amply reward her for her not having neglected the duties of humanity towards them? All the good, all the sensible part of mankind allow, that the true riches of a state, are in the numerousness of it subjects. Trade, arts, the navy, the militia, our colonies all open inexhaustible channels of employment and maintenance. And yet there are who can call children, those children too of the public, not in a ludicrous, but in the dearest tenderest sense, since in the public they ought to find that office of a parent, of which the guilt, the inability, the want of nature in their natural relations, or their death may have defrauded them; there are, I say, who can call such children a burthen! We complain of the defect of population, and yet have seen interest creative of obduracy, and perpetuating ignorance and error, manifestly thinning the species, by nipping those tender blossoms of human kind.

Here, if this notice of the treatment of children should even appear a digression, I should, in favor of the intention, hope forgiveness from a humane reader. He would scarce impute it to me as matter for criticism, the having sacrificed propriety to the introduction of a point so important to humanity. But the truth is, that neither as a digression, nor as a false or over-strained argument, nor as a misapplication, can the same well be considered, by any who will withal consider its strict affinity in so many points to the subject of which I am treating.

It will readily appear, that both these violences offered to Nature in the substituting the men-midwives to the females, and dry-nurses to wet-ones, acknowledge exactly the same common parent, interest, and have exactly the same common effect, the destruction of infants. Is it then possible to be too much on one’s guard against those so flagrant impositions, which are the offspring of that proof-hardened passion? Is any thing sacred from it, since the lives of innocents palpably have not been so, in one branch of practice, nor very presumably are one jot more respected in the other? It is true indeed, that the practice of employing dry-nurses has not yet ascended much among the great and rich; first, because fashions rarely do ascend from the lower classes of life, and next, because there is no such temptation of actual lucre to defend or spread it: but as to that of preferring men-midwives, nothing is so likely as its descending, as it is so much the nature of fashion to descend, and none are more readily adopted by the lower ranks of people from the higher ones, than those fashions which are the most foolish and the most pernicious. And certainly this is not the one that the least deserves those epithets.

Was it not for this influence of the fashion, in making the most unreasonable as well as the most dangerous things pass into practice from the highest down to the lowest life, many an honest man might escape the bad consequences of his following the example of those, than whom none are so liable to be imposed on in such matters, the great and the opulent. These make it worth the while of interested persons to deceive them, and thus often for being cheated, pay with their money, their health, and even with their lives. In the mean time, many who are seduced by the vogue in which they see the men-midwives, employ them on a principle which cannot be enough commended, their natural affection to their wives and children. The reasoning which occurs to a husband in middling or low life on this occasion is probably as follows. “My wife and child are full as dear to me as those of the greatest man in the kingdom are to him, and shall I grudge a little more expence in the provision for their greater safety?” So far he reasons right: all his mistake lies in taking too readily for granted, that same greater safety, to be on the side of the men-practitioners in preference to the midwives, because the former are employed by the great, who, by the by, consult Nature the least of any class of life, even in points of their own health. And certainly in many respects to that sine-quo-non of human happiness, the great had better follow the example even of the poor, than the poor theirs. Make the most then of your reasoning from the prevalence of fashion, the gout and the men-midwives, well considered, are no very enviable appendixes of high-life.

If in some that laudable tenderness for mother and child, is the determining consideration for employing a man-midwife by whom Nature, if consulted, would assure all concerned, that the safety of both was more likely to be endangered than not, there are others again, in whom calling in the aid of a man-midwife is rather matter of luxury, of parade or ostentation, than of opinion of superior safety. These are of that imitative kind of beings, with whom the preference of a man-practitioner for the conducting of his wife’s lying-in, turns upon no other motive, than what would equally make them bestow a silk gown of a new fashion, or a laced-head upon her; from a spirit of emulation of some neighbour or superior.

But what is more surprizing yet, is that notwithstanding the kind of loathing and repugnance with which Nature inspires the women to receive such an office from a man, as that of delivering them, a repugnance to which they had so much better listen, since it has all the characters of a salutary instinct; there are women so weak, as not only not to represent to their husbands the expedience of examining, at least, the propriety of such a fashion, before they blindly adopt it on the faith either of others liable to be deceived, or of those interested in the deceiving them; but who even, in a ridiculous complaisance to that fashion, of which themselves and children are not unlikely to be the victims, will make a point of being attended by a man-midwife, by way of a piece of state.

