had made an impression on them nor given them this prolifick vertue which is absolutely necessary to this purpose This may convince us that diversity of sex is necessarily requisit as well to those Animals as to the more perfect which is Man Diversity of sex would profit little if copulation did not likewise follow though some subtile Women to cloak their shamelesness would perswade one that they were never touch'd by any Man who could get them with Child as she of whom Averroes speaks who conceived in a Bath in which a Man had washt himself a little before and had cast forth his Seed into it which was drawn and suckt in as he saith by the Womb of this Woman but this is a story fit to amuse little children Now to the end these different sexes should be obliged to come to this touch which we call Copulation besides the desire of begetting their like which naturally incites them to it the parts of Men and Women destined to Generation are endued with a delightful and mutual itch to stir them up to the action without which it would be impossible for a Man so divine an Animal born for the contemplation of heavenly things to joyn himself to a Woman in regard of the uncleanness of the parts and of the act And on the other side If Women did but think of a thousand pains and inconveniences which their great Bellies cause them of the pains they endure and the hazard of their lives when they are in labour to which may be added the loss of their beauty which is the most precious gift they have and which makes them be beloved by those that possess them certainly it might also afright them from it But neither the one nor the other make these reflections till after the action whence comes the saying Post coitum omne animal triste considering nothing before but the mutual pleasure they receive by it It is then from this voluptuous Itch and the desire of begetting their like that Nature obligeth both these sexes to this congression As to the mixture of both seeds it is certain that the diversity of sexes and their congression are but for this end without which Generation cannot be though some would have Womens seed serve to no purpose yea that they neither have any nor eject any as Aristotle saith but we have proved the contrary in the Chapter of Conception by the example of daily experience to which you may have recourse to avoid repetition All these three Circumstances to wit the diversity of sexes their congression and the mixture of their matters which is called Seeds must precede Conception to which succeeds Generation on this fashion As soon as the Woman hath conceived that is hath received and retained in her Womb the two prolifick seeds it is every way compressed to imbrace them closely and is so exactly closed that the point of a Needle as saith Hippocrates cannot enter it without violence after which it reduceth by its heat from power into action the several faculties which are in the seeds it contains making use of the Spirits with which these frothy and boyling seeds abound and are as instruments with which it begins to trace out the first lineaments of all the parts to which afterwards making use of the menstruous blood flowing to it it gives in time growth and the last perfection Generation may be divided into three different seasons which are the beginning middle and the end The beginning is when there is no other matter in the Womb but the two seeds which continue so to the sixth day as Hippocrates notes and calls them for that time the geniture as much as to say from whence generation must proceed he speaks of it in his Book De Natura Pueri and he saith that by the experiences he brings of it one may judge of the other times He relates a story of a Woman which at six dayes end cast forth with a noise at once out of her Womb the seeds she had conceived resembling a raw egg without a shell having only the small skin over it or to the abortive eggs which have no shell which little membrane was on the outside a little coloured with red and involved in it this seed which was of a round figure in the internal part might be seen white and reddish fibres with a thick humour in the midst of which was found something like the umbilick vessels Hippocrates calls this first time of generation Geniture as is already mentioned during which time neither figure nor distinction can be observed but only some beginning of a disposition to receive the form of the parts after which follows the second time which begins where the first ends that is at the sixth day and lasts to the 30th The time that the same Hippocrates assures us the males are compleatly formed and the females not till the 42d. After the first six dayes are past and the Womb hath wrought according to the fashion we have explained upon the seeds which are there yet without any mixture of blood having disposed them to receive it it is brought thither in some sooner in some later according to the Womans being nearer to or further from her time of having her Courses when she conceived which produceth effects according to these different dispositions for if they flow too soon or in too great abundance as it befals such as conceive at the point of having their purgations the seeds are drowned and corrupted by it which often causeth a flooding or at least the generation of a false-conception but if they are far from their having them the conception is so much the more stable Now then this blood distilling by little and little into the Womb of the Woman who hath sometime since conceived serves as a fit matter to form and figure out all the parts of the Infant which was only traced out by the seed and yet doth it according to my opinion much like a Painter who after he hath drawn the out-lines with a chauk upon his cloth begins to lay colour upon colour to paint by degrees all the parts of the person whose picture he draws Some little space after the beginning of this second time appears as it were the figure of those three bubbles of which Hippocrates speaks or rather three masses of this matter which grosly represent the three parts called principal the first of which composeth the Head the second in the middle the Heart and the other the Liver there may be likewise seen the after birth with the umbilick vessels fastened to it and the membranes which wrapt up the whole after which from day to day all the other parts of the body are figured in such sort that at thirty dayes end the males are compleatly formed and the females the 42th day ordinarily which is about the time the Faetus begins to be animated though as yet there is no sensible motion Hippocrates seems by these different terms
