An address to British females on the moral management of pregnancy and labour, and some cursory observations on medical deportment
Date: 2024-03-19T00:00:00+00:00
Keywords: Obstetrics; Baillie; Matthew; 1761-1823; Charlotte Augusta; Princess of Great Britain; 1796-1817 -- Death and burial; Labor (Obstetrics); Pregnancy -- Complications; Prenatal care; Croft; Richard; Sir; 1762-1818; Sims; John; 1749-1831

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Title: An address to British females on the moral management of pregnancy and labour, and some cursory observations on medical deportment

Suggested by the death of Her Royal Highness Princess Charlotte Augusta of Wales: with a vindication of Her Royal Highness's physicians, Sir Richard Croft, Dr. Baillie, and Dr. Sims

Author: William Cooke

Release date: March 19, 2024 [eBook #73208]

Language: English

Original publication: United Kingdom: E. Cox and Son, 1817

Credits: Jamie Brydone-Jack, Carol Brown and the Online Distributed Proofreading Team at https://www.pgdp.net (This file was produced from images generously made available by The Internet Archive)

*** START OF THE PROJECT GUTENBERG EBOOK AN ADDRESS TO BRITISH FEMALES ON THE MORAL MANAGEMENT OF PREGNANCY AND LABOUR, AND SOME CURSORY OBSERVATIONS ON MEDICAL DEPORTMENT ***

AN ADDRESS

TO

BRITISH FEMALES

ON

THE MORAL MANAGEMENT

OF

PREGNANCY AND LABOUR,

AND SOME CURSORY

OBSERVATIONS ON MEDICAL DEPORTMENT.

SUGGESTED BY

The Death

OF HER ROYAL HIGHNESS PRINCESS

CHARLOTTE AUGUSTA OF WALES.

WITH
A VINDICATION
OF
HER ROYAL HIGHNESS’S PHYSICIANS,

SIR RICHARD CROFT,
DR. BAILLIE, AND DR. SIMS.

Author William Cooke

By WILLIAM COOKE,

SURGEON-ACCOUCHEUR.

“To enjoy Happiness is a great blessing:—to confer it, a greater.”

LONDON:
PRINTED FOR E. COX AND SON,
ST. THOMAS’S STREET, BOROUGH.

1817.

J. M‘Creery, Printer,
Black-Horse-Court, London.

ADVERTISEMENT.

From the first intimation of the death of Her Royal Highness Princess Charlotte, the general sensation heightened daily, till the climax was completed on the melancholy day of interment. Within this interim it was scarcely possible, without a surreptitious effort, either to speak or think on any other topic.

The prevalence of this acute sensibility—the daily intelligence of consecutive evils—and the relief obtained by fixing the attention on some specific object, gave origin to this pamphlet.

Whatever belongs to moral agency, as well as to the preceptive and practical portions, is the result of previous observation; and for them the Author solicits no other concession than is due to the circumscription of his plan. The style and arrangement he is aware are exceptionable. He pleads in extenuation that the address is extemporaneous:—suggested by a high degree of social feeling with his interesting countrywomen, and under circumstances that forbade the delay which much emendation would have occasioned.

Should it be imagined that the specification of certain incongruities is too severe, the Author solicits credence for an assurance that he has exclusively referred to the excrescence and not the character. There is not an individual in the world whom he has intended to deride.

The vindication he has offered in the sequel is totally disinterested; the persons referred to are entirely unknown to him.

The term Moral prefixed to this Address, may appear disingenuous.—Much difficulty arose in fixing on a single appellation which should embrace a distinguished feature in the address, and yet contra-distinguish it from one purely medical.

Should any hint he has dropt prove useful in quieting unwarrantable fear, or in establishing more safe and happy arrangements in child-birth, or in conducing to a more generous and comprehensive treatment of female diseases or diseases in general, the Author will be most amply recompensed.

Great Prescot-Street,
Nov. 24, 1817.

AN ADDRESS.

There is not an event within the recollection of the British nation, which has called forth more universal and unfeigned sorrow than the death of Her Royal Highness the Princess Charlotte Augusta of Wales.

The earliest indications of her character,[1] as well as its progressive developement, concurred to mark a strong and independent mind; yet did she also afford a striking example of the compatibility of a cultivated mind and uncontrolled judgment, with that purely feminine delicacy of manner, which designates the sex, and constitutes one of its peculiar excellences. Although she occupied a station which denied the accustomed facilities of appreciating human excellence, yet the agreement of testimony, passing through diverse channels, fully authenticates the inference, that she was not merely elevated by royal ancestry, but was distinguished by superiority of natural faculties and intellectual attainments, and by a decided attachment to the Protestant religion. Nevertheless she did not degenerate into masculine habits—a degeneracy, which not unfrequently renders unamiable, a female enriched with uncommon mental endowments.

