INTRODUCTORY LECTURE, DELIVERED BEFORE THE CLASS, AT THE i'l'i:\L\G OF THE FEMALE M11ICIU, COMBE. OF PENNSYLVANIA, 11V J. S. LONGSHORE, M. D., IKol'KSSOR OF OBSTETRICS AND DISEASES OF WOMEN AND CHILDREN. October 12th., 1850. WITH AN APPENDIX. PHILADELPHIA: JAMES YOI'NG, PRINTER, 21 NOKTH SIXTH STREET. 9805 r AN INTRODUCTORY LECTURE, DELIVERED BEFORE THE CLASS, AT THE OPENING OP THE FEMALE IDICU DUKI. OF PENNSYLVANIA BY *,C^ J. S. LONGSHORE, M. PROFESSOR OF OBSTETRICS AND DISEASES OF WOMEN AND CHILDREN, October 12th., 1850. S'J "'' ■■•-.;/'vv yr. WITH AN APPENDIX. ^0'IJ & PHILADELPHIA: JAMES YOUNG, PRINTER, 21 NORTH SIXTH STREET. 1850. 9805 To the Faculty of the Female Medical College of Pennsylvania. Gentlemen : At a meeting of the class held on Monday the 28th inst., it was unanimously re- solved, that each of you be respectfully requested to publish your Introductory Lee tures, and the undersigned were appointed a committee to carry the resolutions into effect. Feeling a deep interest in the success and prosperity of the Institution, they are Impressed with the conviction that no better means could be adopted to promote its advancement, than to spread before the world just such matter, arguments and ap- peals, as were presented to those in attendance during the week, devoted to the de- livery of those Lectures. The impressions made on the audiences in attendance, was of the most salutary kind. The ability of the incumbents of the respective chairs was fully established, and all that is required to extend and deepen that impression, is to disseminate proper information in regard to the school, and a knowledge of the entire competency of the professors. Yours, most respeetfully, PHffiBE WAY, } ANGENETTE A. HUNT. > Committee. HARRIET P. WEBB, ^ To N. R. MOSELEY. M. D., Dean. College Building, No. 229 Arch Street, Philadelphia, Nov. 4, 1850. Ladies : I am in receipt of your kind letter of the 29th ult.. and in answer would say that for my own part, as my Lecture was not written with a view for publication, I must decline your kind request. Dr. Longshore will comply with your wishes ; as for the other members of the Faculty, I cannot answer, but should they think favorably, you will hear from them individually. Believe me, however, when I say for them and myself, that we appreciate, to the fullest extent, your approbation of our humble endeavors to communicate to you from our several chairs the subjects which we have the honor to teach in this Institution. Yours respectfully, N. R. MOSELEY, M. D., Dean. To PHCEBE WAY, 1 A. A. HUNT, S. Committee. H. P. WEBB. $ Ladies,—» The law of progress is the law of nature, all animate,- organized nature, from the most insignificant vegetable germ up to man, the last and greatest of God's works, obeys this law with the utmost precision and fidelity, and man, despite of himself, is a progressive being. All nature, within, without, governing and influencing him, imperatively demands obedience to this great eternal law, and man proud, dignified, elevated as he is, claiming in the scale of creation, a position but two removes below his Creator, is required to bow in humble submission to this universal decree, and progress, physically, mentally, and morally from the cradle to the grave; and released from the affairs and circumstances of time, it is fair to presume he is destined, still, in obedience to the same law, spiritually, to advance in the scale of progressive existence, thoughout all eternity. In no age of the world's history, have there been presented more sub- lime evidences of the development of this law, than in the present. Nu- merous, indeed, and magnificent have been the discoveries in the arts and sciences, which have formed important epochs in the course of time, since creative energy called man into existence. During all the past ages of the world, as man has progressed, the various institutions with which he has been connected, have also yielded to the same omnipotent influence; even heathenism itself, has progressed towards civilization, and civilization approximated towards refinement; political economy has been stripped of much of its rigor, and mild and equitable laws have taken the place of harshness and cruelty; religion has been shorn of much of its bigotry, superstition, and idolatry, and practical righteousness substituted in their stead. But all the improve- ments and discoveries of the preceding generations, have been surpassed and eclipsed by the achievements of the present age. Chemistry may boast of large acquisitions drawn from the researches of philosophers who lived previously to our time ; but it must be conceded that it derives its greatest importance from the labors bestowed on it in the nineteenth century. Originating with the ancients, in the crude pro- 4 INTRODUCTORY LECTURE. cess of working metals, it has by gradual and steady development, grown into a most important branch of practical philosophy—contributing largely to the vast improvements in agriculture and the arts—for which our own time is so distinguished—the generation of steam, and its appli- cation as a propelling power, and the beautiful art of Daguerreotyping, are amongst its trophies, won in the present day. Electricity, in common with every other branch of human knowledge, proves the operations of the great law of progress. The simple attractive power which amber and other electric substances acquire by friction, was long known to philosophers.. This point formed the nucleus around which gathered the results of experiments and researches, through all subsequent ages, until, by a series of progressive developments, it has taken its place amongst the practical sciences, and the discovery of the identity of lightning and electricity—the invention of the lightning rod and the magnetic telegraph, are amongst its many beneficial gifts to man. The science of Medicine, more legitimately connected with our pur- pose, supplies us a history, commencing, as it most probably must have done, with the very existence of our race, which furnishes a most perfect example illustrative of our position, Anteriorly to the time of Hippocrates, medicine was neither studied as a science, nor practised as an independent profession. Hippocrates, a na- tive of Greece, lived 400 years before the Christian era. That he must have possessed a strong, original genius, cannot be denied, in view of the vast amount of labor he bestowed on his favorite art. Indeed, to the labors of this Grecian sage does the science of medicine owe its ori- gin as such. All the accounts which have been transmitted on the sub- ject of medicine, from a date prior to this epoch, .are either conjectural or fabulous. Posterity, by common consent, have awarded to this great philosopher the enviable title of the " Father of Physic." As we cast the eye back over the past ages of the world, we can behold the gradual but steady development of the healing art; the master-stream having been formed by a coalescence of the jettings of innumerable springs, arising amid the jungles of ignorance, and the marshes of the intellectual darkness of primeval night. In its descent along the decli- vities of time, it has been augmented in consequence and value, by the innumerable tributaries in the shape of new theories and" independent systems, which have all along its course contributed their full proportions towards making it what we now find it. The present day is no less celebrated than former times, for its sys- tems, theories, isms, and pathies. We vary, however, from our prede- cessors in the fact, that while their differences and distinctions were con- fined mainly to the profession,—ours are embraced, enjoyed, defended, introductory lecture. 5 and propagated by the masses, affording additional evidence of the un- foldings of the law of progressive development. General intelligence, not content to assign to a privileged few the exclusive guardianship and protection of the general health, is engaged in bringing forth and deve- loping the various popular schemes of hygiene, as well as reputed cura- tive processes. Prominently amongst these stand Homoeopathy, Mesmer- ism, Hydropathy, Thompsonianism, and, perhaps, Eclectic Medicine. That Allopathy, by which is meant the opposite of Homoeopathy, the ordi- nary medical practice, has been benefited and improved by the existence of these dogmas—as was the Hippocratic practice by the numerous theo- ries and systems succeeding it, notwithstanding the many absurdities and superstitions with which they were mingled, it would be unwise and un- true to deny. Since these innovations have taken hold of the public mind, many abuses of the lancet, mercury, and other active remedies, have been corrected. By Homoeopathy we are taught that many times, very little or no medication is the better practice, and that we may firmly rely for a cure upon the recuperative powers of nature, and upon addressing our means to the mental or spiritual parts of our nature, instead of the phy- sical. By Hydropathy, physicians have been directed to inquire into the curative properties of water, and the various ways in which it may be advantagously applied as a remedial agent, to the exclusion of other, and perhaps, less beneficial means. A late orthodox medical writer has said that "many of the phenomena of Mesmerism, are as real as the phenomena of ordinary sleep,"* and after some observations on the effects it has on the nervous system,—he exclaims, "but what a field for Neurological research is hereby spread out;" by it, surgery, in many instances, has been stripped of all its horrors, and pain relieved as if by magic. But while we are willing to award to these popular dogmas, all to which they are justly entitled, as affording the means of preventing and alleviating human suffering, we cannot subscribe to them individually, as independent, exclusive systems, each containing within itself all that is necessary to combat successfully the numerous and complicated ills to which life is heir. Without the elements of Allopathy, the disciples of those various reforms as they are called, would make a sorry figure in their endeavors to arrest the tide of human ails. Anatomy, Physiology, Surgery, Materia Medica, Chemistry, Obstetrics and Comparative Anatomy, have all been developed by the deep searching investigations of Allopathy, and without them no system of healing can be rendered universally bene. * British and Foreign Med. Chir. Review for April, 1850. 