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Forceps

Page history last edited by Anna Laycock 7 years, 3 months ago

 

Forceps 


 Author and Researcher - Anna Katherine Laycock

 

Forceps are defined by the Oxford English Dictionary as "An instrument of the pincers kind, used for seizing and holding objects, esp. in surgical and obstetric operations." (OED). The use of forceps for obstetric purposes became prominent in the eighteenth century, with the rise of man-midwifery. However, the introduction of the instrument did cause some controversy, with opponents of the forceps deeming them unnatural and dangerous. Major players in the forceps debate included Edmund Chapman, William Smellie, John Burton, William Hunter and William Douglas, who all published essays, treatises and midwifery manuals stating their opinions on the best way to practice midwifery and criticising the methods of others. 

 

Obstetric forceps seldom appear in literature of the eighteenth 

A pair of 18th century forceps designed by William Smellie.(1)century, which is unsurprising due to their specific purpose and association with the most intimate parts of a woman's body. However, in Laurence Sterne's Tristram Shandy, forceps play a central role in the birth of Tristram and the forceps debate is discussed in the narrative. As I will explore further,Tristram Shandy engages with the arguments for and against forceps advocated by the leading obstetricians of the day in their publications. 

 

Overall, by investigating the use of forceps in the eighteenth century, one can explore the changing societal customs and perceptions of childbirth throughout the century; particularly how midwifery changed from a predominantly collective female practice to a medicalised male one. 

 

 

 A pair of 18th century forceps designed by William Smellie.(Image 1)

Contents


 

 

 

 


 

 

 

 

 

 

A brief history of the obstetrical forceps


 

Historically, the invention of the obstetrical forceps has been attributed to the Chamberlen family in the early seventeenth century. The Chamberlen family were Huguenot refugees who settled in London during the late sixteenth century. The eldest son, Peter Chamberlen (1560-1631) was a surgeon to Queen Anne and served as an accoucheur to Queen Henrietta Maria, being present at the birth of Charles II in 1630. It is thought that Peter was the original inventor of the forceps. The Chamberlens managed to keep their invention a secret within the family, passing the instrument down through three generations of Chamberlen obstetricians. However, at the beginning of the eighteenth century the secret had leaked with the first written accounts of similar but improved obstetrical tools appearing, such as from Chapman and Pugh who significantly both lived only a few miles away from the Chamberlens in Essex. By 1720, a similar instrument to the Chamberlen forceps was being demonstrated in Paris and there are accounts of at least two London obstetrician practitioners using a type of tool resembling the forceps. Yet, it was not until the 1730’s when the secret of the forceps at last truly became public. Edmund Chapman published his Essay Towards the Improvement of Midwifery in 1733 which included the first account of the obstetrical forceps and gave the instrument their name. As soon as the instrument was in the public domain, it was adopted by many other leading obstetricians such as Alexander Butter and William Giffard who also published works detailing the benefits of using forceps. However, the forceps were a controversial instrument which instigated debates as to whether interventionist equipment was necessary and safe during labour among obstetricians and midwives throughout the eighteenth century. 

 

 

 

The Chamberlen forceps which were discovered at their home at Woodham Mortimer Hall in Essex. They are now displayed at the Royal College of Obstretricians and Gynaecologists. (Image 2) 

 



Forceps and the rise of Man-Midwifery


 



This caricature(Image 3),drawn by Scottish illustrator Isaac Cruikshank, for a 1793 pamphlet written by Samuel William Fores arguing against man-midwifery, ridicules the role of the man-midwife. It highlights the man's reliance on instruments such as forceps, hooks and perforators, compared to the woman's more simplistic and natural techniques. The image depicts how men have been intruding into the traditional female occupation of the midwife, and thus illustrates this new hybrid Man-Midwife to be a monster. The text underneath the image reads "A Man-mid-wife, or a newly discover'd animal, not known in Buffon's time; for a more full description of this Monster , see, an ingenious book, lately published, price 3/6, entitled, Man-Midwifery dissected, containing a Variety of well-authenticated cases, elucidating this animal's Propensities to cruelty & indecency, sold by the publisher of this print, who has presented the Author with the Above for a Frontispiece to his Book".
 

In William Hunter and the Eighteenth Century Medical World, Adrian Wilson describes forceps as the “key to the lying-in room” for man-midwives. (343) The invention of the forceps can be attributed as one of the main factors for the sharp rise in man-midwifery during the eighteenth century. Midwifery was traditionally a female occupation, the expectant mother would be assisted by the local midwife and a number of female ‘gossips’ who were most likely neighbours and friends. Men were prohibited from the delivery room and for the preceding lying-in month. Before the invention of forceps and the rise of man-midwifery, childbirth was a communal female custom, therefore it is not surprising that there was opposition to the medicalisation of childbirth and the entrance of men into the lying-in room.

