;• 7Cp ey -^ '? \ ^~T=^ f ' 4 6 \4 / ■ '>>^_7 ^ ^X .' « ' ^V <*■**■?■&/*? '-*■**( ;-:^--<: ~) '■.-.-^ r *x v. r ..j AN INTRODUCTORY LECTURE COURSE ON OBSTETRICS, DISEASES OF WOMEN AND CHILDREN, DELIVERED IN THE UNIVERSITY OF PENNSYLVANIA, NOVEMBER 3, 1840. --------\f-------- BY HUGH L. HODGE, M.D. , Committee. Charles D. Bobo. j INTRODUCTORY LECTURE. Gentlemen, Students of Medicine: Commencing another course of Lectures on the Science and Practice of Obstetrics, I cannot refrain from urging on your at- tention the great importance of this branch of the Profession. Without any intention to reflect censure on the past or present generation of physicians, there can be no doubt whatever, that Midwifery has not been so generally or so accurately studied as it ought to have been; that practitioners of medicine have imagined, that no particular study is required for the Obstetrician; that the general principles of Medical Science constitute a sufficient pre- paration, without any specific attention to the details of our art; yea, they have imagined, that any judicious mother or nurse, with some experience, may be safely entrusted with the manage- ment of labor; involving, as it frequently does, the life of the mother and her offspring. Such sentiments, gentlemen,are too common in the Profession; and, of course, are eagerly received by the community; but are, as might be easily shown, utterly at variance with reason and experience. Reason might be called to our assistance to demonstrate, that the peculiarity of the human form, the arrangement of the pelvic viscera; the shape, size, measurements of the bony pelvis, and of the foetus; that the physiological state and functions of the uterus and its appendages, in the unimpregnated, as well as the pregnant condition, during and after labor; that the pathological state of females during those important moments of her exist- ence, when she carries within her system the product of concep- tion; when she is agonized almost beyond endurance in giving birth to the long desired object of her affections; or when she is confined to the bed of languishing and pain, resulting from pre- vious suffering; should all be accurately understood by any and every one who undertakes the practice of obstetrics. How ab- surd is it to imagine, that any degree of experience can give that knowledge of anatomy, physiology, and pathology, which can only be learnt in the halls of medical science, where the organs 4 and tissues are unfolded to the eye, and the secret functions of the living economy made apparent to the understanding. A man must know anatomy before he can even recognise the tissues and organs involved in the parturient process; before he can even discover the presentation and position of the foetus; of course, long before he is prepared to assist or interfere in the process of parturition. Certainly, all reasoning on the subject would de- mand, a priori, a knowledge of what are the relative forms and dimensions of the pelvis, and the foetus, before the practitioner can possibly be prepared for the discharge of his duties in pro- tecting or preserving the lives of the mother and her infant during the process of delivery. Experience, as well as reason, emphatically declares the same truths. Never can it be known, at least in this world, the vast amount of suffering, disease, and of death, which results to par- turient females and their infants, from the officious interference of ignorant practitioners with the process of gestation and labor. Enough, alas! too much is known to demonstrate, that just in proportion as ignorance predominates, mischief ensues. When, on the contrary, the parturient female receives the attentions and assistance of one, instructed in the theory as well as the practice of the science of obstetrics, she becomes comparatively safe. Accidents are prevented by suitable directions and remedies du- ring gestation and labor; by early detecting, and, if necessary, promptly relieving any deviation from the natural process; and by those minute, but important and ever varying attentions to the patient's general system, which favor the grand object of hastening delivery with perfect safety and in the most natural manner. In modern times, therefore, notwithstanding all the enervating influences of civilized life, the delicacy and weakness of the female system induced by luxurious and fashionable indulgences and pleasures—in modern times, where females are under the care of instructed practitioners, the amount of suffering is wonderfully diminished, and the number of fatal and dangerous complications, are exceedingly lessened. Would, gentlemen, I could say, that such instructed practitioners were every where to be found. Would that it were even true that the females of this happy and favored land, or even of any portion of it, were universally blessed with judicious and scientific assistance. Nevertheless, much has been accomplished—public attention is becoming in- terested; the fathers and husbands of females are daily becoming 5 more alive to the dangers of parturition; and sensible that scien- tific assistance is essential for the comfort, and often for the pre- servation of