brain upon the sharp Artery and the Lungs and sometimes from a blood of the like nature which flowes from the whole habit towards the Breast upon the suppression of the Terms as also from having breathed in too cold an air which irritates the parts and excites them to move in that manner but being begun by these causes it is very often augmented by the compression the Womb of the pregnant Woman makes upon the Diaphragma which cannot have its free liberty in those that bear their Children high because by its great extension it bears up almost all the parts of the lower Belly towards the Breast and principally the Stomach and Liver forcing them against the Diaphragma which is thereby compressed as we have said This may be remedied by the Womans observing a good diet something cooling if sharp humours cause it avoiding all meats salted spiced or hautgoust she must forbear sharp things as Orenges Citrons Pomgranats Vinegar and others of the like nature because they yet more and more by their pricking quality excite the Cough but she may make use of Lenitives and such as sweeten the passages as juice of Liquorish Sugarcandy and Syrup of Violets or Mulberries of which they may mix some spoonfuls with a Ptysan made with Jujubes Sebestens Raisons of the Sun and French Barly alwayes adding a little Liquorish to it It may not likewise be amiss to turn the abundance of these humours and draw them downwards by some gentle Clyster If this regimen prevails nothing and that there appears signs of fulness of blood it will be necessary at whatsoever time it be of her going with Child to bleed her in the Arm and though this remedy be not usually practised when they are young with Child yet in this case it must for a continual Cough is much more dangerous than moderate bleeding If the Cough comes of cold let her be kept in a close Chamber with a Napkin three or four times double about her Neck or a Lambskin that it may keep her warm and going to bed let her take three or four spoonfuls of Syrup of burnt Wine which is very pectoral and causeth a good digestion if it be made in the following manner Take half a pint of good Wine two drams of good Cinamon bruised half a dozen Cloves with four ounces of Sugar put them together in a Silver Porenger and cause them to boil upon a Chafindish of coals burn it and afterwards boil it to the consistence of a Syrup which let the Woman take at night an hour or two after a light supper It must alwayes be observed from whatsoever cause the Cough proceeds that the Woman go loose in her clothes for being strait-laced the Womb is the more thrust down by the endeavours the Cough causeth it to make And because sleep is very proper to stay defluxions it may be procured if there be occasion by some small Julip using by no means the strong Stupesactives which are dangerous to a Woman with Child if there be not a very great neceâ—sity as there was in my Kinswoman who had furious accidents by the hurt she got from the stumble of which I gave you an account in the 12th Chapter of this Book There are Women that carry their Children so high especially their first because the large Ligament which support the Womb are not yet relaxed that they think them to be in their Breast which causeth so great an oppression and difficulty of breathing that they fear they shall be choaked assoon as they have either eaten a little walked or gone up a pair of Stairs which comes as I said before by reason the Womb is much enlarged and greatly presseth the Stomach and the Liver which forces the Diaphragma upwards leaving it no free liberty to be moved whence is caused this difficulty of breathing Sometimes also their Lungs are so full of blood which is driven thither from all parts of the body when with Child that it hardly leaves passage for the air if so they will breath more easily as soon as a little blood is taken from the Arm because by that means the Lungs are emptied and have more liberty to be moved But if this difficulty of breathing comes from a compression made by the Womb against the Diaphragma in forcing the parts of the lower Belly against it the best remedy is to wear their clothes loose about them and rather eat little and often than to fill their Bellies too much at once because it is thereby more pressed against the Diaphragma and so augments the accident Neither must she use any viscous or windy meats as Pease c. but only such as are of an easie digestion she must all the while avoid any occasion of grief and fear because these two passions drive the blood to the Heart and Lungs in too great abundance so that the Woman who can hardly already breath and hath her Breast stuft will be in danger of being suffocated for the abundance of blood filling at once and above measure the Ventricles of the Heart hinders its motion without which one cannot live CHAP. XVI Of the swelling and pains of the Thighs and Legs IT is very easie for them that are acquainted with the Circulation of the Blood to conceive the reason why many big-bellied Women have their Legs and Thighs swelled and pained and sometimes full of red spots from the swelling of the Veins all along the inside of them which extreamly hinders their going Many think which is in some measure true that the Woman having more Blood than the Infant needs for its nourishment Nature by vertue of the expulsive faculty of the upper parts which are alwayes most strong drives the superfluity of it upon the lower which are the Legs as most feeble and aptest to receive it because of their scituation to explain it thus is something to purpose but I think the Circulation of the Blood will teach us better how this comes than that we need to have recourse to this expulsive faculty It is then thus according to my opinion Following the ordinary motion of the Blood the Crural and the Saphene Veins receive into them what is brought to the lower parts by the Arteries and convey it along the Leg and Thigh ascending still by the Iliacks towards the Heart which are emptied into the Cava to ascend again by it to the Heart and so successively This being so de facto as need not be doubted since it is a verity founded upon experience when a Woman is with Child and chiefly towards the last months and the Womb is much extended and possesseth a great part of the lower Belly then it begins to press the Iliack Veins by its greatness and heaviness and so hinders the Blood from following its course and having its motion so free as before she was with Child which being so the inferior parts which are the Crural and Saphene Veins become swelled much in the same manner as the
Veins of the Arm do upwards when bound with a Ligature for bleeding or by any strong compression upon the upper parts which happens because the Veins being compressed the Blood is there stopt finding its passage more difficult The Iliack Veins being then so pressed by the bigness and heaviness of the Womb all those of the Legs and Thighes swell in such a manner as that they empty themselves into the substance of the parts and throughout the five Coverings which thence become swelled yea and these Veins and amongst the rest the Saphenes dilated and become varicose sometimes from the inward and upper parts of the Thigh to the very extremity of the Foot in which the Blood stagnating without its free circulation is altered and corrupted which causeth great pains and swellings in all these parts This oftner befalls Women that are very sanguine walk much and use great exercise which aided with a fulness of the Vein makes a rupture of the Valvules which serve to facilitate the motion of the Blood as the suckers of a Pump which retain the water when it is raised thither which Blood falling down again not being so supported causeth by its quantity and stay these dilatations of the Veins which are called Varices For to remedy this when a Woman hath her Veins dilated let her only use whilst she is with Child a palliative cure in swaithing this Varicos-part with a swaith three or four fingers broad according to the bigness of it beginning to swaith from the bottom and conducting it upwards to the beginning of the Varices that by this means these varicos Veins which are alwayes outward being moderately closed should be hindred by this compression from further dilating and the Blood not be corrupted by the stay it makes there which after this will not want its circular motion because the greatest part of it passeth then by the Vessels deeper placed A Woman in this condition should likewise keep her bed if she can because by this scituation her body being equally layed the Blood circulates much the easier and is not then so much troubled to return by these Veins to the Heart as when it must ascend by them the Woman standing upright which is the cause the Legs alwayes are more swell'd at night than mornings if there be in any other parts of the Body signs of plenitude and abundance of Blood they may bleed her without danger There are other Women whose Legs only swell because of their weakness and not for the reason just above mentioned and are so oedematous that when you press them with your Finger the print of it remains there which is because they want natural heat sufficient to concoct and digest all the nourishment sent to them and to expell the superfluities of it which by that means remaining there in great quantity leaves them so oedematous For to resolve these sort of Tumours you may use a Lee made with the Ashes of Vines and the Decoction of Melilot Camomile and Lavender afterwards they may be somented with Aromatick Wine in which they may moisten their compresses to be laid upon them repeating them three or four times a day to fortifie them which may be made with Rosemary Bayes Tyme Marjoram Sage and Lavender of each an handful of Province-Roses half a handful Pomegranat flowers and Alum each an ounce boil them together in strong Red-Wine three pints to the consumption of a third