I have myself known women so infected by this silly vanity, that on receiving visits from their friends after lying-in, and being delivered by a woman, with the utmost safety and satisfaction to them, have been ashamed of having had the better sense and regard for themselves, to employ a midwife in defiance of the fashion, and have told their friends, that it is true Mrs. —— had lain them, but that there was a Doctor at hand in the next room. This by the by was false, for such a Led-Doctor is neither needed nor employed, where a midwife that knows her business is called. If any occasion for medical or even chirurgical skill arises from the complication of a case, there is always time to have the advice of a regular physician, or a regular surgeon, because that complication can never escape timely notice. It can only then be, for the sake of his iron and steel instruments, that a man-midwife has so much as the pretext of being necessary, and I hope to prove, that all the needful can be much better done without them. Yes, I repeat it, better done without them.

For here and throughout the reader will please to observe, that it is on the superiority of safety in employing midwives that I impugn the growing fashion of a recourse to men-practitioners. It is the side of Nature I take against a set of mean mercenaries, who commit the cruellest outrages upon her, under the falsest of all pretences in them, that of assisting her. I would not be so criminal as to wish the benefit of a false argument, in a point of life and death to those mothers and children, my tender care, even could I be silly enough to imagine, that I could pass such an one upon my reader. I wave therefore all plea of the novelty of this upstart profession of men-midwives. Such a plea I readily confess is not receivable. Were It so, how many valuable discoveries or improvements must have been stifled in their birth, if the objection to their being novelties was a valid one? All that I would contend for is, that an innovation should not be admitted only because it is an innovation; and that the decision of a matter of such capital importance, is better left to Reason, always herself submissive to Nature, than abandoned to Fashion, which so often acknowledges no other jurisdiction than that of whim or humor.

There is no prescription for error, no sanction in custom against improvements. But certainly in such a capital point as the life of so many human creatures, in short, in one of the most sacred objects of government, that of population, such a novelty as that of bringing men-midwives into general practice, requires rather a greater authority than that of Fashion, while there is such a standard of essay as Reason.

Inoculation was not long since a novelty in this nation. The lady who introduced it, for any thing I know to the contrary, still lives to enjoy the honor of having procured so great a benefit to mankind. But then this benefit would bear the fairest of all trials, that of calculation: for what is reason itself but another word for calculation? The procuring then the small-pox by inoculation, in a body duly prepared, and especially at an eligible age, affords, according to the doctrine of chances, so much a fairer prospect of safety, than in the case of a spontaneous or accidental infection, that nothing scarcely could be imagined more friendly to Nature than such a rational prevention of her danger, from a distemper too rarely escaped, for the possibility of that escape to be employed as an argument against such a method of prevention. Here then the seeming violence offered to Nature, appeals for its justification to Nature, Reason and Experience.

Consult Nature as to this innovation in the employing men-practitioners preferably to the midwives, who have been for ages, and so universally considered as the properest for that function. Nature will tell you, that it is injuring her to suspect her of being so cruel a mother-in-law, as to deny her tenderest production the female sex sufficient succors within herself, or leave women under a necessity of recurring to men for aid in their greatest need of it, during those sufferings, to which it has pleased the great master of Nature to subject peculiarly the women. If Nature then is but another name for his Fiat through all his works, never was his will more plainly signified than by her voice in this point: a repugnance in both sexes to that office being administered by a man. A repugnance which is not even one of Nature’s least remarkable signs of abhorrence from this innovation, and is only to be surmounted in the men by interest, and in the women by their false fear, or what is weaker yet, by their rage in following that bell-weather Fashion, though it should lead them like sheep to the slaughter. The uncouthness and inaptitude of the men, so ill compensated by their miserable inventions of iron and steel instruments, form another loud protest of Nature against this important function being committed to men-operators.

Consult reason, and reason founded upon those dictates of Nature, to which time only gives the more strength, will tell you, in contempt of fashion, that the men-midwives will never do any thing in a matter rather too universal for any excellence in it to depend upon Greek, Latin, or Arabic; that they are, in short, only hatching of wind-eggs, in the study of an art, which no incubation on it will ever sufficiently naturalize to them.

If to experience you appeal, I have already furnished unrefutable arguments of that’s being against the men-midwives. But let them remember my confession, that the number which I have quoted of women happily delivered is taken from the course of practice of good midwives. I am not here an advocate for bad ones, nor would I wish to authorize them if I could. All that I shall say, and dare aver is, that the very worst of them, unless their hands are cut off, or at least deserve to be cut off, can hardly be worse than the best of the men-operators.

