readily drive away the Milk There are some which boil Sage and Box Leaves in Urine with which they do foment the Breasts pretty warm and lay a Cloth upon them dipt in it But great care must be taken in the application and change of these things that the Woman catch not the least cold as also that no Inflammation or Impostumation be caused instead of driving back the Milk Wherefore such Remedies are to be chosen as are restraining repercussive or resolving according to the different dispositions required I know some Women who hold it for a very great secret and most certain and fit to drive the Milk effectually back and that is to put on her Husbands shift yet warm immediatly after he hath taken it off and wear it until the Milk be gone but in case the Milk doth in the mean time vanish 't is superstitious to believe that this Shirt is the cause of it and that it can produce such an effect it happens rather because all the humours of the Body of their own accord taking another course than to the Breasts do not daily flow in so great abundance to them Wherefore in the use of all these Remedies the principal must not be forgotten which is to take care that they tend downwards procuring to that purpose a good and ample evacuation of the * Cleansings Lochia which is much furthered by keeping the Belly open by Clysters provoking them in doing whereof the Milk will soon vanish All that we have said in the former Chapters of this Third Book is only to be observed when the new-laid Woman hath no manner of Indisposition for in case that any happen she must be governed in another manner and according as the Accidents require of which we intend now to treat in the following Chapters CHAP. V. Of several Diseases and Symptomes which happen to a Woman new laid and first of Flooding WE have elsewhere mentioned the Flooding which precedes Labour and shewed the only means to remedy it which is to deliver the Woman assoon as possible let us now see what is fit to be done to that which happens immediatly or in a little time after proceeding from the late opening of the orifices of the Vessels of the Womb by the loosening of the Secondine which cleaved to it this Blood flowes then so much more abundantly by how much it is subtiler and hotter or by the agitation of a long and hard Labour and besides when a Woman is Sanguine or Plethorick This Accident may often happen by a too sudden or violent pulling away of the After-Burthen and sometimes from some part of it being left behind in the Womb or else some false Conception which then endeavouring to expel it presses and forceth forth the Blood out of the Vessels newly opened and sometimes a great Clod of Blood remaining in the bottom of the Womb will produce the same effect which by reason of the distention it often causes excites Pains like to those a Woman endures before Labour and doth not cease tormenting her until she hath voided it and then she is at ease but sometimes the Blood continuing still to flow and remaining in the bottom of the Womb becomes new Clods which is the cause why the accident renews again as before and continueth so by fits in the intervals of which there comes away some Serosities of the Blood retained which dissolves and makes some persons ignorant of the Art to think that the Flux is stopt although it still continues flowing within where it stops only by some blood so coagulated but when this Clod comes away the Flooding begins again pure Blood and in great abundance Flooding is a more dangerous Accident than any other which may happen to a Woman newly laid and which dispatches her so soon if it be in great quantity that there is not often time to prevent it Wherefore in this case convenient Remedies must be speedily applied as well to stop it as to turn it back from the places whence it flowes To which purpose 't is fit to consider what causeth this Flooding and if it be a false Conception piece of the Burthen or clodded Blood remaining behind all diligence must be used to fetch them away or to cause a speedy expulsion of them but if when nothing remains behind in the Womb the Blood doth notwithstanding continue to flow you must bleed the Woman in the Arm not so much thereby to empty the fulness as to make diversion let her Body be laid equally flat and not raised that so the Blood may not be sent down to the lower parts let her keep her self very quiet without turning from side to side that so the Humours may not be stirred the upper part of her Belly must likewise not be swathed or boulstered for such straitness augmens the evil let her Chamber be kept a little cool and let her not be too warm covered in her Bed that so the flooding through Heat may not be continued All the world forbids Clysters in this case lest as they say the humours be drawn down in great abundance but I have twice experimentally found the contrary where great Floodings have been stopt by Clysters of which I will give you a particular account that so it may be useful on the like occasion I was three years since called to a Woman who was surprized with a very great Flooding immediatly after the Midwife had delivered her which she had done with too much violence as the good Woman assured me who told me She felt a very great pain at the instant she pull'd away the After-birth and that she perceived at the loosening of it a Crack Now from the moment that she was so delivered she lost for five or six daies continually so great abundance of Blood that I could scarce believe she could without dying had I not seen it my self during all this time they had to no purpose used all the means they could imagine to stop this accident and because with it she complained of great pains in her Belly they gave her Anodine and cooling Clysters for fear lest giving her others more strong the Flooding would be more and more excited She had taken so four or five Clysters which came away as they were given without any Excrement which seeing and judging that assuredly some gross Excrements being retained in the Intestines from before the time of her Labour which could not be evacuated by these Anodine Clysters did cause so great a Chollick which she felt all over her Belly which appeared puft up I caused her to take one common and one pretty strong Clyster contrary however to the opinion of most persons who not knowing the cause of the distemper bade me have a care lest it should as they said cause a greater Flooding but the issue of it was quite otherwise than they expected for the good Woman voided with this Clyster a Pan full of gross Excrements which having staid there a long
which we say are excited by wind give the Woman immediatly after Delivery Oyl of sweet Almonds and Syrup of Maiden-hair mixt together some do more esteem Oyl of Walnuts provided it may be made of good Nuts but this hath a worse taste than the other This remedy serves to lenify and line the inside of the Intestines with its Unctuousness by means whereof that which is contained within them passeth away the easier but as we have said elsewhere this mixture is so nauseous that it doth often for that reason more hurt than good wherefore I prefer a good warm Broth for those who have an aversion to the Oyl Others give half a glass of good Hippocras but that in the condition the Woman is in may do more hurt by causing a Fever Now for the better preventing these kind of Pains let the Woman keep her Belly very hot and be careful not to drink her Drink too cold and if they torment her very much hot Clothes from time to time must be laid on her Belly or a Pan-cake fryed with Walnut-oyl may be applied to it without swathing her Belly too strait And for the better evacuating the wind out of the Intestines give her a Clyster which may be repeated as often as necessity requires but if by this means the pains of the Belly are not appeased 't is certain they are maintained by some other cause If it be known that some strange body is retained in the Womb the expulsion of it must be procured or it must be fetcht away by putting the Fingers into the Entry of it according to the direction already given for the extracting of a false Conception and if it be great Clods which retained do also cause these pains they will not fail to cease assoon as they are fetcht away but also the same accident will soon return if new Blood flowes into the cavity of the Womb and coagulates there again as it often happens for it cannot endure to keep any thing in its capacity after the Childs birth If the Womans Cleansings be suddenly stopt which a little before came down in great abundance you need not search for any other cause of the pains she endures and the speediest remedy is to bring them down which is effected by Clysters that draw downwards by hot and aperitive Fomentations to the bearing place and by bleeding in the Foot preceded by that of the Arm if the case require it As to the Pains the Woman feels in her Loins and Groins which come by reason of the great distention or in part ruption of the Ligaments of the Womb thereabouts fastened rest alone and a good scituation of the body will be sufficient to fortifie and reunite them without greater Medicines because they cannot be actually applied to the part affected alwaies observing a good Diet and not forgetting in all these several sorts of pains to provide for the natural evacuation of the Lochia for 't is one of the principal means to obtain a good issue CHAP. IX Of the Lochia which flow from the Womb in Child-bed Whence they come and the Signs when they are good or bad I Do not find that Authors have so sufficiently enquired into the cause of the Lochia which are evacuated in Child-bed as to make us truly understand what they are either in respect of their Nature affirming it to be the blood usually purged away every Moneth before they were with Child which being collected about the Womb flowes away when it opens after the birth of the Child or in respect of the quantity of this evacuation and the length of time it ought to continue Hippocrates in his Book De Naturâ Pueri would have at the beginning an Hemine and an half a day of which measure though common in his time we have no certain knowledg for some will have it to be our half Pint others a Pint or therebouts and that they continue for a Male-child thirty daies for a Female fourty diminishing every day by little and little until there comes no more and the evacuation is compleated Galen saies that these Lochia are only vitious humours and the residue superfluity of the Blood with which the Child was nourisshed in the Mothers Womb. But I will as near as I can here describe to you the manner how I conceive this evacuation to be made and the reason why they diminish day by day and change their colour consistence and quality according to the several times Assoon as the Child is born there flowes away from the Womb at the same moment some waterish humours besides those which came away before at the breaking of the Membranes These Waters then are very often bloody not that they are so by Nature but because there is for the most part Blood mixed with them which comming from the Vessels of the Womb because of the agitation and commotion they received in the Birth become so reddish but immediatly after the Burthen is compleatly loosened then pure blood flows away and the reason why these Lochia flow freely and are very red the first day is because the Vessels against which the Burthen was fastened in the Womb are but newly opened but the Blood flowing by little and little in less abundance because the greatest plenitude hath been at first evacuated doth clod in small drops on the extremitie of all those Vessels whereby they are stop'd and then there comes away onely the most serose part of it and therefore the Lochia begin the second and third day to be more pale and less coloured and after that the colour of them is less bloody every day as the Vessels close until they are at length very pale which happens when the Vessels being almost perfectly reunited there distills only the meer moisture of them as also of the whole substance of the Womb through which a quantity of it doth likewise transude Now these serose Humidities acquire by the heat of these places a consistence somewhat thick and that more or less according as they come away in greater or lesser quantity and according to the length of time they stay there And then the Lochia do almost resemble in colour and consistence troubled Milk which makes the World believe it is Breast Milk which is in that manner emptied downwards but in truth it is an Abuse as great as common For my part I know no other cause of this ordinary change of the colour and consistence of the Lochia nor of the diminution of their quantity than that which we daily find in the Suppuration of a great wound somewhat incarnated for assoon as the wound is first made it bleeds fresh and in good large quantity because the Vessels are then open but a little after during the first and second daies it yields only bloody Serosities forasmuch as some small portions of the Blood being clodded about the mouths of the Vessels do in part stop them and afterwards stopping them more it yeilds a white *
they discharge as well as Men. Such a will not open their eyes to behold a verity so clear may make reflection on the resemblance of Infants to their Mother which could not be unless her seed had been more praedominant than the Fathers when he begot them which likewise happens after the same manner when the Fathers hath more force and vertue Which may evince that the Womens seed contributes as well to the formation of the Infant as the Fathers If they will not agree to a thing so common let them make another reflection on the generation of certain Animals which participate of the nature of the Male and Female of which they are engendred though of different kind as we daily see Asses and Mares produce by their coupling Mules which are Animals of a middle nature resembling both the one and the other that produced them We may then learn by this that both Seeds are necessary for a true Conception provided they be prolifick that is containing in them the Idea of all the parts of the body and then the Womb being greedy of it delights it self in it and easily retains it when received else it soon afterwards rejects it It is not absolutely necessary that both the Seeds be received and retained intire without the loss of some part for provided there be a moderate quantity of it 't is sufficient Nor must we imagin that though all of it be not received into the Womb the Child formed out of it will want some limb as an arm a leg or other member for want of sufficient matter inasmuch as the forming faculty is whole in every part of the Seed of which the least drop contains in it potentially the idea and form of all the parts as we have lately made appear but indeed when the Seeds are received but in small quantity the Child may be the less weaker for it Or if either or both of them have not the requisit qualities or though well enough conditioned if the Womb be imbued and stuft with ill humours as the menstrues whites and other filth or any other fault if then there be a conception it will be contrary to Nature and there will be ingendred false births Moles or dropsies of the Womb mixed with some other strange bodies which are very troublesome to Women till they void them It is therefore without cause that many Women are blamed when their children are born with red and livid spots which very much disfigure the faces of some of them It is usually said but without reason that this proceeds from the mothers longing to drink Wine for though some have by chance been in effect harrassed as they affirm with these passionate desires during their being with