part strain it and keep it for the use above mentioned But since Pregnancy for the most part causeth these tumours they likewise ordinarily cease when the Woman is brought to bed because then she purgeth forth the superfluity of her whole habit by means of her Lochia CHAP. XVII Of the Hemorrhoids THe menstrous Blood that used to be purged away every month being collected in a great quantity near the Womb which permits it not now to be evacuated by the usual passage being so exactly closed during Pregnancy is forced to flow back into the whole habit and chiefly upon the neighbouring parts of the Womb and causeth in many the Hemorrhoids both internal and external All the several sorts of them which we shall not describe may as well happen to them at this time as at another but we will only speak of that sort which is caused by pregnancy because our design is only to make known some particulars of the maladies Women are in this condition subject to Hemorrhoids are tumours and painful inflammations ingendred by a flux of humours upon the extremities of the Hemorrhoid Veins and Arteries and are caused in great-bellied Women by the abundance of Blood which is cast upon these parts because the body at this time is not purged of its superfluities as it was accustomed before It is likewise very often caused by the great endeavours that Women sometimes make to go to stool when they are costive because the Womb being placed upon the Rectum hinders by pressing it the excrements contained in it from being easily extruded and by these endeavours the Blood which is in the neighbouring Vessels being likewise expressed swells and blows up their extremities upon which comes these painful inflamations call'd Hemorrhoids of which some are internal some external some small and with little or no pain and some extreamly big and painful This may suffice for their general differences without coming to their particulars which would require a more ample explication If they are small and without pain either internal or external it is easie enough to prevent their further growth by Remedies which hinder and turn the flux from those parts but there is more reason to cure the great and painful ones by easing first the great pain for as long as that continues the Flux is ever augmented To this purpose if the big-bellied Woman have in the rest of her body other signs of repletion she may safely be once let blood in the Arm and sometimes if there be great necessity twice for to turn away the humours and to evacuate the fulness by which the pain will likewise be appeased If the gross excrements retained in the right Gut be the cause of it and that she be costive let her take an emollient Clyster of the Decoction of Mallows Marshmallows Pellitory and Violets with Hony of Violets to which may be added Oyl of sweet Almonds or sweet Butter being careful to add nothing that may irritate lest it augment the Disease especially when they are inward Piles And to the end the Women may then the better receive the Clyster t is fit that a small end of a Pullets gut be put upon the end of the pipe to cover it on the outside that so it may be put up the Fundament with less pain afterwards let her keep a moderate and cooling diet and continue in bed till this flux of humours be passed and the mean time anoint the Piles with hot stroakings from the Cow or foment them with the Decoction of Marsh-mallows White-broth
blew according as the Vessels are more or less full of blood and especially the Vein which gives it that colour and is so much the more apparent as it is superficial in that place There are many Authors admit as we have said the Ourachus into the number of these Umbilical vessels saying that it serves to empty the Childs urine into its Membranes however experience shewes us it is no vessel and that it passeth not forth of the Navel but that it is only a ligament in a Child as it is in a Man which coming from the bottom of the Bladder terminates at the Navel without traversing it as they have hitherto mistaken it I have opened and dissected above thirty Foetus's in none of which did I ever find it hollow but alwaies very solid and tendinous towards the place where it it fastned to the Navel and very like as I have already said to a small Lute string Notwithstanding I ever found it manifestly hollow in an Ewe which was terminated with their other Umbilical vessels at their Cotyledons in which Animals are also two Umbilical veins to be seen going both near one the other to the Liver which makes that their Navel-string consists of five Vessels but it is not the same in a human Foetus for there is but one onely Umbilical Vein and two Arteries To understand well how the nourishment is conveyed to the Infant by the Umbilical vessels it is very necessary to conceive and know in what manner the Blood circulates which is after this manner The blood having been conveyed by the mothers Arteries which end at the bottom of the Womb in the Placenta which is there fastned makes a natural transfusion through the Umbilical Vein into the Childs Liver after which it is carried into the Vena cava and thence to the Heart whence it is sent to all the parts by means of the Arteries and very near a like portion in quantity being in the Iliac Arteries is conducted into the Umbilicals which are there terminated for to be carried back into the Placenta where this blood being again elaborated returns to make the same journey by the Umbilical Vein passing again to the Childs Liver and thence to the Heart and so alwayes successively without the least intermission But to be able to conceive easily how the blood circulates in the Placenta and how by the help of that part is made a mutual transfusion from the one to the other as well in respect of the Mother as of the Child we need but imagine it to be a common part and depending on both their bodies for as to the Mother the circulation is there made just as in her Arm or any other part of her whatsoever and as to the Child it is even the same There are no Valvules found in the Umbilical Vein though I have curiously examined it nor are any necessary these Valvules ar every frequent in the Veins of the Arms and Legs because these parts are obliged to make different motions which compressing the Vessels would trouble those of the blood if it were not so sustained and hindered from recoiling but the Umbilical Vein hath no need of any because the Navel-string is loose and floting in the midst of the waters where it cannot be comprest and therefore the motion of the Blood cannot be there intercepted as it is sometimes in the Arms and Legs or other parts where there are strong contractions Assoon as the Child is born these Vessels which are bigger in a Foetus because of their cavity than they are in a Man dry up and that part of them which is without the belly falls off and is separated close to the Navel five or six days after for which reason they lose their first use and begin afterwards to degenerate into suspending Ligaments to wit the Vein into that of the Liver and the two Arteries serve to extend and sustain the Bladder by the sides where they are joyned to it the bottom of which is yet suspended by the Ourachus which comes not through the Navel as hath been said but remains so pendant all the rest of its life We have hithereo made mention of all those things which are found with the Child in the Womb let us now show what are the different scituations of it in the Womb according to the different times of Pregnancy It is a thing of very great consequence and deserves some reflections The three following Figures represent the different natural scituations of the Child in the Womb. That which is marked B shews how it is scituated the seven first months of Pregnancy That which is marked A shews the same scituation on the back-side And the third marked C shews in what fashion it is scituated towards the end of a Womans reckoning and at the time that it is disposed to be born Explication of all the Wombs in which are contained all the Children represented in different postures as well in this place as in all the following A A A A Shews the substance of the Womb. B The Membrane called Chorion which lines the Womb within C C C C The membrane Amnios which is so united and joyned to the Chorion that both of them seem to be but one single Membrane D D D D Shews all the space which is filled with waters in the midst of which the Infant flotes and is scituated E E The After-birth fastened to the bottom of the Womb. F F F The Navel-string which fluctuates hither and thither in the waters CHAP. V. Of the several natural scituations of an Infant in the Mothers Womb according to the different times of Pregnancy WHen we shall have explained the several natural scituations of an Infant those contrary to Nature causing for the most part all ill labours will easily be conceived It may be considered that generally the Infants as well Male as Female are usually scituated in the midst of the Womb for though sometimes a Womans great Belly is a little higher on the one side than the other yet that is because the globe of the Womb inclines more that way and this scituation on the side must be understood only in respect of the Mothers belly and not of her Womb in the midst of which it is alwaies placed because there is but one only cavity in a Womans Womb marked with a small line in its length without having two or more separations as is seen in those of other Animals There are some who would have these two imaginary cavities to be the cause why Women sometimes bear Twins yea and sometimes more and that the Males are rather engendered on the right and Females on the left side which is Hypocrates's opinion in the 48th Aphorisme of his 5th Book where he saith Foetus Maris dexträ uteri parte Foeminae sinisträ magis gestantur but without any certain reason for it because some Women have the Males on the left-side others the Females on the right and when there are