 

The use of forceps by man-midwives enabled men to gain access to the most intimate parts of the female body. Philip Rhodes, a historian of London’s first Lying-In Hospital states; “when the forceps became available to accoucheurs for the first time, it must have seemed as if there were a sudden flood of light cast in dark places!” (qtd. in Blackwell 78). Indeed, it can be seen that forceps allowed men to exert control over women’s bodies. Interestingly Bonnie Blackwell describes the “mechanical mother"; a life sized model of the pregnant female body, that was used in student lecture halls to demonstrate forceps (see Dolls for further information about artificial substitutes for the human body). Blackwell points out;

 

The medical theater brought the capricious womb and its fragile contents under the controlled setting of a university hall, and offered to obstetric students the promise of a total, visual mastery of the female body: a mastery so complete that their profession did not even need live women, because it could manufacture new and improved female bodies which were suited to its specifications. The innovations of eighteenth-century man-midwifery engendered a new perception of birth as theater, for doctors trained in surgeries and hospitals emerged with expectations about the female body, labor, and time which were premised on dramatic convention; they left universities convinced that labor, like all plots, could conform to the Aristotelian unities. (82)

 

With forceps as the principal prop, childbirth became a theatrical event in these student lectures. Labour was a dramatic plot, with the man-midwife as the hero, stepping in with his forceps to save the unborn child. This image of the ‘heroic’ man-midwife is satirised in Laurence Sterne’s Tristram Shandy, as I will explore later. Forceps enabled men to power over the female body; whereas before the unpredictable mother’s body was in control of the birth of her child, the forceps allowed men to intervene and speed up the process. 

 

Indeed, after the introduction of forceps, many midwifes and obstetricians publicly expressed their opposition to the instrument. They deemed the use of instruments and the intervention of man unnatural during childbirth. In her famous work, A Treatise on the Art of Midwifery, staunch forceps opposer and midwife, Elizabeth Nihell, posits; “Nature, if her expulsive efforts are but, in due time, and when requisite, gently and skilfully seconded by the hands alone, will do more, and with less pain than all the art of the instrumentarians, with their whole armoury of deadly weapons” (454). Nihell argues that Nature should be in charge of childbirth, not man, and that the “natural hand” is the “best instrument” (454). Nihell was firmly against man-midwifery, believing that they threatened the wellbeing of the woman and child. 

 

Nihell’s views were widely supported as can be seen from arguments against man-midwifery and the use of forceps in this article from the Hicky’s Bengal Gazette, published on the 20th of October 1781:

 

I take for granted I need instance no more Cases, to convince an unprejudiced Reader of the Danger of these abominable Forceps.Their very Nature, not only enables a Man—but in the Language of Doctor Smellie, tempts him to exert his Force, inconsistent with Safety.—Hands, are the best, and most natural Instruments. Is a Child to be torn thus from the Womb? —Horrible Idea—Satisfied that I have transcribed enough to convince any reasonable Person of the Danger of Instruments, I shall shock my Readers with no more such inhuman Relations—but refer whoever can remain unconvinced, to Doctor Sentelise's two Volumes.   If it be said that these Passages should not be read by Women, because they will frighten them—I answer, that there is no occasion for their being read by those Women who do not intend to employ a Man Midwife, wantouly, before they know that their Case is site of many thou-sands. But if a Woman does intend to employ a Man, notwithstanding the Custom is so indecent, and unnatural —it is better she should be frightened, by reading this Book—that risk being injured, perhaps irreparable, in parts of the most expensive Sensibility. (Hicky’s Bengal Gazette)

 

Using passionate language, rhetorical questions and hyperbole, the author of this article attempts to shock the reader and discourage them from employing a male-midwife. 

 

It is noteworthy that the article mentions Dr William Smellie, the leading man-midwife of the eighteenth century, as his use of forceps caused much anger among forceps opponents. Controversially, in his most famous work, A Treatise on the Theory and Practice of Midwifery, Smellie advocates that “the forceps be unlocked, and the blades disposed cautiously under the cloths so as not to be discovered” (272). Unsurprisingly, Smellie’s suggestion that the forceps be used secretly led to shock and outrage. It promoted the violation of women’s bodies by men, and depicted how forceps and the medicalisation of childbirth had allowed men direct and open access to women’s most intimate areas for the first time. Women in the eighteenth century were often dressed from head to toe in artificial adornments - clothing, wigs, make-up…etc (see Stockings, Swift’s A Beautiful Young Nymph Going to Bed and Pope’s The Rape of the Lock for information about the literary representation of women's dress) - therefore with the forceps, male-midwives were able to get under the many layers of clothing and have direct access to the physical body. Consequently, with the invention of the forceps and the rise of male-midwifery, the protection of women’s modesty and dignity was called into question.

 

 

"Doctor Forceps" satirical cartoon. This illustration depicts a blind and senile forceps practitioner.

This type of cartoon would have been widely distributed among the public through cheap prints.(Image 4)

 

 

 

 

Forceps in Midwifery Manuals, Treatises and Essays


 

 


 

Above are images from two eighteenth century books concerning midwifery.(Image 5)  (Image 6) The forceps debate was played out through essays, treatises, manuals and letters in which the authors argued their points and sought to persuade their readership. Bonnie Blackwell argues that “obstetric writing and fiction were, in the eighteenth century, far more prone to collision than has yet been acknowledged by either medical or literary historians” (85). Indeed, many eighteenth century books and documents regarding midwifery and the use of forceps can be seen as having similarities to fictional literary texts.

