PROPOSALS FOR TEACHING THE ART OF MIDWIFERY, WITH A SYLLABUS of the LECTURES, BY THOMAS COOPER, M. D. Accoucheur and Physician to the Lying-in-Wards of the Middlesex Hospital. PROPOSALS. THE Course will consist of Eighteen Lectures, to begin on the first Mon- day of every Month, at Ten in the Forenoon, at the Doctor’s House, in Northumberland Street, Charing Cross, or at any more convenient Hour, to be fixed by the Gentlemen who enter, after the Introductory Lec- ture. It is expected, however, that every one will be punctual to the Time appointed. Each Pupil to pay, for the first Course, four, and for every subsequent Course, two Guineas; the Mo- ney to be paid on or before the second Lecture; to pay also Half a Crown on attending the first natu- ral, and every subsequent laborious and preternatural Labour. During the first Course, each Pupil shall be inti- tled to attend at two Labours, and deliver one natu- ral Case. In the second Course, to deliver two natural, and one difficult Case. In the third, (according to Seniority) to deliver the first preternatural Case that occurs, and to at- tend whatever Labours may happen at the Apart- ments in the Course of his Studies. Gentlemen [4] Gentlemen who choose to enter for three Courses at once, to pay seven, for six Months, ten, for one Year, fourteen, and to become a perpetual Pupil, twenty Guineas; and shall be allowed La- bours, and Opportunities of Practice, in Propor- tion. A private Course, to one or two Gentlemen, with proper Opportunities of Practice, six Guineas; and five Shillings for every Labour. Dr. COOPER will read an Evening Course to any Number of Gentlemen, not less than four, on the same Terms, for the Accommodation of such Gentlemen as have finished every other Part of their Education. Gentlemen may also be accommodated as House Pupils, with whom the Method of Instruction will be familiarised by private Conversation (exclusive of the Lectures) at such Times, and in such Man- ner, as not to break in upon the Pursuit of any other Study, by which Means Gentlemen may at the same time attend the Hospitals, and anatomi- cal Lectures, and compleat the Course of their Edu- cation within the Year. Each House Pupil, may engage for four, six, or twelve Months, to pay on Entrance for their Board, at the Rate of forty Guineas per Ann. and for their Education according to the Terms abovementioned. Proper Apartments are provided for the Accom- modation of the Poor, with a convenient Chamber for the Gentlemen to wait in, when any Women are in Labour. The Doctor has also frequent Oppor- tunities of sending his Students to attend Women at [5] at their own Apartments, on which Occasion, each Gentleman attends singly, according to Seniority, a Preference being always shewn to the House Pupils; and if each Student has not his proper Opportunities of Practice during the limited Time of the Courses he attends, they are procured him afterwards as soon as possible. Each Student pays to the Matron of the Doctor's House Half a Crown, to the Nurse One Shilling, on Entrance; and Sixpence to the Messenger when ever called to a Labour. Women are instructed by themselves, and may have the most extensive Opportunities of Practice and Improvement, at the Middlesex Hospital, on very easy and advantageous Terms. Dr. COOPER may be spoken with, at his House in Northumberland Street, Charing Cross, any Morning before Ten; or at the Middlesex Hospital, in Marybone Fields, any Thursday at Twelve. ADVERTISEMENT. THESE Lectures are digested under the three general Heads of THEORY, PRACTICE, and DISEASES, under each of which Divisions will be comprehended all that is essential to be known by the Accoucheur. Under the first Head will be explained, the Ana- tomy and Functions of the Parts concerned; the second will comprehend all the Variety of Cases that can possibly occur, from the most easy to the most difficult [6] difficult and perplexing Labours, with the best Method of Assistance, particularly enlarging on the Method of relieving the most lingering and labori- ous Cases by the Hand only. This Division will be embellished with a Variety of useful and necessary Precepts, Precautions, and corollary Observations, and may be deemed a complete System of Practice, built upon Theory, and a useful Theory deducible from Practice. In the third Division will be given a concise History of the various Diseases the Fair Sex are peculiarly subject to; the Maladies of preg- nant Women, and of Women after Delivery, (par- ticularly the Lochial Fever, a Subject hitherto but indifferently handled) with the Diseases of Children, and their various Diagnostics, Prognostics, and Method of Cure. By this Disposition, the Lectures will be made more methodical and extensive, than by blending promiscuously, in the common Method these three distinct Branches of the obstetric Art. The Laws of Mechanics, as far as they are analo- gous to the Operations of Nature in the Act of Par- turition, and necessary to the comprehending or ex- plaining any relative Branches of the Art, are pro- perly explained in