child yet we must not superstitiously believe as many do that these spots are so caused but rather from some other cause which must be searcht for elsewhere And that which makes it appear it cannot proceed from hence is that almost throughout all Italy where nothing but white wine is drunk as also in Anjou in France I have seen divers persons marked with these red spots and in case it proceeded from their Mothers longing to drink Wine they ought to be white spots or of an Amber colour being the colour of the wine of these Countries but we ought rather to conclude that they are caused from some extravasated blood at the time the Infant is formed which marks the skin yet very tender with these spots and colours it in whatsoever part it toucheth much after the same manner as we see it marked with Gunpouder or some waters producing the like effect when it is washt and bathed with them I will not however deny that the imagination hath a power to imprint on the body of the Infant marks of this nature but that can only be when young with Child and principally at the very moment of conception for when the Child is compleatly formed the imagination can in no wise change its first figure and Women must wean themselves from these vain apprehensions which they say they have to such things every moment and serves some of them for a pretext to cover their liquorishness Since my discourse is fallen upon this subject of Marks with which oft times the bodies of Infants are spoted in their birth and which comes as is ordinarily believed from the imagination of their Mother it seems to me not much from my purpose to recite you a circumstance very particular sound on Me when I came into the world as my Father and Mother have often told me which is that my Mother being with Child of me and almost at the end of her reckoning as it appear'd afterwards the eldest of her three Sons which she then had of six years old and her first-born whom she loved with an extraordinary tenderness and passion dyed in seven dayes of the small Pox all which time she continned night and day by his bed side tending him in all his necessities not suffering any other to do it whatsoever desires were made to her not to weary and trouble her self as she did for the Childs sickness alledging that in her present condition she ought to be careful of her self and not be the cause of death to the Infant she went with in fine at the end of seven dayes her Son dyed upon which the next day she was delivered of me who brought effectively into the world with me six or seven of the small Pox. Now it is certain that it would be irrational to say that I had then contracted these small Pox in my Mothers Womb by her strong immagination But if I were asked whence they proceeded I should answer that the contagious air she breathed without discontiuuance during the whole sickness of her deceased Son had so infected the mass of her blood with which at that time I was nourished that I rather than she easily received the impression of this contagion because of the tenderness of my body Let us therefore assert that the imagination cannot produce any of the above mentioned effects but at the moment of conception or within few dayes after and that we ought for the most part to search elsewhere if we desire the truth of it the cause of most of these Spots Marks and Signes with which many Infants are born CHAP. III Of the Signs of Conception AS it is very hard and belonging only to expert Gardeners to know Plants as soon as they begin to spring forth of the Earth so likewise there are none but expert * Chirurgeons onely practise Midwifery in France Chirurgeons can give a Woman certain assurance of Conception from its beginning although some of these signs resembling those of the suppression of the Terms and other maladies in Women cause many to be deceived in it I will not trouble my self to make a recital of a great number of signs of conception which rather tend to superstition than an effective verity but only 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
but left for the Printer to make choice of the most familiar of them which he mistaking was to prevent further trouble suffered to be so printed I do not intend this work to incourage any to practise by it who were not bred up to it for it will hardly make a Midwife though it may easily mend a bad one Yet notwithstanding I do recommend it to the perusall of all such women as are carefull of their own and their friends safeties there being many things in it worthy their noting And designing it chiefly for the female sex I have not troubled my self to oppose or comment upon any Physical or Philosophical Position my Author proposeth I hope no good Midwives will blame me or my Author for reprehending the fault of bad ones who are onely aimed at and admonished in this work and I am confident none but the guilty will be concerned and take it to themselves which I desire they may and amend Farewell Hugh Chamberlen From my House in Prujeans-Court in the Old-Baily London this 15th of May 1672. ERRATA PAge 8. line 8. for Intestin read Intestinum Pag. 13. lin 1. r. such as P. 19. l. 3. f. upper parts r. Nipples l. 19. r. Womb is free P. 58. l. ult r. that miscarried P. 63. l. 24. r. Hypogaster P. 95. l. 9. r. Corroberatives P. 96. l. 4. r. a Wafer will be very fit P. 101. l. 18. f. Iorn r. Iron P. 132. l. 11. the Comma behind together must be before it P. 133. l. 15. f. the r. a. l. 28. f. which it yet does r. as it also doth P. 213. l. 1. f. capable r. able P. 224. l. 24. f. marked D. r. C. and the same in pag. 236. l. 9. P. 287. l. 1. f. an r. a. P. 301. l. 3. f. brannes r. meales P. 430. r. CHAP. XXXVI l. 24. r. requisite Books newly printed Aurora Chymica or A rational way of preparing Animals Vegitables and Minerals for a Physical use c. Authore Edw. Bolness Med. R. Ord. A Philosophical Essay Declaring the probable Causes whence Stones are produced in the greater World as also the Causes and Cure of the Stone in the Kidnies and Bladders of Men c. By Dr. Thomas Shirley Physician in Ordinary to his Majesty Sold by W. Cadman at the Popes-head in the lower Walk of the New-Exchange Praxis Medicorum Antiqua Nova The Antient and Modern Practice of Physick examined stated and compared By E. Manwaringe Dr. in Physick Sold by Tho. Archer Bookseller under St. Dunstans-Church in Fleetstreet The First Book Of the Diseases and different Dispositions of Women with Child from the time of Conception to the full time of Reckoning MAny Indispositions may arrive to Women from the time of Conception to the full term of Labour because they are then not only subject to those which are caused by pregnancy but to those also which happen at other times It is not my design so to enlarge as to examine all but onely to enquire into the principal and most usual Maladies that accompany Great-Bellies and have during their course some particular Indications for their Cure for as for those which have only general Indications and may happen indifferently to a Woman at any time they may easily be known and redressed by the ordinary means provided that you have all the while regard to the disposition of the Great-Belly It would be sufficient to my purpose of a through examination in pursuance of my intention of every circumstance of a Great-Belly to begin with the explication of a Conception which must precede it but since that cannot happen but to a fruitfull Woman I will before I discourse of it that you may the better understand it from its original give you some considerable Observations concerning the Fruitfulness and Barrenness of Women for Barrenness proceeds oftner from Women than Men for there are many conditions required in a Woman which Men have no occasion of who only need to provide a small quantity of their Seed and that at once to generate but Women besides their Seed must have a fit place to receive both as the Womb is when well disposed and matter appointed for the Child's nourishment during its whole stay there as is the menstruous blood This is the cause that for one impotent Man there may be above thirty barren Women found Let us therefore first of all see what are the signs of Fruitfulness and Barrenness in Women CHAP. I. Of the signs of Fertility and Sterility in Women By the Fertility of a Woman I understand a natural disposition of her Body by means of which with the assistance of a Man she may engender her like And by Sterility which is directly contrary I intend an * Incapacity Impotency which proceeds from some vice or fault either of her whole body or of some particular part We must how make some enquiries after the most notable signs of the one and the other and chiefly of those which may be perceived by our sight or touch by which we may better judge than by many others that for the most part are uncertain For those which are taken from different temperaments may easily deceive us forasmuch as we may often find Women of a very ill habit and full of ill humours notwithstanding fruitful First therefore we affirm the Womb to be a part absolutely necessary to fertility and the principal object to be represented and examined to make a judgment of it but as we find not every Ground proper to yeeld Fruit and that some are so ungrateful as to produce nothing so likewise it is not enough for a Woman to have a Womb to be capable of Conception since we find divers that have them barren We have already * In his Anatomy not yet printed shewed you exactly what the composition and natural structure of it ought to be for to serve to so admirable an end as generation Wherefore we will now speak no further of that but refer you to that place to be informed You must know then in general that the signs of fecundity in a Women are that her Womb be well disposed that she be at least thirteen or fourteen years of age and at most but 45 or 50 generally and for the most part though some yet very rarely conceive sooner or later according to their different natures and dispositions that they be of a good temperament and indifferently sanguine that they have their Courses in due time of good blood and laudable in coulour quantity quality and consistance and regularly every month at once without interruption from the time they begin to flow till the time the evacuation is compleated We say that the bloud ought to be good and laudable because it is a regurgitation and natural evacuation only of what is superfluous in Women not with Child and yet of age capable of Conception which hath no malignity in it self as many falsly imagine for in healthful women
most essential and ordinary by which a Chirurgeon may be assured of it of which some may presently be perceived others not till afterwards He shall first examine and inform himself whether the Woman hath all or most part of the signs of fertility which are already named in the discourse of them if not he must impute them to some other cause and supposing she be fruitful you may then know whether she have conceived by their agreement and more then ordinary delight in the act It is not enough for a Woman to be certain she hath conceived and to yeeld and receive her seed with the Man 's into her Womb unless it close at that instant and retain it There is an Article amongst the customs of Paris in which it is said that to give and keep is not good but it is not so in Conception for a Woman gives and casts her Seed into her Womb and there retains it She may know whether she retains the Seeds if she perceives nothing flow down from the Womb after Copulation The Woman some few months after perceives also some small pain about her Navel and some little commotions in the bottom of her Belly caused by the Womb 's closing it self to retain the Seeds and contracting it self so as to leave no empty space the better to contain them and embrace them the closer The light pain of the Navel comes from the Blader of the Urine from the bottom of which proceeds the Urachus which is fastened to the Navel which is a little agitated by that contraction and kind of motion that happens to the Womb when it is closed to retain the Seeds and from the like agitation comes also those little commotions of the Belly These are the signs of Conceptions which may be known at the moment they happen and may be yet more certainly known if you perceive the inward Orifice exactly close Besides these signs there are others which cannot be known till some time after as when the Woman begins to have loathings having no other Distemper loseth her appetite to meats which she did love longs to eate strange things to which she was not accustomed which happens according to the quality of the humours predominating in her and with which her stomach abounds She hath often nauseatings and vomitings which continue a long time the Tearms stopping no other cause appearing having alwayes before been in good order her Breasts swell wax hard and cause pain from the flowing of the blood and humours to them wanting their ordinary evacuation their upper parts are firmer and larger because of the repletion the Navel starts her Nipples are very obscure or dark coloured with a yellowish livid circle round about her Eyes are dejected and hollow the whites of them dull and troubled her blood when she hath conceived some time is alwayes bad because the superfluities of it not being then purged as accustomed is altered and corrupted by their mixture Moreover there is a sign which all the Women esteem and hold in this doubtful case for very certain which is en ventre plat enfant y a in a flat Belly there is a Child Indeed there is rime in this proverb and something of reason but not as they imagin that the Womb closing it self after Conception draws in a manner the Belly inwards and flatten's it which cannot be because the Womb free and wavering not fastened forwards to the Belly whereby to draw it back after that manner but it may possibly be by reason that Women grow lean by the indispositions of their pregnancy and wax thinner and smaller not only in their Belly but also throughout their whole body as may be known the two first months of their pregnancy during which time that which is contained in the Womb is yet very small but when the Womans blood begins to flow to it in abundance then the Belly waxeth daily bigger and bigger afterwards until her reckoning be out All these signs concurring in a Woman who hath used copulation or the most part of them together and successively according to their seasons we may pass our judgment that she hath conceived notwithstanding that many of them may happen upon the suppression of the Terms which usually produce the like for every one knows that it causeth also in Virgins disgusts nauseatings and vomitings but not so frequently the swelling hardness and pains of the breasts as also extravagant appetites a livid colour of the Eyes and others to which you must have regard The Matrix may be yet exactly close and the Woman not conceived Yea there are some in whom they almost never open unless very little to give passage to the Tearms which happens to some naturally to others by accident as by some callosity proceeding from an Ulcer or other malady If all these signes of Conception which sometimes may deceive us though rarely if they concur together do not give us a sufficient assurance of it and that we desire a better Hippocrates teacheth us a way to know it which I believe to be no more certain than the rest it is in his 42d Aphorism of his 5th Book where he speaks in this sort Si velis noscere an conceperit mulier dormiturae aquam mulsam potui dato si ventris tormina patiatur concepit sin minus non concepit If you desire to know whether a Woman hath conceived or no give her going to rest a draught of Metheglin and if afterwards she feels pains in her Belly caused by wind she hath conceived if none she hath not as he saith Which is grounded as I believe upon the supposition that Metheglin breeds wind which cannot pass easily downwards because the Womb being full compresseth with its greatness the * The great Gut Intestin rectum on which it is scituated and causeth those winds to rumble which are constrained to recoyl back into the other Intestines If there be any occasion where Physicians or Chirurgeons ought to be more prudent and to make more reflections upon their Prognosticks for an affair so important as this is it is in this which concerns their Judgments as to conception and Womens being with child to avoid the great accidents and misfortunes which they cause who are too precipitate in it without a certain knowledge The faults which are committed through too much fear at such a time are in some sort excusable and to be pardoned but not those caused by temerity which are incomparably greater There are but too many poor Women who have been caused to miscarry by Medicines and bleeding not beleiving they were with Child which are so many murders they are guilty of who caused it either through ignorance or rashness besides the death which they bring to those little innocent creatures by destroying them in their Mothers belly they often thereby put the Mothers into great danger We have lately had in Paris in the year 1666 a miserable example of this kind in a Woman hanged and
