'MIDWIFERY strictly signifies the art of delivering WO MLI1 ; but it is now universally understood to include also the ph) siology and pathology of the pregnant and puerperal states, and a knowledge of the management of infants and children, both in health and disease.
The tern), in the English language, is derived from the two Saxon words signifying mead and wife, the mid wife being the woman who got a present or gift for ac complishing the delivery. The old Scotch term for midwife is howdie, supposed to be derived from the Saxon word signifying childbirth.
French name their midwives, from their reputed skill, sages femmes ; whilst the art itself is styled, from the confinement of the patient, L'art des ?ccouchemens. In all ages, and in every country, the practice has been generally in the hands of females; and both in ancient and modern language the appellation of the practitioner is always feminine, with the exception of the French term accoucheur.
By the Roman law, midwives were recognised as a distinct class in society, and partook of certain immu ties and advantages in common with medical practition ers. At the present time, in several continental coun tries, no one can practise midwifery without a license ; but in Britain it is otherwise, as every one who chooses to run the risk incurred by common law for the fruits of ignorance, may practise as a midwife. With regard to accoucheurs, they stand in this peculiar state, that they sometimes are considered as belonging to medicine, and sometimes to surgery. With the exception of a tem porary measure adopted by the College of Physicians in London, no public body has issued distinct licenses to male practitioners In some German universities, it is explicitly attached to the united degree of doctor of medicine and surgery. In others, it seems indifferently to belong to the doctor of medicine or master of sur gery. In the university of Glasgow, the only one in Britain which confers surgical degrees, the right to practise midwifery is included in the degree of magister chirurgim.
Historical Sketch of the Progress of Midwifery.
It would be quite impossible, in a work of this kind, to trace the history of midwifery minutely through every individual who has written on the subject, from Hippo crates downwards. Even to a medical reader, this would be more a matter of curiosity than utility. It ap pears from the early writers whose works we possess, that in natural labour the patient was placed on a parti cular kind of seat or and the process of delivery conducted altogether by the midwife, who, we may pre sume, from little being said of her duty, had no very difficult office to perform. It was only in cases of pro
tracted labour, or in those where the child could not be born, either on account of its position, or size compared with the pelvis, that the male practitioner was called ; and at this place it may be observed, that Paulus iEgi neta, in the 7th century, seems to be the first who was styled a man midwife. The practice adopted in such cases, no doubt varied a little at different times, and io different hands; but the general principles of conduct were not much diversified, and may be learned by con sulting the works of Etius, Albucasis, and Avicenna. In tedious labour, the effect of concussion was some times tried to promote delivety; but it was more com mon to employ means for producing relocation, such as emollient applications, and even the warni bath. B.00d letting, so useful in many cases of tedious labour, was strongly recommended by Hippocrates; and it is much to be regretted, that his authority in this respect has been so long slighted by the moderns. Those, on the other hand, who seemed to be too much enfeebled, were or dered to he sprinkled with vinegar, or to sit over va pours supposed to have a strengthening quality.
In preternatural positions, the presentation was either pushed back, and the head male to come forward ; or, the protruding member was twisted off, and the child pulled away piecemeal. When the head was large, or the pelvis small, various modes were adopted. The head, by some, was pushed back, if not impacted, and the child turned, so as to allow the practitioner to de liver by the feet. This continued long to be the re source in all cases where it was practicable, as there was thus a possihility of saving the child. Btu if the obstacle were considerable, the infant always perished, and, in many cases, the body was actually torn away from the head. This accident in aftertimes gave rise to different contrivances for extricating the head which thus remained in the uterus. Other practitioners, at a very early date, endeavoured to deliver the child by fixing a fillet or band around the head, thereby becom ing able to pull it down. In a greater number of in stances, however, they accomplished delivery by open ing the head, or fixing a hook or crotchet into it, or squeezing it in forceps furnished with teeth.