Most mothers since the beginning of time had given birth at home with midwives or other women in attendance. It was a long, painful and exhausting experience. Finally in the 1850s wealthy women were offered some relief from ether after it was used for Queen Victoria during her labor. Following the Queen’s lead ether, chloroform, and even laughing gas in the United States, were administered for decades to women able to afford delivery in a hospital. Because some doctors were better trained than others babies being born at home were likely to have had safer births without the effects of these gases.
Page 1106 in our 1910 manuscript states that a method of “painless childbirth” had been developed by doctors, Bernard Kronig and Carl Gause, in Germany. Hallelujah! Just what every woman in the world had been hoping for. It sounded wonderful, even the name “Twilight Sleep” (Dämmerschlaf in German) was promising. Doctors from the US went to Germany to learn to use this new miracle combination of drugs that would herald childbirth without pain. Soon gas was out of favor and powerful drugs were in.
Twilight sleep was said to be “especially suited to the requirement of nervous women.” I find it interesting that men were so sure what women needed in view of the fact that not one of them had passed a bowling-ball-sized human through their loins. To this day many men are inclined to have very strong opinions about a woman’s body and what she should be allowed to do with it, but back to the topic at hand.
Twilight Sleep was made up of a combination of morphine and scopolamine. Morphine is derived from opium and acts on the central nervous system, causing pain relief. Scopolamine comes from a mixture of nightshade plants. It causes patients to fall into a semi-conscious state resulting in amnesia.
Both drugs are still in use today, but not routinely with labor patients. Morphine is a powerful and useful pain reliever that can lead to opioid dependence in some situations. Scopolamine is used orally or by a transdermal patch to treat nausea, vomiting and motion sickness. You may have used or seen fellow passengers use these patches to prevent or combat seasickness.
Possible side effects from scopolamine listed today include the following: drowsiness, disorientation, dry mouth, blurred vision, dilated pupils, confusion, hallucinations, difficulty urinating and rash. https://medlineplus.gov/druginfo/meds/a682509.html
What is wrong with this picture? In retrospect, it does not seem a chemistry degree is necessary to foresee problems with this combination of drugs. The pain relief of morphine was a big plus for the laboring mother, however, it could depress respiration in the newborn leading to a life-threatening emergency. The scopolamine rendered the mother semiconscious during the painful childbirth experience, however, it caused amnesia. The mother usually remembered nothing of the experience including seeing her newborn for the first time nor hearing the first cries. The effects of this drug had significant potential to defer or even diminish bonding between mother and child.
Both of these drugs crossed the placenta and depressed the fetus’s central nervous system. For decades babies would be born drugged, and unable to breathe normally. It is no wonder they were held upside-down and spanked to start them breathing. After over sixty years of Twilight Sleep administration, the practice was abandoned in the 1970s due to the harmful side effects. Unfortunately, this was after the birth of my two daughters and I am sure after many of you or your children were born.
Lakshmipati G. (Care of the Medical Outpatient, (Preface) 1st ed. 2003. pp. vii–vii. Nama publication, Coimbatore, Tamilnadu) has said:
“Half of what is true today will be proven to be incorrect in the next five years. Unfortunately we don’t know which half that is going to be.”
Sadly, this is true even today. One only hopes that such truth will be proven in only a few years rather than the centuries or decades it has taken in the past.
An Art or a Science?
Whether the practice of medicine is an art or a science has been debated for centuries. Many, if not most, feel that it must include both. For a comprehensive discussion of this subject read Dr. Sadhu Charan Panda’s research. He is Editor, Journal of Community Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3190445/
Change, does it occur too fast or too slowly?
The Complete Guide to Prevention and Cure of Disease is still in print. If you are interested in reading all 20 medical books in one volume written over 100 years ago see: https://www.amazon.com/Library-Health-Twenty-Books-One-Scholl/dp/B007GNBQB6/ref=sr_1_10?s=books&ie=UTF8&qid=1516977599&sr=1-10&keywords=library+of+health+by+Scholl