Veins of the Arm do upwards when bound with a Ligature for bleeding or by any strong compression upon the upper parts which happens because the Veins being compressed the Blood is there stopt finding its passage more difficult The Iliack Veins being then so pressed by the bigness and heaviness of the Womb all those of the Legs and Thighes swell in such a manner as that they empty themselves into the substance of the parts and throughout the five Coverings which thence become swelled yea and these Veins and amongst the rest the Saphenes dilated and become varicose sometimes from the inward and upper parts of the Thigh to the very extremity of the Foot in which the Blood stagnating without its free circulation is altered and corrupted which causeth great pains and swellings in all these parts This oftner befalls Women that are very sanguine walk much and use great exercise which aided with a fulness of the Vein makes a rupture of the Valvules which serve to facilitate the motion of the Blood as the suckers of a Pump which retain the water when it is raised thither which Blood falling down again not being so supported causeth by its quantity and stay these dilatations of the Veins which are called Varices For to remedy this when a Woman hath her Veins dilated let her only use whilst she is with Child a palliative cure in swaithing this Varicos-part with a swaith three or four fingers broad according to the bigness of it beginning to swaith from the bottom and conducting it upwards to the beginning of the Varices that by this means these varicos Veins which are alwayes outward being moderately closed should be hindred by this compression from further dilating and the Blood not be corrupted by the stay it makes there which after this will not want its circular motion because the greatest part of it passeth then by the Vessels deeper placed A Woman in this condition should likewise keep her bed if she can because by this scituation her body being equally layed the Blood circulates much the easier and is not then so much troubled to return by these Veins to the Heart as when it must ascend by them the Woman standing upright which is the cause the Legs alwayes are more swell'd at night than mornings if there be in any other parts of the Body signs of plenitude and abundance of Blood they may bleed her without danger There are other Women whose Legs only swell because of their weakness and not for the reason just above mentioned and are so oedematous that when you press them with your Finger the print of it remains there which is because they want natural heat sufficient to concoct and digest all the nourishment sent to them and to expell the superfluities of it which by that means remaining there in great quantity leaves them so oedematous For to resolve these sort of Tumours you may use a Lee made with the Ashes of Vines and the Decoction of Melilot Camomile and Lavender afterwards they may be somented with Aromatick Wine in which they may moisten their compresses to be laid upon them repeating them three or four times a day to fortifie them which may be made with Rosemary Bayes Tyme Marjoram Sage and Lavender of each an handful of Province-Roses half a handful Pomegranat flowers and Alum each an ounce boil them together in strong Red-Wine three pints to the consumption of a third part strain it and keep it for the use above mentioned But since Pregnancy for the most part causeth these tumours they likewise ordinarily cease when the Woman is brought to bed because then she purgeth forth the superfluity of her whole habit by means of her Lochia CHAP. XVII Of the Hemorrhoids THe menstrous Blood that used to be purged away every month being collected in a great quantity near the Womb which permits it not now to be evacuated by the usual passage being so exactly closed during Pregnancy is forced to flow back into the whole habit and chiefly upon the neighbouring parts of the Womb and causeth in many the Hemorrhoids both internal and external All the several sorts of them which we shall not describe may as well happen to them at this time as at another but we will only speak of that sort which is caused by pregnancy because our design is only to make known some particulars of the maladies Women are in this condition subject to Hemorrhoids are tumours and painful inflammations ingendred by a flux of humours upon the extremities of the Hemorrhoid Veins and Arteries and are caused in great-bellied Women by the abundance of Blood which is cast upon these parts because the body at this time is not purged of its superfluities as it was accustomed before It is likewise very often caused by the great endeavours that Women sometimes make to go to stool when they are costive because the Womb being placed upon the Rectum hinders by pressing it the excrements contained in it from being easily extruded and by these endeavours the Blood which is in the neighbouring Vessels being likewise expressed swells and blows up their extremities upon which comes these painful inflamations call'd Hemorrhoids of which some are internal some external some small and with little or no pain and some extreamly big and painful This may suffice for their general differences without coming to their particulars which would require a more ample explication If they are small and without pain either internal or external it is easie enough to prevent their further growth by Remedies which hinder and turn the flux from those parts but there is more reason to cure the great and painful ones by easing first the great pain for as long as that continues the Flux is ever augmented To this purpose if the big-bellied Woman have in the rest of her body other signs of repletion she may safely be once let blood in the Arm and sometimes if there be great necessity twice for to turn away the humours and to evacuate the fulness by which the pain will likewise be appeased If the gross excrements retained in the right Gut be the cause of it and that she be costive let her take an emollient Clyster of the Decoction of Mallows Marshmallows Pellitory and Violets with Hony of Violets to which may be added Oyl of sweet Almonds or sweet Butter being careful to add nothing that may irritate lest it augment the Disease especially when they are inward Piles And to the end the Women may then the better receive the Clyster t is fit that a small end of a Pullets gut be put upon the end of the pipe to cover it on the outside that so it may be put up the Fundament with less pain afterwards let her keep a moderate and cooling diet and continue in bed till this flux of humours be passed and the mean time anoint the Piles with hot stroakings from the Cow or foment them with the Decoction of Marsh-mallows White-broth
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
in her Womb and besides a great Fever and difficulty of Breathing as it ordinarily arrives in these Cases 'T is most certain that if she were immediatly blooded in the Foot being very Plethorick as we have supposed there would be so great abundance of Humours drawn down into the Womb that the Inflammation would be thereby much augmented and consequently all the Accidents of the Distemper but 't would be much better in this case rather to alter the Habit first by bleeding in the Arm and afterwards the most pressing Accident being partly diminished it will be very much to the purpose to bleed in the Foot for by this means Nature which was almost overcome under the burthen of these redundant humours being eased of some part of them doth the more easily command and govern the rest but on the other side if there be a stoppage without the appearance of a great plenitude in the Body and without any notable accident Bleeding in the Foot if it be desired may be then presently put in practice However I think it most convenient that it should * Not ncessary except for reasons abovementioned alwaies be preceded with bleeding in one of the Arms. CHAP. XI Of the Inflammation which happens to the Womb after Delivery VEry often the stopping of the Lochia of which we have lately discoursed and especially at the beginning of Child-bed doth cause an inflammation to the Womb which is a very dangerous Disease and the death of most of the Women to whom it happens It is also very often caused from some hurt or bruise of the Womb by any Blow or Fall and especially for having been too rudely handled in a bad and violent Labour or by the falling out of the Womb after Labour or else because of some false Conception or other strange Body remaining behind in it which corrupts there and likewise because it might have been too much compressed in the beginning of the Labour by the great Swathes and Napkins wherewith the Midwives and Nurs-keepers usually swathe the Belly of a new-laid Woman to keep it as they say in its place which happens also very often when the Blood being stirred and over-heated by the agitation of a rude Travail is carried thither in too great abundance and there stays without evacuation An Inflammation of the Womb may be known by being much more swelled after Labour than is requisite and when the Woman feels very great heaviness in the bottom of her Belly and that it is swelled and blown up almost as big as before Delivery if she have a difficulty in making Water and going to Stool or that she perceives her pain augment when she is voiding her Excrements because the Womb presses the right Gut upon which it is placed and to which by its proximity it communicates the Inflammation as well as to the Bladder she hath then also besides a great Fever with a very great difficulty of Breathing a Hiccough Vomiting Convulsions and in the end Death if the Disease be not soon cured A Woman that hath received a bruise or any violent compression of the Womb is in great danger that after the Inflammation if she do no die of it an Abscess will be there made or that there will remain some Scirrhous Tumour and it may be an incurable Cancer which will make her lead a miserable and languishing life the rest of her daies Wherefore assoon as an Inflammation is perceived the Cure of it must be endeavoured by tempering the heat of the humours and turning and emptying the superfluities of them assoon as may be first extracting or procuring the expulsion of such strange things as may remain in the Womb after Labour according to the directions given in its proper place and above all treating her at this time with very great tenderness using not the least violence for fear the evil may be thereby augmented The Humours may be tempered by a cooling Diet using food that nourishes little wherefore let her be contented with only Broath for her nourishment made of Veal or Pullet but not too strong of the Flesh together with cooling Herbs such as Lettice Purslane Succory Borrage Sorrel and the like let her abstain from Wine and drink Ptysan made of the roots of Succory and Dogs-grass Barley and Liquorish let her keep her self very quiet in her bed let her not be swathed too strait and let her body be kept open with simple Anodine Clysters because if there be any Acrimony in the humours they will cause Throwes which extreamly pains the inflamed Womb and amongst all the passions of her mind let her especially avoid Anger The redundancy of Humours may be evacuated and diverted by Bleeding which at first must be in the Arm and not in the Foot for the reasons given in the foregoing Chapter reiterating it without loss of much time for the accident is very pressing until that the greatest part of the plenitude be a little evacuated and the Inflammation something diminished and then bleeding in the Foot will not be amiss if the case require it It may be convenient to anoint the Belly with Vnguentum refrigerans Galeni or Oyl of Roses or Oyl of sweet Almonds mixt with a little Vinegar Injections may likewise be given into the Womb provided they be not Restringent lest making a greater stoppage of the Lochia which alwaies flow a little in this case the distemper be not augmented for which reason let temperate Medicines be only used without any manner of astriction as Barley water with Oyle of Violets or luke-warm Milk Sometimes an Inflammation of the Womb converts into an Aposthume which yeilds a great quantity of matter there is then much danger of corruption in that part as well by reason of its Heat and Moisture which are the principals of it ' as because no proper Remedies can be applied or easily kept to it since therefore nothing else can be done we must be contented with an universal Regimen and Detersive Injections to cleanse off the matter that so the corruption be not augmented by its long stay there which may be effected by a Decoction of Barley and Agrimony mixt with Oyle of Roses and Syrup of Wormwood and heightned with some Spirit of Wine if there be a great putrifaction But if the Imposthume turnes to an ulcerous Cancer then notwithstanding the use of any Remedies whatsoever this mischeivous disease will endure 'till death wherefore we must be contented with Palliative Medicines a good Diet and in this follow the precept of Hippocrates in the 38th Aphorisme of his Eighth Book Quibus occulti Cancri fiunt non curare melius curati enim citius intereunt non curati vero longius vitam trahunt It is better saies he not to take an occult and hidden Cancer in hand for it hastens the death of the Patient and they which let it alone live longest Now he means by an occult Cancer that which breeds within the Body and especially that