But while it is to the tribunal of Nature, of Reason, and of Experience, that I presume to wish that this same Fashion might be brought; I readily acknowledge its force though not its justice. I feel the power of it, with pain, for the sake of humanity^[21]! My opposition then to this fashion is rather founded in duty than in hope. The weakness of it will probably furnish fashion only a new matter of triumph, not indeed over me who am too low for it, but over the welfare of mankind, which it has often, in more points than this, the pleasure to see sacrificed to it, though in not one perhaps more palpably than in this one.

In the mean time it might be worth the while of even those who not being themselves men-midwives, nor having any personal interest in patronizing them, owe their favorable notion of them to their own fair judgment; it would, I say, even be worth their while to consider that there may possibly be a time, when they may themselves see reason to change that judgment of theirs. They may possibly discover the illusions of interest, under the old stale mask of service to the public. They may find out the folly of fashion. But will not it be too late, when that fury of fashion shall, like a pestilence, have either swept away the good midwives, or at least have so thinned their numbers, as not to leave enough for the demand of the service? They must in time become, to all intents and purposes, like an old obsolete law, as effectually abolished by disuse, as if abrogated by a formal repeal. “The matter would not be much if they were,” an instrumentarian will probably say, but I doubt much, whatever he might gain by it, whether mankind or population would profit much by that extermination, even though the men-midwives with their tire-tÊtes, crotchets, and forceps, were to succeed to their business.

And that such an extermination is far from improbable, will appear no strained inference to those who consider the power of Fashion, which establishes its tyranny, much as the first Roman emperors did theirs over that commonwealth, by leaving a semblance of liberty without the substance; whence the baneful effects do not the less follow, or rather the more surely follow. Thus there is indeed as yet no act of parliament for the preference of men-practitioners or the extinction of the midwives, but the statutes of fashion are not only more forcible than any act of a human legislature, but, in this matter even than the laws of Nature herself tho’ inculcating their observance, under pain of death, or at the least of severe corporal punishment; such as being torn with cold pinchers, or cut or punctured with instruments, or put to more pain than necessary.

Already has fashion driven numbers of women out of their livelihood to make way for the encroachments of the men on the female provinces of industry, though there never was a time, in which it was not a just complaint that there were rather much too few means of employment for women. Fashion has determined it otherwise, and many callings formerly appropriated to females are now exercised by men.

But as to this profession of midwifery, even the total extinction of the real midwives, would not be perhaps so bad as giving that name to those poor creatures in training under the men-practitioners, who independently of their own incapacity of practice, consequently of forming good practitioners, have a palpable interest not to suffer their women-pupils to gain any eminence in the profession that might give umbrage to themselves^[22]. The midwives whom these men-practitioners would perhaps gratiously allow to subsist, might to their own insufficiency add the dangerous circumstance of creating, or at least of not preventing, by duly exerting themselves in the predisposing part, the necessity of calling in their protectors, especially where recommended by them. Not that I imagine even these mock-midwives would wilfully be guilty of such prevarication in their duty. For them not to deserve such a suspicion, it is enough that they are women, consequently tender-hearted. But that does not exclude the idea of weakness. But where so fair a virtue as gratitude may disguise even from themselves the fouler motive of interest lurking at bottom, if that tenderness is not even destroyed, it may not impossibly be made a tool of, and join in persuading them, that things had really better be left to the men-practitioners, whose creatures and devotees they are. Thence a negligence superadded to their defect of skill. Such subalterns then would, at least, not be dis-inclined to the “FINDING” themselves “AT A LOSS”, or yet worse for the patient, have by their omissions, if not commissions, bred the occasion of “finding” themselves “at that loss”, even mechanically, and without the direct design of paying their court to their recommending “accoucheur, their man of honor and real friend,” in a candid recourse to him. Pity it were indeed that so charming a harmony should not subsist between the accoucheurs and such midwives, for the “MUTUAL ADVANTAGE” of both! A harmony, which however could hardly be established but at the expence of the sacrificed patients.

And here I appeal to the reader’s own fair judgment, whether I over-strain the consequence against such wretched creatures as they cannot but be who must, for bread, be so subservient to the men-midwives, and be what the French call, their Âmes damnÉes (souls sold). Can any thing be more probable than that these good women dignified by the men-practitioners, out of their special grace and favor with the title of midwives, will on all occasion consult the “advantage” of their kind patrons and “real friends”. And how can that advantage be better consulted than by bungling their work so as to make it appear necessary to have a candid recourse to the good Doctor, who recommended and warranted them? can it, in short, be imagined, that they will be less mere machines than Dr. Smellie’s Dolls, or indeed furnish less occasion, than the education under those Dolls, for the iron and steel instruments, which are the most part understood to be indispensably necessary where the midwife shall have failed. And as to such midwives as have been formed or recommended by the men-practitioners, their not failing would indeed be the wonder!

