of members of the medical profession, and more especially of surgeons, in the practice of midwifery, and after the middle of the 17th century they began to publish the records of their experiences in special treatises. The most important of these writers were French—as Mauriceau, Viardel, Paul Portal, Peu and Dionis. The work of Mauriceau, which first appeared in 1668, is specially interesting from its having been translated into English in 1672 by Hugh Chamberlen, who in his preface made the then incredible statement that his father, his brothers, and himself had long attained to and practised a way to deliver women in difficult labours without hooks, where other artists used them, and without prejudice to mother or child. Many years had still to elapse before the secret of the Chamberlens leaked out. In the course of this century some women who had large experience in midwifery appeared as authors. Thus in England Jane Sharp in 1671 wrote The Midwives’ Book, or the whole art of Midwifery discovered; in Germany, Justine Siegemund, in 1690, Die Chur-Brandenburgische Hoff-Wehrmutter; and earlier and better than either, in France, Louise Bourgeois in 1626 published Observations sur la stérilité et maladies des femmes. Perhaps they were beginning to feel that there was some need to assert their power, for it was during this century that parturient ladies began to call in men to attend them in natural labours. According to Astruc, Madame de la Vallière wished her confinement to be kept secret, and Louis XIV., in June 1663, sent for Jules Clement, the court surgeon, to superintend the delivery. This was accomplished successfully. The king gave him the title of accoucheur. Clement afterwards attended the dauphiness and other court ladies, and went thrice to Madrid to assist at the confinement of the queen of Philip IV. Up till this epoch physicians and surgeons had only been summoned to the lying-in room by midwives who found themselves at the end of their resources, to give help in difficult cases where the child was usually dead and the mother often moribund. Now that it began to be a fashion for women in their ordinary confinements to be under the surveillance of a physician, it became possible for men with their scientific training to study the normal phenomena of natural labour, and through the medium of the printing-press to communicate the results of their observation and experience to their professional brethren. Hence the books of the men already referred to, and of others that appeared later, such as the Traité complet des accouchement of De la Motte, 1721, which is a storehouse of acute observations and wise discussion of obstetric measures. In other countries than France physicians and surgeons began to take up midwifery as a speciality and not as a subsidiary part of their practice, of which they were somewhat ashamed (le Bon, one of the writers whose work is found in Bauhin’s Gynaecia, says: “Haec ars viros dedecet”), and it was in Holland that a work was produced that has earned for its author the designation of the Father of Modern Midwifery. Heinrich van Deventer, who practised as an obstetrician at the Hague along with his wife (a Vroedvrow, as he was a Vroedmeester), published in 1696 a preliminary treatise called Dageraat (Aurora) der Vroedvrowen, and in 1701 he followed it up by a more complete second volume, of which the Latin edition that came out simultaneously with the Dutch has a title beginning Operationes Chirurgicae Novum Lumen Exhibentes Obstetricantibus. It has the supreme value of being the first work to give a scientific description of the pelvis, and to take some steps towards the development of the mechanism of labour. The “obstetricantes” for whom Deventer wrote are both men and women. In the early part of the 18th century women had still the main and often the sole charge of their parturient sisters; but the practice of having a doctor to superintend or to supersede the midwives kept spreading among the classes who could afford to pay the doctor’s fee; and by the time Deventer’s treatise was doing its educational work in an English translation, as The Art of Midwifery Improved, in 1716, the doctors were getting into their hands the “harmless forceps” with which a living child could be extracted without detriment to the mother, in conditions where formerly her child’s life was sacrificed and her own endangered. This life-saving instrument was invented in London, but by a man not of English birth. The Huguenot, William Chamberlen, fled from Paris to escape the St Bartholomew massacres, carrying with him to Southampton his wife, his two sons, and a daughter. William Chamberlen seems to have been a surgeon, and his descendants through four generations had large and lucrative practices in London. The eldest son Peter, who was old enough when he came to England to be able to attest the birth and baptism of a younger brother, is, on good grounds, credited with being the inventor of the forceps, which for a century was kept a secret among brothers, sons and grandsons. Hugh, indeed, a great-grandson of William, and the translator of Mauriceau, had offered to sell the family secret for 10,000 crowns; but his failure to effect delivery in a test case that Mauriceau put to him led the profession to believe that he was a boastful quack. Palfyn of Ghent, when in Paris in 1723, putting a work on anatomy through the press, laid before the Academy of Science a pair of forceps, which was figured in Heister’s surgery in 1724. He has thus the honour of first laying before the profession a midwifery forceps. But his implement was ill-constructed, and never came into general use. Meanwhile the knowledge that the Chamberlens were really possessed of a serviceable instrument must have stimulated other practitioners. Perhaps a colleague with a keen eye may have got sight of it on some occasion, or an intelligent midwife had been able to describe the “tongs” which she had seen one of the family apply. In 1734 Dr Edward Hody published a record of Cases in Midwifery that had been written by Mr William Giffard, “surgeon and man-midwife.” The dates range from January 1724 to 1731. Amongst the cases are several where he effected the delivery by means of the forceps—“extractor,” he calls it—of which a figure is given; and when Edmund Chapman, who practised first at Halstead and afterwards in London, published his Treatise on the Improvement of Midwifery in 1733, he speaks of the use of the forceps as “now well known to all the principal men of the profession both in town and country.”
In the course of the 18th century the development of midwifery in the hands of medical men made greater strides than in all the preceding ages. The progress was accelerated by the establishment of chairs of midwifery in the universities of various countries, Edinburgh taking the lead in the appointment of a professor in 1726, and Strassburg coming closely after in 1728. In Strassburg the chair had the advantage of being at once associated with a clinical service. Lecturing was carried out, moreover, by men who were devoting themselves as specialists in midwifery and the diseases of women and infants, and were succeeding in developing lying-in institutions for the benefit of poor women in labour that became schools of instruction both for midwifery nurses and for medical students. Two new operations came during this epoch to enhance the powers of the obstetrician, viz. symphysiotomy, first introduced by Sigault in Paris; and the induction of premature labour, first carried out by Macauley in London in circumstances described by Denman in the preface to his Midwifery. William Hunter in London, Sir Fielding Ould in Dublin, Röderer in Göttingen, Camper in Amsterdam, Baudelocque in Paris, Saxtorph in Copenhagen, and many other authors contributed to progress by their atlases and their books. But there are three whose names stand out pre-eminently because of the influence they exerted on the whole obstetric world—Levret, Smellie and Boër. Kilian, in his vidimus of the history of midwifery, calls Levret “one of the greatest masters in the department that ever lived.” Of Smellie he says: “Inferior to Levret in nothing, he excels him in much.” Boër he characterizes as “the most meritorious and important of German obstetricians.” Levret improved the construction of the forceps, and widened the sphere of their applicability; Smellie worked in the same direction, and furnished, moreover, descriptions and illustrations of natural and morbid labours that are of classical value; and Boër first clearly placed pregnancy (which Mauriceau, e.g. had spoken of as “a nine months' disease ”) and parturition in the category of physiological processes that might be hindered rather than