compression is much greater in respect of the Veins which are alwaies more outward and ought to carry back the Blood to the Heart than of the Arteries by means of which it is carried to all the parts for besides that the Arteries lye deeper they have also a continual Pulsation by the favour of which a little Blood ever slides away and this is the reason that in all Compressions or Ligatures of parts provided they be not too-hard the Blood is easily carried into them by the Arteries and but very hardly or not at all carried back by the Veins which is the reason that the part receiving much more than it sends back or consumes for its nourishment must needs swell on this fashion by Repletion If they that practise Midwifery do but well consider what I have said when occasion offers which is very often they will find that these kind of Knobs or Tumours which many Children have on their Head at their birth proceed ordinarily from no other cause than what I have here explained These Tumours many times are so great and high that the Woman not being yet delivered nor having the inner Orifice of the Womb well dilated they do hinder the discovery of the part the Infant first presents making Midwives sometimes to imagine not being able to feel any bone of the Head with their Finger that it is the Childs Shoulder or some other part nay some of them cannot tell what that swelling is they feel but they may soon know it by reason these Tumours though feeling very fleshy at the touch are notwithstanding harder than any Shoulder or Buttock of a Child which parts are alwaies more soft and without hair as the Head hath the Bones of which may also be easily perceived if having the Finger anointed with Oyl or fresh Butter it can be introduced into the inner orifice for the parts of the Head within the Womb are not swelled 't is only this which offers to the Orifice and is prest and begirt by it as we have said If a Child comes with any other part besides the Head as an Arm or a Leg and that these parts likewise remain a long time prest in the Passage and in a posture much constrained or that they be come forth they likewise swell for the same reason There must not only be Remedies applied to these Knobs and Bruises of young Childrens Heads but endeavours must be to prequent them or at least to hinder them from becoming so big the means to prevent them is to procure the Delivery assoon as may be that the Infants Head may not rest so too long and be straitned by the Garland of the inner orifice of the Womb which must be well anointed with Oile or Emollient Ointment as well to further its dilatation as that the Head may the sooner and the easier pass Some may object That if these Tumours happen from the cause I have mentioned they would disappear assoon as the Infant is born because then the Head being no longer prest nothing hinders the Blood which had rumefied the part from returning having its motion free But they must know that by its too long stay it makes in one part it looseth the spirits which are there suffocated of which being destitute it can no longer move and being extravased without the Vessels out of its natural place as it will be when the Vessels containing it are too full it slides into all the little vacuities of the part for which cause it cannot afterwards return by the ordinary waies wherefore there is a necessity in this case either that it be resolved through the part or if it stay any time that it comes to Suppuration which however must be avoided if it be possible because of the nearness of the Brain which in Infants is not covered over with the Skull at the Sutures which are alwaies very open especially towards the Mould To resolve these Tumours then assoon as the Child is born foment them with warm Wine or Aquavitae and wetting a Compress in it put it upon them some Mid-wives only dip a Compress in Oyl and Wine beat together others in Oyl of Roses onely having first fomented them with Wine but if notwithstanding this they come to Suppuration the matter must not be suffered to remain there too long for fear lest the bones of the Head which are very tender and thin in new-born Children become altered and soule in this case it must be opened with a Lancet in a proper place according to Art putting upon it afterwards a Plaister of Bettony if a Leg or an Arm be thus swelled it must likewise be wrap'd up with Compresses dipt in Wine wherein Provence-Roses Camomil-Flowers and Melilot have been boyled Sometimes also Male-children have the Scrotum very much swelled which may happen to them by reason of some Waters contained in their Membranes or because they were bruised or too rudely handled by the Chirurgeon or Midwife in the Labour In these cases Compresses dipt in Wine with Roses are very proper to both Chap XXI lib 2 pag 381 CHAP. XXI Of the Mould of the Head and of the Sutures being too open VEry often Children who come before their time not having yet acquired their full perfection as also they which are by nature weak have the Mould of their Head and the Sutures so open by the distance and separation of the Bones one from another that it is very soft and almost without any support because the Bones easily yeild to every side these Children are not usually long-lived One must not think then to bring the bones close together by binding the Head strait for this would so presse the Brain which is very tender that it would cause a worse Malady in taking away the liberty of its motion whereby its functions would be depraved and afterwards totally abolished It will be sufficient to bind them softly with a small Cross-cloth lest they should be too unsteady and commit the rest to Natures work which by degrees will close up these Sutures in finishing to ingender and dry up and unite these bones of the Head which were not hitherto perfectly formed The place where the Sagittal Suture joins and terminates in the midst of the Coronal which it alwaies in every Child divides in two continuing to the very root of the Nose is called * Mould the Fountain of the Head because 't is the softest and moistest part of it which for this reason is the last dryed and closed up The Figure of it is represented in the Head placed at the beginning of this Chapter There are Children who have it sometimes open 'till they are three years old if not longer which is a great sign of the weakness of their natural Heat It is usually quite closed up at the end of two years and sooner or later according as the Infant is more or less moist or more or less strong Until these Bones are entirely closed 't is convenenient
their Yards not persorated who notwithstanding have these Waters whilst they are in their Mothers Womb. It must be observed that when there is more than one Child they are never in the same Membrane unless their bodies are joyned and adhering together which is rare and monstrous when it happens but each of them have their Membranes and Waters apart and separated in which they are each wrapt up by themselves These Waters thus collected within these Membranes have divers very considerable uses They serve the Infant to move it self the more easily as it were by swimming from one side to the other and that it may not hurt the Womb by its frequent motions in striking dry against it which would cause great pain and often excite to abortion they serve also very much to facilitate its passage in the Birth making the way very slippery and by that means the orifice of the Womb being moistened is better widened and yeelding when they break * Right time of good Labour just when the Child is ready to follow or a little before for else remaining dry it is born with greater difficulty and the Mother also more tormented by it John Claudius de la Corveé Physitian to the late Queen of Poland in his Book intituled De Nutritione Faetus would have these Waters to serve the Infant chiefly for nourishment and that it sucks them by his mouth and swallows them as he imagins whilst he continues in the Womb but the truth of the contrary being known to the least Scholar it would be but labour in vain to refute all the reasons he brings to prove and support his saying for they destroy themselves and do all of them correspond to the falshood of their principle Having thus sufficiently explained the Membrans and Waters of the Faetus we must in order inquire after the parts by means of which it is nourished whilst in the Womb which shall be our following discourse These three Figures represent the Placenta or After-birth and the umbilical vessels of the Infant The first shews the shape of the Burthen to the midst of which is fastened the Navel-string round it may be discerned the * Skins Membranes of the Infant which remain thus wrinkled when the Child is come forth of it A A A Shews the body or cake of the Burthen B B B The Skins fastened round about it C C C The Navel-string which contains the Infants umbilical vessels and proceeding from his Navel are inserted in the midst of the burthen where they produce an infinity of branches D D Certain eminencies called knots found on the string proceeding from the dilatation of the umbilical vessels more in one place than in the other The second Figure shews the Burthen turned on the outside and the Childs belly opened that the distribution of the umbilical vessels may be then considered E E E Shows the Burthen on that side which cleaves to the Womb on this side there appears no vessels as there doth on the other but only some simple interlinings and small outlets by which the Blood that transudes the Womb may distil into this parenchymatous mass F F F The Membranes Skin or Skirt H A portion of the Amnios separated from the Chorion marked I. G A part of the Chorion separated from the Amnios marked H. I I I The Navel-string in which are many knots K The Navel where the vessels enter L The umbilical veine which enters into the fissure of the Liver M The two umbilical Arteries which being conducted along the side of the Bladder are inserted into the Iliac Arteries and sometimes into the Hypogastricks N The Urachus which from the bottom of the Bladder couching between the two umbilical Arteries is fastened in the Navel without passing forth in which place it is not hollow in the least and is extreamly small The third Figure shews the burthen of Twins where each Child hath his several Navel-string and Membranes apart O O O O The fleshy substance or body of the Burthen common to both Children P P P The Skirt or Membranes which wrap up the Child on this side apart Q Q Q The other Membranes which contains the other Child apart As to the strings which are double to this After-burthen that on the right is dissected at the end to shew that there are but three vessels only in it R R Shews a strong Membrane in which these three umbilical vessels are inclosed S. The Veine which is very big T T The two Arteries much less than the Vein The other string cut on the other end where are only seen the orifices of the vessels Chap. III. lib. 2. pag 159. 