proceed from the evil temper of the Womb in his 62 Aphorism of the 5th Book where he saith Quae frigidos densos habent uteros non concipiunt quae praehumidos habent uteros non concipiunt extinguitur enim in ipsis genitura Et quae plus aequo siccos adurentes Nam alimenti defectu semen corrumpitur Quae vero ex utrisque nactae sunt moderatam temperiem eae faecundae evadunt All such Women whose Womb is cold and close cannot conceive nor they who have it too moist because the Seed is extinguished in it And likewise such who have it too dry and hot because for want of aliment the Seed corrupts but such as are of a moderate temperament are fruitful Of all these which Hippocrates recites in this Aphorism the most common according to my opinion is the continual Humidity of the Womb fed by an abundance of the Whites with which many are very much inconvenienced the humours of the whole Body being accustomed to steer their course this way which can very hardly be turned away when inveterate and the Womb being imbued with these vicious moistures becomes inwardly so unctuous and slippery that the Seed though viscous and glutinous cannot cleave to it nor be retained within it which is the cause that it slips immediatly away or in some short time after it is received Barrenness may also proceed from the whole habit of the Body as when a Woman is too old or too young for the Seed of the young is not yet prolifick neither have they the menstruous blood which two things are requisit to fruitfulness and that of the aged is in too small a quantity and too cold who likewise want the menstruous blood An universal intemperature though the Woman be of convenient years renders them however barren as it happens when they are hectick hydropick feaverish and sickly and especially so much the more as the noble parts are fallen from their temperament and natural constitution There are however many Women which seem barren for a long time because of some of the fore-mentioned Reasons yea till they are thirty five or forty years old and sometimes longer who yet at last conceive being cured of the indispositions which hindred them and having changed their temperament by their age of which we have had a remarkable example in the person of Queen-mother lately deceased who was above two and twenty years married and without Children and yet afterwards to the great joy and content of all France she had our invincible Monarch Lewis the 14th now reigning to whom God grant a long and happy life Some of these Barrennesses may sometimes be cured by removing their causes and procuring the dispositions we have said are necessary to fruitfulness yea of those which proceed from an universal intemperament by reducing the Body with a good and convenient regimen to a good order and this according to their respective indispositions Wherefore if a Woman have naturally the Vagina too narrow and not from some of the causes above-mentioned she ought to be joyned to a Man whose Member is proportionable if possible and if that will not do which happens very seldom she must endeavour to relax it and dilate it with emolient Oyls and Oyntments if the neck of the Womb be compressed by any humour it must be resolved and suppurated according to its nature and scituation having alwayes care to prevent the corruption of these parts which being hot and moist are very subject to it because the womb serves as a sink by which all the ill humours of the body are purged so that you must take great care that these kind of Tumours turn not to a Cancer which is a very mischievous malady and causeth the poor Women miserably to languish which are afflicted with it and which after many insupportable pains brings them almost alwayes to an inevitable death When the Vagina is not clear in its capacity because of any scar after a rent caused by some force or violence to the Woman or of some hard labour or after an ulcer which caused the two sides to be agglutinated whether inwardly or outwardly it must be separated the best that may be with a * A kind of large Incision-knife Bistory or some other Instrument according as the case requires hindring by interposed Linnen that it do not again agglutinate When a Woman hath no Vulva or outward entry of the Womb pierced which is very rare it must be opened by making a long Incision Fabricius recites the like case in a Girl of thirteen years of age who was like to die of it because her Terms could not come down there being no perforation wherefore he did the like operation which succeeded very well and made her by that means capable of generation As to the inward orifice of the Womb if it be displaced either towards the back or sides it may be in some sort remedied by making the Woman to observe in the act of generation a convenient posture that the Man's Seed may be ejaculated towards the orifice and if the Whites or other Impurities of the Womb cause barrenness as it is for the most part by the discharge of the whole habit on this place it must be helped by Evacuations Purgations and a regular Diet according to their different causes and qualities of these ill humours Having thus discovered the most certain signs of Fertility and the marks of Sterility I will now the better to pursue the order I have proposed treat of Conception CHAP. II. Of Conception and the conditions necessary for it IT is most certain according to the Rule of Nature that a Woman is incapable of conceiving if she have not the conditions requisit for fruitfulness we have mentioned them in the foregoing chapter let us now examine in this what is Conception and how it is caused Conception is nothing else but an action of the Womb by which the prolifick seeds of the Man and Woman are there received and retained that an infant may be engendred and formed out of it There are two sorts of Conceptions the one true according to Nature to which succeeds the generation of the Infant in the Womb the other false which we may say is wholly against Nature and there the seeds change into water false-conceptions moles or any other strange matter The qualifications requisit for a Woman to conceive according to Nature are that the Woman receive and retain in her Womb the Mans and her own prolifick seed without which it cannot come to pass for it is necessary that both seeds should be there nor is it at all true what Aristotle and some other of his followers affirm that the Woman neither hath nor can yeeld any seed a great absurdity to believe for the contrary may easily be discovered by seeing the Spermatick Vessels and Testicles of a fruitful Woman appointed for this use which are wholly filled with this seed which in coition
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
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
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
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
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
it hardly differs either in colour consistence or quality from that which remains in the vessels except in the small alteration which is caused by the heat of the place whence it proceeds and by the mixture of some humours with which the womb is alwayes plentifully furnisht This evacuation if in order ought to be every month but once though some have them every fourtnight or at the end of three weeks according as they are more or less sanguine or cholerick or have their blood heated and to continue two or three days together or six at most and that by little and little constant without interruption and also more or less according to the difference of their particular temperaments If a Woman have few of them as when she grows in years she becomes barren forasmuch as this blood seems to nourish the Child in the Womb and likewise if she have too many because the Woman thereby grows too weak and the Womb too cold There are notwithstanding some Women who void more of them in two days than others in eight They must flow by little and little without interruption and not all at once for great and sudden evacuations cause great dissipation of spirits of which abundance are necessary for generation and the interruption of these evacuations shews some impediment in nature or some vice or evil disposition of the Womb. If all these signs concur we may very probably judge the Woman fruitful I say probably because there are many who have them all and yet cannot conceive though they do their endeavours and observe thereto all the requisite and necessary circumstances which we shall hereafter mention There are likewise others who notwithstanding they have not all these conditions are fruitful Now if all the above named patticulars are found in a Woman that is barren and that you desire to inquire more narrowly and to be informed more certainly whether she be capable of conception Hippocrates teacheth a way to know it to which I give little credit because the reasons of it are very obscure It is in his 59 Aphorism of his 5th Book where he saith Si mulier non concipiat scire placet an sit conceptura vestibus undique obvolutam subter suffito ac si odor corpus pervadere videatur ad nares os usque non sua culpa sterilem esse scito If a Woman doth not conceive and you are desirous to know whether she is capable or no wrap her close round with clothes and put a perfume under her and if she perceive the sent to pass through her body to her nose and mouth be assured saith he it is not her fault she is barren Fertility was anciently so esteemed by our fore-fathers that they believed Barrenness to be a mark of reprobation by reason of which the fruitfull Servant despised her barren Mistress as we reade in the 16th Chapter of Genesis where mention is made of Sarai Abraham's Wife who seeing that she could have no Children and being past the age of hoping for any and that her Husband was displeased at it bid him take her Aegyptian Chamber-maid named Agar to lie with him that by her means the might give him lineage which good Father Abraham quickly did and had by her afterwards a Son which was called Ishmael but from the time this Maid had conceived she began to despise her Mistress Sarai who was as yet barren The Women of our times are not so earnest to have lineage after this fashion there being but few that will suffer their Husbands to caress their Chamber-maids much less * Lovingly charitably to excite them to follow this example which custom is abolished amongst us I also admire the great passion which many have who complain of nothing with greater regret than to the without Children especially without Sons For my part I believe they that descend from Caesar or the Family of Bourbons may with some reason be led away with this superstitious and common inclination of preserving their kind and be vexed with these sorts of inquietudes which no wayes become ordinary people though excusable and may be permitted to great Monarchs and illustrious men When we perfectly understand the natural dispositions we may the easier discern those contrary to nature wherefore the signs of fruitfulness easily teach us those of barrenness The signs and causes of barrenness proceed either from the age or evil temperature and vicious conformation of the Womb and parts depending on it or the indisposition and intemperature of the whole habit The evil conformation of the Womb renders Women barren when its neck called the Vagina is so narrow that it cannot give way to penetration and when it is wholly or in part closed by some external or internal membrane which is very rare if at all or by any tumour callosity or cicatrice which may hinder the Woman from the free use of copulation But it is not sufficient that the Man's Yard enter the Vagina which is the anti-chamber to the Womb for if in the act of copulation he knocks at the door which is the internal orifice and it be not opened all is to no purpose This orifice is likewise hindred from opening by some callosity proceeding from abundance of ill humours which usually slow down from the Matrix or by some tumour which may happen to it or also by some part which may so compress it that it cannot dilate to receive the Seed as doth the Epiploon or cawl in fat Women according to the opinion of Hippocrates in his 46th Aphorism of his 5th Book where he saith Quae praeier naturam crassae non concipiunt iis os uteri ab omento comprimitur priusquam extenuentur non concipiunt Women exceeding fat do not conceive because the Cawl compresseth the orifice of their Womb neither can they till they grow lean I do not willingly admit amongst the causes of barrenness this compression of the inward orifice by the Epiploon forasmuch as Aritin hath very well remedied it by some of the postures invented by him by which this orifice need not be so compressed in the action The most frequent reason why this orifice opens not in this act to receive the Man's Seed is the insensibility of some Women who take no pleasure in the venerial act but when they have an appetite the Womb desirous and covetous of the Seed at that instant opens it self to receive it and be delighted with it But though the Vagina or neck of the Womb and the inward orifice opens to give passage to the Seed yet may they very often continue barren if the scituation of this orifice be not rightly placed but either backwards towards the * Great or right Gut Intestin rectum or towards either side all which hinders the Man from †shooting darting his Seed directly into it and consequently the Woman from conceiving Hippocrates seems to have noted all the signs and causes of barrenness which usually
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
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
