An essay to instruct women how to protect themselves in a state of pregnancy: ... also, some observations on the treatment of children, which ... may ward off dangerous diseases, ... By Mrs. Wright, ...

AN ESSAY &c.

SECTION I. On the Diseases of early Pregnancy.

THIS Section may deserve the attention of women who are constitutionally afflicted with troublesome complaints in the first months of preg∣nancy. The most common symptoms of breeding are, sickness, loathing, vomiting, giddiness, drowsi∣ness, heartburn, diarrhoea, a painful fulness of the breasts, nervous fits, faintings, &c. If the patient is healthy, or of a full habit, it may be useful for her to let blood repeatedly, in small quantities, not exceeding six or seven ounces at a time, especially if the sickness is attended with flushings, parched mouth, or any other feverish symptoms; larger evacuations are not safe. The bowels in such cases ought to be kept soluble by ripe fruits, cooling diet, magnesia, cream of tartar whey, soluble tar∣tar,

manna, or such gentle things, and yet more advantageously by oily or emollient clysters; an useful domestic injection may be made in a few minutes thus:—Take of strained gruel, about three quarters of a pint, brown sugar, one ounce, Castile soap, half an ounce, salad oil, two ounces; this, or something like it, may be thrown up occasionally. If frights or falls have done harm, the same treatment is recommended. When vomiting is troublesome, I have frequently known this symptom carried off by drinking chamomile tea, or giving two or three grains of ipeca∣cuanha, to cause a discharge of the offending matter from the stomach. It may be remembered, as a general rule, that all strong or violent remedies are hurtful, therefore, we caution against antimonials, mercurials, cathartics, jalap, aloes, or even rhubarb, because it often causes griping pains. When ner∣vous complaints come on, the most effectual relief may be obtained from gentle opiates. If the pa∣tient is delicate or weak, bleeding may do harm; but an invigorating diet in small quantities, and a little pure old wine, taken from time to time, may be useful. Much more may be said to make up a

book; if more is wanted, we recommend the advice of an experienced physician; let it be remembered, I do not propose to trouble my readers with a large volume; my intention is only to give useful hints in a shilling pamphlet; it is not necessary to say more on this part, but come in course to our Second Section.

SECTION II. On the Diseases of advanced Pregnancy.

THE diseases of advanced pregnancy ought to be well understood by every midwife; for if ill treated, may be attended with the worst consequences. As pregnancy advances, the uterus increases in size, and presses more and more heavily on the bowels, by which their important functions are impaired, the circulation of the blood, and the nervous in∣fluence, are materially obstructed, what wonder then if disagreeable effects often come from such causes?

Let us now mention some of the complaints that take place, and the best means of removing them. When the gravid uterus rises higher up into the abdomen, in the fifth, sixth, or seventh month of pregnancy, then commonly commences the com∣plaints of advanced pregnancy, such as colics, cramps, hysteric fits, pains in the back, difficulty of breathing, oedematous or watery swelling of the

legs, &c. vomitings, convulsions, difficulty or sup∣pression of urine, micturition, haemorrhoids, varicous swellings in the veins of the legs, besides some others we shall not mention. If colic torments the patient, let her have the intestines moderately emptied by gentle laxatives, lubricating clysters, or blood∣letting, according to circumstances, in case she is strong or feverish, and costiveness ought to be guarded against. If cramps are frequent, the same treatment may be useful; if they are slight, we have frequently known walking barefooted on the cold floor to give speedy relief; when more uneasy, the following liniment will afford case: take of tincture of opium, one ounce, of camphorated spirit of wine, six drams, oil of amber, two drams, spirit of ammonia, four drams, mix them, and let some of it be well rubbed occasionally on the parts affected. If piles are painful, the body must be kept open as above, but we recommend castor oil, if not offensive, for this purpose, one or two spoonsful is a moderate dose; if the haemorrhoids are very un∣easy, we recommend strongly the following mixture and ointment: take of balsam capivi, two drams, mucilage of gum arabic, one ounce, tincture of

columbo root, one ounce, simple cinnamon water, two ounces, sirup of ginger, one ounce, mix them and give a desert spoonful thrice a day. The oint∣ment may be depended on: take of gall nuts in fine powder, one ounce, pure verdigrise powdered, two drams, hog's lard, two ounces, mix them to make an ointment, which may be applied to the swelled parts occasionally. When great difficulty of breathing attacks the patient, great relief may be procured from bleedings, and keeping the body soluble. When a dropsy of the whole body, called anasarca, comes on, it may proceed from laxity, and ought if possible to be removed, without loss of time; we have little experience of this complaint, it seldom occurs, yet we have heard much, but we believe that a strengthening and warm stimulating diet is useful, with generous wine, but spirits, watery meats, or fluids, are hurtful; after a safe delivery, much may be done. If the fluor albus comes on, the same mode of treatment as in the dropsy may be recommended.

