A GUIDE TO HEALTH

                             by Benjamin Colby
                            Milford, N.H., 1846

PART VI-MIDWIFERY

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EDITORS NOTE:
CHAPTER I MIDWIFERY
CHAPTER II.GENERAL DIRECTIONS FOR TREATMENT IN CHILD-BIRTH
     PREVIOUS TREATMENT.
     TREATMENT DURING LABOR
     TYING AND CUTTING THE NAVEL STRING.
     MANAGEMENT OF THE PLACENTA OR AFTER-BIRTH.
CHAPTER III.TREATMENT AFTER DELIVERY.
     AFTER-PAINS.
     COSTIVENESS.
     FLOODING.
     MILK LEG.
     SORE NIPPLES.
CHAPTER IV.TREATMENT OF CHILDREN.
     STILL BORN INFANTS.
     MECONIUM.
     FLATULENCY OR COLIC.
     TONGUE-TIED.
     RUPTURE.
TESTIMONY OF REGULAR PHYSICIANS IN FAVOR OF
   FEMALE MIDWIVES, AND AGAINST THE INTERFERENCE
   OF DOCTORS

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EDITOR'S NOTE:  

     Quaint and antiquarian though this book may seem, Colby, a more polished
voice than his mentor, Samuel Thomson, was dealing as best as possible with the
arrogant, hubristic and mechanistic disarray of Medicine between 1800 and 1860. 
The Thomsonians were radical populists that espoused the rude concept that common
sense and a little learning was a better doctor than professionals seemingly
addicted to bloodletting, purging with heavy metals, and heroic cleanses.  They
were a popular and robust "sect", with lay practitioners crawling all over the
woodwork like ticks on a feeble dog.  

     The substantial presence in later years of "irregular" physicians (licensed
M.D.s) such as the Eclectics and the Physio-Medicalists, as well as medical
Homeopathy, was opposed with almost religious fervor by the "regulars" of the
Eastern Establishment.  Better funded (often by public moneys) and with close ties
to full universities, the regulars prevailed in almost all arenas by the first
decade of the twentieth century.  The last Eclectic Medical School closed to
resounding indifference in 1938.  Well before that time, mainstream American
Medicine had responded to the CAUSE of opposition by cleaning its house, and
reestablishing the general trust of most Americans.  The populist movements, by
whatever name, had served the greater good...and sealed their own doom.

     Frankly, the problems of mid-nineteenth-century medicine uncomfortably
resemble the state of medicine at the end of the twentieth century, with
alternative medicine/healing/therapy presenting a populist resistance to Standard
Practice Medicine that seems to be growing almost expotentially.  The slow,
ritually scathing indictment by Colby of Medicine in his day may seem
quaint...unless you remember that the physicians he verbally eviscerates were
products of the most rigorous training available anywhere.  His denouncement of
the quack remedies of his age are blamed upon the people's loss of faith in
regular medicine, a state disturbingly similar to our present circumstance.

     In this final section of "A Guide to Health", Colby rales against one of the
great evils of medicine, as viewed by the Thomsonians...medical birthing.  He then
presents the Thomsonian methodology for non-invasive delivery and infant
care...and (in case the reader missed it the first time) rales yet AGAIN.  Samuel
Thomson himself felt that the over-zealous physician, faced with disease, and
guilty of over-medication, could be forgiven; it was easy to view disease as an
enemy to be conquered by any means, rather then the end result of disharmony. 
Thomson and other medical populists of the 19th century felt that Medicine's
intervention into that tattered remnant of Women's Society still surviving in a
patriarchal century...midwifery...could ONLY be explained by greed.  Thomson
likened the presence of a physician at birth (in case of emergency) to the
presence of a physician at a feast (in case a guest were to choke)...redundant and
dangerous.

     If the last century is an example to learn from, it will be many frantic
years before we "irregulars" bring about the re-ordination of mainstream medicine
back into the vitalist center.  In that context, as well as for some of its
surprisingly sound observations, this popular little book from 150 years ago can
serve as a parable for our present perceptions of the early-stages of medical
decline.
Michael Moore
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(ORIGINAL PART III.)

