may be found out by the hand of a Skilful Midwife As to the prognostick if the Closure be in the Orifice of the Privities it is easily Cured by a small Section But if it be in the inner Parts the Cure is much more difficult When a Membrane shuts the passage it is easily Cured but when the Closure is from fleshy Matter as it happens after Ulcers then the Cure is much more difficult The Closure of the inner Orifice of the Womb is Incurable for Chirurgcial Instruments cannot work upon it If the Closure of the Womb be contracted from the Birth it must be opened by simple Section but if it takes its rise from an Ulcer as it often happens in the French-Pox we must consider whether it be an Excrescence of Flesh that does not wholly stop the passage and whether it quite stops For if it be only an Excrescence we must endeavour convenient Evacuations going before first to hinder the increase of the Flesh by drying and discussing Medicines and afterwards we must lessen the Flesh by Medicines made of Frankincense Birthwort the Bark of Frankincense Roses Balaustins Mastick Myrrh Aloes and the like and if these things are not sufficient we must use burnt Allom Unguentum Aegyptiacum and the like or the Flesh may be cut off by that Instrument that is used for extirpating a Polipus But if the Neck of the Womb be wholly shut we must endeavour to renew the Ulcer and to take off the superfluous Flesh by the foresaid Medicines or it must be cut If a Tumour shut the passage of the Womb it must be removed by proper Remedies If it be occasioned by a Compression of the Neck of the Womb that which causes the Compression must be removed namely a Stone in the Bladder a Tumour of the right Gut or the like When the passage is too narrow it most commonly proceeds from hardness and dryness and therefore you must use moistning emollient and relaxing things as half Baths Fomentations Liniments and Pessaries and so the part being relaxed you must put a leaden Pipe or white Wax fitted for the purpose moistened with Butter or some emollient Oyl and she must always wear it or at least a-nights and a-days let a Pessary made of Cotten be used anointed with Oyntment Marsh-mallows or the like CHAP. X. Of Suppression of the Courses THere is said to be a Suppression of the Courses when in Women of a mature Age that neither give suck nor are with Child the Evacuation of Blood by the Womb which is Naturally wont to be Monthly flows seldom or sparingly or is wholly stopt Because this Suppression proceeds from Natural and Preternatural Causes the signs of both shall be distinctly proposed lest the Practitioner should be deceived by Women being with Child by Illegitimate Coition and so rashly prescribe Medicines to provoke the Courses First therefore Women with Child most commonly retain their Natural Colour and others do not Secondly the Symptoms which do happen to Women with Child at the beginning abate Daily but on the contrary in Suppression of the Courses the longer they are stop'd so much the more the Symptoms are increased Thirdly In Women with Child after the third Month the motion and situation of the Child may be sensibly perceived by laying the hand on the Belly But in others the Swelling is not at all hard nor is it always contained within the Limits of the Womb. Fourthly If the inward Mouth of the Womb be touched by a Skilful Midwife she will find it not exactly closed as it is in Women with Child but rather hard contracted and somewhat painful Fifthly Women with Child are most commonly cheerful but on the contrary in a Suppression they are most commonly sorrowful and sad A Suppression of the Courses is very dangerous and many desperate Diseases arise from it The Cure of this Disease must be varied according to the variety of the Causes and first if it proceed from too great a quantity of Blood bleeding must be ordered in the Arm and a large quantity of Blood must be taken away afterwards it must be drawn downwards by opening the lower Veins about the time the Woman used to have her Courses before she was ill If by reason of want of Blood the Courses stop as after long Fevers after great Evacuations and when the Body is much wasted you must not endeavour to provoke the Courses till the Body is replenish'd and a sufficient quantity of Blood is bred which being done they generally flow of their own accord but if it happens that Nature forforgets her Office she must be rous'd up by opening the lower Veins and by Medicines proposed in the Chapter of Hysterick Diseases But the quantity of Blood must be moderate lest the strength should be dejected and the Sick should fall into a Consumption yet it must be carefully noted that every wasting of the Body does not shew a want of Blood but only that which succeeds great Evacuations and the like For sometimes it happens that the Courses being suppressed and detained in the Veins occasion an ill quality whereby the Blood is rendred unfit to nourish the Parts upon which account the Body wasts tho the Veins are full of Blood in which Case large bleeding is required As to the suppression of the Courses which happens by a preposterous motion of the Blood when it is evacuated by bleeding at Nose by Vomiting Spitting or Hemorrhoids and other parts the Cure of it is perform'd by repelling the Blood from the parts through which it flows contrary to Nature and by drawing it back to the passage of the Womb. The first is performed when the Blood rushes out of the upper parts by washing the Arms Head and Face with cold Water and by forbearing the exercise of those parts especially singing and speaking aloud The second is perform'd by opening the lower Veins three or Four days before the Blood breaks out and by Cuping-Glasses applied to the Thighs and Legs sometimes with sometimes without Scarification by provoking the Hemorrhoids by Running by Walking Fomentations and Baths made of opening Herbs but the Bath water is especially commended and the Sick must bath in them often a good while after Meals but the water must not rise above the Navel and at the same time the upper parts be cool'd by fanning them If the Blood flow by the Hemorrhoids the Cure is very difficult for if you use things to draw downwards they bring them also to the Fundament and if you use astringent things to it they by nearness of the parts repell what should be brought to the Womb so that the only way of Cure is to apply such things to the Womb as may allure the Blood thither after you have used such things as draw the Blood downwards CHAP. XI Of an Immoderate Flux of the Courses AN immoderate Flux of the Courses comes either in Child-bed or at other times as to the first that afflicts Women most on
either and it happens sometimes that the same Man has Children by another Woman and the same Woman Children by another Man when together they were Childless It comes to pass sometimes that after a Woman has conversed ten or more Years with her Husband and has not conceived afterwards she has had Children the cause whereof is the change of her Constitution by time Having made frequent mention of Womens Seed I must here acquaint you that many Learned Physicians and Anatomists deny that Women have any Seed for some Women send forth no humour as is called Seed and yet they are Fruitful enough yea some after they have begun to emit such an humour tho indeed they took great pleasure in Copulation yet grew less fruitful than before 'T is also said by some that a seminal Air or Vapour arising from the Mans Seed and not the Seed it self causes Conception but passing by Controversies and nice Speculations I according to my way of Writing set down such Methods and Medicines as are approved of for the Cure of this Disease And First the narrowness of the genital parts by reason of youth in progress of time will grow large enough and therefore there is no need of any other Cure but in the mean while Copulation must be forbid for by the too early use of it the natural constitution of the parts is disordered but if it proceed from small stature or age it is incurable Over-fatness may be corrected by a spare and proper Diet and by convenient evacuations If Barrenness proceeds from a disorderly Diet as from excessive eating or drinking the Woman must be reduced to a regular course of Life Such as are robust and of a manly Constitution must by all means be reduced to a womanly state that they may become fit for generation they must forbear strong Meats and Labour and the Courses must be forced and by Bleeding and Purging and the like the habit of the Body must be rendred cold and moist But the most frequent cause of Barrenness is a cold and moist disposition of the whole Body and of the Womb which the Whites often accompany and for the cure in this case the Whites must be cured by the method prescribed in the Chapter of the Whites and the following things must be ordered which are peculiarly proper And First the flegmatick humours must be evacuated by Medicines that purge Sweat and force Urine and revulsion must be made by Issues in the Arms Neck and Legs and the principal parts must be strengthened by Treacle Mithridate Confection of Alkermes and the like Afterwards such things must be used as are proper by a specific quality to strengthen the Womb and to help Conception Take of the roots of Eringo and Satyrion candied each one Ounce of green Ginger candied half an Ounce of Hazel Nuts Pine Nuts and Pistachies each six Drams one Nutmeg candied of the Seed of Rocket and Cresses each two Drams of the ashes of a Bulls Pisle of the Reins of Scinks and of the raspings of Ivory each one Dram of confection of Alkermes three Drams of Diambra and sweet Diamoch each one Ounce and an half of Ambergriese half a Dram with the Syrup of candied Citrons make an Electuary let her take the quantity of a Nutmeg at bedtime drinking upon it a glass of good Wine Some count the Secundine of a Woman dried and powderd very effectual one Drachm of it being taken The Seeds of Bishops weed are also much commended Many good Authors affirm that if a Woman drink six Ounces of the juice of Garden Sage with a little Salt the fourth day of her Menstruous Purgation and a quarter of an hour after has Conversation with her Husband she will infallibly conceive And by the use of this remedy Aetius says the Egyptian Women became fruitful after a great Plague It 's said many have conceived when their having Children has bin despair'd of by thrusting up far in the Privities Garlic heated with Oyl of Spike and wrapt in a fine rag for it powerfully forces the Courses and cleanses and delights the Womb. CHAP. XIV Of the Parts of Women that serve for Generation THE Parts serving for Generation in Women may be divided into the Privities the Womb the Testicles and the Vessels that prepare and carry That part is called the Privities which appears at first sight without dissection it reaches from the lower part of the Os Pubis within an Inch of the Fundament it is less and closer in Maids than in those that have born Children It hath two Lips which toward the Pubes grows thicker and meeting upon the middle of the Os Pubis makes that rising that is called the Hill of Venus its outward substance is Skin covered with Hair as the Lips are which begin to grow in this place about the age of Fourteen the inner substance of the Hill of Venus chiefly consists of Fat which makes it bunch up which in Copulation hinders the bones of the Pubes of the Man and Woman to hit one against another which would by causing pain abate the Venereal pleasure A Muscle springing from the sphincter of the Fundament lies under this Fat Its Office is to straighten the Orifice of the Sheath The Nymphs and the Clitoris appear when the Lips are drawn a little aside The Nymphs stand next the Urine as it spouts out from the Bladder and keeps the Lips from being wet they are placed on each side just within the Lips they are two fleshy and soft Productions beginning at the upper part of the Privities where they make that wrinkled membranous Production which cloaths the Clitoris like a Fore-skin They are in shape and colour like the Thrils that hang under a Cocks Throat they have a red substance partly Fleshy partly Membranous within Soft and Spongy composed loosly of small Membranes and Vessels so that they are very easily distended by the influx of the Animal Spirits and Arterial Blood They are larger in grown Maids than in Young and grow larger upon the use of Venery and after the Bearing of Children their use is to defend the inner Parts and to cover the passage of the Urine and a good part of the Orifice of the Sheath in the upper part of the Privity Betwixt the Nymphs is placed the Clitoris it answers to a Man's Yard in shape situation substance erection and differs from it only in length and bigness Those that are called Hermophrodites have it so long and big as to be able to Converse with Women in the manner of Men. They are not of two Sexs as is commonly reported only their Stones are placed in the Lips of the Privities and their Clitoris is preternaturally extended But in most it does not appear unless the Lips are drawn aside It is a little long and round Body it lies under the fat of the hill of Venus and puffs up in Venery and straightening the Orifice of the Sheath makes it embrace the Virile
