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Anesthesia In Obstetrics

The introduction of anesthesia in Obstetrics was slow because of the opposition of the clergy and the medical profession.  In 1591, Eufama McAlayne of Edinburgh was buried alive on Castle Hill for begging a potion from a midwife Agnes Sampson to relieve her labor pains. 

Pain in labor has been considered as a natural atonement of women for the original sin commited in the garden of Eden.  Hence, most prominent clergymen objected to the administration of anesthesia in a parturient mother.

Leading  minds in medicine like Meigs, Hodge, Bedford, were against the use of anesthesia in midwifery.  They believed that, "Self respecting women should not submit to the stupor or drunkeness produced by anesthetics!"

Ether Mask
Circa 1850
     Metal frame mask with thumbpiece and folding out cross-shaped bars to be covered with gauge.  The mask was placed over the patient's nose and mouth and ether or chloroform was  dripped into the gauze to effect anesthesia.  On January 19, 1847, James Young Simpson administered ether to a patient in labor.  The following year, chloroform was introduced into obstetrics by the same doctor.

Chloroform Mask
Circa 1880
     Chloroform mask made by Reed and Barton.  In use, gauze was placed over the mesh portion and the wire spring ring held it in place.  The device was placed over the patient's nose and mouth and chloroform or ether was dripped into the gauge to effect anesthesia.  Chloroform was favored over ether because the latter was quick acting, nicer smelling, lasted longer, and not flammable.  The first question a laboring patient asked  her doctor was,  "have you brought the chloroform doctor?" 
inh inh1

                                                                           Reynold's Obstetric Inhaler
Circa 1910
It is a self administered ether inhaler during labor.  The body is made of nickel plated brass.  The handle is made of oak. 


Ether Inhaler.

Bloodletting in Obstetrics

Bloodletting in pregnancy was part of prenatal care and was a common practice.  Up to 300 ml (10 oz) of blood was taken at least once in mid pregnancy.  A bleeding bowl shown below catches and measures the amount of blood let go.  It was considered that bloodletting would remove the phletora of blood that makes the process of labor difficult.  The superficial veins of the arm more than in the legs were mostly cut. Rarely leeches were utilized. 

In early 1800's  bloodletting was used for pain relief of labor.  Dewees attributed pain in labor to abnormal biological conditions produced by civilization; loss of power in the longitudinal muscular fibers (Right photo in red), over the circular fibers of the uterus (Right photo in blue).  The resistance of the circular muscle fibers, could be overcome by bleeding the patient.  The sharp knife was snapped into the vein of a laboring patient with a spring.   The spring lancet is a small brass instrument measuring  5.5 x 3 cm. with leather case. Circa 1780.

Thumb Lancet
Circa 19th Century
Bloodlettting was found to relieve severe menstrual cramping.  Besides  bed rest from 4 to 6 weeks, the poor woman was bled at the veins of the hand or arm.  The devise shows a small double-edged blade that could be pivoted between the handle.  With thumb pressure the blade could be positioned at any angle to cut the veins.   This method of treatment was repeated from time to time.  Ouch!!
Turtle shell cover.  (L 9.5 cm)
Bleeding Bowl
Circa 18th Century

     A rare authentic pewter bleeding bowl used to catch blood in bloodletting procedures in the 18th Century.  There are four rings on the inside of the bowl denoting 4 ounces (120 cc) each.  Bloodletting was used to rid the body of yellow or black bile or blood poisons.  Eclampsia, formerly known as Puerperal Convulsions was thought to be caused by body toxins.  The patient was bled of 16 to 30 ounces (1 liter), until she was on the verge of shock.  Puerperal Convulsions was almost always fatal to the pregnant patient. 

       Art work by Rey Evangelista
Leech Glass Carrier
Circa 19th Century

Often times general bloodletting was followed by the use of leeches for treatment of incapacitating menstrual cramps.  The leeches were applied within the vulva, or on the groins.  (Meig's Midwifery, 1838).  The photo on the left is a hand blown smooth glass carrier used to store the blood suckers.  The lip of the glass carrier is everted for tying a cloth to keep in the leeches.  (H 7 cm)

Fleam & Knife Bleeder
Circa 18th-19th Century

Eclampsia, formerly called the puerperal convulsions, was thought to be caused by blood borne toxins, thus the name "Toxemia".  The toxins originated from the uterus causing swelling and inflammatin ot the brain of pregnant women causing her to have seizures.  Bloodletting was used to unload the vessels of the brain (Ramsbotham, 1865). The temporal artery or the jugular vein was cut by a folding fleam or knife bleeder.  The bloodletting device was used around the 18th and 19th Century.  It is made of brass with a tortoise shell shield.

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