160. Fig. II CHAP. IV. Of the Placenta and Umbilical Vessels of the Child SInce the Infant is only nourished with the Mothers blood whilst it is in the Womb and that big-bellyed Women never have any that is fair or good provident Nature hath formed the Placenta to serve it for a Magazin that it may alwaies have sufficient and be there again elaborated and perfected to render it more convenient for its nourishment for without doubt so gross a blood as the Mothers cannot possibly be converted into its delicate substance if it were not first purified in the Placenta which is afterwards sent to it by meanes of the Umbilical vein and brought back as we shall shew hereafter by the Arteries which are the conduits of which the the Navel-string is composed We say then that the Placenta is nothing but a spongy and fleshy mass somewhat like the substance of the Spleen woven and interlaced with an infinity of Veins and Arteries which compose the greatest part of its body made to receive the Mothers blood appointed for the Infants nourishment which is in the Womb. This mass of spongious flesh is thus called because it resembles in figure a Cake some call it the Delivery because being come forth after the Child is born the Woman is quite delivered of the burthen of her great-belly It is likewise called the After-burthen because it is as a second labour of which the Woman is not discharged till * Sometimes in flouding it comes before the Child after the Child is born there are some which give it the name of the Uterine Liver because they say it serves as a Liver to prepare the blood appointed for the Infants nourishment and Laurentius likes rather to call it the * Sweetbread Pancreas of the Womb and appoints the same use for it as for the Pancreas of the lower belly to wit for a rest and support to the vessels of the Navel which disperseth an infinite number of branches throughout all its substance This Placenta is made of the menstruous blood of the Mother which flowes into the Womb by the accumulation of which is formed this Parenchymatous mass the shape of it is flat and round of about he bigness of a Trencher and two fingers breadth thick towards the middle of it where
the Child I brought it alive and it was presently baptized by a Priest that was in the Chamber The poor Patient and all the company present which were in great number found then manifestly that the Chirurgion and Midwife who said she could not be delivered had but little reason to assure any such thing The Operation was finished time enough for the Childs baptism which praised be God it received but too late to save the Mothers life who having before lost all her Blood dyed an hour after she was so delivered by the same weakness that she often fell into before she was delivered The flooding indeed ceased presently but she had not Blood enough left to enable her to resist those frequent faintings which she might have done as may probably be conjectured if the Chirurgion that first saw her had delivered her three long hours before as without doubt he might as easily have done as I in which time she lost above twenty * each Porenger contains about four ounces small porengers of Blood of which four or five possibly might have been sufficient to have saved her life she being a young Woman of a very good constitution having no inconvenience or sickness when she was surprised with this fatal accident which befel her as aforesaid about eleven in the morning and she was delivered about seven at night and because she had lost so much Blood before the Operation it proved unprofitable she dying an hour after having her perfect senses to the moment she expired which was about eight the same night I will upon this lamentable Subject to the end more care may be taken in the like cases examine by way of digression what might be the motive of this proceeding of the Chirurgeon and of some others of the same humour It must necessarily be agreed that it was for one or more of these three causes why either he would not or could not lay this Woman when he saw her two hours before me which as I noted before might easily have been done It was either through Ignorance Malice or Policy To imagine it his Ignorance I cannot perswade my self because he hath too great Reputation for that although many persons that understand the Art very well easily agree with me that he is of the number of those of whom may justly be said Minuit praesentia famam That it was through Malice who can imagine a man of so detestable a resolution could be found but if it were neither Ignorance nor Malice it is easy to guess it a damnable Policy qualified by some with the name of Prudence * A good Warning not to rely too much upon the advice of such famous Practitioners or Midwives that prefer their Reputations above their Consciences this false Prudence they ordinarily use that are in great reputation ever endeavouring to their utmost to shun dangerous Cures lest they that understand not the Art should quit the good opinion they had of them when it happens that the Patient dies under their hands although they were carefully and duly delivered This was just our misfortune for this Chiurgeon who was very much esteemed by many Women of quality whom he delivered avoided all he could dangerous labours subject to ill success as this was and the rather then because there was in my Sisters Chamber a Lady of quality Wife to one of the chief Captains of the Guards who dwelt in the same house and whom he ordinarily delivered which was the cause that believing the issue of the Operation doubtful he chose rather to preserve the esteem of his ancient practice amongst such as understood not the business well enough to be judge of his proceedings than to do in this case his Christian duty to which one ought alwayes to have more regard than to all these Interests of vain Reputation which usually corrupts the Conscience They that make use of this Policy are often accessory to the death of poor Women who call for their assistance and of their Children also I was willing to recite every circumstance of this Tragedy that one may know in the like case the necessity of a speedy delivery I have since that had many in the same case to whom by the assistance of God I warranted the lives of the Women and saved the Children of which I had in my self more satisfaction than I could have gained by all the honour the World could procure me by so wicked a policy which neither Chirurgeon nor Midwife of an upright Conscience will ever use Now since in all floodings there ever follows weakness and faintings we must endeavour to preserve that little strength the Patient hath left and augment it if possible that so they may have sufficient to endure the operation and to escape afterwards to which purpose there ought to be given her from time to time good strengthening Broths Gelly's and a little good Wine she must alwayes smel to Rose-vinegar and have a warm toast dipt in Wine and Cinamon applied to the region of her Heart which will do her more good than solid food for as Hippocrates saith in the eleventh Aphorism of his second Book Facilius est potu refici quam cibo one is sooner nourished by drink than meat because the liquid aliments are much sooner distributed than the solid And to prevent the Blood from flooding in great abundance till she can be delivered * Rather Ligatures above the elbows because too much Blood is already lost a Vein in her Arm may be opened to turn a little the course backwards and apply all along her Reins Napkins wet in Water and Vinegar But if the flooding proceds from the separation of the after-burthen from the Womb as my Sisters was all these things are to little purpose and the best expedient is to deliver the Woman assoon as may be though she were but three or four months gone with Child or less because all ought as well to be brought away whatever is within the Womb whether it be Fals-conception Mole or Child without leaving any thing behind which when it is quite cleared closing and contracting it self stops the flooding for the reasons above alledged and all accidents which were caused by it wherby the Woman afterwards recovers if there be but sufficient strength remaining after delivery as certainly will be if not delayed too long CHAP. XXI Of the weight bearing down or relaxation of the Matrix which hinders a Woman with Child in her walking and the freedom of coition MAny Women with Child find an extraordinary weight at the bottom of their Bellies which comes because the Womb by the weight it contains in its capacity bears down upon the neck and sometimes so low that they cannot walk without pain and stradling at which time also they cannot use copulation but with great inconvenience The bearing down of the Womb is when it only falls into the Vagina without coming in the least without the Privities for then it