Womans Belly And the Plaister above mentioned may be used It is believed that the two following Medicines will certainly retain the Child in the Womb if they be used before it is torn from the Vessels of the Womb. Take of leaves of Gold Number twelve of Spodium one Dram the Cocks treading of three Eggs not addle mix all very well till the Gold be broken into small peeces afterwards dissolve them in a draught of White Wine and give it three Mornings following At the same time let the following Cataplasm be applied Take of Male Frankincense powdred two Ounces the whites of five Eggs let them be stirred together over hot Coals add Turpentine to make them stick then spread them upon Tow and lay them upon her Navel as hot as she can possibly endure them twice a day Morning and Evening on the three days afore-said CHAP. XXI The Signs that precede a Natural and Vnnatural Delivery THE signs preceding a natural Labour a few days before are sinking down of the Belly which hinders a Woman at that time in walking as easie as she used to do and thence flows from the Womb slimy humours appointed by nature to moisten and smoothen the passage that its inward Orifice may the more easily be dilated when it is necessary which beginning to open a little at that time suffers that slime to flow away The signs accompanying present Labour are great pains about the Region of the Reins and Loins which coming and redoubling by intervals answer in the bottom of the Belly with reiterated Throws the Face is red and inflamed because the Blood is much heated by the continual endeavours of the Woman to bring forth the Child as also because that during these strong Throws her respiration is ever intercepted for which reason much Blood hath recourse to the Face her Privy Parts are swelled because the Infants head often thrusts and causes the Neighbouring Parts to distend outwards upon which account they appear swell'd in this manner she is often subject to vomiting which makes many believe who know not the cause of it that the Women are for this reason in danger But it is generally the sign of a speedy delivery because the good pains are then excited and redoubled every moment until the business is finished When the Birth is very near Women are troubled with an universal trembling and chiefly of the Legs and Thighs with the heat of the whole Body and Humours which then flow from the Womb and they are often discoloured with Blood which with the signs above mentioned is an infallible sign of the nearness of the Birth This the Women usually call shows and if one then puts up their Finger into the Neck of the Womb they will find the inner Orifice dilated at the opening whereof the Membranes of the Infant containing the Waters present themselves and are strongly forc'd downwards with every pain the Woman has at which time one may perceive them to resist the Finger more or less as the pains are stronger or weaker These Membranes with the Waters in them when gathered that is when they are advanced before the head of the Child which makes the Midwives call it the gathering of the Waters presenting themselves at this inward Orifice do then resemble very well to the touch of the Finger abortive Eggs which have yet no shell but are only covered with a simple Membrane After this the pains redoubling continually the Membranes are broken by the strong impulse of the Waters which incontinently flow away and then the head of the Child is easily felt naked and presented at the opening of the inward Orifice of the Womb now all these or the greatest part of them meeting together at what time soever of a VVomans going with Child it be whether at the full time or no one may be assured she will soon be delivered But great care must be taken not to hasten her Labour before the necessity of it be known by these signs for that would but torment the VVoman and Child in vain and put them both in danger of their lives Labour contrary to nature is when the Child comes in an ill Figure and Situation as when it presents any otherwise than the Head first as also when the Waters flow away a long time before it is born also when the After-burthen comes first The Labour is also grievous when accompanied with a Fever or any other considerable Disease which may destroy the Child in the Womb also when pains are small and come slow with long intervals and little profit upon which account the Woman is extreamly tired but the wrong posture of the Infant is most commonly the cause of difficult Labour As soon as it is known that the Woman is certainly in labour by the signs above mentioned then must all things necessary to comfort the Woman in her Labour be got ready and the better to help her care must be taken that she be not strait laced a pretty strong Glister may be given her or more than one if there be occasion which must be done at the beginning before the Child be too forwards for afterwards it is very difficult for her to receive them in the mean while all things necessary for her Labour should be put in order as well for the Woman as the Child her Midwifes Stool or rather a Pallet-bed girted placed close by the Fire if the Season require it the Pallet ought to be so placed as to be turned round about when there is occasion the better to help the Woman If the Woman be full of Blood it may be convenient to Bleed her a little for by this means her Breasts being disingaged and her Respiration free she will have more strength to bear down her pains which may be done without danger because the Child being about that time ready to be born hath no more need of the Mothers Blood for its nourishment which has been often practised with good success Besides this Evacuation often hinders her having a Fever after delivery and to preserve her strength it will be convenient to give her some good Gelly Broaths new laid Eggs or some Spoonfuls of burnt Wine from time to time or a Toast dipt in Wine avoiding solid Food Above all she must be perswaded to hold out her pains bearing them down as much as she can at the instant when they take her The Midwife must from time to time touch the inward Orifice with her Finger to know whether the Waters are ready to break and whether the Birth will follow soon after she must also anoint all the bearing place with emollient Oyls Hogs grease or fresh Butter if she perceive it can hardly be dilated and all the while she must be near her Woman to observe her gestures diligently her complaints and pains for so she may guess pretty well how the Labour advances without being obliged to touch her Body so often The Woman may by intervals rest her self on
and a very considerable abscess follows in which Case it must be opened just below the Swelling in the most convenient place and after the Matter is evacuated a detersive Decoction must be injected into the Cavity made of Barly-water and Oyl of Roses to which Spirit of Wine may be added if there be any danger of Corruption and afterwards the Ulcer must be Dressed according to Art Sometimes it happens that the Perineum is so rent that the Privities and the Fundament is all in one in this case having cleansed the Womb from such Excrements as may be there with Red-wine let the Rent be strongly stitched together with three or four stiches or more according to the length of the separation taking at each stich good hold of the Flesh that so it may not break out and then dress it with Linimentum Arcaei or the like claping a Plaister on and some Linnen above to prevent as much as may be the falling of the Urine and other Excrements upon it because the acrimony of them would make it smart and cause 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 happens to be with Child she will be obliged to prevent the like mischief to anoint those parts with Emollient Oyls and Oyntments 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 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 does straighten the parts yet more wherefore it were to be wished for greater security against the like accidents that the Woman should have no more Children CHAP. XXII Of hard Labour MAny Causes may be assigned that occasion hard Labour as the natural weakness of the Mothers Body or her Age she being too Young or too Old or it may be occasioned by Diseases that she had with her big Belly leanness or too much dryness of the Body or Fat compressing the passages of the Womb the ill conformation of the Bones encompassing the Womb as in those that are Lame may also occasion it Wind swelling the Bowels a Stone or Preternatural Tumour in the Bladder that presses the Womb may be the occasion so may the ill constitution of the Lungs or of the parts serving respiration for the holding of the Breath conduceth much to the Exclusion of the Child Various Diseases of the VVomb may also render the Delivery difficult as swellings Ulcers Obstructions and the like The hard Labour is occasioned by the Child when by reason it is Dead or Putrified or any way Diseased it cannot confer any thing to its own exclusion also when the Body or Head is too large or when there are more than one so Twins most commonly cause hard Labour or the ill situation of the Child is the cause or when the Hands or the Feet offer first or when one Hand or one Foot comes out first or when it is doubled or when the Membranes break too soon so that the VVater flows out and leaves the Orifice of the VVomb dry at the time of Exclusion or when the Membranes are too thick so that they cannot be easily broken by the Child Cold and dry Air and a North-wind are very injurious to VVomen in Labour because they bind the Body and drive the Blood and Spirits to the inner parts and they are very injurious to the Child coming from so warm a place And hot Weather dissipates the Spirits and weakens the Child Crude Nourishment and such as is difficultly concocted and binds taken in a great quantity before Labours renders it difficult the Stomach being weakned and the common passages contracted which ought to be open in this Case Drowsiness hinders the action of the Mother The unseasonable motion of the VVoman much retards the Delivery as when she refuses upon occasion to stand walk lie or sit or slings her self about unadvisedly so that the Child cannot be Born the right way being turned preposterously by the restlesness of the Mother Urine in the Bladder or Excrements in the right Gut or the Piles when they are much swell'd hinder Natures endeavours by narrowing the Neck of the VVomb Fear Sorrow Anger make the Labour difficult A Blow a Fall or a Wound may also much obstruct the Labour Want of good assistance to lift the Woman up just at the time of Delivery and an Ignorant Midwife who orders the Woman to endeavour an expulsion and to stop her breath when the ligaments of the Fetus stick firmly to the Womb so that the Woman is tired before the time of her Delivery In hard Labour Women commonly give a Spoonful or two of Cinamon-water or Cinnamon powder'd with a little Saffron or half a Dram of Confection of Alkermes in Broth or half a Scruple of Saffron alone in some Broth or every hour a lit-VVine If these things are not sufficient the following may be used which have been frequently found very effectual Take of Dittany of Creet and both the Birthworts and of Troaches of Mirrh each half a Scruple of Saffron and Cinnamon each Twelve Grains of confection of Alkermes half a Dram of Cinnamon-water half an Ounce of Orange-flower-water and of Mugwort-water each one Ounce make a Potion Oyl of Amber and of Cinnamon and extract of Saffron are very effectual in a small quantity namely five Grains of extract of Saffron four or five drops of Oyl of Cinnamon twelve or fifteen drops of Oyl of Amber in Wine Broth or some other Liquor and let the Woman take Sneesing Powder for it hastens delivery The Midwife must frequently anoint the Womb with the Oyls of Lilies or of Sweet Almonds and the Belly must be fomented with a Decoction of the Roots of Marshmallows and Lilies of the Leaves of Mallows Violets Mugwort of the Seeds of Fenugreek and Flax of the Flowers of Camomile and Melilote Sharp Glisters must be also injected to stimulate the Womb and to carry off the Excrements Anoint the Navel with Oyl of Amber If the Child begins to come forth preposterously as with one Arm or Foot the Midwife must thrust them back and turn the Child right which may be done by placing the Woman on her Back upon a Bed with her Head low and Feet high CHAP. XXIII Of a dead Child WHEN the Child is dead the motion of it ceases which either the Woman felt before in the Womb or the Midwife with her Hand a sense of weight with pain afflicts the Belly and the Child falls like a Stone from side to side the Belly feels cold the Eyes are Hollow the Face and Lips pale the extream parts cold and livid the Breasts flaccid and at length the Child putrifying stinking matter Flows from the Womb
and an ill and strong smell exhales from the Womans Body and her Breath stinks If the Secundine be excluded first it is a certain sign that the Child is dead The whole cure consists in the exclusion or extraction of the Child Take of the Leaves of Savine dryed of the roots of round Birthwort of the Troches of Myrrh and of Castor each one Dram of Cinnamon half a Dram of Saffron one Scruple mingle them make a Powder whereof let her take one Dram in Savine Water Foment the Pubes Privities and Perineum with an Emollient Decoction made of the Leaves of Mallows and Marsh-mallows and the like and let a Pessary be put up the Privities Take of the Roots of round Birthwort Orris Black Hellebore of Coloquintida and Myrrh each one Dram of Galbanum and Opopanax each half a Dram with Ox Gall make a Pessary If after having tried Medicines a long while the Child cannot be ejected it must be extracted by a Surgeon either with Instruments or with the Hand alone CHAP. XXIV Of the Caesarian Delivery THE Caesarian Delivery is a dextrous extraction of a Living or Dead Child from the Mothers Womb which cannot be other ways excluded and that without endangering the Life of both or of either and without spoiling the Faculty of conceiving and by this Art the first Scipio Africanus of the Romans was cut out of his Mothers Womb and therefore was called Caesar This Caesarian Section is thought to be necessary when the Mother and the Child are so weak that they cannot be preserved any other way The use of it is twofold one that a living Child may be extracted the other that the Mother may be preserved alive and tho' it is very hazardous yet in a desperate case it is better to do something than nothing especially when a confederacy is like to be broken by the death of a Wife or when a Family is like to be extinguished or some Kingdom or Principality is like to be lost In this manner we find in the Annals of Spain the King of Navar was preserved for his Mother being wounded in the Belly by the Saracens as she was Hunting a Noble Man coming to her help saw the Child put its hand out of the Wound and drew it forth and educated it privately and afterwards when the Nobility was contending about the Election of a Prince he brought out the young King and so the Controversie ended The causes which require this operation are a too great Child or Twins or more that endeavour to be born together or if a fleshy Mole join to the Child the ill posture of it and if it cannot be reduced to a better either by its own help or the help of others or because it is dead or so much swell'd by a Disease that the Naturall passage is too narrow But in this case it is best to take it away peece-meal The causes on the Mothers part are the narrowness of the passages either naturally by reason she is too young or too old or because the VVomb is shut either by a Cicatrix or a Callous Moreover many tumours in the Womb or the Mouth of it may be the cause In these cases tho it be very dangerous yet it is very necessary to use Section and the operation may be happily performed as may appear by several Experiments to him that reads Rousel But before you enter upon this Operation you must consider whether the Child can be Extracted any other way that is safer and easier You must moreover consider whether there are Signs of Death and if so you must not enter upon the Operation lest