Having chosen retirement, with her excellent consort, His Serene Highness Prince Leopold, we had probably long been ignorant of the prospective blessings which awaited our favoured land, had it not pleased Him who regulates the world by his providence, to transplant her hence, at a time the most unexpected, and in a manner the most interesting. At this moment her virtues shine with an almost overwhelming lustre; and whilst every eye fixes itself on her pre-eminent station, and the imagination brings to the present hour future years of sorrow, we hear an almost consentaneous exclamation—the Hope of England is departed!

Deeply participating, however, as we do in the general grief for the death of an amiable Princess, and sympathizing with the sorrowful illustrious family, it is not within our province to eulogize the deceased, nor can we hope to console the surviving relatives; yet there is one class of mourners that demands commiseration, and whose claims will be more particularly directed to the practitioners of medicine.

If it be within the department of a medical practitioner to soothe the afflictions of mankind, unquestionably a large portion of his attention and kindness is demanded at the present time. Whilst almost every occupation is more or less suspended, as a tribute to departed excellence, and as a token of loyal sympathy, it would be disreputable to a profession, so important to the welfare of mankind, to withhold its share in the general emotion.

The public feeling of sorrow is honorable to the British nation, and illustrates the superior sensibility and the moral pre-eminence derived from the diffusion of Christian principles. Where these principles are adopted and diffused, men cannot circumscribe within their own bosoms, or within the bosom of their families, those sources of pleasure or grief which the Creator has bestowed indiscriminately. We ought to participate in each other’s pleasures, and to sympathize is mutual sorrow.

Duties often devolve on a practitioner of surgery, which demand the control of his feelings; and this has elicited the popular charge, that sensations, common to the rest of mankind, are to him unknown. Surely we are traduced—and on an occasion like this it will neither be thought unphilosophical, nor unworthy the attention of a scientific mind, to incline itself to an event which has agitated the country, and which especially fills the bosom of every female in the land.

Collectively, it is impracticable to exhibit their interest on the occasion, but as individuals there is an important niche which they, and none else can occupy. It would neither be wise nor honorable to extinguish sensibility, nor to suppress the salutary eloquence of social grief; but to counteract the indulgence of excessive passion, and to guard against the fruitful evils to which there is a consequent and perpetual tendency, is perfectly consistent both with wisdom and honor; and a prompt and generous effort to accomplish purposes so desirable, must be a pleasing tribute to the illustrious House, by whose afflictions these passions have been created.

It redounds to the credit of the clergy, not only in the established church, but equally of all denominations, that the mournful event has been observed in the most obvious and impressive manner, and their office been made subservient to the condolence and moral improvement of society. Yet is there one class of persons, most interesting from their sex, from their condition in life, and from their extraordinary participation in the event, owing to peculiar circumstantials of coincidence, which, though accessible to the ordinary means of consolation, demands the most solicitous and encouraging attention. It is unnecessary here to observe, that the persons alluded to are females in the state of pregnancy, and more particularly those, who, like Her Royal Highness, are anticipating the first parturition.

They cannot but discern that the persons most competent to administer encouragement, are those to whose management their health is entrusted; and upon their accoucheur it unequivocally devolves not only to assist in the moments of child-birth, but to use every precaution to conduct to that period in safety. Timidity and apprehension often modify the nature of child-birth, without any extraordinary occurrence. Instances of predicted death, and predicted suffering, have been fully authenticated; and those, who have attributed the prescience to supernatural agency, have been misled. Persons who die at a predicted time, die not in consequence of the thing portended:—if the prediction rest upon some imaginary omen, or unwarrantable timidity, death is the punishment of their superstition, or their fears.

Sympathetic sorrow and fear must be distinguished. Who would interdict at the present a moderate indulgence in the former? but, for inordinate fear, this fatal instance of child-birth does not supply the least well-grounded occasion. It cannot, however, be averted, that females thus delicately situated, will be the subject of needless apprehension, and may become enslaved by unwarrantable anxiety and terror; and which it is the duty, and will I am persuaded, be within the power, of a conscientious man, nearly, if not wholly, to suppress.

It would be a dereliction from my present feelings, nor do I think it incompatible with the design, to ask, if practitioners in Midwifery, and of Medical Science in general, in their attachment to the custom of administering drugs, and in their repugnance to a species of fanatical empiricism, do not too much disregard the moral treatment of disease?

Let it not be supposed that I would question the efficacy of Medicine, or that I would tolerate the chicanery or chimeras of Tractorism or Magnetism; for though it would be well if the articles of our Materia Medica were reduced to at least one twentieth of their present number, I cannot hesitate to aver, that some drugs are capable of acting specifically on the animal frame. Must it not also be admitted, that although, upon every genuine principle of philanthropy, we would sweep imposture “with the besom of destruction,” the audacious empiric has produced effects well adapted to astonish the vulgar, and to claim for himself a large portion of ephemeral reputation?