those individuals who are the source of all their domestic happiness. Females themselves, notwithstanding all the delicacy and timidity of their natures, are rapidly, throughout our country, acknowledging the fundamental truth, that experi- ence without science is almost nugatory in alleviating the suffer- ings of parturition, and in warding off its dangers. They are, indeed, prepared to yield their prejudices to the now well estab- lished fact, that scientific assistance is alone available. They wait only for the appearance of suitable obstetricians. They are even anxious that physicians, properly instructed, should settle in their vicinity, who shall supplant the midwife and the empiric; indeed, all those ignorant of anatomy and physiology, as well as of obstet- rics; and who shall bring to their assistance, all the innumerable blessings which our department of the profession bestows in such rich profusion on the most interesting, the most lovely, but at the same time, the most helpless and suffering portion of the com- munity. There can be no doubt, when females are convinced that their sufferings will be diminished and their lives less endangered by the employment of scientific accoucheurs, that all feelings of false delicacy, all the prejudices of education will immediately vanish. Experience in Europe, and in most parts of our country, attest the truth of the remark. The responsibility, therefore, of this subject must in part rest with the members of our profession. The truth must be presented to the minds and be brought home to the con- sciences of physicians, that if the practice of obstetrics remains in the hands of the ignorant, it is the fault, the crime of the profes- sion. It is because medical men are not properly instructed, and are not prepared to meet the emergencies of the case. Hence the immense mass of unnecessary suffering, the awful sacrifice of human life from ignorance, neglect, rashness and wickedness on the part of the uninstructed empiric in midwifery, must be charged upon those, who are too indolent or inattentive to acquire the principles of obstetric science; whose conscious ignorance prevents their maintaining the rights and exercising the blessed privileges of the profession in going about to do good. Gentlemen, Students of Medicine, these remarks should be remembered by you, now, while you are students, before you become practitioners of medi- cine; now, while you have the opportunity of gaining that know- ledge which will render you extensively useful; an opportunity, 6 which, if neglected, will probably never again be presented. The requisite fundamental knowledge must be laid in anatomy and physiology, must be matured by extensive and accurate demon- strations of the mechanics of labor and illustrations of pathologi- cal states before you can profit by the most extensive clinical experience. You will hereafter go forward as the Guardians of females and their children. Their physical welfare, their health and strength, the diminution of their sufferings, and the preservation of their lives will depend on you. To you, as the future physi- cians of our land, will the eyes of the community be directed; on you will rest the responsibility; and be assured, if not suitably prepared to meet this responsibility, you will meet not only the neglect of society, but its reproaches, and what is still more to be feared, the upbraidings of your own consciences. On this occasion, time is far too short to pass in review, all the duties of the obstetrician, and to present the facts and arguments by which the nature and importance of these duties may be illus- trated. On former occasions, analogous to the present, I have shown that the science of obstetrics, although it has immediate reference to the process of parturition, yet embraces necessarily in its scope all the peculiarities of the female system, anatomically and physiologically. It must take cognizance of the healthy or diseased state of the female, not only at the time of labor, but during the period of pregnancy. It is called upon to investigate the causes of sterility—the connection which exists between the health of the female, and that of her child; whether disease can be propagated from parents to children; the nature of hereditary diseases, and hence, the propriety or suitableness of marriage under such circumstances. The welfare of females and children, and through them, the welfare of society at large is committed to this department of practical medicine. Passing by some of these points for the present, let us view the obstetrician under the character of the guardian of the " Rights of Infants." Here also we must restrict ourselves to a portion only of these rights, and the consequent duties which rest on the practitioner of midwifery. In the hearing of many now present, I endeavored last year to demonstrate, that the rights of infants commence at the period of conception in the ovary of the female; that it was a vulgar error, entirely unsupported by reason or philosophy, to suppose 7 that life was imparted at the time of birth, at the period of quick- ening, or at any other stage of pregnancy; that the theological division into