A Vomitu singultus malum Some advise that after all these things have been tryed in vain great Cupping-glasses should be applyed to the region of the stomach to keep it firm in its place but I believe it to be a Chip in Pottage which doth neither good nor hurt because the stomach is loose and no wayes adhering to this upper part of the belly but since these Vomitings cool it and daily weaken it I should advise a big-bellied Woman to wear in the Winter upon its region a good piece of warm Serge or soft Lambskin which would a little warm those parts and help digestion which is alwayes weak The Italians have a Custom which is not bad they wear to the same purpose a fair piece of Stuff under their Doublets upon the region their stomach of which they are so careful that if they should leave it off but two dayes in the Winter nay even in the Summer they would think themselves sick and they are so grear lovers and so curious of it that this Stomacher is often their greatest bravery enriching it with Gold and Silver Embroidery and Ribonds of very fine colours We have discoursed enough about Vomiting caused by Pregnancy wherefore we will pass forwards to some other Accidents CHAP. XII Of Pains of the Back Reins and Hips ALL these Accidents are but the effects of the dilatation of the Womb and the compression it makes by its greatness and weight on the neighbouring parts which are much greater the first time the Woman is with Child than afterwards when the Womb only receives the same dimensions it had already before but when it hath not yet been dilated it is more sensible of this extention and the ligaments which hold it in its natural scituation suffer a greater stress in the first pregnancy having never before been forced to lengthen to answer the extent of the Womb than in the following Great-Bellies to which it obeys more easily the second time These ligaments as well round as large cause these pains being much straitned and drawn by the bigness and weight of the Womb which contains a Child to wit the large ones those of the back and loyns which answer to the reins because these two ligaments are strongly fastened towards these parts the round ones cause those of the groins share and thighs where they terminate They are sometimes so violently extended by this extream bigness and great weight of the Womb especially of the first Child as I said before that they are lacerated and torn being not able to yeeld or stretch any farther and chiefly if the Woman in that condition makes a false step which causeth in them almost insupportable pains and other worse accidents as it happened two years since to a near Kinswoman of mine who being six months gone or thereabouts of her first Child felt the like after she had stumbled and perceived at the same moment something crack in her Belly towards the region of the Reins and Loins which was one of these large ligaments with a kind of noise by the sudden jolt she received At the same instant she felt extream pains in her Reins and Loins and all the one side of her Belly which made her immediately vomit very often with much violence and the next day she was taken with a great continued Feaver which lasted seven or eight dayes without being able to sleep or rest one hour all which time she continued to vomit all she took with a strong and frequent Hiccough having also great pains which seemed as if they would hasten her Labour which for her sake I was very apprehensive of as also of her death but with the help of God having put her immediatly to bed where she continued twelve whole dayes in which time I bled her thrice in her Arm on several dayes and made her take at two several times a small grain of Laudanum in the yolk of an Egg a little to ease her violent pains by giving her rest alwayes ordering her from time to time good strengthning Cordials all these symptoms which at first seemed desperate ceased by little and little and she went on her full time when she was happily delivered of a Son which lived fifteen months notwithstanding all those mischievous accidents she met with which were enough to have kill'd half a dozen others but God sometimes is pleased to work Miracles by Nature aided with Remedies fit for the purpose as well as by his Grace This History informs us I think very well how these Pains of the Loins Back and Reins come and the pregnant Womb causeth also those of the Hips by its greatness and weight in compressing them and bearing too much upon them There is nothing will ease all these sorts of Pains better than to rest in Bed and bleed in the Arm if there were any great extension or rupture of any ligament of the Womb as was in the case recited And when the Womb bears and weighs too much upon the Hips if the Woman cannot keep her Bed she ought to support and comfort her Belly with a broad Swaith well fitted for the purpose and to bear it as patiently as she can to the time of her Labour which will free her from all these accidents CHAP. XIII Of the Pains of the Breasts AS soon as a Woman conceives her Tearms wanting the ordinary evacuation the passages being stopt and the Woman breeding daily blood there is a necessity she consuming but little whilst young with Child the fruit being yet very little also that the vessels which are too full should disgorge part as it doth upon the parts disposed to receive it such as are the kernels and glandulous parts especially the Breasts which imbibe and receive a great quantity of it which filling and extreamly swelling them causeth this Pain in them which Women feel when they are with Child and happens also to those whose Terms are only suppressed In the beginning we ought to leave the whole work to Nature and the Woman must only have a care she receives no blows upon those parts which are then very tender nor be straight laced with her Bodies or other stiff Wastcoats that might bruise and wound her upon which follow Inflamations and Abscess But after the third or fourth month of going with Child the blood being still sent to the Breasts in great abundance 't is much better to evacuate it by bleeding in th' Arm than to turn or drive it back on some other part of the Body by repercussive or astringent Medicines because it cannot flow to any part where it can do less hurt than in these Wherefore I should rather prefer the Woman being very plethorick to evacuation by bleeding in the Arm than any other way because of shunning thereby the Accident of which speaks Hippocrates in his 40th Aphorism of the 5th Book Quibus Mulierilbus in Mammas sanguis colligitur furorem significat If the blood be carried in too great abundance to
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
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
lethale The particular causes of Abortion are all the accidents mentioned in the preceding chapters as violent and frequent vomitings because there is not only want of sufficient nourishment for Mother and Child when the food is so continually vomited up but also great reachings and endeavours by which the Womb being often compressed and as it were shaken is at last constrained to discharge it self before its time Pains of the Reins great Cholicks and Gripes may likewise cause the same accident as the Strangury also for there are then made strong compressions of the Belly every moment to expel the Urine Great Coughs by their frequent agitation suddenly thrusting the Diaphragma with force downwards give also violent shocks to the Womb. Great Loosnesses endanger a Woman to miscarry according to the 34th Aphorism of the 5th Book and sooner if a Tenesmus follows which is great needings whereby the right Gut seeks to expel the sharp humours that irritate and provoke it This makes us take notice of the 27th of the 7th Book Mulieri utero gerenti si tensio supervenerit facit abortum for in this case the Womb which is scituated upon the Rectum receives a great commotion by its continual needings If a Womans Courses flow immoderatly it is impossible her Fruit can be in health as it is in the 60th Aphorism of the 5th Book for besides that the Infant is not sufficiently nourished the Womb also by being too much moistened is easily relaxed and opened Letting Blood immoderately doth the same for the same reason especially if the Child be great according to the 31th Chapter of the same Book But one of the worst accidents which cause Abortion is that Flooding which proceeds from the separation of the After-birth from the Womb of which we treated in the 20th Chapter of this first Book The Dropsie of the Womb hinders the Child from growing to perfection for the great abundance of Water extinguisheth the natural heat which is already at that time much debilitated and the Pox in the Mother infects the Child and often Kills it in her Belly as we have demonstrated in the preceeding Chapter and whatever very much agitates and shakes the big-bellied Womans body is capable of making her miscarry as great labour strong contorsions or violent motions of what manner soever in falling leaping dancing and running or riding going in a Coach or Waggon crying aloud or laughing heartily or any blow received on the Belly because that by such agitations and commotions the ligaments of the Womb are relaxed yea and sometimes broken as also the After-birth and Membranes of the Faetus are loosned A great noise suddenly and unexpectedly heard may make some Women miscarry as the noise of a Cannon and chiefly Thunderclaps and yet more easily if to this noise be added the fear they usually have of such things which happens rather to the young than elderly Women because their bodies being more tender and transpirable the air which is strongly forced by that noise being introduced into all her pores offers a great violence by its impulsion on the Womb and on the Child within it which the elder being more robust thicker and closer resist with more ease Great watchings causing a dissipation of the Womans strength and much fasting for want of food hinders the Infant from acquiring its perfection fetid and stinking smells do much contribute to abortion and amongst others the smell of Charcoal as appears by the History recited in the 10th Chapter of this Book The indispositions of the Womb produce the same effect as when it is callous or so small or so much compressed by the Epiploon that it cannot be extended as it ought to be sufficient to contain the Child and Burthen with ease together with the Waters which may likewise happen if the Woman be too strait laced or keeps in her Belly with strong and stiff Busks for to be well shap'd or by this subtilty to conceal a great-belly as some do frequent copulation especially towards the end of her reckoning may effect the same thing because then the Womb being very full bears much downwards and its inward orifice being very near is subjected to violence If a Woman miscarries without any of these accidents and that one desires to know the cause of it Hippocrates explains it in his 46th Aphorism of the 5th Book where he saith Quae veró mediocriter corpulentae abortum faciunt secundo mense aut tertio fine occasione manifesta iis acetabula uteri mucoris sunt plena nec prae pondere faetum continere possunt sed abrumpuntur any Woman indifferently corpulent that miscarries the second or third month without manifest or apparent cause it is because the Cotylâ—dons of the Womb which are the inward closures of its vessels are full of viscous filth by reason of which they cannot retain the weight of the Faetus which is loosened from it To this accident phlegmatick Women are very subject and those who have the Whites exceedingly which by their continual affluence moisten and make the Womb within so slippery that the After-burthen cannot adhere to it which also relaxeth it and its inward orifice that the least occasion causeth abortion But if the passions of the body cause so much hurt to a big-bellied Woman those of the mind do no Iess and specially Choler which agitates inflames disperses and troubles all the Spirits and mass of Blood by which the Child suffers extreamly because of the tenderness of its body but above all sudden fear and the relation of bad news are capable to make the Women miscarry at that instant as it happened to the Mother of that Cousin of mine whom I mentioned in the 10th Chapter of this first Book which likewise the other passions may cause according as they are more or less violent but not so easily There are yet other causes of miscarrying which may be said to proceed from the Infant as when they are monstrous because they do not then follow the rule of Nature as likewise when they have an unnatural scituation which makes them torment themselves because of their incommodity and they oblige the Womb to expel them not being able to endure the pains they cause which it yet does when it is so great that it cannot contain it to the full time nor the Mother furnish it with sufficient nourishment If we find one or more of the above specified accidents and that the Woman withall hath a great heaviness in her Belly so that it falls like a ball on her side when she turns and that there proceeds out of her Womb stinking and cadaverous humors it is a sign she will soon miscarry of a dead Child moreover her Breasts will confirm it if having been hard and full in the beginning they become afterwards empty and flabby as is specified in the 37th Aphorism of the 5th Book and the 38th of the same Book saith That if one of a big-bellied Womans Breasts who hath