already severall in English as also here and there a passage that might offend a chast English Eye and being not absolutely necessary to our purpose the rest I have as carefully as I could rendred into English for the benefit of our Midwives some of whom may yet very well admit of an additional Knowledge The principal thing worthy their observation in this Book is accurately to discover what is properly their work and when it is necessary to send for advice and assistance that so many Women and Children may be preserved that now perish for want of seasonable help My Author marks out the breaking of the right Waters for the proper season of a naturall Delivery and when ever a Child is not born thou or soon after Nature is so much short of performing her office This is certainly a great truth and all wrong births should never be longer delaied and for the most part Floodings and Convulsions not so long lest the Woman lose her life before ever the Water breaks but if no dangerous Accident intervene in a right labour one may lengthen out their expectation to 12 hours after and though some may have been happily delivered 24 hours or two dayes after yet should I not advise any to run that hazard provided they can have an expert Physician to deliver them without destroying the Child because many have perished in that case and it is not prudent to venture where but one of many escapes for the longer the Labour continues after the Watters are broke the weaker both Woman and Child grow and the drier her bodie which renders the birth the more difficult and 't is over good taking time by the foâ—eâ—…p And that Midwifes skill is certainly the greatest and she deserves most commendation who can soonest discover the success of the Labour and accordingly either wait with patience or timely send for advice and help Nor can it be so great a discredit to a Midwife let some of them imagine what they please to have a Woman or Child saved by a Man's assistance as to suffer either to die under her own hand although delivered for that Midwife mistakes her office that thinks she hath performed it if she do but lay the Woman because her principal duty is to take care that she and her Child be well with safety and convenient speed parted and if this be impossible for her and feasible by another it will justifie her more to wave her imaginary Reputation and to send for help to save the Woman and Child than to let any perish when possibly to be prevented As in the case of my Author's Sister in the 20th Chapter of his first Book Yet in Countries and places where help and good advice is not seasonably to be had Midwives are compelled to do their best as God shall enable them which dangerous and uncertain tryals would not become them to put in practice upon Women where no timely assistance need be wanting Most wrong Births with or without pain all Floodings with Clods though little or no pain whether at full time or not all Convulsions and many first Labours and some others though the Child be right if little or no pain after the breaking of the Waters and the Child 's not following them in some six or ten houres after requires the good advice of and peradventure speedy delivery by those Physicians that are expert in this practice for though some few may escape in these cases yet far the greater number would perish if not aided by them And let me therefore advise good Women not to be too ready to blame those Midwives skill who are not backward in dangerous cases to desire advice lest it cost them dear by discouraging them and forcing them to presume beyond their knowledge or strength especially there being already but too-too-many over confident Those few things wherein I dissent from my Author if of dangerous consequence I note in the Margent if not I passe it by leaving it to the election of the Reader I must confess he is in many places too prolix a fault that many of the French affect however I chose rather to translate him according to his own stile than contract him and also to leave unaltered some things not very well expressed being of no great moment I find also that he doth not distinguish between the words Plaister and Ointment but useth them promiscuously one for the other In the 17 Chap. of the second Book my Author justifies the fastning Hooks in the head of a Child in a difficult Labour where it comes right which I confesse hath been and is the practice of the most expert Artists in Midwifry not onely in England but throughout Europe and hath very much caused the report that where a man comes one or both must necessarily dye and makes many for that reason forbear sending untill either be dead or dying But I can by no means approve of that practice or those delaies because my Father Brothers and my Self though none else in Europe that I know have by Gods blessing and our industry attained to and long practised a way to deliver a Women in this case without any prejudice to her or her Infant though all others being reduced for want of such an expedient to imploy the common way do and must endanger if not destroy one or both by the use of these Crochets By this manuell operation we can also both shorten the time and lessen the number of pains in a right Labour if there be the least difficulty without danger and with advantage to both Woman and Child If therefore the use of Hooks by Physicians and Chirurgeons be condemned without thereto necessitated through some monstrous birth we can much lesse approve of a Midwifes using them as some here in England boast they do which rash presumption in France would call them in question for their lives In the 15th Chapter of this Book my Author proposeth the conveying sharp Instruments into the womb to extract a head which is a dangerous operation and may be much better done by our fore-mentioned Art as also the inconvenience and hazard of a Child dying thereby prevented which he supposeth in the 27th Chapter of this 2d Book I will now take leave to offer an Apology for not publishing the secret I mention we have to extract Children without hooks where other Artists use them which is that there being my Father and two Brothers living that practise this Art I cannot esteem it my own to dispose of nor publish it without injury to them and think I have not been unserviceable to my Country although I do but inform them that the forementioned three persons of our family and my self can serve them in these extremities with greater safety than others The Reader also may please to know that some explanations in the Margent as lovingly p. 6. and untimely unseasonably p. 22. with some others were never intended to have been inserted