 

Obstetricians, such as Edmund Chapman, included first person accounts of some of the cases they attended to in their publications. Chapman’s An essay on the improvement of midwifery includes narratives about fifty of Chapman’s cases, often detailing his use of forceps. He can be seen as casting himself as the hero in these narratives;  he describes the midwives’ “endeavours of no service”, and by stepping in and using his forceps Chapman successfully “delivered [the woman] of a Son, who with his Mother is now living” (76;71). The cases are told like a story. Each has a dramatic title which summarises the case, such as; “Two children extracted by the Feet after the Membranes were broke”, “A Head separated and left behind in the Womb, extracted with the Crotchet”  or “Of a Woman that was delivered at the Anus.” (80; 82; 87). These dramatic and shocking titles are similar to newspaper headlines, they compel the reader to read the following narratives out of curiosity.

 

Significantly, some writers of midwifery books present their arguments through a series of letters. The form of these books resembles the popular epistolary novels of the eighteenth century. S.W Fores’s Man-Midwifery dissected uses the epistolary form. He presents his argument against man-midwifery and opinions about the use of forceps in fourteen letters addressed to Alex Hamilton, in response to Hamilton’s published letters to Dr W Osborn. There is a dichotomy in the use of the private and personal form of the letter in a public, open format of a published book. By using the epistolary form, the writers enhance their arguments by directly positioning themselves against another’s viewpoint. William Douglas’s Letter to Dr. Smellie (pictured above) ridicules Smellie’s newly invented wooden forceps and criticises the way he teaches and practices midwifery. Through the epistolary form, the forceps debate was played out clearly through writing; the arguments between obstetricians of differing opinions were staged in a public format. 

 

Obstetric writing and The Diary of Thomas Turner

 

It is interesting to compare eighteenth century obstetric writing to Thomas Turner’s account of the death and post-mortem of a pregnant woman from his parish in his diary. Turner writes on the 13th July 1756; “This day died Elizabeth Elless, and immediately after she was dead, Mr Adams told me Mr French and I would be fined on account of her death. The reason was because we carried her before a justice and asked her to swear the father” (50). It is insinuated in this short entry that it was believed to be a possibility that Elless committed suicide due to the pressure she was being put under from Turner and French to declare who the father of her child was. However, despite Turner’s personal involvement in the case and the probable grief it would have caused him, in the diary entries of the next two days Turner displays great emotional distance from the events. Indeed, Turner’s account of the post-mortem has many similarities to medical writing. 

 

On the 14th of July, Turner recounts the series of events leading up to Elizabeth Elless’s death, listing precisely the times that her symptoms appeared and using medical terminology. The next diary entry details the post-mortem itself. Turner gives a factual account of the operation, including a diagram of the incision made into Elless’ abdomen and presents the findings of the post-mortem in his diary;

 

They also opened the uterus where they found a perfect fine female child, which lay in the right position and        would, as they imagined, have been born in about 48 hours. And as the membranes were all entirely whole, and the mob full of the water common on such occasions, there was convincing proof she was never in travail. The ilea were all very much inflamed, as was the duodenum, but they both declared they could see no room to suspect poison. But if anything else had been administered, it had been carried off by her violent vomiting and purging. (53)

 

At the end of his diary entry Turner concludes that the most likely cause of Elizabeth Elless’ death was bilious colic. Significantly, the structure of the diary entry is comparable to a medical case study. Similar to William Smellie,Turner outlines the patient’s history, details the examination of the patient, relates the findings and presents a diagnosis. In this entry Turner adopts a medical discourse for his personal diary. It could be assumed that he was familiar with medical writing and modelled his narration on their format. Indeed, he does mention reading medical treatises in his diary such as "Mead On Poisons"and "the 5th volume of Medical Essays and Observations, published at Edinburgh by a society of physicians" (61; 113). It is notable that for Turner reading for pleasure included medical writing as well as fiction. Ultimately Turner's diary highlights that there are interesting similarities between medical writing and other forms of literature in the eighteenth century which can be researched further. 

 

For more information about the role and influence of medical literature in a different context during the eighteenth century, see Smelling Salts .

 

 

 

 

Smellie's drawing of straight and curved forceps, as illustrated in one of his midwifery manuals. (Image 7)

 

 

Forceps and Politics


 

Adrian Wilson in The Making of Man-Midwifery (1995) highlights how during the first few decades of forceps practice the use of forceps was split along party lines.  On the whole, Tory obstetricians were in favour of forceps and used them in their practice, whereas the Whigs were opposed to the instrument and favoured the style of an alternative midwifery promoted by Dutch obstetric surgeon, Hendrik van Deventer. England in the eighteenth century was a polarised political country, therefore it is not surprising that the forceps debate had a political element. 

 

Wilson points out that Hugh Chamberlen II was a Tory supporter and he sold his family’s invented forceps under an oath of secrecy to other Tories. Their shared political allegiance helped keep the instrument a secret. Significantly, it was not until after the death of Hugh Chamberlen and many of his exclusive circle of Tory obstetricians that the use of forceps became more widespread; firstly among other Tories and then much later in the century among Whigs as well.