Body is only supported by the stability of these Bones wherefore we must rather believe as most probable that such a disjunction and separation was caused either by the falling of this Womans Corps from the high Gibbet to the ground after execution or rather by some impetuous blow on that place received from some hard or solid thing If we examine well the different figure and structure of these Bones between a Man and a Womans Sceleton we shall find a larger empty space and distance between these Bones much more considerable in Women than Men and that to this purpose the least Women hath the Bones of the Ischion more distant the one from the other than the biggest Man they have all likewise the os sacrum more outwards and the pubis flatter which makes the passage from this capacity larger and more able to give issue to the Child at the time of Labour they have besides this the Bones illia much more turned outward that the Womb being impregnated may have more room to be extended on the sides and be more at ease supported by such a disposition as is here represented These two Figures of Bones represent the Bones that form the whole capacity of the Hypogastrium A shews the Mans Bones B the Womans for to know the difference that the Womans is more capacious and spacious than the Mans for C C D D E E are at a larger distance one from the other in the Womans than they are in the Mans and besides that Women have the Coccyx marked F more turned outwards than the Men which gives way to the Infants Head to pass without great difficulty through the large passage there is between the two Bones of the Ischion marked E E without any necessity for the separation of the Os pubis as some have imagined contrary to truth Chap I. lib. 2. pag. 144. Moreover having often seen and dissected Women dead a few dayes after delivered I found it very difficult to separate these bones with a strong sharp Penknife where I could never find the least appearance of any preceding separation And if the advanced in years have more pain with the first Children than younger Women it doth not proceed from the difficulty of the separation of these bones which never is for the reasons above but because the membranes of their Womb are dry hard and callous and particularly its internal orifice which therefore cannot so easily be dilated as young Womens being more moist Having sufficiently explained what is Delivery and all its differences we must now examine what signs usually precede and what accompany a natural Delivery and an unnatural which shall be the subject of the next Chapter CHAP. II. The Signs that precede and accompany aswel a natural as an unnatural Delivery WHen Women with Child chiefly of their first perceive any extraordinary pains in their Belly they immediately send for their Midwife taking it for their Labour who when she is come ought to be well informed of the matter and careful not to put her in Labour before there is a disposition to it for many times both Mother and Child lose their lives when it is excited before the due time Those pains which may be called false are usually caused by a Cholick proceeding from Wind which come and go griping the whole Belly without any forcing downwards or into the Womb as those do which proceed or accompany Labour and this Cholick is dissipated by warm clothes applied to the Belly and a Clyster or two by which true Labour-pains are rather furthered than hindered A Woman may feel other kind of pains coming from an emotion caused by the Flux of the Belly which are easily known by the frequent stools that follow The signs preceding a natural Labour few dayes before are that the Belly which before lay high sinks down hinders a Woman at that time from walking as easie as she used and there flows from the Womb slimy humours appointed by nature to moisten and smooth the passage that its inward orifice may the more easily be dilated when it is necessary which beginning to open a little at that time suffers that slime to flow away which proceeds from the humours that strain through the thin substance of the Infants membranes and acquires a viscous consistence by the heat of the place The signs accompanying present Labour that is shewing that the Woman is effectively in Labour are great pains about the region of the Reins and Loins which coming and redoubling by intervals answers in the bottom of the Belly with reiterated throws The face red and inflamed because the Blood is much heated by the continual endeavours a Woman makes to bring forth her Child as also because that during these strong throws her respiration is ever intercepted for which reason much Blood hath recourse to the Face Her privy parts are swell'd because the Infants Head lying in the Birth often thrusts and causeth the neighbouring parts to distend outwards which thence appear swelled in this manner She is often subject to vomitting which makes many believe who know not the cause of it that the Women to whom it happens are in danger but on the contrary it is ordinarily a signe of speedy delivery because the good pains are then excited and redoubled every moment until the business be finished This Vomitting comes from a sympathy between the Womb and Stomach by reason of the ramifications of the nerves of the sixth pair of the Brain which are distributed to both the one and the other and by which it communicates the pain it feels at that time arising from the agitation the violent and frequent motions of the Child causeth and the strong compression the muscles of the lower Belly makes during the throws for to help the issue of the Child besides when the birth is very near Women are troubled with an universal trembling and principally of the Legs and Thighs not with cold as at the beginning of an Ague-fit but with the heat of the whole body and the humours which then flow from the Womb are often discoloured with Blood which with the signs above mentioned is an infallible mark of the nearness of the birth 't is that the Midwives usually call Shows and if one then puts up their finger into the neck of the Womb they will find the inner Orifice dilated at the opening of which the membranes of the Infant containing the Waters present themselves and are strongly forced downwards with every pain the Woman hath at which time one may perceive them to resist and appear to the finger so much the more or less hard and extended as the pains are stronger or weaker These membranes with the waters in them when gathered that is when they are advanced before the head of the Child which makes the Midwives call it the gathering of the waters presenting themselves at this inward Orifice do then resemble very well to the touch of
Twins sometimes both are of the same Sex sometimes not and indifferently scituated on the right or the left This is all can be said in general of the scituation of Children in the Womb. But in particular when we consider the several Figures it makes it differs according to the different times of Pregnancy for when the Woman is young with Child the little Foetus called Embryo is alwaies found of a round Figure a little oblong having the Spine moderately turned inwards the Thighs folded and a little raised to which the Legs are so joined that the Heels touch the Buttocks the Arms are bending and the Hands placed upon the Knees towards which the Head is inclining forwards so that the Chin toucheth the Breast It resembles in this posture very well one sitting to void his Excrements and stooping down his head to see what comes from him The Spine of its Back is at that time placed towards the Mothers the head uppermost the face forwards and the feet downwards and proportionable to its growth and grandeur it extends by little and little its members which were exactly folded in the first months It keeps usually this posture till the seventh or eighth month at which time the head being grown very big is carried downwards by its weight towards the inward orifice of the Womb tumbling as it were over its head so that then the feet are uppermost and the face towards the Mothers great gut Some believe that only Males are so turned downwards when they are born and that the Females are with their face upwards but both the one and the other are alwaies turned downwards with their face towards the Rectum of their Mother as is abovesaid and when it happens otherwise it is unnatural for the Childs face coming upwards will be extremely bruised and the nose wholly flatted because of the bones hardness in the passage It may be noted that when the Child hath thus changed its first scituation being not yet accustomed to this last it stirs and torments it self so much sometimes that the Woman by reason of the pains she feels is apt to believe it her Labour And if this circumstance be well considered they will find it to be that first pretended endeavour which Authors imagine the Child makes for to be born in the Seventh moneth and not being able to accomplish it remains so till the Ninth and that reiterating it in the eighth if it be born it lives not long because it was not able to endure two such puissant endeavors so near together But it is a meer abuse for if the Child turnes it self so with the head downwards or rather is turned it is but by a natural disposition of the weight of the upper parts of the body and if it stirs much at that time and soon after it is not from a desire to be born but from the inconvenience it receives from this new posture to which it was not before accustomed as already hath been mentioned And it begins to turn thus sometimes from the Seventh month rarely before but by accident oftenest about the eighth Moneth and sometimes in the ninth only and at other times also it doth not turn at all as we way easily perceive in those that come in their first scituation that is with their feet foremost From whence it is easie to conjecture and I hold it for a certain truth that the Children are the more strong and robust and consequently may more likely live by how much the nearer they approach to the more natural and perfect time which is at the end of the ninth Month. The Infant then is turned on this manner with his Head downwards towards the latter end of the Reckoning to the end only that he may be the better disposed for its easier passage into the world at the time of Labour which is not then far off For in this posture all its joints are easily extended in comming forth and the Arms and Legs cannot hinder its birth because they cannot be bended against the inward orifice of the Womb and the rest of the body which is very supple passeth very easily after the Head which is hard and big be once quite born When there are many Children they ought if it be natural to come in the same Figure as when there is but one but usually by their different motions they do so incommode one the other that almost alwaies one of them presents wrong at the time of Labour yea and before which is the cause that one comes often with the Head the other with the Feet or any other worse posture and sometimes both come wrong However the Infant may be scituated in the Mothers belly or in whatsoever fashion it be that it presents at the birth if it be not according to the posture above described it is alwaies against Nature and the natural scituation is so necessary to a good and legitimate Delivery that those which are against nature do cause for the most part bad Labours When a big-bellyed Woman is happily arrived near her haven she ought then to take great care she suffers not shipwrack there which she will avoid if she observes exactly at the end of her reckoning the Rules which follow CHAP. VI. What a Woman ought to do when she hath gone her full time I Am not of the opinion of most Mid-wives who advise Women with Child that they may as they say have the better labour to use more than ordinary exercise towards the end of their reckoning as Liebaut also directs who orders them to ride in Coaches or trotting Horses which is a very dangerous advice and causeth daily many wrong Births for as we said in the precedent Chapter 't is about that time that ordinarily the Child turns its head downwards and its heels upwards for to be born right and the poor Women often believing they may procure an easie labour make it by this extraordinary exercise very unhappy which because of the agitation and commotion of the body causeth the Child to take a wrong posture or makes the Womb so to bear down and be engaged in the cavity of the Hypogastrium that afterwards it hath not at due time liberty to be turned which is often the reason why it comes in its first posture that is with the feet besides that labour which ought to be Natures work if the Child come right is thereby excited before the full time and though it were but four or five days it hinders not as I have said elsewhere from being as prejudicial to them as we see it is to the taste goodness and conservation of Fruit gathered but few days before its perfect maturity Wherefore I counsel a Woman though almost contrary to the unreasonable opinion of every one to keep her self more quiet than ordinary when she draws near her time that so her Child may be able to turn it self directly right and that she by all means avoids being strait laced that so
it may have more space to be turned into a fit posture to be born she must then likewise observe a good diet of meat of good juyce and easie digestion rather boiled than rosted to moisten the better and keep the body thereby open rather than by Clysters which may hasten labour she may about eight or ten days before Labour anoint her privities with Goose Capon or Hogs Grease or fresh Butter or foment those parts with fomentations which may by mollifying and loosening render those passages more smooth and slippery This ought principally to be done by those that go with their first Child because their passages are more strait than others who have had Children already but they who are a little in years have much more pain and are longer in Labour of their first Child than others who are indifferent young because the Membranes of their Womb are harder and dryer wherefore they cannot yeeld so well nor the inward Orifice be so easily dilated Some Authors commend bathing the better to relax those parts but it is dangerous lest by their too much moistness and the emotion they cause to the whole Body they make her come a little before her time Many Women bleed by way of prevention when they are or believe themselves to be at their full time which custom I cannot approve if it be only for prevention but I do in case some other necessity require it provided they abstain from it after the seventh Moneth because the stirring of the Child caused by bleeding is sometimes so vehement that the Womb is constrained to open before its time to be rid of the Child If a Woman with Child observes these Rules she will have reason to hope for a good issue of her Labour in the mean time let her provide her self of a good Midwife or an expert and handy * Chyrurgeons onely Practise in France as noted before Chyrurgeon to attend upon her assoon as she perceives the least pain or throw of what kind soever for as a small wind or shake will serve turn to make ripe fruit fall so the least Cholick or any other false pain may bring forward her Labour and surprise her unprovided of help Let us now see what is necessary when she is effectively in Labour CHAP. VII What is to be done when the Woman first falls in Labour A Womans travel is only many pains with reiterated Throws by which she endeavours to bring forth her Child It is so called because both Mother and Child suffer and take much pains in this action Most people believe that there is no other reason for the cause of this evil but because God hath so ordained it and that Woman according to his Word must bring forth with pain because of her sin according to what is written in the 3d. Chap. of Genesis I will greatly multiply thy sorrow and thy conception in sorrow thou shalt bring forth Children and thy desire shall be to thy Husband This curse was indeed very great because it hath extended to all Women that have brought forth Children since that time and will continue to all that shall come hereafter However we find that all the Females of other Animals suffer as much and are in as great danger of their lives as a Woman when they bear their young This perswades us that besides this precise will of God in respect of a Woman there must be yet a natural reason wherefore it cannot happen otherwise and that is That it is