CHAPTER I

MIDWIFERY

     THERE is no part of the practice of medicine or surgery, in which a reform is
more loudly called for, than in that of midwifery. But few are fully conscious of
the unnecessary suffering and destruction of human life, produced by the unnatural
interference of male accoucheurs.  Were the dictates of nature and the light of
reason followed, instead of the false theories of those who profess to be learned
and wise, the homes of many childless parents might now be made cheerful by the
innocent merriment and fond caressing of their offspring.  We do not charge upon
the faculty a disregard for the sufferings of the female sex; we know them to be
as humane, as benevolent as others, but a strong inducement is held out to them to
retain this practice under their "exclusive jurisdiction," when they must know
that females are fully competent and far better adapted to perform the office of
midwife than males.  That strong inducement is the fee.  If this service was to be
done gratuitously, the probability is, physicians would soon come to the
conclusion that their presence was not necessary at the time of child-birth.  No
physician can have failed to notice that his introduction into the chamber of
parturition produces an unfavorable change in the patient, that frequently is not
entirely overcome.  Do they argue that females are not competent to officiate as
midwives?  If we search the annals of history, we shall find that females were the
only midwives until the seventeenth century.  It is said that during the latter
part of the sixteenth century, a physician in Hamburgh was publicly branded,
because he was induced by curiosity to be present at a delivery, in female attire.
Madame Boivin, the celebrated lecturer on midwifery, in Paris, has superintended
the delivery of more than twenty thousand women.  Many American women have devoted
their time to the business, with a success seldom equaled by the other sex.
Females who understand the Thomsonian system, and have given their attention to
the practice of midwifery, have seldom met with any difficulty.  My own experience
and observation compel me to believe that ninety-nine in a hundred of the cases
that are so very alarming and often fatal to mother or child, would be
comparatively safe and expeditious under the management of such females.  Mrs.
Whitney, formerly of Nashua, has attended many cases with perfect success and
satisfaction to all concerned.  Any other woman may be equally successful, by
obtaining a knowledge of the medicines and the management of such cases. If women
cannot be obtained who will take the responsibility, let those husbands who are
convinced of the impropriety oŁ the present practice, inform themselves upon the
subject, and attend upon their own wives.  We know a Methodist minister in Maine,
who has attended upon his wife with eight or nine children, without any trouble,
and we know of many others who do the same.  We hazard the assertion, unpopular as
it may be, that the presence of a physician is no more necessary to the safe
delivery of ninety-nine cases in a hundred in childbirth, than it is when a
healthy woman is eating wholesome fruit.

     "Females have been made to believe, says Dr. Beach, "that physicians only are
competent to assist them in the hour of child-birth, and that midwives are
incompetent; by which, this branch of medicine has been very unjustly and
improperly wrested from them, and monopolized by the faculty.  Did females know
the ignorance, the untimely and rash interference with the unwieldy hands of
doctors, the exposure, the rash attempts to accomplish delivery, the injury done
by bleeding, minerals, ergot, and instruments,--I state, did they know all this,
the serpentine charm which now unfortunately deludes them would be broken, and
they would shrink with disgust and horror at the very thought of employing males
in parturition or child-birth.  Nothing but the grossest ignorance leads them to
embrace a practice so unnatural and revolting.  In nearly every case, nature is
quite sufficient to expel the child; and when aid is required, females are in
every respect calculated to render all the assistance required, except perhaps on
some rare or extraordinary cases.  A very little instruction and experience will
enable any sensible female to become proficient in this branch of medicine; and I
venture to affirm that her success will be far greater than that of male
practitioners. In proof, I refer to the practice of Mrs. Ruth Stebbins, of
Westfield, Mass., Mrs. Halsey, of New York, and hundreds of others, whose great
success is ample evidence of their skill and competency.  Also, Madame Boivin, and
Lachapelle, of France, who have been present at the delivery of more than forty
thousand cases, nearly all of which terminated favorably, even without aid; and
observe also the great success of other midwives in Germany, Denmark, and other
parts of the world.  So stupidly or willfully blind are many females, that they
are ignorant that nature accomplishes the delivery, and that the doctors get the
credit and the fee, while the worthy and skillful midwife is pronounced ignorant
or incompetent.  I cannot see why such a custom, so recent, unnatural, and novel
in its character, should have prevailed and gained such an ascendancy, except in
the same manner that every other foolish and absurd fashion prevails.

