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reasonable and laudable implied desire of the deceased person when living, and of his surviving relations and others. Besides these considerations, the notorious and unnecessary frequency of dissections creates an unpleasant suspicion and anxiety in a person, both on his own account and for his relatives and friends. There are in this country too many surgeons, and too many lecturers on anatomy, even in proportion to the number of students, of which there are also too many; so that these lectures by their superabundance are oftener a matter of gain than of necessity. If some plan were adopted to prevent too great a number of lectures, and thus to secure the attendance of as many students at each lecture as can properly receive instruction, it would be desirable, because it would be a saving of dissections. The fact is, that with all their dissections, nineteen out of twenty medical men throughout the country are not sufficiently competent to act in surgical operations of much difficulty, even to set and manage a fractured limb: nor is it likely, even if surgeons were not too numerous, because such cases comparatively so seldom happen, that they can have no adequate experience. If a plan were adopted for the great bulk of surgeons to attend to physic and less difficult surgical cases, and one surgeon or more residing in each considerable market-town, according to the population, were to exclusively practise in difficult surgical operations, the skill and experience of the latter class would be of peculiarly great benefit to the public. The plan would have the additional advantage of reducing the frequency of surgical dissections. The proper subjects for dissection appear to be all criminals who have suffered capital punishment, and those deceased prostitutes of the description of street-walkers, who have regularly followed their vile pursuits for a long time, say three years successively or upwards, previous to their deceases. If the most were made of dissections, these bodies, in addition to those of medical men or other persons who may choose voluntarily to bequeath their remains for the purpose, would be quite sufficient for the surgical and healing arts, with the aid of excellent treatises, with plates, on human anatomy. I will not digress further on this subject; it relates to an indelicacy of small importance in comparison with the indelicacy only of man-midwifery.
Perhaps it will be urged by some persons, as an excuse in favor of the future adoption of man-midwifery in particular instances, that the agitation of the present question, and the exposure of the accoucheur's misconduct having become so public as it now is, medical men will in future act with propriety. This is a selfish and temporising plea. Their corrupt desires cannot be extinguished, and the public cannet and never will be sufficiently on their guard. Medical men have opportunities or pretexts for
eluding vigilance. Can the public interest, even should it be excited by my efforts, and those of a thousand other writers on this subject, create a lasting sensation in the community? Can we permanently change the course of nature in the human passions? Would not time obliterate the effects of our exertions, unless a change of system is effected, while all the abuses of man-midwifery would recur, as all mankind are naturally more or less, individually, prone to selfish gratifications? Ought we to be so devoid of charity, as to have no concern for posterity? Are we to slumber over the partially beneficial and temporary effects of precept on the evils of a bad system, without offering our aid and the influence of our example in support of an attempt, easily practicable, to change the system for one that will not only completely and permanently extinguish these evils, but is in its nature without a single peculiar defect? Besides, is the gross indelicacy of the ordinary assistance, or even the presence of the accoucheur in common cases, and the still greater indelicacy of his assistance in others, of no consequence?
There being no original and purely natural impediments to the proposed reformation, I will now inquire into the contrived obstacles opposed to it. In order to contend successfully in any adverse enterprise, we should become acquainted with the position and strength not only of our open enemy, but of our secret adversaries; and we should carefully ascertain on what force we can rely for conquest. As far as medical men are concerned, most of them are obviously averse to a change in the present system, and the same remark applies to many of their near relatives and particular friends. But as there are some persons in the profession of more liberal minds, and an amply sufficient number, no doubt, who would be willing, if respectfully solicited and with offers of a fair remuneration, to instruct an adequate number of suitable women in the practice of midwifery; and as the other opponents mentioned, besides the medical men, are comparatively few in number, and their ill-directed efforts easily to be frustrated, by the suspicion which attaches to their relationship a peculiar intimacy with those of the profession who are averse to a change; it is natural to inquire, what is the real cause of the present delay? Nearly two years have elapsed since I first addressed the public, in my small tract, on the subject of the proposed change, and in a few months afterwards, copies were gratuitously circulated very extensively in the metropolis and the country; yet hitherto no general plan of public utility has been attempted. With the exception of two courses of lectures on the practice of midwifery lately given in Manchester by Mr. Radford, a respectable surgeon practising there, to female students and practitioners exclusively, I know of
no efficient steps having been yet taken to instruct women in the practice of midwifery. The ladies do not appear to have generally used their persuasive influence in a matter which so greatly concerns them. Except in a few partial instances, they have not, as far as I have been able to inform myself, adopted my suggestion of employing midwives of the present day in general cases, as a temporary expedient, calling in a surgeon, or appointing him to be near at hand, if it should be requisite: a measure so obviously proper, that in the present agitation of this subject it would naturally occur to their minds. No matter, whether my humble endeavors, or the efforts of those who have since ably written in support of the good cause, have been equal to the great importance of it; the mere title-page of my pamphlet, the bare suggestion of the subject for consideration, would, I am certain, be sufficient with most persons of even moderate capacity and discernment to decide the question, if unbiassed by prejudice or influence, in favor of a change of the present system. The attention of the public has now been excited, and I am convinced that they are generally anxious to have the system altered. The public being now on their guard against the influence and machinations of medical men and their open abettors, these persons cannot be the sole nor principal cause of the present delay. No; the delay rests chiefly with a certain, and that not a small portion of the fair sex. This portion may be divided into two classes. One of these classes, of which I will dispose first, as being of the two by much the least numerous and influential, is the monthly nurses usually attending ladies preparatory to and during their accouchements. These female nurses are generally well acquainted with the accoucheurs in their respective neighborhoods, being frequently obliged to them for recommendation. Indeed the recommendation is often reciprocal between both parties in their respective callings. The nurse having many private opportunities, is therefore very likely from prejudice and partiality to speak in fayor of the accoucheur's practice, and to throw out hints of danger in substituting a midwife: all which observations, coming from an experienced and often unsuspected, though deceitful nurse, it is not to be wondered at that many young married ladies should readily approve of and credit her statement. Ladies in general, however, from a knowlege of the nurse's relative situation, have discernment to detect this fallacy, and are therefore enabled to expose it to those of their sex, whose youth and inexperience may render them liable to its effects.
