Letters to ladies, detailing important information concerning themselves and infants

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LETTERS TO LADIES,

Dedication

To the Wives of the Ministers of the Gospel of the United States.

Ladies,

It is not more on account of your respectability that I inscribe these Letters, than from the influence which your example must have with the generality of your sex. You will never refuse to join in the work of promoting female delicacy and usefulness ; and therefore I ask you not only to read these letters seriously, for your own good, and for the good of the offspring rising to take charge of the country — but to assist me in persuading all women to devote a few hours to the consideration of the subjects thus pressed upon their attention.

Preface

A long time lias elapsed, since I promised a publication on the subjects treated of in these letters. Thoush constantly solicitous to have a few weeks spared from my pressing engagements to prepare them, I could not earlier succeed. I have seized the first opportunity, and although I have not delayed to give a better dress — -the substance, the doctrines, the directions, are as 1 wish, and may be safely relied upon by the ladies.

It was my intention, at one time, not to have annexed my name to these letters, as I was not ambitious for any other feeling than that of having made the attempt to serve the sex. But it soon appeared indispensably necessary, that advice on such important subjects, to be properly attended to, should come from a responsible man, of regular professional education.

The part relating to the offices women should perform to each other at births, has nothing to recommend it, but the correctness of the extracts from the best writers, occasionally divested of such technical terms as could be dispensed with. So much has been written on midwifery, and such is the simplicity of the operations of nature for delivery; that it

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X PREFACE.

would puzzle ingenuity itself to devise a new idea on the subject ; much less an improvement in practice.

I am sensible that it is the opinion of medical characters of mind, that, as the world abounds in such a variety of books, no man should publish, unless he had something new to communicate. Mv chief object is, the instruction of those, who know uot what has been published. To disseminate, among the uninformed, the improvements of the learned, I consider nearly as respectable as making the improvements. To a mind, thinking only of doing good, the business of dissemination is just as pleasurable as that of discovery. Nevertheless, I am not unconscious of making some original suggestions in this work. Had some of them oc^ curred to those familiar in the make of books, they would have been conveyed in larger volume. The necessity of condensation, on the present occasion, ought not to prevent their receiving full attention. On the subject of exciting the flow of milk from fche breasts, particularly iu cases of barrenness, I am anxious for an early application, because convinced it will prove of general utility.

How far, in most countries, medicine should be trusted in the hands of common people,— is a question of difficult, doubtful decision : for one presuming medlar has often done as much mischief, as the judicious have done good. But, if there be a eoimtty in which medical knowledge may be dif-

PREFACE. XI

fused, it is in the United States, where professional services are so often dilatory and out of time. If there be a part of the community to whom this knowledge should be confined, it is, assuredly, the female part, — at least concerning themselves and children. Their delicacy of frame, and sensibility of system, leading to speedy termination of disorders, renders this knowledge, by them, not of questionable value, but of most important benefit. Instead of giviug articles to the sick in their families, contrary to proper treatment, or withholding some little remedy, equal to the cure in the commencement, they might, without much intellectual exertion, acquire such knowledge as would insure essential service ; at least until the arrival of physicians. The more they attend to such knowledge, they will be endeared the more ; be, as they should, contributory to the interests, as to the pleasures of mankind.

To ladies of good candid minds, no apology will be necessary for the plain manner in which I have stated some subjects, deemed offensive to converse about, yet important to health. Only those of affectation of feeling, can fancy there is indelicacy in understanding what may save from exposure, disease, and death. I was pleased with a French lady, who, shortly after her arrival in my neighbourhood, sent in the night for a physician to her child, suddenly taken alarmingly ill : on his entrance, observing her more than half naked, he was

XU PREFACE.

about withdrawing, when the earnest mother exclaimed, in broken English, — " Sacrez ! fool doetor — you let my child die cause I no dressed." It is certain, that the mind in private, with perfect purity, turns to every point, and instead of seizing at extraordinary means on emergencies, we should deliberately, previously acquire qualifications for acting. I am conscious I have pressed in this work several practices, which many of the respectable part of the sex are in the habit of observing, without the advice of a physician. Such directions are offered only to those who do not observe them, and the more earnestly to induce those who do, to assist in inculcating them among the negligent and uninformed. To produce the stronger impressions in other cases, I have purposely repeated the same advice.

