using these things a long time before the Hour of Labour to relax and dilate them the easier lest there should happen a rupture of any part when the Child is born for sometimes there happens a dilaceration to the Fundament by which both are rent into one outwardly If a Woman be in years of her first Child let her lower parts be likewise anointed to mollify the inward orifice and the Vagina or Neck of the Womb which being more hard and callous do not easily yield to the necessary distension of Labour which is the cause why such Women are longer in Labour than others and why their Children being forced against the inward orifice of their Womb which is as we have said a little callous and also for remaining long in the passage are born with great Bumps and Bruises on their Heads Small and mishapen Women should not be put to Bed till at least their Waters be broke but rather kept upright and walking about the Chamber if they have strength being supported under the Arms for in that manner they will breath more freely and mend their Pains better than on the Bed where they lye all on a heap Let those that are very lean also moisten these parts with Oyls and Oyntments to make them more smooth and slippery that the Head of the Infant and the Womb be not so compressed and bruised by the hardness of the Mothers bones which form the Passage The weak Woman should be strengthened the better to support her Pains giving her good jelly Broths with a little Wine and a Tost in it or other good things as the case requires If she fears the Pains let her be comforted assuring her that she will not endure many more but be speedily delivered On the contrary if her Pains be slow and small or none at all they must be provoked by frequent Clysters a little strong that so they may be excited by the needings at Stool and afterwards let her walk about her Chamber that the weight of the Child may also help a little If the Woman floods or hath Convulsions which is by many too long neglected she must be helped by a speedy Delivery as we have already declared and shall repeat hereafter in its proper place If she be costive let her use Clysters which likewise may dissipate a Cholick at those times very troublesome causing great and useless Pains very hurtful because they fleet to and again through the Belly without bearing down as they should do If she cannot make water because the Womb bears too much on the Bladder let her try by lifting up her Belly a little or else by introducing a Catheter into her Bladder draw forth her Urine If the difficulty or slowness of the Labour comes from the ill Posture of the Woman let her be placed in a better more convenient to her Habit and Stature observing the circumstances given in the First Chapter of this Second Book If she be taken with any distemper she must be treated for it according to its nature with more caution than at another time having alwaies regard to her present condition If it proceed only from the indispositions of the Womb either from its oblique scituation it must be remedied as well as can be by the placing of her Body accordingly If it be by its vitious conformation having the Neck too hard and too callous and too strait it must be anointed with Oyls and Ointments as above directed If it come from a strong Cicatrice which cannot be mollified of a preceding Ulcer or a Rupture of a former bad Labour so agglutinated it must be separated with a fit Instrument lest another Laceration happen in a new place and leave the Woman in a worse condition than before it must be made in that place where the case most requires it taking care that it be not upwards because of the Bladder If the Membranes be so strong as that the Waters do not break in due time they may be broken with the Fingers * Let the Midwife be first well assured provided the Child be come very forward into the Passage and ready to follow presently after for otherwise there is danger that by breaking these Waters too soon the Child will remain dry a long time and to supply that defect you must moisten the parts with Fomentations Decoctions and Emollient Oyls which can never be so well as when Nature doth its own work with the Waters and ordinary Slime which alwaies happen well when they come in time and place Sometimes these Membranes with the Waters press three or four Fingers breadth out of the body before the Child resembling a Bladder full of Water there is then no great danger to break them if they be not already for when it so happens the Child is alwaies ready to follow being in the Passage but above all be careful not to pull it with your Hand lest thereby you loosen before its time the After-burthen to which it adheres very strongly If the Navel-string comes first it must be presently put up again and kept up if possible or else the Woman must be immediately delivered But if the After-burthen comes first it must never be put up again for being come forth it is altogether useless to the Infant and would be but an obstacle and hinderance in the way if it were put up in this Case it must be cut off having tyed the Navel-string and afterwards draw forth the Child assoon as may be lest that he be suffocated If the Woman hath fallen or is hurt let her immediately keep her Bed and take her rest If it be any Passion that retards the Labour and cannot totally be overcome let them endeavour to moderate it If it be Shamefastness or Modesty the