the Womans Death be laid upon the Section and your rashness But when you have througly weighed all things if the Woman be of a strong Nature tho by reason of the Labour she is weak you may venture upon the Operation Most Authors would have it made on the left side of the Belly because it is more free from the Liver but I says Mauriceau think it will be better and more skilfully made just in the middle of the Belly between the two right Muscles because in this place there is only the coverings and the white line to cut To dispatch then with more ease and speed the Chyrugeon having placed the Woman so that the Belly may be a little raised let him take a good sharp incision Knife very sharp on one side with which he must quickly make an Incision just in the middle of the Belly between the two right Muscles unto the Peritoneum of the length and extent of the Womb or thereabouts after that he must only peirce the Peritoneum with the point of his Knife to make an Orifice for one or two of the Fingers of his left hand into which he must immediately thrust them to cut it lifting it up with them and conducting the Instrument for fear of pricking the Guts in proportion to the first incision of the coverings which having done the Womb will soon appear into which he must make an Incision in the same manner as he did in the Peritoneum being careful not to thrust his Instrument at once too far in having then so opened the VVomb he must likewise make an incision in the Infants Membranes taking care not to wound it with the Instrument and then he will soon see it and must immediatly take it out of the burthen which he must nimbly separate from the bottom of the VVomb and finding it to be yet living let him praise God for having so blessed and prospered his Operation But the Children so delivered are usually so weak if not quite dead as it often happens that it is hard to know whether it is alive or dead yet one may be confident the Child is living if by touching the Navel-string the Umbilical Arteries are perceived to move as also the Heart by laying the Hand on the Breast and if it prove so means must be used to fetch it to it self by spouting some VVine into the Nose and Mouth and by warming it until it begins to stir of it self But it is to be noted that Mauriceau much disapproves this cruel Operation and says it ought not to be performed until the VVoman is dead for that the VVoman always dies in the operation or presently after CHAP. XXV Of the Secundine retained IN a natural Birth the Secundine is usually excluded presently after the Child and when it is not the Life of the Woman is much indangered It is retained by the too great thickness of the Coats the swelling of them and by an afflux of Humours occasion'd by hard Labour also by the strutting of the Mouth of the Womb after the exclusion of the Child The External Causes are Coldness of the Air whereby the Secundine is repelled and the Orifice of the Womb shut Certain perfumes whereby the Womb is allured upwards violent passions of the Mind as Fear and sudden Frights the perverseness of the Woman who will not
evening for some weeks But if the Remedies above-mentioned don't well agree which often happens in thin and choleric Constitutions then a Milk-dyet may be used for some Women which one would wonder at at first that have been a long while afflicted with Hysteric Diseases and could be relieved no other way have been recovered by Dieting themselves for some time only with Milk and especially those that Labour with an Hysteric Cholick which can't be appeased by any thing but Opiates to which repeated Women are much accustom'd the pains returning as soon as the vertue of the Opiate fades But riding on Horse back or in a Coach every day for a long while is the best remedy This is the general way of Curing this Disease which is apply'd to the original cause namely the weak constitution of the Blood and so is to be used only when the Fit is off therefore as often as the Fit comes join'd with any one of the fore-said Symptoms if the Disease be such or so great an one that it will not bear a Truce till it may be cured by Medicines that strengthen the Blood and Spirits we must presently make use of Hysteric Medicines which by their strong and offensive smell recall the disorderly and deserting Spirits to their proper Stations whether they are taken inwardly or smelt to or outwardly apply'd such are Assa-faetida Galbanum Spirit of Sal Armoniac and lastly whatever has a very ungrateful and offensive smell In the next place you must take notice that if some intollerable pain accompanied the fit or violent Vomiting or a Loosness then besides the Hysterics above-mentioned Laudanum is to be used which is only able to restrain these Symptomes But in quieting the pains which Vomiting occasion we must take great care that they are not mitigated either by Laudanum or any other Opiat before due evacuations have been made unless they exceed almost all humane patience Therefore in lusty Women and such as abound with Blood a Vein must be opened and the Body purged especially if they have been lately seized with the fit But if weak Women and those of a quite contrary Constitution labour with such a fit and pain and have been afflicted with it not long ago it will be sufficient to cleanse their Stomachs with a gallon of Posset drink taken in and ejected by Vomiting and then to give a large Dose of Venice-Treacle and a few spoonfuls of some Spirituous Liquor that is pleasing to the taste with a few drops of Liquid Laudanum to be taken presently after But if the Sick has Vomited a great while and there is danger lest by a further provocation by Vomits the Spirits should be put into a rage and the Sick too much weakened in this case you must give Laudanum without delay and such a Dose that is sufficient to vanquish it But here two things are to be chiefly noted first that when you have once begun to use Laudanum after due and necessary evacuations it must be taken in the same Dose and must be often repeated till the Symptom is quite conquered only such a space must be betwixt each Dose that we may know what the former has done before we give another and then when we treat the Disease with Laudanum we must do nothing else and nothing must be evacuated for the gentlest Glister of milk and sugar is sufficient to spoil whatever has been repaired by the Laudanum and to occasion a return of the Vomiting and pain But though the Pains above mentioned are apt to overcome the vertue of the Laudanum yet violent Vomiting indicats the largest Dose of it and that it should be very often repeated for by reason of the Vomiting the Laudanum is cast up before it can do any good unless it be given afresh after every time the Sick Vomits and chiefly in a solid form and if it be given in a liquor the quantity must be so small that it must but just wet the Stomach so that by reason of the small quantity of the matter it cannot be cast up for instance some drops of Liquid Laudanum in one spoonful of strong Cinnamon-water or the like and the Sick must be admonished to keep her self quiet presently after taking the Laudanum and that she keep her Head as much as is possible immoveable for the smallest motion of the Head provokes Vomiting more than any thing else and when the Vomiting ceases and is as it were tam'd it is expedient to give a Dose of Laudanum morning and evening to prevent a relapse which also ought to be observed after a Loosness or Hysteric pains And because frequent mention has been made of Liquid Laudanum in this Chapter and it is much used in other Diseases Women are subject to I will here set down the best way of making it Take of Spanish-wine one pint of Opium two ounces of Saffron one ounce of the Powders of Cinnamon and Cloves each one Drachm let them be infused together in a Bath for two or three days till the liquor comes to the consistence of a thin Syrup strain it and keep it for use The Dose is sixteen or twenty Drops to be taken in a small draught of Beer or in some distilled-water CHAP. II. Of the Green-Sickness THE Green-sickness is an ill habit of the Body proceeding from Obstructions it is accompanied most commonly with a beating of the Heart difficulty of breathing and a longing for absurd things and an unfitness for motion and other Symtoms the Face and whole Body are pale and sometimes of a leaden and green colour there is an inflation and as it were a swelling upon the Eye-lids the Legs also swell especially about the Ankles there is a heavy and often a lasting pain of the Head the Pulse is quick the Sick are drowsie and have an aversion for wholsome food lastly the Disease increasing and the Obstructions being multiplied a suppression of the Courses at length follows which shews the Disease is confirmed This Disease most commonly is not dangerous but if it be neglected too much it occasions great Diseases as hard Swellings a Dropsie and other grievous Diseases which at length kill the Patient When the Disease is small and chiefly arises from Obstructions of the veins of the Womb it is easily cured by Marriage in young Virgins Those that have had this Disease a long while are either Barren or bring forth Children that are Sickly and short lived The Cure is to be perform'd by the same Method and Medicines proposed in the foregoing Chapter for the cure of the Hysteric Diseases CHAP. III. Of Women that never had their Courses THE flux of the Courses is an undoubted sign that a Woman is mature yet there are some Women that never had them tho' they have had conversation with their Husbands and some of them have had Children and others not some of them have enjoyed good health and others have been sickly the cause of this defect is in general two-fold
the first day after a difficult Labour and is accompanied with a long train of Hysteric Symptoms and as it happens only on the first days so usually does not last long for if a thickning diet be order'd it soon abates The following Drink may be also used Take of Plantain water and Red wine each one Pint boil them till a third part be consumed sweeten it with a sufficient quantity of white Sugar and let her take half a pint twice or thrice a day and in the mean while the following Medicine tyed up in a rag may be often held to her Nose Take of Galbanum and Assa foetida each two Drams of Castor one Dram and half of Volatile Salt of Amber half a Dram mingle them Or instead of it Spirit of Sal armoniac may be used But as to the Flux which happens out of Child-bed you must bleed in the Arm and eight Ounces of Blood must be taken away the next Morning the following Purge must be given Take of Tamarinds half an Ounce of Sena two Drams of Rubarb one Dram and an half infuse them in a sufficient quantity of Fountain water in three Ounces of the strain'd Liquor disolve of Manna and Syrup of Roses solutive each an Ounce make a Purging Potion which is to be repeated every third day for twice Every Night at bedtime through the whole course of the Disease give an Ounce of Diacodium mixt with two Ounces of Black Cherry water Take of the Conserve of dried Roses two Ounces of the Troches of Lemnian Earth a Dram and an half of Pomgranate peel and of red Coral prepared each two Scruples of Blood Stone Dragons Blood and Bole-armenic each two Scruples with a sufficient quantity of Simple Syrup of Coral make an Electuary whereof let her take the quantity of a large Nutmeg in the Morning and at five in the Afternoon drinking upon it six Spoonfuls of the following Julip Take of the waters of Oakbuds and of Plantain each three Ounces of Cinnamon water hordeated and of Syrup of dried Roses each one Ounce of Spirit of Vitriol a sufficient quantity to make it pleasantly acid Take of the Leaves of Plantain and Nettles each a sufficient quantity beat them together in a Marble Mortar and press out the juice clarifie it and give six Spoonfuls of it cold three or four times in a day after the first Purge apply the following Plaister to the region of the Loins Take of the Plasters of Diapalma and ad herniam each equal parts mix them and spread them on Leather A cooling and thickening Diet must be order'd only it may be proper to allow once or twice a day a small glass of Claret to recover the strength CHAP. XII Of the Whites THis obstinate and lasting Disease may be cured by bleeding once and by Purging with two Scruples of Pill Coch-Major four times and by the following strengthening Medicines Take of Venice Treacle one Ounce and an half of the Conserve of the Yellow Peel of Oranges one Ounce of Diascordium half an Ounce of Ginger candied and Nutmegs candied each three Drams of compound Powder of Crabs eyes one Dram and an half of the outward Peel of Pomgranats of the roots of Spanish Angelica and of the troches of Lemnian Earth each one Dram of Bole-Armenic two Scruples of Gun-arabic half a Dram with a sufficient quantity of Syrup of dried Roses make an Electuary whereof let her take the quantity of a large Nutmeg in the Morning and at five in the Afternoon and at Night drinking upon it six Spoonfuls of the following infusion Take of the roots of Elecampane Masterwort Angelica and Gentian each half an Ounce of the Leaves of Roman Wormwood white Horehound the lesser Centory and Calaminth each one handful of Juniper-berries one Ounce cut them small and infuse them in five pints of Canary Wine let them stand in infusion and strain them only as you use them CHAP. XIII Of Barrenness BArrenness proceeds from many causes but they may be reduced to four Heads according to the four Natural Operations which are required to perfect Conception The first is that the Woman in Copulation receive the Mans seed Secondly that it 's retain'd a due time Thirdly that it is nourished in the Womb Fourthly that the Woman afford due Matter for the forming and necessary increase of the Embroy and hence four impediments of Conception arise First The Reception of the Seed is hindered by many causes as immature Age when by reason of the narrowness of the Genital passages the Woman cannot admit the Mans Yard or at least not without great pain which makes her dislike Copulation and Old Age has the same effect for in elderly Virgins the Genital parts for want of use are rendr'd so strait that they can't easily receive the virile Member and such as are lame or have their Limbs distorted or their Hips depressed can scarce lye in such a posture as is necessary for a fit Reception of the Seed too much fat also stops the passages and makes the Copulation incommodious And lastly a cold intemperies of the Womb makes the Woman dull so that she scarce injoys any pleasure in Copulation or is so flowly moved that the inward Orifice of the Womb does not open seasonably to receive the Mans Seed The Passions of the Mind also are a great hinderance especially hatred between Man and Wife whereby the Woman having an aversion for such pleasure does not supply Spirits sufficient to make the Genital parts turgent at the time of Copulation nor does the Womb kindly meet the Seed and draw it into its Cavity from whence and from mixture of both the Seeds Conception arises The Reception of the Seed may be also hinder'd by Swellings Ulcers Obstructions Narrowness or Distorsions of the Genital parts or of the Neighbouring parts or by a stone in the Bladder or the like Conception may be also hindred by reason the Seed is not retained upon the account of too great moisture of the Womb namely when it s fill'd with many excrementitious humours whereby being render'd too laxe it cannot be contracted as it ought to retain the Seed received but this chiefly happens by reason of miscarriage or hard labour whereby the Fibres of the Womb and its inner Orifice are torn but the Whites are the most common cause of Barrenness Conception is also hindred when the Seed is not sufficiently nourished in the Womb as when the Intemperies of the Womb is so very cold that it extinguishes the Seed or so hot as that it dissipates it or over-moist or dry The Age fit for Conception is from fourteen to fifty and therefore those Women that are younger or older do not conceive by reason of a defect of Seed and menstruous Blood yet it must be confessed that some Women have conceived who never had their Courses A disproportion betwixt the Mans and Womans Seed is also the occasion of Barrenness tho there is no sensible defect in
