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.
THE END.