The Making of Man-Midwifery by Adrian Wilson

Author:Adrian Wilson [Wilson, Adrian]
Language: eng
Format: epub
ISBN: 9780429663352
Barnesnoble:
Publisher: Taylor & Francis
Published: 2018-12-12T00:00:00+00:00

Chapter Nine

A new synthesis: William Smellie

We come now to the most famous of the men-midwives. William Smellie initiated the large-scale teaching of midwifery in London; he realized the potential of the midwifery forceps; and he produced a Treatise on the theory and practice of midwifery that dominated published obstetrics for a generation and beyond. And Smellie towers even higher over historical images of this subject: he has received two full-scale biographies, his three-volume treatise was reprinted with copious notes in 1876–78, and his name even finds its way into history books and into the Dictionary of scientific biography.1 A rounded picture of Smellie’s midwifery would require a book in itself; here I shall examine him from a few selected angles, paying particular attention to the development of his methods, chiefly in the 1740s.

Life and writings

In the 1720s Smellie was a surgeon and apothecary in Lanark; among the cases in his local practice was emergency obstetric surgery of the traditional kind.2 His chief techniques were craniotomy and turning the child — although at some point he acquired a fillet from his local colleague Dr Inglis, and a blunt hook from Dr Gordon of Glasgow. Neither of these instruments altered the basic constraint that he was usually called to deliver a dead child, and his obstetric surgery was merely part of a wider general practice, for which he was well equipped by his earlier experience as a naval surgeon.3 But in 1737, having become aware of the recently published forceps, Smellie began to concentrate on midwifery, embarking on a mission to acquire the instrument and to realize its potential for saving the lives of children.4 Although married, he had no children of his own and could there-fore travel in pursuit of this goal. In 1739 his quest took him first to London and then to Paris, where he attended the forceps classes of Grégoire. Returning to London in the following year (1740), Smellie set himself up as a teacher of midwifery; in the next 10 years he taught over 900 male practitioners, and an unknown number of “female pupils”. Like Grégoire in Paris and Manningham in London, Smellie used “machines” that simulated the female pelvis and the unborn child. In a remarkable innovation that both imitated and outflanked Manningham’s lying-in infirmary, he induced poor mothers to be used as teaching material by setting up a fund for their maintenance during lying-in. This inverted the prevailing relations between practitioner and patient; and the gossips, the mother’s female friends, were replaced by the pupils, Smellie’s mostly male friends.5 The lying-in fund (to which his pupils contributed) was a large-scale initiative, encompassing 1150 mothers within 10 years, i.e. more than two deliveries a week.6 Smellie made his teaching cheap — three guineas as against Manningham’s 10 or 20 guineas; he offered further courses at a discount rate, enabling a pupil to deepen his or her knowledge; and he issued certificates of attendance, which gave his former pupils quasi-licences. All these arrangements Smellie seems to have developed in the early 1740s.

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