impossible the Womb being very strait in comparison of the Childs bigness and very sensible because of its Membranous composition should receive a necessary dilatation for the Childs birth and such great violence without suffering considerable pains for it Now since a Woman for this cause cannot shun these pains she must endeavour to endure them with patience in the hope of being suddenly delivered from them by a fortunate labour Assoon as it is known that the Woman is certainly in Labour by the signs mentioned in the Second Chapter of this Book where both those preceding and those accompanying Labour are recited of which the principal are Pains and strong Throws in the Belly forcing downwards towards the Womb the dilatation of the inward Orifice perceived by touching it with the finger as also the gathering of the Waters which come before the Head of the Child and thrusting down the Membranes which contain them through which between the Pains one may in some manner with the Finger discover the part which presents especially if it be the Head of the Child by its roundness and hardness Then must all things necessary to comfort the Woman in her Labour be go ready and the better to help her care must be taken that she be not strait-laced a pretty strong Clyster may be given her or more than one if there be occasion which must be done at the beginning and before the Child be too forwards for afterwards it is very difficult for her to receive them because the Gut is too much compressed they serve to excite it to discharge it self of its excrements that so the Rectum being emptied there may be more space for the dilatation of the passage as also to stirr up the pains to bear the better downwards through the endeavours she makes when she is at stool and the while all necessary things for her Labour should be put in order as well for the Woman as the Child a Midwifes stool or rather a Pallet-Bed girted placed close by the fire if the season require it which Pallet ought to be so disingaged as to be turned round about the better to help the Woman when there is occasion If the Woman be * full of blood Plethorick it may be convenient to bleed her a little for by this means her Breast being disingaged and her respiration free she will have more strength to bear down her pains which she may do without danger because the Child being about that time ready to be born hath no more need of the Mothers blood for its nourishment which I have often practised with good success besides this evacuation often hinders her having a Fever after Delivery in expectation of which hour she may walk about her Chamber if her strength permits and to preserve her strength it will be convenient to give some good gelly broths new-laid eggs or some spoonfuls of burnt or brewed Wine from time to time or a Tost dipt in Wine avoiding at that time solid food Above all she must be perswaded to hold out her pains bearing them down as much as she can at the instant when they take her The Midwife must from time to time taste the inward orifice with her finger to know whether the Waters are ready to break and whether the Birth will soon after follow she must likewise anoint all the bearing place with emollient Oyles Hogs-grease or fresh Butter if she perceive that they can hardly be dilated and all the
using these things a long time before the Hour of Labour to relax and dilate them the easier lest there should happen a rupture of any part when the Child is born for sometimes there happens a dilaceration to the Fundament by which both are rent into one outwardly If a Woman be in years of her first Child let her lower parts be likewise anointed to mollify the inward orifice and the Vagina or Neck of the Womb which being more hard and callous do not easily yield to the necessary distension of Labour which is the cause why such Women are longer in Labour than others and why their Children being forced against the inward orifice of their Womb which is as we have said a little callous and also for remaining long in the passage are born with great Bumps and Bruises on their Heads Small and mishapen Women should not be put to Bed till at least their Waters be broke but rather kept upright and walking about the Chamber if they have strength being supported under the Arms for in that manner they will breath more freely and mend their Pains better than on the Bed where they lye all on a heap Let those that are very lean also moisten these parts with Oyls and Oyntments to make them more smooth and slippery that the Head of the Infant and the Womb be not so compressed and bruised by the hardness of the Mothers bones which form the Passage The weak Woman should be strengthened the better to support her Pains giving her good jelly Broths with a little Wine and a Tost in it or other good things as the case requires If she fears the Pains let her be comforted assuring her that she will not endure many more but be speedily delivered On the contrary if her Pains be slow and small or none at all they must be provoked by frequent Clysters a little strong that so they may be excited by the needings at Stool and afterwards let her walk about her Chamber that the weight of the Child may also help a little If the Woman floods or hath Convulsions which is by many too long neglected she must be helped by a speedy Delivery as we have already declared and shall repeat hereafter in its proper place If she be costive let her use Clysters which likewise may dissipate a Cholick at those times very troublesome causing great and useless Pains very hurtful because they fleet to and again through the Belly without bearing down as they should do If she cannot make water because the Womb bears too much on the Bladder let her try by lifting up her Belly a little or else by introducing a Catheter into her Bladder draw forth her Urine If the difficulty or slowness of the Labour comes from the ill Posture of the Woman let her be placed in a better more convenient to her Habit and Stature observing the circumstances given in the First Chapter of this Second Book If she be taken with any distemper she must be treated for it according to its nature with more caution than at another time having alwaies regard to her present condition If it proceed only from the indispositions of the Womb either from its oblique scituation it must be remedied as well as can be by the placing of her Body accordingly If it be by its vitious conformation having the Neck too hard and too callous and too strait it must be anointed with Oyls and Ointments as above directed If it come from a strong Cicatrice which cannot be mollified of a preceding Ulcer or a Rupture of a former bad Labour so agglutinated it must be separated with a fit Instrument lest another Laceration happen in a new place and leave the Woman in a worse condition than before it must be made in that place where the case most requires it taking care that it be not upwards because of the Bladder If the Membranes be so strong as that the Waters do not break in due time they may be broken with the Fingers * Let the Midwife be first well assured provided the Child be come very forward into the Passage and ready to follow presently after for otherwise there is danger that by breaking these Waters too soon the Child will remain dry a long time and to supply that defect you must moisten the parts with Fomentations Decoctions and Emollient Oyls which can never be so well as when Nature doth its own work with the Waters and ordinary Slime which alwaies happen well when they come in time and place Sometimes these Membranes with the Waters press three or four Fingers breadth out of the body before the Child resembling a Bladder full of Water there is then no great danger to break them if they be not already for when it so happens the Child is alwaies ready to follow being in the Passage but above all be careful not to pull it with your Hand lest thereby you loosen before its time the After-burthen to which it adheres very strongly If the Navel-string comes first it must be presently put up again and kept up if possible or else the Woman must be immediately delivered But if the After-burthen comes first it must never be put up again for being come forth it is altogether useless to the Infant and would be but an obstacle and hinderance in the way if it were put up in this Case it must be cut off having tyed the Navel-string and afterwards draw forth the Child assoon as may be lest that he be suffocated If the Woman hath fallen or is hurt let her immediately keep her Bed and take her rest If it be any Passion that retards the Labour and cannot totally be overcome let them endeavour to moderate it If it be Shamefastness or Modesty the persons who are the cause of it must quit the Chamber and if timidity and fear of Pain she must be advised that it is the will of God it should be so and that her Labour will not be so bad as she imagines perswading her to submit to the necessity by the consolation of the unfortunate whose pain seems always more supportable by the consideration that it is common so she must be informed that others endure the same Pain and greater than hers if she be melancholy let her be diverted by some good news promising her such a Child as she desires and in a word though she suffer much she must consider it but as a bad journey which one quarter of an hour of good Weather makes one forget all past as she will when she is brougt to bed assuring her chiefly that she is in no danger especially when it is not very apparent for then one ought to acquaint her with it that she may settle both her temporal and spiritual affairs When the difficulty is only caused by a dead Child the method mentioned in the natural Labour must be observed and besides the Woman must do all she can to further her Delivery because the
the Blood may notwithstanding circulate in all the other parts of the body to which I answer that in respect to the Infant 't is either absolutely necessary that the Blood for want of respiration should be elaborated or prepared in the * Thick part of the Burthen Placenta and therefore there must be a free communication or for want of it that the Infant must immediatly breath by the mouth as well to be refreshed as to drive forth by exspiration the fuliginous vapours which not being possible whilst in the Womb it must unavoidably be choaked and dye in a very small time if it wants both together Wherefore in this case the Woman must without any delay be delivered which if Nature doth not speedily perform the Child must be drawn forth by the Feet Women that have great Waters and a long string to the Burthen are very subject to this mischief for the Waters coming forth in great abundance at the breaking of the Membranes do often at that instant draw the string which swims in the midst forth along with them and much the easier if the Infants Head be not advanced very forward into the Passage for to hinder the coming forth of it in this manner Assoon as 't is perceived you must immediatly endeavour to put it back to prevent the cooling of it behind the Childs head lest it be bruised as we have already noted whereby the blood may coagulate there keeping it in that place where it was thrust back until the Head being fully come down into the Passage may hinder the coming down of it again which may be effected by holding it up with the Fingers of one hand on that side it comes down until the Head be advanced as abovesaid or in case the hand be taken away to put a piece of fine soft rag between that side of the Head and the Womb for to stop up the way it came down by alwaies leaving an end of the rag without the body for to draw it forth by at pleasure But sometimes notwithstanding all these cautions and the putting back of it it will yet come forth every Pain then without further delays the Chirurgeon must bring the Child forth by the Feet which he must search for though the Infant comes with the Head for there is but this only means to save the Childs life which it would certainly lose by the least delay in this case Wherefore having placed the Woman conveniently let him gently put the Head which offers back provided it be not engaged too low among the bones of the Passage and that it may be done without too great violence to the Woman for in that case * See the Preface it will be better to let the Child run the hazard of dying than to destroy the Mother and then slide up his Hand well anointed under the Breast and Belly to search for the Feet by which he must draw it forth according to former directions this being dispatched let him immediatly take great care of the Infant which is ever in this case very feeble CHAP. XXVIII Of a Labour wherein the Burthen either first offers or first comes quite forth THe coming forth of the Navel-string before the Infant of which we have treated in the foregoing Chapter is often cause of his death for the reasons there given but the coming first of the Burthen is yet much more dangerous for besides that the Children are then ordinarily Still-born if they be not assisted in the very instant the Mother likewise is often in very great peril of her life because of her great floodings which usually happen when it is loosened from the Womb before its due time because it leaves all the Orifices of the Vessels open to which it did cleave whence flowes incessantly Blood until the Child be born because the Womb whilst any thing continues there doth every moment strongly endeavour to expel it by which means it continually voids and epresseth the blood of the Vessels which are always open as we have already often explained when the Burthen is so separated as long as the Womb remains extended and cannot be closed until it hath voided all that it did contain and comes by the contraction of its membranous substance to stop them by pressing them together Wherefore if we ought to be vigilant to succour an Infant when the String comes first we ought much more to be so when the Burthen comes forth first and the least delay is ever cause of the Infants sudden death if the Woman be not speedily delivered because the Infant cannot stay then long in the Womb without suffocation standing then in need of breathing by the Mouth as is explained in the foregoing Chapter the Blood being no longer vivified by the preparation made in the Burthen the use and sunction of which then ceaseth from the instant it is separated from the Vessels of the Womb to which it was joined for which reason there immediatly follows a great flooding which is so dangerous for the Mother that without speedy help she soon loseth her life by this unlucky accident When the Burthen is not wholy come forth but lies in the Passage some advise to put it back before the Child be fetcht but I am not of that opinion for when it comes into the Passage before the Infant it is then totally divided from the Womb at the bottom of which it ought ordinarily to be scituated and fastened until the Child be born but because assoon as it is wholly loosened as it alwaies is when it comes first it becomes a Body altogether unnatural it must never be thrust back but contrarily be ferched away and at the very moment after bring the Child by the Feet although it came naturally with the Head first for what reason can there be to put it back since it is of no use to the Infant from the moment it is separated from the Womb as cannot be denied And such a proceeding is so farr from being useful that this Burthen would much hinder the Chirurgeon from being able to turn the Child as he ought for to bring it by the Feet Wherefore when it presents in the Passage which may be soon perceived if they find every where a soft substance without the least resistance to the touch of any solid part finding likewise the String fastened to the middle of it and the Woman flooding extremely as is ordinary at such times then instead of thrusting it back the Burthen must be brought away that so there may be more liberty and room to extract the Child according to former direction The Burthen being quite loosened from the Womb and coming first in the Passage must not be thrust back into it again much less must it be put back when is is quite come forth of the Body Care must be only taken not to cut the String till the Child be born not out of hopes of any benefit from it to the Infant during the