animate and inanimate foetuses, is an absurdity. Arguments were also adduced to prove, not only that human ex- istence commenced at conception in the ovary, but that all the direct influences which the mother as well as the father exert on their offspring, were exerted at this same important epoch. It is at the generation of the embryo, when the male germ meets the female germ in the vesicle of the ovary, and when, by some mys- terious process, another being is produced, that all the essential peculiarities of this new existence are at once acquired; when not only physical existence, but intellectual, moral, and spiritual ex- istence commences; when the spirit or soul forms that most incon- ceivable union with matter which characterizes the human race, and gives so much value, such dignity to the life of man. Hence, the important inference that, as human life is a sacred right, given by the Creator, and solely at his disposal; that as the divine command is " thou shalt not kill," the foetus in utero, yea, the imperceptible embryo, in the Fallopian tube, or in the vesicle of the ovary, is in complete possession of this valued right, and that no one can, without violating the divine law, designedly at- tempt its destruction. Hence, the efforts to induce abortion in pregnant females is indeed criminal, and ought, in obedience to the law of nature, to be punishable by all human tribunals, as a violation of the law against murder. There may be, and no doubt are, various degrees of guilt in regard to « criminal abortion," ac- cording to the degree of ignorance, or the nature of the motive which may prompt the act, and perhaps also according to the nature of the means by which it is effected. It is still, however, murder, whether executed by that most base individual, who, clothed with the sacred garbs of the medical profession, will so far forget all moral obligations as a man and as a physician, as to employ that knowledge which he acquired for the preservation of life and the alleviation of human misery, for the base and wicked purpose of destroying the innocent embryo; or whether executed by that thoughtless, or ignorant, or wicked mother, who, violating all maternal feelings and moral considerations, will designedly re- sort to any and to every means by which the unborn offspring of her own body may be destroyed. In every form in which this sin may be presented, its nature is the same-it is a violation of that unalienable right to live, which the embryo and the foetus possess in common with the child and the adult man. s Again; the life of infants should be guarded, not only against all direct and malicious modes of producing abortion and prema- ture labor, but also, against all those indulgences and practices on the part of females, by which the lives of their offspring will be endangered, either during the period of gestation, during la- bour, or after the birth of their children. First, They should be protected against involuntary or accidental abortion, as well as against voluntary or criminal abortion. Hence during pregnancy, females should be made sensible of the import- ance of the being lodged within their system; they should be taught, that it is a living, sentient, and immortal existence, endowed with intellectual and spiritual properties—that however insensible they may be to these important truths, yet their whole conduct should be regulated by a sincere, anxious, and conscientious desire to preserve the life of their unborn progeny; that they have no right, there- fore, to say," it is of no importance how I live," or " what I do," —" I care not whether I become a mother or not." They must be taught, that they are already mothers when conception has occurred. This question is already settled. They assumed the responsibility of this character in submitting to the consequences of the marriage relation. This responsibility cannot now be evaded. Henceforth, nolens volens, they must act under the pressure of this responsibility. They therefore violate the right which every foetus possesses for its life, if they indulge themselves in those pleasures, occupations, or practices which endanger the occurrence of abortion or premature labour. They are reprehen- sible, if they eat, or drink—if they walk, or ride—if they indulge their passions and caprices in any way, or in any degree which may excite the uterine contractions, and thus induce an abortion which involves the life of a human being. What then must be thought of those mothers, who will, (in violation of these natural and fundamental truths,) persevere in their course of self-indul- gence, and perhaps yield themselves to all the follies of fashiona- ble dress, society and dissipation, totally regardless of the being to whose existence they have been instrumental? And especially, what severe condemnation should fall upon those who from in- disposition to bear children, will take violent medicines, will walk, run, or jump, in the most violent manner, to rid themselves of what they deem a nuisance, but which in reality is an exist- ence, endowed with all the attributes, corporeal and spiritual, which belong to man in all the boasted vigor and pride of