the umbilical vessels are fastned but it is thinner towards the edges of all its whole circumference It is covered with the Chorion and Amnios on the side next the Infant and on the other side it is joined and fastened to the bottom on the inside of the Womb It is strongest fastened to the Womb with its circumference by means of the Chorion as we have hinted already in the preceding Chapter which cleaves so close to it by the interlacings of an infinity of Vessels which appear very large in its surface that it cannot be separated from it without laceration of its substance If one considers diligently as I have done the Placenta on that side which joyns to the Mother they may perceive that it is also indued with a kind of light membrane which is so frail and small that it is almost imperceptible however it may manifestly be discerned by wiping away the blood with which it is alwaies coloured There may be again observed that all the superficies on this side is as it were much interlined not unlike in some measure those of an Oxes reins and there appears likewise many small out-lets by which the blood that transudes through the pâ—rous substance of the Womb distills into this fleshy mass Although there be two Children in the Womb nay three if twins that is to say begotten in the same act they have usually but one common After-burthen which hath as many Navel-strings fastened to it as there are Children which notwithstanding are separated one from the other by their several membranes in each of which the Children are apart with their Waters if at least as I have said in the precedent Chapters their bodies be not joyned and adhering one to the other in which case the Twins of this kind have as well their Waters in common as that they are involved in the same membranes but if they be superfetations there will be as many burthens as Children and as superfetation if there are as many as may possibly be happen but very rarely so there are few Women that have their burthens separated when they are delivered of several Children We scarce find any creature but a Woman that hath an After-burthen like what we have described and dischargeth it as useless assoon as the Child is born for most other Animals cast forth nothing after their young except the waters only and some slime with the membranes which surround them and instead of this fleshy mass those which ordinarily as a Woman bring forth but one young at a time have only some Cotyledons which are many spongious kernells joyned inwardly to the proper substance of their Womb where terminates all the branches of the Umbilical vessels of their young which kernells as I have often observed in the dissecting of sheep are not bigger than Hemp seed when they are not with young but when they are with young they swell extremely and become of the bigness of a thumb the one bigger the other lesser they then resemble much the Figure of a round Mushroom not yet spread on the wrong side after it be cut from its stalk and to each of those Cotyledons or kernels are fastened the ramifications of the umbilical Vessels however it is certain that the Animals which have ordinarily more than one at a time as Bitches Rabbits and others have no Cotyledons instead of which each young hath in its Cellule a kind of particular Placenta which the dam eats asson as she voids it after she hath gnawed and cut off with her teeth the Umbelical vessel which held it When a big-bellyed Woman hath the least indisposition of her whole habit there is almost ever some mark and impression either in colour or substance on the after-burthen which she voids in her labour because it being of a very soft substance easily imbibes the ill humours of the body which used to be voided by the Womb. Its natural colour ought to be red and so much the fairer and better coloured as the Woman is in good health its substance must be whole and equally soft without the least schirrous hardness From the midst of the Burthen proceeds a string composed of many vessels joined together which serve to conduct the blood appointed for the Infants nouriture the number of them is disputed amongst Authors some reckon four that is two Veins and two Arteries others five adding the Ourachus to them but it is very certain that there are but three only in a humane Foetus as I have found by many dissections to wit one Vein and two Arteries the vein having sent forth into the Placenta an infinity of branches like to the roots of a tree is conducted by a single channel all along the string to the Infants navel which it passeth to be at last terminated in the midst of the Fissure which is in the inferiour part of the Liver and the two Arteries taking their rise out of the same Placenta from a great number of the like roots pass along the same string by two conduits piercing also the Infants Navel and end in its Iliac Arteries and sometimes in the Hypogastricks The Vein is much bigger than the Arteries its cavity is capable to admit a writing-quil into it and those of the Arteries only a small bodkin about half the bigness of the Vein These three Vessels composing the string are wrapt up in one Membrane thick and strong enough proceeding from the Chorion which likewise is clothed about with a production from the Amnios and may easily be separated but besides that this first serves them as a sheath in which they are all three lodged it separates them again one from the other by its duplications When the vessels of the string are full of blood it is then of about the bigness of a finger and ordinarily of the length of a good half Ell and sometimes of two thirds or three quarters It is necessary it should be of this length that the Infant may have liberty to move it self in the Womb and to go forth of it at its birth without tearing the After-burthen to which it is fixed There are many very plain inequalities like unto knots which only proceed from the dilatation of the Vessels which being varicose and fuller of blood in one place than another causeth these eminences Some Midwives believe superstitiously or would make others believe that the number of these pretended knots answers the number of Children the Woman shall have afterwards which is without reason because Women delivered at forty years of age and of their last Child as we find by daily experience have as many knots on the Navel-string as a Woman of twenty years who may yet have a dozen Children they say further That if the first knot be red the next Child the Woman shall have will be a Boy if white a Girl but this Proposition is as ill grounded as the other for these Knots appear only red or to speak more properly of a dark
Mater Pus which proceeding from the moisture sweats through the substance of the flesh and of these Vessels which have been but newly closed acquires a thick and whitish consistence by the heat of the part and the stay it makes there Now the better to conceive this by a comparison you must imagine that there is a kind of a wound made by the loosening of the Burthen from the Womb by reason of which there happens if it may be so said a kind of Suppuration the Pus and excretions of which are the Lochia They which believe that when the Lochia ar◠pale it is the Milk of the Breasts which flowes by the Womb judge so because the Milk usually abates in proportion to this evacuation and say besides that by the Colour and Consistency it must needs be Milk but if they were acquainted with Anatomy they would know that there was no passage which hath to this purpose a communication from the Breasts to the Womb unless they think it is done by the means of this imaginary * The communication of Veins without Arteries whereby they help one another Anastomosis of the †Belonging to the Breasts Mamillary Veins with the * Belonging to the Flanks Epigastrick which cannot possibly be because neither of them have any tendency either to the Breasts or the Womb as Anatomy makes manifest for the Mamillar comes from the Subclavicular under the Sternum without yielding any sign to the Breasts nor so much as touching them and the Epigastrick ariseth from the Iliacks without having the least communication with the Womb. Laurentius who knew very well it was for this reason impossible Milk should pass from the Breasts to the Womb by this passage finds out another way which is as far from the truth as the first His opinion as he saith is that the Milk and Blood flow back from the Veins of the Thorax which bedew the Breast to the Axillary Veins and from thence to the Trunk of the Vena-cava by the continuity of which they flow down into the Hypogastrick Branch and from thence finally into the Womb but besides that it would be very difficult for the Milk after so long a way to come forth without being perfectly mixed with Blood the Circulation of the Blood which he knew not shewes us plainly that it is impossible because it doth mount back by the lower parts of the Body from the Vena cava to the Heart without a possibility of carrying any thing into the Womb whence it appears that he is as far as others from informing us how it can be done For my part I believe with much more reason and I think that it is not Breast milk which is thus evacuated by the Lochia but this abundance and superfluous humidity which distills from and transudes the Vessels and substance of the Womb as I have explained by means of which the whole habit of body being much emptied there remains not sufficient to be carried to the Breasts and little or none flowing to them that which is contained in them is dissipated by transpiration and digested by the natural heat of the parts Now the Milk by this evacuation is dried up just as we see a Pond is that one would drain out of which it is not absolutely necessary to let the water run which fills it but it sufficeth to turn back the stream that feeds it to another place