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Percivall was born at Woollaton Hall, Nottinghamshire in 1596, the youngest of the six sons of Sir Percival and Lady Bridget Willughby. There were also five daughters. Although his parents were not well off, he was educated at Eton and Magdalen College, Oxford, where he obtained a BA in 1620. He was then placed with Mr James van Otten, barber surgeon of London, who undertook to teach him music, physic, and surgery over a 7 year period for £100. Unfortunately, van Otten died in 1624.
Returning to Derby, Willughby entered practice and soon gained the reputation of being a fine physician and “man midwife”, although he was only admitted as a Licentiate of the College of Physicians, London, in 1640. In 1631 he married Elizabeth Coke and they had three sons and two daughters, one of whom became a midwife. In 1655 the family moved first to Bromidgham in Staffordshire and then a year later to London to seek better education for the children. There he practised midwifery among “the meaner sort of women.” In 1660 he returned to Derby and resumed his extensive, successful, and laborious practice, often travelling considerable distances on horseback to visit patients.
Willughby was cultured, modest, and humble. He was also a very practical and caring doctor. His high reputation rests on his pioneering midwifery. He was the first professional man to devote his practice entirely to obstetrics. In the 1670s he completed a manuscript based on the many cases he had attended since 1630. It was written expressly for midwives and physicians called in to assist with difficult cases, and sheds light on practice in the 17th century. He strongly opposed meddlesome midwifery, his emphasis being on natural delivery:
“In the first place, I wish and desire all midwives not to bee too forward, or too officious in their undertakings, least that they disquiet nature, whose onely work it is, and I would have them to understand, that they bee but nature’s servants in all motion, hereafter shall be shewed ... And let all midwives bee assured, that it is not their labours, in pulling, and haling their women’s bodies, that causeth deliver. But that it is the work of Dame nature...”
The influence of Willughby’s friend, Dr William Harvey is apparent, as he cites him in the manuscript on no less than 21 occasions. Indeed he wrote: “I know none but Dr Harvey’s directions and method, the which I wish all midwives to observe and follow and oft to read over and over again; and in so doing they will better observe, understand, and remember the sayings and doings of that most worthy, good and learned Doctor whose memory ought to be had for ever in great esteem with midwives and child-bearing women.” Elsewhere he records: “There came into my house, at Darby, my honoured good friend Dr Harvey in 1642. We were talking of several infirmities, incident to the womb.”
Unfortunately, Willughby’s manuscript, though partly published in Dutch in 1754, was not fully published in English until 1863, when Dr Henry Blenkinsop, senior surgeon to the Warwick Dispensary, printed a limited edition of a 100 copies under the title Observations in Midwifery (fig 1). The extracts that follow are taken from that edition, reprinted in 1972.1 Among them are a number of original descriptions later credited to others.
On maternal posture during labour:
“All women bee not delivered after one fashion. Some desire to bee in, or on, their beds, others, to be sitting on the midwife’s stool; or on a woman’s lap; some kneeling; others, standing, supported by two women, or hanging with their armes about their necks... The placing of a woman in a fitting posture doth much facilitate the birth.”
On an arm presentation in 1650:
“I found the arme swel’d, discoloured, and mortified. I placed her kneeling on a hard bolster, and put her head down, in a descending posture, to a pillow, that was laid on a woman’s lap, sitting afore her. I gently slid up my anointed hand into her body. I quickly found the child’s foot, and, by the feet, I gently drew the child; the body of the child turned round, the arme slided up of itself. I kept the child’s face toward the back of the woman. I put my middle finger into the child’s mouth, and placed my other fingers over the child’s face, then I drew again leasurely by the feet. So the child was soon born, and the after-birth was quickly fetched, and shee safely delivered, and laid in her bed. And all this was done in lesser time than half a quarter of an houre, as severall women, yet living, can testifie this to bee true, and so performed. And, in a short space, shee recovered.”
On pelvic deformity due to rickets:
“Difficulty of birth may also bee caused through ill position of the bones, which hathe beene observed in such, as have beene crooked in their bodies. As also in others, which have weake backs, and loynes, going wadling in their childhood. As also in others, which have had the infirmity, called the Rickets; and in such, as have been compelled to weare iron bodies, to keep them from being crooked. Through these meanes, their tender bones, in their minorities, have been so altered, and pressed together, and with time confirmed, that, losing, in part thus their circular roundness have become ovall, through which the child will never bee produced, but by violent force of hand, or by some instrument.”
On the use of pulvis parturiens (ergot of rye):
“I was then sent for, and found her sitting, whether in a chair, or on a woman’s lap, I do not now remember. Shee was very pale, and faint, having a dying countenance, and her midwife not attending her work, but pulling her by the nose, to keep life in her. I willed the midwife, with the women, to lay her on her bed. With good spirits, and uterine cordials shee came again to herself, and when, afterward, labour began to approach, I gave her a dose of pulvis parturiens, and put her into her midwife’s hands, as shee was lying on the bed, and shee was speedily delivered of a dead child. And thus, at the second time, shee was recovered.”
On testicular trauma following breech delivery:
“In the yeare 1646 this midwife was called to one Isabel Carter, whose child came by the buttocks... The child’s cods were pressed forth, and did hang out of the woman’s body above an inch and half, very flamp and black, and the doubled body was fixed in the birth. The woman in distres desired mee to help her. After placing her kneeling on a bolster, I put her in a bending posture descending. I removed the child upwards into the hollownes of her body. I fetched the feet down, and, through God’s great mercy, and permission, I quickly delivered the woman of a living child, by the feet. This woman, and her husband, with their son, were living in Darby, 1660, and hee is a handsome young youth, yet living in Anno 1670. The blacknes and bruisings of the cods were cured with oile of egges.”
On obstetric palsy following breech extraction:
“A week, or more, after delivery, the child was swel’d in the right arme, and was weake in the wrist; and could not hold up the hand, but that it hung flagging downe ... The child could not suck at the first, but made pityfull faces, when it endeavoured to suck, and cried weakly.”
Management of the third stage of labour:
“The after-burden is easiest drawn forth when the woman kneeleth... (It) oft commeth of itself, yet it is not amisse to assist nature for the producing of it. There bee some midwives, that never offer to fetch the after-birth, but suffer nature to expell it, and their women have done well... If it be feared, that some part of the after-birth should remaine unfetched away, do not again make a new searching for it in the womb...usually, after a refreshing sleep, when that the woman maketh water, the remaining part will come away, and, with the water, it droppeth into the chamber-pot.”
Willughby’s wife Bridget died in 1666 aged 67, while he lived on to the grand old age of 89, dying in 1685. They were both buried in St Peter’s Church, Derby.