Thus the name of a midwife may subsist after the reality shall have perished, and the world so often deceived by mere names, may not perhaps discover this annihilation till long after it is effectuated, or till it is too late to repair the damages, which will hardly fail of discovering it to them. Of good midwives there never were too many; but they are now much too few; though still not more rare in proportion than those of the men-midwives, who may be called good, comparatively to so many of them as are dangerously superficial. Discouragement has already greatly hindered the places of the good female-practitioners who are gone off the stage, from being duly supplied. Proper subjects decline taking up a profession, in which they must have to dread the prevalence of so false a prejudice against them, as that which determines the preference of the male-operators. It is easier to destroy, than to create a-new; and perhaps when the need of good midwives shall be at the greatest, the difficulty of finding such, will make the employing of men-practitioners, with all the so just objections to them, even a necessity. Things are not at present perhaps far from that point, and an alarming consideration that would be to all women, if they were but to reflect on the increase of pain and danger to themselves in the hours already too big with both, of their increase, I say, by the most aukward and violent aid of the men, compared to the so much more effectual and gentle methods so natural to the women-assistents.

If the parties then principally concerned in the decision of this question, and especially the women who are the patients, and their tender relations of husband, father, or brother, &c. were but to consult their own feelings, their reason, and even that instinct which, in this point, is itself so strong a reason from its being the voice of Nature never unhearkened to with impunity, they would soon, to your objection drawn from a fashion scarce less ridiculous than pernicious, allow no more weight than, in fact, it deserves.

Objection the Fourteenth.

You must allow, however, that it must be a false modesty that, in the women, which can oppose the preference of the men-practitioners to the female ones.

ANSWER.

I know indeed that Dr. Smellie (page 2. of his introduction) attributes the opposition made by the Athenian women^[23] to the prohibition of midwives, and to the acceptance of men-practitioners in their room to “mistaken modesty.” It may however with more reason and truth be averred, that the admittence of men to that function by women, would be in the women a most egregiously MISTAKEN IMMODESTY. Since, surely the virtue or grace of female modesty is not an object to be held so cheap, as to be sacrificed for worse than nothing, for nothing better, in short, than the purchase with it of danger or perdition to both the mother and child. After so valuable a sacrifice as that of modesty itself, it may perhaps sound mean to add any thing comparatively, so trifling as that of the hire not given to the person who prostitutes herself in some sort on a so much mistaken hope, but to the very person to whom she is prostituted in that hope of superior safety.

I am not then here to assume a character, that would become me so ill, of a Casuist or Divine, by pretending to fix the degree of moral turpitude in the submission of modest women to a practice, which, I will even allow might be justified by the superior consideration of safety to two lives, if that consideration was not a question most impudently begged, with so little foundation, that the very contrary thereof is the truth.

Neither would I here incur the just charge of impertinence, in giving my private and insignificant opinion on an undecency so unwarranted by any necessity. That would look too like dictating to others, what they are to think of a practice, of which every one will doubtless judge for himself. The boundaries of female modesty are so well known, and so ascertained by common consent, that surely it little belongs to me to offer new lights upon that subject.

What I have then to say, on this head, is purely in justification of that modesty, which the men-midwives are for obvious reasons pleased to call a false one, though so far as it pleads for excluding them, it is an ingratitude to that Nature, of which it is the peculiar gift to the female sex, not to term it even a wise virtue.

Society especially stands indebted to Nature for her suggestion of modesty in this point. If in all ages, in all civilized countries, the wife is considered as the peculiar property of a husband, insomuch, that all laws human and divine consecrate, if I may use the expression, to him alone, exclusive of all other men, the access to the reserved parts of the wife’s body, certainly such a privilege can hardly be thought lightly communicable. And what can be more so than suffering a man, mercenarily or wantonly, or perhaps both, to invade that so sacred property, under the mask of a service, for which he is by Nature so evidently disqualified? While Nature too has made so ample a provision for this very service, in fitting the women for it, with so much more propriety and safety, both to the concern of the public in the welfare of population, as well as to the domestic honor of families, which is not without some danger, at least, from the practice of midwifery being in the hands of men.

As to this last averment of mine, the truth of it is so glaring, that it does not even need Dr. Smellie’s own implicit confession of it, in his instructions to the men-practitioners in general, or, if you please, to his more than nine hundred pupils.