which being done and no more new water falling into the Pond it will soon be dried up as well because the water is dissipated in Vapours as drunk in by the Earth which contains it And for the same reason when we see Milch-nurses want their ordinary courses it is because that all the redundant humours in their body being sent to the Breasts and emptied by the sucking of the Infant there remains no superfluities for matter for the Terms and for this cause it is not necessary that the Menstrual blood should be carried from the Womb to the Breast for Nurses Milk to be made of it but it is enough that the humours flow towards them without going at all to the Womb so likewise it is not necessary the Breast Milk should be sent to the Womb to be evacuated with the Lochia it being sufficient that the humours are drawn towards it without going to the Breasts We must not think as some imagine that the Blood flowing after Labour is bad and corrupted and the reliques of that good which the Infant hath taken for his Nourishment nor that it hath remained in and about those places during the whole time of being with Child for this Blood coming immediatly out of the Vessels opened by the separation of the Burthen from the Womb is the very same with all the rest of the body in which immediatly after Labour no great change is observed unless it be by so much alteration as the disposition of the place from whence it proceeds may cause and according as it flowes abundantly or slowly and as it is mixt with other impurities which are emptied at that time or that it makes some stay in the Womb after it is out of the Vessels and if it had so staid in and about the Womb as some would have it without Circulation during the whole time of Pregnancy 't is most certain it would have putrified even as we see the water of a Lake for want of Agitation and Motion is infected and corrupted but there is no other superfluity nor relique of the Childs nourishment but the gross blood with which the whole mass of the Secondine is replenished After having considered the nature and quality of these evacuations we say that for their quantity and time of continuance there is no certain and particular Rule for some Women have many a long time and others but few and of a short continuance which usually happens according to the Season Country and Age according to the Temperament more or less Hot or Moist the Habit more or less replete and according to the Vessels remaining a long or a short time open But in general this Evacuation is for the most part finished in fifteen or twenty days and sooner or later according to the circumstances lately mentioned and indifferently the same to a Woman delivered of a Boy or a Girl during which time the Lochia diminish in quantity from day to day until they totally cease at the end of the same afterwards the parts remain yet somewhat moist without any manifest evacuation except in Women subject to the Whites This discourse must be understood of Labours at full time for after a Mischance the less the Foetus is and the less time the Woman is gone with Child the less ordinarily are her Evacuations The Signs when the Lochia are good and commendable are that they be fresh the three or four first days and that they lose this bloody tincture by degrees and become pale that they be of an equal consistence without any
in the Womb. CHAP. XII Of the Inflammation of the Breasts of the new-laid Woman UNtil of late it was alwaies believed that the Blood was the matter whereof the Milk was made in the Breasts but it is much more probable that the Chyle onely and not the Blood is destined to its generation as well as it is the true matter out of which all the Blood of the Body is made That which easily makes us judg so is the new discovery of the Channel of the Thorax which conveighs the Chyle into the Subclavian Vein found out by Monsieur Pecquet Physician of the Faculty of Montpelier to whom all posterity will be eternally indebted for having means hereby of being disabused of several notable Errors which for want of so fair and necessary a knowledg was slid and entertained into the Practice of Physick until this time However since the Vessels which may for this purpose conveigh part of this Chyle to the Breasts are not yet manifestly known we will content our selves to explain after the following manner the cause of the Inflammation of the Breasts which doth very often happen to Women newly delivered All the Blood and Humours are so heated and agitated during Travail by the Pains and Throws of Labour that the Breasts composed of glandulous and spongious bodies easily receiving in too great abundance of these Humours which flow to them from all parts are soon inflamed thereby because this Repletion doth very sensibly and painfully distend them to this contributes very much the suppression of the Lochia and an universal fulness of the Body This Inflamation may likewise happen by the Womans having been too strait laced by some blow received upon the Breasts or for having lain upon them which easily bruise them as also for want of having given Milk to the Child in as much as by this means the Milk which is in great quantity in the Breasts not being evacuated is overheated corrupts by too-long stay there But from whatsoever cause this Inflamation of the Breasts in a Woman new-laid may proceed convenient Remedies must be speedily applyed lest it afterwards aposthumates or else that not suppurating there remains a scirrhous hardness which in time may degenerate into a Cancer a very pernitious Malady and for the most part incurable when confirmed Besides the danger that an Inflamation of the Breasts may be converted into these dangerous distempers there happens usually to the Woman in those parts which are very sensible an extream pain which often causeth shaking Fits and afterwards a Fever with so great a burning of the whole Body that she can scarce endure any Cloaths upon her and when she doth never so little uncover her self or put her Arms out of the Bed she hath new shaking fits which afterwards augment the heat of her Feaver it is no great wonder that a Feaver soon happens upon this occasion because the Breasts by their nearness to the Heart do easily communicate their Inflamation which sometimes excite Fury and Phrenzy if the Blood be suddenly and in great abundance carried thither as Hippocrates assures us in the 40th Aphorism of his 5th Book Quibuscunque Mulieribus ad Mammas sanguis colligitur furorem significat If saies he the blood be carried to and in great abundance collected in the Breasts it signifies that Fury and Phrenzy will follow Now the principal and most certain means to hinder the afflux of so great a quantity of Humours to the Breasts and prevent the coming of an Inflamation there is to procure a good and ample evacuation of the Locbia by the Womb. Wherefore if they are supprest they must be provoked by the means elswhere directed for by this evacuation all the Humours will take their course towards the lower parts The whole habit of Body may be emptied by bleeding in the Arm afterwards for a greater diversion and the better to bring down the Lochia bleed in the Foot during which Topical Remedies to the Breast must not be forgot as in the beginning to chase well into them Oile of Roses and Vinegar beat together laying upon them afterwards Unguentum refrigerans Galeni and a third part of Populion mixt with it or a Cataplasme made of the setlings found in a Cutlers Grin-stone-Trough Oile of Roses and a little Vinegar mixt together if the pain continue very great another Cataplasm may be made of the Crum of white Bread and Milk mixt with Oile of Roses and the Yolks of raw Eggs upon all these may be laid Compresses dipt in Vinegar and Water or in Plantane Water but great care must be taken that these Remedies applied to the Breast be only cooling and repressing without any great Adstriction for it may cause a scirrhous tumor which would remain a long time and it may be a worse distemper After the height of the Inflammation shall be past and the greatest part of the antecedent Humours evacuated and turned aside let Medicines a little resolving be used to digest resolve and consume the Milk which abounds in the Breasts to prevent corruption by its stay wherefore let them be drawn by the Child or some other person or else resolved unless that it be suppurated It may be resolved by the application of pure Honey to the Breasts which in this case is very effectual or else a red Cabbadg-leaf may be anointed with it and applyed to the Breasts having first withered it a little before the Fire and all the hard Stalks and Veins taken out do not lace the Breasts too strait nor apply any course or rough Clothes to them that they may not be therewith scratched and bruised A very good remedy for the same is a whole red Cabbage boiled in River water to a Pap and then well bruised in a wooden or marble Mortar and pulp'd through a Sieve which mixt with Oyle of Camomil may be applied as a Poultis to the Breasts In the use of all these means let the Woman observe a cooling Diet not very nourishing that too much Blood and Humours may not be engendered of which there is already too great a quantity she must alwaies keep her Body open that the Humours may be so much the more carried downwards and consequently turned from the Breasts During the whole time the Inflammation continues let her keep her Bed lying on her back that she may have the more ease for being raised the Breasts which are gross and heavy because of the abundance of humours with which they are repleted do very much pain her when they hang down let her stir her Arms as little as may be and after the fourteenth or fifteenth day of her Child-bed when she hath sufficiently cleansed and the Inflammation is abated and she no longer Feverish purge her once or twice as the case shall require to empty the ill humours which remain in the whole habit of her Body If notwithstanding all these Remedies the swelling of the Breast doth not go down and that she still