who not that is when they are near their time and by this means may likewise know when 't is necessary to forward Labour or retard it as much as ought to be when Women are not yet gone their full time As to what respects the several terms to which a Woman may go with Child there is a great controversie amongst Authors but all agree that the most ordinary terms are either the seventh or the ninth month which is known and also approved by all Hippocrates is of an opinion that the Child born in the eight month cannot live because he cannot support two such puissant endeavours so near one to another having already endeavoured to be born the seventh month which is as he saith the first legitimate term of Labour and failing then if reiterating the same endeavours the eighth month he be born he is thereby so weakned that he seldom lives as he often doth when born by the first endeavours in the seventh month his strength not being before exhausted by vain attempts This seems very likely to many but if they that practise Deliveries make a true reflection on it they will find that it is the Matrix alone assisted with the compression of the muscles of the lower Belly and Diaphragma which cause the expulsion of the Child being stirred up by it's weight and not able to be further extended to contain it and not as is ordinarily believed that the Infant being no longer able to stay there for want of the nourishment and refreshment useth his pretended indeavours to come forth thence and to that purpose kicking strongly he breaks with his feet the membranes which contain the waters inasmuch as when the Child is naturally born the membranes are alwayes rent before the head which pressing and thrusting each throw the waters before it causeth them to burst out with force The same Hippocrates likewise admits the tenth month as also the beginning of the eleventh at which time he saith the Children live but he will by no means that Children can live if born before the seventh forasmuch as they are then too feeble and not capable to support the external injuries as indeed we see and find it every day I do boldly affirm and it is also very true that the ordinary term of going with Child is nine whol months but I cannot consent that Children born in the seventh month do oftner live than those of the eighth but much to the contrary I believe that the nearer they approach to the natural term of nine months the stronger they are and therefore that Children born in the eighth month rather live than those of the seventh which is wholly contrary to the opinion of many persons who blindly follow in this the sense of Hippocrates and all Authors without making any reflection upon the thing for to disabuse themselves of this vulgar belief founded upon the pretended vain endeavours which they say are made by the Infant in the seventh month for as we see not only in the same Country and Field but also on the same Vine-Grapes sometimes six weeks ripe before their ordinary season and others not till above a month after which happens according to the Territories the different regards of the Sun and according as the Vine is cultivated So likewise we see Women brought to bed of their Children six weeks and two months before and sometimes as long after their ordinary tearm If it be not that the Womb not being capable of an extention beyond a certain degree cannot bear its burden but a little while aftet the reckoning is out although there have been Women as Hippocrates acknowledgeth who have gone ten or eleven whole months with Child which notwithstanding is so much the more rare by how much it exceeds its limits These things happen also to Women according to the different dispositions either of their whole body or of their Womb alone or as well according to their rule of living and the greater or lesser exercise they use and may likewise happen on the Childs part for by example if at seven months he is so big that the Womb can no longer contain him nor dilate it self more without bursting it is then provoked by the pain which this violent extention causeth to discharge it self of him and so likewise in the eighth month if there be the same reason and some weeks sooner or later according to a multitude of other circumstances or also by any outward cause as a violent shaking of the whole body blow fall leap or any other causes whatsoever hastening the pains of Delivery that which makes these Children live a longer or a lesser while is according as they are at that time more strong and perfect and the Woman nearer her time which is at the end of the ninth month There are many Women that believed they were brought to bed at the 7th and 8th month as likewise others that they went 10 or 11 whole months with Child which may some times be when notwithstanding they are effectively delivered at the due time That which deceives them usually is their believing as we have already said themselves with Child from the time of the retention of their courses having had them during the two first months of their pregnancy yea and sometimes longer and others also misreckon themselves when their courses are stopped two months before they conceive It is also easie to know that a Woman though well regulated cannot exactly know by the suppression singly the certain time of her being with Child for example if she lies with her Husband upon the point of the coming down of her terms and she conceives upon it then she may make her reckoning from the time of their suppression which may be very near the truth but if she conceives immediatly after she hath had them which happens oftenest and that all along the whole month she daily copulates with her Husband at the end of which time her courses not coming down she may very well reckon her self with Child yet for all this she cannot know by this sign which night she conceived and so for three weeks or a month more or less she may be mistaken in the time As we have said that Children are more or less long-lived according as they approach nearer the ninth month so we may easily know that they of six months and much less those that are younger cannot be long-lived because they are yet too weak to resist the outward injuries There hath often been great contestations amongst the Physitians to determine whether a Child born the eleventh or twelfth month after its pretended Fathers death can be legitimately born and consequently admitted to Inheritance or rather disinherited as a supposed Child This question hath been well debated sometimes by the Romans as well as by us and there have been parties both for and against this opinion as for my part I will to avoid prolixity leave it undecided and add nothing upon this
Mole from which it is sometimes divided and sometimes cleaving to its body which puts it in great danger of being mishapen or monstrous because of the compression which this strange body causeth to the Infant yet very tender In the year 1665 being at Mr. Bourdelots Doctor in Physick of the Faculty of Paris where was every Monday held Academical Conferences As they fell upon the discourse of the Circulation of the Blood which I explained according to my opinion they brought thither the Infant of a Woman newly brought to bed at her full time which wanted all the upper part of the head having no skull no brain no nor any hairy scalp but had only in lieu of all those parts a Mole or fleshy mass flat and red of the thickness and bigness of an after-burthen covered with a simple membrane strong enough This Infant had however all the other parts of the body fat and well composed and shap'd This monstrous disposition was the cause of its death assoon as it was born and yet it was very wonderful and astonishing to consider how it could live so without brain as also very difficult to understand how this fleshy mass could serve in stead of it whilst it was in the Mothers belly It was interwoven with many vessels like a kind of * The fleshy part of the burthen Placenta yet of a more firm substance Mr. Clerk and Mr. Juillet my Brethren and good Friends were then present and saw this Prodigy as well as my self A Woman having a Mole hath a much worse colour and is every way more inconvenienced than a Woman with Child and if she keeps it long she lives all the while in danger of her life Some have them two or three years and sometimes all the rest of their lives As hapned to a Peuterer's Wife of whom Ambrose Paré makes mention in his Book of Generation who had one seventeen years and at last died of it We will declare the Remedies convenient for it in another place where we speak of its extraction CHAP. X. In what manner a Woman ought to govern her self during her being with Child when it is not accompanied with other considerable accidents to endeavour to prevent them A Woman with Child in respect of her present disposition although in good health yet ought to be reputed even as though she were sick during that neuter estate for to be with Child is also vulgarly called a sickness of nine months because she is then in daily expectation of many inconveniences which pregnancy usually causes to those that do not govern themselves well She should in this case resemble a good Pilot who being imbarqued on a rough Sea and full of Rocks shuns the danger if he steers with prudence if not 't is by chance if he escapes Shipwrack So a Woman with Child is often in danger of her life if she doth not her best endeavour to shun and prevent many accidents to which she is then subject all which time there must be care taken of two to wit her self and the Child she goes with for from one single fault results double mischief inasmuch as the Mother cannot be any wayes inconvenienced but the Child partakes with her Now to the end she may maintain her self in good health as much as can be in that condition which alwayes keeps a middle state let her observe a good dyet suitable to her temperament custom condition and quality which the right use of all the six non-natural doth effect The Air where she ordinarily dwells ought to be well temper'd in all its qualities if it be not so naturally it must be corrected as much as may be by different means she must avoid that which is too hot because it often causeth by dissipating too much the humours and spirits many weaknesses to Women with Child particularly also that which is too cold and foggy for causing great Rhumes and distillations upon the lungs it exciteth a cough which by its sudden and impetuous motions forcing downwards may make the Woman miscarry She ought not to dwell in narrow Lanes very dirty nor near common Dunghils For some Women are so nice that the stink of a Candle not well extinguisht is enough to bring them before their time as Liebaut assures us he himself had seen which likewise may be caused if not sooner by the smell of Charcoal as hapned once to a Laundress whom I knew hat miscarried the fourth mouth being in extream haste to finish some Linen on a Saturday night she had not patience to kindle the Charcoal in the Chimney but in the Room in a Chafingdish which flew up into her head and made her miscarry the same night and in danger of dying Let the Woman therefore endeavour as much as her convenience will permit to live in an Air free from these inconveniencies The greatest part of Women with Child have so great loathings and so many different longings and strong passions for strange things that it is very difficult to prescribe an exact dyet for them but I shall advise them in this case to follow the opinion of Hippocrates in his 38th Aphorism 2d Book where he saith Paulo deterior potus cibus suavior tamen melioribus quidem sed insuavioribus praeferendus Meat and Drink though not so wholsome if it be but pleasant is to be preferred before that which is wholsom if not so pleasant which in my opinion is the rule they ought to observe provided what they long for is commonly used for dyet and not strange and extraordinary things and that they have a care of excess If the Woman be not troubled with these loathings let her then use such a dyet which breeds good juyce and in quantity sufficient for her and her Child her appetite may regulate that She must not then fast nor be abstemious because overheating the Mothers blood thereby renders it unfit to nourish the Child which ought to be sweet and mild and makes it tender and weak or constraius it to come before its time to search what is fit for it elsewhere she must not eat too much at a time and chiefly at nights because the Womb by its extent possessing a great part of the belly hinders the stomach from containing much which causeth thereby a difficulty of breathing because it compresseth the Diaphragma which as then hath not an intire liberty to be moved Wherefore let her rather eat a little and often let her bread be pure Wheat well baked and white as is that of Gonesse at Paris or the like and not course houshold Bread or Bisket which swells up the stomach nor any other of the like nature that 's very stuffing Let her eat good nourishing meat as are the tenderest parts of Beef and Mutton Veal Fowl as fat Pullets Capons Pidgeons and Partridge either roast or boyled as she likes best fresh Egs are also good And because big-bellied Women have never good blood let her put
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