The oedematous, or watery swellings of the lower extremities, seldom come from the same cause as the

general dropsy, but entirely from the presture of the gravid uterus, and though they are of little im∣portance, yet it may be proper to diminish them, by bleeding, laxatives, a spare opening diet, friction, and a horizontal posture. If the patient is weakly, cordials and a comfortable diet may be useful. Delivery contributes more than any thing to the cure. When varicous or distended swellings of the veins become large and painful, they may be made easier, by taking away occasionally small quantities of blood from the arm, and keeping the body open, because they come from the pressure of the gravid uterus. The best application to the parts is a styptic or astringent water, which a venerable physi∣cian of great experience assures me is often very useful in varicous dilatations: take of blue vitriol and alum, of each three ounces, of water, two pints, boil them till the salts are dissolved, then filter the liquor, and add one ounce and a half of the vitriolic acid, and two drams of pure or refined verdigrise, lay on the swelled veins compresses of linen, and bind them on with a tightish roller, and keep these compresses constantly moist with this solution.

We have strongly recommended the frequent use of injections, to keep the body soluble, and if we could persuade those for whom this little Essay is intended, to use the self-syringe with their own hands, without any assistant, it might prevent the trouble of taking medicines, it would be less un∣easy, less painful, less expensive, or disagreeable, at the same time more delicate; but these are not all the advantages, a syringe throws the clyster farther up than any other contrivance into the colon or great gut, where all the obstructed matter is de∣tained, by the pressure of the distended uterus on the os sacrum or rump bone.

We earnestly recommend the introduction of the self-syringe into every house, for the use of those who have complaints in their bowels, about the anus, or are troubled with costiveness. They may be purchased in every considerable pewterer's shop. I have been told, and I believe it implicitly, that there are many persons of both sexes, who with some hesitation took these machines into their houses, that now they understand how to use them, they would not part with them on any consideration.

SECTION III. The Qualities necessary in an Accoucheur and an Accoucheuse.

HERE we will offer a few remarks on the quali∣fications necessary for an accoucheur, or rather let me describe the sort of accoucheur I would recom∣mend. A man-midwife ought to be not younger than forty, not talkative, possessing much sagacity and prudence, naturally modest, benevolent and humane; in short, a gentleman, and withal have the reputation of being well educated. A midwife ought to be turned of thirty, clean, and neat in her person, pleasant in her manners, gentle, at∣tentive, and kind to her patients, by supporting their spirits in distress, civil to servants, but no∣thing of a gossip, healthy and active, never taking snuff, fond of children, skilful and tender in handling new born infants, capable and ready to teach awkward nurses how to dress or clean them, qualified to write safe and useful prescriptions for a morbid mother, or an ailing child; she ought

to be a woman that hath been well instructed, that hath had much practice, not conceited, nor proud, nor vain, nor superstitious, but firm in her mind, plain, discreet, and honest; a sincere friend in every family, always disposed to call in to her assistance a physician, or an experienced accoucheur, whenever there is any necessity, or even a distant desire of some kind relation, for this will raise her reputation, prevent reflections, and demonstrate her discretion.

The fashion of latter years hath taken the practice of midwifery almost entirely out of the hands of women, and placed it into those of the men, and the reasons for it were obvious. Formerly every conceited gossiping woman that chose to act as a midwife, began this profession, without instruction, I had almost said without common sense, or any one requisite for such an important employment, and many notorious evils ensued. Then the physicians and surgeons, being men skilled in physiology, rescued many unfortunate patients from the fangs of igno∣rant women, and it becoming a lucrative branch of business, they kept it snug, till a numerous body in

the inferior departments, desiring to share the pro∣fits, came forth, like a hord of hungry untaught men, from the labours of the pestle and mortar, with a few hooks, forceps and crotchets, in a bag, like Dr. Slop, they call themselves accoucheurs, or men-midwives, but for obstetric knowledge, we have seen some of them as ignorant as messengers of the contents of their dispatches, yet some of these men have arrived at eminence, or rather have ac∣quired extensive practice and fortunes, but in cases of difficulty, they are as awkward as any of the most ignorant female practitioners. Women often em∣ploy men to act as midwives, from a supposition that they must know more than the women mid-wives; but this, like many other suppositions, may frequently have no real foundation in truth.