adult age. It is time that these facts should be promulgated—that fe- 9 males should be reminded that not to adopt proper measures dur- ing gestation to preserve their offspring, is almost equivalent to employing positive means for its destruction: That the negative virtue of self-denial must be constantly practised by every female who deserves the honor, or acts up to the responsibility of being a mother. Secondly. Similar observations may be made respecting the du- ties of females and their attendants during the agonizing moments of parturition, when the foetus having escaped all the dangers of its uterine existence is, for a few hours, exposed to still more immi- nent danger during its transit from the uterus through the canal of the pelvis and vagina. The nature and variety of these dangers will be hereafter pointed out; suffice it now to say, that they exist in every case; that they are often of the most serious character and not unfrequently eventuate in the death of the child. Many, very many children are "still-born;" that is, are born dead. It is not for us to declare, or even to surmise, how many of these have perished from mismanagement, ignorance, neglect, or, how many have been actually destroyed in the birth, by hands which every natural feeling, every principle, human and divine, should have rendered active in administering to its comfort and its ever returning wants. The proportion of deaths of children from these various causes during labor is no doubt very large: hundreds and thousands of infants are annually immolated on the altars of ignorance, neglect and cruelty. We will not now inquire who are responsible for this terrible mortality: but let it be observed, that the responsibility does not rest solely with the immediate agents of destruction. Let it be remembered that much, very much rests on the medical profession, whose duty it is to teach females and their attendants the value of fostal life; to impress on their minds that, whatever may be the essential dangers of parturition, yet that these dangers may be lessened exceedingly, and very generally rendered almost nugatory, by the influence of obstetric science, and on the con- trary, will be almost certainly augmented and very frequently induced by ignorance or rashness; and hence that every female is culpable who will entrust herself and her infant during the dangerous process of parturition to any one whose studies have not qualified him for this important duty: provided proper assist- ance can be procured. The profession should inculcate on its members the necessity of a more general knowledge of the prin- ciples of obstetrics, the value of such knowledge, and the duty 2 10 of every practitioner to be prepared for any emergency; that the lives not only of mothers but of the children also, may be pre- served. Let it be also inculcated, that although the life of the child is always secondary when compared to that of the mother, yet nevertheless it is not to be thoughtlessly sacrificed for the imme- diate relief of its parent's suffering. The accoucheur is the guar- dian of the child as well of the mother, and as such he will be often called upon to protect it against the inordinate anxieties of the relations of the patient, and even of the patient herself, in cases of difficult and tedious labor. Often, gentlemen, you may hereafter find yourselves the only friend of an unborn infant; all present are ready to sacrifice it for the immediate relief of the mother; while you, resting on the firm principles of your science, can calmly estimate the dangers of the case to the mother, and also to the child, and determine how far her sufferings may be safely prolonged for the preservation of the infant. Beware of yielding hastily to the entreaties of your almost delirious patient for instant relief at any sacrifice, and of doing that which will hereafter lie heavily on your own conscience, and for which you will be condemned even by those who were most importunate for the destruction of the child for the safety of the parent. Thirdly. After birth it may be thought useless to utter a word in defence of the lives of infants. However indifferent a mother may be to her child in the uterus—however ready the friends of the pa- tient and even the female herself, during the agonies of labor, may be to sacrifice it when her safety is doubtful, yet no sooner is the process finished, no sooner has the cry of the new-born babe reached its parent's ears, than the full gush of maternal love bursts forth, and for worlds, she would not suffer it to be injured; nature speaks in a voice not to be mistaken. Yet, strange as it may be, we must again proclaim that physicians are, even in modern times and in Christian countries, frequently found to be the only protector for the helpless, innocent, new-born infant. Although the crime of infanticide, which has disgraced almost every barbarous nation which has ever existed on this earth— Greeks and Romans not excepted—has through the blessed influ- ences of knowledge and religion been almost dissipated in Chris- tian countries, yet physicians, better than any others, know how often there is no welcome for the helpless