the Breasts it signifies that the Woman is in danger of being frantick because of the transport which may be made thence to the Brain which accident is avoided by moderate bleeding in the Arm as also by a regular cooling dyet moderately nourishing for to diminish the quantity and temper the heat of the humours of the whole habite CHAP. XIV Of Incontinence and difficulty of Urine THe scituation of the Bladder which is placed just upon the Womb is sufficient to instruct us wherefore pregnant Women are sometimes troubled with difficulty of urine and the reason why they cannot often hinder nor scarce retain their water which is caused two wayes 1. Because the Womb with Child by its bigness and weight compresseth the Bladder so that it is hindred from having its ordinary extension and so incapable of containing a reasonable quantity of urine Which is the cause that the bigger the Woman grows and the nearer her time she approaches the oftner she is compelled to make water which for that reason they cannot keep 2. If the weighty burden of the Womb doth very much compress the bottom of the Bladder it forceth the Women to make water every moment but contrarily if the neck of it be pressed it is filled so extreamly with urine which stayes there with great pain being not able to expel it forasmuch as the Sphincter because of this compression cannot be opened to let it out Sometimes also the urine by its acrimony excites the Bladder very often by pricking it to discharge it self and sometimes by its heat it makes an inflamation in the neck of the Bladder which causeth its suppression It may be likewise that this Accident is caused by some Stone contained in the Bladder then the pains of it are almost insupportable and much more dangerous to Woman with Child than to one that is not because the Womb by its swelling causeth perpetually the stone to press against the Bladder and so much the violenter are these pains as the stone is greater or the figure of it unequal and sharp It is of great consequence to hinder these violent and frequent endeavours of a big-bellied Woman to make water and to remedy it if possible both in one and the other indispositions because by long continuance of alwayes forcing downwards to make water the Womb is loosned and bears very much down and sometimes is forced the inconvenience not ceasing to discharge it self of its burden before the ordinary time This is that should be endeavoured to be hindred having respect to the different cause of the distemper as when it comes from the bigness and weight of the Womb pressing the Bladder as it is for the most part the Woman may remedy it and ease her self if when she would make water she lift up with both her hands the bottom of her belly she may wear a large Swaith accommodated to this use which will bear it up if there be occasion and hinder it from bearing too much upon the Bladder or to do better she may keep her Bed If it be the acrimony of the urine that makes the inflammation on the neck of the Bladder it may be appeased by a regular cooling dyet drinking only Ptisan and forbearing the use of Wine and all sorts of Purgations because they send the filth of the whole body to the part affected and by their heat do yet more augment the acrimony and inflammation but she will do well to use mornings and evenings Emulsions made with the cold Seeds or Whey mixt with Syrup of Violets This Remedy is proper by refreshing gently to cleanse the urinary passages without prejudicing either the Mother or Infant If the inflammation and acrimony of the Urine be not removed by this Rule of Dyet they may let her blood a little in the Arm to prevent any ill accident that may happen they may likewise bath her outward entry of the neck of her Bladder with a Decoction of emollient and cooling Herbs as the leaves of Mallows Marsh-mallows Pellitory and Violets with a little Linseed which being viscous will help the conduit of the Urine to dilate it self the easier there may be also Injections given into the Bladder of the same Decoction to which may be added Honey of Violets or else of lukewarm Milk But if the Woman notwithstanding she observes these Directions cannot make water recourse must be had to the last remedy which is to draw it forth by a Catheter represented and marked with the Letter M in the Table of Instruments at the end of the second Book which being anointed with Oyl Olive or sweet Almonds having first lifted up and thrusted the Belly a little upwards must be gently introduced by the urinary passages into the very hollow of the Bladder and then the Urine will immediately pass away which being finished the Catheter must be taken forth and if the suppression continues it may be used again in the same manner until the accident quite leave her and then they may try whether she can urine naturally If she be in very great extremity she may use an half-Bath luke-warm provided she be not too much moved by this Remedy abstaining also from all Diureticks which are very prejudicial to big-bellied Women because they provoke abortion If on the other side this evil arises from the Stone which presenting it self to the neck of the Bladder stops the urinary passage whilst with Child she must be contented to have it only thrust back with a Catheter but if it be small one may try to draw it forth with a small Probe fit for the purpose putting the fore-finger into the Vagina to keep it in subjection that it recoyl not back towards the Bladder which is only to be done to the small ones for she must be delivered before the great ones can be drawn forth it being better to leave her in that condition than to endanger her life or the Childs by drawing it CHAP. XV. Of the Cough and difficult breathing WOmen whose Children lie low are oftener troubled with difficulty of Urine as we have mentioned in the foregoing Chapter than they whose Children lie higher who are indeed exempted from this and the like inconvenience but are then more subject to a Cough and difficulty of breathing than the former A Cough if violent as sometimes even to vomiting is one of the most dangerous accidents which contributes to Abortion because it is an essay by which the Lungs endeavour to cast forth of the Breast that which offends them by a compression of all its Muscles which pressing all the inclosed air inwards with which the Lungs are much extended thrusts also by the same means with a sudden violence the Diaphragma downwards and consequently all the parts of the lower Belly but particularly the Womb of the pregnant Woman which accident continuing long and violent often causeth her to come before her time This Cough proceeds sometimes from sharp and biting rheumes which distill from the
Belly which is likewise more equally in its circumference extended than if there were a Child she will also have the Lips of the Womb her Thighs and Legs swell'd aedematous and a worse colour in her Face than when she is with Child Now as this Dropsie may come alone so likewise may often happen together with a true Conception these Waters being then contained without the membranes of the Child in the capacity of the Womb for though there may be much Water within these membranes it is not properly the Dropsie of the Womb because there must ever naturally be some in the midst of which the Faetus is contained Notwithstanding sometimes there is such a quantity of them which doth so prodigiously swell the Womans Belly that one would believe she had two or three Children when she hath but only one which is much weakned by it because the greatest part of its nourishment is resolved into these Waters which almost extinguisheth and suffocates that little natural heat which is there Some Women have evacuated three or four quarts above two months before they were brought to bed when this happens they are then contained in the Womb without the Membranes for else the Child would be necessitated to be born presently after these Evacuations * That being the right time of Labour if it were the Waters that ought naturally to be contained in the membranes that came away The best Remedy for this kind of Dropsy the Woman being vvith Child is to vvait vvith patience the hour of her delivery observing the mean time a drying dyet but vvhen it is only Water contained in the Womb she must use Diureticks to cause the Womb to open to evacuate them and her Courses must be endeavoured to be provoked having alwayes a care to destroy by convenient Purges the cause of the generation of such superfluities The Womb is sometimes so full of these humours that it dischargeth some on the outward parts and principally upon those vvhich are near as the lips of the Privities vvhich often are thereby so swelled that they become quite blown up and sometimes in some Women are so big and swelled that they cannot close their Thighs together for them vvhich hinders their vvalking unless vvith pain and great inconvenience This Swelling is then livid and almost transparant even as a Hydrocele because of the quantity of clear Water vvhich filled it and because it may be painful and inconvenient to the Woman during her labour by reason they straiten the passages it vvill be necessary to remedy it before vvhich for the greater certainty must be done by the operation of the hand making many scarrifications vvith a Lancet all along the lips vvhereby the humours will sweat out and distil forth by little and little after vvhich Compresses dipt in Aromatick and Astringent Wine must be put upon it to prevent Relapses by fortifying the parts causing the Patient to observe all the vvhile a good dyet fit for the Dropsie Some vvould apply Leeches to avoid the pain of the Lancet but they are not so proper because the small orifices they make assoon as they are taken off immediately close again which happens not so soon to the Scarrifications made as big or little as one will and may be kept open by oyntments applied to them as long as may be thought fit or necessary CHAP. XXIII Of the Venereal Disease in Women with Child IT is not very hard to imagine how a breeding-Woman that hath the Pox can communicate it to a Child in her belly because this contagious disease corrupting all the mass of the Mothers blood it is necessary the Infant which hath then no other sustenance should be infected with it converting this bad blood into its own substance the acrimony of which Blood easily causeth in an Infants tender body those malignant ulcers which all such whose Mothers are contaminated with it usually bring with them at their birth The Pox which in its essence is of the same species and is only distinguished by degrees according as it is greater or less communicating it self by the means of the Mothers blood will make more or less impression on the Infants body according to its strength or weakness and if the big-bellied Woman have Ulcers very near the Womb as in the neck and neighbouring parts by this proximity the venom will be very easily conveyed to it I do not design here to enquire into the bottom of this Venereal Disease nor to write particularly of the cure of it but intend only to shew vvhether the Woman may undergo the Cure vvhilst with Child or ought therefore to defer it till after they are brought to bed That this may be the better determined we must make some distinction for when the Woman is towards the end of her Account it ought to be deferred till after she is brought to bed when both she and the Child if infected may be taken in hand because the labour coming on when the Woman is in the midst of her Cure she may run the hazard of her life and besides if the Child should be then still-born one would be apt to think it was killed by the violence of the Medicaments and blame the Chirurgeon of rashness When the Pox is but in the first degree and hath caused no great accidents one ought then likewise to remit the eradicating Cure till after Childbed and be contented only with the palliating by a convenient dyet and gentle purgers from time to time to prevent the evils encreasing but if the Woman when young with Child hath the Pox in the highest degree accompanied with very great and continual accidents which threaten danger if her Cure be protracted till after Delivery because in so long a time these accidents augmenting more and more it would be impossible but her Fruit should be corrupted and very hard if she did not miscarry that the greatest of these two evils be avoided she having strength enough ought to be taken in hand for to imagine the worst that the Remedies make her miscarry it is no more than the greatness of the Disease would otherwise certainly do Let her then be taken in hand without suffering the accidents longer to augment vvhich by continuance render themselves much more dangerous both to her and her Child being careful to give her the gentlest Remedies and with more preparation and circumspection so that the Evacuation procured to her by Salivation be rather by little at a time and the longer than too great and sudden and above all that it be rather by anointing the upper parts only with * As Unguentum Neapolitanum Mercurial Oyntments and not by Perfumes which sooner endanger miscarrying by opening the Womb besides that they sooner cause the Fruit to perish if it had life For the same reason also no Mercurial Medicine must be taken in at the mouth vvherefore frictions of the upper parts are to be preferred endeavouring alwayes as much
as may be to be Masters of the Evacuation and to hinder it from causing a Loosness for that is more dangerous than Salivation because of the continual forcing downward in going to stool by which the Womb receives great commotion and is extreamly agitated I know very well that many will not easily be perswaded but that either it is impossible to cure a Woman of the Pox whilst she is with Child or that she and her Child cannot undergo the Remedies without inevitable danger of death however the experience I have had of it my self makes me to be of another opinion which I am vvilling to communicate for an example in the like case In the Year 1660 when I practised Midwifery in the Hostel de Dieu at Paris a young Wench not above twenty years old came thither to lie-in of her second Child that had had the Pox before ever she conceived the first time and after miscarried of a dead Child rotten with the Pox therefore being big this second time and perceiving the accidents of ber disease to augment more and more she concluded there was no hopes this great Belly would succeed any better than the first because she had all over her Body especially upon both her Breasts very many malignant Ulcers which encreased day by day and fearing it might turn to a Cancer before her Reckoning was compleat being but three months gone she resolved to submit to a thorough-Cure then and to hazard her life in that condition to save her Child's having no other hopes to effect it nor being able her self to resist the growing disease She acquainted three or four Chirurgeons both vvith her disease and design not at all concealing her great-belly who for that cause would not undertake her although she was fully resolved upon it and promised to pay them vvell telling her that their Conscience would not suffer them to do it in the condition she was in and that it would be better she would patiently submit to it aswell as she could till she was brought to bed and then they vvould very vvillingly undertake her But when she found none would undertake her unless she concealed her great-belly vvhich was not hard to be done being but three months gone and believing there was no better an expedient She met with another to whom she mentioned nothing of her great Belly that put her into the ordinary course as if there had been no Conception and besides the common Remedies used in this disease he gave her a Salivation by five or six reiterated Frictions of the Oyntment vvhich followed her very plentifully five vvhole vveeks so that she vvas vvell and perfectly cured without leaving the least ill accident behind of her disease When she was almost recovered and that all had succeeded wel she told her Chirurgeon she was four months a half gone with Child for she was three months when she came to him where she lodged six weeks intire without having it in the least perceived which at first he could hardly believe