two Children begins to flag it is a sign she will miscarry of the Child of that side and of both if both flag in the same manner It is most certain a Woman is in more danger of her life when she miscarries than at her full time because as we have said before abortion is wholly contrary to Nature and very often accompanied with flooding and in more danger of miscarrying alwayes if she miscarries of the first and some apprehend then an impossibility of ever having Children after to which young married people are very subject because of the violent emotion and perturbation of the whole body excited by ardent and frequent copulations but notwithstanding they may preserve their fruit when their greater vigour is over and their loves a little moderated We have taught in each of the foregoing Chapters how to prevent all the accidents before recited any of which is sufficient to make her miscarry and the easier if many are complicated wherefore to avoid a troublesome and needless repetition you may have recourse to the Remedies there taught by which both Women and Children may escape the danger of death They that are subject to abortion ought above all to take their ease and keep in bed if they can observing a good diet and refraining copulation assoon as she believes her self to be with Child avoiding the use of all Diureticks and Aperitives which are very pernicious as also violent passions of the mind because they are very prejudicial She ought likewise to be loose in her dress that she may breath the freer and not strait laced and rackt as most of them are ordinarily with their Busks under their cloths to make their bodies strait and amongst other things they had need take heed of slipping and falling in their walking to which big-bellied Women are very subject because the bigness of their Bellies hinders them from seeing their way they will therefore do well to wear low-heeld shoos with large soals to prevent hurting themselves as too many daily do I admire in this case the superstition of many Midwives and some Authors who order a Woman with Child to take assoon as she hath hurt her Belly with a fall some Crimson Silk small minced in the yolk of an Egg or the grains of * Kermes Scarlet and treddles of several Eggs put into the yolk of one as if that entring the stomach were able to fortifie the Womb and the Child in it and to keep it there for which there is no appearance of reason or truth but quiet rest indeed contributes much to it which for this reason is usually directed for nine dayes although such a one hath need of 15 dayes or more for her hurt or commotion and to others five or six is sufficient during which time may be applied hot to the Belly Compresses steeped in Aromatick and Astringent Wine But because there are many Women so infatuated with this superstitious custom that they would not believe themselves out of danger if they took not that Crimson Silk or the Treddles of the Eggs which is a pure conceit one may give it to those that desire it to content them because these Remedies though useless can yet do no hurt It is now time to make an end of this first Book in which I have only mentioned the most ordinary distempers which have some particular indications in their cure during the Womans being with Child of which I have not treated very exactly because it may be supposed that one may elsewhere have a more perfect knowledge of them with all their circumstances let us now pass to the second Book to treat of Deliveries not only the natural but likewise all that are contrary to nature it being the principal motive that induced me to write and to teach as well as I can the best and most methodical deportment in it The End of the first Book BOOK II. Of Labours Natural and Unnatural with the way how to help Women in the first and the right means of remedying the rest AS it is very unprofitable to those that imbark on the Sea for a long Voyage as for example to the Indies or the like if after having by their prudence escaped all the dangers they could meet with in so long a Voyage they are shipwrackt in the Haven So likewise it is not sufficient that a great-bellied Woman should be preserved from all the Diseases mentioned in the preceding Book for nine whole months if at the end of that time she be not well delivered of it by a happy Labour This therefore shal be the whole subject of this second Book where we will treat as well of the Natural as Unnatural Labours and teach the manner of aiding and comforting Women in the first and the means to remedy all the rest CHAP. I. What Labour is and the diffenrences of it together with its different terms BY a Delivery we understand either an emission or extraction of the Infant at the full time out of the Womb. This definition may comprehend as well the Natural which is accomplished by emission when the Infant coming in a commodious and natural Figure the Womb sends it forth without extraordinary violence as the delivery contrary to Nature which we are often obliged to perform extracting it by manual operation Every time the Womb le ts pass or sends forth whatsoever it had retained and formed after conception must not be call'd a labour for observing what I have already noted above and what I will here again repeat that it may be more plain If a Woman voids by the Womb what is contained in the beginning after she had conceived it is properly called an effluxion or slip because at that time there is nothing formed or figured neither have the Seeds yet any firm consistence which is the cause why it flips away so easily with the least opening of the Womb as often happens between the first conceiving and the seventh and eight day only after which until the end of the second month the Woman somtimes le ts slip false-conceptions which turn to Moles if they continue any longer in the Womb which is then called an Expulsion And if after the third month or thereabouts the time when the Faetus is wholly formed and animated it is sent forth before the seventh in that case it is an Abortion which is alwayes the cause either that the Infant comes dead into the World or dies soon after But we properly call Labour or Delivery every issuing forth of an Infant which happens after the end of the seventh month to all the remaining part of the time afterwards because there is then a sufficient perfection as also strength enough to come into the World and live in it afterwards As to the general differences of Labour we must take notice that the one is legitimate or natural the other illegitimate or against nature To come to the knowledge of each we say that four conditions must