“He (the Accoucheur) ought to ACT and SPEAK with the utmost DELICACY of DECORUM, and NEVER VIOLATE the TRUST reposed in him, so as to harbour the least IMMORAL or INDECENT design; but demean himself in all respects suitable to the DIGNITY of his PROFESSION,” p. 447.

Here I confess myself so smitten with the propriety and sanctity of the precept of the good Doctor’s, and particularly with the needfulness of it, that I would advise every man-practitioner of midwifery, of a certain age that might require it, to have the said commandment wrote out in gold letters, and wear it about his arm, especially on his proceeding to officiate, by way of amulet, phylactery or preservative against any incident temptation to violate his trust, or to fall off from the high dignity of his profession. All that I fear is, that its virtue may not always be to be depended upon, against the energy planted by nature in the difference of the sexes. No one would be farther than I from the cruel injustice of drawing consequences unfavorable to any set of men, from the misconduct of any particular individual in it.^[24]Errors are purely personal. If I then so much as mention the case of a man-midwife convicted of having debauched a gentleman’s wife, in consequence of his admission to the practice of his profession of midwifery upon her, it is by no means neither with a design to insult the unhappy criminals, nor to draw from thence an inference to the disfavor of the men-practitioners in this point, beyond what I am authorized by the constancy of the temptation from Nature, to all, yes, to all, who, by their age, in one sex, are not past it: I say in one sex, because in the other, the female, the very circumstances of a woman’s needing a midwife, shews that she is not past the age of, at least, causing a temptation. Further, it would even be a matter of argument on the side of the men-midwives, that so few instances come to the knowledge of the public, of the ill-consequence of a practice which breaks down the capital barriers of modesty; if those ill-consequences were not, in the nature of them, not only a secret, but easy to be kept secret. Who would complain but the husband or relations of transactions between a man-midwife and his patient? But then how seldom need a third to be let into such a secret?

I would not then have the men-midwives to be too forward to treat the modesty of the women on this head as a false one, or their scruples as a weakness. Modesty in this case is not only the safeguard of the lives of themselves and children, but of their own honor, which if it does not receive an actual fall in such a subjection to a man-midwife, had perhaps better not be so unnecessarily risked so near the brink of the precipice.

I am not writing here for Italians or Spaniards, or any of the inhabitants of those countries who are so prone to jealousy, perhaps because they know their women. I am now addressing myself to Englishmen, not jealous, because, if they know theirs, they must know that, in proportion to the number, no women on the earth have more of the reality of virtue and modesty. I will not suppose then any thing so offensive, as that the chastity of the generality of them is not infinitely superior to the advantages or overtures for design afforded the men admitted to such a privacy, as that of attending them in their lying-in and delivering them. But would the honestest woman, or one however sure of herself or of her virtue, think it eligible, without a full satisfactory proof of that superior safety, which is her object in preferring men-midwives, to be herself the occasion of temptation to those people? How can she answer that she will not be it? In that so formidable army of mercenaries, actually continuing to form itself under the banners of Fashion, and headed by Interest, can she answer that the insensible stoics of it, will fall to her share? Would a woman, I will not say, of strict principles of honor, but barely of not the most abandoned ones, submit herself in the manner she must to a man-midwife, on her employing him, if she would but satisfy herself, as she easily may, that his aid cannot be more effectual than that of a woman? But what! if it is most undoubtedly a less safe one?

But this is far from all to be objected on the head of modesty to this practice. The opportunities, if not of temptation, if not of seduction by it, at least of offensiveness to female reserve are such, as would make even a husband, the least susceptible of jealousy, so uneasy for the outrages to which the employing of a man-midwife in the course of his wife’s pregnancy and delivery might expose her, as would make him think it no indifferent point for his judgment to settle whether such outrages might not better be spared her. It will not I presume be denied, that all female modesty is a flower, the delicacy of which cannot be too much guarded against any tendency to blast it, and that nothing can threaten more that effect, than such infringements of the unity of a husband’s privilege in the sole incommunicable possession of his wife’s body, as are implied in the course of a man-midwife’s attendance. An unity of privilege, which, when broke in one point, does not always stop at that, but may proceed to farther breach, where there is art on one side, and weakness on the other. Many women are doubtless proof against the slipperiness of such an overture: but all have not alike strength of mind.

But lest I should be here taxed with forging of phantoms merely for the honor of combating them, I shall only entreat all parties concerned to consider the following so probable circumstance, and then let them decide as their own judgment will direct them: a circumstance taken (can any thing be fairer?) even from a man-midwife’s own stating, as well as from the nature of things, of which none need be ignorant that will think at all about them.