6 introductory lecture. ficial While it is the genius of those independent systems to exclude every thing that is not strictly of themselves, it is the province and pride of Allopathy to embrace within its expansive folds, every known thing that is useful. Orthodox Allopathy, therefore, "accepts even empirical experience in the cure of disease, whenever it is so offered as to be satisfactory, that it is not fallacous; for, to defer the adoption of a useful and practical method of healing, until a science, necessarily imperfect, demonstrates its fitness, would be a crime against medical ethics; the practitioner is bound to advance the science as much as in him lies, but his first duty is to practice the art with the greatest success. This catholicity of faith and practice, is in direct opposition to the exclusiveness and dogmatism of medical heresies and quackeries. True medicine will adopt the therapeutic experience of even a Morrison, if proved, however it may repel his absurd hypothesis, or so-called sci- ence; and it will weigh the results of Homoeopathic curative experience, however it may dissent from a belief in the efficacy of infinitesimal doses or in the dogma of similia similibus currantur. Such an estimate has, indeed, long been going on, and we trust will be extended."* A posi- tion less liberal than this, exhibits both bigotry and empiricism, and is as obnoxious to objections and criticisms, as any of the condemned inno- vations. While all these systems and schemes combine to crush Allopathy, like a band of rebels to capture a mighty prince, it remains unmoved, surveying the defiles of the invading forces; and as they move onward, picks from the advancing ranks their ablest and best material with which to fortify its own entrenchments. However much a universal desire for correct medical intelligence may tend to misdirect its votaries, and perpetuate those empirical dogmas and visionary theories, it nevertheless proves the progressive nature of human inquiry, which in its unfoldings and developements has created an insa- tiable thirst for this kind of information, and thousands of the male portion of our population, annually throng the institutions of our country, in order to drink at the various fountains whence flow the streams of medical knowledge. In order to satisfy the imperative demands, of the same laudable desire, on the part of educated and intelligent females, "THE FEMALE MED- ICAL COLLEGE OF PENNSYLVANIA, has been instituted. The demand for this institution being so universal, so pressing, and so extensively appreciated, the Legislature of Pennsylvania, upon the * British and Foreign Med. Chir. Review for April, 1850. introductory lecture. 7 presentation of a bare petition, without any of the means not unfrequently employed to secure the passage of similar acts, with great unanimity granted it a charter as broad and as liberal as any in the State, and at the same time entitled to privileges, and vested with powers equal to the most favored Medical School in the country. Under these favorable auspices, then, do we commence the labors of the first course of Medical Instruction. Called from the exercise of a private country practice, to teach Ob- stetrics, and the diseases of Women and Children, in the first regularly authorized Female Medical School in the world, while I deeply appre- ciate the honor conferred on me, in assigning me this distinguished po- sition, I at the same time too sensibly feel the vast importance and re- sponsibility of the post; while it will be my duty to induct you step by step into an acquaintance with this exceedingly delicate, yet deeply inter- esting branch of medical science, it will also give me pleasure to afford you every opportunity to facilitate your studies, that can be made avail- able in the opening of a new institution, where the means of instruction must necessarily be less abundant than in those of greater age. If there can be one branch of medicine of more consequence to females than another, it must be that in which they are individually interested, the one that applies immediately to their wants, their necessities and their sufferings. Where is the female who has passed through the trying season of gestation, harrassed with sufferings, innumerable and indescrib- able, and the more painful and perilous process of parturition, that has not longed for more knowledge of her own formation, and a better ac- quaintance with the functions, and physiological relations and offices of the various organs connected with this most important and interesting part of nature's work, the procreation of our species? or where is the woman thus situated, that would not have esteemed it a high favor to have had an accomplished, educated female attendant, who from her very nature was capable of feeling for and sympathising with her, and into whose bosom she could, in confidence, have poured her sorrows, her afflictions and her sufferings ? At this moment, far the most important and peculiar in all its bear- ings and relations of any other, during her whole existence, a period when all restraint, both mental and physical, except so far as her safety is invol- ved, should be removed, and she be permitted to enjoy the largest liberty in responding to the various promotings of nature, to be aided by a tho- roughly qualified attendant of her own sex, could not but be more desirable, more consistent with her comfort, more safe, and abundantly more in accor- dance with the requirements of genuine refinement, and female delicacy. That there is a melancholy deficiency of a knowledge of the anatomy m introductory lecture. and physiology of their own bodies, amongst the females of our country, is too strikingly apparent every where. Moreover an ignorance of the proper management of children is also the source of incalculable suftering to the infant, and consequently much trouble and anxiety to the mother. Dr. Hodge, the present distin- guished Professor of Obstetrics in the University of Pennsylvania, in an introductory lecture delivered ten years ago, held the following language: " Hundreds and thousands of mothers inflict great sufferings on their children from ignorance, actuated as they usually are, by the strongest feelings of love and devotion to their children, and having never been properly instructed in the duties of maternity, they become exceedingly anxious for the safety and welfare of their offspring. " They listen to every friend or visiter, however ignorant or unskilful; they imbibe all the floating prejudices of society, and prompted by the kindest feelings, and by anxious desires to benefit their infant, they rashly enter upon a train of experiment in diet, clothing, exposure, &c> which too often is pregnant with the most direful consequences to the health of the child and the happiness of the mother." It is, however, an exceedingly gratifying relief to the dark picture, to perceive here and there some bold spirits, who are unwilling longer to be trammelled by the prevailing customs that sanction ignorance, and esteem the study of their own system, as taught from this chair, too indelicate for pure minds to engage in, but who rush forward and seize upon every available opportunity, at ever so great a sacrifice of time, comfort and means, to aid them in the prosecution of this very desirable pursuit. Were this knowledge more generally diffused amongst our female population the amount of maternal and infantile suffering that might be prevented, no mortal can estimate. Much of the intolerable suffering incident to gestation, and many of the dangers of child-bearing result directly from irregularities and violations of the laws of health in earlier years, and inasmuch as during uterine existence the foetus is wholly dependant upon the maternal secretions for its support, its health must be, to a greater or less extent, influenced by her own. Nay, frequently mothers are required to sit whole days and nights anxiously and pain- fully watching the writhing and agonies of their infants, the cause of which was inherited from themselves, the result of former ignorance and early imprudence. Many, very many, of the female diseases that make existence irksome, and life a burthen, originate in this fruitful source of evil; and how many "long, tedious days" of suffering, both mental and physical, and "wearisome, sleepless nights " of anguish and despair, and unrestrained introductory lecture. 9 exposure to male observation, not unfrequently for the mere gratification of impure curiosity, chilling and revolting to every sense of female refinement, might be avoided, and lives • otherwise doomed to affliction and sorrow, rendered healthful and happy, by imparting proper physi- ological instruction to females. Let the boudoir and the toilet give place to the studio and drawing, and the trashy works of fiction, to the expositions of substantial science; then will begin to dawn the era of better and happier times for poor suffering woman, and thdse engaged in the praise-worthy work, instead of being mere cyphers on the stage of life, will be hailed as the benefactors of their sex and race. Society, in obedience to the great law of progress, is rapidly tending to a radical change in this important particular; woman is beginning to awake to a true sense of her position, and instead of remaining content with being the mere doll and puppet, only designed for the amusement and pleasure of the opposite sex, she is beginning to see that she has highly important duties to perform in the great drama of life, in which not only her own happiness and comfort are involved, but also those of her whole race, and in order to fill this high and holy office agreeably to the great design that instituted it, she is now setting about making the necessary preparations; and as the best and most efficient means of carrying out this great work, the Female Medical College of Pennsylvania was insti- tuted. The instructions given within these walls, will be highly beneficial to every one who attends them; and no female, whether mother, wife, daughter, or sister, who has the leisure and means should fail to avail herself of them. At the head of her family, woman's jurisdiction extends to the hygienic as well as to the domestic regulations of those over whom it is her province to preside; and every one acknowledges the utility of proper qualifications for the latter duty, how much more imperative is the necessity for equal qualifications, at least, for the former, how few are there who assume this honorable and dignified position, that possess a solitary prerequsite, for the important station? To the wife and mother is consigned mainly the guardianship of the health of the household. What higher trust could be dedicated to her ? and what weal or woe'depends upon its faithful or deficient fulfilment ? Were females generally better instructed in the duties pertaining to the sick room, and more familar with the symptoms, causes, and diagnosis of disease, they would be abundantly better prepared to assume