be a greater hinderance to the Childs sucking and that it turn not into an ill natured Ulcer CHAP. XXIV Of Gripes and Pains of the Belly of a young Child MAny Children are so griped that they cannot forbear crying night nor day for the great pains they feel in their Belly with which some are so vext and tormented that they dye of it 'T is very often the first and most common distemper which happens to little Infants after their Birth which in general and for the most part comes from the sudden change of their nourishment forasmuch as having alwaies received it by the Umbilical Vessels whiles they were in their Mothers Belly they come to change it of a sudden not only the manner of receiving it but the nature and quality of it assoon as they are born for instead of purified Blood only which was conveyed to them by means of the Umbilical Vein they are obliged for want of it to be nourished with their Mothers Breast-milk which they suck with their Mouth and from which are engendered many Excrements causing the Gripes as well because it is not so pure as the Blood with which it was fed in the Womb as because the Stomach and Intestines cannot yet make a good Digestion nor an easie Distribution being not accustomed to it The particular causes of these Gripes are either when the Moeconion amassed during all the time of Pregnancy is not evacuated soon after the Infants birth and that by its too-long stay in the Intestines it acquires a sharp and pricking Acrimony or that becoming hard the Infant cannot void it nor the new Excrements which proceed from the Milk which he hath taken at the first 't is also sometimes because the Child not being able to suck with ease he swallows in sucking the Milk with difficulty much air and wind which being retained in the Stomach and sliding into the Intestines doth painfully distend them This Wind sometimes is caused when a Child takes a greater quantity of Milk than he can digest or because of its ill quality as when the Woman gives her Breast-milk assoon as she is delivered without staying to have it purified Cold may also make it suffer the same But very often it is for giving him Pap too soon as also when it is not enough boiled because this nourishment which is gross and viscous cannot be easily digested by a new-born Babe whose Stomach is not yet accustomed to it and Worms that are engendred in the Intestines by their stirring and biting do also much torment them Besides all these things already mentioned the Midwife also may cause great pains in the Childs Belly by driving back into it the cold and clodded Blood out of the Navel-string before it be tyed For to remedy all these pains in the Belly which Women usually call all by one common name of Gripes respect must be had to their different causes as to that which is the general cause the too sudden change of the nourishment To avoid it one must forbear giving the Child suck until the next day lest the Milk being mixt with the Phlegm which is then in the Stomach corrupt and at first it must suck but little until it be accustomed to digest it If it be the Moeconion of the Intestines which by its long stay causeth these pains for to help to discharge them of it give them at the Mouth a little Oyl of sweet Almonds and Syrup of Roses as we have directed before and to provoke it further give it Beets-stalk covered over with Honey for a Suppository or a sugar'd Almond also dipt in common Honey or one may give it a small Clyster If a Child cannot suck with ease regard must be had to that which hinders it for if it be Tongue-tyed it must be cut as is above directed and if it be because the Nurse is hard milcht change her for one whose Milk is better purified and let her rather suckle it a little and often than more at once than the little Stomach can easily digest at a time And above all whiles the Child is griped give it no Pap because this food by its viscositie doth easily cause obstructions which afterwards engender Wind. If it be Wormes lay a cloath dipt in Oyle of Wormwood mixt with Ox-gall upon the Belly or a small Cataplasme mixt with Powders of Rue Wormwood Coloquint Aloes and the seed of Citrons incorporated with Ox-gal and flower of Lupines and to draw drive them more downwards if the little Infant can take any thing by the Mouth give it a small infusion of Rhubarb or half an Ounce of compound Syrup of Succory having before given it a small Clyster of sugar'd Milk for by this means the Wormes which shun the bitterness of the Medicines and seek after the sweetness of the Milk are easily brought away by Stool When these Gripes are caused by Wind as it often happens or by any sharp Humours in the Intestines anoint the Childs Belly all over with Oyl of Violets or with Oyl of sweet Almonds or else with Oyl of Walnuts Camomil and Melilot mixt together having first warm'd them in which also a Cloath may be dipt to lay upon it or a small Pancake may be made with an Egg or two fried in Oyl of Walnuts for to be applied to it and they may take a little Anodine or Carminative Clyster according as the cause of the Gripes is known above all ever keeping the Child very warm CHAP. XXV Of the Inflamation Ulceration or shooting forth or rupture of the Navel of a young Infant THe continual cries of little Children because of the Pains and Gripes which they feel at the beginning doth somtimes cause such an agitation of the Belly that the Navel-string falling off too soon and before it be entirely closed and cicatrized there happens there an Inflammation and Ulceration at other times also for the same reason although it be outwardly healed not being so within it is dilated and thrust outward the bignesse of a small Egg and sometimes bigger which is usually called Exomphale or shooting forth of the Navel There are some who imagine when it is so inflamed and ulcerated that it was because the String was tied too-near the Belly which caused a great pain and inflamation to follow Others say that Nature having used to discharge the Urine by this part during the Childs being in the Mothers Belly doth at first still continue to send it this way and that it causeth this Accident by its acrimony for which there is no reason for 't is impossible the Urine should regorge from the Bladder to the Navel by the Urachus forasmuch as it is not hollow in an humane Foetus as we have elsewhere made appear And how near the Belly soever the Navel-string is tied and how hard provided some of the true skin which is sensible be not also tied with it it can cause no manner of pain to the Child because it is a dead and
inanimate part assoon as a Child is born and likewise insensible because there is no Nerve distributed into it But this Inflamation usually comes as I have mentioned because the Infant feeling the great pains and gripes in his Belly doth continually cry and thereby hinders the Navel from healing it may likewise be caused by a violent and frequent Cough because by these efforts the Blood is forced back into the remaining end of the Umbilical Vein which it alwaies keeps dilated and being corrupted by its stay there failes not to make an inflammation of the Navel and that which was tyed coming to fall off before it was perfectly healed there remains a very bad Ulcer upon which sometimes follows great loss of Blood and it may be Death The principal thing to be observed in the cure of this Malady is to appease the Cough and quiet the Childs crying respecting that which causeth it without which it would daily increase and if it were the Gripes it must be remedied as is directed in the foregoing Chapter as to the rest if the Navel be inflamed one must lay upon it Vnguentum refrigerans Galeni mixt with as much Populeon or a small Boulster dipt in Oyl of Roses with a little Vinegar Unguentum Rosatum Album mixt together is also good for it If the Navel continues ulcered after the String is fallen off Deficcative and Astringent Medicines must be applied to it such as is small Rags dipt in Lime water which is not too strong or Plantane water wherein a little Allom hath been dissolved If the Ulcer be small a Pledgit of dry Lint will be sufficient Many put to it only a little powder of a Post These things are better for this purpose than Plaisters which are never so drying because of the Oyles and Grease which enter into their composition But if notwithstanding one would use them he may take Desiccativum rubrum or Diapompholigos particularly observing to put a good linnen Compress on the top of these Remedies with a Swath to keep them fast until the Navel be ciccatrized and perfectly healed lest besides its Ulceration it be forced outwards and that its Vessels open by the violence of a great Cough or by the agitation which the Gripes cause in the Childs Belly As to the rupture of the Navel in young Children whether great or little the cure of it must not be otherwise undertaken than by Swathes and Compresses fitted for the purpose 'till they have acquired a more reasonable Age when if the Malady be not cured by the Swathes the Operation may be done if desired But if after the inflamation there growes an Imposthume which causeth the shooting forth of the Navel and that the tumor of it be very great then it ever kills the Children and if it be opened the matter indeed may be emptied but there is great danger that together with it the Guts come forth in the same place the first time the Child cries which may afterwards persuade those that understand not the Art that this accident happened through the Chirurgeons ignorance For this reason Ambrose Parè in his 94th Chapter of his Book of Generation adviseth you not to meddle with it but rather to let the Child die without doing any thing to it as he saith he did himself when he was sent for by a Taylor in the like case He recites in the same place