but perceiving her Belly rather grown bigger than lesser during the Evacuation the Physick had made he was immediately assured of the truth of it She informed him that the reason why she had concealed her great-Belly was the refusal four Chirurgions to whom she had confest it made to take her in hand From the time she was cured she suffered not the least inconvenience during all the remainder of her time except a little want because all the money she had was given the Chirurgeon for her Cure which made her come to the Hostel de Dieu to lie-in where I delivered her of a Child at the full time as big fat and healthy as if the Mother never had had the least touch of that disease in her whole body and which was very remarkable the Burthen which is a part very susceptable of the least impression of a Woman 's corrupt humours was as neat fair and ruddy as could be imagined This example which is very true may convince us that a big-bellied Woman may be taken in hand for the Pox and more safely if the Precautions noted above be carefully observed For it is without contradiction that if this Woman had not been cured she had this second time been brought to bed of a rotten Child as before Relating once this History to a Chirurgion a Friend of mine he told me that himself twice in two different persons had the same success who were very well cured and their Children likewise well born at the full time without having the least impression of the venom in any part of their Body Varandaeus confirms to us this truth in the second Chapter of his second Book of Womens Diseases where he precisely tells us that he had seen big-bellied Women who had had this disease eradicated by anointings with Mercury and Salivation prescribed by Empericks which may convince us that this Cure will easily have a better success when governed and managed by a knowing and methodical person In a word 't is easie to be perswaded that they can endure it although with Child because many very often have continual Feavers for twelve or fifteen dayes and other acute distempers for which they have been necessited to be nine or * Such frequent bleeding Women with Child in so short a space is not approved in England ten times blooded and yet notwithstanding have oft-times gone through with their Children to their full account and been delivered of them as well as if they never had had any ill accident CHAP. XXIV Of Abortion and its Causes WHen a Woman casts forth in the beginning what she had retained by conception in the Womb 't is called an Effluxion or a sliding away of the Seeds because they have not yet acquired any solid substance if they miscarry of a false-conception which is ordinarily from the later end of the first to the end of the second month it is called an Expulsion but when the Infant is already formed and begins to live if it comes before the time ordained and prescribed by Nature it is an abortion which may happen from the second to the beginning of the seventh month for afterwards it is accounted a Birth because the Infant being strong enough and having all its perfections may then live which is impossible if he comes before These things thus understood we then say that an Abortion is an issuing forth of the Child yet imperfect out of the Womb contrary to Nature before the term limited which is the cause that for the most part it is dead or if sometimes alive it dies in a short time after We may in general assert that every acute Disease easily makes a Woman miscarry because they destroy her fruit which being dead never stayes long in the Womb and also puts the Woman in great hazard of her life as saith Hippocrates in the 30th Aphorism of his 5th Book Mulierem gravidam morbo quopiam acuto corripi
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
two Children begins to flag it is a sign she will miscarry of the Child of that side and of both if both flag in the same manner It is most certain a Woman is in more danger of her life when she miscarries than at her full time because as we have said before abortion is wholly contrary to Nature and very often accompanied with flooding and in more danger of miscarrying alwayes if she miscarries of the first and some apprehend then an impossibility of ever having Children after to which young married people are very subject because of the violent emotion and perturbation of the whole body excited by ardent and frequent copulations but notwithstanding they may preserve their fruit when their greater vigour is over and their loves a little moderated We have taught in each of the foregoing Chapters how to prevent all the accidents before recited any of which is sufficient to make her miscarry and the easier if many are complicated wherefore to avoid a troublesome and needless repetition you may have recourse to the Remedies there taught by which both Women and Children may escape the danger of death They that are subject to abortion ought above all to take their ease and keep in bed if they can observing a good diet and refraining copulation assoon as she believes her self to be with Child avoiding the use of all Diureticks and Aperitives which are very pernicious as also violent passions of the mind because they are very prejudicial She ought likewise to be loose in her dress that she may breath the freer and not strait laced and rackt as most of them are ordinarily with their Busks under their cloths to make their bodies strait and amongst other things they had need take heed of slipping and falling in their walking to which big-bellied Women are very subject because the bigness of their Bellies hinders them from seeing their way they will therefore do well to wear low-heeld shoos with large soals to prevent hurting themselves as too many daily do I admire in this case the superstition of many Midwives and some Authors who order a Woman with Child to take assoon as she hath hurt her Belly with a fall some Crimson Silk small minced in the yolk of an Egg or the grains of * Kermes Scarlet and treddles of several Eggs put into the yolk of one as if that entring the stomach were able to fortifie the Womb and the Child in it and to keep it there for which there is no appearance of reason or truth but quiet rest indeed contributes much to it which for this reason is usually directed for nine dayes although such a one hath need of 15 dayes or more for her hurt or commotion and to others five or six is sufficient during which time may be applied hot to the Belly Compresses steeped in Aromatick and Astringent Wine But because there are many Women so infatuated with this superstitious custom that they would not believe themselves out of danger if they took not that Crimson Silk or the Treddles of the Eggs which is a pure conceit one may give it to those that desire it to content them because these Remedies though useless can yet do no hurt It is now time to make an end of this first Book in which I have only mentioned the most ordinary distempers which have some particular indications in their cure during the Womans being with Child of which I have not treated very exactly because it may be supposed that one may elsewhere have a more perfect knowledge of them with all their circumstances let us now pass to the second Book to treat of Deliveries not only the natural but likewise all that are contrary to nature it being the principal motive that induced me to write and to teach as well as I can the best and most methodical deportment in it The End of the first Book BOOK II. Of Labours Natural and Unnatural with the way how to help Women in the first and the right means of remedying the rest AS it is very unprofitable to those that imbark on the Sea for a long Voyage as for example to the Indies or the like if after having by their prudence escaped all the dangers they could meet with in so long a Voyage they are shipwrackt in the Haven So likewise it is not sufficient that a great-bellied Woman should be preserved from all the Diseases mentioned in the preceding Book for nine whole months if at the end of that time she be not well delivered of it by a happy Labour This therefore shal be the whole subject of this second Book where we will treat as well of the Natural as Unnatural Labours and teach the manner of aiding and comforting Women in the first and the means to remedy all the rest CHAP. I. What Labour is and the diffenrences of it together with its different terms BY a Delivery we understand either an emission or extraction of the Infant at the full time out of the Womb. This definition may comprehend as well the Natural which is accomplished by emission when the Infant coming in a commodious and natural Figure the Womb sends it forth without extraordinary violence as the delivery contrary to Nature which we are often obliged to perform extracting it by manual operation Every time the Womb le ts pass or sends forth whatsoever it had retained and formed after conception must not be call'd a labour for observing what I have already noted above and what I will here again repeat that it may be more plain If a Woman voids by the Womb what is contained in the beginning after she had conceived it is properly called an effluxion or slip because at that time there is nothing formed or figured neither have the Seeds yet any firm consistence which is the cause why it flips away so easily with the least opening of the Womb as often happens between the first conceiving and the seventh and eight day only after which until the end of the second month the Woman somtimes le ts slip false-conceptions which turn to Moles if they continue any longer in the Womb which is then called an Expulsion And if after the third month or thereabouts the time when the Faetus is wholly formed and animated it is sent forth before the seventh in that case it is an Abortion which is alwayes the cause either that the Infant comes dead into the World or dies soon after But we properly call Labour or Delivery every issuing forth of an Infant which happens after the end of the seventh month to all the remaining part of the time afterwards because there is then a sufficient perfection as also strength enough to come into the World and live in it afterwards As to the general differences of Labour we must take notice that the one is legitimate or natural the other illegitimate or against nature To come to the knowledge of each we say that four conditions must
cleave to it notwithstanding that it is then a little wrinkled and uneven because its Membranes which were very much enlarged contract themselves immediatly after the Child and its Waters which kept them extended are excluded * Be careful of those that are not but they that are expert in this Art can easily judge of it If you find the Burthen wholly loosened from the Womb it will not be difficult to draw it forth when you have got it in your Hand but if it cleaves finding the side where it sticks least begin there to separate it gently by putting some of your Fingers between it and the Womb continuing by little and little to do so till it be quite loose and afterwards to draw it forth very carefully observing the whilst if it cannot be otherwise rather to leave some part of it behind than to scrape or scratch the least part of the Womb for fear of a flooding inflammation or Gangrene which cause death being also careful not to draw it forth till it be wholly or the most part of it separated for fear of drawing forth the Womb with it and preserving it as whole as these reflections will permit because of shewing it to the company that they know the Operation is well done When the Chirurgeon finds not the Womb open enough for to direct his hand immediatly into it let him * Danger in delays presently anoint all the Womans Privities with Hogs-grease that they may be dilated with more ease afterwards let him by little and little put up his Hand but without much violence the Woman may likewise contribute to this dilatation as also to the exclusion of the Burthen if she bears strongly down holding her Breath and exciting her self to vomit or sneeze and do those other things directed in the above mentioned Chapter but if notwithstanding all this she cannot void the Afterbirth and if the Womb cannot be dilated enough to fetch it or that it cleaves so fast as it cannot be separated then to avoid a greater mischief we must leave it to Nature assisting her with remedies which suppurates wherefore Injections into the Womb are proper made of Mallows Marsh-mallows Pellitory and Linseed in which is mixed a good quantity of Oyl of Lillies or fresh Butter This injection softens and tempers and by moistning and mollifying makes the Orifice to be the easier dilated and helps by Suppuration the loosenings of the Burthen And to hasten the expulsion of it give her a strong Clyster that so by the motions to go to Stool it may cause it to be voided as it hath arrived to many that have rendered it in the Bed-pan and sometimes when they have least expected it One may at the same time to prevent a Fever and many other accidents which usually happen bleed her in the Arm or Foot according as it may be necessary and convenient and strengthen her that the Foetus and cadaverous Vapours coming from the putrifaction of the Burthen ascend not to the Noble parts which may be done by good Cordials often used not such as are made of Theriacle Mithridate or the like for which no reason can be given but their specifick or rather imaginary Faculties and are fitter to cause Vomiting than comfort the Heart but true Cordials are such as yeeld good nourishment and at the same time comfort the Stomach without nauseating it as those Drugs do which are only good for them that sell them Wherefore let her have good Broaths and Gellies she may drink Limonade or Orengade or have in her Ptisan Syrup of Limons or Pomgranats or from time to time if she be weak and free from a Fever a little Wine and Water mixed which we say is the best in some cases but not alwaies and most natural of all Cordials besides other Remedies may be provided according to the accidents which happen by reason of the staying behind of the Burthen always endeavouring to bring it away assoon as possible for as long as it