The scientific mind ought to appreciate the influence which one human being is capable of exerting over another; and by reflecting on it, the most available line of conduct in the removal of disease will be discovered. It is true, artifice has often taken precedence of merit. Attractive as popularity undeniably is, the practitioner who solicits the aid of artifice to rise into notice, not only forfeits his character, but hazards the sacrifice of future professional honor and success, on the altar of a most precarious goddess:—

“To seek honor, is to lose liberty.”

Recently the most strenuous efforts have been made to render the medical profession more worthy of public confidence, but the appropriation of means has surely been surprisingly perverted. It cannot be questioned, that a youth intended for this department of human labor, ought to be liberally educated, and that he present his testimonials to an accredited and competent tribunal is perfectly laudable; but that after five years apprenticeship, and after an extended durance at a recognised medical school, he should be submitted to the investigation of a trading company, is totally repugnant to every principle of science, and is calculated to divert the attention from those generous and enlightened principles, which should actuate the members of a profession often denominated learned and liberal.

It is not the knowledge of ancient and modern languages, of mathematics or moral philosophy, of chemistry, or pharmacy, or botany, or even of anatomy, physiology, and nosology, however important or essential, which can fully qualify a man for the honorable discharge of the arduous and responsible duties of his station. He must be a philanthropist. However extensive and useful his knowledge, if he has not a zest for the alleviation of human suffering, he incalculably circumscribes the usefulness of his acquisitions. There are men, indeed, who have pursued science with abstracted ardor; and there is indubitably something fascinating in those sciences, which are accessible to a medical student. But if there is an universality in Bacon’s maxim, that “knowledge is Power,” in what does the power of knowledge consist, but its direction to some useful purpose?

Some men have directed all their time and talents to insulated departments of medical or surgical practice. Does not this make them pedantic? Although they have risen high in these departments, yet having but partially appreciated other objects, they are contemned, notwithstanding they are effecting equal good by different agency. Division of human labor has its advantages; but, if frittered into needless division, it injures the whole.

Some distinguished men too have become so notorious in their tenets, that it is difficult to ascertain whether their reputation be that of paradox or merit.

There are others also, who seem to think it honorable to be eccentric; and, to increase the anomaly, have chosen an eccentricity, which ordinarily is esteemed disgusting. Abruptness, rudeness, insensibility, coarseness of manner, vulgarity, or obsequiousness, may be found in men, whose minds are far superior to mediocrity; and although nature or education might have been somewhat defective, it is not difficult to recognise the features of some pernicious habit. We have seen striking indications of disregard to human suffering in our hospitals; and often has it called forth a disgusting expression of risibility amongst the students. Painful, indeed, is it to observe the mistaken excellence attached to an apparent disregard of human suffering: it seems to be thought, that there is something philosophical in conquering the common sympathies of human life, although it is by them society is cemented.

Although no personal graces—no urbanity—no kindness, can be substituted for unremitting study, and discriminating observation, yet it is practicable to adopt a deportment equally remote from pliancy and barbarity.

For what beneficial end, many will exclaim, are these observations made? and had I not drawn for myself the line of demarcation, I would gladly meet the inquiry in an attempt to prove that some men of superior knowledge, and of eminent rank, would have greatly extended their benefits to human nature had not their manners been repulsive:—that the extraneous habits of these men are borrowed, by an aspiring race of students, who appear in plumes of fancied beauty; whose affected air justifies the suspicion that the art of medicine is not merely conjectural:—and that by ingenuousness, candour, kindness, and an attentive regard to mental phenomena, united certainly with a competency of knowledge, not only the honor of the profession is enhanced, but its utility promoted. If there are no diseases of mind independently of body, which we are willing to admit, the influence of mind on body must be allowed. The popular belief in the salutary influence of faith, is well founded—the opposite feeling of distrust, will act perniciously. The man whose mind is properly furnished will dexterously seize occasions of alleviating distress, which another, who may be almost exclusively watching for diseased structure, would not easily comprehend.[2]

An attempt to make chronic cases of disease subservient to any mercenary purpose, is an entire perversion of the liberal dictates of science; and often renders the most assiduous exertions unavailing. Where there is scarcely sufficient disease to impose bodily restriction, it cannot be expected that protracted courses of medicine can be endured, unless it be administered in the most simple and unobjectionable form. Nevertheless, it is a duty to subdue chronic diseases; and often it can only be done by a persevering management of diet, aided by medicine.

We return from this digression to the condition of our interesting countrywomen; and, as a tribute of respect to the memory of her Royal Highness, would endeavour to direct to their advantage the preceding observations.

