William
Smellie
1697-1763
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 infants 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 Smellies forceps. He developed
a craniotomy scissors, Smellies 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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