stays in the Womb the Woman feels continually great Pains almost like to them before her Child was born although there remained but a small piece of it and until the whole be voided the Pains will still be repeated although in vain unless the matter be well disposed before but the lesser the piece is of the Burthen retained the more difficult it is sometimes to be expelled because the impulses which the Woman can make by helping her Throwes are not so great when the matter contained in the Womb is small as when it is of a considerable bigness for then it is more strongly thrust and compressed which is the reason why a Woman miscarries with greater difficulty than when brought to Bed at her full time There are many Midwives who having broken the Navel-string as * This may happen to a good Midwife but the fault is when they do not discover it that seasonable help may be applied abovesaid leave their work imperfect and commit the rest to Natures work but very often the poor Woman dies because of the great mischiefs which happen usually before the suppuration of the Burthen so retained To avoid which assoon as they meet with the like case they must endeavour to fetch it according as we have directed or if they find themselves not capable to do it because the Hand must be put up into the Womb which is more properly the work of a Chirurgeon expert in those cases let them presently send for one that so he may be yet able before the Womb closeth to introduce his hand for the longer it is deferred the more difficult will be the work There are other Midwives bold enough to undertake this Operation but for want of industry or necessary knowledg they cannot effect it and leave the Woman oftentimes in a worse condition than if they had never medled with it as happened about a year or little more since to a poor Woman in the Fauxbourgh Sâ— Marcel whom I helped three days after she was delivered being half gone by a Midwife of the same Fauxbourgh at the desire of Mr. Bessier a Chirurgeon and my good Friend who conducted and accompanied me to her where I found her in continual pain all over her Belly which held her like throws of another Travail voiding black humours extremely stinking and offensive with which she had also a great pain in her Head and a Fever which in a short time would without doubt have augmented if I had not presently fetched what remained wherefore having enquired of the persons present in her Chamber how she was delivered and when they told me not yet three whole days but that the Midwife not being able to fetch all did only bring away some small pieces of the Burthen told them * An excuse of some of our Midwives that they need not be troubled at what remained perswading them alwaies that it would come away of it self and that nothing more was to be
Hand that so he may have more liberty to introduce it into the Womb and sliding it then along the Childs body either by the Belly or side as he finds it easiest he shall fetch the Feet and turning it bring them to the Passage and so deliver the Woman as is already directed If it be the Back which presents to the Birth it is also impossible to be born in that Posture what Pains soever the Mother endures and besides the Child having the Body folded inwards and almost double his Breast and Belly are so prest together that he usually wants little of being suffocated to avoid which the Chirurgeon must quickly slide up his Hand along the Back towards the inferiour parts until he meets the Feet for to bring it forth the same way as if it came Footling But when the Child comes with the Breech if it be small and the Mother big having the Passages very large he may sometimes with a little help be born so for though he comes double yet the Thighs being folded towards the Belly which is soft and gives way it passeth without much trouble Assoon as the Chirurgeon finds the Child to come with the Buttocks foremost he must not permit it to engage lower in the Passage for it will not come so unless it be very small and the Passage very large as we have already said This being then in good time perceived he must if he can thrust back the Breech and sliding up his Hand along the Thighs to the Legs and Feet of the Child he must bring them gently one after the other forth of the Womb by folding stretching wagging and drawing them gently towards the side being careful not to winde them too much or cause a dislocation and then let him draw forth the rest of the Body as if it came with the Feet foremost I have said that the Chirurgeon perceiving the Child to come with the Breech foremost ought to put it back if he can for sometimes he will be advanced so forward in the Passage that you may sooner destroy both Mother and Child than reduce it back when once strongly engaged When this happens he cannot hinder it from coming in this Posture in which his Belly is so pressed that he often voids the * Childs ordure meconium by his Fundament However he may much help this Birth by sliding up one or two Fingers of each Hand on each side of the Buttocks for to introduce them into the Groins and having crooked them inward he must draw the Breech just out to the Thighs then by drawing and wagging it from side to side he will disengage them from the Passage as also the Feet and Legs one after the other being careful of dislocating any part and then he may extract the rest as before when coming with the Feet The first Woman I ever layd was of a Child which I drew †This way ought to be avoided if possible thus forth with the Buttocks foremost being constrained to it because assoon as ever the Waters broke which happened before I could arrive to hinder it they were so forward that it was impossible to do it otherwise which I performed very well and in short time without prejudice to the Mother or Child doing as I have directed CHAP. XXV Of those Births wherein the Infant presents Belly Breast or Side THe Back-bone may easily be bent and turned forwards a little but by no means backwards without excessive violence Wherefore the worst and most dangerous Figure that a Child can offer in the Womb to the Birth is the Belly or the Breast for then its Body is constrained to bend backwards and whatever Throws or endeavours the Woman makes to bring it forth it will never be accomplished for she will sooner perish with her Child than ever advance it in this posture into the Passage wherefore it is in great danger if not timely succoured And in case it should escape which would be very strange it would be a long while after its birth weak in the Back But that which augments the danger much more is that for the most part the Navel-string comes forth when the Child comes with the Belly Therefore assoon as it is discovered to be so the Chirurgeon must apply the sole remedy of drawing it forth by the Feet as speedily as may be in the following manner Chap XXV lib. 2. page 248. When a Child comes with Breast or Belly the Chirurgeon must always proceed after the same manner in both inasmuch as they require the same circumstances An Infant may likewise come with the Side which way it is as impossible to pass as the two former but it is not so much tormented nor is this scituation so cruel for it may remain in it a longer time without dying than in the two former wherein it is much more racked than in this in which the Body may be bended forward and not backward as in the other neither doth the Navel-string come forth so easy as when it comes with the Belly first In this as in the other two Births the Chirurgeon must draw the Child forth by the Feet on this fashion having placed the Woman as she ought to be he may push back a little with his hand the Infants body the better to introduce it which he may slide along the Thighs till he finds the Legs and Feet by which he must turn it and afterwards draw it forth just in the same manner as before with the same observations Nor ought he to amuse himself in any of these three Births for to place the Head right that it might come naturally because it is in great danger of dying in these unnatural Positions if not drawn forth with speed which can never be effected unless it be by finding the Feet as I have directed CHAP. XXVI Of Labours wherein several Children present together in the different Postures above named IF all the unnatural Figures and Scituations which we have hitherto described that a single Child may come in do cause those many difficulties and dangers mentioned surely the Labour wherein several together come in these bad scituations must be much more painful not only to the Mother and Children but to the Chirurgeon also for they are then so constrained and pressed that for the most part they trouble each other and hinder both their births besides the Womb is then so filled with them that the Chirurgeon can scarce introduce his Hand without much violence which he must do if they are to be turned or thrust back for to give them a better position than wherein they present Chap XXVI lib. 2. pag 250. Sometime since I delivered two Women within a Week one of the other both of Twins one of each being dead and the other living the living Child of the first Woman was born before the dead and the dead of the second was expelled before the living And the same thing happens every day in respect
of strong and weak Children for that which is nearest the Birth whether alive or dead strong or weak is always first born or must be brought first if it cannot come of it self otherwise the difficulty of the Labour would yet be augmented as well in length of time to the Mother as the violence done to the first Child in putting it back for to fetch the second first In the 8th Chap. we shewed speaking of natural Labours how a Woman should be delivered of Twins coming both right it now remains to direct what ought to be done when they come either both wrong or one of them only as it is for the most part the first coming right the second Footling or any other worse Posture and then must the Birth of the first be hastened as much as may be that so there may be presently way for the second which hath suffered much by this unnatural Position to fetch it by the Feet without trying to place it right although it were somewhat inclined to it because it hath been already so tired and weakened as also the Woman by the Birth of the first that there would be more danger that it would sooner dye than come of it self Sometimes when the first is born naturally the second offers the Head likewise to the Birth in this Case 't is good committing a work so well begun to Nature to finish provided she be not too slow for a Child may dye although right by lying too long in the Birth and the Woman who hath been much tormented with bearing the first is usually so tyred and discouraged when she thinks that but half her work is over that she hath no more Pains or very few and slow nor any considerable Throws to bear the Second as she had done the First Wherefore if the birth of the Second proves tedious and the Woman grows weaker let the Chirurgeon defer it no longer but direct his Hand gently into the Matrix to find the Feet and so draw forth the second Child which will easily be effected because there is way made sufficient by the birth of the first and if the second Waters be not broke as it often happens yet intending to fetch it Footling he need not scruple to break * Skins or skirts the Membranes with his Fingers although elswhere we have forbidden it but that must be understood with distinction for when a Labour is left to Natures work they must break of themselves but when a Child shall be extracted by Art there is no danger in breaking them nay contrarily they must be broke that the Child may be the easier turned which else would be almost impossible Above all the Chirurgeon must be careful not to be deceived when both Children together offer to the Birth either their Hands or Feet and must well consider in the Operation whether they be not joined together or any otherways monstrous as also which part belongs to one Child and which to the other that so they may be fetcht one after the other and not both together as would be if it were not duely considered taking the right Foot of the one and the left of the other and so drawing them together as if they belonged both to one Body because there is a left and a right by which means it would be impossible ever to deliver them but it may easily be prevented if having found two or three Feet of several Children presenting together in the Passage and taking aside two of the forwardest a right and a left and sliding his Hand along the Legs and Thighs up to the Twist if forwards or to the Buttocks if backwards he finds they both belong to one Body and being certain of it he may then begin to draw forth the nearest without regard which is strongest or weakest bigger or less living or dead having first put a little aside that part of the other Child which offers to have the more way and so dispatch the first whatever it is assoon as may be observing the same Rules as if there were but one that is keeping the Breast and Face downwards with every circumstance directed where the Child comes Footling and not fetch the Burthen till the second Child be born because there is commonly but one for both which if it were loosened from the sides of the Womb would cause a flooding for the reasons already alledged that the orifices of the Vessels to which it was joined would continue open by this separation as long as the Womb was dîstended by the other Child yet within it and never close as it often happens till being quite emptied of all it begins to contract it self and retire as a man may say within it self When therefore the Chirurgeon hath drawn forth one Child he must separate it from the Burthen having tyed and cut the Navel-string and then fetch the other by the Feet in the same manner and afterwards bring the Burthen with the two strings as hath been shewed in the proper place If the Children offer any other part than the Feet the same course must be taken as is directed in the foregoing Chapters where the several unnatural Figures are discoursed of alwayes observing for the reasons abovementioned to begin the Operation with the Child that is lowest in the Passage and in the most commodious Figure for extraction Chap XXVII lib 2. pag 255. CHAP. XXVII Of a Labour when the Navel-string comes first AN Infant doth not alwaies present with the Belly when the Navel-string comes first for though he presents naturally as to the Figure of his Body that is with the Head first yet sometimes the Navel-string falls down and comes before it for which cause the Child is in much danger of death at least if the Labour be not very quick because the Blood that ought to pass and repass through those Vessels which compose it for to nourish and enliven the Child whilst he continues in the Womb being coagulated hinders the circulation wh ch ought to be there made which happens as well by the contusion as the cold those Vessels receive being much pressed in the Passage when it comes together with the Head or any other part as also because the Blood doth there coagulate as is said by reason of the cold which it takes by the coming forth of the Navel-string But though this accident may cause the Infants suddain death 't is not so much for wart of nourishment without which he might pass a day or more there being blood enough in his Body for that purpose but because the Blood can be no longer vivified and renewed by Circulation as it hath continual need which being obstructed alwaies causeth the creatures sudden death sooner or later according as it is more or less obstructed I know it may be objected that though the Circulation be so hindered and intercepted by the coming forth of the String it need not therefore cause such a sudden death to the Child because