PHILADELPHIA, September, 18ir. %

Contents

Page.

Dedication 5

Plan for a lying-in hospital - - 6

Preface ... - 9

Letter First - - 21 Reasons why females should attend to the subjects

of the work 32

Letter Second 33 Remarks on cleanliness - - - 35

Objections to perfumes - - ib.

Best means of removing the filth from the surface

of the body 36 Warm-bath - - - -37

Cheap plan for warming water - - 38

Rheumatism - - ■ - ib.

Air-bath - M . - 39

Cold and salt-bath - - ib

•

Cleansing the feet - - - 40

Preventive of colds - - ib.

Cleansing the arms ib.

Sitting daily in cold water - - 41

Preventive of costiveness 43

Preventive of the small size of the female person ib.

Preventive and cure of piles - - 45

Warts, boils, and fistulas 46

Excoriations - - - 48

Of the teeth - - « - ib*

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XIV CONTENTS.

Page.

Best tooth powder - - 49

Decayed teeth - - - 51 Diseases they produce ... -52

Extraction strongly advised - - ib.

Tooth-ache. — The remedies, and caution not to extract sound teeth - - -53

Of the skin 54

Receipt for making the skin look well - ib.

Means of softening the skin 55

To prevent and cure pimples of the skin - 56

Letter Third - - - 57 General knowledge of the principles of medicine

recommended - - - ib.

Fibres forming the body, possessed of contractile

power, called irritability - - 58 Food dissolved in the stomach, and conveyed to the

blood - - - - ib.

Circulation of blood ib.

Principles of animal life - - - 59 Principles of disease 60 Principles on which cures^re effected - 61 Formation of the parts orour bodies, on the principles of chemical attractions 62 Healing of wounds on the same - - 63 Of fat in our bodies - ib.

Starvation — means of lessening its rapid destruction 65 Of sympathy, or particular connection between different parts of the body - - ib.

Letter Fourth - - 69 History of the menses - - ib

Cautions during the evacuation - 71 Irregularities of the discharge - - ib. Excessive menstruation - - 72

CONTEXTS. XV

Paof,

Obstructed and suppressed - - 74

Period of cessation - - -77

The whites 79

Hysteric fits - - - 82

Indigestion 85

Letter Fifth - - - 89 Description of female pelvis - - ib

Bones of the child's head - - 92

External parts of the female organs of generation 94

Their inflammation 95

Internal parts - - - ib.

1. The canal to the bladder, called urethra, - ib. Obstruction of urine, drawing off the water with

a catheter 96 Painful discharge of urine, called stranguary - 99

2. The birth-place, called vagina - 100 Its contraction - - - ib.

It receives the mouth of the womb - 101 Womb described - - ib.

Its connections - 102 The end gut, called rectum, behind the womb - ib. Falling down of the womb ^ - - 103 Falling backwards of the wonw - - ib.

Turning inside out of the womb - - 104 Dropsy of female testicle - - 105 Venereal disease - 106 Clap, or gonorrhoea ib.

Pox, or syphilis - 107 Letter Sixth - - - 111 Conception - ib.

Growth of contents of the womb - 112 Quickening - - - - 115 Expulsion in forty-two weeks - - 116 The « waters" - - - 116

XVI CONTENTS.

Page.

The after-birth ib.

The navel cord - - - 117

Circulation between mother and child - ib.

Rules of conduct during pregnancy - 118

Diseases of pregnancy - - 119

Inflammation of bowels - - 120

Of pain in the pubes or front bones - 121

Of sickness of stomach - - - 122

Of heart-burn ... ib.

Of cholic - - - 123

Of fainting ib.

Of swelled legs - - - ib.