the finger the abortive Eggs which have yet no shell but are only covered with a simple membrane after this the pains redoubling continually the membranes are broken by the strong impulsion of the waters which incontinently flow away and then the head of the Child is easily felt naked and presented at opening of the inward Orifice of the Womb Now all these or the greatest part of them met together at what time soever of a Womans going with Child it be whether full time or no one may be assured she will soon be delivered but great care must be taken not to hasten her Labour before the necessity of it be known by these signs for that would but torment the Woman and Child in vain and put them both in danger of their lives as that Midwife did whom I found endeavouring to put the above named Martha Rolet in Labour at six months end because of some pains she had in her Belly and Reins without any other accident answering them downwards which History is at large in the sixth Chapter of the first Book to shew that in some cases we must make no more haste than good speed Labour contrary to Nature is when the Child comes in an ill Figure and scituation as when it presents any otherwise than the Head first as also when the Waters flow away along time before it is born because it remains dry in the Womb and they are absolutely necessary to moisten the passage and render it more slippery When the After burthen comes first it is an accident which renders the Labour always dangerous by reason of the great flux of Blood usually following of which the Mother may die in a few hours and the Infant because it receives no more nourishment is quickly smotherd in the Womb for want of respiration which it then needs if it stay never so little after The Labour is also grievous when accompanied with a Feaver or any other considerable Distemper which may destroy the Child in the Womb as also when pains are small and come slow with long intervals and little profit by reason of which a Woman is extreamly tyred but the difficulty most frequent and ordinary comes from the Infant 's wrong posture We shall speak more particularly of the signs of all these different Deliveries in treating of them severally hereafter and now come to the inquiry of some particulars without which it is impossible to assist a Woman safely in her natural Labour or to help her in the unnatural ones and therefore we will examine every thing that is in the Womb with the Infant during pregnancy and first describe those that first offer themselves to pass the Orifice when the Woman is neer her delivery which are the membranes of the Infant and the waters contained in them This Figure represents the Membranes of the Infant wholly separated from the Womb in which it is contained with the Waters These Membranes in some manner resemble a great Bladder through which the figure of the Infant may be a little perceived there is likewise seen on the upper part the After-burthen marked A on that side which is fastened to the bottom of the Womb. Chap II. lib. 2 pag 150 CHAP. III. Of the Membranes of the Infant and the Waters AS soon as the two Seeds have been confusedly mixed and retained by conception the Womb immediately after by means of its heat * Extrieates disentangles separates this Chaos for to make out of it the delineation and formation of all the parts and begins to work upon these Seeds which though to the sight they appear similar and uniform yet in effect contain in them many dissimilar parts all which it separates and distinguisheth one from the other inclosing the most noble and on the * Covering outside the most glutenous and viscous of which first the Membranes are formed for to hinder the Spirits wherewith the â—…mous Seed abounds from being then dissipated to serve afterwards to contain the Infant 〈◊〉 Waters in the midst of which it swims that they may not stream away As the Membranes of the Faetus are the first parts formed so are they with the Waters the first thâ—… in time of Labour present themselves to the paâ—â—age before the Infants Head Most Authors are so dark in the descriptions they make of these Membranes that it is very hard to conceive them as they are by the explication they make of them They do not so much as agree in the number of them some account three as well for a Child as a Beast to wit the Chorion the Amnios and the Allantoides others account but two because there is no Allantoides in a humane Faetus but to speak properly if it be strictly examined what there is as I have often done there will be never found but two which are so joyned and contiguous the one to the other that it may be said to be but a double one which may indeed be separated and divided into two I will explain it on such wise as may be best understood by those that are ignorant of it for there are many who think with Galen that these Membranes are separated and distant the one from the other and that the one surrounds only the Infant and the other receives the Waters which are partly engendred from sweat and partly from the urine as they imagine and believe further that these Waters themselves are separated the one from the other by these Membranes which is quite contrary for they are both so joyned the one to the other that they compose as it were but the same body and involver which serves as we have already said to contain the Infant with the Waters which are all of a nature and shut up in the same Membranes as I shall make appear hereafter in speaking of their original it matters not to the truth after what manner this be explained provided it may be understood as it is The exteriour part of this Membrane or double * Covering Involver or if it be esteemed two the first Membrane presented without is called Chorion from the Greek word 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 signifying to contain because it immediately contains 〈◊〉 â—…ons the other which is called Amnios that is a little Lamb because it is so small and thin Galen in his 15th Book of the use of parts calls the burthen Chorion But to render this more intilligible we shall take this first Membrane for the Chorion which may be again separated and divided into two though effectively it be but one The Chorion is a little rough and unequal throughout the whole outside of it in which many small capillary vessels may be observed running quite round as also many little fibres by which it cleaves to every side of the Womb but it is a little more smooth within where it joyns every-where and unites with the Amnios in such a manner as that it appears as we have already declared but as one and