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
Mater Pus which proceeding from the moisture sweats through the substance of the flesh and of these Vessels which have been but newly closed acquires a thick and whitish consistence by the heat of the part and the stay it makes there Now the better to conceive this by a comparison you must imagine that there is a kind of a wound made by the loosening of the Burthen from the Womb by reason of which there happens if it may be so said a kind of Suppuration the Pus and excretions of which are the Lochia They which believe that when the Lochia ar◠pale it is the Milk of the Breasts which flowes by the Womb judge so because the Milk usually abates in proportion to this evacuation and say besides that by the Colour and Consistency it must needs be Milk but if they were acquainted with Anatomy they would know that there was no passage which hath to this purpose a communication from the Breasts to the Womb unless they think it is done by the means of this imaginary * The communication of Veins without Arteries whereby they help one another Anastomosis of the †Belonging to the Breasts Mamillary Veins with the * Belonging to the Flanks Epigastrick which cannot possibly be because neither of them have any tendency either to the Breasts or the Womb as Anatomy makes manifest for the Mamillar comes from the Subclavicular under the Sternum without yielding any sign to the Breasts nor so much as touching them and the Epigastrick ariseth from the Iliacks without having the least communication with the Womb. Laurentius who knew very well it was for this reason impossible Milk should pass from the Breasts to the Womb by this passage finds out another way which is as far from the truth as the first His opinion as he saith is that the Milk and Blood flow back from the Veins of the Thorax which bedew the Breast to the Axillary Veins and from thence to the Trunk of the Vena-cava by the continuity of which they flow down into the Hypogastrick Branch and from thence finally into the Womb but besides that it would be very difficult for the Milk after so long a way to come forth without being perfectly mixed with Blood the Circulation of the Blood which he knew not shewes us plainly that it is impossible because it doth mount back by the lower parts of the Body from the Vena cava to the Heart without a possibility of carrying any thing into the Womb whence it appears that he is as far as others from informing us how it can be done For my part I believe with much more reason and I think that it is not Breast milk which is thus evacuated by the Lochia but this abundance and superfluous humidity which distills from and transudes the Vessels and substance of the Womb as I have explained by means of which the whole habit of body being much emptied there remains not sufficient to be carried to the Breasts and little or none flowing to them that which is contained in them is dissipated by transpiration and digested by the natural heat of the parts Now the Milk by this evacuation is dried up just as we see a Pond is that one would drain out of which it is not absolutely necessary to let the water run which fills it but it sufficeth to turn back the stream that feeds it to another place which being done and no more new water falling into the Pond it will soon be dried up as well because the water is dissipated in Vapours as drunk in by the Earth which contains it And for the same reason when we see Milch-nurses want their ordinary courses it is because that all the redundant humours in their body being sent to the Breasts and emptied by the sucking of the Infant there remains no superfluities for matter for the Terms and for this cause it is not necessary that the Menstrual blood should be carried from the Womb to the Breast for Nurses Milk to be made of it but it is enough that the humours flow towards them without going at all to the Womb so likewise it is not necessary the Breast Milk should be sent to the Womb to be evacuated with the Lochia it being sufficient that the humours are drawn towards it without going to the Breasts We must not think as some imagine that the Blood flowing after Labour is bad and corrupted and the reliques of that good which the Infant hath taken for his Nourishment nor that it hath remained in and about those places during the whole time of being with Child for this Blood coming immediatly out of the Vessels opened by the separation of the Burthen from the Womb is the very same with all the rest of the body in which immediatly after Labour no great change is observed unless it be by so much alteration as the disposition of the place from whence it proceeds may cause and according as it flowes abundantly or slowly and as it is mixt with other impurities which are emptied at that time or that it makes some stay in the Womb after it is out of the Vessels and if it had so staid in and about the Womb as some would have it without Circulation during the whole time of Pregnancy 't is most certain it would have putrified even as we see the water of a Lake for want of Agitation and Motion is infected and corrupted but there is no other superfluity nor relique of the Childs nourishment but the gross blood with which the whole mass of the Secondine is replenished After having considered the nature and quality of these evacuations we say that for their quantity and time of continuance there is no certain and particular Rule for some Women have many a long time and others but few and of a short continuance which usually happens according to the Season Country and Age according to the Temperament more or less Hot or Moist the Habit more or less replete and according to the Vessels remaining a long or a short time open But in general this Evacuation is for the most part finished in fifteen or twenty days and sooner or later according to the circumstances lately mentioned and indifferently the same to a Woman delivered of a Boy or a Girl during which time the Lochia diminish in quantity from day to day until they totally cease at the end of the same afterwards the parts remain yet somewhat moist without any manifest evacuation except in Women subject to the Whites This discourse must be understood of Labours at full time for after a Mischance the less the Foetus is and the less time the Woman is gone with Child the less ordinarily are her Evacuations The Signs when the Lochia are good and commendable are that they be fresh the three or four first days and that they lose this bloody tincture by degrees and become pale that they be of an equal consistence without any
in the Womb. CHAP. XII Of the Inflammation of the Breasts of the new-laid Woman UNtil of late it was alwaies believed that the Blood was the matter whereof the Milk was made in the Breasts but it is much more probable that the Chyle onely and not the Blood is destined to its generation as well as it is the true matter out of which all the Blood of the Body is made That which easily makes us judg so is the new discovery of the Channel of the Thorax which conveighs the Chyle into the Subclavian Vein found out by Monsieur Pecquet Physician of the Faculty of Montpelier to whom all posterity will be eternally indebted for having means hereby of being disabused of several notable Errors which for want of so fair and necessary a knowledg was slid and entertained into the Practice of Physick until this time However since the Vessels which may for this purpose conveigh part of this Chyle to the Breasts are not yet manifestly known we will content our selves to explain after the following manner the cause of the Inflammation of the Breasts which doth very often happen to Women newly delivered All the Blood and Humours are so heated and agitated during Travail by the Pains and Throws of Labour that the Breasts composed of glandulous and spongious bodies easily receiving in too great abundance of these Humours which flow to them from all parts are soon inflamed thereby because this Repletion doth very sensibly and painfully distend them to this contributes very much the suppression of the Lochia and an universal fulness of the Body This Inflamation may likewise happen by the Womans having been too strait laced by some blow received upon the Breasts or for having lain upon them which easily bruise them as also for want of having given Milk to the Child in as much as by this means the Milk which is in great quantity in the Breasts not being evacuated is overheated corrupts by too-long stay there But from whatsoever cause this Inflamation of the Breasts in a Woman new-laid may proceed convenient Remedies must be speedily applyed lest it afterwards aposthumates or else that not suppurating there remains a scirrhous hardness which in time may degenerate into a Cancer a very pernitious Malady and for the most part incurable when confirmed Besides the danger that an Inflamation of the Breasts may be converted into these dangerous distempers there happens usually to the Woman in those parts which are very sensible an extream pain which often causeth shaking Fits and afterwards a Fever with so great a burning of the whole Body that she can scarce endure any Cloaths upon her and when she doth never so little uncover her self or put her Arms out of the Bed she hath new shaking fits which afterwards augment the heat of her Feaver it is no great wonder that a Feaver soon happens upon this occasion because the Breasts by their nearness to the Heart do easily communicate their Inflamation which sometimes excite Fury and Phrenzy if the Blood be suddenly and in great abundance carried thither as Hippocrates assures us in the 40th Aphorism of his 5th Book Quibuscunque Mulieribus ad Mammas sanguis colligitur furorem significat If saies he the blood be carried to and in great abundance collected in the Breasts it signifies that Fury and Phrenzy will follow Now the principal and most certain means to hinder the afflux of so great a quantity of Humours to the Breasts and prevent the coming of an Inflamation there is to procure a good and ample evacuation of the Locbia by the Womb. Wherefore if they are supprest they must be provoked by the means elswhere directed for by this evacuation all the Humours will take their course towards the lower parts The whole habit of Body may be emptied by bleeding in the Arm afterwards for a greater diversion and the better to bring down the Lochia bleed in the Foot during which Topical Remedies to the Breast must not be forgot as in the beginning to chase well into them Oile of Roses and Vinegar beat together laying upon them afterwards Unguentum refrigerans Galeni and a third part of Populion mixt with it or a Cataplasme made of the setlings found in a Cutlers Grin-stone-Trough Oile of Roses and a little Vinegar mixt together if the pain continue very great another Cataplasm may be made of the Crum of white Bread and Milk mixt with Oile of Roses and the Yolks of raw Eggs upon all these may be laid Compresses dipt in Vinegar and Water or in Plantane Water but great care must be taken that these Remedies applied to the Breast be only cooling and repressing without any great Adstriction for it may cause a scirrhous tumor which would remain a long time and it may be a worse distemper After the height of the Inflammation shall be past and the greatest part of the antecedent Humours evacuated and turned aside let Medicines a little resolving be used to digest resolve and consume the Milk which abounds in the Breasts to prevent corruption by its stay wherefore let them be drawn by the Child or some other person or else resolved unless that it be suppurated It may be resolved by the application of pure Honey to the Breasts which in this case is very effectual or else a red Cabbadg-leaf may be anointed with it and applyed to the Breasts having first withered it a little before the Fire and all the hard Stalks and Veins taken out do not lace the Breasts too strait nor apply any course or rough Clothes to them that they may not be therewith scratched and bruised A very good remedy for the same is a whole red Cabbage boiled in River water to a Pap and then well bruised in a wooden or marble Mortar and pulp'd through a Sieve which mixt with Oyle of Camomil may be applied as a Poultis to the Breasts In the use of all these means let the Woman observe a cooling Diet not very nourishing that too much Blood and Humours may not be engendered of which there is already too great a quantity she must alwaies keep her Body open that the Humours may be so much the more carried downwards and consequently turned from the Breasts During the whole time the Inflammation continues let her keep her Bed lying on her back that she may have the more ease for being raised the Breasts which are gross and heavy because of the abundance of humours with which they are repleted do very much pain her when they hang down let her stir her Arms as little as may be and after the fourteenth or fifteenth day of her Child-bed when she hath sufficiently cleansed and the Inflammation is abated and she no longer Feverish purge her once or twice as the case shall require to empty the ill humours which remain in the whole habit of her Body If notwithstanding all these Remedies the swelling of the Breast doth not go down and that she still