     "I have practiced this branch of medicine ever since I began my profession;
but so fully convinced have I been that it is wrong, and belongs to the other sex,
that I have abandoned it to its rightful owners, the female midwives; and I am
therefore as anxious to bring about a reformation in this department as in other
branches of medicine.  I trust that I shall have at least the enlightened portion
of community to sustain me in a cause of such vital importance both to the moral
and physical well-being of the female sex.  The tales that are told by designing
physicians of the hair breadth escape of numerous women, to whom they have been
called just in time to save life, and of the danger of trusting to females, have
filled those over whom they have an influence with awful apprehension, and thereby
secured to themselves a branch of medicine that reason, experience, and the finer
feelings of the female sex loudly proclaim, belongs only to females." 

     Says Mrs. Arnold, of Westfield, Mass., in a letter to the editor of the
Botanic Medical Reformer,  "It (man-midwifery) is contrary to every principle of
delicacy and refinement, and disgusting to every feeling of our nature.  It is an
unheard of practice in most countries, except in some parts of Europe and
enlightened America.  It is degrading to our natures, and a reproach to any people
who submit to the practice." 


CHAPTER II.

GENERAL DIRECTIONS FOR TREATMENT IN CHILD-BIRTH

     PREVIOUS TREATMENT.--The mother's cordial, mentioned in this work, should be
taken two or three weeks previous to confinement.  If costive, take enough of the
pills No. 1, to keep the bowels regular.  If troubled with acidity of the stomach,
take the anti-dyspeptic powder after eating.  Take half a teaspoonful of valerian
and as much composition, occasionally at bed time.

     TREATMENT DURING LABOR.--When labor commences, which may be known by the
regular "bearing-down pains," send for the most experienced woman in your
vicinity; if she will not take the responsibility, let the husband take it
himself, provided he or the woman know how to proceed.  If neither know any thing
about it, get the best Thomsonian physician you can find, and in case there is
none near, get the regular that gives the sick the least medicine.  The physician
or midwife should first ascertain whether the pains are true or false.  True pains
may be known by their location, being more concentrated in the portion of the
bowels, through the loins and hip, returning every ten or fifteen minutes, leaving
the woman comparatively easy in the intervals.

     It will be proper for the midwife, at this period, to examine, in order to
ascertain what part of the child presents, which may be done by passing the
largest finger, dipped in sweet oil or slippery elm  mucilage, up the vagina, and
the nature of the presentation can be determined.  In ninety-nine cases in a
hundred, the presentation will be natural, the head presenting. If the feet or
breech presents, the labor should be allowed to progress without turning, as the
most experienced midwives admit that more danger and suffering attends an
interference, than when nature is left undisturbed.  If the arm or shoulder
present, the delivery is not impossible, but difficult, until the infant be
turned, and the feet brought down into the passage.