Infants and many ill accidents which after befal the poor Women not causing them to be helped in due time and from the moment they perceive the difficulty of the Labour to pass their understandings To avoid therefore these calumnies let the Chirurgeon never use the Crochets but very rarely and when there is no other way as also to endeavour his utmost as much as the case will permit to bring the Child whole although dead and not by bits and pieces to give the wicked and ignorant no pretence of blame I say as much as the case will permit that is with respect to the Woman under his Hands for to save her he had better sometimes bring the dead Child with * Those Instruments very unsafe for the Woman and having a better way cannot pass them without manifesting my dislike Instruments than kill her by tormenting her with excessive violence for to bring it whole but in a word we must in conscience do what Art commands without heed to what may be spoken afterwards and every Chirurgeon that hath a well ordered conscience will ever have a greater regard to his duty than reputation in performing of which let him expect his reward from God CHAP. XXXII Of extracting a Mola and false Conception HAving at large spoken in another place of the Causes Signs and Differences of Mola's and false Conceptions and shewed that a Mola alwaies ariseth from a false Conception there remains nothing to be demonstrated but the manner how it ought to be extracted Now since these things contained in the Womb are totally preternatural their expulsion must be procured assoon as possible which is very difficult when these strange Bodies cleave to it and especially the Mola which not being drawn forth will often continue so fastened two or three whole years nay sometimes the whole remaining part of the Womans life as Paré tells us in the Story of the Pewterers wife that had one seventeen years whom he opened after her death To avoid the like accident and abundance of inconveniences which a Mola brings it must be endeavoured to be expelled assoon as may be trying before you come to Manual Operation to cause the Woman to expel it of her self to which purpose give her strong and sharp Clysters to stir up Throwes for to open the Womb to give way to it relaxing and moistening it with emollient Ointments Oyls and Grease not omitting bleeding in the Foot and half Baths if there be occasion The Mola will certainly be excluded by these means provided it be but of an indifferent bigness or that it adheres little or not at all to the Womb but if it cleaves very strongly to the bottom of the Womb or that it be very big the Woman will hardly be rid of it without the help of a Chirurgeons hand in which case after that he hath placed the Woman conveniently as if he were to fetch a dead Child let him slide his Hand into the Womb and with it draw forth the Mola using if it be so big as that it cannot be brought whole which is very rare because it is a soft tender body much more plyable than a Child a Crochet or Knife to draw it forth or divide it into two or more parts as the case shall require If the Chirurgeon finds it joined and fastened to the Womb he must gently separate it with his Fingers ends his Nailes being well pared putting them by little and little between the Mola and the Womb beginning on that side where it doth not stick so fast and pursuing it so until it be quite loosened being very careful if it grows too fast not to rend nor hurt the proper substance of the Womb proceeding according to the directions we have given for the extraction of a Burthen staying behind in the Womb when the String is broke off This Mola never hath any String fastened to it nor any Burthen from whence it should receive its nourishment but it doth of it self immediatly draw it from the Vessels of the Womb to which it is almost alwaies joined and sticking in some place The substance of its Flesh is also much more hard than that of the Burthen and sometimes it is schirrous which is the cause why it is not so easily separated from the Womb. As to a false Conception though it be much less than a Mola yet it often puts a Woman in hazard of her life because of great Floodings which very often happens when the Womb would discharge it self of it and endeavors to expel it which seldom ceaseth until it be come away because it doth still endeavour to exclude it by which the Blood is excited to flow away and in a manner squeesed out of the open Vessels The best and safest remedy for the Woman in this case is to fetch away the false Conception assoon as may be because the Womb can often very hardly void it without help for it being very small the Womans impulse in bearing downwards cannot be so effectual when the Womb is but little distended by so small a body as when it contains a considerable Bulk in it for then it is more strongly compressed with the Throws Many times 't is exceeding difficult to fetch these false Conceptions because the Womb doth not open and dilate it self ordinarily beyond the proportion of what it contains and that being very little so is its opening which is the reason why the Chirurgeon sometimes is so far from introducing his whole Hand that he can scarce put in a few Fingers with which he is obliged to finish the Operation as well as he can proceeding in the following manner when he hath introduced them Having well anointed his Hand he must slide it up the Vagina unto the inward Orifice which he will find sometimes but very little dilated and then very gently put in one of his Fingers which 〈◊〉 must presently turn and bend on every side unâ—…â—e hath made way for a second and afterwards third or more if it may be done without violence but many times one hath enough to do to get in but two between which he must take hold as Crabs do with their Claws when they take any thing of the false Conception which he must gently draw forth and also the clodded Blood which he there finds afterwards the Flooding will undoubtedly cease if no part of this Conception be left behind as I have often found by experience when I have taken the same course but if the inward Orifice cannot be more dilated than to admit but one Finger and that the Flooding is so violent as to endanger the Womans life the Chirurgeon then having introduced his Fore-finger of his left Hand must take with his right an Instrument called a Cranes-bill or rather a Forceps like that marked G among the Instruments at the end of this Second Book and guide the end of it along his Finger for to fetch with this Instrument the strange Body out of the
