Advice to the Fair Sex

Abstract

There have been several historical studies of the emergence of the man-midwife, or accoucheur, in the eighteenth century and of the gradual supplanting of the female midwife, first in upper-class and then in middle-class households.1 However, the main focus of such accounts has been the struggle over the management of childbirth and the use — and alleged abuse — of obstetric instruments. The debate between midwives and accoucheurs over the management of pregnancy has received less attention. This debate involved not only practice, but also hermeneutics: indeed, the key issues were epistemological. How could pregnancy be known, and who had the authority to speak of it? One of the fiercest exchanges in this respect was between William Smellie and Elizabeth Nihell. The picture is interestingly complicated here in that the quarrel took place, at least in part, by proxy. Elizabeth Nihell’s Treatise on the Art of Midwifery was thought by many to have been written by her husband, while Smellie was defended against Nihell’s attacks by his friend Tobias Smollett. Smellie published the first two volumes of his Treatise on the Theory and Practice of Midwifery in 1752 and 1754: these, like his Anatomical Tables (1754), concentrated on an ‘accurate’ description of ‘the situation of the parts concerned in parturition’ and also gave practical advice on ‘touching’ to diagnose pregnancy.