persons who are the cause of it must quit the Chamber and if timidity and fear of Pain she must be advised that it is the will of God it should be so and that her Labour will not be so bad as she imagines perswading her to submit to the necessity by the consolation of the unfortunate whose pain seems always more supportable by the consideration that it is common so she must be informed that others endure the same Pain and greater than hers if she be melancholy let her be diverted by some good news promising her such a Child as she desires and in a word though she suffer much she must consider it but as a bad journey which one quarter of an hour of good Weather makes one forget all past as she will when she is brougt to bed assuring her chiefly that she is in no danger especially when it is not very apparent for then one ought to acquaint her with it that she may settle both her temporal and spiritual affairs When the difficulty is only caused by a dead Child the method mentioned in the natural Labour must be observed and besides the Woman must do all she can to further her Delivery because the
but left for the Printer to make choice of the most familiar of them which he mistaking was to prevent further trouble suffered to be so printed I do not intend this work to incourage any to practise by it who were not bred up to it for it will hardly make a Midwife though it may easily mend a bad one Yet notwithstanding I do recommend it to the perusall of all such women as are carefull of their own and their friends safeties there being many things in it worthy their noting And designing it chiefly for the female sex I have not troubled my self to oppose or comment upon any Physical or Philosophical Position my Author proposeth I hope no good Midwives will blame me or my Author for reprehending the fault of bad ones who are onely aimed at and admonished in this work and I am confident none but the guilty will be concerned and take it to themselves which I desire they may and amend Farewell Hugh Chamberlen From my House in Prujeans-Court in the Old-Baily London this 15th of May 1672. ERRATA PAge 8. line 8. for Intestin read Intestinum Pag. 13. lin 1. r. such as P. 19. l. 3. f. upper parts r. Nipples l. 19. r. Womb is free P. 58. l. ult r. that miscarried P. 63. l. 24. r. Hypogaster P. 95. l. 9. r. Corroberatives P. 96. l. 4. r. a Wafer will be very fit P. 101. l. 18. f. Iorn r. Iron P. 132. l. 11. the Comma behind together must be before it P. 133. l. 15. f. the r. a. l. 28. f. which it yet does r. as it also doth P. 213. l. 1. f. capable r. able P. 224. l. 24. f. marked D. r. C. and the same in pag. 236. l. 9. P. 287. l. 1. f. an r. a. P. 301. l. 3. f. brannes r. meales P. 430. r. CHAP. XXXVI l. 24. r. requisite Books newly printed Aurora Chymica or A rational way of preparing Animals Vegitables and Minerals for a Physical use c. Authore Edw. Bolness Med. R. Ord. A Philosophical Essay Declaring the probable Causes whence Stones are produced in the greater World as also the Causes and Cure of the Stone in the Kidnies and Bladders of Men c. By Dr. Thomas Shirley Physician in Ordinary to his Majesty Sold by W. Cadman at the Popes-head in the lower Walk of the New-Exchange Praxis Medicorum Antiqua Nova The Antient and Modern Practice of Physick examined stated and compared By E. Manwaringe Dr. in Physick Sold by Tho. Archer Bookseller under St. Dunstans-Church in Fleetstreet The First Book Of the Diseases and different Dispositions of Women with Child from the time of Conception to the full time of Reckoning MAny Indispositions may arrive to Women from the time of Conception to the full term of Labour because they are then not only subject to those which are caused by pregnancy but to those also which happen at other times It is not my design so to enlarge as to examine all but onely to enquire into the principal and most usual Maladies that accompany Great-Bellies and have during their course some particular Indications for their Cure for as for those which have only general Indications and may happen indifferently to a Woman at any time they may easily be known and redressed by the ordinary means provided that you have all the while regard to the disposition of the Great-Belly It would be sufficient to my purpose of a through examination in pursuance of my intention of every circumstance of a Great-Belly to begin with the explication of a Conception which must precede it but since that cannot happen but to a fruitfull Woman I will before I discourse of it that you may the better understand it from its original give you some considerable Observations concerning the Fruitfulness and Barrenness of Women for Barrenness proceeds oftner from Women than Men for there are many conditions required in a Woman which Men have no occasion of who only need to provide a small quantity of their Seed and that at once to generate but Women besides their Seed must have a fit place to receive both as the Womb is when well disposed and matter appointed for the Child's nourishment during its whole stay there as is the menstruous blood This is the cause that for one impotent Man there may be above thirty barren Women found Let us therefore first of all see what are the signs of Fruitfulness and Barrenness in Women CHAP. I. Of the signs of Fertility and Sterility in Women By the Fertility of a Woman I understand a natural disposition of her Body by means of