that he must only pierce the Peritoneum with the point of his Instrument to make an orifice for one or two of the Fingers of his left Hand into which he must immediatly thrust them for to cut it lifting it up with them and conducting the instrument for fear of pricking the Guts in proportion to the first incision of the * Skins Coverings which having done the Womb will soon appear in which he must make an incision in the same manner as he did in the Peritoneum being careful not to thrust his instrument at once too far in thinking to find the Womb a finger or two thick as all Authors affirm contrary to truth in which he would be deceived as those are that never well considered it for it is very certain that at the time of Labour whilst it contains the Child and Waters in it it is not above a single line thick or the thickness of half a Crown although they have all sang to us that by divine Providence and a Miracle the more 't is extended with the Child the thicker it grows which is absolutely false it being only true that it is at that time a little thicker at the place where the Burthen cleaves where its substance is then as it were spongious but every where else it is very thin and becomes the more so by how much it is more extended until being emptied by the Birth of the Child it begins to grow thicker in contracting and gathering to it self all its substance which was before very much extended It being just like the Bladder which being full is very thin and being empty appears to us of half a Fingers thickness which filling again waxeth thinner in proportion to the Urine that flows to it having then so opened the Womb he must likewise make an incision in the Infants Membranes taking care not to wound it with the instrument and then he will soon see it and must immediatly take it out with the Burthen which he must nimbly separate from the bottom of the Womb and finding it to be yet living let him praise God for having so blessed and prospered his Operation But the Children so delivered in these cases are usually so weak if not quite dead as it often happens that 't is hard to know whether 't is alive or dead Yet one may be confident the Child is living if by touching the Navelstring the Umbilical Arteries are perceived to move as also the Heart by laying the Hand on the Breast and if it prove so means must be used to fetch it to it self spouting some Wine in the Nose and Mouth warming it until it begins to stir of it self Midwives usually lay the Burthen very hot on the Belly of such weak Children if that helps 't is rather because of the temperate heat of it than for any other cause for 't is impossible the Infant should receive any spirits from it after it is once separated from the Womb and yet less when the Woman is dead As to the heat of it it can no wise hurt but the weight of this mass layed on the Belly may rather choak it by the compression it makes than do it any good besides when the Burthen is grown cold they put it in a Skellet of hot Wine from whence they think the Spirits renew which being conveyed through the String into the Childs Belly gives it new force but as I have said already that is very useless and the best and speediest remedy is immediatly to separate it and open the Childs Mouth cleaning and unstopping also the Nose if there be any filth to help it so to breath freely keeping it all the while near the Fire until it hath a little recovered its weakness spouting some Wine into the Nose and Mouth of it that he may a little tast and scent it which can not hurt it in this juncture if one observes some moderation in the thing Having now at large treated in this Second Book as well of natural as unnatural Labours and given sufficient instructions to a Chirurgeon to enable him to help Women in the first and to remedy all the different accidents of the latter to which he may be dayly called there rests nothing now to finish it but to represent the Instruments proper to this Art And then we will pass to the Third Book where we must handle many things which they must necessarily know that intend to practise Deliveries Explication of the Instruments A A Crochet or Hook to draw forth a dead Child B Another Crochet for the same purpose according as the case requires either bigger or less both of them must be strong enough and very smooth and equal that the Womb may not be hurt in the Operation and above ten large Inches long or thereabouts and their Handles must be of a moderate bigness for the firmer holding of them C A crooked Knife equal in length to the Crochets fit for the separating a monstrous Child or piercing of the Belly of an hydropical Infant or opening the Head to empty the Brains or to divide it in pieces when because of its bigness or monstrousness it remaines behind in the Womb separated from the Infants Body D. Another small crooked Knife for the same purpose but not so convenient because it cannot be guided but with one Hand E. A sharp Incision-knife fit for the Caesarean Section soon after the Mothers death F A Cranes bill fitted for the drawing forth of the Womb any strange Body or false Conception when the whole Hand cannot be introduced G Another Instrument for the same purpose H A Speculum Matricis with three branches to open the Womb for to discover Ulcers or other Maladies sometimes there deeply scituated I Another of two Branches for the same purpose K Another yet more commodious L A Catheter to let out the Urine when the Woman cannot make Water M A Syringè for injections into the Womb. End of the Second Book The Third Book Treating of Women in Child bed and of the Diseases and Symptomes befalling them at that time Of Children new born and their ordinary Distempers together with necessary directions for to choose a Nurse GOing with Child is an rough Sea on which a big-bellyed Woman and her Infant floats the space of nine Months And Labour which is the only Port is so full of dangerous Rocks that very often both the one and the other after they are arrived and disembarked have yet need of much help to defend them against divers inconveniences that usually follow the Pains and Travail they have undergone in it We have directed in the First Book treating of the Diseases which are incident to Women with Child how to prevent their suffering shipwrack in this Sea during so long a Voyage In the Second we have taught how they may enter this Port and disimbarque there with safety by Delivery It remains then to compleat our work that we expound in this Third and last how the