three Ounces of Oyntment of Marsh-mallows two Ounces of Ducks Fat and Goose Grease each one Ounce of Deers Suet two Ounces of Liquid Storax half an Ounce with a sufficient quantity of Wax make a Cerat Hemlock boyled in Wine and beaten up with Hogs Lard resolves the hardness of the Breasts Green Mints or Chickweed are common applications and of good use either alone or mixed with other Medicines in all the hard Swellings of the Breast occasioned by Milk All Plasters applied to the Breasts must have a hole sniped in them for the Nipples lest they be fretted by them especially that the Milk may be drawn forth whilst the Medicines lye on But it is best to prevent such Swellings at the beginning by procuring an ample and large Evacuation of the Lochia For the Chaps and Excoriations of the Niples Rags dipt in Plantain-water may be applied or the Oyntment called Diapompholigos may be used But great care must be taken that nothing be applied to disgust the Child wherefore some only use Honey of Roses But if the Excoriation and Pain be much the Woman must forbear giving the Child suck If the Child has wholly sucked off the Nipples the Milk then must be quite dried away that so the Ulcers which remain may be the sooner healed CHAP. XXXI Of want of Milk THE cause of want of Milk is a Vice of the Blood the weakness of the Body or of the Child the smallness of the Breasts the narrowness of the Vessels any immoderate Evacuation by another part as by the Mouth by the Courses by the Nostrils or by the Hemorrhoids by immoderate Cold ill Diet Fasting great Labour or Sorrow The whole Cure in a manner consists in Diet. If therefore it be occasioned for want of Blood or by a dry Intemperies from whence it chiefly proceeds it must be cured by a hot and moist Diet and the Air must be moist and moderately warm Sleep is better than immoderate Watching The Bread must be Wheaten and well fermented Goats or Sheeps Milk boil'd with Yolks of Eggs and sweetned is good so is Rice boild with Milk and Honey Potched Eggs Chicken Broath Mutton or Veal Broath or Broath of Phesants or the Flesh of them with a Sauce made of Rocket and Honey the Udders of Animals are also good Of Fishes a Trout Mullet a Salmon Soles Place Pikes and the like are good and for the second Course Sweet Almonds Raisins of the Sun Pistaches Pine Nuts Rocket Parsnips roasted under the Embers or prepared with Honey Diascorides and Avicenna commend Fennel and Smalage Lettice is also good so are Cabbage Wild Thime Leeks Rocket Fennel Let her drink be sweet Wine or White-wine or Barley water with the Seeds of Fennel or Ale wherein if you boyl Butter Sugar and Bread you 'll Scarce find a better Diet for this purpose The German Women use this for their Meat and Drink almost all the time they give suck All things that are acid acrid bitter and very hot must be avoided But if this defect proceed from heat or choler you must use cooling things and the Body must be purged according to the Nature of the Humour But if the Blood be Flegmatick and the Vessels obstructed you must open the Obstructions and attenuate the Blood therefore you must give hot things as Smallage Dill Penny-royal with Wine But you must be careful not to give things that are too hot for they dry up the Milk And as those things which Moderately provoke the Courses breed Milk so those that violently force them lessen it Blood is never to be drawn nor are strong Purges to be used But if it be necessary to use Purging by reason of the fault of the Humours the Nurse must take four days before such things as increase the Milk and such Medicines must be given as increase the Milk As Take of thee Seeds of Fennel of Leeks and Rocket each two Drams of Mace one Dram of the Leaves of Mallows half a handful boyl them in Chicken Broath and let her take six Ounces of the Broath and wash the Breasts with the Broath But if the want of Milk proceeds from the smallness of the Breasts foment them with a Decoction of Fenugreek and Camomile made in Wine or with hot Beer and Butter But if these things do not good you must chuse another Nurse but you must try all things first for change of Milk is very injurious to the Child CHAP. XXXII Of a Woman suckling her own Children and of chusing a Nurse THE Mothers Milk is fittest for the Child because it is most agreeable to it Nature Besides the Mother will be more vigilant and careful than a hired Nurse for none can love the Child so well as the own Mother who upon the account of her affection is unwearied in the attending of the Child and thinks she never does enough for it and is presently awaked by its crying whereas mercenary Nurses often overlay Children and suffocate them Moreover the Body and the disposition of the Mind are more framed by the Milk and Nourishment than by the nature of the Seed and as you often observe that the Child is purged when the Nurse is Purged so the Body and Humours are in a manner the same with hers as Trees partake of the nature of the Soil they are planted in Besides it is the duty of a Mother to nurse her own Child for those that do not are but half Mothers and to be sure cannot love them so well as those that do Upon this account a Roman Youth of the Family of the Gracchi returning Rich and Victorious from the Wars being met by his Mother and his Nurse gave his Mother a Silver Ring and his Nurse a Gold Chain whereat his Mother being offended You said he nourished me only Nine Months in the Womb and then rejected me this Woman received me into her Arms and suckled me two Years and taught me to be orderly The Water nourishes what is bred in the Water and the Earth nourishes what is bred in the Earth Nor is there any Beast so cruel as not to nourish its young ones Tygers Lions and Vipers take care of their young ones and only Man makes Foundlings of his Oh! incredible and execrable Villany what can be more cruel than to expose a tender Infant that implores his Mothers help as soon as possibly she can get rid of it But God in his Providence often punishes their Inhumanity for their Milk often curdles in their Breast and occasions dreadful pains so that those Breasts which were denied their Children are forced to be suckt by Puppies nor is this all for their Breasts are often Inflamed and Suppurated and must be cut with Knives or burnt with red hot Irons or becoming Cancerous the rotten Flesh drops from them piece-meal But some will object in their excuse that they are either too young or too weak yet without doubt if they are able to Conceive they may Suckle too
Poppy Heads Flowers of Roses and tops of Mellilot and apply the following Oyntment Take of Old Treacle one Ounce of the Juice of River Crabs half an Ounce of the Juice of Lettice and of Oyl of Roses each one Ounce and an half of the Yolks of Eggs roasted under the Embers number two of Camphor half a Dram beat them in a Leaden Mortar The Discutients are Ceterach Agrimony Ducksmeat Scabious Thorn-apple the Juice of Coriander Frogs Snails River Crabs Raisins of the Sun stoned and beaten with Rue and Garden Night-shade made into a Pultits are proper to resolve them Many such Medicines are designed to this purpose Cancers requiring variety of Applications If notwithstanding all your Endeavours the Tumour increases and is like to ulcerate you may do well to forewarn the Patient of the danger and if it be loose propose the extirpation of it propose it to them lest afterwards they desire it when it is too late But to undergo this Operation Successfully the Patient ought to be of a strong Constitution and of a pretty good habit of Body and not in declining Age when the Courses are ceased It were also to be wished that the Cancer took its original from some Accident or Bruise and the like and the Operation ought to be performed in the Spring or Autumn of the Year For a Cancer of the Womb Topicks must be applyed which moderately Bind and Cool Take of Oyl of Myrtles and of Roses each two Ounces of the Juice of Night-shade and of Housleek each one Ounce beat them all in a Leaden Mortar with a Leaden Pestle till they grow black then add of Lytharge and of Ceruss washed in Scabious water each three Ounces of Tutty prepared two Drams of Camphir ten Grains make a Liniment wherewith Anoint the Part three or four times a-day The following is said to be better and with it the Tumours of the Paps which are counted Cancerous may be Cured Take of the Oyl of Yolks of Eggs two Ounces of the Juice of Night-shade and Speedwel or of Housleek each half an Ounce of crude Mercury two Drams stir them about in a Leaden Mortar with a Leaden Pestle till they acquire the consistence of a Liniment The foresaid Liniments are to be applyed to the Womb with a long Tent or with a Wax Candle wrapt round with a Rag But Injections may be much easier used Take of Barley water half a Pint of the waters of Night-shade and Plantain each two Ounces of the water of speedwel one Ounce of the white Troches of Rhasis two Drams of Sacharum Saturni one Dram make an Injection If the Pain be very violent add to four Oounces of the Injection one Ounce of Syrup of Poppies If the Cancer be Ulcerated the Dose of the Mercury to be added to the foresaid Liniment must be increased and the Ashes of River Crabs may be conveniently added But all these things are not sometimes sufficient to appease the violent Pain which sometimes will not suffer the Sick to sleep or rest so that we are forced sometimes to use Narcoticks and indeed they are not injurious in this Disease I knew a Woman that was affected with a Cancer in her Breast who took every Night for four Months two or three Grains of Laudanum and was much relieved thereby If much Blood flow from a Cancer ulcerated as it often happens inject into the Womb the Juice of Plantain with a little Frankincense Lastly Seeing a perfect Cure cannot be expected whether the Cancer be ulcerated or not we must endeavour to hinder the breaking of it and the increase of it when it is broken and in both we must qualifie the violence of the Pain by such things as evacuate the whole Body and by other Remedies which alter and evacuate the melancholy Humour and hinder its growth as by Bleeding in the Arm the Hemorrhodial Veins in the Foot by the use of Potions Apozems Juleps Broath Milk Whey Mineral Waters and the like which are commonly prescribed but Purging must more especially be repeated CHAP. XXXIX Of Worms and of the Stone of the Womb. THough many are of the Opinion that Worms are Generated only in the Intestines yet it is manifest by Experience and the Testimony of Learned Men that they are Bred in many other parts of the Body as in putrid Ulcers in the Teeth in the Ears in the Reins and in the Bladder tho' rarely by reason of the acrimony and saltness of the Urine In the Womb also Worms are sometimes generated tho' it be rare because the passages of it are so open that they will not suffer the Humours tho' they are gross and crude to continue there so long as to generate Worms They are most commonly Ascarides and they are most commonly in the Privities or in the Neck of the Womb they are very like those that are in the right Gut perhaps they creep thither from the Anus The material cause of Worms is a cold phlegmatick and crude Humour which is apt to putrifie When there are Worms in the Womb the whole Body is restless and uneasie the Mouth of the Womb is always moist the Women are thin and weak and sometimes the Worms are expelled with the Courses and sometimes they may be seen the Lips of the Privities being opened Women so afflicted sleep disturbedly and often wake in a fright they have disorderly Fevers and all other Symptoms which appear in Worms of the Intestines As to the Cure we must endeavour to hinder the generation of them and to kill them when they are generated this may be done by three sorts of Remedies First By a thin hot and drying Dyet by acid and bitter Meats yet they must consist of good Nourishment and be easily concocted and that are free from all crudity the flesh of Chickens of Hens of small Mountain Birds and the Broath of them with the juice of a Lemon are good Among Fruits Oranges Cappares Olives with Vinegar Among Herbs Endive Sow-thistle and Groundsel Let her Drink be a Decoction of Cinnamon Rubarb the Seeds of Purslain the Roots of China Scorzonera or Sarsaparilla All Meats of Milk Fish and whatever generates Flegmatick Humours must be avoided and full Feeding and a disorderly course of Dyet Secondly Those things must be used which Concoct and Purge off Phlegmatick Humours as Syrup of Wormwood Succory Succory with Rhubarb of the acid juice of Citron with the waters of the same Herbs or of Grass Purslain and Sorrel and the Flegm must be constantly Purged off with Pills of Mastick of Agarick or the like Thirdly Such things must be used as kill Worms and uterine Glisters to that purpose must be injected made of a Decoction of Wormwood Southernwood and Centaury with Allom. Or Take of Mint Calaminth Penny-royal each one Handful boyl them till the third part of the Water is consumed mingle Honey with it and inject it Or Take of the Decoction of Lupins six Ounces of Aloes three Drams