stranger—how often its appearance is regarded as a misfortune by its own parents—how often as a curse rather than as a blessing—how often indeed, 11 especially in cases of illicit love, the hands of a mother, desperate with the contending passions of shame and remorse, are ready to extinguish the life which has just been manifested, and which she, above all others, is bound to protect and cherish. How often also, it may be intimated, is the physician called upon to witness the lives of infants sacrificed on the altar of fashionable folly—to witness mothers surrendering these precious beings to the cold and neglectful charities of ignorant and often depraved hirelings, to die a lingering, painful, tormenting death? while the guilty parent may indulge her passions and waste her time in folly and dissipation. In all such and similar cases, gentlemen, remember your re- sponsibilities as guardians of the lives of infants: act fearlessly and decidedly in cases where the danger is imminent, and on other occasions, speak authoritatively, as physicians, in pointing out the inevitable results of neglect and mismanagement; as men, as Christian men, in arresting the progress of folly, immorality and crime, whether met among the ignorant and poor, or among those who, with all their pretended refinement and education, can close their ears and their hearts to the cries of their own offspring. The duties incumbent on the medical profession are by no means limited to the simple preservation of life; they extend to the constitution, the health, the vigor of children, and of course to all those measures which bear directly or indirectly on subjects so important to the welfare of infants, and hence to the mainte- nance of the physical welfare of the community. Children, therefore, it may be observed, are entitled to a good constitution from their parents. It is a truth universally ac- knowledged, that the temperaments, the constitutions of children are mainly dependent on their parents—that from these also they inherit predispositions to particular forms of disease, hence termed "hereditary diseases," and moreover that in some cases specific complaints under which the father or mother may labor at the time of conception may be propagated to their offspring. Modern observation seems also to have confirmed the idea that not only the physical, but to a certain extent the intellectual and moral character of the parents descend to the succeeding genera- tion. How important are these facts—how strongly do they bear on the welfare of society—and yet how little are they regarded by those most interested in their operation. They embrace the whole subject of hereditary temperaments, constitutions, and diseases, and, of course, the interesting subject 12 of marriage; considered, not as a religious or even a civil con- tract, but as bearing on the physical character, and also on the intellectual and moral condition of the community. Hence, legis- lators have thought it their duty to interfere, and to specify cer- tain states and diseases which shall forbid marriage, or render it null and void. Certain it is, that physicians ought to be fre- quently consulted, and their advice followed, on the important subject of the health and constitution of the candidates for matri- mony. It is a wrong frequently inflicted on the parties them- selves, but especially is it an infringement on the rights of in- fants, that certain individuals should marry. We need not de- scend into minute details on this subject. In general, it may be said, that the marriage relation ought not to be entered into by those who are physically incapacitated from the performance of its duties ; by those females who are so deformed, that even if conception occurs, the birth of the child cannot be accomplished without imminent risk to the mother or her infant; by those indi- viduals who are idiotic, or whose families are liable to idiocy, mania, or other variety of mental derangement; by those who are strongly predisposed to epileptic, or cataleptic convulsions, to scrofulous, pulmonary, and cachectic diseases : and especially should this important and interesting connection be avoided by all those who are actually in a diseased condition, or whose tem- peraments and constitutions have been prematurely broken down and destroyed by the follies and vices to which youth are too fre- quently addicted. Is it not a wrong,—is it not a gross violation of even the common laws of honor, as well as of morals and re- ligion, for a man, whose constitution has been ruined by intem- perance and dissipation, and especially for one who still carries in his system the dregs of those loathsome complaints which have followed the vicious indulgence of his passions, to connect him- self with the young, the healthy, the beautiful, the pure but un- suspecting virgin, whose visions of happiness will soon be blighted by the poison emanating from one whom she received as the partner of her joys, but who proves to be the source of physical and moral pollution to herself; and whose contaminating influ- ences extend to her children; it may be, to her children's children? Gentlemen, remember that as guardians of the rights of in- fants, your influence as physicians, should be exerted as far as possible in preventing such unholy connections; in securing, as far as marriage is concerned, suitable constitutions for succeeding generations. 