the responsible duties universally imposed upon them by the organization of society, viz. taking care of the sick ; it matters but little how skilful or devoted the medical attendants maybe, unless their efforts be seconded by 10 introductory lecture. judicious, intelligent, well qualified assistants, the chance for a favorable termination of a critical case is greatly diminished, and the prospects of a speedy recovery, consequently, vastly lessened. To those, then, who do not desire to make medicine a profession, but would wish to possess a greater amount of medical information than they have hitherto had an opportunity of acquiring, this Institution affords them opportunities never before proffered, and which should not be allowed to go unimproved, whether as a branch of polite education, as an accom- plishment, or a means of rendering its possessor useful in her own family, and the community, where her lot may be cast, the science of medicine as taught in this school, should be made the subject of earnest pursuit. That the exersise of the Itealing art, should be monopolized solely by the male practitioner, as is the case at the present time in this country can be neither sanctioned by humanity, justified by reason, more approv- ed by ordinary intelligence; prejudice, bigotry and selfishness may dispute woman's claim to the high calling, but an enlightened liberty, and intel- ligent sense of justice, never. That woman, from the acuteness of her perception, correctness of her observation, her cautiousness, gentleness, kindness, endurance in emergen- cies, conscientiousness and faithfulness to duty, is not equally, nay, by nature abundantly better qualified for most of the offices of the sick room, than man, very few will venture to contradict, and so far as the manage- ment of the ailments, and peculiar necessities of her own sex, and the disease of children are concerned, woman, by virtue of her superior natural qualifications should be vested with the entire prerogative. The science of obstetrics, in this country and in England, to the dis- grace of the profession, and the shame of man, is almost exclusively in the hands of the male practitioner, and it would require more sagacity and ingenuity than most of them are in possesion of, to adduce one valid reason why this should be the case. From the earliest history of the art, down to 1663, it was practiced by females, almost, if not entirely to the exclusion of the opposite sex, sacred and profane history supplies us with abundant evidence on this point. The distinguished individual, first to make the innovation on the anci- ent, time sanctified custom was "no less a personage, than a court prosti- tute, the Duchess of Villiers, a favorite mistress of Louis XIV. of France,- and the Itero in the disgraceful scene, "the fortunate attendant, "was Julien Clement, who was soon afterwards translated to the "novel and lucrative office of midwife to the princess of France;" "here," says a late writer on the subject of female obstetricians, "then we have the orgin and INTRODUCTORY LECTURE. 11 it is worthy of the corruption and iniquity which have attended its pro- gress." Our females, it appears, are following a fashion first set up by a Parisian concubine one hundred and eighty years ago; and too many physicians seem to have uppermost in their minds the " fortunate attend- ant " and the " lucrative office." It seems that even this " favorite mistress " had some modest scruples, for as Dr. Kendrick remarks, in his Edinburgh Medical Dictionary," she desired it might be kept a profound secret: she sent for Julien Clement, a surgeon of reputation, and he was conducted with the greatest secresy into the house where the lady was, with her head covered with a hood." The same surgeon was employed in subsequent labors of the same lady, and the princesses made use of surgeons on similar occasions : and as soon as it became fashionable, the name of accoucheur was invented to signify that class of surgeons. Foreign countries soon adopted the cus- tom, and likewise the name of accouclieur: for they had no such term in their own language." Professor Davis of London, thinks that ugreat advantages have been realized since the ordinary business of obstetrics has ceased to be a mo- nopoly in the hands of women." In obedience to the universal law of progress, the theory and practice of Midwifery, as well as everthing else, has been developed and improved within the last two centuries. But is it to be inferred, that this advanced state of the art, is attributable to male interference? What evidence has the Professor given us, that the same, nay even greater, and more beneficial results might not have been attained, had the science remained in the possession of its legitimate patrons. While the illustrious names of Madame Boivin, and Madame La Chapelle, names so often referred to, during the past week, stand at the head of this department of medical philosophy, names that men, in their superior wisdom and mighty cunning, are proud to quote and admire, any argument to prove woman's capacity and woman's fitness for all the, high and sacred duties of the puerperal chamber, are vain, and all the twaddle in favor of man's superior fitness, his greater mental and phys- ical abilities, &c. &c, dwindles into the narrowness of unmitigated selfish- ness, or swells into an unwieldy mass of vague absurdities. These names peer high above the customs and selfishness of the times, and stand like beacon lights, amid the dark sea of oppression and outrage, inviting their own sex onward in the cause of usefulness and mercy. But let it be even admitted, that woman was incapable of effecting the great improvements that have been made in the art of obstetrics, does that argue, that she is disqualified from using them for the benefit of her sex? Docs it follow that because man has made improvements in culinary implements, cooking stoves for instance, and kitchen ranges, that woman \'Z INTRODUCTORY LECTURE. is not to use them, the former position is about as preposterous as the latter. " Put woman in possession of all knowledge upon the subject of mid- wifery, and let her use it for the relief of her sex and the good of the race. If woman could manage these matters so exclusively before the dawnings of science, how much more with the light it has afforded. Having, I trust, fully established the fact of the ability of females to practice this highly important art, I now proceed, to notice briefly the propriety and safety of the measure. If there be one appropriate sphere of more consequence than another, within the scope of woman's duty, it is at the bed-side of a suffering sister, at the trying yet deeply interesting period of parturition. "Now, as formerly, woman is most willing to enter and most reluctant to leave the abodes of suffering and sorrow," it has always been her office to ad- minister to the necessities of the afflicted,, and most nobly has she sustained it. It is woman that cheers the drooping spirits, that stays the aching head, and wipes from the brow the "chill dews of death,"—and the privilege should be acceded to her, of presiding over the duties of the parturient room. If there be either meaning or truth in the expression, " female delicacy," then, indeed, is man's superintendence on those occasions highly inap- propriate, indelicate and degrading; for in no position in woman's whole existance are there presented occurrences so sacred to delicacy and refinement as those of the lying-in chamber. If these can be disregarded with impunity, then the door is opened for other improprieties; and cases are not wanting where the impure and unprincipled have been known to gratify the wanton gaze, under the spacious pretext of its being necessary, the attendant himself being the sole judge of the necessity. Were females aware of advantages taken of their sufferings, to practice this and similar impositions upon them, many would risk the issue of their perilous and painful travail, unassisted, rather than submit to the possibility of such outrages upon their feelings and sense of propriety. The safety of the parturient female is doubly enhanced by the atten- dance of a competent medical adviser of her own sex. The shock that is given to every delicate and sensitive female, as the male practitioner enters her room, particularly for the first time, is always attended with more or less mischief; and there is scarcely a teacher that has written or lectured on the subject of obstetrics, that has not lamented the results of this occurrence, unavoidable under the present arrangements of society, amongst whom may be mentioned the distinguished names of a Dewees, a Meigs, and many others. Convulsions, hemorrage, and even a suspen- sion of the process, have resulted from this source, to say nothing of the minor evils attendant upon the unnatural and barbarous custom. INTRODUCTORY LECTURE. 13 Dr. Dewees, in his work on Midwifery, says, that he was once called to attend a lady whose midwife was absent, and the moment he entered the room, her labor pains ceased, and did not re-commence until a fortnight afterwards. He continues; "Every accoucheur has witnessed a tempo- rary suspension of pain on his first appearance in the sick chamber." Who, that has ever experienced the tortures of the tooth-ache, have not been relieved of their pain by the sight of the dentist? The same mental impressions operate on the puerpural patient at the sight of the phy- sician. "The Princess Charlotte, of England^ottng and accomplished, lost her life in confinement with her first child, in 1817. She was attended by the usual parade of royal physicians and distinguished friends, with ministers of state and others assembled in adjoining apartments. ' AH this brought on,' as a medical author writes, ' anxiety of mind and exces- sive fatigue, followed by hemorrage and convulsions, terminating in a fatal syncope, which all their united skill could neither prevent nor cure.' " This event cast a cloud of sorrow over the whole nation—it was the theme of every tongue, and the burthen of every heart. Mr. Hume, member from Scotland, declared, in his place in Parliament, that it was his candid conviction that if she had been spared the useless parade, and attended by a Scotch midwife, she would have been a living woman." It is not an unfrequent occurrenc that the emotions experienced at this moment continue for years; and the patient cannot see her physician without feeling a renewal of the sensations of horror peculiar to the occasion. The extent to which this fearful calamity occurred, in the experience of Madame Boivin, was vastly less, in proportion to the number of cases attended by her, than those that have taken place in the practice of male