 

Whig supporters in the early eighteenth century followed a much different, less interventionist style of midwifery. Hendrik van Deventer (1651-1724) rejected the use of manual instruments, and instead endorsed a style of childbirth based on adjusting the position of the mother. He published The art of midwifery improv’d in 1716 which became the most influential midwifery manual among his English supporters, or ‘Deventerians’. Wilson summarises Deventer’s theory, stating that;“the presentation of the child - on which previous authors had concentrated - Deventer reconceptualised as an aspect of total bodily posture or ‘turning’. The uterus could be oriented ‘directly’ which favoured a natural birth” (81). Also, the ‘Deventer’s Manoeuvre’ became popular among the Whig Deventerians. Wilson writes that the move involved “forcing the coccyx to bend backwards (as it does naturally in normal labour) thereby slightly enlarging the diameter of the passage” (82). Therefore by adjusting the mother’s posture to encourage delivery, instruments such as forceps would become practically unnecessary.

 

When the forceps were brought into the public in the 1730’s, the opponents of the new-invented instrument were Court Whigs who followed Deventer. Deventer’s method was the principal alternative to the forceps during the period as it favoured a more natural, less interventionist approach which forceps opponents approved of. 

 

 

A diagram of foetal positions, the birthing chair and three clyster pipes by Hendrik van Deventer for his book, The art of midwifery improved. Clyster pipes were used to inject herbal remedies into the mother's gut in order to clear it to allow a clearer passage for the baby. The birthing chair enabled the midwife assisting the birth easier access to the baby.(Image 8) 

 

 

 

 

Forceps in Tristram Shandy


 

 

Illustration of the aftermath of the birth of Tristram Shandy by H.W Bunbury. It depicts baby Tristram with a broken nose caused by Dr Slop's forceps. (Image 9)

 

 

The forceps debate is prominent in the novel Tristram Shandy by Laurence Sterne. Protagonist, Tristram, is the victim of the misuse of the instrument as his delivery by forceps causes him to have a broken nose. Tristram’s disdain for the forceps is evident throughout his narrative. His broken nose causes great grief for him and his family. Mr Shandy throws himself on the bed  in despair as he believes Tristram’s flattened nose will mean he will be unsuccessful in life, remembering the family history associating small noses with financial instability. Whilst Mr Shandy’s reaction is no doubt hyperbolic, the novel undoubtedly promotes the arguments against the use of obstetric forceps as I will go on to explore.

 

Firstly, the difference in descriptions of the midwife and Dr Slop, the clumsy forceps practitioner must be noted. The midwife is given an introduction early in the novel, Tristram describes her as a “motherly, notable, good old body of a midwife, who, with the help of a little plain good sense, and some years full employment in her business, in which she had trusted little to her own efforts, and a great deal to those of a dame nature, - had acquired, in her way, no small degree of reputation in the world” (12). Tristram goes onto relate how the midwife, a widow with young children, obtained her position after Yorick sets her up with a licence. Before the midwife enters, she is illustrated to be a caring, motherly figure - the sort of person you would want your child to be delivered by. In contrast the initial description of Dr Slop paints him as a comic ungainly figure. Tristram states; “Imagine to yourself a little, squat, uncourtly figure of a Doctor Slop, of about four feet and a half perpendicular height, with a breadth of back, and a sesquipedality of belly, which might have done honour to a Serjeant in the Horse-Guards” (93). Before the forceps are even used, the reader is compelled to favour the traditional figure of the midwife over the ridiculous forceps practitioner.

 

Significantly, forceps are frequently described using military language in the narrative, highlighting that the instrument is the weapon in the battle between the traditional female midwives and the new male-midwives, or accoucheurs. When Dr Slop forgets his bag of instruments he is described as having “come forth unarm’d” as he has left his “new-invented forceps” at home (97). The forceps were commonly described in the eighteenth century as the man’s ‘key to the lying in room’, thus without this vital instrument Dr Slop is useless. Consequently, Obadiah is sent to bring the forceps to Dr Slop “with all speed” despite the fact that they may be unnecessary as the labour has not yet encountered any difficulties (97). It is ironic that just before the delivery of Tristram by the forceps, they are described as the “armour” Dr Slop “had proved” to be “the safest instrument of deliverance”(136).  Armour is used as a means of protection for the body, however the forceps do the opposite by directly harming the small and vulnerable body of the baby. Ultimately, the forceps are the weapon that triumphs over the female midwife. As Gerald MacLean states; “steel swords, steel scissors, steel forceps: Walter Shandy does anything but resist the steel forceps of the ‘man of science’, but Mrs Shandy resists them adamantly. They eventually triumph over her” (540). The feminine space of the lying-in room and the female practice of midwifery is defeated by the male invention of the forceps.

 

It has been suggested that Dr Slop is a parody of Dr Burton, a well known forceps practitioner and author of An Essay Towards a Complete System of Midwifery (1751), who practised in and around York, close to where Sterne lived. Notably, Burton was an enemy of the Sterne family as Laurence Sterne’s uncle, Dr Jaques Sterne was the Justice of Peace and had a say in Burton’s arrest during the Jacobite risings of 1745. In his writings, Burton promotes the use of forceps and particularly his own invented “new Sort of Forceps, the use of which is far less prejudicial, either to the Woman or Child, and is much more commodious for the Operator” (383-384). Rene Bosch argues that “Slop’s forceps looks in all details like the improved medical instrument that Burton claimed he invented” (208). Therefore, it can be seen that as well as generally mocking forceps practitioners, the character of Dr Slop is a more personal attack on one male obstetrician.