the assaults of this Disease tho they are not hollow and tho there is no apparent Defluction that may occasion the pain yet it is no whit gentler nor shorter nor easier Cured But the pain of the Back is most common which most certainly all feel how little soever they are afflicted with this Disease Moreover this is common to the foresaid pains that the place whereon they were is tender and akes as if it were soundly beaten but this tenderness goes off by degrees And this is worth observing that often a notable coldness of the outward parts makes way for these Symptoms which for the most part does not go off till the fit ends which coldness is almost like that wherewith a Carcass grows stiff yet the Pulse is good Moreover all Hysteric Women complain of a dejection and sinking of the Spirits and sometimes laugh excessively and at other times cry as much without any real cause for either But the most proper and almost inseparable Symptom is a Urin as clear as Rock-water Sometimes ill fumes are belched up and sometimes the Wind that comes from the Stomach is sower just like Vinegar But their Minds are more affected than their Bodies for an incurable Desperation is mixt with the very nature of the Disease A day would scarce be sufficient to reckon up all the Symptoms belonging to this Disease and I think Demetrius reckn'd pretty right tho he mistook the cause of the Disease when he said in an Epistle to Hippocrates that the Womb was the cause of Six hundred Miseries and of innumerable Calamities The external causes of this Disease are either violent motions of the Body or which is much oftner vehement disturbances of the Mind to these disorders of the Mind which are usually the occasion of this Disease is to be added emptiness of the Stomach by reason of long fasting inmmoderate Bleeding a Vomit or Purge that works too much In order to the cure I order that eight Ounces of Blood be taken from the right Arm and that the following Plaister be apply'd to the Navel Take of Galbanum dissolved in Tincture of Castor and strain'd three Drachms of Tacamahaca two Drams mix them make a Plaister The next Morning let her use the following Pills Take of the Pill Coch-major two Scruples of Castor powder'd two Grains of Peruvian Balsam four drops make four Pills let her take them at five in the Morning and sleep after repeat them twice or thrice every Morning or every other Morning according to the Womans strength and as they work Take of the Waters of Black-Cherries Rhue and Compound Briony each three Ounces of Castor ty'd up in a rag and hanged in the Viol half a Dram of Fine Sugar a Sufficient quantity make a Julep whereof let her take four or five Spoonfulls when she is faint dropping into the first dose if the fit is violent twenty drops of the Spirit of Harts-horn After the Purging Pills just described are taken let her use the following Take of the filings of Steel eight Grains with a sufficient quantity of extract of Wormwood make two Pills let her take them early in the Morning and at five in the Afternoon for Thirty days drinking upon them a draught of Wormwood Wine Or if she like a Bolus better Take of the Conserves of Roman Wormwood and of the yellow peel of Oranges each one Ounce of Angelica and Nutmegs candied and of Venice Treacle each half an Ounce of candied Ginger two Drachms make an electuary with a sufficient quantity of Syrup of Oranges Take of this electuary one Drachm and an half of the filings of Steel well rub'd eight Grains make a Bolus with a sufficient quantity of Syrup of Oranges to be taken in the Morning and at five in the Evening drinking upon it a Glass of Wormwood-wine Take of choice Myrrh and Galbanum each one Drachm and an half of Castor fifteen Grains with a sufficient quantity of Balsam Peru make twelve Pills of every Drachm let her take three every Night and drink upon them three or four Spoonfuls of Compound Briony Water through the whole course of this process But if these Pills move the Body which sometimes they do in Bodies that are very easily purged the following may be used instead of them Take of Castor one Drachm of Volatile Salt of Amber half a Drachm with a sufficient quantity of extract of Rue make twenty-four small Pills let her take three every Night But Steel Medicines which must be noted occasion sometimes in Women great disorders both of Body and Mind and not only on the first days which is usual almost in every body but also all the time they are taken In this case the use of Steel must not presently be interrupted but Laudanum must be given every night for some time in some Hysteric water that they may the better bear it But when the Symptoms are mild and it seems the business may be done without Steel I think it sufficient to Bleed and to Purge three or four times and then to give the altering Hysteric Pills above-mentioned morning and evening for ten days which method seldom fails when the Disease is not violent yea the Pills alone Bleeding and Purging being omitted do often a great deal of good But some Women can't bear Hysteric Medicines and are much injured thereby therefore they must not be given to such If the Blood is so very feeble and the confusion of the Spirits so great that Steel ordered to be used according to the method prescribed is not sufficient to cure the Disease the Sick must drink Tunbridge-waters or the like for they cure Diseases more efectually than any preparation of Iron but if in drinking of them any Sickness happen that belongs to Hysteric Symptoms the Sick must forbear drinking them a day or two till that Symptom that hindred their passage is quite gon And it is to be noted that Purging must be avoided all the time the Woman drinks these waters But if this Disease does not yeild to Steel-waters the Sick must go to the Bath and when she has used the waters of it three mornings following the next day let her go into the Bath and the day following let her drink them again and so let her do by turns for two months for in these and others of what kind soever they are the Patient must persist in the use of them till she is quite well Venice-treacle used often and a long time is a great remedy in this Disease Spanish-wine with Gentian Angelica Worm-wood Centory and other strengthening things infus'd in it does a great deal of good some spoonfuls of it being taken thrice a day if the Woman be not thin and of a cholerick habit of Body And truly a large draught of Spanish-wine taken by it self at bed-time for some nights has been very beneficial to some Women Jesuits-powder also wonderfully comforts and invigorates the Blood and Spirits a Scruple of it being taken morning and
naribus erumpere bonum est The cause of this Disease is most commonly some violent Passion of the Mind or some great disturbance happening when the Courses are near flowing it comes also from Obstructions of the Womb or by reason of violent Pains and great Diseases of the upper Parts also from the weakness of them when the VVomb and lower Parts are strong for the weak Parts always receive what the stronger put upon them It also comes from some external Cause as by drinking cold Water unseasonably or by washing the Feet and Legs unseasonably or by the use of Vinegar when the Courses are near The Scope of the Cure is Two-fold the First is the Evacuation of the Blood abounding the other is the Recalling of it to the lower Parts which is chiefly done by Cooling the upper Parts and by Heating Moistning and Opening the lower Parts but both may be well answered by Bleeding in the Foot three or four days before the Blood flows and by applying Cupping-glasses to the Thighs Legs and Hips sometimes Dry but most commonly with Scarification and also by provoking the Hemorrhoids by Frictions by Walking by hot Baths natural or artificial by Fomentations made of opening Herbs by Unctions Pessaries and uterine Glisters But see more of this in the Chapter of Suppression of the Courses The two following Remedies are peculiarly proper for this Disease viz. Bleeding in the Foot for several Months at the times we have mentioned and the Bath-waters wherein the Woman must be Bathed early in the Morning and must continue a while in them but this must be noted that the Waters must not reach above the region of the Liver and in the mean while the upper Parts must be â—anned CHAP. V. Of the Courses coming before their due time and of staying longer than they should IN many Women the Courses flow before their accustomed time and sometimes they stay longer than they should and this anticipation and delay are sometimes orderly and sometimes disorderly The Causes are either the Vice of the Womb as the ill Figure of it or a Solution of the Continuum and sometimes a hurt on some other account as a Vitious humour that irritates before the time by reason of plenty of Blood or the thinness or sharpness of it the quantity of humours occasioning it may be known by the dulness of the Body by the sanguine habit of the Woman by a sedentary and idle Life by excess in eating and drinking or by some other Evacuation stopped or lessened The Acrimony of the Blood may be known by the Heat Erosion and Pain in the Excretion or by the Vitious habit of the Womans Body and the course of her Life foregoing or by the Diet she was wont to use and the like But if it come leasurely and without pain the retentive faculty is weak it may also be occasioned by a blow or fall If it proceed by reason of the Loosness and fault of the retentive faculty it must be strengthened by proper Remedies if it come from a plenitude it must be remedied by a sparing Diet and moderate Exercise and by taking away so much Blood as is agreeable to the strength in the middle of the Month or a little before the Courses flow Frictions also in the Arms and in all the upper parts of the Body are proper the Woman must abstain from Wine and all Strong-waters and instead of them Chalybeats must be used and if these things do not do the business she must be blooded in the Arm but if it proceed from the Acrimony of the Humours she must eat freely Meat of good nourishment and must exercise a little and such Medicines must be used as attemperate the humours and she must be purg'd and Uterine Glisters must be injected made of two Ounces of Oyl of Violets and four Ounces of the Decoction of Mallows but care must be taken that the Courses be not quite stopped because it is dangerous Lastly if a blow a fall or difficult labour occasion this disease the following Cataplasm must be applied to the Womb and Neighbouring parts Take of the Powders of Dragons-blood Frankincense Mastich and of the greater Comfry each two Drams with a sufficient quantity of Turpentine make a Cataplasm If the Woman be of a hot Constitution apply the following Plaister Take of the Powders of Roses Myrtles and Balaustins and Mastich each one Drahom of fine Flour one Ounce with the Whites of Eggs make a Plaister The Courses stay beyond their time by reason of age when they are about to go away or by a vice of the whole Body or of the womb If it proceed on the account of age you must only endeavour to prevent those inconveniences which are wont to follow especially the Gout and a pain in the Hip which may be done by a spare Diet much exercise and by bleeding yearly till Nature has been accustomed to the want of the menstruous Purgation But if it proceed from a Vice of the whole Body it must be treated as a suppression of the Courses If it proceed from a peculiar disorder of the Womb it requires a peculiar Cure and is a Symptom of the kind of the vitiated action of Excretion either because it is hindred by the ill Formation or a gross Humour that Obstructs The Causes therefore are these three which are contrary to the anticipation of the Courses viz. the weakness of the Faculty the fault of the Humours and the dulness of the Sense The impotence of the Faculty is occasioned by the frigidity or moisture of the Temperament or by the depraved Figure of the Instrument the Humour is faulty upon the account of its thickness siccity and clamminess The Sense is rendred dull most commonly by moisture abounding The weak Faculty by reason of Frigidity is known by the Womans perceiving a weight and disturbance after the time of the coming of her Courses is past The fault of the Instrument may be known by what went before as by hard labour a tumour cicatrix leaping or a fall whereby the Womb or a part subservient to it is displaced or the figure of it deformed The fault of the Humour may be known by those things that are evacuated by the Blood as if it be whitish it may be seen if it be gross and clammy a sedentary life and a gross and flegmatic Diet went before the Woman is of a soft pale and leaden habit of body and is fat and by the Bloods flowing slowly and by the long continuance of the Courses sometimes and by their ending in a slime If when they stay a long time before they come the Woman does not perceive any disturbance in the Womb and neighbouring Parts the Sense is dull If the Disease arise from a thick and clammy Humour as it does most commonly it must be cured according to Galen with three sorts of Remedies First by a thin and heating Diet by moderate exercise and frictions of the Legs Secondly by