obstetricians anywhere recorded. This, and various similar instances that might be cited, go directly to show the safety, nay, the decided ad- vantage, in this particular, possessed by the female over male practitioners. But, when we come to take into consideration the immoral tendencies growing out of the practice of initiating males into the privacies of the parturient chamber, compared with these, the most terrific physical evils dwindle into utter insignificance. There could possibly be no means adopted, nor any plan conceived of, better calculated to sap the founda- tion of social and domestic happiness, than the matter under discussion. Accustomed to placing implicit reliance in the sayings and opinions of the physician, when consulted, and believing that a full and unequivocal divulgment of her situation, together with the almost exclusive resigna- tion of herself, as essential to her safety and well-being woman, in 14 INTRODUCTORY LECTURE. the hands of the unprincipled, but apparently virtuous and conscientious practitioner, is too often and too shamefully required to submit to im- positions, (of which she may happily forever remain in ignorance,) revolting to every feeling of delicacy, and repugnant to every sense of female chastity. Those who have had opportunities of hearing the low jeers, the foul slang, and the obscene descriptions given by those who under tbe garb of gentlemen, have been permitted to desecrate the sanc- tity of the lying-in room, will not charge us with speaking thus unadvi- sedly—or hypothetically. But were this all,—were t£ie [unnecessary and unjustifiable- exposures that are too often made, barely for the gratification of an improper curio- sity, or the purposes of shameful and reprehensible experiment, of virtu- ous and respectable, but unsuspecting and confiding females, all we had to complain of,, though disgraceful and degrading as they may be, we might here conclude. But, Ladies, unfortunately for the purity of your sex, and the virtue of ours, this is not all. Repress your indignant emotions while we dwell for a moment, in con- clusion, on tins most unwelcome theme; gladly would we avoid it, did we not in duty owe it to you, and the reform this Institution is deoigned to effect. To remedy any great evil, it requires to be exposed. The mise- ries of the foreign slave trade, and the horrors of the middle passage, might not yet have been corrected, had they not been exposed by a Clark- son and a Wilberforce;—the deep and desolating vice of intemperance might not yet have been arrested, had it not been for the exposures made by the philanthropic labors of the early advocates of the temperance cause. In the capacity of accoucheur and patient there exists the most intimate connexion—second only to that holy relation sanctioned by the matrimo- nial vow—a connexion which is calculated, in an eminent degree, to call into action on the part of the patient, the most sublimated feelings of gra- titude and respect. Where is the woman that has been safely condncted through this trying and painful operation that has not had her heart to swell with the liveliest emotions towards him * ho she esteemed as her be- nefactor and chief friend ? emotions amounting almost to affection. And where is the practitioner that has witnessed the outgushings of unrestrain- ed nature, uttered in tones of thankfulness and exclamations of joy, that has not felt a thrill of response pervade every tissue of his nature, and run through his whole being ? These feelings, to the pure in heart, are right, honorable, ennobling, elevating — but alas ! alas! how often have they been prostituted to the basest of purposes ! Instead of permitting them to pass with the occasion that gave rise to them, how often have they been de- signedly cultivated and fostered on the one hand, and thoughtlessly if not INTRODUCTORY LECTUREt 15 innocently encouraged on the other, until consequences the most disastrous have been the melancholy result ? It is not upon the low, the uneducated, and unrespected alone that this heavy calamity has fallen, but every grade of society,—clergymen, con- gressmen, senators, and obscure private citizens have all felt this wither- ing blight, and been subjects of the unmitigated curse. Could we but turn back the leaves in the annals of crime, the number that would date their origin from this most unnatural relation, would be wholly incredible. However strongly may the female be fortified by chastity, an undimi- nished affection for her husband, by religion and a high sense of propriety, she cannot escape the natural tendency; this very reprehensible custom has towards blunting her moral sensibilities, impairing her high regard for that peculiar delicacy, that makes her character lovely, and degrading herself in her own estimation. But to the honor of the sex be it said, in spite of this barbarous arrangement, the masses maintain their fidelity to virtue and purity, to a most gratifying and ennobling extent. A' late writer ^Count Buffon) has said, " that every situation which produces an internal blush is a real prostitution." This is substantially true, and nothing but an undying constancy, a stern regard for virtue, and a high sense of religious duty, amongst the females of our country, prevent a universal outbreak. The means employed tending to such an occurrence are abundantly sufficient for that end ; and many, alas! very many, who are less supported by these holy influences, become victimized to its de- basing effects. While we would be most reluctant to concede any other than that the profession in general is composed of men possessing a high sense of their moral obligations, and endued with sterling virtue;—who even, like ancient Joseph, turn away from the flaunted charms and proffered caresses of Potiphar's wife, and continue to abide in the consciousness of unsullied purity,—at the same we are called upon to make the melancholy admission, that there are many who hesitate not to induce the ruin of families, and consumate the miseries of husbands, that they may effect their own unholy purposes. Every parturiant female is in danger of encountering one of these, especially if she be required frequently to change her physician. The soul-sickening newspaper reports that daily, almost, meet our view, but too sadly assure us that the foregoing picture is not overdrawn;—the jealousies and contentions, murders and butcheries, that are continually occurring from this cause, (and the equally disgrace- ful and ruinous custom of employing males in the treatment of many of the delicate female diseases,) admonish us to see'k a remedy. 16 INTRODUCTORY LECTURE. Physicians are not superhuman beings endowed with celestial virtues, they are but men, subject to all the frailties of our poor fallen nature, and so long as society continues to place before them temptations to err, to deviate from the path of propriety, community must expeet to endure the results of their own folly. While men are permitted to continue this in- discriminate intercourse with the opposite sex, no reformation can be hoped for, until mankind advances towards a proximity with that primeval purity and innocence enjoyed prior to the invention of fig leaf 'drapery. It affords me no ordinary pleasure to announce to you, that the rem- edy for this evil, under which you have too long, and too patiently suffered, is at hand. Let those of your own sex be thoroughly instructed in the art of obstetrics, and be prepared to encounter any emergency they may meet with. Let this practice go back again into the hands of those who are in every way ""better qualified by nature to exercise it. Then will there be an end to these deplorable occurrences, and peace, and happiness, and contentment will be the result. To this end does the Female Medical College of Pennsylvania appeal to you for support. Let that patronage be bestowed upon it that the importance of the occasion demands ; let it be enabled to send forth its Boivins, and its La Chapelles, to benefit and bless the whole race. Connected with this Institution is a Maternity Charity, to which the pupils will have access, and thereby have opportunities cf acquiring, in ad- dition to their theoretical education, a practical knowledge of this branch of the profession. No other Medical School in this city possess such advantages for acquiring information in clinical obstetrics. In this par- ticular our school presents facilities unrivaled by any sister institution in this Commonwealth—or perhaps in the country—affording a guarantee, all other things being equal, of the superior practical qualifications of those educated within its precincts. Then, in the language of Dr. Morgan, one of the founders of the Univer- sity of Pennsylvania, in an address at the opening of that school, let me say—" Perhaps this medical institution, the first of its kind in America, though small in its beginning, may receive a constant accession of strength, and annually exert new vigor. It may collect a number of pupils, of more than ordinary abilities, and so improve their knowledge as to spread its reputation to distant parts. By sending those abroad duly qualified, or by exciting an emulation among those of parts and literature, it may give birth to other useful institutions of a similar nature, or occasional rise by its example to numerous societies of different kinds, calculated to spread the light of knowledge through the whole American continent wherever inhabited." INTRODUCTORY LECTURE. 