 

 

 

Dr Burton's "Lobster Claw" forceps.(Image 10)

 

Interestingly, the forceps become a metaphor for the child they are going to deliver when they become stuck in Dr Slop’s bag and he pulls them out with considerable difficulty. After a debate with Toby about the value of his newly-invented forceps, Dr Slop “thrust his hand into the bag” and “fumbled so vilely in pulling them out, it took off the whole effect (for they seldom come alone in this life) in pulling out his forceps, his forceps unfortunately drew out the squirt along with it” (168). The squirt is a foreboding instrument as it was used to baptise unborn infants when it was clear they were not going to survive, thus the object’s mention further insinuates that Tristram’s birth will not go smoothly. Also, if the bag can be seen as representing Mrs Shandy’s abdomen and the forceps baby Tristram, the unintentional removal of the squirt could be seen as symbolising the danger of perforation of the bladder which was associated with misuse of forceps. Therefore, the ungainly removal of the forceps from the bag highlights the danger Mrs Shandy and her baby are in from the instrument and its incompetent practitioner.

 

Like the bag, Toby becomes a surrogate for Mrs Shandy in the narrative. Significantly the actual birth scene happens offstage, the reader is not given access to it. Instead we see Toby being injured by the forceps. Dr Slop demonstrates his forceps on Toby’s hands, leading Toby to cry out; “Upon my honour, Sir, you have tore every bit of the skin quite off the back of both my hands with your forceps…and you have crush’d all my knuckles into the bargain with them, to a jelly” (169).  Bonnie Blackwell points out that Sterne uses “language of conception and delivery” to describe Toby as “he is ‘confined’ (T, 1:84) as a woman is and is “full two months gone” (T, 1:94) at one point” (118). Toby’s body becomes the substitute mother. Therefore, the pain inflicted on Toby’s hands by the forceps symbolises the pain inflicted offstage on the silenced Mrs Shandy by the controversial instrument.

 

Furthermore, the brutality of the forceps is further suggested by the threat they make to Tristram’s genitals. Dr Slop tells Mr Shandy “if the hip is mistaken for the head there is a possibility (if it is a boy) that the forceps **************************.” (169). Thus when we are told that Dr Slop “in bringing [Tristram] into the world with his vile instruments, he has crush’d his nose…as flat as a pancake to his face” (193). The nose becomes synonymous with the penis even though Tristram himself denies this. The size of the nose and the penis represent masculinity - the bigger, the better - consequently, Sterne emphasises that Tristram’s masculinity has been damaged by the forceps. 

 

The narrative of Tristram Shandy with its frequent long digressions and loose plot can be seen as a narrative that defies the clock. From the first chapter it is clear that the measurement of time will be a prominent theme as Mrs Shandy interrupts the act of sexual intercourse with her husband asking; “Pray, my dear…have you not forgot to wind up the clock”(6). Her seemingly insignificant and inappropriate comment sets forth a narrative that attempts to thwart the clock. Notably, the clock enters into the forceps debate. After Mr Shandy has seen the effect the forceps had on Toby’s hand he begins to become uncertain about the safety of the instrument. Yet, instead of criticising the forceps he criticises the clock, stating that “in our computations of time, we are so used to minutes, hours, weeks, and months, — and of clocks (I wish there was not a clock in the kingdom) to measure out their several portions to us, and to those who belong to us” (172). If life was not measured by the clock there would be no need for forceps as nature would take its own time in delivering a child without human intervention. Interestingly, Elizabeth Nihell argues in A Treatise on the Art of Midwifery (1760), that "art should aim at imitating Nature: now Nature proceeds leisurely instead of which the forceps goes too quick to work" (415). Tristram Shandy imitates Nature; the narrative can be seen as symbolising a woman’s body, with the birth of the story like the birth of the child; unpredictable and takes a long time. 

 

Overall,  despite the light-hearted comic tone, forceps are presented as a dangerous and unnecessary instrument in Tristram Shandy. The novel implies that nature, not man should be in charge of childbirth and intervention can do more harm than good. The arguments Sterne advocates against the forceps relate to many of the arguments put forward by the anti-forceps obstetricians in their treatises, essays and midwifery manuals. Consequently, Sterne enters this debate through the use of comedy and caricature to mock the arrogant men-midwives and their key to women’s bodies; the forceps. 

 

 

 

Ten diagrams illustrating different methods of delivering a baby using forceps, 1791. (Image 11)

 

 

 

 

Links to relevant websites 


 

A Demonstration of some Eighteenth Century Obstetric Forceps - Journal of the Royal Society of Medicine

 

Extracts from William Smellie's A Treatise on the Theory and Practice of Midwifery

 

Milestones in the evolution of obstetric forceps by Bryan Hibbard

 

A set of 18th Century obstetric forceps - Wellcome Library

 

The start of life: a history of obstetrics by J. Drife - Postgraduate Medical Journal

 

A Treatise on the Art of Midwifery by Elizabeth Nihell

 

 

 

Annotated Bibliography


 

Primary (18th Century Sources)

 

 Burton, John. An Essay towards a Complete New System of Midwifry, Theoretical and Practical: Together with the Descriptions, Causes, and Methods of Removing, or Relieving the Disorders Peculiar to Pregnant and Lying-in Women, and New Born Infants ; Interspersed with Several New Improvements ; Whereby Women May Be Delivered, in the Most Dangerous Cases, with More Ease, Safety, and Expedition, than by Any Other Method Heretofore Practised ; Part of Which Has Been Laid before the Royal Society at London, and the Medical Society at Edinburgh ; after Having Been Perused by Many of the Most Eminent of Their Profession, Both in Great Britain and Ireland ; by Whom They Were Greatly Approved of ; All Drawn up and Illustrated with Several Curious Observations, and Eighteen Copper-plates ; in Four Parts. London: Printed for J. Hodges, 1751. ECCO. Web. 6 Feb. 2014.

