University of Virginia Library

PREFACE TO FIRST EDITION.

In offering these pages to the Profession, I must ask their indulgence, as well as a kindly consideration, for a work which is novel in kind; and lest the gentle critic, with a keen pen, should in his friendly way point out to the reader the palpable faults of my little book, I will at once crave his indulgence for presenting a subject ethnological—rather than medical—in character, and for giving the work to the public with the present faulty arrangement of Chapters.

In the Introduction to Chapter I., I will tell how an examination of that ancient Peruvian Funeral Urn incited me to the study of the customs of Primitive Peoples—at first only of the position occupied by Women in Labor, the subject which would, perhaps, most naturally arouse curiosity and stimulate research on account of the peculiar and very striking facts presented.

So many other strange and interesting, mostly unknown, data accumulated from the responses which my enquiries received from all quarters of the Globe and from the perusal of the many volumes, Medical, Historical and Ethnological, for which I had ransacked the libraries East and West, that one subject after the other presented itself, and in my enthusiasm I developed one after the other. The result was a series of articles upon subjects ethnological, as I have said, rather than medical, which have been gathered in this little book.

Virchow, that leader and master mind, was one of the first, certainly the first of medical men, to develop the science of ethnology, although more with reference to craniology and sociology, yet thus it has become an ally, a

sister science to medicine; why should we not take one step farther? Why should ethnology not prove an aid in the development of other branches of medicine as well? Although a new departure, I may say that Ethnology will add greatly to the study of obstetric science and its thorough understanding; it will be a guide to the study of Midwifery, as Comparative Anatomy is to that of Anatomy, and moreover a necessity to its complete understanding.

I have presented the result of my investigations by reason of their intense interest to me, and because a comparison of the crude methods of Primitive Peoples and Peoples of former civilizations with the teachings of scientific obstetrics of to-day are amusing and interesting, but above all instructive and important. If I have erred, it is my enthusiasm which has carried me away.

So much for the Subject, now for the Arrangement of the work. The chapters follow, not in logical order, but in the succession in which chance presented the material, and the order in which the articles appeared—the first one on Posture, in the Transactions of the American Gynecological Society of 1880; the second, third and fourth in the American Journal of Obstetrics from April, 1881, to July, 1882; and the fifth in the Courier of Medicine of St. Louis for March and May, 1882.

In the arrangement of this volume circumstances necessitated the faulty order, which the reader cannot overlook, yet will, I trust, generously pardon.

Let us glance hastily over some of the more striking features here presented: Is it not a matter of interest to see how the moon, the world over, is connected with the menstruation of woman; how, in France, in past centuries our "monthly flow,'' the German "Monatliche Reinigung,'' was called the "tribute which woman renders the moon;'' the Indian speaks of a woman in this state as having "moon in the ass''—so the world over. Again, the idea of cleansing, purifying, is expressed in the German "monatliche Reinigung,'' whilst the natives of Africa, of India, and of our Western territories, still consider the female at

that time as unclean, and isolate her, keep her away, especially from men, in a separate hut; and that she may be well known to all, when she mingles with others, she is obliged to wear certain well-marked colors during the continuance of the period. This is more particularly the case among the numerous, still natural people of Asia, as it was my good fortune to observe myself among the Nauch girls while traveling in this country. This idea of uncleanliness clings equally to the puerpera during the continuance of the lochial flow, and, remarkable enough, in a different degree to the lochia rubra and alba.

How reasonable! The menstruating woman is confined in a separate hut, is isolated, does no work, rests, is not exposed to cold or exertion, and thus escapes the numerous uterine troubles which befall the civilized female by reason of ignorant or careless exposure during this period of increased sensitiveness.

The parturient is confined in an isolated shelter, which is destroyed when labor is over, or in a hut or house kept for the purpose, in a particular room. Whatever the idea may be, the result is certainly to prevent infection—to prevent puerperal fever.

The Japanese in pregnancy already endeavor to prevent malpositions by external manipulations of the abdomen; others bind the abdomen in pregnancy. How sensible their laws governing coition during pregnancy! we can certainly, with advantage, study their reasonable, though instinctive and crude customs!

A vast and important fund of knowledge may be derived from a study of the various positions occupied by women of different peoples in their labors. According to their build, to the shape of the pelvis, they stand, squat, kneel or lie upon the belly; so also they vary their position in various stages of labor according to the position of the child's head in the pelvis. Does the great number of natural labors resulting not point to a law greatly at variance with the teachings of modern obstetrics? Is it not evident that different positions should be given in different

stages of labor, and in its various periods? But it will necessitate a great advance in obstetric science and much research to determine the underlying law. Here, however, we have the facts.

Although primitive peoples, like modern obstetricians, vary in the method of managing the third stage of labor, manual expression is almost universally resorted to; the vis a tergo is acknowledged, and the cord rarely serves the injurious purpose to which most modern midwives put it. As I say at the conclusion of chapter III., the North American Indians and the African Negroes, undoubtedly other tribes also, have for ages followed a practice so perfect that only within the last few years the most alert of our obstetricians are in a position to compare with them. This fact has been noticed by Dr. C. M. Fenn, of San Diego, California, who has an article in the American Journal of Obstetrics for 1881 contemptuously termed the "Practice and Perils of Belly-squeezing in Mexican Obstetrics,'' in which he tells of their rude ways, and at the close is greatly astonished that no harm is done, but that the women do well. He says: "Convalesence has been rapid and normal in all of the cases which have come under my observation, and sufficient time has elapsed (more than six months since the last case) for the development of uterine ailments. More than this, in a not limited experience among these people, I have met with but two or three cases of uterine disease, and am prepared to assert that metritis, oöphoritis, and kindred maladies, are exceptionally rare.''

How grand a proof from unwilling source to the efficiency of this method which scientific obstetricians are just beginning to adopt, in fact, have just discovered. Massage and expression, external manipulations, have reached such a perfection as uncultured minds can give: we can learn much from the customs of these people, and if developed by science, sifted and classified, great good will result.

The savage mother, the Negress, the Australian or

Indian, still governed by her instinct, is far in advance of the ordinary woman of our civilization. She bathes herself and her offspring at once, she keeps herself clean. Wonderful to say, the same difference exists among the various races of Primitive People in their customs as to nursing as we find among the physicians of to-day. Some few put the child to the breast at once, most wait for two or three days, and of milk fever they seem to know nothing; the time of nursing also varies greatly, usually from one to two years. Their methods of weaning are like our own, in the application of asafœtida to the nipple, or of charcoal, to disgust the child; even the castor-bean plant has been used as a lactagogue, the mother washing her breast with its juice.

I have but briefly referred to some of the interesting points to show how similar the obstetric practices of Primitive Peoples, past and present, are to our own, and yet although crude how far in advance in many points—in all such in which simpler means, the hands and external manipulations will answer. The womb they never enter, instruments they have none, but as far as general treatment and external manipulations will reach their management is wonderful, and we will find much to study, to imitate, and to develop.

The great field opened to us is the study of the position to be occupied by woman in labor, as determined by the configuration of her pelvis and the position of the child's head. Primitive peoples have solved this problem by virtue of their instinct; now it remains for the science of civilized races to determine the when and wherefore.

I trust that what I have said may induce the reader to peruse these pages with a certain interest which will lead him to pardon or forget their faulty arrangement.