a story of a Chirurgeon of his time called Mr. Peter de la Rock who was in very great danger of his life for having opened an Impostume of the Navel of a Child of Monsieur de Martigues which being done the Intestines came forth by the orifice and soon after the Child died which the servants of the house reported was thereby caused and therefore although without reason they would have killed him if the said Monsieur de Martigues had not hindered them but I believe the Chirurgeon had shunned the danger they put him in and that disgrace if he had before made a good Prognostick of what would follow and the danger wherein the Infant was for it may be resembling many of our time who undertake such things that they may be thought more able than others and being but simple fellows boast themselves capable to work miracles he had promised speedily to cure the Child of this Maladie which was incureable that under so fair hopes he might have a good summe in hand paid him In this we must follow Parey's advice with some distinction for if the Impostume be small and the Child strong one must not forbear having first made a good Prognostick to open it and when there is never so little hopes 't is better to practise what Art commands than to forsake the sick in a certain despair CHAP. XXVI Of the Smartings Redness and Inflammation of the Groin Buttocks and Thighs of the Infant IF the Nurse doth not keep the Child very cleanly not changeing the Beds or washing them each time or assoon as they are fouled with their Excrements their acrimony will not fail to cause redness and smartings in the Groins Thighs and Buttocks and afterwards because of the pain these parts will inflame which easily happens by reason of the tenderness and delicacy of their Skin from which the * The outward skin of the body Epidermis is at length separated and worn away if timely care be not taken The cure of these Indispositions is twofold that is first to keep the Child cleanly and secondly to take off the sharpness of its Urine As to the first the Nurse must cleanse the Child of his Excrements assoon as he hath voided them shifting it each time with a clean bed washed in the Buck as to the second thing to be observed of tempering the Childs Urine that cannot be executed but by the Nurses keeping a cooling Diet that so her Milk may have the same quality wherefore let her abstain from all things that may heat her Besides these two generals cooling and drying Remedies must be applyed to the inflamed parts Wherefore each time the Childs excrements are wip'd off let the parts be bathed with Plantane water mixt with a fourth part of Lime-water and if the pain be very great let it only be fomented with luke-warm Milk Many Women ordinarily use the powder of a Post to drie it or a little Mill-dust which they strew upon it Unguentum Album or Diapompholigos spread upon a small rag in form of a Plaister will not be amiss above all when the Nurse opens the Child let her be very careful to wrap the inflamed parts with fine white rags that those parts may not by rubbing together be more galled and pained CHAP. XXVII Of the Ulcers or Thrush of the Mouth of an Infant VEry frequently the Milk of a Nurse that is Red-haired given to Wine or very amorous may by its heat and acrimony cause small Ulcers in an Infants Mouth which are called Aphthae and vulgarly Cancers sometimes also
at first it doth in some sort appear so to be if the Woman but a little before she was brought to Bed felt it to stir strongly if she did not flood much and if she had no very hard Labour but 't is very certain he is yet living although he do not cry nor move any part of his Body after he is born if laying the hand upon his Breast the motion of the Heart be felt or touching the Navel-string near the Belly there is yet perceived a small pulsation of the Arteries Then all sorts of means must be used to recover him out of this weakness Now the best help in this case is to lay him speedily in a warm Bed and Blanket and carry him to the fire and there let the Midwife sup some Wine and spout it into his Mouth repeating it often if there be occasion let her likewise lay Linnen dipt in warm Wine to the Breast and Belly let the Face be uncovered that he may draw breath the easier and to be yet more helpfull to him let the Midwife keep his Mouth a little open and cleanse the Nostrils with small linen tents also dipt in white Wine that so he may receive the smell of it let her chafe every part of his Body well with warm Clothes to bring back the Blood and Spirits which for being retired inwards through weakness put him in danger of being choaked in doing thus by little and little the Infant recovering his strength will insensibly come to stirr his Limbs one after another and so at first cry but weakly which afterwards as he breaths freer will augment and become stronger Besides these helps we have mentioned which certainly are the best and most certain for the weakness of a new-born Babe Midwives ordinarily make use of others which I do not approve of not only because they are useless but because some of them are very dangerous to the Child Some lay the After-burthen being very warm to the Belly and leave it there 'till it is cold I have elsewhere declared that the Burthen by reason of its heat may be something serviceable but notwithstanding because of its weight being so placed upon the Childs Belly which wanting a support is easily compressed it doth very much hinder his respiration which at that time is most necessary for him Others cast the Secondine into the Fire before it be parted and some put it in warm Wine believing that by this means the strength of the Wine conveighed through the Umbilical Vessels is able to give him new vigour But as this fleshy Mass and these Vessels are dead parts assoon as they are out of the Womb so there remains in them no spirits which can be communicated to the Infant And if this practice be continued it must rather be to satisfie custome than for any hope of benefit to be thereby received If these things do no good yet do they no great hurt but are only useless but this which follows is capable to suffocate a Child immediately that is when some do thrust back and make the Blood which is in the Umbilical Vessels to enter into the Body believing that it fortifies and recovers the Child out of its weakness but we have elsewhere declared that the Blood contained in these Vessels lose their spirits assoon as the Secondine is separated and come forth of the Womb nay it is there immediatly after half congealed Now if it be thus thrust back into a weak Childs Liver it remains there being no longer animated with any spirits and instead of giving him new strength it overcomes that little which remains and compleats the extinction of his languishing natural heat to avoid this be careful not to force back the Blood thus into the Infants Belly for besides in these weaknesses unless it should be otherwaies by the Mothers flooding before she was brought to Bed there is alwaies too much of it in the Infants body and instead of sending more to it there must be some drawn back from it towards the extremities that so its Ventricles being a little discharged may have afterwards a more free motion to send back the spirits to all parts which are deprived of them by these faintings Wherefore since the Child must receive nothing from the Vmbilical Vessels after its Birth let them be tyed assoon as may be and then ordered according as we have directed Very often the Children which are weak at their Birth are so by nature as when they come before their time and are so much the weaker by how much they want to compleat the end of the ninth Moneth and also when they are begotten by infirm and sick parents These are hard to remedy and there is nothing more to be done but to nourish and order them well according to our former directions but it will be rare for them to be long-lived and it is much if they do not dye by the least indisposition that befalls their natural weakness CHAP. XX. Of Contusions or Bruises of the Head and other parts of the Body of a new-born Babe THe Bodies of new-born Children are as we have said so tender and delicate that they are easily bruised and hurt and sometimes in a bad Labour their Members are dislocated either because it remained long in an unnatural Posture or because they were handled too rudely in the Operation the most usual and frequent bruise is for the most part on the top of their Head where sometimes at their Birth they have a Knob as big as half an Egg if not bigger as is usually seen in first Labours and which happens the sooner according as the Woman is advanced in Age because the inward orifice of the Womb called the Garland being more callous doth not dilate without much difficulty for which reason the Childs head pressing against it and the upper part of it which naturally presents first to the Passage being begirt with it as with a Garland is puft up and swelled because of the Blood and Humours which fall down and are retained in this part by the great compression which this inward orifice makes round about especially when the Throwes begin to be strong and the Child comes but slowly forward after the Waters which did a little defend it are broke away the Midwife also may do much ill in it if she toucheth it too-often or too-roughly with her Fingers when it lyes in the Birth but many times they are in this case wrongfully accused because for the most part the single compression this orifice makes in form of a Garland about the Childs Head is the cause of this kind of bruised Tumours This part swells after the same manner as we see all others which are either too-strongly prest bound or lased for by this means the Blood which cannot circulate being stopt in great abundance in one part obligeth it to swell and be blown up and by the repletion it makes renders it livid as if it were bruised Now this