13 Nevertheless, unsuitable marriages will occur, especially in a country like ours, in which so few restraints are laid on the liberty of choice by the hands of the government; and, as society becomes more refined and luxurious, the constitutions of females will be rendered more delicate, irritable and feeble. Hence, from this delicacy of system, and from the predisposition to disease, which not unfrequently exists, the temperaments and constitu- tions of children are proportionably injured; even in cases where gestation continues to the full period. In such cases, as already intimated, great care is demanded even to preserve the life of the embryo; and it behooves the mother, assisted by all the lights which medical science can be- stow, to counteract during pregnancy every baneful influence. Self-denial should be her motto: and, by a course of regimen, as regards especially diet, exercise, fresh air, clothing, &c, suited to the peculiarities of her system, and in some cases, assisted by appropriate medicines, she should strive to overcome every morbid predisposition; and, by giving energy to her own system, to im- part vigor to the child in utero. We shall hereafter point out the peculiar dangers, and diseases of pregnancy, and the means at command to alleviate or remove them. The medical attendant must here also, frequently exert all his authority to enforce rules which are, by most females, deemed unnecessary or altogether useless. He must bear in mind the rights of the foetus, and urge upon the mother the importance of this regimen, for its healthy constitution as well as for its life. He must calm every anxiety, quiet every morbid imagination; and, by reason and examples, endeavor to cultivate a cheerful disposition, and to incite an as- surance that all will prosper with her and her child. He must caution her especially against the indulgence of powerful passions, which might interfere with the process of healthy gestation; not, be it remembered, by directly affecting the foetus in utero, but in- directly by disturbing the functions of the uterus, on which the child is now dependent for life and nourishment. Indeed, in every way, the medical man should render the female sensible of the great value and, at the same time, of the extreme delicacy of the being she carries; and that she must be considered responsible for its life, its health, and physical vigor. During the process of parturition, a similar guardianship should be exerted over the child, that nothing shall occur, if possible, to injure its corporeal functions, or impair its strength. It is, however, after delivery, when the intimate connection 14 which has, for so many months, existed between the mother and child is dissolved; when the moral affections are more enlisted, and when the babe is more directly under the governance of its parents, and nurses, that the rights of infants are more frequently trampled on ; and sufferings, I had almost said, torments, are en- dured, day after day, and week after week, by these little sentient beings, which cannot be witnessed without pain as well as pity, and which too frequently find relief only in death. Would that these sufferings could be accurately portrayed; that their causes could be distinctly specified, and be presented so plainly, yet so eloquently and forcibly, to the minds of mothers and nurses, that every prejudice might be dissipated, that igno- rance might be instructed, and that hard-hearted vice and cruelty to these speechless innocents might be banished from the nursery. Would that the time had arrived when medical men would more generally interest themselves in the management of infants; and, becoming acquainted with the juvantia and Isedentia, with whatever is capable of benefitting or injuring their health, would more decidedly and openly and constantly oppose themselves to the mischievous prejudices and practices, by which so much pain is inflicted, so many constitutions ruined, so many diseases in- duced, and so many deaths inflicted. If there be a subject on which philanthropy and eloquence might be advantageously ex- erted, it is the rights ofneiv-born infants; that they might enjoy health and happiness, and be delivered from the innumerable host of injurious influences to which so many are exposed. The present is not a suitable occasion for specifying minutely the causes of infantile suffering, or for indicating the modes of re- lief. The important and the common sources of mischief arise from the ignorance, the carelessness, and the wicked selfishness of mothers and nurses. Hundreds and thousands of mothers inflict great suffering on their children from ignorance. Actuated as they usually are by the strongest feelings of love and devotion to their children, and having never been properly instructed in the duties of maternity, they become exceedingly anxious for the safety and welfare of their offspring. They listen to every advice that is proffered by every