     When it is ascertained that the labor is natural, or that there are no
impediments or obstacles, there will be but very little more to do than to
superintend the person.  It will be necessary to give instruction to the
attendants to have every thing required in readiness.  The usual custom is to turn
the feather-bed back towards the head, and lay a folded coverlet or rug upon the
under bed; the woman should lie on the left side, near the edge of the bed, with
her feet in contact with the bed-post, and a pillow between the knees.  The
attendants should be cheerful, not exciting the fears of the woman by ominous
looks or the relation of unfavorable cases of the kind.  If the pains are severe
and protracted, let the bed be immediately arranged, and all necessary provision
made for the birth of the child.  If labor progresses slowly, add a teaspoonful
each of composition cayenne and valerian to a pint of strong raspberry leaf tea,
and give in half cupful doses.  If the pains continue severe, in consequence of a
rigidity of the muscles and but little is accomplished there by, administer an
injection, composed of two teaspoonfuls of the injection powder, and give the
emetic powder, prepared the same as for an emetic, in small quantities, until the
system becomes relaxed.  Local relaxation may also be produced by applying warm
baths to the parts. Dr. Burns, in his work on Obstetrics, remarks, "A fundamental
principle in midwifery is, that relaxation or diminution of resistance is
essential to an easy delivery; and could we discover any agent capable of
effecting this rapidly and safely, we should have no tedious labors, except from
the state of the pelvis or position of the child."  The agent so earnestly desired
by Dr. Burns, is found in the lobelia inflata, which "rapidly and safely" relaxes
the muscular system, without producing permanent debility; the use of which will
render unnecessary the barbarous steel, so frequently used by the faculty to kill
the unborn child.

     In the last stage of labor, the hand may be kept near the parts, to know the
moment when the head of the child presents, as some little assistance at this time
is called for, to remove the obstruction arising from the clothes, to support the
head of the child in its passage and in the interval of pains, and keep it from
pitching downward, and to detach the umbilical cord from the neck, when found
around it.  After the birth of the head, the pains follow each other in quick
succession until the child is born.

     TYING AND CUTTING THE NAVEL STRING.--After the birth of the child, and all
pulsation has ceased in the navel string, it should be tied with two ligatures,
one about an inch, and the other two inches from the body, cutting the cord midway
between the ligatures.  The child should then be handed to the nurse to be washed
clean and dressed. 

     MANAGEMENT OF THE PLACENTA OR AFTER-BIRTH. --After the delivery of the child,
the mother should take some warm porridge, and be allowed to remain quiet, until
the labor pains are renewed, when the navel string may be gently drawn, and the
placenta will be expelled.  If it should be retained more than an hour, administer
an injection the same as before, which will generally produce the desired effect
in a few minutes.  If the operation of the injection does not expel it, give the
emetic powder as before directed, which will increase nature's efforts, and never
fail to accomplish  the object, without the necessity of manual force.

CHAPTER III.

TREATMENT AFTER DELIVERY.

     Soon after the discharge of the after-birth, the mother should be got up, her
clothes changed, her person washed with warm water by means of a sponge or cloth,
and the bed properly arranged, into which she should be immediately placed. A
broad bandage may be put around the abdomen, and a soft linen or cotton cloth
should be provided to absorb whatever may be discharged, and removed as often as
necessary.  She should now take some warm porridge or gruel, and be allowed to
remain quiet. 

     AFTER-PAINS.--These frequently come on soon after the delivery.  A warm brick
at the feet, composition tea and nerve powder will usually prevent or relieve
after-pains in a few hours.  If not, administer a course of medicine.

     COSTIVENESS.--To prevent costiveness, take two of the pills No. 1 at night,
and a mild injection every morning, for a few days, and avoid tea and coffee, and
fine flour bread.

     FLOODING.--But little danger need be apprehended from flooding, as it rarely
takes place when the work is left to nature, with the aid of remedies that act in
harmony with her.  If, from any cause, it should take place, equalize the
circulation by giving lobelia in small quantities until vomiting is produced.  Put
a warm brick at the feet, and inject, if necessary, per vaginam, a strong tea of
witch hazel.   

     MILK LEG.--This is a white, elastic, and exquisitely sensible swelling,
commencing in the hip, groin, or back, and proceeding down only one leg at a time,
attended with heat, pain, and an inability to move the limb, and great suffering
when moved.  The effect usually extends to the other leg, and frequently becomes
general.  To prevent or cure this form of disease, steam the lower extremities,
and bathe in stimulating liniment, give composition and pills No. 1.  If this does
not remove the cause, give a full course of medicine.

     SORE NIPPLES.--This complaint is exceedingly troublesome to young mothers.
apply the meadow fern ointment mentioned in this work, and protect them with the
nipple shields. 


CHAPTER IV.