which with the assistance of a Man she may engender her like And by Sterility which is directly contrary I intend an * Incapacity Impotency which proceeds from some vice or fault either of her whole body or of some particular part We must how make some enquiries after the most notable signs of the one and the other and chiefly of those which may be perceived by our sight or touch by which we may better judge than by many others that for the most part are uncertain For those which are taken from different temperaments may easily deceive us forasmuch as we may often find Women of a very ill habit and full of ill humours notwithstanding fruitful First therefore we affirm the Womb to be a part absolutely necessary to fertility and the principal object to be represented and examined to make a judgment of it but as we find not every Ground proper to yeeld Fruit and that some are so ungrateful as to produce nothing so likewise it is not enough for a Woman to have a Womb to be capable of Conception since we find divers that have them barren We have already * In his Anatomy not yet printed shewed you exactly what the composition and natural structure of it ought to be for to serve to so admirable an end as generation Wherefore we will now speak no further of that but refer you to that place to be informed You must know then in general that the signs of fecundity in a Women are that her Womb be well disposed that she be at least thirteen or fourteen years of age and at most but 45 or 50 generally and for the most part though some yet very rarely conceive sooner or later according to their different natures and dispositions that they be of a good temperament and indifferently sanguine that they have their Courses in due time of good blood and laudable in coulour quantity quality and consistance and regularly every month at once without interruption from the time they begin to flow till the time the evacuation is compleated We say that the bloud ought to be good and laudable because it is a regurgitation and natural evacuation only of what is superfluous in Women not with Child and yet of age capable of Conception which hath no malignity in it self as many falsly imagine for in healthful women
it hardly differs either in colour consistence or quality from that which remains in the vessels except in the small alteration which is caused by the heat of the place whence it proceeds and by the mixture of some humours with which the womb is alwayes plentifully furnisht This evacuation if in order ought to be every month but once though some have them every fourtnight or at the end of three weeks according as they are more or less sanguine or cholerick or have their blood heated and to continue two or three days together or six at most and that by little and little constant without interruption and also more or less according to the difference of their particular temperaments If a Woman have few of them as when she grows in years she becomes barren forasmuch as this blood seems to nourish the Child in the Womb and likewise if she have too many because the Woman thereby grows too weak and the Womb too cold There are notwithstanding some Women who void more of them in two days than others in eight They must flow by little and little without interruption and not all at once for great and sudden evacuations cause great dissipation of spirits of which abundance are necessary for generation and the interruption of these evacuations shews some impediment in nature or some vice or evil disposition of the Womb. If all these signs concur we may very probably judge the Woman fruitful I say probably because there are many who have them all and yet cannot conceive though they do their endeavours and observe thereto all the requisite and necessary circumstances which we shall hereafter mention There are likewise others who notwithstanding they have not all these conditions are fruitful Now if all the above named patticulars are found in a Woman that is barren and that you desire to inquire more narrowly and to be informed more certainly whether she be capable of conception Hippocrates teacheth a way to know it to which I give little credit because the reasons of it are very obscure It is in his 59 Aphorism of his 5th Book where he saith Si mulier non concipiat scire placet an sit conceptura vestibus undique obvolutam subter suffito ac si odor corpus pervadere videatur ad nares os usque non sua culpa sterilem esse scito If a Woman doth not conceive and you are desirous to know whether she is capable or no wrap her close round with clothes and put a perfume under her and if she perceive the sent to pass through her body to her nose and mouth be assured saith he it is not her fault she is barren Fertility was anciently so esteemed by our fore-fathers that they believed Barrenness to be a mark of reprobation by reason of which the fruitfull Servant despised her barren Mistress as we reade in the 16th Chapter of Genesis where mention is made of Sarai Abraham's Wife who seeing that she could have no Children and being past the age of hoping for any and that her Husband was displeased at it bid him take her Aegyptian Chamber-maid named Agar to lie with him that by her means the might give him lineage which good Father Abraham quickly did and had by her afterwards a Son which was called Ishmael but from the time this Maid had conceived she began to despise her