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William Smellie

William Smellie

William Smellie was by far the greatest figure in British obstetrics. He was first to teach obstetrics and midwifery on a scientific basis; first to lay down safe rules for the use of forceps, and to separate obstetrics from surgery.

Smellie was the son of Archibald Smellie and his wife, Sara Kennedy. He attended the grammar school in his native town of Lanark, in Scotland, and probably received his medical education in Glasgow. In 1720 he commenced practice as a surgeon and apothecary in Lanark. He remained a country practitioner for almost twenty years.

In 1724 he married Eupham Borland, who survived him, and died on 27 June 1769. They had no children.

Smellie became e member of the Faculty of Physicians and Surgeons of Glasgow in 1733. Following studies in Paris, where he attended lectures on midwifery, in 1739 he went to London, where he established a pharmacy.

In London, William Hunter (1718-1783) came to live with him, and he began to give obstetrical lecture-demonstrations to midwives and medical students in 1741.The courses attracted large numbers of students, and his teaching is described by a pupil as "distinct, mechanical, and unreserved." His fee for a single course was three guineas, Smellie obtained his medical doctorate from the University of Glasgow in 1745.

He delivered poor women free of charge if his students were allowed to attend the delivery, thus establishing a trend towards the attendance of medically trained persons at childbirth.

Smellie had a prospering practice, and in 1759 he retired to Lanark to devote the last years of his life to completing his literary works. He bought a small property called Kingsmuir. This, with other land which he had bought before, formed an estate called Smellom, on which he built a house, and there died on 5 March 1763. He was buried near the church of St. Kentigern in Lanark, where his grave is marked by a tombstone and inscription.

Smellie always emphasised the importance of the natural birth process, and in general advised against resorting to surgical methods. He is best known for his descriptions of “the mechanisms of labour”, or how the infant’s head adapts to changes in the pelvic canal during birth. To him are owed the first attempts to measure the foetal cranium in utero.

Smellie was also reluctant to use the forceps, and permitted caesarean section only in the most extreme cases of narrow pelvis. To him the life of the mother always had priority to that of her offspring, so, when he saw it necessary, he never hesitated to perforate and destroy the brain of the foetus in order to save the mother.

Smellie developed various types of obstetric forceps, some with lock and curved blades, called Smellie’s forceps. He developed a craniotomy scissors, Smellie’s scissors. The method of delivery of the after-coming head with the child resting on the physicians forearm is known as the Smellie method. This was a rational attitude considering infant mortality at his time.

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