It is then to be observed, that during a woman’s pregnancy, and before the labor-pains come on, one of the principal points of midwifery is, what is called the art of Touching. Thence are derived the surest prognostics for preparation, and especially from the signs it affords of rectitude or obliquity of the Uterus. I have already offered reasons needless to repeat, why the men can never arrive at the excellence of skill in the women in this particular. But as to the importance of this faculty of Touching, hear what Dr. Smellie himself says.

P. 180. “The design of touching is to be informed, whether the woman is or is not with child; to know how far she is advanced in her pregnancy; if she is in danger of a miscarriage; if the os uteri be dilated; and in time of labor to form a right judgment of the case, from the opening of the os internum, and the pressing down of the membranes with their waters, and lastly, to distinguish what part of the child is presented.”

Again, P. 448. speaking of a midwife, he says, “she ought to be well skilled in the art of touching pregnant women, and know in what manner the womb stretches, together with the situation of all the abdominal VISCERA: she ought to be perfectly mistress of the ART of EXAMINATION in the time of labour”.

Here you have from an unsuspected authority a certainly not over-rated importance of the expedience of preliminary TOUCHING. Now granting, only for argument’s sake, what is assuredly false, that a man-practitioner can be equal (superior he would not in this point, at least, have the impudence to pretend himself) to a midwife; let a husband, let a wife, but reflect on the difference, every thing else being equal, there must be as to modesty, between the function of touching being performed by a man or by a woman. Let a husband, I say, for an instant figure to himself what a figure he must make, what a figure his wife must make, under such a ceremony performed by a lusty HE-MIDWIFE, exploring those arcana of the female fabric, and especially to so little purpose, with his natural disqualifications for so much as knowing what he is about. Will the husband be present? What must be the wife’s confusion during so nauseous and so gross a scene? Will he modestly withdraw while his wife is so served? What must be his wife’s danger from one of those rummagers, if she should be handsome enough to deserve his attention, or a compliment from him on such a visitation of her secret charms, the more flattering from him, not only as he must be supposed so good a judge from the frequency of his occasions of comparison, but as it must imply a superior corporal merit in the woman so visited, as could overcome that satiety which a fastidious plenty of patients might so naturally be imagined to create in a man-midwife? Will any one say, that these suppositions are over-strained, or out of Nature? I fancy, that if the secret histories of many families were ransacked, of the practice on which the men-midwives were in possession, it would not be always found, that those preliminary visitations were not turned to some account of interest or seduction. And yet an omission of that touching might be dangerous. How kind is it then in Nature, to have of herself so far consulted the good and tranquility of society, in palpably bestowing upon women a faculty, which she has as palpably refused to the men, in whom the exercise of it would for obvious reasons be big with so many inconveniences? Is there any breach of charity in the taking for granted the existence of such inconveniences, unless indeed, all of a sudden, in favor of this lucre-begotten sect, the men were ceased to be men, and the women women?

But allowing that nothing was to pass between a man-midwife and his patient, in this act of touching, beyond the necessity of the practice, or in a merely technical sense, that in short no such libertine impression should make itself be felt in the course of such touches, as should discompose the good Doctor’s DIGNITY, and endanger the patient’s honor, by present or future attempts derived from such a strange privity; is it not to be feared, that a designing or interested person may take other advantages besides that of gratifying sensuality? May not a woman, the more attached she is to her modesty, the greater sacrifice she has made of it, in her innocence of intention, only imagine herself but the more subjected to a man, to whom she has submitted in the manner she must do to a man-midwife, and let him take an ascendant over her and her family, of which a midwife would not so much as dream, from her office being so much in course, and too little extraordinary for her to have any extraordinary pretentions or designs? On the contrary, a man-midwife need scarce set any bounds to his. In any differences in a family, especially between man and wife, must not a man-practitioner, from such a familiarity with the wife’s person, have such a footing in the confidence of the wife, as may enable him to dispose of her will almost in any thing? He may be her apothecary, physician, surgeon, privy-councellor, what not? What can a woman refuse a man, to whom she is so deluded as to think she owes her own life, or that of a darling child, all his merit, in which I have before explained? What can a woman in short refuse a man, to whom nothing of that has been refused, in which consist all the preliminaries of granting every thing? She may indeed refuse him the sacrifice of her virtue, if he should think it worth designing upon, but how few things else could she refuse him? Once more the greater value she put on the sacrifice of so much of her modesty, the less would she be able to deny him any thing else, as any thing else must comparatively appear so inconsiderable.