Mistress Sarai who was as yet barren The Women of our times are not so earnest to have lineage after this fashion there being but few that will suffer their Husbands to caress their Chamber-maids much less * Lovingly charitably to excite them to follow this example which custom is abolished amongst us I also admire the great passion which many have who complain of nothing with greater regret than to the without Children especially without Sons For my part I believe they that descend from Caesar or the Family of Bourbons may with some reason be led away with this superstitious and common inclination of preserving their kind and be vexed with these sorts of inquietudes which no wayes become ordinary people though excusable and may be permitted to great Monarchs and illustrious men When we perfectly understand the natural dispositions we may the easier discern those contrary to nature wherefore the signs of fruitfulness easily teach us those of barrenness The signs and causes of barrenness proceed either from the age or evil temperature and vicious conformation of the Womb and parts depending on it or the indisposition and intemperature of the whole habit The evil conformation of the Womb renders Women barren when its neck called the Vagina is so narrow that it cannot give way to penetration and when it is wholly or in part closed by some external or internal membrane which is very rare if at all or by any tumour callosity or cicatrice which may hinder the Woman from the free use of copulation But it is not sufficient that the Man's Yard enter the Vagina which is the anti-chamber to the Womb for if in the act of copulation he knocks at the door which is the internal orifice and it be not opened all is to no purpose This orifice is likewise hindred from opening by some callosity proceeding from abundance of ill humours which usually slow down from the Matrix or by some tumour which may happen to it or also by some part which may so compress it that it cannot dilate to receive the Seed as doth the Epiploon or cawl in fat Women according to the opinion of Hippocrates in his 46th Aphorism of his 5th Book where he saith Quae praeier naturam crassae non concipiunt iis os uteri ab omento comprimitur priusquam extenuentur non concipiunt Women exceeding fat do not conceive because the Cawl compresseth the orifice of their Womb neither can they till they grow lean I do not willingly admit amongst the causes of barrenness this compression of the inward orifice by the Epiploon forasmuch as Aritin hath very well remedied it by some of the postures invented by him by which this orifice need not be so compressed in the action The most frequent reason why this orifice opens not in this act to receive the Man's Seed is the insensibility of some Women who take no pleasure in the venerial act but when they have an appetite the Womb desirous and covetous of the Seed at that instant opens it self to receive it and be delighted with it But though the Vagina or neck of the Womb and the inward orifice opens to give passage to the Seed yet may they very often continue barren if the scituation of this orifice be not rightly placed but either backwards towards the * Great or right Gut Intestin rectum or towards either side all which hinders the Man from †shooting darting his Seed directly into it and consequently the Woman from conceiving Hippocrates seems to have noted all the signs and causes of barrenness which usually
proceed from the evil temper of the Womb in his 62 Aphorism of the 5th Book where he saith Quae frigidos densos habent uteros non concipiunt quae praehumidos habent uteros non concipiunt extinguitur enim in ipsis genitura Et quae plus aequo siccos adurentes Nam alimenti defectu semen corrumpitur Quae vero ex utrisque nactae sunt moderatam temperiem eae faecundae evadunt All such Women whose Womb is cold and close cannot conceive nor they who have it too moist because the Seed is extinguished in it And likewise such who have it too dry and hot because for want of aliment the Seed corrupts but such as are of a moderate temperament are fruitful Of all these which Hippocrates recites in this Aphorism the most common according to my opinion is the continual Humidity of the Womb fed by an abundance of the Whites with which many are very much inconvenienced the humours of the whole Body being accustomed to steer their course this way which can very hardly be turned away when inveterate and the Womb being imbued with these vicious moistures becomes inwardly so unctuous and slippery that the Seed though viscous and glutinous cannot cleave to it nor be retained within it which is the cause that it slips immediatly away or in some short time after it is received Barrenness may also proceed from the whole habit of the Body as when a Woman is too old or too young for the Seed of the young is not yet prolifick neither have they the menstruous blood which two things are requisit to fruitfulness and that of the aged is in too small a quantity and too cold who likewise want the menstruous blood An universal intemperature though the Woman be of convenient years renders them however barren as it happens when they are hectick hydropick feaverish and sickly and especially so much the more as the noble parts are fallen from their temperament and natural constitution There are however many Women which seem barren for a long time because of some of the