 

Dr Burton’s essay promotes his views on how midwifery should be practised. He criticises Dr Smellie’s methods, particularly his leather covered forceps, and presents his own improved design of the forceps. As Dr Slop in Tristram Shandy is thought to be a parody of Dr Burton, I used this source to compare the two figures. 

 

Chapman, Edmund. An Essay on the Improvement of Midwifery Chiefly with Regard to the Operation. To Which Are Added Fifty Cases, Selected from Upwards of Twenty-five Years Practice. By Edmund Chapman, Surgeon. London: Printed by A. Blackwell, for A. Bettesworth and C. Hitch, J. Walthoe; and Sold by T. Cowper, 1733. ECCO. Web. 15 Jan. 2014.

 

Edmund Chapman’s essay was the first account of the obstetrical forceps. He essay details in what sort of cases require forceps and how to use them. He details fifty different cases of labours he worked on. I found the style of writing in this source is comparable to that of fictional literary texts. I used this source to look at the similarities between obstetric writing and fiction. 

 

Deventer, Hendrik Van. The Art of Midwifery Improv'd Fully and Plainly Laying down Whatever Instructions Are Requisite to Make a Compleat Midwife. ... Illustrated with 38 Cuts ... Written in Latin by Henry à Daventer. London: Printed for E. Curll, J. Pemberton, and W. Taylor, 1716. ECCO. Web. 9 Feb. 2014.

 

Deventer’s book promotes a non-interventionist midwifery that was an alternative to forceps practice. I looked at how Deventer’s methods were taken up by Whig obstetricians who opposed forceps.

 

Douglas, William. A Letter to Dr. Smellie Shewing the Impropriety of His New-invented Wooden Forceps ; as Also, the Absurdity of His Method of Teaching and Practising Midwifry. By William Douglas. London: Printed for J. Roberts, 1748. ECCO. Web. 16 Jan. 2014.

 

William Douglas’s letter ridicules Dr Smellie’s use of wooden forceps and his midwifery methods. I found this source interesting as it is written in the epistolary style, and I used it to analysis the effect of the letter form in obstetric writing.

 

Fores, Samuel William. Man-midwifery Dissected; Or, The Obstetric Family-instructor. For the Use of Married Couples, and Single Adults of Both Sexes. Containing a Display of the Management of Every Class of Labours by Men and Boy-midwives; Also of Their Cunning, Indecent, and Cruel Practices. Instructions to Husbands How to Counteract Them. A Plan for the Complete Instruction of Women Who Possess Promising Talents, in Order to Supercede Male-practice. Various Arguments and Quotations, Proving, That Man-midwifery Is a Personal, a Domestic, and a National Evil. In Fourteen Letters. Addressed to Alex. Hamilton ... Occasioned by Certain Doctrines Contained in His Letters to Dr. W. Osborn. London: Published for the Author, by S.W. Fores; and to Be Had of All the ellers in Town and Country, 1793. ECCO. Web. 4 Feb. 2014.

 

This source criticises the practice of male-midwives, deeming them unnatural. I used this source to examine the opposition to man-midwives, as well as analysing the letter format Fores uses. 

 

Nihell, Elizabeth. An Answer to the Author of the Critical Review, for March, 1760. Upon the Article of Mrs. Nihell's Treatise on the Art of Midwifery. By Mrs. Elizabeth Nihell, Professed Midwife. London: A.Morley, 1760. ECCO. Web. 2 Feb. 2014.

 

Elizabeth Nihell addresses a letter to the author of the Critical Review in response to an article criticising her A Treatise on the Art of Midwifery. This source demonstrates how the forceps debate was played out on the public stage through written publications.

 

---. A Treatise on the Art of Midwifery: Setting Forth Various Abuses Therein, Especially as to the Practice with Instruments: The Whole Serving to Put All Rational Inquirers in a Fair Way of Very Safely Forming Their Own Judgment upon the Question, Which It Is Best to Employ, in Cases of Pregnancy and Lying-in, a Man-midwife, Or, a Midwife. London: Printed for A. Morley ..., 1760. Medical Heritage Library. Web. 5 Feb. 2014.

 

Nihell’s famous treatise criticises man-midwifery and the use of forceps. She puts forward a number of arguments against the use of forceps and highlights the use of instruments to be unnatural. Many of the arguments in her work are similar to those advocated in Tristram Shandy. I used this source to analysis the opposition to forceps and man-midwives.

