London: Printed for B. Motte…and T. Wotton, 1734.
Quarto: 22.8 x 18.2 cm. xxxii, 520 pp. Collation: A4, a-c4, B-Z4, Aa-Zz4, Aaa-Uuu4
FIRST EDITION, a rare large paper copy.
With 3 engraved plates (1 folding). Bound in contemporary calf, spine richly gilt in compartments (small repairs to spine and corners), new red morocco label. A very fine and clean copy with very minor blemishes as follows: Opening leaf, last page and last plate a little creased, a few leaves dog-eared, a couple of clean marginal tears (far from text), very slim, short worm-trail in blank margin of closing leaves. First few leaves, Plates 1 and 3, and other scattered leaves a bit soiled, plate 3 stained at margins. Occ. minor stains.
William Giffard is considered the first English obstetrician to publish substantial contributions to clinical midwifery. His book is usually found in octavo format, but a few copies are known printed on large paper in quarto format, like the present copy. However, this copy in gathered in 4s, whereas other large paper copies seen have been gathered in 8s, as the octavo is. The collation for both is the same, but in this issue the name of J. Nourse is omitted from the imprint. All three plates are normally folding, but in this copy only one is, on account of the larger format. The plates are by Andrew Motte, translator of Newton’s Principia and brother of the printer Benjamin Motte. The plates show: 1. Giffard's forceps and the forceps as 'improved' by John Freke, surgeon at St Bartholomew's Hospital. This is the earliest illustration of the instrument. 2. Two engravings on one sheet, illustrating Case CLVII. The first known depiction of an ectopic gestation. 3. Dissection of the uterus of a woman who suffered from a “retained placenta”, probably a chorionepithelioma.
“Giffard was one of the first, after the Chamberlens, to use the forceps, which he called an ‘extractor’, the first case in which he used the instrument occurring on April 20th, 1726. This is the earliest record of the use of the forceps” (Spencer). His forceps, and Freke’s improved version, are illustrated on the first plate, which is the earliest illustration of the instrument.
Giffard’s book contains reports of 225 cases, “carefully described, after the manner of Mauriceau and Smellie, and the work is of interest, not only for the early use of the forceps,…but also for his method of delivering the after-coming head in breech cases [the Smellie manoeuvre], which long preceded Smellie…” (Spencer).
Giffard also described the Ritgen manoeuvre almost a century before Ritgen, and a case of ectopic gestation. The illustration on plate 2 is the first known example of this latter condition.
“William Giffard, (d. 1731), man-midwife, about whose early life nothing is known, practised in Brentwood, Essex, before moving to Westminster, London, in 1724. From 1725 he began recording some of his midwifery cases, with a view to publication. Giffard recorded the use of the forceps from 8 April 1726. He called them his 'extractor'. The blades were straight, not conforming to the pelvis though curved to fit the foetal head. The book has an engraving of Giffard's forceps and of the forceps as 'improved' by John Freke, surgeon at St Bartholomew's Hospital.
“Giffard once used the forceps on a face presentation. He removed the placenta (afterbirth) manually after the birth of the baby. He recorded a case of the uterus turning inside out (inversion) when he had pulled on the cord attached to the placenta when it was still inside the womb. In breech deliveries he brought down the arms. For the after-coming head in breech presentations he used a finger in the mouth, and fingers over the shoulders to pull the head out of the pelvis. The manoeuvre was later attributed to William Smellie, though Giffard predated him by several years. He also supported the perineum at birth with his hand. This became known much later as von Ritgen's manoeuvre after he described it in 1828.
“Giffard also recorded a case which was probably a tumour of the placenta (choriocarcinoma), and he early described the manner of stopping the ante-partum hemorrhage of placenta praevia (placenta in front of the presenting part of the foetus) by turning the presentation to that of the breech using a hand inside the uterus (internal version), then drawing down a leg so that the bleeding site could be compressed.
“In his numerous cases Giffard described many obstetric complications dealt with in competent and practical fashion. He was among the first to write about them. Following the diffused knowledge of the forceps, many obstetricians in London evolved newer methods of coping with obstetric difficulties and taught their methods to students and medical practitioners. Giffard was in the forefront of these movements in ideas and practice. Hody described him as 'a plain man, remarkable for an honest, frank behaviour, of strong judgment, skilful and experienced in his profession and very charitable to the poor, averse to all kinds of flattery, and a generous and judicious practitioner' (Spencer, 18). Giffard died at Brentwood towards the end of 1731.”(ODNB).
Spencer, The History of British Midwifery, pp. 18–22; and Radcliffe, Milestones in Midwifery, pp. 33–34; G&M 6156.3. See Speert pp. 577–578