SECTION IV.

LET us attempt to remark the difference betwixt the Accoucheur and the Midwife.

Comparison of an Accoucheur with a Midwife.

I.

I.

The adroit accoucheur is a person that can foresee and often prevent all the evils of difficult labours, with as little hurry or un∣necessary delay as possible, and to assist, can sometimes use the forceps, or other instruments contrived to re∣move the obstructions to delivery.

The instructed accou∣cheuse is one who is not ignorant of all the natural or preternatural causes of danger that can happen, nor of the means of removing them, yet never useth any artificial instrument; but in preternatural cases, when patience and the hopes of parturition are lost in fruit∣less endeavours, before it is too late, she calls in an approved accoucheur, to assist her. N. B. It is a certain truth, that instruments, the catheter excepted, are very seldom wanted, perhaps sel∣domer than they are used.

II.	II.
The uninstructed accou∣cheur is commonly in too great a hurry to exhibit his dexterity in using his iron instruments, and thereby often doth mischief, it would be horrible to relate. ☞ The most intelligent of the faculty seldom or ne∣ver use instruments.	The ignorant midwife knows not when to assist or to leave the business to nature; so blunders on, till sometimes both mother and infant are lost, where there was in reality no danger.
III.	III.
The accoucheur in great practice cannot in lingering labours afford to lose so much of his time in waiting for slow operations of na∣ture, therefore hurries on delivery, or leaves the pa∣tient till he can call again, when he can find time, par∣ticularly if his patient is not opulent.	The accoucheuse can sit more patiently among fe∣males in a lying-in room, where she is looked up to every moment for assistance; she can better sooth impa∣tience, by recalling hope; she can more properly con∣tinue in the room constantly, and delicately give direc∣tions about what is neces∣sary, so is not so easily tired out with attendance.

IV.	IV.
The accomplished ac∣coucheur hath a more ge∣neral and liberal knowledge of things, by his study in physiology. All the parts of animal bodies are known to him, and he can reason better on cause and effect, than women who have amused themselves with fashions, dress, taste, or ap∣pearance; but such men I have observed are soon fa∣tigued with the conversa∣tions of us poor women.	The sensible and saga∣cious midwife may make herself more agreeable, though she is less learned; and as to her necessary knowledge in anatomy, she may learn it and all the technical terms in a few months; learning is not difficult to those who love study, but knowledge is only useful when we possess sagacity or sense to apply it properly. We have all seen learned fools.
V.	V.
Men in high practice seldom know how to handle new born children; they often touch them with dis∣like, as they would toads or young snakes. What is then to be done when the nurse is awkward, or at a loss how to manage the infant, which is too fre∣quently the case?	Women have commonly a great superiority over men in the care of infants, it is more in their province, and a sensible midwife thinks she should qualify herself for every adverse accident that may happen. In this respect women are prefera∣ble to men.

Seme Reasons offered why Women are preferable to Men as Midwives.

There are many women who cannot converse easily or freely with a man, on many circumstances that happen about the time of parturition, or even on some sexual disorders, this may be called false mo∣desty, but still it exists and causes many evils; here we suppose skilful women might be more agree∣able and useful. One of the first physicians in the city, who I believe to be my friend, said to me one day, lately, that if clever women would dili∣gently study to accomplish themselves in midwifery, he would wish for the sake of propriety, and the good of mankind, that this profession was again restored to female hands. It is the opinion of many learned physicians, that the advantages to the sex are small, if any, by the over grown number of male practitioners, at the same time, they are clearly of opinion, that a number of eminent accoucheurs should be selected and appointed to give advice both to ordinary men and women midwives in difficult and preternatural cases. It is fortunate for us, few, very few parturient females, not one in

many hundreds, need be under the necessity of calling in an accoucheur. Indeed, the numbers of women who are delivered with little assistance, may convince us how much nature acteth in these cases for our advantage. In the obstetric art, as well as in other branches of the science of healing, it might be better if we could wait patiently, and would humbly rate ourselves as the handmaids of nature. Premature practitioners, are apt, like the philoso∣pher in Rasselas, to suppose they can govern the na∣tural course of things, but after a few trials, they must find out their incapacity; a little modesty and common sense, may point out their errors, but con∣ceited young men and ignorant women are seldom easily reclaimed from forwardness, therefore, pru∣dence ought to induce us to have recourse when we can, to intelligent practitioners.