fore-mentioned Reasons yea till they are thirty five or forty years old and sometimes longer who yet at last conceive being cured of the indispositions which hindred them and having changed their temperament by their age of which we have had a remarkable example in the person of Queen-mother lately deceased who was above two and twenty years married and without Children and yet afterwards to the great joy and content of all France she had our invincible Monarch Lewis the 14th now reigning to whom God grant a long and happy life Some of these Barrennesses may sometimes be cured by removing their causes and procuring the dispositions we have said are necessary to fruitfulness yea of those which proceed from an universal intemperament by reducing the Body with a good and convenient regimen to a good order and this according to their respective indispositions Wherefore if a Woman have naturally the Vagina too narrow and not from some of the causes above-mentioned she ought to be joyned to a Man whose Member is proportionable if possible and if that will not do which happens very seldom she must endeavour to relax it and dilate it with emolient Oyls and Oyntments if the neck of the Womb be compressed by any humour it must be resolved and suppurated according to its nature and scituation having alwayes care to prevent the corruption of these parts which being hot and moist are very subject to it because the womb serves as a sink by which all the ill humours of the body are purged so that you must take great care that these kind of Tumours turn not to a Cancer which is a very mischievous malady and causeth the poor Women miserably to languish which are afflicted with it and which after many insupportable pains brings them almost alwayes to an inevitable death When the Vagina is not clear in its capacity because of any scar after a rent caused by some force or violence to the Woman or of some hard labour or after an ulcer which caused the two sides to be agglutinated whether inwardly or outwardly it must be separated the best that may be with a * A kind of large Incision-knife Bistory or some other Instrument according as the case requires hindring by interposed Linnen that it do not again agglutinate When a Woman hath no Vulva or outward entry of the Womb pierced which is very rare it must be opened by making a long Incision Fabricius recites the like case in a Girl of thirteen years of age who was like to die of it because her Terms could not come down there being no perforation wherefore he did the like operation which succeeded very well and made her by that means capable of generation As to the inward orifice of the Womb if it be displaced either towards the back or sides it may be in some sort remedied by making the Woman to observe in the act of generation a convenient posture that the Man's Seed may be ejaculated towards the orifice and if the Whites or other Impurities of the Womb cause barrenness as it is for the most part by the discharge of the whole habit on this place it must be helped by Evacuations Purgations and a regular Diet according to their different causes and qualities of these ill humours Having thus discovered the most certain signs of Fertility and the marks of Sterility I will now the better to pursue the order I have proposed treat of Conception CHAP. II. Of Conception and the conditions necessary for it IT is most certain according to the Rule of Nature that a Woman is incapable of conceiving if she have not the conditions requisit for fruitfulness we have mentioned them in the foregoing chapter let us now examine in this what is Conception and how it is caused Conception is nothing else but an action of the Womb by which the prolifick seeds of the Man and Woman are there received and retained that an infant may be engendred and formed out of it There are two sorts of Conceptions the one true according to Nature to which succeeds the generation of the Infant in the Womb the other false which we may say is wholly against Nature and there the seeds change into water false-conceptions moles or any other strange matter The qualifications requisit for a Woman to conceive according to Nature are that the Woman receive and retain in her Womb the Mans and her own prolifick seed without which it cannot come to pass for it is necessary that both seeds should be there nor is it at all true what Aristotle and some other of his followers affirm that the Woman neither hath nor can yeeld any seed a great absurdity to believe for the contrary may easily be discovered by seeing the Spermatick Vessels and Testicles of a fruitful Woman appointed for this use which are wholly filled with this seed which in coition