It is almost peculiar to the females of this happy land, that they occupy that station in society for which they were designed. Regard is paid to their education—their intellects are cultivated—whilst they retain that modesty and refinement which should ever designate them.

How much of our personal happiness do we owe to them!—are we not indebted to them for the sweetness and chastity of social intercourse—for the cheerfulness of domestic life—for the solace of times of sickness and sorrow—for the building up of our families, and the perpetuation of our names in human existence? Their claims are innumerable, and as cogent as the happiness and welfare of men can suggest.

Every expression of regard to their comfort and happiness is demanded; and when they are subjected to inordinate care, the token should be peculiar and spontaneous. It is unpardonable, that in the treatment of female diseases there should be either rudeness or indecency.

The express object of this paper is to check a disposition to draw illegitimate and unfavourable conclusions from recent circumstances—to divert their thoughts from fear. Yet, as they are capable of reasoning, and, indeed, will not be satisfied, without a rational demonstration, that there is no ground for evil forebodings; we shall endeavour to meet them on this fundamental principle. And, first, we shall attempt to evince that the death of the Princess Charlotte, neither indicates a condition more precarious than heretofore, nor does it detract from the efficient aid which art is adequate to afford at this interesting moment. In the second place we shall point out some circumstances in natural and premature labour, on which recovery greatly depends.

In the case before us there is nothing peculiar. Royalty has no exemptions from disease; nor is there any royal exoneration from the contingencies of human life. If a female, in ordinary rank, die of fever, it is not brooded over to excess; and if one in these subordinate walks fall in the hour of child-birth, soon its influence subsides. But illustrious station gives unparalleled horror to death; not because it differs abstractedly from the death of others, but, because in the fall of persons eminent in rank or office, the relationships of life are more deranged, and even the interests of a country may be affected. Yet is the article death the same. Truly a life so valuable to the country, as that of her Royal Highness, did not exist in Britain. Yet this does not modify the event itself, for death recognizes no distinctions; and so rarely does it happen in these circumstances, that there are persons who have practised midwifery for a series of years without meeting with such an occurrence. The very circumstance that encircles that event with peculiar mystery and solemnity, is calculated to impart to those we are now addressing, the greatest encouragement—it was unexpected. Were it not uncommon, it would not have been unlooked for; and the public are incompetent judges of the unfrequency: for the unfavourable instances, which are rare, are, on this account, topics of popularity; whilst the thousands of happy results, which happen every week, pass unobserved.[3]

In the management of pregnancy, the treatment should commence with the earliest period. To regulate the condition of mind is important; to avoid the sight of disgusting objects,[4] and other circumstances likely to evolve any strong emotion. To live temperately; to avoid stimulating diet; to regulate the bowels by some unirritating aperient, and to use but moderate exercise.

In the arrangements preparatory to parturition, the objects which present themselves are two-fold. First, to secure efficient aid; and, secondly, such attendance as may be most likely to keep the mind comfortable, and which shall carry into full effect every means devised at the time of child-birth as well as subsequently. On the former topic it is neither proper nor necessary to speak. The selection of persons to attend, in parturition, is unquestionably momentous. The nearest relatives are often the most unsuitable. Kindness and sympathy exhibited with confidence inspire courage and patience; but if they are associated with anxiety and impatience, their usefulness is completely frustrated. If relatives are chosen, they should be such as know how to regulate their feelings—when to withhold, as well as when to impart. On the other hand, those who have no feeling, no commiseration, (and there are such among women), should be fully excluded from such an occasion, and there should not be one person present as a mere spectator. But of ordinary attendants, the selection of a good nurse is of chief importance. It should be essential that she have discharged maternal duties; that she be experienced—good tempered—moderately active—of good understanding—modest, not forward; and not loquacious. She should know how to discharge the duties of her office without stepping beyond it. She should have judgment enough to buoy up the spirits when they needlessly flag, and caution enough not to permit unusual symptoms to arise without the cognizance of those on whom that responsibility more particularly rests.