SECTION V. On the Care of Children.

INFANTS often suffer much from the carelessness, ignorance, or officiousness of nurses; to prevent this, it is the duty of an intelligent midwife to cast a careful eye over their conduct, a little conscientious pains ought to be bestowed upon it; cleanliness is a most important article, the infant ought to be washed twice a day in lukewarm water; it is the constant custom in the South of Europe, even in summer, for if perspiration or any other excrementi∣tious matter is left on their tender skins, it will soon become acrid, cause inflammation, excoriation, and consequently much uneasiness; this is not writ∣ten from a fine spun theory, but is the result of ex∣perience. We are of opinion, that washing of ten∣der infants in lukewarm water, is greatly preferable to cold water, and that the theory of relaxation is here more imaginary than real, and that experience confirms this doctrine. If from neglect, the skin of infants becomes inflamed or excoriated, let the

parts be well washed, and made dry, then dust on a little powdered white lead from a muslin cloth, this is simple but effectual, but let the cerussa, or powder of lead, be removed so as not to go near their victuals.

An intelligent midwife that hath as much, perhaps more experience, and I believe hath had better opportunities of instruction, than any other in this city, from the repetition of lectures, hath emphatically desired me to mention, in my pamphlet, that if infants are kept dry and clean, their tempers and dispositions will be more plea∣sant; they will seldom be liable to rickets, or any of those disorders that affect the bones, so as to cause bandy legs, &c. and that when female in∣fants are neglected in these articles, the bones of the pelvis, or lowest part of the body, are often softened and diminished in their natural capacity, so as when adults, the distorted pelvis cannot admit a child to pass easily, and from thence proceedeth the reason for inventing of so many iron instruments to faciliate difficult labours, and to give occasion to bold operators to try their hands; moreover, this gentlewoman adds, that if it were not for the

neglect of cleanliness in infancy, many men and women would be stronger in their loins, better pro∣portioned in their limbs, more healthy, and move more gracefully, but above all, there would be rarely any cause to call in even the prudent and experienced accoucher to assist in parturition; let me add, that these observations are confirmed by the opinions of practical men, whose judgments are not apocryphal. An attention to this doctrine can never do harm, and nurses, who conscientiously discharge their duty, deserve rewards and friendship.

It sometimes happens, that wet nurses have not enough of milk for their nurselings, and make up their food with bread, tapioca, or Indian arrow root, and the common milk of this town; we be∣lieve, that in general, beef tea, mutton or veal broth, mixed with them, is preferable. Infants are liable to acidity in the stomach and guts, which often occasions griping, purging, &c. a little magnesia given occasionally is the best domestic re∣medy. If costiveness at any time comes on, a little manna, or, when very young, a few tea-spoonsful of equal parts of fresh oil of almonds and syrup of

violets, repeated occasionally, is a safe and useful laxative. If vomiting from foul matter in the sto∣mach is troublesome, one or two grains of the pow∣der of ipecacuan may be given as an emetic, with safety, and sometimes, two or three tea spoonsful of wine, and some warm water, by way of assisting the evacuation, will answer the purpose; if more is wanted, the best way is to apply soon for proper advice.

In childrens diseases, much may be done by li∣beral well informed women; in diseases of the bow∣els, diarrhoea, or flux of the belly, vomitings, worms, hooping coughs, &c. rational women may be more in the way of examining their evacuations, and prying into particular complaints, and naturally attend more to their disorder, than either the learned physician, or the skilful apothecary, whose longest visits last only a few minutes, and then are told the symptoms and circumstances by some indistinct at∣tendant, that knows less than she pretends to do; thus a child is often lost in the hands of able men. Even, when children are ill in the small-pox, measles, fever, fits, &c. they are often totally trusted

to the care of very ignorant, pretending old women, who know as little of these disorders, as I do of the French Directory, or the Irish Rebellion. Would it not be better, to find out some intelligent person, who can and will give attention to them? It is true, some do recover in spite of bad treatment, but, if they die, are not the parents blameable for over∣looking so important a concern? If some women can be found fit for all the important duties of a midwife, and of giving sound advice in sexual disorders, or in those of children, why hesitate to employ them? Are women by nature incapable of instruction, or are they deficient in sagacity to be useful? Custom or fashion govern the world, and often deprives us of that judgment, or common sense, that would be more advantageous to society. Let it not be supposed, I wish to reject the advice of able men, far from it, I wish only to demonstrate that women may be capable of being very useful in sexual disorders, as well as in those of children; it seems to me as if nature had allotted this part of the healing art to females, because we have better opportunities of investigating the real state of the illness, and if benevolently assisted by sagacious physicians, might save many lives.