the introductory Lecture; which Lecture, at the Opening of every Course, will be free for the Attendance of any Gentleman of the Medical Faculty, after which the Apparatus will also be displayed. At the End of the Course will be given an ad- ditional Lecture, containing an History of the most approved and most powerful Emmenagogue and uterine [7] uterine Medicines, comprehending their mechani- cal Powers and Method of Operation: with practi- cal Observations on the Virtues of MUSK and OPIUM. SYLLABUS, or HEADS OF THE LECTURES. DIVISION THE FIRST. THEORY. LECTURE I. Introduction—Plan proposed— General System of the animal Oeconomy— Authors recommended—Laws of Mechanics analo- gous to Midwifery—Qualifications and Deportment an Accoucheur. LECTURE II. Contents of the Pelvis—Cursory View of the Parts of Generation proper to Women, external and internal—Bones of the Pelvis—As united—Separately—In the adult—In the fœtal State—Offa innominata—Sacrum, Coccyx—Ilia— Ischia—Pubes—Their Connections, &c. Diffe- rence between a Male and Female Pelvis. LECTURE [8] LECTURE III. A well constructed—A deformed Pelvis—Different Diameters and Depths, of the Pelvis—The fœtal Skull—Its Sutures, Connections, and Diameters—General Observations on the Struc- ture of the Pelvis and the fœtal Skull. LECTURE IV. Of the Vagina—Uterus—Ova- ria—Vessels—Ligaments and Fallopian Tubes—Of the Catamenia—Theory of Conception—Conjec- tures on the Causes of Sterility. LECTURE V. Signs of Conception—Equivocal Signs of pregnant and obstructed Women—The Oeconomy of the gravid Uterus—The Placenta, Funis, Membranes, Waters, &c.—Of the Fœtus, its Nutrition, Secretions, &c.—Of the Increase of the Uterus after Conception—Of the Magnitude, Weight, and Distinctions of the Fœtus—Of the Child’s Situation in the Womb. LECTURE VI. Of Twins—-Superfœtations— False Conceptions and Moles—Of Abortions in ge- neral—From particular Causes—The Child’s Death —Separation of the Placenta from the Uterus—Of extra-uterine Conceptions. DIVISION THE SECOND. PRACTICE. LECTURE VII. Of touching—Signs of La- bour—The Nature, Causes and Effects, of Labour Pains [9] Pains—How to distinguish the true and false Pains— What to be done on that Occasion—The Division of Labours—The Position and Management of the Woman after a natural Labour—Progress of a natural and easy Labour—The Cawl or Monk’s Hood— When and how to break the Membranes—Aquæ fugitivæ—Paucity and Supersfluity of Waters—To guard the Perinæum—To tie the Funis—To deli- ver the Placenta—To pass the Catheter—Method of discovering a second Fœtus. LECTURE VIII. Lingering or tedious Births, not absolutely laborious—The Vertex presenting with little or no Waters—The Forehead on one Side—Various Accidents that may hasten or retard Delivery—How to assist when the Funis is en- tangled—When the lower Part of the Uterus con- tracts round the Child—When the Shoulders rest on the Pubes or Sacrum—To manage the Woman and Child after Delivery—General Observations on natural Labours. LECTURE IX. Of laborious Labours—Their Causes and Consequences—Bulk, or wrong Posi- tion of the Head—Rigidity of the Os Uteri—Di- stortions of the Pelvis—Accidents from the Confine- ment of the Child’s Head—to the Mother—to it- self—Lacerations of the Os Uteri—Vagina—and Perinæum. LECTURE X. Of the various Instruments in- vented to assist in laborious Labours.—The Fillets and [1O] and Forceps, a commodious and simple Ap- paratus—General Rules for using the Forceps— Different Ways of introducing them—when the Head is down to the Os externum—when higher in the Pelvis. N. B. In this Lecture are displayed a Series of old and uncouth Instruments, with Exam- ples of every modern Improvement on the For- ceps, &c. LECTURE XI. When the Forehead is to the Pubes—When the Head presents fair at the Brim of the Pelvis—When the Face presents—The Use of the Crotchets—A more simple, and safer Process—The old Method—The Woman’s Posture —Prolapsus in the Time of Labour—Of the Obli- quity of the Womb or Fœtus. LECTURE XII. Preternatural Labours—Divi- sible into three Classes—The Breech—The Feet presenting—Mixed Labours—The Funis before the Head—Before the Breech, or any other Part—The Placenta at the Os Internum—Floodings in the Time of Labour, premature, or at full Period. LECTURE XIII. Second and third Class of pre- ternatural Labours—How to turn a Child—To pre- vent the Rupture of the Uterus—The Arm—The Shoulder—The Hip—The Back—The Abdomen presenting—The Hydrocephalus, or watery Head— The Head left in the Uterus—Method of extract- ing it by the Hand only—Signs of a dead Child— Method of recovering the Child when stupified by its long Confinement in the Pelvis—Precepts and Precautions [11] Precautions relative to laborious and preternatural Labours. LECTURE XIV. The Delivery of Twins—Of Monsters, and the united Placentæ—The Cesarian Section—The natural Consequences of Delivery— Lochia—Coagula.—After Pains—Preternatural— Floodings—Syncope, &c.