17 Ladies ! here conclude the initiatory ceremonies; here terminates the work of introducing you to a course of medical instructions From each chair you have had presented to your consideration the claims of the several branches, constituting a complete course of education in the god- like art of healing. The difficulties that beset your undertaking have been fully represented ; and tfye asperities in your pathway to the temple of fame have been pointed out. You will not, however, find the road all one continuous series of toil and weariness, but it will be gratefully re- trieved by the intervention of pleasure and enjoyment. Roses will be found interspersed among the thistles, und the roughness of the mountain passes will be leveled down to the smoothness of the daisied plain. This Institution which has been called into existence for your exclusive advantage, is now in your hands. The gentlemanly President, William J. Mullen, Esq., assisted by an energetic and efficient Board of Trustees, has displayed great liberality in arranging and preparing this building for your comfort and convenience. The Faculty have thrown themselves into your cause at no inconsiderable pecuniary and personal sacrifice, and it now remains for you to say whether they shall be sustained or not. Shall the Female Medical College of Pennsylvania, upon which is resting the anxious gaze of an admiring world, be doomed to death and annihilation, now in the first days of its being, or shall it succeed. Shall it be enabled, by a timely and generous support, to survive, this its first struggles for life, and by a gradual and speedy development of its latent powers, become a Hercules in strength, defying the combined efforts of its enemies to crush it? Or, like the majestic oak, shall it strike its roots deep in our soil, and rear its towering trunk heaven-wards, scorning alike the angry blasts that whirl about it, and the violence of the rushing tornado, but gracefully bowing before the gentle zephyrs of prosperity, humanely invite the sick and the suffering to repose beneath the shade of its wide-spread branches ? Do the women of Pennsylvania, of America, duly appreciate the relation in which they stand to this magnificent enterprize ? Can they realize the vastness of the project? Have they yet become impressed with the great truth—that in this Institution is the germ of their emancipation from mental bondage and physical suffering? Do they see here thrown open wide before the portals of the Temple of Medical Science, into which woman is destined to enter, and stand side by side, on terms of perfect equality, with the great, the wise, and the learned of the world ? If their minds have not yet become cognizant of these great realities, I desire, then, to impress it upon them, that such are but sublime facts. Here is your position;—herein consists your future destiny;—here your future glory, and that of your posterity forever. Will you accept or reject them ? If you elect the former, then gather around us, with your influence and support—strengthen our hands—aid us in our struggle for your redemption and elevation, and millions yet unborn will rise up and call you blessed! AI^IPIIIMSL When the foregoing thoughts were penned and uttered, the feelings of the speaker, were nothing but those of good faith towards, and confidence in the virtue, honor and moral integrity of the profession generally, while the propriety and safety of employ- ing female midwives, were advocated upon general principles, the strictures on the conduct of some male practitioners, were only designed for those to whom they were especially applied, viz., to the unprincipled, licentious, and consequently immoral, and ev*ry one is free to admit that, unfortunately, the profession is not clear of such. But, from the manner in which the sentiments and views expressed in the discourse have been received by many of the profession, it is presumptive, at least, that the evils complained of, are much more extensive than was at first apprehended. The truth of the aphorism, " a guilty conscience, wants no accuser," seems in this instance to be fully verified, as many members of the profession who have been informed of the views held by the lecturer, are assiduously engaged in applying the strictures to their own individual cases, and then with the hardicraft of conscience-stricken felons, are most loud an d lusty in denying their guilt, and at the same time heaping anathemas and invectives on the lecturer and the Institution with which he is connected. The infection seems to have spread with amazing rapidity, as every class of the profession, from the unfledged bantling, to the full combed gradnsire furnish representatives of the con- tagion, and aiders and abettors in the frightful clamor. There are, however, many worthy exceptions, who unannoyed by a reproving con- science, and possessed of a becoming liberality, present a mighty prophylatic shield, invulnerable to any miasmiata with which they may be surrounded. These have our most profound regard and esteem. With these we are willing to labor side by side in the great cause of science, for the amelioration of human suffering. The Female Medical College of Pennsylvania while it slept in embryo excited neither the interest, envy nor ridicule of the profession. But since it has been brought into active existence, and taken its place by the side of its sister institutions, in the city and country ; based upon a Legislative Act inferior to none ; supported by a Trusteeship of twenty-four of the most reputable citizens of the City and State; supplied with a Faculty capable of vieing in intellect and moral character with the best; and furnished with a class highly respectable in point of ability, character and numbers; it is made the target at which the bigotry and selfishness of the profession hurl their venom with unmeasured profusion. So dastardly are they in their attacks, that they hesitate not, secretly, to plot the destruction of private reputation, and attempt to immolate at once, talent, virtue, and character, on the altars of their miserable inquisition. A gentleman connected with the school, who occupied a respectable pesition as a public teaeher, before he entered it, whose life is unspotted, and whose character without 20 APPENDIX. a stain was secretly, without his knowledge or consent, proposed as a candidate for mem- bership in one of the oldest and perhaps strongest medical associations in the city, for no other conceivable purpose than to wreak upon him their black ball vengeance, and thereby blast his professional reputation, and render his name odious, as being a fit subject for rejection by their very respectable Medical Society. And to show still further the baseness of the transaction, afler their stock of black balls had become exhausted, a very moral gentleman, quite as much'celebrated on account of the huge Bcucephalus he rides, as for any extraordinary intellectual ability, amused himself by rolling up paper-balls to supply the deficiency, thus thrusting the dagger still deeper into the bleeding wounds of the unconscious victim of their fiendish malignity. What unmitigated meanness? What low-life cowardice? The midnight clan, that sendi forth the incendiary with the burning torch is less to be contemned than such a conclave. This, then, being the spirit entertained against the institution, and such the means employed to crush it—and those connected with it—we appeal to the public, and to the female public especially, to stand by and sustain us. It is for your benefit that the Institution has been established; it is in your cause we are laboring. Give us, then, your patronage, your countenance, your sympathies,—we stand in need of them alh Our conflict is the few against the many—the weak against the mighty. But, not- withstanding the terrible odds, the victory is sure—the conquest certain. It is not the present, but the prospect of the future, that arrays against us these interested multi- tudes—these powerful lines of contending forces. Did they see no danger, in the future, pending against their " craft," they would give themselves but little concern about it. They foresee its ultimate success, and appreciate their future position, hence their present antagonism. Like the Bhrine-makers and worshippers at the Ephesian temple, " they rise up to secure their craft." The contest will be severe but short. Were our enterprize a small thing, with small pretensions, it would be treated as such. Our opponents perceive in it a germ of future greatness; they believe that it can be more easily crushed now, than when it shall have arrived at the maturity of its fully developed strength; hence the cowardly and dishonorable means to overthrow it. Already has it been invidiously assaulted by a portion (a contemptible portion) of the medical press, and such other means resorted to, to effect its ruin, as are worthy of the object in view, and those employing them. For the especial benefit of those who are impressed with the belief that the lecturer stands alone, in regard to the views entertained and expressed in the discourse, and that they are not sustained by facts, relative to the physical evils and immoral tendencies of employing male midwives, the following authentic extracts from legitimate sources are respectfully submitted. Those under the head of Physical Evils are principally the result of officiousness, not likely to be indulged in by the female obstetrician, on account of a natural abhorrence to scenes of butchery and blood. And here again most emphatically we aver, that it is not, in the smallest degree, eur intention or wish to cast reproach upon the profession ; as such, we have for the last sixteen years enjoyed, at least, a respectable share of its honors and emolnments; and we would be the last, now, to be engaged in the ungrateful work of degrading it in public estimation. It is with a view of exposing to the public the ignorance, baseness, and moral depravity of its unworthy members, be they few or many, that they may be driven from their position, and their places filled by those whose physical, mental and moral capabilities pre-eminently qualify them for shedding lustre upon the profession, that we APPENDIX. 21 still persist in the measures we have taken. The following are but a few of the cases that have been recorded. They are, however, sufficient to show that the evils complained of exist to an alarming extent all over the land. A sufficient number of instances, of egre- grious blunders, heartless butcheries, and imprudent conduct, might be collected, in and about this city alone—the great medical emporium of the nation—to make up a list of disgust, horror and shame of incredible length—but we forbear, for the present, bringing to light more than has already been divulged. " A word to the wise is sufficient." PHYSICAL EVItS. A case related by Dr. Channing, Professor of Midwifery in the Medical Department of Harvard University: " I was called to a case of arm presentation in the country. Three physicians had successively abandoned the woman; but the fourth, poor fellow! was still in attendance, and almost worn out. One of the physicians, as I was informed, had cut away the right shoulder; another the left shoulder; and a third the collar bone. She expressed a wish not to be handled any further, and said she was anxious to die. I found the womb quiet, because it had been worn out, and knew that after a sufficient interval of rest it would begin to contract.