they discharge as well as Men. Such a will not open their eyes to behold a verity so clear may make reflection on the resemblance of Infants to their Mother which could not be unless her seed had been more praedominant than the Fathers when he begot them which likewise happens after the same manner when the Fathers hath more force and vertue Which may evince that the Womens seed contributes as well to the formation of the Infant as the Fathers If they will not agree to a thing so common let them make another reflection on the generation of certain Animals which participate of the nature of the Male and Female of which they are engendred though of different kind as we daily see Asses and Mares produce by their coupling Mules which are Animals of a middle nature resembling both the one and the other that produced them We may then learn by this that both Seeds are necessary for a true Conception provided they be prolifick that is containing in them the Idea of all the parts of the body and then the Womb being greedy of it delights it self in it and easily retains it when received else it soon afterwards rejects it It is not absolutely necessary that both the Seeds be received and retained intire without the loss of some part for provided there be a moderate quantity of it 't is sufficient Nor must we imagin that though all of it be not received into the Womb the Child formed out of it will want some limb as an arm a leg or other member for want of sufficient matter inasmuch as the forming faculty is whole in every part of the Seed of which the least drop contains in it potentially the idea and form of all the parts as we have lately made appear but indeed when the Seeds are received but in small quantity the Child may be the less weaker for it Or if either or both of them have not the requisit qualities or though well enough conditioned if the Womb be imbued and stuft with ill humours as the menstrues whites and other filth or any other fault if then there be a conception it will be contrary to Nature and there will be ingendred false births Moles or dropsies of the Womb mixed with some other strange bodies which are very troublesome to Women till they void them It is therefore without cause that many Women are blamed when their children are born with red and livid spots which very much disfigure the faces of some of them It is usually said but without reason that this proceeds from the mothers longing to drink Wine for though some have by chance been in effect harrassed as they affirm with these passionate desires during their being with child yet we must not superstitiously believe as many do that these spots are so caused but rather from some other cause which must be searcht for elsewhere And that which makes it appear it cannot proceed from hence is that almost throughout all Italy where nothing but white wine is drunk as also in Anjou in France I have seen divers persons marked with these red spots and in case it proceeded from their Mothers longing to drink Wine they ought to be white spots or of an Amber colour being the colour of the wine of these Countries but we ought rather to conclude that they are caused from some extravasated blood at the time the Infant is formed which marks the skin yet very tender with these spots and colours it in whatsoever part it toucheth much after the same manner as we see it marked with Gunpouder or some waters producing the like effect when it is washt and bathed with them I will not however deny that the imagination hath a power to imprint on the body of the Infant marks of this nature but that can only be when young with Child and principally at the very moment of conception for when the Child is compleatly formed the imagination can in no wise change its first figure and Women must wean themselves from these vain apprehensions which they say they have to such things every moment and serves some of them for a pretext to cover their liquorishness Since my discourse is fallen upon this subject of Marks with which oft times the bodies of Infants are spoted in their birth and which comes as is ordinarily believed from the imagination of their Mother it seems to me not much from my purpose to recite you a circumstance very particular sound on Me when I came into the world as my Father and Mother have often told me which is that my Mother being with Child of me and almost at the end of her reckoning as it appear'd afterwards the eldest of her three Sons which she then had of six years old and her first-born whom she loved with an extraordinary tenderness and passion dyed in seven dayes of the small Pox all which time she continned night and day by his bed side tending him in all his necessities not suffering any other to do it whatsoever desires were made to her not to weary and trouble her self as she did for the Childs sickness alledging that in her present condition she ought to be careful of her self and not be the cause of death to the Infant she went with in fine at the end of seven dayes her Son dyed upon which the next day she was delivered of me who brought effectively into the world with me six or seven of the small Pox. Now it is certain that it would be irrational to say that I had then contracted these small Pox in my Mothers Womb by her strong immagination But if I were asked whence they proceeded I should answer that the contagious air she breathed without discontiuuance during the whole sickness of her deceased Son had so infected the mass of her blood with which at that time I was nourished that I rather than she easily received the impression of this contagion because of the tenderness of my body Let us therefore assert that the imagination cannot produce any of the above mentioned effects but at the moment of conception or within few dayes after and that we ought for the most part to search elsewhere if we desire the truth of it the cause of most of these Spots Marks and Signes with which many Infants are born CHAP. III Of the Signs of Conception AS it is very hard and belonging only to expert Gardeners to know Plants as soon as they begin to spring forth of the Earth so likewise there are none but expert * Chirurgeons onely practise Midwifery in France Chirurgeons can give a Woman certain assurance of Conception from its beginning although some of these signs resembling those of the suppression of the Terms and other maladies in Women cause many to be deceived in it I will not trouble my self to make a recital of a great number of signs of conception which rather tend to superstition than an effective verity but only the