to be of an opinion that the Males have sooner life than the Females because he saith their heat is greater but for my part I do not beleive that the Male is sooner formed than the Female and that which thus perswades me is because if it were so the Male must likewise be at its full term sooner than the Female proportionable to the same time that the one is animated sooner than the other which wee see the contrary in that the Women are brought to Bed indifferently both of Sons and Daughters at the ordinary terme of nine months Let us therefore say that towards the fifth or sixth week as well Males as Females have all the parts of their body though small and very tender entirely formed and figured at which time it is not longer than a finger and from thence afterwards which is our third time the blood flowing every day more and more to the Womb not by Intervals as the Courses but continually it daily grows bigger and stronger to the end of the ninth month which is the full term of ordinary labour Having explicated Conception and Generation let us now consider great Bellies and their differences CHAP. V. Of big Bellies and their differences with the signs of the true and false great Bellies THE great Belly of a Woman properly taken is a tumour caused by the Infants scituation in the Womb. There are natural great Bellies which contain a living Child and these we call true and others against nature in which instead of a Child is ingendred nothing but strange matter as Wind mixed with Waters which are called Dropsies of the Womb False-Conceptions Moles or Membranes full of blood and corrupted seed for which reason they are called false great Bellies We have already where we treated of Conception and Generation mentioned the causes and signs of a great Belly in its beginning notwithstanding we will again repeat the most certain and ordinary of them which are nauseousness vomittings loss of appetite to things the Woman was accustomed to eat and like longings for strange and naughty things suppression of the Terms without Feaver or Shiverings or other cause pains and swelling of the Breasts all which may be found in Virgins by the retention of their Courses but the most certain is if putting the finger into the Vagina you perceive the inward Orifice exactly close as also the distention of the body of the Womb considerable more or less according to the time the Woman is gone with Child and the Childs stiring in the Womb gives us indubitable proofs of it It is fit we should be alwayes careful not to be deceived by what we feel stir in the Womb forasmuch as the Infant of it self hath a total and a partial motion the total is when it removes the whole body and the partial is when it moves but one part at a time as the Head Arm or Leg the rest of the body lying still but the Womb blown up in fits of the Mother yea and some Moles have by accident a kind of total motion but never a partial one That of a Mole is rather a motion of falling down than otherwise to wit a motion by which heavy things fall downwards for a Woman who hath a Mole of any bigness considerable whatsoever side she turns her self to her belly falls immediatly the same way like a heavy bowl About the time or very near when the Infant quickens if the Woman be certainly with Child these humors which are carried to the Breasts by the stoppage of her Courses are turned to Milk which when it happens is usually an assured testimony of pregnancy though some Women have been found with Milk in their Breasts but rarely and yet not with Child nor ever having had any which Hippocrates also confirms in his 39th Aphorism of his 5th Book where he saith Si mulier quae nec praegnans nec puerpera est lac habet ei menstrua defecerunt If a Woman hath milk in her Breasts and is neither with Child nor ever had any it comes from the stoppage of her Courses But it is rather whey than milk which in that case hath not the consistence as the Milk of a Woman in Childbed nay the Milk of a Woman with Child is yet but waterish and becomes neither thick nor very white till after labour she begins to suckle her Child The Infant moves it selfe manifestly about the fourth month or sooner or later according as it is more or less strong some Women feel it from the second others about the third month yea some before that time In the beginning these first motions are very small and very like to those of a little Sparrow when first hatched but grow greater proportionably as the Infant grows bigger and stronger and at last are so violent that they force the Womb to discharge its self of its burden as in Travail The common opinion is that the Males quicken before the Females because their heat is greater but that is almost equal for there are some Women perceive their Daughters others their Sons soonest which happens indifferently to Males and Females according as there was a more or less vigorous disposition at their Generation Very often Women who daily use Copulation are subject to be deceived for they usually believe they are with Child if their Courses stop and withal are a little qualmish which is not always true for false conceptions cause almost the same accidents as true which cannot easily be distinguished but by its consequences This false great-Belly is as we have already said often caused by wind which blows up and distends the Womb and which Women oft-times discharge with as much noise as if it came from the Fundament sometimes 't is nothing but water which is gathered there in such abundance as some Women have been seen to void a pail full without any Child though they verily believed they were with Child as did that Wood-Merchant whose story you have in the end of the third Chapter who did not void it till the end of the tenth mouth till when she alwayes believed her self with Child There are others who conceive only fals-conceptions and Moles which may be known by the Infants different motions already mentioned and by the Moles continuing in the Womb often after the ordinary time of labour some Women having them a whole year yea many years according as these Moles are more or less adhering to the inner parts of the Womb and are there entertained and nourished by the blood that flows thither Moles alwayes proceed from some false-conceptions which continuing in the Womb grow there by the blood that flows to them by the accumulation of which they are by little and little augmented if the Womb expels it before two months it 's call'd a fals-conception some are only but as it were the Seed involved in a membrane like that geniture which that Woman voided after six or seven dayes of whom Hippocrates speaks
