Address on obstetrics : delivered before the International Medical Congress, at Philadelphia, September 7, 1876 / by Theophilus Parvin.

  • Parvin, Theophilus, 1829-1898.
Date:
1876
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    “ There is no department of medicine or surgery, superior to midwifery in dignity and utility'.”—Mauriceau. Of American Obstetrics, with its associate branches, Gynaecology and Paediatrics, we commemorate the centennial. "What have Americans done, in the century just closed, to advance these great departments of Medicine ? Plow easy the question and liow difficult the answer! Contemporaneous discoveries and successes are found in these as well as in other fields of human effort, and who, then, shall be primus inter pares ! Sometimes, too, that which is supposed to he new1 2 is really old, and the discoverer has unconsciously trodden in the footsteps of another. Beside this, much of medical knowledge is merely provisional, the best expression of the truth for the time being, and serves only a present utility—a mere ladder by which we ascend to higher platforms and larger planes, and which is then cast aside. Nor does everything claimed as valuable by him who first points it out, prove to be such when thoroughly tested. Alas, for the many Ixions who mistake a cloud for a goddess! Alas, for the fool’s gold that so often delights, so surely disappoints! Change is not synonymous with improvement; so far from change always being progress, it may be retrogression.3 Nor are these the only difficulties. Add to them the limitation of individual knowledge, and the infirmities of human judgment, so liable to error in estimating the value of things present, no matter how deter- mined and desirous one may be suum cuique tribuere. And surmounting all these, there stands in bold relief the fact that the very work of this occasion has been largely anticipated by an able paper in the American Journal of the Medical Sciences,3 from the pen of one who has himself contributed so much to the glory of American Medicine. Confronted by such difficulties, and addressing such auditors, one even of ample qualifi- cations might well shrink from attempting the duty assigned me. Plowever, strengthened by your recognition of these impediments, and 1 Professor Blackie, Horce Hellenicce, observes: “Even in the free exercise of poetical talent in the case of individual poets of highly potentiated imagination, we constantly stumble on comparisons which have been made independently by other poets at other times or in distant countries, and which superficial critics are sometimes eager to fasten on as plagiarism.” Quite similar facts are observed in the history of medicine. 2 Baudelocque, Yol. II, pp. 84, of L'Art cles Accouchemens, Paris, 1781, in referring to the obstetrical forceps remarks: “. . car si plusieurs ont travailU d sa perfection, les autres ne Con rendu que plus imparfait." 3 July, 1876. A Century of American Medicine. Ill—Obstetrics and Gynaecology. By T. Gaillard Thomas, M.l).
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    us,” giving a glimpse at the mechanism of labor, that mechanism soon to be much more fully and clearly expounded by Smellie and Solayres; we have Smellie and William Hunter, representing opposite but concordant elements of obstetrics, mechanism and physiology, the one writing a work upon obstetrics, the fruit of forty years’ study, which for nearly three- quarters of a century was thb best English text-book, and enduring the harmless criticism of Dr. Barton, who probably had his reward in being made the Dr. Slop of Tristram Shandy ; the other preparing those plates of the human gravid uterus, which can never become obsolete ; we have Levret, the geometric obstetrician, explaining the mechanism of labor before the Paris Academy of Surgery, using in his demonstrations the egg of an ostrich and a u mattrice mechanique,” and dividing with Smellie1 the honor of an important improvement in the forceps. With these two men, using the words of Baudeloeque, commenced the most brilliant epoch of obstetric art. But it is not my purpose to mention further the famous obstetricians of the eighteenth century, and allude to any of their special contribu- tions. Enough to add that the two first American obstetric practitioners had been instructed by two of the most eminent of London teachers, for Lloyd,2 in Boston, and Shippen,3 in Philadelphia, were pupils of Smellie and Wm. Hunter. Thus we see that the germ of American Obstetrics was British rather than French, in so far giving probable contradiction to the assertion of Dr. Tyler Smith when he states, “ notwithstanding the blood relation between the United States and this country, American Midwifery is far more the child of France than of England.” So, too, probable contradiction is given by these other facts, that Dr. Samuel Bard, the author of the first American work on obstetrics, had received his pro- fessional training largely in Edinburgh ; and that there, too, after having previously been a house-pupil in London under Drs. Osborne and John Clarke, was instructed Dr. T. 0. James, the first professor of obstetrics in the University of Pennsylvania. And the famous Dewees, who bears the same paternal relation to American Obstetrics that Physick does to American Surgery, or Rush to American Practice, and who u has the high honor of first attempting a full course of lectures on obstetrics in America,”4 was too independent a thinker and original investigator to he unduly swayed by the teachings of any man or of any school.5 6 And finally, the obstetric books of the American profession have been British or American much more than French. Seventy or eighty years ago, the practice of obstetrics was almost exclusively in the hands of women, even in the long settled parts of the United States, and, as the tide of population passed westward, the female midwife was still the trust of the matrons among the early settlers who 1 Possibly, according to the recent researches of Dr. McClintock, each of them was anti- cipated by Dr. Pugh (see Dublin Journal, June, 1876), so that there is an end to the con- test in this matter between France and England. 2 Dr. Bartlett, of Massachusetts, states that Dr. James Lloyd, of Boston, was the first systematic practitioner of midwifery in that section of the country, 1754. 3 In 1756 Dr. William Shippen engaged in the same practice at Philadelphia, and sub- sequently was Professor of Anatomy, Surgery, and Midwifery in the University of Penn- sylvania. 4 Eulogium upon William P. Dewees, by Prof. Hugh L. Ilodge. These lectures were first delivered in 1797. 6 “ Drs. James and Dewees should be regarded as the fathers of obstetric science in America: the former, erudite and polished, gave currency to the teachings of the British schools ; the latter, more vigorous and energetic, exemplifying theoretically and practically the doctrines of the French obstetricians.”—Preface to Hodge’s Obstetrics.
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