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
Mother and Child must afterwards be ordered and declare how at this time to prevent and remedy divers Indispositions which often happen to them both Let us first consider those that arrive to a Woman new layd and then we shall pass to those that regard a new-born Infant CHAP. I. What is fit to be done to a Woman new-laid and naturally delivered IMmediatly after the Woman is delivered and the Burthen come away care must be taken that the loosening of it be not followed with a Flooding which if it be not a soft Closure to the Womb must immediatly be applied five or six double to prevent the cold Air by entring in from sudden stopping the Vessels by which the Woman should cleanse by degrees whereby there would certainly happen many ill accidents as great Pains and Gripes of the Belly Inflammation of the Womb and divers others which we shall mention hereafter particularly and which may easily be the cause of her death When the Womb is so closed if the Woman was not delivered upon her ordinary Bed let her be presently carried into it by some strong body or more if there be need rather than to let her walk thither which Bed must be first ready warmed and prepared as is requisite because of the cleansings but if she were delivered on it which is best and safest to prevent the danger and trouble of carrying her to it then all the soul linnen and other things put there for the receiving the Blood Waters and other Filth which comes away in Labour must be presently removed and she must be placed conveniently in it for her ease and rest which she much wants to recover her of the Pains and Labour she endured during her Travail that is with her Head and Body a little raised for to breath the freer and cleanse the better especially of that Blood which then comes away that so it may not clod which being retained causes very great Pains All this will happen if they have not liberty to come freely by this convenient scituation in which she must put down her Legs and Thighs close together having a small Pillow for her greater ease if she desire it under her Hams upon which they may rest a little being so put to Bed let her lye neither of one side nor the other but just on the middle of her back that so the Womb may repossess its natural and proper place It is an ordinary custom to give the Women assoon as they are delivered two Ounces of Oyl of sweet Almonds drawn without fire and as much Syrup of Maiden-hair mixed together which is as well for to sweeten and temper the inside of the Throat which was heated and hoarse by her continual Cries and holding her Breath to bear down her Throws during her Labour as also to the end that her Stomach and Intestines being lined with it should not be so much afflicted with dolorous Gripes But this Potion goes so much against the Stomachs of some Women that being forced to take it with an aversion and disgust it may do them rather more hurt than any wise comfort them Wherefore let none have it but those that desire it and have no aversion to it I approve rather in this case of a good Broth to be given her assoon as she is a little setled after the great commotion of Labour because it will be both more pleasing and profitable than such a Potion And having thus accommodated her and provided for her Belly Breasts and lower parts after the manner we shall direct in the next Chapter leave her to rest and sleep if she can making no noise the Bed-curtains being close drawn and the Doors and Windows of her Chamber shut that so seeing no light she may the sooner fall asleep If she had endured a hard Labour she must be then ordered as the case requires and as shall be hereafter declared but what we have here directed is only for a natural Labour and where no extraordinary difficulty happens CHAP. II. Of convenient Remedies for the lower parts of the Belly and Breasts of Women newly delivered SInce the lower parts of a Woman are greatly distended by the birth of an Infant it is good to endeavour therefore the prevention of an inflammation there wherefore assoon as the Bed is cleansed from the foul linnen and other impurities of the Labour and that the Woman is therein placed according to the direction of the preceding Chapter let there be outwardly applied all over the bottom of her Belly and Privities the following Anodine Cataplasm made of two Ounces of Oyl of sweet Almonds with two or three new-laid Eggs Yolks and Whites stirring them together in an earthen Pipkin over hot Embers till it comes to the consistence of a Pultiss which being spread upon a Cloth must be applied to those parts indifferently warm having first taken away the Closures which were put to her presently after her Delivery and likewise such clods of Blood as were there left This is a very temperate remedy and fit to appease the Pains which Women ordinarily suffer in those parts because of the violence then endured by the Infants Birth it must lie on five or six Hours and then be renewed a second time if there be occasion afterwards make a Decoction of Barley Linseed and Chervil or with Marsh-mallows and Violet leaves adding to a Pint of it an ounce of Honey of Roses with which being luke warm foment three or four times a day for the first five or six days of Child-bed the bearing-place cleansing it very well from the Blood Clods and other Excrements which are there emptied This Stupe is likewise very good to temper and appease the Pains of those parts Some persons only use to this purpose luke-warm Milk and many Women only Barley-water Great care must be taken at the beginning that no stopping things be given to hinder the cleansings but when ten or twelve days are past and that she hath cleansed very sufficiently Remedies may then be used to fortifie the parts to which purpose a Decoction is very proper made of Provence-Roses Leaves and Roots of Plantane and Smiths water that Iron is quenched in and when she hath sufficiently and fully done Cleansing which is usually after the 18th or 20th day there may be made for those that desire it a very strong astringent Lotion to fortifie and settle those parts which have been much relaxed as well by the great extension they received as by the humours with which they have been so long time soaked This Remedy may be composed with an Ounce and an half of Pomegranate Peel an Ounce of Cypress Nuts half an Ounce of Acorns an Ounce of Terra Sigillata a Handful of Provence-Roses and two drachms of Roch-Allum all which being infused a whole night in five half Pints of strong red Wine or that it may not be too sharp a quantity of Smiths water mixed with that Wine afterwards boil it well to
neglect committed towards her in her tending For this Reason one must not be of the opinion of many Nurse-keepers who will have a new-laid Woman to be well fed as well to restore her lost strength by the tediousness of the Labour and by the quantity of Blood then evacuating for which cause they believe the Woman must be well nourished to make more Blood as also to fill up her Belly which is very much emptied by the Birth of the Child but it is much better to follow in this the counsel which Hippocrates gives us in his Tenth Aphorism of the Second Book where he saies Impura corpora quo plus nutriveris eo magis laeseris The more you nourish impure Bodies the more you hurt them Now it is certain that a Woman newly delivered is of this sort as you may know by the quantity of Cleansings and Superfluities which flow from her Womb at this time when for this reason they must be very regular in their Diet especially the three or four first daies in which time she must be nourished only with good Broaths new laid Eggs and Jellies without using at the beginning more solid Meats but when the great abundance of her Milk is a little past she may with more safety eat a little Broath at her Dinner or a small piece of boil'd Chicken or Mutton as she likes best afterwards if no accident happens they may by degrees nourish her more plentifully provided in the mean time that it be a third part less than she was accustomed to take in her perfect Health and that her Food be of good and easie digestion not suffering her to eat any of those Cakes Tarts or other Pastries which are usually provided at the Childs Baptism As for her Drink let it be Ptysan which is Liquorish Figs and Aniseeds boiled in Water or at least boil'd Water being careful not to give it her too cold she may also provided she be not Feaverish drink a little white Wine well mixed with Water but not till after the first Five or Six days Although I prescribe this Rule in general for all those who are newly brought to Bed yet there are some who must not observe it so exactly as laborious Women who being of a very strong and rebust constitution require a more plentiful feeding to whom notwithstanding if they do not change the quality they must at least retrench the quantity of their ordinary food having alwaies respect to what every person accustom themselves to which the same Hippocrates doth likewise teach us in the 17th Aphorism of the first Book where he saith Animadvertendi sunt quibus semel aut bis quibus copiosior aut parcior aut per partes Cibus est offerendus dandum verò aliquid tempori regioni aerati consuetudini Great care and notice must be taken to whom to give meat once only or twice as also to whom to give more or to whom less or by little and little but some allowance must be made in respect of Time Countrey Age and Custome What we have already said shall suffice for direction in their Meat and Drink The Child-bed Woman must likewise keep her self very quiet in her Bed lying on her Back with her Head a little raised and not turning often from side to side that so the Matrix may be the better setled in its first Scituation she must free her self at that time from all care of business leaving it to the management of some of her Kindred or Friends let her talk as little as may be and that with a low voice and let no ill news be brought to her which may affect her because all these things do cause so great a commotion or perturbation of her Humours that Nature not being able to overcome them cannot make the necessary evacuation of them which hath been the death of many The Citizens Wives have a very ill Custom which they would do very well to refrain that is they cause their Children to be baptized the second or third day after their Labour at which time all their Relations and Friends have a Collation in the Child-bed Room with whom she is obliged to discourse and make answers to the Gossips and all Comers a whole After-noon together with the usual Complements of those Ceremonies enough to distract her and though there is scarce any of the Company which do not drink her Health yet by the noise they make in her Ears she loses it besides all this she is often constrained out of respect to forbear the use of her Bed-pan and other necessaries which are very prejudicial to her and this happens just at the time when she ought to have most rest because about the third day the Milk flowes in greatest quantity to the Breasts this is the reason why ordinarily the next day they have a very great Feaver She ought alwaies to keep her Body open with Clysters taking one once in two daies which not only evacuate the gross Excrements but also by drawing downwards cause her to cleanse the better When she hath observed this Rule a fortnight or three weeks which is very near the time of having cleansed sufficiently that those parts may be throughly cleansed before she goes abroad and begins upon a New score let her take a gentle Purge made of Senna Cassia Syrup of Succory with Rhubarb which is good to purge the Stomach and Bowels of those ill Humours Nature could not evacuate by the Womb as it did the other Superfluities this Purge may be repeated if necessary all which being done and that no indisposition remain she may bath once or twice or to wash and cleanse her Body and afterwards she may govern her self according to her former Custome CHAP. IV. How to drive back the Milk in those Women who are not willing to give suck THere are many Remedies used to this purpose some of which hinder the afflux of humours to the Breast and others dissipate and in part dissolve the Milk therein contained Those which hinder the Humours from plentifully flowing thither are Oile of Roses well mixt with Vinegar with which the Breasts are to be anointed all over or Unguentum Populeum with Ceratum refrigerans Galeni equally mixt and extended upon a piece of Linnen or gray Paper and so applyed to the Breasts Others use Linnen dipt in luke-warm Verjuce in which a little Allom is dissolved that so it may be more Astringent and others lay to them the Lees of Red Wine alone or mixt with Oyl of Roses Those Remedies which dissolve and dissipate the Milk from the Breast is a Cataplasme of the four * Of Linseed Fenugreek Beans and Fitches Branns Honey and Saffron boiled with the Decoction of Chervil or Sage Others apply Honey only and some others rub the Breast alone with Honey and put upon it the Leaves of Red-Cabbadg the great Stalks first being taken away and they a little deadned before the fire this remedy doth very