TREATMENT OF CHILDREN.

     STILL BORN INFANTS.--When the child does not show any signs of life, after
being completely discharged, a little cool water should be dashed in the face, and
along the spine, and upon the breast. If the sprinklings do not succeed, immerse
in warm water, and rub the surface freely; also put a little Cayenne tea into the
mouth from your own, or through a silver tube.  There is no harm in persevering in
the use of the means that have been found successful, for you can but fail; and
instances have been known of success after an hour's apparently fruitless labor.

     MECONIUM.--The first evacuation from the bowels is called the meconium.  Much
uneasiness is sometimes manifested among nurses lest it should not be discharged,
and physic frequently resorted to.  A little molasses and water is all that is
required, and seldom any thing to promote its discharge, except the mother's milk.
  

     FLATULENCY OR COLIC.--There is no custom more injurious than that of dosing
children for every little appearance of uneasiness; it deranges the stomach and
bowels, and leads to serious difficulty.  A little weak composition will usually
relieve flatulence or colic. 

     TONGUE-TIED.--Sometimes there is a thin, white membrane, extending under the
tongue almost to the tip, so as to hold the tongue from projecting beyond the
teeth. This membrane should be slightly cut with a pair of sharp scissors.  If it
does not prevent the child from nursing, it need not be cut until the child is a
year old, and perhaps not at all. 

     RUPTURE.--Sometimes, from crying or other causes, infants are afflicted with
ruptures; when this happens, the earliest attention is required.  The infant or
child should be placed in a recumbent position or on its back, then press the
tumor or protruded part back, make a compression of linen, which has been
previously wet in a decoction of oak bark, apply it over the rupture, and secure
it with a bandage.  If this fails to keep it in its proper situation, apply a
truss. 


TESTIMONY OF REGULAR PHYSICIANS IN FAVOR OF
   FEMALE MIDWIVES, AND AGAINST THE INTERFERENCE
   OF DOCTORS

     Says Dr. Beach, President of the Reformed Medical College of New York,
"Thanks and blessings have been poured upon me, under the idea that I had saved
lives in labor, when I had merely looked on and admired the perfectly adequate
powers of Nature, and superintended the efforts of her work; and it is Nature that
accomplishes all, while the accoucheur gets the credit of it.  There is not one
case in a thousand in which you can do more than remain a silent spectator, except
to calm the fears of the ignorant and timid attendants.  The mischief and injury
that is done by the untimely interference of art, is incalculable.  In pregnancy,
women are bled till they have not strength enough to accomplish delivery; and,
when it takes place, the forceps or other instruments are used, which often prove
fatal to the mother or child, or both.

     "Were all women instructed in this branch, many lives would be saved.  They
ought to be instructed in midwifery, and those who are of a proper turn of mind
should be well qualified to act in the capacity of midwives:  NO MAN SHOULD EVER
BE PERMITTED TO ENTER THE APARTMENT OF A WOMAN IN LABOR, EXCEPTING IN
CONSULTATIONS OR ON EXTRAORDINARY OCCASIONS. THE PRACTICE: IS UNNECESSARY,
UNNATURAL, AND WRONG."

     Dr. Bard, in speaking of the abominable interference of doctors under the
pretense of making room for the child to pass, says, "It is impossible to censure
this dangerous practice too severely; it is always wrong, nor can there be any
period in labor--the most easy and natural, the most tedious and difficult, the
most regular or preter-natural --in which it can be of the least use; in which it
will not unavoidably do great mischief: it will render an easy labor painful; one
which would be short, tedious; and which, if left to nature, would terminate
happily, highly dangerous."

