"Much knowledge[20] is necessary to discriminate the kind of cases in which assistance is proper, and determine the time at which that assistance ought to be employed, as well as the mode of its application. It is this which distinguishes the scientific from the ignorant obstetrician; it is this important knowledge on which the life, the future health and comfort of many a parturient woman must depend; which, nevertheless, has been held in such low estimation by some members of the profession, as to be thought unworthy of cultivation by the scientific and literary mind; unfit to be possessed by men of respectable station in society; and the adaptation of which knowledge to practice has been characterized, in an official document under the seal of the highest of our medical corporate associations, as 'an art foreign to the habits of gentlemen of enlarged academical education.'[21] In the same communication it is asserted, 'that the most successful practice of midwifery requires no such laborious preliminary study as is necessary for the practice of medicine, else discreet matrons, and plain uneducated men in the country, who frequently arrive at great notoriety in this calling, would not acquire that credit which they often attain.'... nor, perhaps, are we generally expected to regulate the number of individuals to be present, though we may be called upon occasionally to exercise our authority in this respect. The only persons whom I would willingly admit are the nurse and some female married friend, the mother, or other near relation, or an intimate acquaintance, to act as _confidante_ to the sufferer, into whose sympathizing ear she may whisper all her apprehensions and distresses, and from whom she may receive those numberless comforts and sustaining consolations of which she stands so eminently in need. Unmarried females are neither the most fit companions for the patient, nor the most useful assistants to the practitioner.[22]