more easie reduction of it being careful assoon as it is reduced to wipe off the Oile as much as may be to avoid a Relapse But if notwithstanding all this the Womb cannot be put up because it is very much enflamed and tumefied which happens when it hath been a long time so without the use of necessary means during which time it is continually moistened with Urine and other Excrements which contribute very much to its corruption in this case there is great danger that it will gangrene and be afterwards the death of the Woman There have however some Women escaped this accident Pareus recites the History of such an one which Rousset doth also amongst his Caesarean-births but this happens very rarely As to the second part of this Cure which consists in the retention of the Womb in its place and the strengthening of it so reduced it will be done by a convenient scituation Let the Woman for this purpose keep her self in Bed on her back having her Hips a little raised her Legs something crossed and her Thighs joined together to prevent the falling of it out again but the best way is to put up a Pessary into the Neck of the Womb for to keep it firm There are two or three sorts made for this purpose the several Figures of which are at the beginning of this Chapter Some are round and a little longish of the figure of an Egg and of the length and bigness of the Neck of the Womb where it must be left after that it is introduced into it but these are often subject to fall out again and are not so useful and convenient as the other which are made of a piece of Cork that they may be light They ought to be of a thick circular figure like to a small wreath and pierced with a pretty big hole in the middle which serves aswel for the lodging supporting and receiving of the inner orifice of the Womb as for the giving passage to the superfluous humours which are thence evacuated These kind of Pessaries must be covered with white Wax that they may be more smooth and incapable of hurting the Woman that useth them they must be pretty large that they may be the easier kept when they are put up they may also have a small String fastened to them to pull them out at any time to clean But this String is not so very necessary because they may be easily enough taken out with one Finger they may be made some of them exactly round and others something of a square Figure or triangular the corners must be rounded or blunted These sometimes hold better and fall not so easily forth as the round but either the one or the other may be used as shall be thought most fit During the flowing of the Lochia from the Womb nothing els must be used to strengthen but only to keep it so in its natural place for astringent Remedies proper for the prevention of the Relaxation of it will very much prejudice the Woman by stopping of these evacuations and above all it must be observed in this distemper that the Womans Belly be not strait swathed any more than for a stay only in which many Midwives are deceived believing they keep it the better in its place by how much they swath the Belly the straiter for by this strong compression of it they force the Womb yet more down She must use the Bed-pan in Bed lying along if possible when she goes to Stool keeping her hand all the while on the bottom of her Belly to bear it up But when the time of her Purgations is fully over and that she hath cleansed very well astringent Injections may be then used without danger respect must likewise be had to the whole habit of the Body to dry up the humours by an universal course and the Woman must not rise out of her Bed in at least five or six Weeks time that so the Womb and its Ligaments may be restored and fortified in their natural Scituation It happens also sometimes that by the great Throwes the Woman endures at her Labour the Fundament falls quite out in this case if the Child be very forward in the Passage 't will be sufficient before this accident happens to hinder it if possible persuading the Woman not to help her Throwes so strongly but if it be already fallen down they must stay till the Child be born ere it can be put up for before that it will be difficult to do without much bruising the Intestine Assoon then as the Woman is delivered let it be reduced in the same manner as that of the Womb after having fomented bathed and anointed it if necessary forbearing afterwards during her Child-bed the giving of her Clysters because the force she useth in rendring of them will again cause the falling down of the Fundament CHAP. VII Of the bruises and rents of the outward parts of the Womb caused by Labour IT is no wonder that often and especially in first Labours there happens bruises amd rents in the lower parts of a Woman the cause of which is easily known if the bigness of the Childs Head be but considered which must needs make a great distention of those strait parts by passing and coming forth of the Womb which parts being thereby extremely pressed against the hardness of the bones thar surround it are easily bruised and when they are not able to be sufficiently dilated they must necessarily be torn asunder Almost all Women in their first Labours do very much complain when the Child is in the Passage that the Midwives prick and scratch those parts and do believe that the hurts and bruises which are there after Labour do happen because the Midwives handled them too roughly but they are very much mistaken for this comes because the Childs Head in passing makes a violent distention and separation of the four Caruncles and other adjacent parts which are bruised and sometimes rent by it from hence spring the pains of which they then complain as if they were pricked and scratched whereof they are never after sensible in their following Labours because those parts having once given way to an Infant are ever after very easily relaxed and extended and every Travail with less Pain than other These contusions and rents must never be neglected lest they degenerate into malignant Ulcers for the Heat and Moisture of these parts besides the filth which continually flows thence doth easily contribute towards it if convenient Remedies be not timely applyed Wherefore assoon as a Woman is laid if there be only simple Contusions and Excoriations apply the Cataplasme formerly directed to those lower parts to ease pain made of the Yolks and Whites of new-laid Eggs and Oyl of Roses seeth'd a little over warm Embers continually stirring it till it be equally mixt and then spread upon fine Cloth it must be applyed very warm to the bearing-place for five or six hours when
being taken away lay some fine Rags dipt in Oyl of St Johns-wort on each side the bearing-place and renewing them twice or thrice a day foment these parts with Barley Water and Honey of Roses to cleanse them from the Excrements which pass and when the Woman makes Water let them be defended with fine Rags to hinder the Urine from causing smarting and pain by touching them Sometimes the Bruises are so great that the Bearing-place is inflamed and a very considerable Abscess follows which I have met with in which case it must be opened just below the swelling in the most convenient place and after the matter is evacuated a Detersive Injection must be injected into the Cavity with the same Fomentation above-mentioned viz. Barley-water and Oyl of Roses which may be a little heightned with Spirit of Wine if there be any danger of Corruption and afterwards the Ulcer must be dressed according to Art But sometimes it happens by an unlucky and deplorable accident that the Perinaeum is rent so that the Privity and Fundament is all in one if it were so let alone without reunion the Woman afterwards happening to be with Child would indeed be delivered with more ease and without danger of suffering the same again as is usual when healed after such an accident but likewise if it remains in this manner 't is so great an inconvenience that her Ordure comes both waies Wherefore having cleansed the Womb from such Excrements as may be there with red-Wine let it be strongly stitched together with three or four stitches or more according to the length of the separation and taking at each stitch good hold of the flesh that so it may not break out and then dress it with an agglutinative Balm such as is Linimentum Arcei or the like clapping a Plaister on and some linnen above it to prevent as much as may be the falling of the Urine and other Excrements upon it because their acrimony would make it smart and put it to pain and that these parts may close together with more ease let the Woman keep her Thighs close together without the least spreading until the cure be perfected But if afterwards she happen to be with Child she will be obliged to prevent the like mischief to anoint those parts with emollient Oyls and Ointments and when she is in Labour she must forbear helping her Throws too strongly at once but leave Nature to perform it by degrees together with the help of a Midwife well instructed in her Art who being warned by the first disgrace will do her best to avoid a second for usually when these parts have been once rent it is very difficult to prevent the like in the following Travail because the Scar there made doth straighten the parts yet more wherefore it were to be wished for greater security against the like accident that the Woman should have no more Children Now if by neglecting such a rent the Lips of it be cicatriced and that Cure be desired you must with a good pair of Scissers cut off those Scars in the same manner as is done in a Hare-lip and it must afterwards be drest accordingly or as if it newly happened CHAP. VIII Of after-Pains which happen to a Woman new-laid and of their several causes THe most common accident that usually troubles most Women during their lying in is after-Pains We have formerly shewed how they are accustomed to be prevented in giving the Woman immediatly after she is laid two Ounces of Oyl of sweet Almonds drawn without fire with as much Syrup of Maiden-hair but since notwithstanding this Remedy the Woman is much pained in her Belly let us enquire what may be the cause of all these gripes which are usually called without distinction After-pains and are sometimes felt about the Reins Loins and Groins sometimes in the Womb only and sometimes about the Navel and all over the Belly either continually or by fits with some remission in a certain place or sometimes on one side and somtimes on another all which reflections teach exactly their several causes and accordingly the Remedies must be varied The Pains of the Belly for the most part proceed from one only of these four causes or several of them together the first is by Wind contained in the Bowels by which they are easily filled after Labour as well because they have more room to dilate then when the Child was in the Womb by which they were comprest as also because the nourishment and matter contained as well in them as in the Stomach have been so confused and agitated from side to side during the pains of Labour by the frequent Throws which alwaies much compress the Belly that they could not be well digested whence this wind is afterwards generated and consequently the Gripes which the Woman feels running in her Belly from side to side according as the Wind moves more or less and sometimes also towards the Womb because of the compression and commotion which the Bowels make being extremely thereby agitated The Second Cause of these Gripes which torments the Woman as much as the former is that which proceeds from some strange body resting in the Womb after Labour which it endeavors to expel by continual Throws and it is sometimes a false Conception or a piece of the Burthen and very often clodded Blood which cause this torment and never cease til what is so contained in the Womb be come away these Painâ— are very like the same that a Woman endures before she is delivered and are not abated by Clysters as those are that proceed from Wind but on the contrary are rather thereby excited and augmented Thirdly These Pains are often caused by the sudden suppression of the * Childbed cleansing Lochia which abundantly filling the whole substance of the Womb causeth a great distention and by its long stay an inflammation which is communicated by means of the Peritonaeum to all the parts of the lower Belly by eason whereof it swells and is extended and grows extreamly hard which accident continuing very often kills the Woman in a short time after The Fourth and last cause of these Pains is the great extension of the Ligaments of the Womb by reason of a hard Labour here they remain more fixt about the Reins Loins and Groins than any other part because they are the places where these Ligaments are fastened however these Pains do sometimes communicate themselves by continuity to the whole Womb and the rather when it hath been bruised by a violent Labour 'T is commonly held that a Woman is not troubled with these Pains so much of her first Child as of the following but daily experience confirms us that it happens indifferently according as the present and various dispositions contribute to it either more or less there being no certain rule in respect either to first or last Labours All these Pains must be cured according to their several causes and to prevent thoes
curdled or clotted Blood that they have no ill Scent that they be without Acrimony and that they flow in a moderate quantity We say that they must not be fresh but the four first days because they will not be else the true Lochia but a pure flux of Blood which will be very dangerous and that they must lose by degrees this reddish colour to become pale this sign teacheth us that the Vessels which have been opened are by degrees closed again that they be of an equal consistence without curdled or clodded Blood by this means we are assured that there is no mixture of any strange matter and that they are governed and regulated by Nature they must have no Foetor or ill scent and be without Acrimony in this case we know that there is no danger of corruption or inflammation in the Womb they must flow in a moderate quantity that so the superfluous humours may be evacvated for if the Lochia flow in so great an abundance as to cause Fainting or Convulsions the Woman will be in danger of death as Hippocrates in the six and fiftieth Aphorism of his Fifth Book assures us Si Muliebri profluvio convulsio animi defectus superveniunt malo est If saies he Faintings and Convulsions follow the Lochia it is dangerous and he adds in the following Aphorism Menstruis abundantibus Morbi eveniunt subsistentibus accidunt ab utero Morbi If the Courses or Lochia flow too much Diseases follow and if they stop Diseases happen from the Womb. Diseases proceeding from too great abundance of the Lochia are as we have said in the first Aphorism Convulsions and Syncopes or Faintings and if they do not kill the Woman they weaken her very much she grows lean she remains a long time pale her Legs and Thighs swell and afterwards she becomes Hydropick As to the distempers which follow the suppression of the Lochia we will mention them in the next Chapter CHAP. X. Of the suppression of the Lochia and the Accidents which follow thereupon THere is so great a flux of Humours from all parts to the Womb when a Woman is with Child and during the commotion in her Labour that in case there be not afterwards sufficient evacuation of them the Woman is in great danger of very ill Accidents and sometimes of death it self because these humours corrupting by their stay there will certainly cause a great inflammation and this is the reason why the suppression of the Lochia is one of the worst and most dangerous Symptoms which can befall a Woman after Delivery especially if they happen to be totally and suddenly stopt the first three or four days which is the time when they should come down plentifully for then follows an acute Fever great pains in the Head pains in the Breast Reins and Loins suffocation of the Mother and an Inflammation which is suddenly communicated all over the lower Belly which becomes very much swelled and blown up there happens also a great difficulty of Breathing Choakings Palpitations of the Heart Syncopes and Faintness Convulsions and often Death if the suppression continue or if the Woman escapes it she is in danger of an Abscess in the Womb yea and afterwards a Cancer or there may happen great Imposthumes in the lower Belly which is usual because of the nearness of the place as also Gouts Sciaticas and Lameness or Inflammation or Abscess in the Breast if the Humours be carried towards those parts The Câ—uses of the stoppage of the Lochia proceed either from a great Loofness because a great Evacuation that way turns the Lochia and makes them stop or any strong Passions of the Mind as great Fear or Grief or any Anger or Soundings for these things do cause the humours to retire suddenly inwards and by this quick motion they often cause Suffocations Great Cold stops the Lochia because it closes the Vessels and Pores of the Womb the use of astringent Remedies produces the same effect as also cold Drink because by condensing and thickning the humours they hinder their easie flowing strong and frequent agitations of the Body by rarifying and dispersing them throughout every part doth likewise not permit them to be evacuated by the Womb. To bring the Lochia well down let the Woman avoid all perturbations of spirit which may stop them let her lye in Bed with her Head and Breast a little raised keeping her self very quiet that so the Humours may be the easier carried downwards by their natural tendency let her observe a a good Diet somewhat hot and moist let her rather use boiled Meats than roast and if she be any thing feaverish let her use Broaths only with a little Jelly let her avoid all binding things let her Ptysan be made with Aperitives such as are the Roots of Succory Dogs-grass and Asparagus with a little Aniseed and Hops and every other time let her take a little Syrup of Maiden-hair in a glass of this Ptysan and above all let her carefully shun cold Drink Clysters may likewise be given her to draw the Humours downwards and her lower parts may be fomented with an emollient and aperitive Decoction made with Mallows Marshmallows Pellitory of the wall Camomil Melilot the roots of Asparagus and Linseed with which Decoction the Womb may likewise be injected and with the Herbs being well boiled and strained through a very course Cloth let a Cataplasme be made with the addition of Oyl of Lillies or Hogs-grease and applyed very hot to the lower Belly together with these let her Thighs and Legs be strongly rub'd downwards bathing them very hot with the same Emollient Decoction there may be likewise applyed large Cupping-glasses to the uppermost part of the inside of her Thighs It would not be much amiss to use an Aromatick Perfume if it were not that it caused a heaviness of the Head as Hippocrates notes in the 28th Aphorism of the Fifth Book where he saith Sufficus Aromatum muliebria educit saepius verò ad alia utilis esset nisi Caepitis induceret gravitatem Now whilst all these things are put in practice bleeding in the Foot or Arm must not be forgot according as the accidents caused by this suppression of the Lochia require neither must we blindly follow the opinion of many Women who believe that bleeding in the Arm in this case is very pernicious This Imagination is so firmly rooted in the heads of almost all of them that if in case a Child-bed Woman happens to dye after bleeding in the Arm they sail not absolutely to condemn that as the cause But this their opinion is not according to knowledg for sometimes Bleeding in the Arm is better than in the Foot and at other times that in the Foot is more certain than bleeding in the Arm As for example suppose a Woman be very full of Humours throughout the whole habit of her Body and her Lochia be supprest by reason of which there happens an Inflammation