Persons whose minds have been little cultivated, are apt to seek undue commendation, and to gain by improper means the confidence of their employer. However well disposed and well informed the lady, perhaps her knowledge of parturition may be circumscribed by her personal experience. But the nurse is supposed to have gained much knowledge, beyond the immediate obligations of her own station, by her intercourse with medical practitioners. She thinks herself competent to the comparison of the different methods of management which may consist in mere circumstantial differences, but which by her are made important. She thinks herself competent to change diet, to administer medicine, to regulate the time of rising and sitting up, in the absence of the practitioner, and often even contrary to his orders. Because they have seen spirituous liquor given in some cases without actual injury, they think it may be given in all; and it is often only by a positive injunction this can be counteracted. They propagate unnecessary follies respecting the peculiar dangers of certain days. And if the patient be dejected, they rally them, and often urge the necessity of premature rising to dinner or tea, to promote cheerfulness. Within the last few weeks, though spirits had been decidedly prohibited in a case of first parturition, as soon as the practitioner had left, the nurse so boldly urged some brandy, that the lady could not refuse compliance. The obtrusiveness and loquacity of this person very materially affected the recovery of an interesting woman. We express ourselves strongly and decidedly on this point, because we pity a delicate inexperienced female, who happens at so critical a moment to be managed by an ignorant or obtrusive nurse; and because we have no question that most of the evils which spring up subsequently to parturition, arise from the contravention of proper orders, either respecting quietude or diet. During the first few days or week in all cases the entire regulation of even minute particulars should be under the direction of the medical attendant; and in some cases this attention must be carried farther. It must not be tolerated that a woman who shall have had the longest experience, and who may even be able to detect striking differences, should prescribe either counter to established regulations, or when medical advice is accessible. There certainly are instances of sudden transition, in which the nurse must act according to her best judgment, and in which, if wrong, she is not blame-worthy. When on this topic, I cannot totally exonerate the accoucheur from some connivance in the assumed importance of the nurse; and through a want of explicitness and decision, she has often been left either to the selection of her own plans, or plans have been so carelessly or loosely suggested, that it may justly be questioned whether it was intended they should be enforced.

It would indeed be a great advantage to society, if persons of this description were not permitted to assume the office of nurse without testimonials: but as the field is now open, not only should ladies be circumspect in the selection, but it behoves the guardians of the public health, even if it be unsolicited, to counsel their friends in the choice. In their intercourse with nurses, they are best qualified to assert their respective merits, and they ought to distinguish between the meritorious and the ignorant or froward.

At the time of child-birth, there are some practices which are extremely hurtful, and which cannot always be guided by professional advice. And it would be well for ladies themselves to predetermine in what manner these things should be regulated. The exhaustion consequent to child-birth, has occasioned the pretty general custom of allowing the patient to lay an hour undisturbed; but at the end of this hour, it is often inevitable, whatever the degree of indisposition, that the patient must be raised into an erect posture, before she can be placed in bed, owing to the improper arrangement of dress and bed-clothes.

Hemorrhage, fainting, and many inconveniences under these circumstances, are not unusual. Amongst the higher and more intelligent nurses this practice certainly is nearly unknown. Where there is time before-hand, dress and bed-clothes should be so managed, that there shall be no occasion to raise the patient from the horizontal posture. However trivial this may seem, it is, without the smallest doubt, a frequent cause of very serious alarm; and no practitioner can safely leave a house till this removal has been undergone. It would be commendable if ladies themselves exercised their thoughts on this subject, and on which they may take counsel, with great propriety, previous to the commencement of indisposition.

We are not now presuming to address the members of the profession. Yet, for the sake of female practitioners of midwifery, the unnatural and improper custom of giving opiates immediately after every case of parturition must be decried. The apology for this practice is to ease the after-pains; that is, to counteract those contractions of the womb, by which it regains its natural state.

Truly cases happen in which the constitution sympathizes so greatly with these pains—the patient becomes so irritable, that an opiate, seasonably interposed, acts almost as a charm; but when administered through habit, it checks secretion—constipates the bowels—prolongs the after-pains—and very seriously affects the head.

To practitioners of this description, I would also say, that especially in lingering cases, the management of mind is truly important. The mind is in the condition of the quickest sensibility. Every thing transacted about the patient should be done openly. All whisperings or attempts at secrecy, excite the utmost curiosity, and essays at evasion only heighten the distress. All allusion to unfavourable cases should be most sacredly avoided. Nothing should tempt the individual on whom reliance is placed in these instances, to concede the truth—a falsehood once detected, contravenes all future trust; and however there may be exhibited the external signs of belief the mind will be harassed with the most painful suspicion. A most guarded prognostic too, not only in reference to the issue, but the duration, is essentially requisite. The endurance of pain, ever raises more or less anxiety for ease; and as in child-birth it is known there is a limit—a period when the trouble shall instantly cease—there is peculiar desire to ascertain the probable duration of suffering. The hopes and wishes of practitioners often seduce them into a definition. The period arrives, and is succeeded by disappointment—another is fixed, which equally disappoints the expectation, and ceaselessly enervates the patient. A disposition in the attendants to excite unwarrantable expectation too, should be early checked. The solicitous inquiries of the patient, must be met by a candid avowal of her situation—a decided assurance, that although it is not possible to define the duration, the procedure is perfectly safe. A distinct assurance should be given, that although there are numerous little circumstances which retard or expedite delivery, they do not affect the termination. That with the prospect of a safe deliverance, a somewhat prolonged suffering is comparatively trivial. And, in most cases, however serious, it is easy to suggest some exemption, for the absence of which thankfulness should be cultivated.