* This very soon took place, and in a short time after my arrival the child was delivered." The most ignorant old colored woman from a Carolina plantation could have cut off an arm or two and left the case. No well instructed female midwife was ever guilty of such an outrage. " In 1839, Dr. Septimus Hunter, of New York, was sentenced to one year in the *J penitentiary, for causing the death of a woman in childbirth. This physician of more than eight years practice, in attempting to remove the placenta, mistook and tore away the uterus." " A doctor in New Hampshire attended a woman. She having given birth to one child, the accoucheur kept her in position for several hours, and continued to apply snow to her abdomen, as he said, to "make her bring forth another;" declaring she had twins. But his wonderful science and obstetric skill were of no avail; for that could not be brought forth which had not been conceived." A similar case occurred within the writer's own knowledge. A woman was delivered of a fine large boy, when the accoucher, with a face as grave as a sage, assured the attendant that " there was another," and accordingly commenced his explorations, and continued them for the space of half an hour, to the great distress of his patient. But his searches were vain—the other did not appear at that time, nor to him ever. This was a graduate of one of the leading schools of Philadelphia. From the Boston Medical and Surgical Journal.—Mrs. C, aged 35, slight form and delicate constitution, was taken in labor, with her second child, on the morning of the 10th of March, 1845. Nothing occurred up to the thirtieth hour to mar the anticipations of the expectant husband, or interfere with the delectable anxiety of the old ladies to behold the arrival of the young stranger. The mouth of the uterus had been tardy in dilating, and at this period its efforts began to flag. Forty hours had now elapsed with but little progress of the head. Ladies will talk in a lying-in chamber, and with little provocation lash themselves into a high state of excitement. It was soon whispered that something must be wrong ; side winds were thrown out at the doctor, until the patient became alarmed and the doctor nervous. All action of the uterus had now ceased. The doctor being asked " what was the matter," replied that 22 APPENDIX. the head was too large, and that something must be done, the woman being feeble, and not able to stand it long. A consultation was proposed and agreed to. Will you, sir, credit the result of this consultation ? It was deliberately and cooly proposed to destroy the child, and deliver it piecemeal, as the only means of saving the mother. The question next arose, how should they accomplish this ? for instruments neither possessed, and to send for another counsel would be a loss of time, and repugnant to their judgment. And now, Mr. Editor, what do you think these men of science agreed upon as the best weapon wherewith to destroy the child ? "Arcades ambo! " Tell it not in Gath; whisper it not in the streets of Askelon ! A "jack-knife" was the tool selected ! Yes, and they resorted to the barn to sharpen it on a grindstone, and then proceeded to insert the blade into the cranium of the child. After a few ineffectual efforts, the operator made a sudden plunge, and, believing he had penetrated the skull, o-ave the knife a rotary movement, and withdrew it, to think what was next best. While pausing to concentrate their murderous efforts, unexpectedly the uterus con- tracted steadily and forcibly, and the head of the child came into the world, followed in quick succession by the shoulders and body, to the utter discomfiture of the doctors. But the worst feature of the tragedy was not yet over. In their confusion to hide their disgrace, they left the cllild to its fate, who soon eked out its brief existence, from a wound in the right temporal region; the "jack-knife" having glided off the skull without penetrating, and divided a branch of the temporal artery. Very respectfully, N. MOORE. " Moral.—Beware of jack knives, and of some men-midwives; particularly the latter, for then there would be no danger from the former." S. GREGORY, A. M. " I would advise such to practice butchery rather than midwifery, for in that case they could sell what they slay." DR. MAUBRAY. From Female Midwifery Advocated.—Extract from a Lecture by Gunning S. Bod- ford, A. M., M. D., Professor of Midwifery and the Diseases of Women and Children, in the University of New York, to his class of Medical Students, November 1, 1845 : " Allow me, in the most solemn and emphatic manner, to caution you against an error which, unfortunately for suffering humanity and the honor of our profession, has too generally prevailed. I allude to the indiscriminate and unpardonable use of instru- ments in the practice of Midwifery. If the grave could speak, how fearful would be its revelations on this topic! How monstrous the guilt of those who revel in innocent blood ! No more than six weeks since I was visited by a medical gentleman, who had been in practice but a short period; and, in the course of conversation, the subject of operative midwifery was introduced; and he observed to mc that he had enjoyed the best opportunities for becoming familiar with the use of instruments, for his preceptor had performed the operation of embryotomy* on an average sixteen times a year. To you, gentlemen, an announcement of this character may appear a romance, but 1 have myself seen in this city scenes of blood sufficient to satisfy my mind that this is not an exaggerated picture; and I will take the liberty of citing one case, among several others now fresh in my memory, to show you that I do not speak without cause when I protest against the unholy acts of men who were intended neither by Heaven nor nature to assume the sacred duties of the lying-in chamber." The Professor proceeds to relate a case of " atrocious butchery" too thrilling and horrid here to mention. The two " operative" accoucheurs had cut up the child and * A division of the foetus into fragments, to extract it by piecemeal. APPENDIX. 23 removed it, excepting the head, which was yet undelivered. They had ruptured the uterus, and partly disemboweled the woman. When Dr. Bedford arrived, the perspi- ration of death was on her. " In her agonies," he says. " she supplicated me to save her, and said, with a feeling that none but a mother can cherish, that she was willing to undergo any additional suffering if she could only be spared to her children!" After narrating the case, the doctor proceeds. " The question may now be asked— Why was embryotomy had recourse to in this case ? I never could ascertain. There must have been some secret reason for it—the burning love, perhaps, which some men have for bloody deeds. There was no deformity of the pelvis; the head of the fetus was of the usual size, and as far as I could learn it was an ordinary labor." The terms Forceps, Blunt-Hook, Crotchet, and Perforator, are as familiar in the profession as house-hold words; and many physicians conceive their stock of office furniture incomplete, until they are supplied with a case of obstetrical instruments, many of which are but implements of torture and death. And a frequent exhibition of them, with a due degree of learned parade, is often resorted to as a means of creating in impression, in the minds of the astonished beholders, of the superior skill of their possessor. And with those who depend more upon their burnished instruments, than their judgment and learning, for acquiring business and reputation, it not unfrequently occurs that the sufferings of their patient, perhaps enhanced by their manual interfe- rence, and the alarm of husband and friends, created by their knavish manoeuvers, are seized upon as suitable occasions for manifesting their skill in the use of their high prized, and but too often, agencies of destruction, employed without the least earthly necessity. That every physician engaged in the practice of midwifery should be fully prepared, with all the means that art and science are capable of furnishing for the preservation of life, and the relief of the suffering, we are free to admit. But, at the same time, we hold that a knowledge when to use them not, is, at least, equally necessary to the safety of the patient; and a disposition to act, only when that knowledge prompts—is as essential as either—means or knowledge—all three are of equal importance— and it is difficult to say, in the absence of which, the danger, in a case of emergency would be most in- hanced. Ignorance or knavery, directs the use of these instruments far more frequently than necessity. The operation of Embryotomy, according to Velpeau, is only " indicated when the foetus is dead, or oa the point of dying, and the passages are too much contracted to permit its extraction with the forceps or by turning." Now to show how extremely rare is the necessity for the operation, in the experience of a female practitioner, I make another quotation from the same author. He says, " out of a total of more than twenty thousand labors Madame La Chapelle has indicated only three instances," making one in every six thousand six hundred and sixty-six. Dr. Collins, of Dublin, performed em- bryotomy in seventy-nine out of sixteen thousand four hundred and fourteen, making one in every two hundred and seven. By this showing, so far as it goes, and all similar data agrees with it, we have two very important points established. 1. A necessity for the murderous operation seldom occurs in the lifetime of one individual in ordinary practice. 2. That the safety of both mother and child is greatly enhanced when left to the care of a competent female obstetrician. Dr. Dewees, late of this city, in his " System of Midwifery," says, in confirmation of the first point, " I believe that the united experience of all the American practitioners would not have led to a correct conclusion on this subject; as the occurrence of deformity of the pelvis is so very rare as never lo have been encountered by some practitioners of pretty extensive experience. As far us regards my own, I must declare, I have not met with extreme deformity in American women three times in my life." THE FORCEPS. The design of this instrument is to afford assistance in difficult labors without injuring the mother or mutilating the child ; and, on account of its comparative harmlessness, and an inordinate thirst for glory on the part of some members of the profession, its use has become entirely too familiar, especi- ally in the hands of a portion of the younger part of the practitionersf>f our country lu their ardor 24 APPENDIX. forecte* they forget or disregard the excellent rule laid down by Velpeau, viz: "The forceps ought never to be applied without an evident necessity, because, although it might not be mischievous to the child, the mothermay receive the greatest injury from it." Now, how often does this " evident necessity" occur ? Dr. Collins, page 10, tells us that during his mastership of the Dublin Lying-in Hospital, " 16,414 deliveries the forceps was used only 24 times and the lever 3 times, making 27 cases in all, or one case in 608 deliveries,"—and this too in a country celebrated for deformed