Of cramp - - - - 124

Of flooding - - - 125

Of abortion, or miscarriage - - 133

Of barrenness - - - 139

Letter Seventh - - - 143 General remarks on delivery - - 146

History of the operations for the birth of the child ib.

Cutting the navel cord - - 156

Delivery of after-birth - - - 157

Recapitulation to be commuted to memory - 158

Questions and answers ™- - - 159

Recapitulation of labour, from Dr. Merriman 162

Rules for management, from do. - - 165

Letter Eighth ... 157 General remarks on the evils of bad management at

birth ib.

Of bursting the perineum - - - 169

Of swellings, and of tearing the birth-place at labour ib.

Delivery of after-birth, when detained - 170

Loss of blood at delivery - - ib.

Pulling down the womb - - 171

CONTENTS. XV U

Page.

Of twins r - - -172

Of breech presentments - - 174

Of presentment of feet or knees - - 177 Of presentations of the head, the forehead, the face,

and with the hand, or arm - - 178 Of presentations of parts necessarily requiring interference - - - 180

1. Superior extremities - - 181

2. The back, belly, or sides - 182

3. The navel cord ib.

Recapitulation - - - 183 Difficulties at birth on account of the mother 186 Defective pelvis ib.

Delivery of the child by the crotchet - - 187 Defects in the action of the womb - 190 Delivery by forceps - - - 192 Difficulties from after-birth at the mouth of the

womb - igs

Labour with convulsions - > - ib.

Cases of common occurrence - - 197 Rare cases, from Dr. Bard, of the turning inside out

of the womb, called inversion - - 202

Letter Ninth - 209 General remarks on the treatment of women after

delivery - ib.

Directions to be observed for preventing diseases,

and producing a flow of milk - - 211

Diet - - . j 214t

Of giving milk - - -- 218

Diseases of lying-in women , - - 221

Fainting after delivery - - ib.

Chills .... o 2g

After-pains - ^ \u c

XV111 CONTENTS.

Page.

Local inflammation - 223

Inflammation of the breast - - 224

Sore nipples - 227

Milk fever - - - 229

Child -bed or puerperal fever - - 230

Miliary fever - 232

Common fever - - - 235

Swelled leg - ib.

Madness or mania - - 237

Letter Tenth - - - 239 General remarks on the treatment of children after

birth - - - ib.

Means to prevent their taking cold - 240 First washing and dressing navel - - 241 First application to mother's breast - ib. Rules for giving nourishment - - 242 Raising children without the breast - 244 Moving children - 245 Diet of mother on account of the child - 246 Daily washing in warm water - - ib.

Rocking children - 248 Proper place for them to sleep — new plan - 249 Daily causing them to open their bowels - 250 Of abundance of air for them - - 251 Of their clothing — to be neither excessive or defective - - - - 252 Exposure to sun and rains - - 253 Simplicity of diet recommended - ib.

Bad effects of cake - 254 Of excess and changes in their diet - 255 The time for vveaning children - - ib. Teething of children - - 256 Cutting gums universally recommended - 257

CONTENTS. XIX

Vxnv..

Teaching children to govern themselves - 259

Letter Eleventh - 261 Diseases of children - - ib

Of early colds - 262

Eruptions of the skin - - ib.

Sore eyes - - - 263

Swellings — excoriations - - 264

Hooping cough - 265

Of the croup - ib.

Wind in the stomach and bowels - - 266

A sickness with or without throwing up - 269

The thrush frog, or sore mouth - - 274

Sore and scald head - ■- 27S

The measles - 280

Ofcholic - 285

Of convulsions - - - 287

Of fever - - - 291

Of worms - 299

Of mumps - 301 Of cow pock .... 3Q3

Of chilblains ... 304

Of scalds and burns - 305

Itch ib.

Bowel, or summer complaint - - 307

C3 3 The reader is requested to correct, in page 103, line 22, as follows : erase in and insert retro in the word inversion.

LETTERS TO LADIES.

