This small book was written in 1914 by Dr. Henry Smith Williams, an MD, attorney and science writer, at the request of Dr. J. Whitridge Williams. Dr JW Williams was associate professor of gynecology in at Johns Hopkins University Hospital beginning in 1894, vice-president of the American Gynecological Society in 1903-04, and Chief of Obstetrics at Johns Hopkins University Hospital from 1911 to 1923.
The theme of the book is Dr J.W.W’s new ‘business plan’ for using healthy maternity patients as the primary source of income for a national system of hospitals. The audience targeted by its authors were the philanthropists of the day (Carnegie and Rockefellers Foundations), as well as husbands, elected officials and influential trendsetters in society.
The Stanford medical library copy of this book was digitized by the Google Library Project.
Original Google Book ~ published 1914 ~ 133 pages Entire Original Twilight Sleep: A Simple Account of the New Discoveries in Painless Childbirth ~ written by Dr Henry Smith Williams, MD, published in 1914
Has navigational “BOOKMARKS” if opened in an Acrobat PDF program
The good doctor’s story
in his own words,
organized by topic:
Pain associated with biologically normal childbirth ~
“Nature provides that when a woman bears a child she shall suffer the most intense pain that can be devised!
The pain of childbirth is the most intense, perhaps, to which a human be can be subjected.
…the sacred function of maternity … causes her months of illness and hours of agony;
p.12 …how has it come about that this most natural and essential function should have come to be associated with so much seemingly useless suffering.
…the wonderful effort that has been made by a band of wise physicians in Germany to give solace to the expectant mother, and to relieve the culminating hours of childbirth of their traditional terrors.
Even in this second decade of the 20th century, … women bring forth children in sorrow, quite after the ancient fashion, unsolaced by even single whiff of the beneficent anesthetic vapors through the use of which the agonies of tortured humanity may be stepped in the waters of forgetfulness.
Evolutionary pain as a pathology of modern civilization among the upper classes ~
“…. the cultured woman of to-day has a nervous system that makes her far more susceptible to pain and to resultant shock than was her more lethargical ancestor of remote generations.
… women of primitive and barbaric tribes appear to suffer comparatively little in labor, coupled with the fact that it is civilized women of the most highly developed nervous or intellectual type who suffer most.
Such a woman not unnaturally shrinks from the dangers and pains incident to child-bearing; yet such cultured women are precisely the individuals who should propagate the species and thus promote the interests of the race.
This seems to suggest that the excessive pains of childbirth are not a strictly a ‘natural’ concomitant of motherhood, but rather that they are an extraneous and in a sense an abnormal product of civilization.
Is there not fair warrant for the assumption that the pains which civilized women—and in particular the most delicately organized women –suffer in childbirth may be classed in this category?
Abnormal pain as an evolutionary threat to the (Caucasian & European) race ~
Considered from an evolutionary standpoint, the pains of labor appear not only uncalled for, but positively menacing to the race.
…… any trait or habit may be directly detrimental to the individual and to the race and they may be preserved, generation after generation, through the fostering influence of the hot-house conditions of civilized existence.
Evolutionary of labor pain in white women ~ a Darwinian segue to a perverse form of eugenics
Everyone knows that the law of natural selection through survival of the fittest, which as Darwin taught us … does not fully apply to human beings living under the artificial conditions of civilization. These artificial conditions often determine that the less fit, rather than the most fit, individuals shall have progeny and that undesirable rather than the desirable qualities shall be perpetuated.”
The problem of making child-bearing a less hazardous ordeal and a far less painful one for these nervous and sensitive women is a problem that concerns not merely the women themselves, but the coming generations. Let the robust, phlegmatic, nerveless woman continue to have her children without seeking the solace of narcotics or the special attendance of expert obstetricians, if she prefers. But let her not stand in the way of securing such solace and safety for her more sensitive sisters.
… every patient who goes to the hospital may have full assurance that she will pass through what would otherwise be a dreaded ordeal in a state of blissful unconsciousness.