There hath been some conjectures agitated among men of no mean consideration, false or true, I leave to others to determine; they have supposed, since women of all ranks, gave themselves up to men∣midwives, they have lost much of that delicacy, which before rendered them so amiable, and in losing delicacy, say they, may not chastity itself be easily violated? If we lose possession of either, or both, what are we? Others suppose, since that period, more elopements, trials for crim. con. divorces, pri∣vate intrigues among married women, have been com∣mon, and that we have acquired more of a mascu∣line swing in our gait. Some men of gallantry have not scrupled to say, that women who employ men∣midwives, are in general, an easier prey than those who do not. It is step by step, or slow advances, that women commonly arrive at vice, just so, do thoughtless boys become cruel, by being suffered to torment birds, beasts, reptiles, insects, &c. by and by, they lose every feeling of humanity, and can murder men without horror. If we could but be cautious to defend ourselves against the approach of all impropriety, the ladies of Britain would be as superior in virtue as they are in beauty. 〈…〉〈…〉

A comparative Review of Male and Female Temperaments.

Females, when young, may at least claim equal esteem with their brothers, the lords of creation, for filial affection, and all the virtues of parental obedience; as wives, men of great observation have given testimony in their writings, that we are by no means inferior to our husbands in conjugal duties.

As mothers, I have still the testimony of men, that we are full as tender and careful of our chil∣dren as their fathers are; as mistresses of fami∣lies, are we not equally economical, as kind to our servants, and benevolent to the poor? Authors of the most eminent abilities, after a comparative review of both sexes, have candidly declared, upon the whole, we are by no means inferior, or rather we are superior, in acting our parts in all the con∣cerns of life. All these commendations we can re∣ceive with conscious pride, while we merit them, but when we part with delicacy or modesty, alas! how are we fallen! even, like a flower after it is cropt, soon loseth all its sweetness, and is cast like a loathsome weed away. I wish my amiable readers

may consider here what I have said, both in a moral, and a religious point of view; it can do them no harm, and if the thinking part of men can also agree with me, it may be an object worthy of their atten∣tion, to lessen, or do away one of the greatest causes of our misfortunes and unhappiness.

I could wish that female education was more so∣licitously attended to. When young, we often have a bad education, which is worse than none; so by imitation, from bad examples, of ease, free∣dom, fashion, grace, &c. insensibly we lose the elegant sweetness of female delicacy and reserve. I am always happy to see young ladies exhibit ex∣cellence in the dance, to hear the charms of music from their well-toned instruments, or transported by the melting sounds of the voice, and to behold their taste in drawing; but I am sometimes sorry to find, that these accomplished young ladies are ignorant of the grammar of their own language, that they are deficient in understanding the first principles of virtue, and that they have had no instruction on the holy scriptures; the first of these two last, may shew them the beauty and felicity of moral conduct, and

the second, the eternal bliss, that is promised us, in studying the laws of our Almighty Cre∣ator, or Redeemer; and I will venture to assure my fair readers, that by studying carefully these sacred laws, so as to practise them as strictly as possible, they will find continually that satisfaction in their minds, that will give cheerfulness to their features, that will beautify their beauty; besides, if the day of adversity should overtake us, the consciousness of having done our duty, will feel to afflicted minds as a source of celestial consolation.

I am a mother myself, and it is on these prin∣ciples I endeavour to instruct my children. If I dared, as a female writer, I would venture to re∣commend to young ladies of fashion, some attention to history, geography, botany, natural history, mo∣ral and natural philosophy, &c. these might occupy any blank in their minds, and make them capa∣ble to carry on agreeable conversations on any sub∣ject; this would make them admired by all their ac∣quaintances, and adored by their husbands, it would render their actions more graceful, and their beauty more pleasing; it would make religion more rational, by opening their eyés to the power and goodness of the Almighty in all his works.