Letter I

Containing reasons why Ladies should attend to the subjects of the ivork*

THE influence of pure, delicate, and cleanly women in society has long been the subject of remark. With the appearance of but little power, they have borne a sway more irresistible than that of males. When mothers have been noble or debased, it has often been the consequence that men have been refined or depraved. In no age has violence imposed on the placable spirits of the sex, without severe suffering j not so much from present loss of pleasure, as from reaction on the rising generation. The interest, the affection, the duty of all require that every effort should be made to preserve women delicate and virtuous ; to keep them out of the way of temptation, as well for the present as succeeding societies. Nothing can be more certain, than that in defiance of our wishes and expectations, our own daughters will partake more or less of the prevailing manners of the times ; will be pure and refined, or indelicate or unprincipled, according to their associates. It is therefore obvious, that by assisting in the establishment and preservation of good practices in the community, we assist in perpetuating them among those dearest to our hearts.

It Avas, ladies, from very sincere feelings to promote your welfare that I designed this publication ; feelings,

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increased by the hope of its tendency to prevent practices I deem improper, from extending to my own female descendants and dearest friends, whose shield and whose power, in common with their sex, should rest on their virtue, their delicacy, and their usefulness. My first object was, to arrest the useless, the indelicate, the injurious, yet growing practice, of calling on men midwives, in common cases of births ; the second object, to ensure better treatment of yourselves and children.

In soliciting your attention to this subject, it is not my desire to make you midwives or physicians. I only ask you to learn the principles of the facts you have already learnt, while gratifying the universal curiosity on the subject of the birth of man. Accurately understand, at least the outlines, leave nothing to fancy, and you will be able to command, to render important services in scenes where you have appeared as idle, useless spectators. You will be able to direct ignorant attendants, as physicians direct nurses at the bed-sides of those delicate patients refusing to exhibit their persons. You will not only save the expense of male attendants, the wives from disgust, and husbands from mortification, but what is of vast importance, indeed, you will always be able to detect, and forbid the officious meddling of the ignorant midwives, sometimes terribly destructive to mother and infant. The great importance alone, of giving these common women proper directions, enabling them ever afterwards to act with propriety, ought to be a sufficient inducement for all of you to attend to this subject.

Many of you pay great attention to the preparation of compositions for eating, you do not consider it improper to learn that this food is ground under the teeth, blended with saliva, swallowed, digested, and then passing through the bowels, is discharged by the organ and at the orifice assigned for the purpose. Truly then you ought not to think it strange, that I should request you to acquire a knowledge of the preparation and passage of the human body. None of your mixtures for eating, nothing in truth, that you have learnt, can be of greater importance. You can acquire all the necessary information in less time than you require for a novel. The famous Cleopatra of Egypt is said to have studied, and written for the public on the subject. Should affectation of feeling induce you to say that it is too indelicate — how inconsistent will be such an assertion with an unnecessary exposure of your persons at births, to the hands and eyes of physicians.

Indeed, it is on account of your delicacy, that I intreat you to acquire valuable information respecting your own structure. Nature has given you functions to perform, every body knows you perform them ; and can you seriously think there is as much indelicacy in endeavouring privately to acquire accurate information, as there is in your neglect to do it, rendering it almost indispensable to expose yourselves to the hands and eyes of strangers ?

There is not the least reason in the common aversion of mothers for their daughters to be acquainted with the history of generation before their marriage. Ignorance of any subject appearing mysterious, naturally tends to the excitement of curiosity ; and it is very likely this ungratified curiosity to learn the nature of generation, has inclined females to dishonourable connection. According to reason and common sense, assuredly it must appear, that for inquisitive girls to act with prudence, it is best they should be instructed plainly, that they should be told, as Milton represents an angel sent to Adam in Paradise, declaring, that sexual connection is not the heaven or happiness of a rational mind ; that it is an operation common to brutes. Learning that there is nothing so greatly -desirable about it, so wonderfully mysterious, they must be. less inclined to yield to a dishonourable prostitution. They will the more readily believe, that to be rational and proper, there must be a refined regard for the object of their love, and their union with him, consummated according to the usages of the virtuous. Indeed, it clearly appears to my mind, that a young lady, understanding the whole subject, not having had her fancy inflamed by a mysterious silence, could not be prevailed upon to tarnish by her conduct, the honour of her sex, and dignity of her family.