 

Smellie, William. A Collection of Cases and Observations in Midwifery By William Smellie, M.D. To Illustrate His Former Treatise, or First Volume, on That Subject. Vol. II. London: Printed for D. Wilson and G. Nicol, and T. Durham, 1768. ECCO. Web. 2 Feb. 2014.

 

In this book, Smellie illustrates what he believes is the best way to use forceps. He his experiences of obstetrics through narrating a series of cases. I read this source alongside Smellie’s Treatise to analysis the way Smellie promotes forceps.

 

---. A Treatise on the Theory and Practice of Midwifery. London: Printed for D.Wilson, 1752. Google Books. Web. 4 Feb. 2014.

 

Smellie’s Treatise was one of the most influential and controversial books concerning forceps in the eighteenth century. Smellie was a prominent forceps practitioner and in his Treatise he promotes the use of the instrument. I used this source to examine the debate between obstetricians about forceps and how they should be used.

 

Sterne, Laurence. Tristram Shandy. London: Penguin Classics, 2012. Print.

 

Sterne’s novel is one of the only pieces of literature from the eighteenth century that mentions the use of forceps, and can be seen as the only work to do so in any detail. I used Tristram Shandy extensively to analyse the presentation of forceps in literature. 

 

Turner, Thomas. The Diary of Thomas Turner, 1754-1765. Ed. David Vaisey. Oxford: Oxford UP, 1984. Print.

 

Thomas Turner's diary provides an account of mid eighteenth century rural life. Turner held a number of important positions in East Hoathly including; the shopkeeper, schoolmaster, undertaker, surveyor, and overseer of the poor. I found the description of the death and post-mortem of the Elizabeth Elless particularly interesting as Turner's narrative is comparable to medical discourse.

 

Unknown. "Vol. II Pages 465 and 466." Hicky's Bengal Gazette [Calcutta] 20 Oct. 1781, 39th ed.: n. pag. Eighteenth Century Journals. Web. 3 Feb. 2014. http://0-www.18thcjournals.amdigital.co.uk.pugwash.lib.warwick.ac.uk/transcript.aspx?imageid=261087,261089&searchmode=true&previous=0

 

This author of this article staunchly opposes the use of forceps. He uses persuasive language to discourage his readers from employing a man-midwife and warns them of the horrors of forceps. I used this article to look at how forceps were presented in the press. 

 

Secondary Sources

 

Blackwell, Bonnie. "Tristram Shandy and the Theater of the Mechanical Mother." Elh 68.1 (2001): 81-133. Project MUSE. Web. 10 Jan. 2014.

 

Blackwell discusses the rise of the medicalisation of midwifery in relation to Tristram Shandy. She describes the ‘mechanical mother’, a model of a woman’s body used to demonstrate forceps in student lecture theatres. I found this source particularly useful when exploring the representation of forceps in Tristram Shandy, as well as providing socio-historical information about the rise of man-midwifery.

  

Landry, Donna, and Gerald Maclean. "Of Forceps, Patents and Paternity: Tristram Shandy." Eighteenth Century Studies 23.4 (1990): 522-43. JSTOR. Web. 15 Jan. 2014.

 

This article analyses the depiction of childbirth in Tristram Shandy. I used this article when analysing the portrayal of forceps in the novel. 

  

Wilson, Adrian. The Making of Man-midwifery: Childbirth in England, 1660-1770. Cambridge, MA: Harvard UP, 1995. Print.

 

Wilson’s book is a historical study into the rise of man-midwifery in the eighteenth century. This source was extremely useful for providing background information about the changes childbirth underwent during the eighteenth century. This source was particularly useful for providing information regarding the political debate around forceps. 

  

---. "William Hunter and the Varieties of Man-midwifery." William Hunter and the Eighteenth-century Medical World. Ed. W. F. Bynum and Roy Porter. Cambridge: Cambridge UP, 1985. 343-69. Print.

 

This chapter by Wilson examines the rise of man-midwifery in the eighteenth century, with particular reference to William Hunter, a leading man-midwife who opposed the use of forceps. This source was useful in examining the opposition to forceps by leading obstetricians. 

 

Images

 

1.   Smellie's Obstetrical Forceps. 2010. Photograph. Science Museum, London.Science Museum. Web. 01 Feb. 2014. <http://www.sciencemuseum.org.uk/objects/obstetrics_gynaecology_and_contraception/A500206.aspx>

 

2.   The Chamberlen Forceps. N.d. Photograph. Royal College of Obstetricians and Gynaecologists., London. Liverpool Medical Institution. Web. 10 Jan. 2014. <http://www.lmi.org.uk/Data/10/Docs/18/18Hibbard.pdf>.

 

3.   Cruikshank, Isaac. A Man-Midwife. 1793. Wellcome Library, London. Wellcome Library. Web. 12 Feb. 2014. <http://blog.wellcomelibrary.org/2012/12/man-midwife/>.

 

4. Darly, M. Dr Forceps. 1773. Black and white line engraving. Colonial Williamsburg, Williamsburg. Colonial Williamsburg. Web. 27 Feb. 2014. <http://www.history.org/Foundation/journal/Winter03-04/cartoons.cfm?showSite=mobile>.