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
will alwaies be separated in the very same place just close to the Belly because it is a part which remains wholly * Without life inanimate after the Child is come into the World wherefore whether Boies or Girles let the Knot be made at least an inch from the Belly as we have already directed and not nearer lest it pain or inflame the Childs Navel It will not be from the purpose to mention here a business of great consequence which is sometimes capable to kill the new-born Babe without almost knowing the cause of it 't is a very bad custome some Midwives have before they make the Knot they drive all the blood out of the String into the Infants Belly believing that by this means they fetch it to it self and strengthen it when it is weak but 't is no such matter for assoon as these Vessels are never so little cooled the blood it contains quickly loses its spirits and is half coagulated in an instant which is the reason that being driven back into the Infants Liver it is enough to cause very great Accidents not because of its abundance but because having quite lost its natural heat it is afterwards soon corrupted and changeth and spoileth the Childs Blood with which it comes to mix They commonly put this ill custome in practice when the Child is weak but this doth sooner suffocate them for if they need Blood to give them vigour it must be good and laudable and not that which is half clodded and destitute of its natural heat Wherefore whether the Child be strong or weak if you will not put it in danger of its life or at least cause to him great oppressions pains and gripes forbear driving his blood thus out of the String into the Infants body Now having thus tyed and cut the String wash the Child presently all over for to swaddle it afterwards as we shall direct CHAP. XVII Hôw a new-born Babe must be washed and cleansed from the Excrements as also how it ought to be wrapped up in swadling Cloaths WHen the Midwife hath ordered the Childs Navel-string just as we have directed in the foregoing Chapter let her presently cleanse it from the Excrements it brings with it into the world of which some are within the body as the Urine in the Bladder and the Moeconion found in the Guts and others without which are thick whitish and viscous proceeding from the slimyness of the Waters there are Children sometimes so covered all over with this that one would say they were rubbed over with soft Cheese and certain Women of easie belief do really imagine it was because they had often eaten some while they were with Child that their Infants are thus full of this thick white Excrement which in colour and consistence is not unlike white Cheese Let the Child then be cleansed from all these Excrements with Wine and Water a little warmed and every part of his body where this Excrement is as principally the Head because of the Hair and the folds of the Groins and Arm-pits and the Cods which parts must be gently cleansed with a soft Rag or a soft Spung dipt in this luke-warm Wine If this viscous Excrement stick so close that it will not easily be wash'd off of these places it may be fetcht off with Oile of sweet Almonds or a little fresh Butter melted with the Wine and afterwards well dried off one must also cleanse and unstop with tents of fine Rags wet in this liquour the Ears and Nostrils for the Eyes they may be wiped with a soft dry rag not dipt in this Wine that it may not pain them and make them smart After the Child is thus washed and cleansed from these Impurities and Blood which comes away in the Labour with which sometimes its whole Body is besmeared all the parts of it must be visited to see if there be any fault or dislocation whether the Nose be straight or its Tongue tyed whether there be no bruise or tumor of the Head or whether the Mould be not overshotten or whether the Scrotum in case it be a Male be not blown up and swelled in short whether it suffered any violence in any part of its Body and whether they be well and duely shaped that so Remedies may be used according to the nature of the indisposition discovered But as it is not sufficient to cleanse the outside of the Childs body you must above all observe that it must discharge the Excrements retained within wherefore examine whether the Conduits of the Urine and Stool be opened for some have been born without having them perforated who have died for want of voiding their Excrements because timely care was not taken of it as to the Urine all Children as well Males as Females do render it assoon as they are born especially when they feel the heat of the fire and sometimes also the Maeconion of the Guts but nevertheless usually a little after If the Infant doth not render it the first day that it may not remain too long in his Belly and cause very painful Gripes put up into his fundament a small Suppository to stir it up to be discharged to this purpose a sugar'd Almond may be used anointed over with a little boiled Honey or else a small piece of Castile-soap rubb'd over with fresh Butter you may also give the Child to this purpose at the Mouth a little Syrup of Roses or Violets mixt with some Oyl of Sweet Almonds drawn without fire anointing the Belly also with the same Oyl or a little fresh Butter It may be known when the Child hath voided all its Maeconion if the Stools change from black and become pale which is about the second or third day losing by degrees this tincture in proportion to the generation of new Excrements from the Milk which about this time mixes with the first As to the Maeconion which is an Excrement in colour and consistence like to the Pulp of Cassia found in the Childs Guts when it comes into the World 't will be enough to the purpose to examine what it is and from whence it proceeds wherefore without dwelling upon the different explications of Authors touching its generation I will ingeniously give my thoughts of it which is that it comes from the superfluous Blood daily discharged as it doth in all persons and of all ages by means of the Hepatick channel which coming from the hollow of the Liver goeth and emptyeth into the Intestine Duodenum out of which is formed the Moeconion which afterwards serves to keep the Intestines of the Foelus open and dilated that so they may the better perform their office after its birth and to make it appear that it is truely thus made and that the superfluous Blood is continually discharged by the Hepatick channel into the Duodenum as I do say there are some people of Fourscore years of age that were never let Blood nor never lost any outwardly who nevertheless
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
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
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
much more credible that the cause of the small Pox is the corruption of a contagious Air which doth principally infect and spoil the blood of Infants and Youth who are more disposed to it than they that are further advanced in years because of the tenderness and softness of their Bodies and more at certain years and some seasons than at others as it may easily be perceived every day for in pestilential times the small Pox is much more common in the Spring and Summer than at the end of Autumn or in Winter The small Pox doth differ from the Meazels though they are so like in the beginning that often it is difficult to distinguish them one from the other 'till after the second or third day when the small Pox which at first appeared like the Meazels begins to rise into Pustules and to whiten The Meazels are caused of a Blood bilious and over-heated which only makes red spots throughout the Skin without or with but very little elevation which comes soonest and principally on the Face but the small Pox proceeds from a sanguine and pituitous matter which being more thick and viscous produceth many Pustules rising high and by degrees growing white and ripening after which their matter drying away they are converted into Scabs Of the Signs of the small Pox some precede and others accompany them they that precede are a Fever Sottishness Dizziness and Pain in the Head very troubled Urine weariness and pains in the Reins and Loins reachings and vomitings difficulty of breathing frequent Yawnings Sneezing itching of the Nose redness of the Eyes and universal weariness all over the Body but when the small Pox begins to come forth there appears about the third or fourth day many Pimples rising every where which grow and augment as well in bigness as number 'till the eighth or ninth day during which time they ripen and whiten by degrees the Head and Face swells the Eyes are closed by a great flux of humours thither the Nose is stopped with excrements which there dry the Patient is troubled with a hoarse Voice a dry Cough sore Throat and great difficulty to breath and then all the parts of the Body are so swelled through the abundance of Pimples that it appears blown up and monstrous There may be two kinds of small Pox according as it is more or less malignant the first is that which is accompanied with but a simple emotion of a Fever only stirred up by an ebullition of Blood and Humours soon ceasing from the beginning without any evil accident which ripens suppurates and is easily and speedily cured the Pustules of these do rise full and the matter is white smooth and well concocted and the Infants easily escape it if they are but well tended But the other sort of small Pox totally malignant is that which is caused from some contagious and pestilential humour where the Pustules are flat brown obscure or livid having small black spots in their middle they come forth but slowly and no Suppuration follows or 't is very bad sanious watry and accompanied with pernitious accidents as a malignant Feaver Phrenzy great difficulty of Breathing Faintness Dysenterie and others which often are mortal or at least malignant Ulcers foulness of the bone loss of sight disfigurement and great deformity of the Face or lameness of some member according to the places where these vitious humours are conveyed and retained These havocks are caused by that which all Women call usually the Master-pock which is nothing else but many Pimples by their neerness and bigness joining together and mixing their matter which being thus in great quantity amassed into one place gnawes and corrodes the part deeper than if they were spread and disperst in many distinct Pustules for which cause its cavity remains much more hollow and deformed by reason of the great loss of substance there usually made and depositing or transporting this villanous matter upon the Bones or other parts it foules them or causes their other accidents as we have recited The Prognostick is drawn from the different nature which we have now explicated for if the Fever be small and that it ceases proportionably to the coming forth of the Pimples if they be not in too great quantity and that they ripen and whiten speedily it is a good sign but if the Feaver be violent in the beginning and augments every day with difficulty of Breathing and other accidents according as the Pimples come forth if they are in great number black flat dry and without Suppuration it is a sign of death besides Infants are not in so great danger as elder persons in as much as this Disease is more agreeable to their Age and Nature and that they also have a thinner and softer Skin through which this matter is easier expelled than through theirs that is harder and whose Pores are less open As to the Meazels they are never so dangerous as the small Pox because its matter being more subtile is much easier and sooner evaporated which usually terminates in three or four daies at the end of which sometimes follows the small Pox which often makes some as we have said take them one for another in the beginning at which time they appear almost the same The Cure of the small Pox particularly consists in the force and vertue of nature that endeavours to expel these malignant humours wherefore it must be assisted to overcome them as much as may be and fortified that it may be able to finish the work it hath undertaken being very careful not to divert it from its operation by an untimely bleeding or a Medicine unseasonably given To remedie this Malady keep the Child to a good diet avoiding solid meats all the time giving it only Spoon-meats as Broaths made with Veale and Fowl or a little of a good Jelly let his drink be Ptysan made with cleansed French-Barly the roots of Dogs-grass and Liquorice and a few Raisons of the Sun If it be a sucking Infant he must have no Pap 'till he be perfectly cured and since then by reason of his age he cannot receive Remedies often enough nor other food at the Mouth than Nurses milk let her observe a good Diet her self to refresh and temper her Milk as much as may be let her not carry the Child into the Aire but keep it in a close Room neither too hot nor cold for too hot Air weakens it extreamly by greatly resolving and dissipating the spirits and a too cold Air drives the Humours back into the Body and hinders the coming forth of the small Pox. Some advise it to be kept in a Bed hung round with Red Curtains because this Colour doth ordinarily move the Humours from the Centre outwards but this often hurts the Eyes and inflames them by its vivacity to which also in this disease there happens a great flux wherefore I believe a softer Colour what ever it be ought to be preferred but custome