A Vomitu singultus malum Some advise that after all these things have been tryed in vain great Cupping-glasses should be applyed to the region of the stomach to keep it firm in its place but I believe it to be a Chip in Pottage which doth neither good nor hurt because the stomach is loose and no wayes adhering to this upper part of the belly but since these Vomitings cool it and daily weaken it I should advise a big-bellied Woman to wear in the Winter upon its region a good piece of warm Serge or soft Lambskin which would a little warm those parts and help digestion which is alwayes weak The Italians have a Custom which is not bad they wear to the same purpose a fair piece of Stuff under their Doublets upon the region their stomach of which they are so careful that if they should leave it off but two dayes in the Winter nay even in the Summer they would think themselves sick and they are so grear lovers and so curious of it that this Stomacher is often their greatest bravery enriching it with Gold and Silver Embroidery and Ribonds of very fine colours We have discoursed enough about Vomiting caused by Pregnancy wherefore we will pass forwards to some other Accidents CHAP. XII Of Pains of the Back Reins and Hips ALL these Accidents are but the effects of the dilatation of the Womb and the compression it makes by its greatness and weight on the neighbouring parts which are much greater the first time the Woman is with Child than afterwards when the Womb only receives the same dimensions it had already before but when it hath not yet been dilated it is more sensible of this extention and the ligaments which hold it in its natural scituation suffer a greater stress in the first pregnancy having never before been forced to lengthen to answer the extent of the Womb than in the following Great-Bellies to which it obeys more easily the second time These ligaments as well round as large cause these pains being much straitned and drawn by the bigness and weight of the Womb which contains a Child to wit the large ones those of the back and loyns which answer to the reins because these two ligaments are strongly fastened towards these parts the round ones cause those of the groins share and thighs where they terminate They are sometimes so violently extended by this extream bigness and great weight of the Womb especially of the first Child as I said before that they are lacerated and torn being not able to yeeld or stretch any farther and chiefly if the Woman in that condition makes a false step which causeth in them almost insupportable pains and other worse accidents as it happened two years since to a near Kinswoman of mine who being six months gone or thereabouts of her first Child felt the like after she had stumbled and perceived at the same moment something crack in her Belly towards the region of the Reins and Loins which was one of these large ligaments with a kind of noise by the sudden jolt she received At the same instant she felt extream pains in her Reins and Loins and all the one side of her Belly which made her immediately vomit very often with much violence and the next day she was taken with a great continued Feaver which lasted seven or eight dayes without being able to sleep or rest one hour all which time she continued to vomit all she took with a strong and frequent Hiccough having also great pains which seemed as if they would hasten her Labour which for her sake I was very apprehensive of as also of her death but with the help of God having put her immediatly to bed where she continued twelve whole dayes in which time I bled her thrice in her Arm on several dayes and made her take at two several times a small grain of Laudanum in the yolk of an Egg a little to ease her violent pains by giving her rest alwayes ordering her from time to time good strengthning Cordials all these symptoms which at first seemed desperate ceased by little and little and she went on her full time when she was happily delivered of a Son which lived fifteen months notwithstanding all those mischievous accidents she met with which were enough to have kill'd half a dozen others but God sometimes is pleased to work Miracles by Nature aided with Remedies fit for the purpose as well as by his Grace This History informs us I think very well how these Pains of the Loins Back and Reins come and the pregnant Womb causeth also those of the Hips by its greatness and weight in compressing them and bearing too much upon them There is nothing will ease all these sorts of Pains better than to rest in Bed and bleed in the Arm if there were any great extension or rupture of any ligament of the Womb as was in the case recited And when the Womb bears and weighs too much upon the Hips if the Woman cannot keep her Bed she ought to support and comfort her Belly with a broad Swaith well fitted for the purpose and to bear it as patiently as she can to the time of her Labour which will free her from all these accidents