     Says Dr. McNair, "All that is proper to be done in a case of natural labor,
from its commencement to its termination, will suggest itself to any person of
common understanding; and I have long labored under the conviction that the office
of attending women in their confinement should be entrusted to prudent females. 
There is not, according to my experience and the reports of the most eminent
surgeons, more than one case in ten thousand that requires the least assistance. 
I am aware, however, that there are crafty physicians who attempt and often
succeed in causing the distressed and alarmed female to believe that it would be
altogether impossible for her to get over her trouble without their assistance;
and for the purpose of making it appear that their services are absolutely
necessary, they will be continually interfering when there is not the least
occasion for it.  It is my confirmed opinion, after forty years' practice, that
there would be much less danger in cases of confinement, if they were entrusted
altogether to females.  There is no doubt in my mind but that one half of the
women attended by these men, are delivered before their proper period; and this is
the reason why we see so many deformed children, and meet with so many females who
have incurable complaints.  If the business was entrusted to aged midwives, they
would give more time, and nature would have an opportunity to do its work; and if
necessary, advice might be had with more safety."

     "It is a very common circumstance," says Dr. Beach, "for an inexperienced
practitioner to rupture the bladder in the attempt to rupture the membrane, which
would render the woman miserable during life.  I am acquainted with twenty five or
thirty females who have met with this sad misfortune, and many of them were
attended by those who were termed our most successful or old experienced
physicians."

     Dr. Rush, speaking of child-bearing among the Indians, says that "Nature is
their only midwife.  Their labors are short, and accompanied with but little pain,
and she returns in a few days to her usual employment; so that she knows nothing
of those accidents which proceed from the carelessness or ill management of
midwives or doctors, or the weakness that arises from a month's confinement in a
warm room."

     Says Dr. Whitney, "I pledge myself as a physician, that all honest doctors
will tell you that labor is the work of nature; and she generally does it best
when left to herself."

     Says Dr. Curtis, Professor of the Medical Institute at Cincinnati, speaking
of the use of instruments, the lancet, opium, and ergot in midwifery, "Strange to
tell, these and similar are the means which men have introduced into the 'art of
aiding women in child-birth,' on account of which they claim superiority of skill
over the proper sex, whose highest ambition was to watch the indications of
nature, to aid her timely and promptly. Sad change! when almost constant
wretchedness takes the place of rare and partial inconvenience.  I lay it down as
a rational position, on the strength of historical testimony as well as sound
logic, that women are as able as other animals to reproduce their species without
extrinsic aid."

     Says Dr. Dewees, a popular author on Midwifery, "It is a vulgar prejudice,
that great and constant benefit can be derived from the agency of an accoucheur,
especially during the active state of pain; and this feeling is but too often
encouraged by the ignorant and designing, to the injury of the patient, and to the
disgrace of the profession."

     Dr. Blundell, in his Obstetrics, relates a case where he was called in
consultation, after the scientific M. D. had labored two days to effect the
delivery of a child.  He says, "On entering the apartment, I saw the woman lying
in state, with nurses, accoucheur, and all the formalities attending a delivery;
one small point only was necessary to complete the labor, which was, that she
should be pregnant; although the practitioner, one of the omnipotent class, had
distinguished the child's head, there was in reality no child there.  A few hours
after, the patient died, and on examining the abdomen, we found the peritoneum
full of water, but the womb was unimpregnated, and no bigger than a pear."

     Dr. Ewell, in speaking of man midwifery, after thirty years' practice, says,
"I view the present increasing practice of calling upon men in ordinary births, as
a source of serious evils in child bearing, as an imposition upon the credulity of
women, and upon the fears of their husbands; as a means of sacrificing delicacy,
and consequently virtue--it is the secret history of adultery."  In his remarks to
the ladies on this subject, he says, "Away with your forebodings when pregnant;
believe the truth, that in all human probability you will do perfectly well, that
the most ordinary woman can render you every needful assistance without the
interference of doctors.  Their hurry, their spirit for acting, have done the sex
more harm than all the injudicious management of midwives, of which they are so
fond of talking.  This Dr. Denman, Dr. Buchan, and many other really great
physicians, have long since remarked."

     In view of the facts here presented, coming from the highest authority, who
that has candidly considered the subject, does not feel a spirit of indignation
against a class of men who should thus dupe and deceive confiding and suffering
females ? Let light on this subject be diffused among the fair sex, and an eternal
veto will be put upon the practice of male midwives. "Even so let it be."