But this is not the serious object of my present solicitude. It is to wrest the practice of midwifery from the hands of men, and to transfer it to women, as it was in the beginning, and ever should be. I have seldom felt a more ardent desire to succeed in any undertaking, because I view the present increasing practice of calling on men in ordinary births, as a source of serious evils to child-bearing : as an imposition upon the credulity of women — and upon the fears of their husbands : as a means of sacrificing delicacy, and consequently virtue : as a robbery of many of the good common women of their proper employment and support. Truly it shows as extraordinary a revolution in practice, as any afforded from a survey of all the arts. That all females do bring forth their young without assistance, excepting the human in a state of civilization ; and that women should call for the assistance of men, the only animals tormented by jealousy, is a fact that will scarcely be credited in a Turkish Harem, or by the christians of some future and purer age. Should the strangers to the practice, inquire if our men have large unwieldy hands — great curiosity about women ; should they ask if our women had the requisites for useful services — small hands — good sense of touch, and patience in attendance — they will absolutely deny this monstrous perversion of the course of nature.

From the peaceful and retired occupations of women, they are generally more numerous in the community than men. Nevertheless, the men have assumed several offices, properly belonging to the weaker sex. The natural consequence is, that many women, as men in similar circumstances, wanting profitable occupation, seek the employments of the vicious. In as much, therefore, as these men midwives have meddled with this proper business of women, they have been instrumental in the depravity of many. Indeed, it is owing to their acting where they are not required, that the female practitioners are so often ignorant — not having the opportunity ox means to qualify themselves for attendance on ladies.

Several observing moralists have remarked, that the practice of employing men midwives, has increased the corruption among married women. Even among the French, so prone to set aside the ceremonies among the sexes — the immorality of such exposures has been noticed. In an anecdote of Voltaire, it is related that when a gentleman boasted to him of the birth of his son, he asked who assisted at the delivery : to the answer a man midwife, he replied, then you are travelling the road to cuckoldom. The acutely observing historian of nature, Count Buffon, (on puberty) observes, " virginity is a moral being, existing solely in purity of heart. In the submission of women, to the unnecessary examinations of physicians, exposing the secrets of nature, it is forgotten that every indecency of this kind is a violent attack against chastity—that every situation which produces an internal blush, is a real prostitution." It is very certain, where these exposures have been most common, as in large cities, there adultery has been most frequent. Be it folly, or prejudice, or not, there is a value in the belief, that the husband's hands alone are to have access to his sacred wife. Break through the prejudice, if you please to call it so, but for once, unless powerful reasons command it, the rubicon is passed ; and rely upon it, the barriers, on future emergencies, will not be so insuperable. Time and opportunity to press on a grateful heart, for a favour in regions where magnified favours have been conferred, have been used, and more frequently desired. To convince you of this, you will not require me to enter into the secret history of adultery. Many of these modest looking doctors, inflamed with thoughts of the well-shaped bodies of the women they have delivered, handled, hung over for hours, secretly glorying in the privilege, have to their patients, as priests to their penitents, pressed for accommodation, and driven to adultery and madness, where they were thought most innocently occupied. In one case, I was well assured, that a physician in Charleston, infuriated with the sight of the woman he had just delivered, leaped into her bed before she was restored to a state of nature. The melancholy tale of the seduction of the wife of a member of congress from Carolina, by her accoucheur, is a warning that ought not to be disregarded. The beautiful organization of the lady preyed on his mind for years : he sought her from one to the other extremity of the country, regardless of all dangers ; and on acquiring his game, received a premature and violent death — leaving horror and ruin in the family he had been hired to serve.