friend or visitor, however ignorant or unskilful; they im- bibe all the floating prejudices of society, and, prompted by the kindest feelings, and by anxious desires to benefit their infants, they rashly enter upon a train of experiments in diet, clothing, exposure, &c, which too often is pregnant with the most direful 15 consequences to the health of the child and the happiness of the mother. They forget what should be the fundamental maxim of every mother, that the provisions made by the God of Nature for the support and nourishment of their children must be exactly adapted to its nature,and its powers of nutrition; and that all human attempts to improve this diet must necessarily be futile and vis- ionary, inasmuch as the Creator is wiser than the creature. Fresh and pure air, cleanliness, and the unadulterated streams of rich and pure nutriment which spontaneously flow from the mammas of a healthy, happy, and loving mother, must be enumerated among the rights of infants, of which they will not, and cannot be deprived with impunity. Carelessness, not so frequently on the part of mothers, as of nurses, is another fruitful source of mischief to infants. How many accidents, more or less serious, and too often fatal, occur from the neglect or carelessness of nurses; how many diseases are generated by inattention to their diet, cleanliness, clothing, exer- cise, exposure, &c; how many are constantly sacrificed from in- attention from hired nurses, who often have no sympathy, no attachment for children; and how often too, no doubt frequently from necessity, but frequently where no adequate excuse can be presented, are mothers to be charged with want of proper atten- tion, care, and affection for their children. There is no being so helpless as man in the first stages 6f his existence; and there is no being, which, from its intrinsic importance, is so fully entitled to the most unremitting care and watchfulness. It is a right which ought not for an instant to be withheld. The third specified source of the ill-treatment of children arises from the wicked selfishness of nurses, especially in cases where the mothers are not nurses. The wants, necessary and artificial, of infants and children, are numerous—requiring unremitted de- votion by day and by night. Much demand is therefore made upon the strength and health, as well as upon the temper and pa- tience of a nurse. No wonder, therefore, as human nature is con- stituted, that the temper and patience often fail, and the poor child suffers in mind and in body the consequences of a ruffled temper, and often of unbridled passion. Contusions, fractures, deformities, idiocy, death have frequently resulted. Perhaps, however, there is no greater source of injury to the health of infants, nor any which hasdestroyed a larger proportion of children than the dangerous and abominable practice of secretly administering carminatives, cordials, and anodynes to quiet the 16 restlessness, or subdue the sufferings from disease, by ignorant nurses, whose only object is to stupify the infant, that their own rest may not be disturbed, or their comfort destroyed. The secret administrations of these poisons have slain their thousands—while thousands who have not actually perished, have had to mourn and suffer through a series of years, all the evils of ruined health and strength. Add to this, the mal-treat- ment which the diseases of infants are continually receiving from ignorant and prejudiced nurses—from still more wicked and no less ignorant empirics, whose nostrums are deluging every por- tion of our country, and you have a mass of misery—the length and breadth—the height and depth of which is not to be esti- mated, which harrows up the benevolent feelings of the soul, especially when the thought is presented, that the sufferers are infants—helpless, speechless, innocent infants—who are thrown upon the arms of females for nourishment and protection, but, in these cases, meet with suffering, disease, and death. Surely, young gentlemen, the bare allusion to these miseries of infants, to such gross and fatal violations of their natural una- lienable rights, is sufficient to rouse up every generous principle in your bosoms—to fill you with pity for them and a holy indig- nation against their oppressors, and induce you at once to make the firm resolve, that on your part nothing shall be wanting to vindicate their rights, and to restore them to the possession and enjoyment of that health, comfort, and vigor to which they are all entitled under the providential arrangements of the God of Nature. This is one grand object of the medical profession, and more especially of obstetrics. Commencing, therefore, at this time, a new course of instruction on these interesting subjects, forget not the welfare of females and their children; study mi- nutely and accurately their anatomical and physiological peculiar- ities,—make yourselves masters of their diseases, and go forth from these halls of science, prepared to contend with ignorance, and prejudice, and wickedness; go forth with the noble determina- tion to be numbered among the defenders of the physical and moral rights of women and their children.