“In Johns Hopkins Hospital,” said Dr Williams, “no patient is conscious when she is delivered of a child. She is oblivious, under the influence of chloroform or ether.
Physiological normalcy as an impediment to medicalization
That word “physiological” has all along stood as a barrier in the way of progress.
The truth is that in assuming an upright posture and in developing an enormous brain, the human race has so modified the conditions incident to child-bearing as to put upon the mother a burden that may well enough be termed abnormal in comparison with the function of motherhood as it applies to other races of animate beings. Moreover, … the displacement of the uterus after parturition is a condition of unknown cause, notwithstanding its frequency and the severe character of
the suffering that it ultimately entails.
The 19th-century Disease – The Mysterious Displacement of Uteri
Take, as a single illustration, the matter of displacement of the uterus. I have quoted Dr. Williams to the effect that no one knows just why such displacements occur, or in what cases they are likely to occur. What we do know is that in a certain large proportion of cases, such a displacement does occur in the course of the few weeks succeeding delivery.
And Dr. Williams is authority for the statement that the displacement may ordinarily be remedied effectually and permanently by the simple expedient of using a supporting pessary for a few weeks, if the condition is diagnosed at once and the remedial agency employed.
Thousands of women go through life without enjoying a really well day, because of such a uterine displacement, undiagnosed or uncorrected. Yet it goes without saying that the woman who is attended by a midwife or by an unskilled practitioner is usually never so much as examined to determine whether the uterus has or has not maintained its natural position after childbirth.
If the service of the lying-in hospital had no other merit than the single one of assuring to each other mother the normal involution, and retention of normal placement of her uterus, its service in the interests of the health and welfare of women would still be enormous.
The mother’s “ordeal” of physiological function plus the doctor’s pitch for lying-in hospitals
What an incalculable boon and blessing it would be, then, if conditions could be so altered that every woman brought to childbed might be insured efficient and skillful service in carrying her through the ordeal that the performance of this physiological function imposes upon her.
That word “physiological” has all along stood as a barrier in the way of progress.
And this can be accomplished in no other way than has been suggested, except by the extension of a lying-in service far beyond the bounds of anything that has hitherto been attempted.
To meet their needs, it would be necessary to have a small lying-in hospital located in every town of three or four thousand inhabitants. At first thought, this seems an ideal impossible of realization. But if we consider the matter with attention, without for a moment overlooking the practicalities, we shall see, I think, that such a project by no
means present insuperable difficulties.
In time every mother in the community should come to patronize such a hospital; for it will come to be known that the home is no place for a woman during the ordeal of childbirth.
These comforts, it must be borne in mind, include the use of pain-annulling drugs. In this country, it is customary to anesthetize the patient with chloroform, though some competent practitioners prefer ether. We have already seen that the merits of the morphine-scopolamin[e] treatment, inducing the Twilight Sleep, are to be fully tested at the Johns Hopkins Hospital…
Patient Education and Public Relations in the Vocabulary of Propaganda
Sub-heading in the book: “OBJECTION FROM WOMEN”
Of course, there will be difficulties in the way of carrying out such a scheme, with its implied sojourn in a hospital for the great majority of women during their accouchement.
The chief objections will come from the women themselves. Indeed, this is about the only opposition that need be considered. Woman is the ruler in America, and what she wishes is never denied her. So it remains only to gain the assent of women to put
the project for the wide extension of a lying-in service ….
… the farm wife must be educated before she could be made to see the desirability of this arrangement. The first thought of the average wife is that she cannot possibly be spared from home, and that the idea of going to the hospital is not even to be considered. But as soon as the advantages offered by the hospital – painless childbirth, safety to the offspring, and rapid and permanent recovery – come to be generally known the feasibility of the project will quickly be demonstrated.
What a boon it will be, then, to the six million farm wives of America, when facilities have been provided, and customs have been established, making it certain that she may have the comforts of a lying-in hospital, with adequate medical attendance, to solace her in what would otherwise be the dangerous ordeal of motherhood.