Vomits and Sudorisicks must be deferred till the Courses are over or you must use those that are very gentle lest Nature should be hindred or diverted for if so the Blood may be unseasonably detained or may rush upon some principal part or increase the Disease But if it happen that the Womans Courses are procrastinated it is lawful to Purge for sometimes we see that Purging brings the Courses If the Disease be Chronical it is best to Purge eight days after the Courses are gon off But if the Courses come before their due time in Diseases which is the second way of complication nothing in curing Womens Diseases is so difficult and dangerous especially at the beginning of the Disease before universal Remedies have been given for at other times if we do nothing there is the less perplexity but if at the beginning you Bleed or Purge you hinder the menstruous Purgation and if you do neither the Disease increases Those things that are proper for the Disease stop the Courses and if they flow they do not relieve the Disease because they are then Symptomatical for such an evacuation is almost always pernicious at the beginning of the Disease for Nature at that time seldom promotes any useful evacuation wherefore we must diligently consider what good or hurt comes from it and from what cause the anticipation of the Courses in Diseases proceeds for in the beginning and in the increase as we said it is full of danger but in the state and declination the cruption of the Courses if they flow easily is wont to be advantageous by reason of the fitness of the Season for evacuation if it be not complicated with some other evacuations of Nature The Anticipation of the Courses proceeds from many causes but from whatever cause it come if there be a plenitude the Cure must be begun by bleeding in the Foot But if the Courses flow at their accustomed time and happen to come at the beginning of the Disease you must first wait on Nature and if after twelve hours the Flux is not or is not like to be sufficient you must bleed in the Foot to compleat the natural evacuation of the Woman and moreover you must take away so much Blood as the Disease requires for we must respect Custom and the Disease too and this may be understood of violent Diseases yet it is chiefly to be used in small ones and therefore that they should not grow to be violent you must incourage the Courses by all means by Ligatures Frictions Suppositories Glisters and other things which are sufficient to provoke the parts near the Womb and if the Disease arise from a cold cause you must give such Medicines as promote the Courses and also respect the Disease But if a Purge be necessary you must defer it till the Courses are over lest the Blood being moved and disturbed thereby greater mischief should be occasioned But if the Disease be one of the greatest as a Quinsey Frensy Plurisie or an acute Fever you must first bleed in the Foot afterwards the same day you must bleed in the Arm but in the mean while you must apply Ligatures to the Legs whilst the Blood flows and this is good Practice for the Indication of the most violent Disease is always to be respected before that Indication which is taken from the Courses and in the same manner you must proceed in the other Seasons of the Disease wherein you ought to defer Purging Vomiting and Sweat if the Disease requires them till the Courses are gone off for the Indication of the Courses is greater than the Indications of these helps unless a Sanies flow beyond the appointed time which is not to be accounted at that time to proceed from fulness and in this case an Indication for purging being urgent you may Purge The Fourth Case was when upon the Courses stopt a Disease came In this case we must first consider whether the Courses are but now stopt or whether they have been stopt a long while and moreover whether the Disease proceeds from this suppression for if it arise from hence you must without doubt bleed in the Foot first nor must we Purge Vomit or Sweat before and afterwards in the Arm if the Disease require it especially if it be four days past the accustomed time of the Courses But if the suppression be new and the Disease not urgent before you use other means you must expect a while the flowing of the Courses especially if you do not understand rightly the nature of the Disease for it is more secure the Courses being stopt to bleed in the Foot than to Purge Vomit or Sweat But if notwithstanding bleeding in the Foot the Courses flow but slowly you ought to give such Medicines as move them and it will be proper to give them before they begin if you suspect that Nature will not do the business throughly her self But if the Courses delay and the Disease grows worse thereby most affirm that the Cure must be begun by those helps which the Disease and its Cause require without respect to bleeding in the Foot But I am not of the same Opinion for in slight Diseases and in such as will bear a Truce experience has taught me that it is best to bleed in the Foot for the indication from the Courses stopt is more to be minded than a small Disease and therefore they ought to be provoked first by Ligatures Cupping-glasses Frictions and Medicines and afterwards you must provide for the Disease But if the Disease be violent as a Quinsie Pleurisie or the like then certainly those Remedies must be given which the Disease requires without consideration of the Veins of the Foot But when the Courses should come at the time of the Disease and are stopt by reason of the Disease and its Cause without doubt we ought to bleed in the Foot and to take away so much Blood as the plenitude of the Womb requires or till the Courses flow and if there be occasion we may Purge gently and not divert the Course of Nature Lastly if when the Disease is present the Courses flow by drops before their time you must proceed as in the second Case concerning the Anticipation of the Courses in Diseases Or if it happen at their due time you must treat them as in the third Case when the Courses happen with the Seasons of the Disease only the dropping of the Courses signifies a greater oppression of Nature and therefore requires larger bleeding CHAP. VIII Of the Courses coming difficulty and with violent Symptoms THis Disease is like a Dysury or adifficulty of Urine for it is accompanied with Pain and a great disturbance the Symptoms often come before the Courses and sometimes with the Courses the Blood comes by drops and is attended with violent Pain This Symptom comes upon an Obstruction of the Courses sometimes upon Solution of the Continuum an Ulcer Erosion and painful disorders in the neighbouring parts
The Courses as was said before come sometimes drop by drop and sometimes plentifully sometimes by intervals and sometimes continually sometimes orderly and sometimes disorderly It is most commonly occasioned by the same Causes from whence a suppression of the Courses proceeds but gentler for there is not a total Suppression but an unequal Obstruction of the Vessels of the Womb by reason of thick clotted and feculent blood which stretches the Vessels and Nature violently endeavouing to Evacuate it a gross wind arises which distending the Vessels and the neighbouring parts occasions the violent pain which continues untill the clods are ejected Sometimes the Blood flows plentifully yet the Courses are counted difficult and lessened because tho a great quantity is evacuated yet it is not answerable to the plenitude The second Cause is an Ulcer or some preternatural Tumour in the Womb or neighbouring parts which are provoked and hurt by the commotion of the Blood The third is the acrimony of the Humours This Disease is known by a pain in the Head a pain in the Stomach Restlesness pains in the Loins and of the lower Belly just like the pains of Child-bearing coming with the Courses or eight days before There is often also fainting and convulsions and a palpitation of the Heart and by these you may know that the Blood is clotted or thick and a small swelling is sometimes perceived in one or both of the Groins by reason of clotted Blood contained in it and just before the evacuation of the clotted Blood the pain is most violent and at the same time if wind be joined with it it breaks from the Womb or backwards with a noise and there are wandring pains about the Loins and Hips If an Ulcer be the cause Sanies or Pus is mixed with the Blood and the Courses flow always with a fixed pain This Disease afflicts Virgins and those that are Barren The Cure is two-fold the first respects the Cause the second the mitigating the Pain If it proceed from feculent gross and clotted Blood a thin Diet and moderate Exercise must be ordered and Medicines that cause Revulsion and Evacuation must be used Blood therefore must be drawn from the Arm if there be a great quantity of it but if the quantity be small from the Foot and the clotted Blood that cannot be evacuated must be drawn out by Cupping-glasses applied to the Thighs and Legs with Scarification and by Ligatures upon the Legs and the Humour may be turned by applying Leeches to the Fundament if the pain continue after the Courses are stopp'd but they must not be used before Secondly Evacuation must be used with this distinction when feculent and grumous Blood is the cause you must Bleed when an Ulcer Wind or an Acrid Matter you must Purge most Thirdly The Passages must be Relaxed and Opened and the Pain mitigated wherefore if the matter be thick slatulent feculent or clammy a Dram of Venice Treacle or of Mithridate must be taken at Bed-time in three Ounces of Balm-water and Baths must be provided and Lotions for the Legs made of a Decoction of Marsh-mallows of the Seeds of Flax Fenugreek Dill Rhue and Mugwort and the Feet must be bathed in it hot a while and the vapours must be received and a Spunge dipt in it must be applyed to the Privities and the lower Belly must be Fomented afterwards with Flannel dipt in Wine and Oyl of Roses or with a Bladder half full of warm Oyl but it will be better to anoint the Navel and the region below it with Oyl of Saffron of White-lillies the Seeds of Flax of Capers of Yolks of Eggs or of sweet Almonds among which or with one of them must be dissolved a Drachm of Treacle a Pessary dipt in the same is also is of great use or the foresaid Parts may be annointed with Hens-fat and Butter or with Butter and some of the foresaid Oyls The following Oyntment is also very proper Take of the juice of Angelica one Drachm of Oyls of Capers and of White-lilies each one Ounce and an half of White-wine half an Ounce with Wax make an Oyntment The following Cataplasm is also very good Take of common Oyl of sweet Wine and fresh Butter each two Ounces of Bran three Ounces boyl them gently apply them hot and repeat them frequently But if acrid and eroding Matter be the cause you must use gentle Oyntments and Fomentation of warm Water or Purslain and Lettice Water with Emulsions of the cold Seeds and the Parts must be anointed with the Oils of sweet Almonds of Violets and of Roses If the Disease proceeds from an Ulcer you must endeavour the Cure of it and you must mitigate the Pain by injecting uterine Glisters made of four Ounces of warm Water and if the heat be very much the Water must be sweetned with Sugar and you must add one Drachm of the white Troches of Rhasis Or the Glister may be made with three Ounces of Allum-water which is of excellent use or with so much Barly-water with an Ounce of Syrup of Roses or with Milk-water with Sugar or with an Ounce and an half of Milk it self with the like quantity of a Decoction of the Leaves and Seeds of Plaintain to which may be added half an Ounce of the emulsion of the cold Seeds and if the Pain and Heat is very violent inject two Ounces of the Decoction of Henbane or white Poppies But if these things will not do the business some Opium must be mixed with the Decoction before mentioned Lastly if other remedies will not do the business an Issue must be opened in the Leg. CHAP. IX Of the Closure of the Womb. VIrgins labouring under this Disease are said to be Imperforate This closure is wont to be in three places viz. in the mouth of the Womb in the neck of it and in the Privities It is occasioned either in the first Formation when a Membrance covers the Orifice of the Womb or its Neck or by a Wound or Ulcer preceding which growing together stops the Neck of the Womb or joins the Lips or it is occasioned by Humours or a Compression If the Closure be in the Privities it may be easily known but if it be in the Neck or Orifice of the Womb it is not found out till the Courses begin to flow or till Women are Married for at the time of the menstruous Purgation Pains and Gripes are perceived in the region of the Womb at certain times with a sense of weight yet no Flux follows Moreover you may guess at it if the Maid be of good habit of Body not Cachetical and without Obstruction the Disease continuing the Womb swells so that Virgins seem to be with Child and sometimes the whole Body which looks livid But if the Neck of the Womb be closed it may be known in the first Copualtion because it cannot admit the Virile Member Lastly if the Orifice of the Womb be shut it is difficultly known but it
the Bed to refresh her self but not too long especially if she be a little short thick Woman for they have always worst Labours if they lie much on their Beds in their Travail especially of their first Children than when they are prevailed with to walk about the Chamber but they must be supported under the Arms if it be necessary for by this means the weight of the Child causes the inward Orifice to dilate sooner than in Bed When the Waters of the Child are ready and gather'd the Midwife ought to let them break of themselves for the breaking of them before the Infant be wholly in the passage prolongs the Labour for by the too hasty breaking of these Waters which ought to help the Child to slide forth with greater ease he remains dry which hinders afterwards the Pains and Throws so that they cannot be so effectual in excluding the Child as otherwise they would have been It is therefore better to let them break of themselves and then the Midwife may easily find the Child bare by the part which first presents and so judge certainly whether it comes right that is with the Head which she will find hard big round and equal but if it be any other part she will perceive something unequal and rugged and hard or soft more or less according to the parts immediately let her dispatch to deliver her Woman if she be not already and assist the Birth which ordinarily happens soon after if natural in the following manner After the Waters be broke of themselves as above-said let the Woman be presently placed on the Pallate provided for her to this purpose near the Fire or she may if she like it better be delivered in her ordinary Bed for all Women are not accustomed to be delivered in the same posture some will be delivered on their Knees others standing leaning with their elbows on a Pillow upon a Table or the side of a Bed and others lying upon a Quilt in the midst of the Chamber But the best and surest way of Delivery is in Bed to avoid the inconvenience and trouble of being carried thither afterwards in which case it ought to be Furnished rather with a Quilt than a Feather-bed having upon it Linnen and Cloaths in many folds with other necessaries to be changed upon occasion that the Woman may not be incommoded afterwards with the Blood Waters and other filth which is voided in Labour The Bed must be so made that the Woman being ready to be delivered should lie on her back upon it with her Head and Breast a little raised so as that she be neither lying nor setting for in this manner she breaths best and will have more strength to help her pains than if she sunk down into her Bed being in this posture she must spread her Thighs abroad folding her Legs a little towards her Buttocks somewhat raised by a small Pillow underneath and her Feet must be staid against some firm thing moreover let her hold some By-standers with her Hands that she may the better stay her self during her pains Being thus placed near the side of her Bed with her Midwife by to help upon occasion she must take courage and further her pains the best she can bearing them down when they take her which she