 

5.    Nihell, Elizabeth. An Answer to the Author of the Critical Review, for March, 1760. Upon the Article of Mrs. Nihell's Treatise on the Art of Midwifery. By Mrs. Elizabeth Nihell, Professed Midwife. London: A.Morley, 1760. ECCO. Web. 2 Feb. 2014. http://find.galegroup.com/ecco/retrieve.do?sgHitCountType=None&sort=Author&tabID=T001&prodId=ECCO&resultListType=RESULT_LIST&searchId=R3&searchType=BasicSearchForm&currentPosition=3&qrySerId=Locale%28en%2C%2C%29%3AFQE%3D%280X%2CNone%2C16%29elizabeth+nihell%3AAnd%3ALQE%3D%28BA%2CNone%2C124%292NEF+Or+0LRH+Or+2NEK+Or+0LRL+Or+2NEI+Or+0LRI+Or+2NEJ+Or+0LRK+Or+2NEG+Or+0LRF+Or+2NEH+Or+0LRJ+Or+2NEM+Or+0LRN+Or+2NEL+Or+0LRM%24&retrieveFormat=MULTIPAGE_DOCUMENT&userGroupName=warwick&inPS=true&contentSet=ECCOArticles&&docId=CW3308555063&retrieveFormat=MULTIPAGE_DOCUMENT&docLevel=FASCIMILE&workId=CW3308555063&relevancePageBatch=CW108555063&showLOI=&contentSet=&callistoContentSet=ECLL&docPage=article&hilite=y

 

6.   Douglas, William. A Letter to Dr. Smellie Shewing the Impropriety of His New-invented Wooden Forceps ; as Also, the Absurdity of His Method of Teaching and Practising Midwifry. By William Douglas. London: Printed for J. Roberts, 1748. ECCO. Web. 16 Jan. 2014.http://find.galegroup.com/ecco/retrieve.do?sgHitCountType=None&sort=Author&tabID=T001&prodId=ECCO&resultListType=RESULT_LIST&searchId=R2&searchType=BasicSearchForm&currentPosition=21&qrySerId=Locale%28en%2C%2C%29%3AFQE%3D%280X%2CNone%2C15%29william+douglas%3AAnd%3ALQE%3D%28BA%2CNone%2C13%29+2NEL+Or+0LRM%24&retrieveFormat=MULTIPAGE_DOCUMENT&userGroupName=warwick&inPS=true&contentSet=ECCOArticles&&docId=CW3307276864&retrieveFormat=MULTIPAGE_DOCUMENT&docLevel=FASCIMILE&workId=CW3307276864&relevancePageBatch=CW107276864&showLOI=&contentSet=&callistoContentSet=ECLL&docPage=article&hilite=y

 

7.   Smellie, William. A Sett of Anatomical tables, with Explanations, and an Abridgement, of the Practice of Midwifery, with a View to Illustrate a Treatise on That Subject, and Collection of Cases. London: Published for the author, 1754.http://find.galegroup.com/ecco/retrieve.do?sgHitCountType=None&sort=Author&tabID=T001&prodId=ECCO&resultListType=RESULT_LIST&searchId=R6&searchType=BasicSearchForm&currentPosition=113&qrySerId=Locale%28en%2C%2C%29%3AFQE%3D%280X%2CNone%2C7%29smellie%3AAnd%3AFQE%3D%280X%2CNone%2C7%29forceps%3AAnd%3ALQE%3D%28BA%2CNone%2C13%29+2NEL+Or+0LRM%24&retrieveFormat=MULTIPAGE_DOCUMENT&userGroupName=warwick&inPS=true&contentSet=ECCOArticles&&docId=CW3307563929&retrieveFormat=MULTIPAGE_DOCUMENT&docLevel=FASCIMILE&workId=CW3307563929&relevancePageBatch=CW107563929&showLOI=Yes&contentSet=&callistoContentSet=ECLL&docPage=article&hilite=y

 

8. Deventer, Hendrik Van. The Art of Midwifery Improv'd Fully and Plainly Laying down Whatever Instructions Are Requisite to Make a Compleat Midwife. ... Illustrated with 38 Cuts ... Written in Latin by Henry à Daventer. London: Printed for E. Curll, J. Pemberton, and W. Taylor, 1716. ECCO. Web. 9 Feb. 2014. http://ihm.nlm.nih.gov/luna/servlet/detail/NLMNLM~1~1~101434228~139734:-Various-positions-of-fetus-in-uter

 

9.   Bunbury, H. W. An Episode in Tristram Shandy: Dr. Slop with His Wig on Fire Angrily Gesticulating to Susannah Who Holds Her Nose near the Wounded Baby Tristram Shandy. 1773. Wellcome Library, London. Wellcome Library. Web. 13 Feb. 2014. <http://blog.wellcomelibrary.org/2012/12/man-midwife/>.

 

10. Burton's Lobster Claw Forceps. N.d. Photograph. Department of Obstetrics, University of Edinburgh, Edinburgh. The Obstetrician's Armamentarium. San Anselmo: Norman, 2000. 38. Google Books. Web. 17 Feb. 2014.http://books.google.co.uk/books?id=NkLYuno1QDIC&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false

 

11Unknown. Ten Diagrams Illustrating Various Methods of Delivering a Baby Using Forceps. 1791. Etching. Wellcome Library, London .http://catalogue.wellcomelibrary.org/record=b1174960

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