Varied as the cases of parturition are, if the principle is kept in view, an intelligent mind will supply the deficiency. And a female will be conducted through a lingering labor with much less suffering, and much less exhaustion than under more unguarded treatment. The choice of food under these circumstances, certainly is not indifferent. In the time of labor, all the functions are disturbed—not only by sympathy, but by the positive influence of pain. Such diet should be adopted as is least irritating, and with most facility is converted into nutriment. Gruel, preparations of arrow-root, sago, &c., without wine (except under peculiar circumstances) are best, and the patient should be encouraged to take them at proper intervals.

After labor, quietude is the chief subsidiary; but some regard must be had to the state of the patient. The sudden transition from long-suffering to almost entire case, produces a striking moral effect, and effusions of grateful expression generally succeed. The stimulus of distension and pain, being withdrawn, a great degree of faintness often supervenes. The administration of a small quantity of brandy or wine in some gruel, is highly proper where this happens in any threatening degree—but should only be continued till that sensation is removed. Some ether in camphorated mixture, we have often seen very speedily remove the faintness and agitation which succeed delivery.

Soon there is an adaptation to the change—the functions regain their accustomed office—the palpitation of the heart subsides—the pulse, which might have been fluttering and intermitting, becomes regular, though still quick and full. Stimulant substances must be entirely withdrawn, and gruel, or other simple articles of nutrition must be substituted.

Often, early after labor, pain and throbbing in the head, aversion to light and sound arise; attended sometimes with a quick, at others, a very slow pulse; the latter, indicating a great degree of congestion, or accumulation of blood in the head. In this case, medical advice ought to be promptly solicited, especially if it has not subsided by a gentle aperient—as castor oil. Powerful doses of purging medicine will become necessary; and, perhaps, bleeding from the arm, or leeches to the temples, may be required.

Whenever the body becomes sore and painful, especially if it be attended with suppression of the discharge, constipated bowels, and fever, no time should be lost in demanding medical assistance.

In child-bed fever, early and free employment of bleeding and purging, with strict attention to low diet, will almost universally succeed.

In reference to the child, where there is no disease, the chief object of attention should be, to secure it against unnecessary exposure. Too much washing at first may be pernicious; and the practice of using spirits in these ablutions, merits reprobation. By the celerity of their evaporation, they produce a degree of cold much more intense than would be produced by the application of cold water, which would be universally condemned.

It would be totally incompatible with a small pamphlet, and with this extemporaneous address, to trace and delineate all the varieties of child-birth. Yet, we think enough has been suggested to secure as much safety in the time of parturition, as is attainable amidst the uncertainties of human life.

Perhaps, however, it is not proper to overlook some peculiarities in premature birth.

Abortion or miscarriage, which usually is accidental, sometimes becomes habitual; and at about the same period of conception, on many successive occasions, this disappointment will happen.

If there is a strong claim in the ordinary occurrences of pregnancy, for an attentive regard to the condition of mind as well as body, it acquires its utmost urgency in those conditions in which habitual miscarriage happens. The claim is urgent in behalf of the unfortunate individual, whose life is a perpetual series of suffering and anxiety, who is not only subjected, perhaps, every six or eight months to the debilitating effect of excessive hemorrhage, but whose mind is oppressed by disappointment, arising out of domestic and conjugal relationships, even more heavily than by the influence of personal suffering.

Until our present knowledge is enlarged respecting the association of mind and body, and the ultimate connexion of different systems of structure, we cannot appreciate the extent of moral influence.

Blushing shews the influence of mind on the circulating system; loss of appetite and sensation of stricture across the stomach, its influence on that organ; and perhaps the diaphragm, palpitation on the heart. Various phenomena indicate the influence of the mind and nervous system on secretion and absorption. And although we may believe the mind to act on the nervous system, that system on the vascular and absorbent, we never shall fully understand the nature of most diseases till the nature of this intercourse be more clearly developed. But if we allow the ascendancy of mind, its agency becomes most powerful when most sensitive; and when, with this morbid sensibility, it is most subjected to molestation.

How interesting and impressive are the claims of a female under these circumstances; and attempts to administer relief, by the unassisted aid of medicine, will, not unfrequently, issue in disappointment.

The causes of miscarriage vary; and as various as are the causes, must be the medical treatment. These causes primarily belong, in general, to the parent; but they may exist independently in the conception. With the former only we are interested at present. They may arise in the parent from either general or local causes. Every thing affecting the general circulation, deranges that of the womb in particular. But there are cases, in which there appears congestion or accumulation in the womb, without any manifest general disturbance. We must recur to a former observation; for till we understand the manner by which mind and the nervous system affect the general circulation of blood, we cannot understand the phenomena of abortion. Yet, is it a fact, that sudden mental affection, whether arising from excessive joy or sorrow, disgust or fear,—will often speedily and inevitably produce it.

