Remembering Past Greats: William Smellie

Author Information

Prasad M
(Assistant Professor, Department of Obstetrics and Gynecology, Seth G S Medical College and K E M Hospital, Mumbai, India.)

William Smellie was a Scottish Obstetrician who lived between 1697 and 1763. While he is commonly remembered for the famous Mauriceau-Smellie-Veit technique for vaginal breech delivery, this contribution of his to Obstetrics, is just a small fraction. He was a pioneer in teaching obstetrics. One of the first pictorial essays of obstetric anatomy, “Atlas of the Gravid Uterus” is attributed to Smellie and his contemporary William Hunter. This included detailed drawings of the internal dissections of expired women with a gravid uterus.

The book he authored in 1752 is hailed as a pioneering and important book in Obstetrics. The book was received so well, that an updated edition, with an extensive elaboration of his principles and techniques, was required to be published by him in the same year.
He was the first to describe the bony pelvis, its dimensions and its variants. He was the first to describe the diagonal conjugate. He was the first to elucidate rotational forceps in an occiput placed posteriorly. He was the first to apply forceps for the after-coming head in a breech delivery. He had designed many types of forceps, and had uniquely used wood as the material, rather than metal.[1] However, some commentators have falsely accused him of being “instrument-happy”, due to his apparently excessive usage of instrumental delivery. Though the neonatal obstetric palsies are attributed to Erb, Duchenne and Klumpke, these were described in detail only between 1870 and 1885. Though the number of cases were lesser, Smellie had already described these obstetric palsies way back in the 1740s.[2]
A recent article has reproduced selected passages of his original book.[3] Barring a few years in France (where he collaborated with Mauriceau and Levret), he predominantly practiced in London and his home town, Lanark, in Scotland. Despite this, his influence spread far and wide. A recent article has also covered how he had a long and significant impact on medical practitioners in Japan, which lasted more than a century.[4]

Nevertheless, some recent medical historians have pointed accusatory fingers on Smellie regarding involvement in unethical activities to obtain bodies to perform dissection, and accusations of murder had been raised.[5] However, such controversies have been put to rest, and befitting replies have been given to such accusations, by experts.[6]
Recently, retrospective historical analysis of maternal mortality rates at various eras have been undertaken. It was found that along with few other pathbreaking midwives, Smellie stood out as an obstetrician with a much lesser mortality rate, compared to prevailing estimates.  It was further elucidated that Smellie’s choice of obstetric maneuvers and instrumental deliveries (which resulted in significant morbidity in that era) only in carefully selected patients, was probably the main foundation for reduction in maternal mortality rates.[7]
To sum up, William Smellie was an obstetrician par excellence. We must not forget to acknowledge his contributions, which we obstetricians rely upon, ubiquitously.

References
  1. Biographies. In O’Dowd MJ, Philipp EE, editors. The History of Obstetrics and Gynecology. 1st ed. Lancs: Parthenon Publishing Group 2000; pp. 644-5
  2. Collado-Vazquez S, Jimenez-Antona C, Carrillo JM. [Obstetric brachial palsy, a historical review]. Rev Neurol. 2012; 55(10):619–25.
  3. Woods R. Dr Smellie’s prescriptions for pregnant women. Med Hist. 2008;52(2):257–76.
  4. van der Weiden RM, D’Orlando A, Uhlenbeck GC. The continuing influence of William Smellie (1697–1763) in Japan during the early Meiji Period (1868–1880s). J Med Biogr. 2013; 21(3):193–5.
  5. Shelton DC. Man-midwifery history: 1730–1930. J Obstet Gynaecol. 2012;32(8):718–23.
  6. Roberts ADG, Baskett TF, Calder AA, Arulkumaran S. William Smellie and William Hunter: two great obstetricians and anatomists. J R Soc Med. 2010;103(5):205–6.
  7. L√łkke A. Mrs Stone and Dr Smellie: British eighteenth-century birth attendance and long-run levels and trends in maternal mortality discussed in a north European context. Population Studies. 2018 Jan; 72(1):123–36.
Citation

Prasad M. Remembering Past Greats: William Smellie. JPGO 2018. Volume 5 No.9. Available from: http://www.jpgo.org/2018/09/remembering-past-greats-william-smellie.html