pelvis. Again, we find in Merriman's Synoptical Table, that out of 1,800 cases 1746 might have terminated spontaneously " without any assistance either manual or instru- mental." Of the 20,357 labors that took place at the Maternite, at Paris, from 1797 to the end of 1811, 20,183 were natural, leaving, out of that immense number, but 274 requiring arristance. Madame La Chapelle, in her new tables, divides the labors that have fallen under her notice into two periods, the first extending to the 31st December, 1811, comprises 15,662 cases, of which 15,380 were spontaneous and 272 difficult; the second, from the 1st January, 1812, to 31st December, 1820, comprises 22,243 labors, of which 21,074 terminated without any artificial assistance and 269 by the assistance of art. If our accoucheurs observed the rule just quoted, and it is the only one that should govern their actions in the employment of obstetrical instruments of any kind, their forceps would rust in their drawers for want of use—for we seldom find an individual whose private practice affords him 21,974 cases of midwifery in a professional life of 30 years, which would make 732 cases hi a year, and over 2 per day. Where is the accoucheur in this country who has enjoyed a practice to half that amount, that has not in the given time used, instruments one hundred times,—that is if he possesses them ? and if so, the rule given by Velpeau, and approved by every judicious modern author who has written on the subject, must have been most shamefully and wickedly violated. Then, we repeat, let this practice go back into the hands of females, duly qualified, by nature and education, for all the high and responsible duties pertaining to it. Then, like a La Chapelle, may they preside over parturient ceremonies of thousands upon thousands of their fellow beings, prepared by learning and skill to assist if " evident necessity" occur, but otherwise to remain a passive observer of this interesting portion of Nature's own handiwork. THE OIUIORAE TENDENCY. In endeavoring to sustain the allusion made in the lecture, relative to the immoral tendencies of em ploying men-midwives, I first present the testimony of Thomas Ewell, M. D., Of Virginia; " Honorary Member of the Philadelphia Medical Society, and former Surgeon in the Navy Hospital, Washington City." Dr. Ewell was a learned physician, of thirty years' practice, and of high standing in the estimation of the profession. In his "Letters to Ladies, detailing Important Information concerning Themselves and Infants," published in Philadelphia, in the Introduction to the work, he speaks and argues as follows: " The serious object of my present solicitude is, to wrest the practice of midwifery from the hands of men and transfer it to women, as it was in the beginning and ever should be. I have seldom felt a more ardent desire to succeed in any undertaking, because I view the present practice of calling on men, in ordinary births, as a source of serious evils to childbearing; as an imposition upon the credu- lity of woman, and upon the fears of their husbands; as a means of sacrificing delicacy, and conso quently virtue; and as a robbery of many good women of their proper employment and support. " Truly it shows as extraordinary a revolution in practice as any afforded by a survey of all the arts. That all females bring forth their young without assistance except the human in a state of civilization ; and that women should call for the assistance of men, while the human species is the only one tor- mented by jealousy, is a fact that will scarcely be credited in a Turkish Harem, or by the Christians of some future and purer age. Should the strangers to the practice inquire if our men have large, unwieldy hands, great curiosity about women ; should they ask if our females had the requisites for useful services—small hands, nice sense of touch, and patience in attendance—they will absolutely deny this monstrous perversion of nature. " From the peaceful and retired occupations of women, they are generally more numerous in the community than men.* Nevertheless, the men have assumed several offices properly belonging to the weaker sex. Th2 natural consequence is, that many women, as men in similar circumstances, wanting * According to the census of 1840, there are in New England 15,000 more females than males. APPENDIX. 25 ;>roper occupation, seek the employment of the vicious. Inasmuch, therefore, ns these men-midwives have meddled with this proper business of women, they have been instrumental in the depravity of uiany. Indeed, it is owing to their acting where they are not required, that female practitioners are rften so ignorant—not having the opportunity or means to qualify themselves for attendance on ladies. L' Several observing moralists have remarked that the practice of employing men-midwives has increased the corruption among married women. Even among the French, so prone to set aside the ceremonies between the sexes, the immorality of such exposures has been noticed. In an anecdote of Voltaire, H is related that when a gentleman boast >d to him of the birth of a son, he asked who assisted at the delivery; to the answer, ' A man-midwife,' he replied, ' Then you are traveling the road to cuckoldom.' The acutely-observing historian of nature, Count Buffon, (on puberty,) observes, ' Vir- ginity is a moral quality, a virtue which cannot exist but with purity of heart. In the submission of women to the unnecessary examinations of physicians, exposing the secrets of nature, it is forgotten that every indecency of this kind is a violent attack against chastity; that every situation which causes an internal blush is a real prostitution.' " It is very certain, where these exposures have been most numerous, as in large cities, there adultery has been most frequent. " Be it folly or prejudice, or not, there is a value in the belief, that the husband's hands alone are to have access to his sacred wife. Break through the prejudice, if you please to call it so, but for once, unless powerful reasons command it, the Rubicon is passed; and rely upon it, the barriers, on future emergencies, will not be so insuperable. Time and opportunity to press on a grateful heart, for A favor in regions where magnified favors have been conferred, have been used and more frequently desired. To convince you of this, you will not require me to enter into the secret history of adultery. " Many of the.-: modest-looking doctors, inflamed with the thoughts of the well-shaped bodies of the women they have delivered, handled, hung over for hours, secretly glorying in the privilege, have to their patients, as priests to their penitents, pressed for accommodation, and driven to adultery and malness, where they were thought most innocently occupied. In one case, I was well assured that a physician in Charleston, infuriated with the sight of the woman he had just delivered, leaped into her bed before she was restored to a state of nature. The melancholy tale of the seduction of the wife of a member of Congress from Carolina, by b£r accoucheur, is a warning that ought not to be disregarded. The beautiful organization pf the lady preyed upon his mind for years ; he sought her from one to the other extremity of the country, regrrdless of all dangers ; and on acquiring his game received a prema- ture death—leaving horror and ruin in the family he had been hired to serve. " Whatever you niay think on this subject, there are many husbands to whom the idea of their wives' exposure is horribly distressing. I have heard of cases affording singular mixtures of the dis- tressing with the ludicrous. In one case in my neighborhood, the husband sent for his physician to his wife in labor, yet was so strongly excited at the idea of her exposure, that he very solemnly declared to the doctor, that if he touchsd his wife, or looked at her. he would demolish him! No man possessed of a correct and delicate regard for his wife, would subject her to any exposure to a doctor, that could be avoided without danger, " But the opposition, the detestation of this practice cannot be so great in any husband as among some women. The idea of it has driven some to convulsions and derangement; and every one of the least delicacy feels deeply humiliated at the exposure. Many of them, while in labor, have been so shocked by the entrance of a man into their apartment, as to have all their pains banished. Others, to the very last of their senses suffering the severest torment, have rejected the assistance of men. To be instrumental in relieving one of this truly interesting cast, will be a heavenly consolation to all who can be alive to the pleasures of serving the virtuous. " If all other considerations united cannot induce you to attend to this subject, the mechanical advantage between a man's and delicate woman's hand, ought to command your decision in favor of employing and encouraging female assistants. Such is the confined organization of the parts for our birth, and such the large size of man's hands, that I verily believe as much mischief as good has been deni by them, as has been stated by more extensive observers than myself. "The rule that I would prescribe to the females for whom I felt the most affection and solicitude, would be this: On no account submit to the interference of men in common labor; do it most readily in the uncommon cases, when a midwife under the direction of a physician cannot afford relief I will venture to add, that there is not a physician, disinterested, of sound sense, who would not approve of the rule. The best authors on midwifery decidedly recommend it." 26 APPENDIX. Such views, from such a source, are certainly entitled to respect; and the candid, disinterested manner in which they are given should enlist for them the confidence of the community. But, as regards the rule laid down in the last paragraph, while it is entirely applicable to the present condition of society, and indispensible in the present state of obstetrical knowledge amongst female midwives— it will be rendered of no account, so far as the graduates of the Female Medical College, of Pcnusyl vania, are concerned—as their opportunities of acquiring correct theoretical knowledge are equal to those of- any other class of medical students in this city, and their means of attaining practical informa tion, as afforded by the Philadelphia Lying-in Asylum, are superior to any in the country. So that, instead of their calling on the male practitioner, the latter, no doubt, will find it to his advantage, as well as the good of his patients, to take council of the former. When did a Boiven or a La Chapelle consult with a male obstetrician on account of bis superior knowledge ? Report of the Trial " The People vs. Dr. Horatio M. Loomis,for Libel." Tried at the Erie County Oyer and Terminer, June 24rA, 1850, etc., etc. Justice Mullett; John Treahor and Leander J. Roberts, Associate Justices. Reported by Frederick T. Parsons, Stenographer. Buffalo, 1850. 