' v natev°r you may think on this subject, there are many husbands to whom the idea of their wives' exposure of person, is horribly distressing. I have heard of cases, affording singular mixtures of the ludicrous and distressing. In one case in my neighbourhood, the husband sent for his physician to his wife in labour, yet was so strongly excited at the idea of her exposure, that very solemnly he declared to the doctor, he would demolish him if he touched or looked at his wife. No man possessed of a correct and •delicate regard for his wife, would subject her to any exposure to a doctor, that could be avoided without danger.

But the opposition, the detestation of this practice, cannot be so great in any husband, as among some women* The idea of it has driven some to convulsions and derangement ; and every one of the least delicacy, feels deeply humiliated at the exposure. Many of them while in labour, have been so shocked at the entrance of a man in their apartment, as to have all their pains banished. Others, to the very last of their senses, suffering the severest torments, have rejected the assistance of men. There have been many of this description in all ages ! virtuous and sainted souls — they preferred dying in all the agonies, the throes, and the convulsions of fatal labours I They did err on the side of delicate feeling ! but their errors will be blotted out for ever ! To be instrumental in relieving one of this truly interesting cast, will be a heavenly consolation to all who can be alive to the pleasure of serving the virtuous.

It requires but a little understanding of this subject, to enable you frequently to prove of great service in removing the fears and forebodings of many ignorant sufferers, who imagine that only professional skill can afford relief. Many such objects of commiseration have languished day after day, solely from the want of a little information in one of the attendants ; all unnecessarily lamenting that physicians cannot be procured. By a little information, you can at all times prevent the miserable mutilation of mother and child, which has frequently been committed in a shocking manner, solely from the grossest ignorance. Indeed, to be able to say to ignorant widwives, fancying they must be doing something continually, " Thou shalt not interfere — thou shalt not meddle with nature," will alone be sufficient to effect essential service. On other occasions, and in all parts of the country, sudden labours coming on, before proper attendance can be had, you will be able to do important good to mother and child. One case of suffering of this kind, from want of assistance, in my opinion, is a great reflection on the ladies who are convenient for attendance. Indeed I think it disgraceful, that any female should be allowed to grow up in ignorance — in pursuit of pleasure, too fancifully nice — so falsely delicate, as not deliberately to get so much knowledge in one hour, as will enable her to do, or to direct the unlearned servant, how to perform the little offices required on the emergency, to which all of them are subject.

It is not to be disguised, that all classes in the community have to deplore the loss of some friend in child-bed. Many are mourning at the loss of amiable wives — victims to what ought to have been the subject of their joy. Parents are still lamenting the premature death of their daughters — buoyed up with the hopes of feeling as mothers, when the pains of labour were forgotton. Innumerable babes have been sacrificed in the most afflicting manner ; many of whom may have become ornaments to their country. All such calamities may have been prevented, if but one lady in the neighbourhood of each case, had have devoted but a part of the time spent in guessing about the operation, to an accurate knowledge of the subject, so that she might have directed the ignorant and meddling attendants. It is said the Lord declared he would save the city of Sodom if but ten men were found good in it ; and surely it is equally certain, that the whole of you should attend to this subject, with the prospect, even that only ten might be called on to render the needful assistance.

Every day shows that the practice of midwifery requires no particular skill, no superior knowledge, no slight of hand, nothing beyond the most common sense and observation, to do all that is required with perfect success. Nature has so wisely provided for the birth of the young, that even the extensive practice so highly rated among ladies is not necessary for the discharge of all the duties required from attendants. The male practitioners, who in general, from accidents, have got into great repute, received their first impressions from books, from directions which any one in the country can comprehend. The increasing applications to these women doctors, remaining satisfied with such business, are really made in vain ; for most commonly, in qualifications they are not far removed from the sisters of the profession. Physicians of the best abilities, discovering, that it is by the fingers instead of the talents, that many get the most profitable business, attend to this subject only in the beginning. An introduction into better occupation, excepting in the cases of their favourites, is almost invariably followed by an abandonment of midwifery ; so that the ladies have often to look out for different attendants.