—On the Coming of the Milk—The Structure of the Breasts—The lactise- rous Ducts and Vessels—Corollary Observations, by Way of Aphorisms, deductible from the foregoing practical Lectures. DIVISION THE THIRD. DISEASES. LECTURE XV. Diseases peculiar to Women— Obstruction, Suppression, and immoderate Flow of the Menses—Chlorosis—Imperforated Hymen— Fluor Albus—Hysteric Affections—Furor Uterinus —Relaxation of the Ligamenta Uteri—Inflamma- tion of the genital Parts—Schirrous Tumours, and cancerous Ulcers, in or near the Uterus—Gangrene, or Mortification of those Parts—Sterility. LECTURE XVI. Diseases of pregnant Women, and of Women after Delivery—Nausea—Longings —Diarrhæa—Costiveness—Piles—Swellings and Pains in the Breasts—Lowness of Spirits—Menstru- al Discharges—Abortion—Swelling of the Labia, Legs [12] Legs and Thighs—Difficulty, Retention, and In- continence of Urine—Cough and Difficulty of Respiration—Violent Floodings—Suppression of the Lochia—the Lochial fever—Milk Fever— Eruptive Fever—Prolapsus—Various Forms of Pes- saries and the Manner of applying them—Tumefac- tions and Suppurations of the Breasts—Sore Nipples. LECTURE XVII. Diseases consequent on la- borious Labours—Tumefaction of the external Parts —Lacerations—Of polipose, cancerous, and schir- rous Tumours—of Herniæ—Rupture of the Vesica urinaria—Various Species of false Gravidation— Causes—Dropsy of the Ovaria—Comparative View, and Distinction of the Signs of Conception and false Gravidation—Medicines required by Women in Labour—Authors who have wrote on the Dieases of Women. LECTURE XVIII. Of the imperfections and Diseases of Infants—The Obstruction of the excreto- ry Passages—Misconformation—Contusion—and Excoriations of the Head—or other Parts—The Spina bifida—Hydrocephalus—Total or partial Want of the cranial Bones—The Hare Lip—Ra- nula, or Confinement of the Tongue—Starting of the Navel—Hernia-congenita—Tumefaction in the Breasts—Gripes—Errysipelas—Red Gum—Thrush —Dysentery—Dentition—Fit—Venereal Taints —Scrophula—Small Pox—Measles—Rickets— Hooping Cough—Worms. Concluding [13] Concluding LECTURE—On the mechanical O- perations and Powers of the most useful Emmena- gogue and uterine Medicines—On the Powers of Musk and Opium—On the Treatment of venereal Symptoms in pregnant Women. Dr. COOPER has printed a Compendium of Midwifery for the Use of his Students, from the foregoing Course of Lectures, to prevent the Trou- ble of taking Notes: To which is added, an Ap- pendix, containing the Heads of the concluding Lecture, and a Formula of Prescription; or PHAR- MACOPOEIA OBSTETRICARIA. Every Student is intitled to a Copy with his Certificate; the Price of which to such Gentlemen as do not attend the Lectures is Half a Guinea, as it is not in the Hands of any Bookseller, but to be had only of the Doctor, being merely intended as a Compliment to his Students. The foregoing Lectures are exemplified and il- lustrated by a very curious and extensive Apparatus consisting of four Machines, being Human Skele- tons, properly stuffed and covered, which exhibit as exact Representations of Nature as it is possible for the Power of Art to arrive at; with Fœtuses of different Bulk, imitating the Form and Appear- ances of real Children as near as possible. The first Machine shews the whole abdominal Viscera, in Situ, with the Blood Vessels, &c. and the Manner of the Uterus contracting after Delivery, and the Expulsion [14] Expulsion of the Placenta, Membranes, &c. The second is calculated to shew the Progress of Labour in the more easy and natural Cases, being a Figure with a well formed Pelvis; to this Machine there are three Uteri to fix on or remove at Pleasure, first a flaccid one, to shew the State of the Uterus in flooding Cases; secondly, a thick leather Uterus of a particular Construction, to shew the Position of Twins; and thirdly, a very curious transparent Uterus, to shew the Manner of turning a Fœtus when the Membrares are entire. The third is a Machine with a distorted Pelvis, to shew the more laborious Cases, and the instrumental Method of Delivery. The fourth, a Machine with a very ca- pacious Pelvis, on which are explained the Method of separating the adhering Placenta, and of turning the Fœtus when the Waters are all evacuated, and the Uterus is forcibly contracted round the Body of the Child. A Preparation in Spirts of the Body of a Woman who died undelivered, from the Consequences of an uterine Hæmorrhage, the Placenta at the Os Uteri, and the Fœtus presenting with the Breech. Three Casts in Plaister of Paris, painted from the above Preparation. A Series of Human Ova and Fœtuses, from the earliest Appearance of Human Existence, to the full Period of Gestation (among which is one Fœtus in Utero of seven Months); with many other Preparations to explain the Oeconomy and Functions of the Parts concerned. A Fœtus of the [15] the full Growth without a Cranium. Three Ex- amples of a well constructed and three of the strait and distorted Pelvis. Three united Twin Placentæ. Sections of the Pelvis and Fœtal Skulls of different Proportions. A Collection of Instruments that have been in Use from the earliest to the present Time; and Pessaries of various Constructions.