though the Milk have no ill quality in it self it may however corrupt in the Childs Stomach because of its weakness or for some other indisposition in which acquiring an acrimony instead of being well digested there ariseth thence biting Vapours which forming a thick Viscosity sticking like a kind of white Soot all over the Mouth doth easily cause and engender these small Ulcers by reason of the tenderness and delicacy of it This Guido makes us take notice of when he saies that these Ulcers for the most part happen to Children by the badnesse of the Milk or by its ill digestion Of these Ulcers some are benigne as they that are caused by a simple heat of the Nurses Milk or by the Childs blood and humours being a little overheated or also for having had a small fit of a Feaver and they are then very superficial of small continuance and easily yeilding to Remedies Others are malignant such as are caused by a venereal Vnome or that happen after a malignant Feaver and are Scorbutick which are putrid corrosive and spreading and do not only possess the superficies of the membranes which covers the roof of the Mouth and Tongue but making its Scabs deeper is communicated to all the internal parts of the Throat as the Venereal ones especially which can never be cured by ordinary Remedies but must be handled with Specificks without which they ever augment and soon kill little Infants who are too weak to undergo the Remedies fit for their cure The Ulcers of the Mouth according to Galen are of difficult Cure because they are in hot and moist places where easily Putrefaction and Corrosion is augmented besides the Remedies applied cannot lodg there being soon washed away with Spittle To cure these Ulcers when they are small and without malignity you must take care to temper and cool the Nurses milk prescribing her a cooling Diet bleeding and purging her also if there be occasion wash the Childs mouth with Barley or Plantane-water and Honey of Roses or Syrup of drie Roses mixing with them a little Verjuice or juice of Lemmons as well to loosen and cleanse the viscous Humours which cleave to the inside of the Childs mouth as to cool those parts which are already overheated this may be done by means of a small fine Rag fastened to the end of a little stick and dipt in this Remedy wherewith the Ulcers may be gently rubbed being careful not to put them to too much pain lest irritating of them an Inflammation be caused to augment the malady The Childs body must not be kept open that the Humours being carried to the lower parts so many vapors may not ascend as usually do when the Excrements of the Belly are too-long retained If the Ulcers participate of any malignity let Topical Remedies then be used which do their work speedily and as it were in an instant for to correct the evil qualities of the humours that cause them and prevent their further augmentation for it being impossible if they should remain long in these parts but their effect and vertue would be hindered or much diminished by the moisture of the Mouth For this purpose touch the Ulcers with Water of Plantane sharpned with Spirit of Vitriol taking great care that the Infant swallows none of it and the Remedy must be so much the stronger and sharper as the Ulcers are profound and malignant assoon as they have been cauterized with this Water by only touching them once or twice with it according to their bigness depth or corruption that no sharp serosities may distill upon the places not yet ulcered and upon the Infants Throat wash its Mouth with Plantane water or with a Decoction of Barley Agrimony and Honey of Roses continuing to touch and wash the ulcers as it may be judged convenient and until you find that they spread no further To prevent that in the use of these sharp Medicines not the least portion of them may fall upon the Childs Throat and that by swallowing of them he may receive no great prejudice some chuse rather to cauterize these Ulcers with small Linnen tents dipt in boiling Oyl which though afterwards swallowed cannot in the least prejudice him It will also not be amiss to purge the ill Humours out of the whole habit of the Child giving him half an Ounce of Syrup of Succory with Rhubarb If these Ulcers are maintained by a Venereal venome these Remedies may for some time hinder their increase but they will never be cured unless such as are more specifick to that Malady be applied as we shall hereafter direct CHAP. XXVIII Of the pain in breeding the Teeth THe Teeth which were hidden in the Jaws usually begin to come forth not all at a time but one after another towards the fifth or sixth Month sometimes sooner and sometimes also later for to effect which they cut the Gums wherewith they were covered Then because of the exquisite sence of those parts there happens so great pains to the Children that many who hitherto were very well are now in great danger of their life and often die by reason of many mischievous accidents which happen to them at that time Hippocrates names the principal of them in the 25. Aphorism of his Third Book In progressu verò quum â—am dentire incipiunt gingivarum prurigines febres convulsiones alvi profluvia maximè quum caninos edunt dentes his praesertim pueris qui crassissimi sunt alvos duras habent When saies he Children begin to breed their Teeth they are troubled with ching of their Gums Feavers Convulsions and Loosnesses and principally when they breed their Tusks or Dog-teeth especially those Children who are fat or full of Humours and bound The Dog-teeth commonly called the Eye-teeth cause more pain to the Child than any of the rest because they have a very deep root and a small Nerve more considerable which 't is said hath communication with that that makes the Eye move and as Hippocrates also saith Those Children which are very gross and bound in their body are upon this account in much more danger than others because the pains in these causeth a much greater sluxion of humours upon the diseased part with which their bodies alway abound when they are costive The Teeth which are first bred are the cutting or fore-teeth as well because they are sooner perfect as because being smaller and sharper the Gums are easier pierced through and also with less pain than by the rest which are softer at the begining and being larger cannot so soon make their way at least not without greater efforts Signs when Children will breed their Teeth are when the Gumms and Cheeks are swelled they feel a great heat there with an itching which often makes them put their Fingers in their Mouths to rub them from whence much moisture distills down into the Mouth because of the pain they feel there the Nurse in giving them suck finds the Mouth hotter they
ones wherein no part falls down but only there is a distention of the Membranes of the Scrotum and Testicles caused by some matter there collected as well through the natural weakness of those parts as with being bruised and pressed in a bad Labour amongst which the watry and windy happen oftenest for as for the fleshy and varicose they happen never or but very rarely in little Infants For the cure of the watry called Hydrocele which is caused by waters contained in the common or proper membranes of the Testicles apply to the swelling Remedies that may resolve and dry up the Waters therein and dissipate the wind and afterwards fortifie the parts They may be resolved with Fomentations of the Decoction of Camomil Melilot Rue Majoram and Fennel in which also the Compresses to lay upon them may be dipt they may be dried with Lime-water wherein a little Allom is dissolved and after that the greatest part of Waters are resolved and dried away let the parts be fortified lest others be there ingendred by putting to it Compresses wet in red Wine wherein Roses and Allum have been boiled ever having respect to the cause of the Hydrocele and that which feeds it but if these Remedies prove in vain the Tumour must be opened to evacuate the Waters by a single prick of a Lancet with which one must be satisfied in little Infants who for the weakness of their Age tenderness of their Bodies and want of the use of their reason cannot then undergo a greater Operation for the Cure of an Hydrocele CHAP. XXXII Of the Scabs which are upon the Head and Face of young Children WE intend to treat here only of such Scabs as have no malignity and are only caused by the supurfluity of some Humors which for being simply over-heated are easily conveighed to the Head and Face where they make little Pimples in which these humours continuing are corrupted and converted into matter which after eat through and ulcerates the simple superficies of the Skin and drying round about the place where it came out make those crusts there usually called Scabs with which some Childrens Head and Faces are every where so covered that they seem to have a Cap and a Mask of a piece for which nothing can be seen but only the Eyes and edges of the Lips which are exempt from it Many persons will have these Scabs aswell as the Meazels and Small-pox to proceed for the most part from some superfluity and residue of the menstruous blood from which the Infant purgeth it self after it is born which because it cannot be well rectified is so driven out that it may be cast off as useless but it is often from the ill nourishment of the Children who sometimes suck more Milk than they can digest as also from the ill quality of it whence is engendred a quantity of viscous and corrupt humours causing these Scabs which come most upon the Head and Face because they are moister especially in Children than any other part of the body These Scabs may be known not to be malignant when they are superficial moist and yellowish and when the Scabs being taken off the Skin appears red and crimson without being deeply ulcered The course of these humours must by no means be hindered by driving them inwards because their evacuation defends little Infants from many ill Diseases and we ordinarily see them whose Bodies have a long time purged away such superfluities to be in better health after they have cast forth all this kind of corruption and as Guido saith very well Though to the sight these Scabs are ill yet in respect of their cause they may be very good because nature is thus accustomed to purge the Infants bodies in thrusting out these excrements but endeavours must only be used to hinder the generation of more of these ill humours in the Child wherefore a healthful Nurse must be provided for it whose Milk is perfectly purified and very cool the Childs Belly must ever be kept open and purged if necessary with a little Syrup of Roses or Succory that so the humours may not be sent in too great abundance to the Head nor the sanies under the Scabs may not eating and corroding the Skin cause deep Ulcers it will not be amiss also to make the Scabs fall off that there may be a freer vent or issue for which fresh Butter is ordinarily made use of rubbing them therewith to moisten them or with the Liniment of Oile of sweet Almonds laying afterwards a Cabbadg or Beet-leafe upon it changing them twice or thrice a day to avoid the offence and corruption of the moisture which these things draw forth These things ought to be continued till the Child be perfectly cured and no other because they do very much suppurate the Scabs and only draw away the superfluous humours which should in no wise be retained within for fear lest a worse malady happen after the evacuation of which the places will dry and heal of themselves all this while the Childs hands must be pinned down lest by rubbing and scratching the Scabs when they itch should by irritating these parts cause an inflammation whereby a yet greater abundance of humours will flow thither CHAP. XXXIII Of the small Pox and Meazels in Infants THe small Pox is a contagious Disease to little Infants which somtimes also happen though more rarely to persons already advanced in age in which abundance of Pustules all alike do break forth throughout the superficies of the Skin engendred from the impurity of the Blood and other Humours which nature there casts out as an universal emunctory to cleanse the whole body of them Many antient as well as modern Physicians attribute the cause of this disease to the residue of the menstruous blood wherewith the Infant was nourished in the Mothers Womb which after its birth coming to be heated and to boil in the Vessels is separated from the whole Mass of Blood which hath been since engendred and is spread throughout all the superficies of the Body to be in that manner rejected and expelled This reasoning according to my opinion is not very probable for we daily see many Men and Women who though very aged have never had this Malady which they could never have avoided if it proceeded from the remainder of the menstruous Blood wherewith every one without exception is nourished in their Mothers Womb. They which maintain this opinion reply that though some persons be exempted from this Disease 't is because their strong and robust nature could digest and consume those superfluities or else purge them off by other wayes as by a Loosness or in some manner more insensible However they must confess and agree that this menstruous Blood if it were that could not remain hid and quiet in the Body for 30 40 or 50 years after Birth without producing its effects as we see in several that have not this disease 'till those years but 't is