may do by holding her Breath and forcing her self all she can just as when she goes to stool In the mean while the Midwife must comfort her and persuade her to endure her Labour bravely and put her in hopes of a speedy delivery The Midwife with her Hand anointed with Oyl or fresh Butter may gently dilate the inward Orifice of the Womb putting her Fingers ends into its entry and stretching them one from another and thrusting by little and little the sides of the Orifice towards the hinder part of the Childs Head anointing these parts also with fresh Butter When the Infants Head begins to advance to the inward Orifice it is commonly said it is crown'd and when it is come so far that the extremity begins to appear manifestly without the privy Parts it is then said that the Child is in the passage and the Woman in Travail imagins tho it is no such thing that her Midwife hurts her with her Fingers finding her self as it were scratched and pricked with Pins in those parts by reason of the violent distension which the bigness of the Childs Head causes there When things are in this posture the Midwife must seat her self conveniently to receive the Child which will soon come and with her Fingers ends her Nails being close paired endeavour to thrust as above-said this crowning of the Womb back off over the Head of the Child and as soon as it is advanced as far as the Ears or thereabouts she may take hold of the two Sides with her two Hands that when a good pain comes she may quickly draw forth the Child taking care that the Navel-string be not then intangled about the Neck or any other part lest thereby the After-burthen be pulled with violence and possibly the Womb also whereunto it is fastened and so cause Flooding or else break the string whereby the Woman may come to be more difficultly delivered It must also be observed that the Head be not drawn forth straight but shaking it a little from one side to the other that the Shoulders may sooner and easier take place immediately after it is past which must be done without losing any time lest the Head being past the Child be stopt there by the largeness of the Shoulders and be in danger of being suffocated in the passage But as soon as the head is born if there be need the Midwife may slide in her Finger under the Arm-pits and the rest of the Body will follow without any difficulty As soon as the Midwife has in this manner drawn forth the Child she must put it on one side lest the Blood and Waters which follow immediately after should choak it afterwards let her be very careful to examin that there be no more Children in the Womb which she may know if putting her hand up the entry she finds there another Water gathering If it be so she must have a care not to go about to fetch the After-burthen till the Woman be delivered of all her Children wherefore the first string must be cut being first tied with a Thred three or four double and the other end must be fastened with a string to the Womans Thigh As soon as the Child is born before the Navel-string is tied or cut the Woman must be freed of the After-burthen To perform this the Midwife having taken the string must wind it once or twice about one or two of her Fingers of her left hand joined together the better to hold it wherewith she may then draw it moderately and with the right Hand she may only take a single hold of it above the left near the Privities drawing likewise with that very gently
to the consistence of a Pultiss apply them often with a rag Or infuse Galls in Rain-water eight days and with soft Wool sprinkled with Sulphur and dipt in this Water and dried without pressing make a Pessary But Secondly And chiefly you must use Astringents Foment the Genitals with the Water or Decoction of Acorns unripe Sloes and of Horse-tail or Foment the Parts with Allom-water or with Stiptic-Wine that is red and rough Wine boyl'd with Galls Leaves of Myrtles Red Roses Pomgranet-peel Balaustines and Cypress Nuts Or Take of Cypress Nuts and Galls each one Pound of Roch-allom and the filings of Iron prepared in Vinegar each half a Pound boyl them in a sufficient quantity of the Waters of Galls which Tanners use and Foment the Parts often with it The following Water is counted excellent Take of Galls and of Cypress Nuts each half a Pound of Allom six Drams Bole-armonick half a Pound of the Meal of Acorns and of old Beans each half a Pound the Whites of twelve Eggs of Powder of Brick one Pound let them be all finely powdered and infuse them three Days in Smiths Water or in a decoction of Sloes Medlars or Horse-tail with half a Pint of Rose Vinegar then Distill them in a cold Still with a gentle Fire add to the Water that comes off of the Powders of Mastick Myrrh and Dragons Blood each two Drams Set the water in the Sun in the Summer for ten days this straitens the Privities smoothens the Belly and makes the Breasts solid CHAP. XXXV Of Abscesses and Corrosive Vlcers arising from Distempers of the Womb in Childbed THE Womb is sometimes terribly affected in Child-bed and produces Fevers of very Malignant and Venomous Natures which soon cause Phlegmons and worse Tumours in the Womb it self and sometimes in other parts of the Body there being none of them on which the Uterine Ferment has not an influence The Exhorbitances or Degenerations of that whether from an hurt in Labour from part of the After-birth left behind from cold taken or the Lochia stopt soon produce such Virulent Distempers in the Blood as make it cast out a Tumor either upon the part it self or else outwardly upon the Muscles of the Body where when they light they prove corrosive sometimes eating out the Flesh in which they lodge which falls off in whole pieces without that change of colour in the Skin which is in Gangreens so that sometimes the Bone it self is laid bare by them The Causes are hard Labour the Womb hurt or part of the Secundine left behind Cold taken in Child-bed and a predisposition in the Humours by reason of their peccancy in quantity or quality The Prognostick may be taken from the largness or other qualifications of the Abscess and the Symptoms that happen to the Body thereupon If the Tumor happens only from some little disturbance in the Womb of a Person otherwise of a good habit of Body the cure is hopeful If part of the After-birth be retained there is no hope 's of Cure till that be removed nay if it stay so long as to induce Putrefaction of the part it will be too late then to remove it If the Body be of an ill Habit the Tumours are apt to Degenerate into very Venomous and Malignant Abscesses which if they do not suddenly kill do at least produce ill conditoned Ulcers hard of Cure and for the most part mortal in the long course of the Disease In the Cure of these Abscesses you are to inform your self how the Womb is disturbed and appease that and if any part of the After-birth be left behind to endeavour the bringing that away and by good Sudorificks Cordials and the like to expel the Venom and fortifie the Spirits against the Malignity that is thereby contracted and to attemperate the heat and the Acrimony by Julips and Emulsions The Swellings arising from these require to be treated in their beginning with moderate Repellents and Discutients afterward according as the Matter prepredominates make way for its discharge A young Woman after Child-bed was seized with a great Pain and Swelling in her Groin with a Fever Bleeding and Lenient Purgatives to Evacuate the Humours were prescribed also Cordial Juleps and the like to attemperate the Heat and fortifie the Spirits and Moderate Repellents mixed with Discutients in Fomentations and Plasters with Bandage were used which dispersed the Humor in the Thigh and restored that part to its former temper But in the mean time the Tumor increased in the Groin and was suppurated after the manner of a Bubo it was opened and a detersion was endeavoured but the Sinus reaching down the Twist the Matter could not be discharged without laying it more open as in Sinous Ulcers by which method it was cured A Gentlewoman in Child-bed was seized with a Fever and the Ninth Day complained of a pain in her Foot Discutients were prescribed together with things proper for the Fever to breath out the impacted Matter in her Foot but the pain increasing the upper part of the Foot from the Instep to the Toes were Oedematous but from the inside of the Ancle to the middle of the Sole of her Foot inflamed and seeming to apostumate The ill consequences of an Apostumation in that part amongst the Tendons and Bones and where the Skin is usually so hard and tough that our strongest Causticks could difficultly penetrate being feared It was resolved to endeavour the restraint of the Influx and so to dry up the Humour affecting the part to which purpose was applied the following Plaster Take of Barley Meal Six Ounces of Flax Seeds powdered Six Drams of the Flowers of Camomile and Elder each three Drams of the Flowers of Red Roses and Balaustins each one Ounce these with the addition of Honey of Roses and Oyl of Myrtles were boyled to the consistence of a Plaster in red Wine and at Bed-time an Anodyne Draught was given to cause rest The next Morning the Patient was somewhat relieved and when the Dressings were taken off the Tumor and Inflammation seemed less This way of dressing was continued with Compress and Bandage and the Humour was in few Days dried up and the Foot seemed well but there appeared again a Swelling on the Foot and Apostumated in the Sole of the Foot in three several places which were opened with a Caustick to prevent the increase of the Matter and the Eschars were divided to give a vent and they were dressed with Basilicon and the Plaster as before and the flowing of the Matter was indeavoured to be hindred dayly by Compress and Bandage but the Position of the Foot gave way and it sunk lower so that there was a necessity of applying another Caustick which proved effectual to the Discharge of it so that the upper Orifices healed but this last Eschar separated slowly and left the great Tendon bare the Separation was furthered by the use of Oyl of Turpentine with Basilicon applied warm and the
of Honey one Ounce which may be injected also with the like quantity of Decoction of Mercury and Wormwood or the following Pessary may be used Take of Bulls Gall one Dram and an half of the Powder of Lupins two Drams of Oyl of Wormwood two Ounces of good White-wine half an Ounce mingle them and dip the Cotton for the Pessary in it At the same time apply to the Region of the Womb the following Oyntment Take of the Leaves of Wormwood Costmary and Calaminth each one Handful of Peach Leaves half an Handful boyl them in the sharpest Vinegar or in Wine for the Womb to the strained Liquor add of Aloes and Agarick each half an Ounce of Coloquitida three Drams of Oyl of bitter Almonds and of Bulls Gall each a sufficient quantity with a little Wax or without it make an Oyntment You may also make a Cataplasm of the same Herbs boyled and bruised with the Meal of Lupins Oyl of Wormwood and Ox Gall and the Pill of Aloes or of Hiera must be taken often a Scruple at a time That the Stones grow in every part of the Body Galen testifies as in the Bladder Reins Liver Intestines Lungs and therefore it is no strange thing if they should be generated also in the Womb as Aetius writes but they are not altogether like the Stones of the Bladder nor are they loose for if so they could not continue in the Womb but they grow to the Tunicks of the neck of the Womb. The causes of them are the same as of the Stone in the Bladder namely gross and viscid Humours The signs of them are a dull pain in the Womb and the Courses are inordinate and a Finger being put up the Anus the Stone may be selt But if the Stone be in the neck of the Womb the pain is great and affects the neighbouring parts and the Womb and the Woman can not sit without pain As to the Cure an emollient and lubricating course of Diet must be used and the gross and viscid Humours must be Purged off But the chief part of the Cure is to be performed by extracting the Stone but first the parts must be quieted by an emollient Glister made of a Decoction of Mallows Marsh-mallows Fenugreek of the Seeds of Flax and a great deal of Oyl of Roses and of Lillies to make the Manual operation the easier which must be performed in the following manner The Womans Thighs being spread the Chirurgeon must thrust up two of the Fingers of his Left-hand and with his Right he must press the upper part of her Belly to force the Stone out and this may be the easier done if the Stone be in the Neck of the Womb but if it be in the Womb it self the Operation will be more difficultly performed But if the stone grow to the mouth or neck of the Womb and cannot be extirpated this way it must be cut out the Woman being rightly placed and the parts dilated with a Speculum Matricis which being done those things must be injected into the Womb which cure Ulcers first Astringents and such things as stop Blood and afterwards drying things and an exact Course of Diet must be ordered and the Woman must be Purged twice in a Year lest the Stone should grow again The Cure of the Stone in the Bladder in Women is to be managed much in the manner as in Men but it seldomer happens and is easier Cured because the passage of the Urine is larger and shorter and straighter in Women But if it happen and must be extracted the Chirurgeon must put two of the Fingers of his Left-hand the VVoman being placed as above directed into the Privities and with his Right he must press the Bladder and force the Stone to the neck of it so as to make it pass the Muscle that shuts the neck of the Bladder and then a little above the wings of the Privities at which place the Stone occurs he must cut so that the Stone may be extracted with a pair of Forceps Lastly the Ulcer must be Cured by Astringent and Incarnating Medicines CHAP. XL. Of a Condyloma of the Hemorrhoids Warts Thymus Acrocordo and a Ficus and of Scabs of the Privities and of Chaps and Clefts of the same A Condyloma is a Tubercle arising from an Inflammation and resembles the Knucles when the Hand is shut It is cured by four kind of Remedies First by Diet and Purging Medicines that respect the antecedent cause Secondly By drying and repelling Topicks if the Callus be newly bred as by Baths and Vapours of a Decoction of Vervain of the Leaves of Brambles of Acacia Ivy-leaves to which must be added by reason of the Pain Camomile Flowers and if the Condyloma be Inflamed such things must be used as mitigate the pain as the following decoction Take of the leaves of Melilot Mallows and Marshmallows each half an handful of the Seeds of Flax and Fenugreek each three Drams of the Flowers of Camomile two Pugils boyl them and to a Pint of the Decoction add two Ounces of Roses inject it by a Syringe or warm Milk may be so injected If the Condyloma being old is grown hard and does not yeild to the foresaid Medicines Aetius commends as a wonderful remedy Mineral Misy mixed with Turpentine or instead of it Roman Vitriol a Dram of the Troches of Steel reduced to powder and mixed with the Oyls of Roses and Wax and made into an Oyntment with half an Ounce of the Juice of Mullein is also very good The following is also much commended Take of Tuty thrice burnt and washed of Ceruss washed of the Froth of Silver washed each two Drams of the Yolks of two roasted Eggs Wax Sope and Oyl of Roses each two Ounces make an Oyntment But if these things do no Good it must be cut off and if there be many of them they must be burnt off and the Ulcer must be regularly cured but cutting or burning in these parts is dangerous and must not therefore be used unless there be an absolute necessity If there be Hemorrhoids they are either in the Mouth or Neck of the Womb or in the Womb it self or in the Privities they are as divers as those in the Anus they are either blind or open they are with or without Inflammation they differ also upon their bigness Number and Figure they are occasioned by Chaps and by a Condyloma but chiefly by gross and feculent Humours falling upon the Veins of the Womb or by an inordinate defluxion of Menstruous Blood into those Veins This Disease may be known by a weight in those Parts and Women so affected are weak and subject to Spontaneous Lassitude But if the Hemorrhoids of the Womb or Anus flow moderately they cure and prevent many Diseases and the unseasonable stopage of them occasions the Falling Sickness and many other Diseases They are cured as the Piles of the Anus There are four sorts of Warts of the Womb and