And in cases happening without any cognizable incident, analogy justifies the inference of moral agency, as its predominance in producing congestion, and in deranging action, in other parts is perceptible.[5] It is not intended to deny, that mind is often affected consecutively; and in these cases, there is a pernicious reflected action on the body.

In the management of these cases, especially when they may be deemed habitual, moral treatment is in the highest degree momentous. It is an indispensable pre-requisite, that not only the judgment, but the candor of the practitioner be fully appreciated, before perfect acquiescence can be commanded in precautionary measures. Sacrifices of great domestic interest must often be required.

It may be necessary to enjoin an almost constant observance of the horizontal posture; almost total seclusion from social intercourse, at least such intercourse as may disturb the circulation; and even of separating, for a considerable time, from conjugal association. And these measures will never be fully and perseveringly adopted, but when the mind is satisfied that the advice results from knowledge, and when the progress is watched by the assiduities of kindness.

Frequent recurrences of discharge and pain, threatening immediate miscarriage, certainly should not discourage. We have frequently seen pregnancy go on to its completion, notwithstanding these occurrences; but a slight deviation from the precepts we have enjoined may undo all that the efforts of weeks or months had accomplished. When once the womb has admitted of a full developement, the change has often been most salutary. The period of suckling—the lengthened period of freedom from pregnancy, (which suckling will probably secure), conduces greatly to restore the constitution, and to enable it to sustain future pregnancies without inconvenience. In these protracted cases, occasional interposition of medicine will be useful; but if a protracted course of medicine be needful, it should be assimilated as much as is practicable with domestic preparations, except in some anomalous instances.

In the allusions we have made to medical character, let it not be inferred that the slightest reflection on the Physicians of Her Royal Highness is designed. Writers in some of the public papers have cruelly animadverted on the conduct of one of them, at least, in this momentous event; and the only apology which occurs to us is, that their censures were the illegitimate though too often fertile offspring of vehement sorrow. Had the influence of these remarks been limited to the gentlemen whom more or less they were intended to reprehend, they would have been comparatively unimportant; but they are scattered through the kingdom, and, without the slightest authority, tend to alloy unmingled and consecrated grief. To cherish the most latent doubt that the illustrious Princess did not derive the utmost aid from human experience, will heighten and pervert the general lamentation; and were it possible the surviving Prince could be accessible to such a feeling, how would it embitter future years, which, with undissembled sincerity, we hope he will survive, in useful and happy life!

There are documents, however, before the public, from which unfavourable inferences have been deduced; and our observations will be impotent, unless the legitimate tendency of these documents be traced.

It must be conceded, that interested as we were in the life of Her Royal Highness, and as we ever have been, and continue to be, in the life of our truly revered but afflicted Monarch, the brevity of official communication creates disappointment; but are we justified in propagating the opinion, that what is withheld is necessarily unfavourable?

We have been informed, that a respectful solicitation, presented to one of the Physicians, to publish the Princess’s case, has been declined; and the prudence of his decision is very perceptible.

It would demand an extraordinary coincidence of rare qualities to communicate the full result of ocular and tangible observation. To designate a disease is by no means difficult; but to describe on paper all the distinctions of an experienced eye, and all the erudition of habituated touch, and to impart to them the full energy of the original source of demonstration, would require a power of delineation which is unattainable. However explicit, therefore, an attempt might be to detail so affecting a case as this, it is impossible the contumelious should not find something to censure, and the wrangler something to dispute; and a fountain of interminable and painful controversy might be opened.

It seems ostensible, that the honor of attending Her Royal Highness devolved on Sir Richard Croft by voluntary and personal choice; and however deeply and mournfully he may review the fall of so illustrious a personage beneath his own eye, it cannot but ever be a source of grateful remembrance, that he was the subject of such distinction. There would be the utmost inconsistency in assigning to patronage an election like this. Dr. Croft has long occupied an eminent rank as an accoucheur; and more unequivocal testimony to his qualification could not be rendered, than that the most clamorous for public investigation have paid to his talents the meed of praise.

Of the celebrated Dr. Baillie, who occupies pre-eminently the public confidence, and whose contributions to medical knowledge will honour his name to the latest posterity, it would be insulting to offer a defence. Nor indeed are we aware of an implication that either his conduct or that of the other respectable physician, Dr. Sims, was deemed impeachable.

Doctors Baillie and Croft seem to have been in attendance early on the first day, and, in the evening of that day, the latter judged it expedient to have, at immediate command, the counsel of Dr. Sims. This, as a precautionary step, is honorable to Dr. Croft, and will ever shield him against a successful imputation of temerity. It seems probable, however, that Dr. Sims was not introduced to the Princess till after the accouchement; and upon this circumstance, much severity of comment has been indulged.