But hitherto I have spoke only of those outrages and dangers to modesty from the preparatory attendance of the man-midwife as occasion may require, during the pregnancy. But as to his officiating in the crisis of the labor-pains and delivery, there are two very essential points of consideration.

The first. The modesty of the women, unaccustomed to the approaches of other men than a husband, must be in great sufferance in the moments of their labor-pains. All Nature agonizes in them. They are at once weakened in the flesh and in the spirit. The bare presence of a man to officiate at such a time, may excite in them a revolution capable of stopping the labor-pains caused by the expulsive efforts of delivery, which thus becomes dangerously retarded, and may so overpower them, as to put them in the greatest peril of their lives. This is what has often happened. You may see frequent examples of this revolt of Nature against the ministry of men-midwives in Dr. La Motte himself, a man-midwife. If Nature then suffers so much in women at that juncture, when a person, nay even of the same sex, offers her aid, in certain indispensable occasions, to which humanity is subjected; how greatly must the presence of a man increase their constraint and embarrassment, and rob them still more of that so necessary freedom in the animal functions! But how greatly ought the women to thank that their instinctive repugnance of Nature to such a prostitution of their persons, if they consider those tortures, which, by the listening to that same repugnance, may at once be saved to their modesty, and to their personal feeling. Let them paint themselves the following posture prescribed by a man-midwife. “The patient must be commodiously placed, that is to say, on the bed-side, her thighs raised and expanded, her feet drawn up to her posteriors, and kept steady in that posture by some trusty helpers.”^[25] Levret, p. 161. On the use of the new crooked forceps. Here it may be said; “why there is nothing in this attitude, however shockingly indecent, but what may be sanctified by the extremities of necessity”. Very well. But what must a husband, what must a wife think at her being spread out in this manner, under the hands and eyes of a man-practitioner, with his helpers, perhaps his trusty apprentices, only for the experiment of a forceps of a new invention, the merit of which too is a so contested an one, that Levret himself is forced to own that, “that same FORCEPS would be^[26] an instrument of pure SPECULATION, and not of PRACTICE, IF (N. B. that IF) a certain general precept should be true,” which, by the by, is most certainly so! So that, in this case, for example, you see how a woman may be treated, only to ascertain the merit of some new-fangled gimcrack of an instrument. But to how many occasions of as little, or even less necessity than this, for putting a woman into postures of this sort, might not wantonness, interest, or other motives give birth? Or can pretexts for such insults to modesty be wanting to designingness?

The second consideration is this. Those moments of weakness of spirit, and infirmity to which the labor-pains subject the women may, in some of naturally the weakest of them be, liable to leave impressions in favor of a man-midwife, the less suspected of harm, and consequently the more dangerous for their being suggested by that gratitude for his imaginary^[27] contribution to their deliverance, which is itself a virtue, though the object of it is so miserably mistaken by them. Let any one image to himself what must often happen in Nature, a woman sinking under her pains, her mind all softened and overpowered with her present feelings, and looking up for relief to the man, employed, as she imagines, to procure it her, though the real fact oftenest is, that he will not have enough prevented her pain, or perhaps greatly occasioned its increase. Of this however she knowing nothing, sees him in the amiable light of her deliverer from her actual and intolerable state of pain. In the mean time, those aukward uncouth endeavours of his to relieve and deliver her, even though they should aggravate her torture, pass upon her for master-pieces of art or skill. “Who would be without a man-midwife?” At length, Nature sometimes, even in spite of all his omissions, or bungled operation, proceeds in her favorite task of delivery, that is to say, if he has not hurried or made tragic work of it, with his mispractice or his instruments. The patient then is rid of her burthen, and what are then her feelings? Those of exquisite delight, from the comparison with what she was induring but the instant before. It is a transport of joy, not unmingled with gratitude, to the person to whom she fancies herself in any measure obliged for it. The ugliest wretch on earth, so he could but be imagined the cause of such a delivery, would, in those instants, assume in her eyes the form of Loveliness itself. Even with the greatest innocence of heart she could hug, she could kiss him in the ebullitions of her joy and gratitude. Let no one imagine these expressions are over-strained. Such a rapture of felicity, in the sudden case of being taken as it were down from a rack, is not of a Nature to know any bounds of moderation, nor can be conceived but by those who have felt it. Her gratitude would even extend to inanimate things, much more to the dear Doctor, to whom she conceives she owes so much. She eyes him with all the intense eagerness of a gratitude so fond, that its transiency into a passion of another nature would not appear such a prodigy, to those who consider how apt passions of tenderness are to confound motives and run into one another. The melting-softness of those moments of infirmity and weakness of spirit, affords a susceptibility of impressions, which may not afterwards be so soon worn out, and of which the usual affection from the difference of sexes, in the parties, may sooner or later come in for its share. Dr. Smellie has, as I have before observed, implicitly allowed the possibility of a temptation to men, and shall I not follow his laudable example of candor, and confess that there may also be weak women?