The other, and the more formidable class of female opponents, are mothers, of all ages; not considering them with reference to their parental situation, but as females having experienced child
birth, assisted, as has been the general custom for the last half century, by accoucheurs. I enter on this part of the subject with much regret, that occasion should have been given for doing so, conscious as I am that a large and important part of the fair sex are justly liable to severe censure for their present perverseness; nevertheless I enter on it unhesitatingly, because I have the general and permanent welfare and happiness of the sex at heart. I hasten to say, that I speak not in censure of all mothers, nor even of most mothers; for I am convinced from conversations I have had with some of them, and from various other sources of information, that many are advocates, or are privately in favor of the proposed change in the system of midwifery. This assertion, that mothers are the principal cause of the present delay, is not founded on hasty presumption, but on long and mature observation and reflection, and on information. It is supported as well by argument, as by particular instances and general facts within my knowlege. How are we to account for the seeming apathy of the fair sex in general to the proposed change, notwithstanding the readiness of midwives of the present day, as a temporary and conditional expedient, and notwithstanding the concurrence of nearly all men, except accoucheurs, in the propriety of it? We must look for the cause of this coolness in some considerable portion of the fair sex themselves. Now no man in his senses can suppose, that the sex in general are naturally prone to wilfully support the vices, and experience the great temporary evils of man-midwifery. Monthly nurses, as well as accoucheurs, I have shown to possess little influence since the present subject has been brought into public notice. Mothers, by reason of their experience, authority, and consequence, and their pervading all ranks of society, possess very extensive influence. This influence has been hitherto very successfully exercised by many of them amongst themselves and young married females, either actively or by a specious neutrality, in opposition to the introduction of the practice of midwifery by midwives. They have thus exercised their influence for the following reason. They have absurdly viewed the present agitation of the subject and the proposed change as a source of shame to themselves, as having participated in the errors of the present system; and suppose that if the reformation were effected, they should hereafter suffer in a comparison with females who, in their earliest occasion and subsequently, had wholly availed themselves of it: they have therefore endeavored to silence the subject, and prévent the effecting of the change. With respect to facts in support of the position I have taken, I could adduce several striking instances, but it would be invidious to particularise examples, because by alluding to special circumstances, though no namés
were given, the instances might be appropriated; and if they were appropriated correctly, it would nevertheless be partially severe to do so, and create an irritation, which, after this sufficient allusion, might serve only to give a partial check to the desirable purposes of this tract. As a general fact, I can confidently assert that my intercourse with society having enabled me to observe the conduct and manners of the many mothers with whom I am personally acquainted, or by whom I am personally known, and who have known me to be the author of the former editions of this tract, I have without pretending to much penetration perceived from their manners enough to convince me that some of them are, or have been, hostile to the proposed reformation. As a collateral proof that this is the case, I have observed with much pleasure, that nearly all those ladies with whom I am more or less acquainted, who are either unmarried or are married without having had children, and who are arrived at an experienced age so as to form their own opinions unbiassed by the arts of others, have signified to me indirectly, yet in the most unequivocal manner, their approbation of the cause I am supporting; and I do not recollect one of them to have signified contrarily.
It is certainly a despicable circumstance, that any mother should harbor such narrow principles, that she cannot view with complacency this great projected improvement in the situation of the present and future generations of females; because, as not having been introduced on the earliest occasion that she could have availed herself of it, she is foolish enough to suppose it would, if effected, be to her a source of shame. Will she be so uncharitable as to have no concern for the health and safety, the decency and morals, of her own sex, and for the connubial fidelity, the peace and happiness mutually of husband and wife? Can she continue to be so selfish as to place the transitory, trifling, and unreasonably unpleasant feelings of herself and a few other equally selfish mothers of the present age, in competition with the naturally and reasonably anxious desires, the good taste, the purity of morals, and the happiness in a considerable degree of the present, and all future generations of society of both sexes? If a corrupt pride instigate her to partly sacrifice her regard for her own delicacy, let charity, on the other hand, teach her to surmount this pride, and also to respect delicacy in others; let it prompt her to reflect on the evils of man-midwifery which I have described, and then to lend her best aid and the influence of her example in support of the practice of midwives. Let her remember, that it is not only prudent to avoid error, but magnanimous to acknowlege it, where the acknowlegement is no injury to her, and an advantage to others. I have as good an opinion of the fair sex generally as a man rea