Advocating, as we have, the moral management of child-birth, we believe, without the slightest reservation, that the arrangements which were made, were best adapted to sustain confidence and courage in a protracted case of natural labor; and that the unnecessary interference of another practitioner would have been improper. It is not certain that Dr. Sims was held merely in reservation; but if he were, on Dr. Croft alone the competency to judge could rest; and whilst experience justifies his competency, a most striking pledge is given that he was not actuated by rashness.

A painful reference was made to the preliminary arrangements; but in us their simplicity excites admiration. There is a certain, and, perhaps, indispensable attendance on the parturient royal female, unknown in subordinate society; but irrespective of this, it seems to have been efficient and not superfluous. Can it be supposed that a privilege was denied to this amiable Princess, which is claimed by every woman in the country; that of selecting her own attendants?—and that no supernumerary solicitous matron should be in waiting—and that no unnecessary fears should be created by needless medical introduction, exhibits a regard to moral influence which should ever be in requisition.

All the lucubrations of censoriousness have not been noticed:—because, by establishing prudence as well as reputation in the more prominent and responsible acts, it may safely be believed that objects of less moment were not disregarded.

To illustrate the cause of death would be indelicate. It was one of those uncontrolable incidents which characterize the precariousness of human life, and which must be referred to the “will of God,” the wisdom of whose providential administration will be developed in a future world.

FOOTNOTES:

[1] “Yesterday, Aug. 6, 1801,” (says the late excellent Bishop Porteus), “I passed a very pleasant day at Shrewsbury House, near Shooter’s Hill, the residence of the Princess Charlotte of Wales. The day was fine, and the prospect extensive and beautiful, taking in a large reach of the Thames, which was covered with vessels of various sizes and descriptions. We saw a good deal of the young Princess. She is a most captivating and engaging child, and, considering the high station she may hereafter fill, a most interesting and important one. She repeated to me several of her hymns with great correctness and propriety; and on being told that when she went to South-end, in Essex, as she afterwards did, for the benefit of sea-bathing, she would then be in my diocese, she fell down on her knees and begged my blessing.”—Life of Porteus, by Hodgson, p. 160.

[2] We recollect a most striking instance of this dexterity. An elderly and most susceptible lady was under the management of a respectable country practitioner, for a complication of nervous diseases. On paying one of his accustomed visits, he was alarmed for the safety of his patient. She had passed a night of unspeakable agitation, and her irritability was then excessive. It was attributed to an idea of having been poisoned by the compounder of her medicine, and she believed herself in the embrace of death. “Madam,” said the gentleman peremptorily, “I was aware of the accident, and brought with me an antidote.” He had immediate recourse to her former medicine, with some little disguise, which she took, and soon became tranquil. It is highly probable, had not some such method been adopted, she might actually have perished. See also a very interesting case in the Quarterly Review for July, 1816, p. 397.

[3] I do not think it inconsistent or irrelative to quote a passage from the Sermon of a celebrated preacher.

“I am afraid that this unusual result should produce an unhappy effect upon the spirits of those who are approaching the hour of child-birth. Let them recollect, that it is promised, ‘the woman shall be saved in childbearing if she continue in faith, and charity, and holiness, with sobriety.’ And, although it cannot be concealed that some sink in the struggle, (and for unfathomable reasons, the blow has fallen upon that illustrious personage, whose memory is this day embalmed with a nation’s tears), yet such occurrences, rare as they comparatively are, should be no more brooded over, as bearing upon this particular situation, than any of those calamities which are usually termed the accidents of life, are considered to affect its ordinary tenour and duration. It would be ungrateful, it would be sinful, to draw unfavourable conclusions from circumstances so extraordinary, against His tenderness and providence, who hath hitherto delivered, and will still deliver. Such persons are earnestly and affectionately exhorted to ‘lift up their eyes unto the hills, whence cometh their help,’ remembering, that their help cometh from the Lord, who made the heaven and the earth. And under this and every other instance of human instability and calamity, one common principle remains as a hope which cannot be shaken. We can look from earth to heaven, and say, ‘Thou, O Lord, remaineth for ever, thy throne from generation to generation.’”—Dr. Collyer’s Sermon, occasioned by the Death of the Princess Charlotte.

[4] This caution against disgusting objects does not imply, that in consequence of mental impression natural deformities arise. This unquestionably is a popular error, and the tales in circulation to justify it are either totally unfounded, or assignable to other causes.

[5] We believe, that in delicate females, unequal distribution of blood is the cause of that peculiar order of diseases, denominated nervous.

THE END.

J. M‘Creery, Printer,
Black-Horse-Court, London.

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THE NATION IN TEARS,
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Table of Contents

- AN ADDRESS

- Author William Cooke

- ADVERTISEMENT.

- AN ADDRESS.

- FOOTNOTES:

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- Transcriber’s Note:

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