its cavity The grosser nutricious Juice being deposited by the Umbilical Arteries in the Amnios as soon as the Mouth Gullet and Stomach and the like are formed so perfectly that the Foetus can swallow it sucks in some of the said Juice which descending into the Stomach and Intestines is received by the Lacteal Veins as in grown Persons The Infant therefore is nourished three several ways but only by one Humour First by apposition of it while it is yet an imperfect Embrio and has not the Umbilical Vessels formed But after these are perfected it then receives the same nutricious Juice by the Umbilical Vein the more Spirituous and thin part whereof it changes into Blood and sends forth the grosser part by the Umbilical Artery into the Amnios which the Infant sucks in at its Mouth and undergoing a new Concoction in its stomach is received out of the Intestines by the Lacteal Veins as is done after the birth A Child in the Womb differs from an adult Person in many parts the parts are less the colour of the whole reddish the Bones soft and many of them gristly and flexible in the Head There are several differences First the Head in respect to the proportion of the rest of the Body is bigger the Crown is not covered with Bone but only with a Membrane the Bone of the Forehead is divided as also of the under Jaw and the Os Cuneiforme is divided into four The Bone of the hinder part of the Head is distinguished into three four or five Bones The Brain is softer and more fluid and the Nerves very soft The Bones that serve the Sense of Hearing are wonderfully hard and big the Teeth lie hid in the little holes of the Jaw-bone the Dugs swell and out of them in Infants new born whether Male or Female a serous Milk issues forth sometimes of its own accord and sometimes with a gentle pressure The Vertebrae of the Back want their spinous processes and each of them made of three distinct Bones The Heart is remarkably big and its Auriculae large There are two Unions of the greater Vessels that are not conspicuous in grown Persons First the Foramen ovale by which there is a passage open out of the Cava into the Vein of the Lungs just as each of them are opening the first into the right Ventricle and the latter into the left Ventricle of the Heart and this Foramen just as it opens into the Vein of the Lungs has a Valve that hinders any thing from returning out of the said Vein into the Foramen Secondly the Arterial Channel which two fingers breadth from the Basis of the Heart joyns the Artery of the Lungs to the Aorta it has a pretty lage Cavity and ascends a little obliquely from the said Artery to the Aorta into which it conveys the Blood that was driven into the Artery of the Lungs out of the right Ventricle of the Heart so that it never comes into the left Ventricle as the Blood that is sent out of the left Venticle into the Aorta never came in the right except a little that is returned from the nutrition of the Lungs but past immediately into it out of the Vena Cava by the Foramen ovale so that the Blood passes not through both the Ventricles as it does after the Child is born You may know whether Infants killed by Whores and which they commonly affirm were still-born were really so or no by putting the Lungs of the Infant in Water for if they were still-born the Lungs will sink if alive so as to breath never so little while they will swim The Gland Thymus is very large and consists as it were of three Glands the Umbilical Vessels go out of the Abdomen the Stomach is narrower but pretty full of a whitish liquor The Caul is scarce visible the Guts are seventimes longer than the Body the Excrements in the small Guts are flegmatick and yellow but in the thick somewhat hard and blackish sometimes greenish the Caecum is larger than usual and often fill'd with Faeces the Liver is very large and extends it self into the left side and covers all the upper part of the Stomach it has a passage which is not in grown Persons called the Veiny Channel which arising out of the Sinus of the Porta carries the greatest part of what is brought by the Umbilical Vein directly and in a full stream into the Cava above the Liver But this passage presently closes as soon as the Infant is born and turns to a ligament as doth the Urachus and the two Umbilical Arteries The Spleen is small the Gall-bladder is full of yellow or green Choler the Sweet-bread is very large and white the Kidneys are bigger and unequal in their Superficies the Renes Succenturiati are exceeding large the Ureters are wide and the Bladder stretched with Urine in Females the VVomb is depressed the Tubes long and the Testes very large the little Bones of the VVrists and Instep are gristly and not firmly joyned together Its Knees are drawn up to the Belly its Legs bending backwards its Feet across and its Hands lifted up to its head one of which it holds to the Temple or Ear the other to the Cheek where there are white spots on the Skin as if it had been rubbed upon the Back-bone turns round the Head hanging down towards its Knees its Face commonly towards the Mothers Back but near the birth sometimes a VVeek or two before it alters its situation and tumbles down with its Head to the Neck of the VVomb and its Feet upwards then the VVomb also settles downwards and its Orifice relaxes and opens and the Infant moving up and down tears the Membrans wherein it is included and the waters flowing into the Sheath but sometimes the Membranes come forth whole at the same time the neighbouring parts are loosened and become fit for distension and the Bones near are so much relaxed in their Joynts that they make way for the Infant and the motion of it so much disturbs the VVomb that the Fibres of it and the Muscles of the Belly contract altogether to expel it CHAP. XIX Of the Management of a Woman with Child THE Woman ought to be kept in a good moderate and clear Air and she must Eat what she likes best and be sure not to Fast too long only she must observe not to eat too much at a time and to comfort the Stomach which is always weak in this condition she may Drink a little Wine or for want of it strong Beer at Meals As to Sleep a Woman with Child requires more sleep than she does at other times As to Exercise and Rest she must order her self according to the different times for at the beginning she ought to keep her self quiet and not to use Copulation Riding on Horse-back or in a Waggon or indeed in a Coach is not safe at any time of her being with Child especially when she
is near her time for such Exercises often cause Miscarriage But she may Walk gently or be carried in a Chair She must not carry or lift heavy Burdens or lift up her Arms too high and therefore ought not to dress her own Head Let her Exercise be gentle walking in low-heel'd Shoes but she had better Rest too much than Exercise too much for more hard Labours are occasioned by violent Exercise than by any other thing Moreover it is convenient that the Woman should abstain from Copulation the last two months for the Body is very much moved and the Belly compressed in the action which causes the Child to take a wrong posture If the Belly be bound as it is often at this time Prunes stewed or Veal Broath may be often used or the following Glister may be used Boyl an Handful of Mallow Leaves in three quarters of a Pint of Milk let the Milk just boyl up add to it two Ounces of brown Sugar and a little fresh Butter strain it for use She must moderate her Passions and great care must be taken that she be not Frighted and that Melancholy News be not suddenly told her but you must endeavour to keep her as chearful as possibly you can the sudden surprizes of joy must be also avoided for excesses on either hand are prejudicial The Cloaths of a Woman with Child should sit easie for any immoderate pressure is apt to make the Child deformed and hurts the Breasts and very often causes miscarriage Unnecessary Bleeding must be avoided so must all strong Purges but if Purging is requisite only such things as Purge gently must be used as Cassia Rubarb and Manna The Cassia is best sucked out of the Canes the Rubarb may be chewed and an Ounce and a half or two Ounces of Manna may be dissolved in Posset-drink and used upon occasion in the Morning Vomiting often afflicts Women with Child but if it be moderate and at the beginning and without great straining it is beneficial if it continues longer than the third or fourth Month it ought to be remedied in order to which let the Woman use good food and a little at a time and let her use with her meat the juice of Oranges she may eat now and then Broth mixed with the yolk of an Egg for it 's very nourishing and of easie digestion and after meals let her eat a little Marmalade of Quinces and she may drink a Glass of Claret she must forbear fat meat and Sauces and sweet and sugar'd Sauces But if the Vomiting continues notwithstanding this regular Diet till the Woman is above half gon she must take the following Purge Take of Tamarinds half an Ounce of Sena one Dram of Rubarb one Dram and an half boyl them in a sufficient quantity of water in three Ounces of the strained Liquor dissolve an Ounce of Manna and an Ounce of Syrup of Succory with Rubarb make a purging potion to be taken in the Morning It may be repeated once or oftener upon occasion And it may be proper for the Woman in the Winter time to were a Lambskin or the like upon her Stomach and Belly If pains of the Back Reins and Hips are violent the Woman must be blooded and take at bed-time sixteen drops of the Liquid Laudanum mentioned at the latter end of the Chapter of Hysteric Diseases in a glass of Canary Wine or in any thing else she likes and she must keep her Bed till the pain abates if the pain is continual the Belly must be supported with a Swaith fitted for the purpose If after the third or fourth Month the Breasts are very painful 't is convenient the Woman shou'd bleed in the Arm if she be full of blood and use a Diet that is moderately cooling and nourishing but if the pain comes at the beginning we ought to leave the whole business to nature only the Woman must have a care that she receives no blows on those parts nor must she be strait laced for fear the Breasts shou'd impostumate If incontinence or difficulty of Urin be occasion'd by the weight and bigness of the Belly the Woman may remedy it and ease her self if when she wou'd make water she lift up with both her hands the bottom of her Belly or she may wear a large Swaith fitted for this use to bear up the Belly but the best way is to keep her in Bed If a sharpness of Urin causes an Inflammation on the Neck of the Bladder it may be appeased by a regular cooling Diet and emulsions of the cold Seeds used Morning and Evening Take of blanched Almonds number twelve of the four greater cold Seeds each one Dram and an half of the Seeds of Lettice and white Poppies each half a Dram beat them in a Marble Mortar and pour on them gently three quarters of a pint of Poppy Water make an emulsion for two doses add one Ounce of Syrup of Violets and half a Dram of Sal Prunella If the Inflammation and Sharpness of Urine be not removed by the things above-mention'd a little Blood may be taken from the Arm and the neck of the Bladder may be bathed with the following Decoction with Flannels dipt in it and pressed out Take of the roots of Marsh-mallows one Ounce of the Leaves of Mallows Marsh-mallows Pellitory and Violets each one handful of the Flowers of Melilote one handful of the Seeds of Flax and Fenugreek each two Drams boyl them in a sufficient quantity of Water to a pint and half But if the Woman notwithstanding she observes these directions cannot make water it must be drawn out with a Catheter by an Artist If the Woman be troubled with a violent Cough she must be blooded in the Arm at any time of her being with Child for this is apt to occasion miscarriage and all salted and spiced meat and sharp things must be forborn She may now and then use juice of Liquorish Sugar Candy and Syrup of Violets and if the Body be bound a Glister of Milk and Sugar may be injected The following Syrup is very proper in this case Take half a pint of Claret Wine one Dram of Cinnamon half a Dozen Cloves and four Ounces of Sugar burn the Wine and boyl it to the consistence of a Syrup whereof let the Woman take three spoonfuls at Bedtime The Woman must go loose in her Clothes and if the Rheum be very thin and the Cough tickles much Sixteen drops of the Liquid Laudanum mentioned in the Chapter of Hysteric Diseases must be now and then taken at bedtime in some liquor she uses to drink If the Legs and Thighs swell and are painful they must be swaithed with a Swaith three or four Fingers broad beginning to swaith from the bottom but in this case 't is best for the Woman to be kept in Bed if there be signs of fulness of blood she must be blooded in the Arm. If the big bellied Woman be troubled with the Piles and abound