in his Book De natura Pueri The others are a little more solid and fleshy resembling in some sort the Gizard of a Foul and are greater or less according to the time they stay in the Womb and also according to the quantity of blood with which they are alwayes soaked Women expel these fals-conceptions sooner or later according as they cleave to the Womb which makes them almost alwayes flood in great quantity at those tunes It is of great importance to distinguish well between a true and a false Belly for the faults committed by a mistake are ever very considerable forasmuch as in a true great Belly the Child ought to continue in the Womb till Nature * This excludes not Art to assist Nature if not able to perform its duty in due season expels it by a natural labour but contrarily the false great-Belly indicates to us to procure the expulsion of what it contains as soon as may be Wherefore we ought to be very careful CHAP. VI. How to know the different times of Pregnancy IF prudence be necessary to enable a Chirurgeon or Midwife to assure a Woman that she is with Child or not and of a true or a false-conception it is likewise as much requisite for them to know how far she is gone to the end they may be certain whether the Infant be yet quick or no which is of great moment because according to the Law if a big-bellied Woman miscarry by a wound he that struck her deserves Death in case the Child were quick otherwise he is only condemned in a pecuniary punishment they ought likewise to take heed lest they cause the death of the Infants and sometimes of their Mother by hastening * To be understood by Medicines as appears by the word miscarry following their labour before its time by imagining that when the big-bellied Woman complains of great pains in her Back and Belly they are the pains of her Labour and instead of endeavouring to hinder them they contrarily provoke them and cause them to miscarry unfortunately before their time I knew a Woman called Martha Rolet who being six months gone with Child or thereabouts was surprized with great pains much like throws of Labour which made her send for her Midwife who as soon as she was come and understanding the case no better than they use to do endeavoured all she could to bring her to bed augmenting her pains by sharp Clysters making her walk about her Chamber as if she had been at her full time but finding at two dayes end no forwardness notwithstanding the continual pains she sent for me to know what was fit for her to do in that case I went to the Woman and found the inward orifice of the Womb dilated enough for the top of my little Finger to enter into its inward part and yet wider towards the outward part but considering that she had no other accident but those pains I caused her immediatly to go to bed where she continued eight or nine dayes in which time her pains ceased the Womb closed exactly as I found some dayes after and she went on with her Child three full months longer and was then brought to bed of a Daughter at the full time strong and robust which is yet living and now five years old or thereabouts Now had I pursued what they began this Woman without doubt would have miscarried at six months which would have * Implies Medicines as before killed the Infant in her Belly and soon after she should have miscarried It is fit to follow this example in the like occasion provided the pains are not accompanied with accidents which may endanger the life of the Mother if not presently delivered as frequent Convulsions considerable floodings of which we shall speak in its place To be well informed of the different times of pregnancy the Womans own relation may sometimes serve turn yet 't is not fit alwayes to trust it it may help to conjecture because many Women are themselves deceived concluding themselves with Child from the staying of their Courses or from their quickning which is not alwayes a certain rule We usually judge of it by the bigness of the Belly but more surely by touching the inward orifice of the Womb. When they are young with Child we can only know it by the signs of conception because what is then in the Womb is of no considerable bigness to swell a Belly but rather on the contrary at that time it grows slatter for the reasons before recited but after the second month the Belly begins by degrees to wax bigger till the ninth month At the beginning in touching the inward orifice you find it exactly close and somewhat long resembling the muzzle of a Puppy new pup'd and is then very thick but by little and little through the extension of the Womb it diminisheth so in all its proportions that when the Woman cometh near her reckoning it is perfectly flat and almost equal with the globe of the Womb and in that manner that it becomes like a small circle a little thick at its entry where the Garland is made at the time of Labour Neither may the time of pregnancy be alwayes judged by the great swelling of the Belly because some Women are bigger when they are half gone than others are at their reckoning it depending much on the bigness of the Infant and also on their number and yet again according as there is more or less water inclosed with them in the Womb but much rather by the internal Orifice which grows daily thinner and flatter and so much the more by how much the Women come nearer their reckoning much in the same manner as we see a tender skin diminish in thickness according as it is extended and dilated even so this orifice grows thinner by the extension which the head of the Infant causeth to it which usually presseth hard against it in the last months This remark is often useful to us in the admission of big-bellied Women that desire to lie in in the * An Hospital so called in Paris Hostel de Dieu at Paris which I very often observed in my practise there of Deliveries in the year 1660 through the permission which my Lord the first President was pleased to give me for there is no place so fit to perfect one in a short time in the practice of so necessary an operation because of the great number which are there daily delivered of all sorts the order is that any Women with Child shall be there charitably received fifteen dayes or thereabouts before their reckoning to which purpose they are searcht before they are admitted because many glad of a good entertainment for nothing present themselves there two or three months before they should saying and affirming they are near their time but by the above-mentioned considerations one may easily judge and know within a very little who are fit to be received and