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The same bright halo that in life she threw.
And left the stalk all flowerless to pine;
This was the curse that fell upon my life-
THE INTRODUCTORY ADDRESS DELIVERED FOR THE
FEMALE MEDICAL SOCIETY,
AT THE HANOVER SQUARE ROOMS,
BY JAMES EDMUNDS, Esq., M.D., FELLOW OF THE MEDICAL SOCIETY OF LONDON, &c., &c., &C., Upon the Occasion of Opening the Second Session of the Ladies' Medical College,
Fitzroy Square, London.
The attempt to provide for ladies opportunities like those which have long been accessible only to gentlemen, for the scientific study of midwifery and its cognate subjects, was last October a mere embryo project. A year's experience on the part of the officers of the Female Medical Society, in connection with the college which is now established in Fitzroy Square, has, however, only confirmed the opinions of those who set the project on foot. Fourteen students entered to the first year's courses of lectures, and the fees paid by those ladies have nearly reimbursed the commitiee for the lecturer's fees. This fact is one of fundamental importance, as, although in the organisation and starting of such an institute, there are large preliminary expenses, which must be met by benevolent persons, yet, in a country like England, the permanent vitality and fructification of the movement can only be secure, when this kind of teaching proves to be as much self-supporting as other kinds of collegiate education. It is only upon this basis, that the college now commenced in London will become the parent of like colleges in other parts of the country; and only when intelligent wellqualified women appear everywhere to urge their claim to this field of usefulness, will it become the custom to employ women as midwifery attendants in general.
So far as the conduct of last year's students enables the committee to predict as to the ultimate taking root of this movement in England, the evidence is all on one side. These ladies have quite equalled in intelligence, attention, and perseverance, their compeers of the other sex; while, in some points, it is thought that impartial observers would have awarded to them the palm. I am particularly borne out in this statement by the opinion of my colleague, Dr. Murphy, who, as Professor at University College, has had no less than twenty-three years' experience in lecturing to male students; and, on the other hand, letters received from patients, who have employed attendants recommended by the committee, have been in every way satisfactory and promising.
Upon a former occasion, when I had the honour of speaking upon this subject to the friends of this Society, it was argued from the structure and physiology of the brain, that there is no evidence of any inferiority of quality in the female mind, as compared with that of the male; and that, while it is clear-alike from the history of deeds performed, and from daily observation of the configuration and size of the female-that, for energy, endurance, and range of power, the male is unquestionably the superior, yet that the ordinary practice of midwifery calls forth none of those faculties for which the male is preeminent; while there are other points in woman—her tenderness of feeling-her instinctive acquaintance with, and sympathy for, the associations of maternity-the unreserved confidence which her sex secures--and the slender delicate hand with which she is furnished which individually and collectively confer upon her a superiority and aptitude for this work so clear, as to make it most singular that ever she should have been ousted by men from a place which is the first and most womanly outside the domestic circle. This substitution was first effected in a dissolute society by the caprice of a French lady, whom, in other respects, the women of England would be the last to imitate ; yet now, strange to say, we are constrained to admit that “they manage these things better in France."
It is a singular anomaly, that up to this day in England the practice of midwifery is altogether unprovided for and unregulated by the State ; that any worn-out old woman can set up and practice midwifery with impunity ; that women who wish to qualify themselves properly have no means of doing so; and that there is no recognised examination open to women which would enable the public to distinguish the qualified from the unqualified, and would save respectable practitioners from being confounded with the careless, ignorant, drunken old creatures who now attend thousands of our poorer class women.
Until the Act of 1815, medical men were in the same position; but now every one must follow out a specified course of study, and pass a recognised test by public examination, before commencing practice. It will at once be evident that the prestige and privileges which attach to public recognition would benefit alike the practitioners of midwifery and the public who require their services. The Female Medical Society is anxious to see brought forward a complete scheme for subjecting female practitioners of midwifery to appropriate regulations; but, at present, its powers are fully occupied with organising proper means of instruction, and arousing the attention of the public.
Beyond and above all other considerations in favour of employing women as midwives, are facts which come out, if we turn to the mortality tables of childbirth and investigate results where the patients have been left in the hands of women, and where, on the other hand, they have had "the advantage” of attendance from educated and skilled medical men.
The Registrar-General has kindly furnished me with returns of the deaths from “puerperal causes” among the entire population of London for the last five years. By the politeness of Mr. Seabrook, the Secretary of the Royal Maternity Charity, I have also been furnished with the returns from the practice of that institution for the last fifteen years.
In the Royal Maternity Charity the aggregate numbers for the fifteen years have been :-Deliveries, 47,600 ; deaths “from all causes,” 133, or i in every 358 ; deaths from "puerperal causes,” 86, or i in every 554. The maximum mortality in any one year from "puerperal causes” has been ui in 3,781 deliveries, or 1 in 344 ; and there is, on the other hand, one year in which the deaths “from all causes' were only 2 in 3,297 deliveries, or 1 in 1,650.
During the five years, 1860-4 inclusive, there were in the practice of this Charity Deliveries, 17,242 ; and deaths from “puerperal causes” 31, or i in 556 ; while, for the same period, the figures from the entire population of London show, on the authority of the Registrar-General, deaths from “puerperal causes," 2,361, to births, 492,634, or i in 2081.
To obtain a more perfect comparison between the returns of the Charity and those of the rest of London, the births and deaths from the Charity must be deducted from the general returns, of which, of course, they form a part ; and we then get the following death rates :-The patients of the Charity die from “puerperal causes" at the rate of 1 in every 556 births ; while those from the rest of the London population die at the rate of 1 in every 204.
In these calculations, “puerperal causes" includes, from the RegistrarGeneral's report, those deaths registered as from “childbirth," and those registered as from “metria." The first may be taken to include all the deaths arising from accident, or irregularity in childbirth itself; the second, those caused by the various modifications of puerperal fever, or bloodpoisoning, which arise in connection with parturition; but it does not include the specific contagions-such as “scarlet fever," "small pox," &c., nor "phthisis,” the deaths from which, although occurring in childbed, are registered under their distinctive headings. The figures from the reports of the Royal Maternity Charity refer precisely to the same two classes of deaths.
These calculations reveal the startling fact that the “poor married women” attended at their own homes by the midwives of the Royal Maternity Charity die from “puerperal causes ” in little more than onethird of that ratio which occurs among the rest of the population of London, which, it is well known, is chiefly attended by medical men. Yet all the patients of this charity dwell in the worst districts of central