It is indeed true that in cases of extremities, such as most certainly are not the frequentest ones, any thought of immodesty may be intirely out of the question. The sad and suffering state of a woman agonizing with pain, at the gates one may say of death, leaves little room for licentious temptations. But, once more, those cases are much the rarest: and even in those, the greater the danger will have been, the greater must the gratitude afterwards be for the imaginary service, that will be supposed to have accomplished the deliverance. Let a midwife have really rendered that service, the gratitude will scarce be so quick, so lively or so lasting, only because she is not a man.

If it shall be here objected, that the men-midwives ought to be above all suspicion or scandal of this sort; I shall only say, that at least it is their interest to appear so. But they themselves will not pretend to an exemption from temptation, nor can answer for themselves that such a temptation may not come into existence, as that all their virtue, fortified by the divine precept before quoted from Dr. Smellie, may not defend them from yielding to it. They are not, or at least ought not to be men in years for obvious reasons as to that manual practice of theirs which at the best is so indifferent. Let any one then consider the consequence of this worse than unnecessarily putting young women, in such manner, into the hands of men in the vigor of their age. Let any impartial person but reflect what barriers are thrown down, what a door is opened to licentiousness, by the admission of this so perfectly needless innovation. Think of an army, if but of barely Dr. Smellie’s nine-hundred pupils, constantly recruiting with the pupils of those pupils, let loose against the female sex, and of what an havock they may make of both its safety and modesty, to say nothing of the detriment to population, in the destruction of infants, and I presume, it will not appear intirely in me a suggestion of private interest to wish things, in this point, restored to the old course of practice of this art of midwifery by women. A course which Nature has so self-evidently established, in her tender regard to the female sex, and to its darling offspring, and in which she has not less consulted one of her primary ends, the Good of Society, in the greater security of the conjugal union and property, which ought to be so sacred, and especially so, for the honor of the human understanding, from the invasion of an upstart profession, sordidly mean in its motives, infamously false in its pretences, shamefully ridiculous in its practice, and yet dreadfully serious in all its consequences.

Conclusion of the First Part.

In the foregoing part of this work I have contented myself with asserting, in general, the perfect inutility of those instruments, of which the male-practitioners themselves confess the danger, and use them not a bit the less for that confession. It is then for the following and second part, that I have reserved the entering into a more particular discussion of them. Therein will appear, upon how false and slender a foundation the gentlemen-midwives have insinuated themselves into a business so little made for them. The truth is, that the pernicious quackery of those same instruments has been artfully made the pretext, and become the sanction of an innovation set on foot by Interest, adopted by Credulity, and at length fostered by Fashion. The employing of midwives was undoubtedly not long since, in this country, the General Rule. The calling in of men-practitioners, upon very extraordinary occasions, was an Exception, and a very rare one, to that General Rule. But by a fatal inversion of the natural order of things, the Exception is recently crept into the place of the General Rule. The point is to consider, whether this palpable violence to Nature is of that benefit to society which it is pretended to be.

I have already examined some of the arguments in favor of the men-practitioners. But the principal one, deduced from the incapacity, or rather aversion of the midwives, upon just grounds, from using instruments, merits an ampler scrutiny. In proof of my candor in it, I shall take most of my remarks on those instruments from what the men-practitioners themselves say, and confess of them. This, I presume, cannot be deemed unfair.

Upon the whole, those parties whom the decision may concern, will please to decide on which side the force of Reason and Truth shall appear the greatest; and so deciding, it is, in fact, in their own favor, and in one of their most capital concerns, that they will decide.

They will decide, in short, whether, upon the whole, the plea of the men-practitioners, founded upon the ignorance of a few midwives which, bad as it is, is more than balanced by their incompetency in the manual function, and to which a remedy might easily be found, is a valid one for driving out of the practice of midwifery a sex, to which the faculty of it is self-evidently the genuine gift of Nature herself, only to make way for a set of interested male-practitioners, whose so boasted art is oftenest signalized by the most barbarous and horrid outrages upon Nature, with this aggravation, that they are needlessly committed under the specious and plausible pretext of flying to her assistence.