8«o.; pp. 50. Such is the title of a pamphlet which has recently passed under the review of a writer in the American Journal of Medical Science, No. XL, New Series, for Qctobcr, 1850. The reviewer appears over the signature of " V. M." Whoever " C. M." may be, the noble sentiments he expresses, in condemnation of the act that gave rise to the trial, do honor to both bis head and heart; and were there more such champions to be found, willing to throw themselves, and the weight of their professional, moral, and social influence, into the cause of outraged woman, and become the volunteer defenders of her safety, her chastity, her feelings, and her morals, against the strongly organized and chartered defamer of her sex; then, indeed, might our profession justly claim the highest title of " dignified ;"'—then might it soon be rendcred,god-like, a condition most ardently to be desired -by every friend of humanity. The reviewer gives the following as the fact of the case, collected from the testimonv adduced by the witnesses on the triai. " It appears that the professor (Dr. Loomis) supposed he had discovered that it was possible, by stethoscopic exploration of the abdomen of the pregnant female, to determine before hand the probable presentation of the child, at the time of parturition. To verify this discovery, he induced Mary Watson, an unmarried female, pregnant the second time, to submit first to this explo- ration by some, if not all, of the members of the graduating. elass under his direction. From the position in which the pulsations of the .foetal heart were heard the most plainly, the professor decided and so announced to the class that the presentation was one describ- ed as -occiput to the right posteriorly, face left anteriorly.' When the time for delivery arrived, the same woman was brought into a room in the college building, where she was fixed comfortably for her confinement, under the care of the wife of the janitor, who was to act as her nurse. The gentlemen who had previously made the stetho- scopic exploration, were now again summoned to be present during the labor, and one by one were permitted to make the usual vaginal examinations. How often during the several hours of labor this was done by each we are not told. ■> Certainly, unless so frequently repeated by the whole body, as very materially to annoy the woman, and interrupt the regular course of labor, but little knowledge could have been derived by each. If the progress was reported by the professor, or one of their number, they could derive no personal benefit from their presence in the chamber. .Be this as it may, however, one great error appears to have been committed in this stage of the procedure. We were taught, by one esteemed throughout the civilized world as no second rate master of his art, that such a presentation is faulty, and should be remedied, in the APPENDIX. 27 early stage, by bringing the occiput into such a position as would permit it to emerge under the arch of the pubis, while the face followed the curvature of the sacram. In the ardor of the professor for the new mode of diagnosis, he omitted this first duty of the accoucheur, and permitted the life of both mother and child to be put in jeopardy, through the necessary tediousness of the delivery by this false position. During nil this time, however, the claims of modesty were regarded, the students maintained a , proper decorum, and the woman lay covered on the bed. When, however, the head was about emerging, the clothing was so far removed as to permit the exhibition of the application of support to the perineum, and the manner in which the head issued was precisely such as had been foretold. She was again covered, the cord tied, the placenta delivered, and the class dismissed. The woman appears as a witness in the case, and testifies that she recovered well, and has no complaint to allege of indecorous treatment, exposure or improper treatment. This we believe to be a plain, honest narrative of the events as they occurred, and we protest against every stage of the pro- ceeding, and shall presently endeavor to justify our objections." This is not the only case of useless and unjustifiable ocular exposure. It is too frequently indulged in, in private practice. It is related of an old practitioner in New England, " famous in midwifery, that used to go joking into the lying-in chamber, and throw the lady's dress over her head with the utmost good humor." The remarks of very pretty woman—beautiful figure—;fine person—elegantly developed limbs—symmetry of form, and other significant expressions from some physicians relative to those whom they have attended in confinement, are evidence that they have allowed their wanton vision to luxuriate on objects sacred to others, whose own virtuous lives, and correct principles, oppose even the suspicion of deception and guilt on the part of those to whom they consign the lives and safety of the dearest objects of their earthly affections, at this delicate and trying period. And furthermore, the endeavor is being made by some schools to introduce the "ocular demonstra- tion" system, as an improvement on the old method of teaching obstetrics—the " manipulations with the machine and mannikin" are considered insufficient, compared with " laying the patient upon her posteriors upon a table, with the person entirely exposed." This plan is approved of by the Professor of Obstetrics in the College of Physicians and Surgeons, of the city of New York, and was given a* part of his evidence in the above case. He further avers, that he " approves of' ocular demonstration' in obstetrics applied to the living female, and would be glad to see it established in his college to morrow." The same professor says, " It is often necessary, to turn the child in the uterus. In turning the foetus it has been his practice to expose the woman entirely. Does not recollect of ever taking but three of his students with him on such occasions. Would have no objections to students being present- not at all. Would prefer it if practicable. On such occasions the woman is exposed, so far as clothes are concerned, entirely." The fact of this system of teaching having been actually introduced in the Buffalo sceool, cannot be denied in view of the above case. But this practice, and the opinions, views. and practice too, of the New York professor, are only, in keeping with the hint given by Dr. Gooch, of London, in his work on Midwifery, third American edition, wherein he says, " We can examine patients in humble life as we please, but-those in higher sjations require a little ceremony." The observations of the reviewer, in reference to the case on which he writes are equally applicable to the entire subject, let the circumstances occur where.they may. He says: " We coincide in one thing only with 'the witnesses for the prosecution; and that is in the opinion that such an exhibition could,havn no effect in inciting '-libidinous emotions.' We cannot conceive of the degree of degradation in which suchra result would be produced, by the spectacle of the hour of nature's extremity. This would, however, be buta, short-s»ghted view of the premises. The unne- cessary exposure of those-parts of our frame which have derived-their common appellation from the natural instinct which prompts their concealment, ehocks the moral sensibility, diminishes the moral feeling, and debates the moral man." The learned reviewer here proceeds at length to show, not only the entire uselessness of sight in the discharge of duty upon these occasions, but its positive disadvantage to both practitioner and patient. If this, then, be the case, and most unquestionably it is, what can prompt such a scheme but a desire to cater to a morbid, sexual inclination ? If " the spectacle of the hour of nature's extremity 28 APPENDIX. may not incite " libidinous emotions." the occasion affords an opportunity for taking liberties, favorable to the contracting of an intimacy, that may endanger the patient's virtue, niul gratify a "libidinous' cl:sire in aftertime. This view of the case is neither original nor isolated, but it is sustained by the opinions of many excellent physicians, and supported by a number of well authenticated facts. When " the moral sensibilitiesb .come shocked, the moral feelings diminished, and the moral man degraded," what better can be expected, than the legitimate effect of a familiarity with such scenes. We protest against the whole system of "Male Midwifery" from the first to the Inst, as being de sight, the handling, and sometimes the fondling, of men, for hours together, as there is in being taught Anatomy and Physiology in a proper dignified manner. The former graceful practice onr delicate opposers follow themselves, and recommend to their daughters, while they almost " go off" in holy horror at the bare thought of man instructing woman in the nature of her being, and laws that Gop has ordained to be known and obeyed—or heavy penalties inflicted. But she must not know herself— she must not listen to instructions relative to her own formation and the laws that govern it. But it is perfecUy consistent with purity, delicacy and propriety to take up woman, part by part, and exhibit her, and demonstrate her every organ, before a class of four or five hundred young men and boys- many of them yet in their teens. Oh! that is exceedingly proper, that can be tolerated. It matters not how impure, how obscene, how vulgar, bow morally depraved, many of the recipient* of this kind of knowledge may be, it is all right. And our fastidious opposer says—nay, proclaims amen to the act—Well, verily! " where ignorance is Miss " indeed " it in folly to be wise!" FEMALE a t I OF PENNSYLVANIA Session ol' rt A [ Dinea.«es r.r \\ • ■ ' .ilititi; Surgery: ^i ^B ('hcmistrv and (l: I The refill r . , -e n\' ].t i-.'iirrs ill t1 September 1st, I-".;. -1 - »I e,.e,mil|e h.u; I.m,I'll. The I.." r 1 n ■ ■ ......u Anatoli Feme ii nl \I. > ,,!.■., Theory tui.i PupiN uill !■■■ : ■ r l' , v have . cannot receive tie «i i I!, -e nut, The n.nr-e ,' three yi'.n -- ■•< ' ■ must t» i,. iui< It, of'u rf.--|" <■'■ hie i>r;i The raiuiulute, .'it th !,, , thesis, written upon hou' i,; Jfl or German, which will in all < y~*' The or nhiation fee v. 1,1 hi •• v: i,'-r nam'. ..-:. 1), -jr.. - will h. <■■ ill soon ..- jT..i ti>. .hi fiffl The lees in this <',,h ■- :^' To each Profe*- ,r-,,;, ?,.^ Matriculation lit, pn I Graduation . The acrvimniorlnlii the I'nioi.. Good 1 The 1 ; .' T v. ,;: '