AMONG the latest and most important advances in obstetric
practice is the adaptation of external manipulations to midwifery:
massage and compression of the uterine globe, for the
purpose of exciting muscular activity and mechanically forcing
out the contents of the cavity. This is of the utmost importance
in checking hemorrhage from a relaxed womb, in the expression
of a retarded placenta (Credé's method) or an aftercoming
head, and in the rectification of malpositions (Wright's
or Braxton Hicks' combined version).
Although these are recent and valued additions, so recent that
they are not as yet practiced by any but the more advanced
obstetricians, they are the most natural, the simplest, and
oldest helps in midwifery, in use among all primitive people
and at all times, from the day of the ancient Hebrews and
Arabs to that of the North American Indians.
Although constantly practiced by primitive people for thousands
of years, these methods have been recently rediscovered
by learned men, clothed in scientific principle, and given to the
world as new.
Before entering upon the subject proper of this paper, I will
briefly outline the history of massage, which, as an alleviant of
human suffering, is intimately connected with the history of
medicine in its earliest days; almost equally venerable is the
history of this art as applied to midwifery, and this leads directly
to the subject in hand, external manipulations in the obstetric
practice of primitive people. I will classify the various kinds
of massage and expression and define their uses, closing with
a comparison of the natural and scientific, and of the development
of external manipulation in modern obstetrics.