CHAP. XIII Of the Pains of the Breasts AS soon as a Woman conceives her Tearms wanting the ordinary evacuation the passages being stopt and the Woman breeding daily blood there is a necessity she consuming but little whilst young with Child the fruit being yet very little also that the vessels which are too full should disgorge part as it doth upon the parts disposed to receive it such as are the kernels and glandulous parts especially the Breasts which imbibe and receive a great quantity of it which filling and extreamly swelling them causeth this Pain in them which Women feel when they are with Child and happens also to those whose Terms are only suppressed In the beginning we ought to leave the whole work to Nature and the Woman must only have a care she receives no blows upon those parts which are then very tender nor be straight laced with her Bodies or other stiff Wastcoats that might bruise and wound her upon which follow Inflamations and Abscess But after the third or fourth month of going with Child the blood being still sent to the Breasts in great abundance 't is much better to evacuate it by bleeding in th' Arm than to turn or drive it back on some other part of the Body by repercussive or astringent Medicines because it cannot flow to any part where it can do less hurt than in these Wherefore I should rather prefer the Woman being very plethorick to evacuation by bleeding in the Arm than any other way because of shunning thereby the Accident of which speaks Hippocrates in his 40th Aphorism of the 5th Book Quibus Mulierilbus in Mammas sanguis colligitur furorem significat If the blood be carried in too great abundance to
the Breasts it signifies that the Woman is in danger of being frantick because of the transport which may be made thence to the Brain which accident is avoided by moderate bleeding in the Arm as also by a regular cooling dyet moderately nourishing for to diminish the quantity and temper the heat of the humours of the whole habite CHAP. XIV Of Incontinence and difficulty of Urine THe scituation of the Bladder which is placed just upon the Womb is sufficient to instruct us wherefore pregnant Women are sometimes troubled with difficulty of urine and the reason why they cannot often hinder nor scarce retain their water which is caused two wayes 1. Because the Womb with Child by its bigness and weight compresseth the Bladder so that it is hindred from having its ordinary extension and so incapable of containing a reasonable quantity of urine Which is the cause that the bigger the Woman grows and the nearer her time she approaches the oftner she is compelled to make water which for that reason they cannot keep 2. If the weighty burden of the Womb doth very much compress the bottom of the Bladder it forceth the Women to make water every moment but contrarily if the neck of it be pressed it is filled so extreamly with urine which stayes there with great pain being not able to expel it forasmuch as the Sphincter because of this compression cannot be opened to let it out Sometimes also the urine by its acrimony excites the Bladder very often by pricking it to discharge it self and sometimes by its heat it makes an inflamation in the neck of the Bladder which causeth its suppression It may be likewise that this Accident is caused by some Stone contained in the Bladder then the pains of it are almost insupportable and much more dangerous to Woman with Child than to one that is not because the Womb by its swelling causeth perpetually the stone to press against the Bladder and so much the violenter are these pains as the stone is greater or the figure of it unequal and sharp It is of great consequence to hinder these violent and frequent endeavours of a big-bellied Woman to make water and to remedy it if possible both in one and the other indispositions because by long continuance of alwayes forcing downwards to make water the Womb is loosned and bears very much down and sometimes is forced the inconvenience not ceasing to discharge it self of its burden before the ordinary time This is that should be endeavoured to be hindred having respect to the different cause of the distemper as when it comes from the bigness and weight of the Womb pressing the Bladder as it is for the most part the Woman may remedy it and ease her self if when she would make water she lift up with both her hands the bottom of her belly she may wear a large Swaith accommodated to this use which will bear it up if there be occasion and hinder it from bearing too much upon the Bladder or to do better she may keep her Bed If it be the acrimony of the urine that makes the inflammation on the neck of the Bladder it may be appeased by a regular cooling dyet drinking only Ptisan and forbearing the use of Wine and all sorts of Purgations because they send the filth of the whole body to the part affected and by their heat do yet more augment the acrimony and inflammation but she will do well to use mornings and evenings Emulsions made with the cold Seeds or Whey mixt with Syrup of Violets This Remedy is proper by refreshing gently to cleanse the urinary passages without prejudicing either the Mother or Infant If the inflammation and acrimony of the Urine be not removed by this Rule of Dyet they may let her blood a little in the Arm to prevent any ill accident that may happen they may likewise bath her outward entry of the neck of her Bladder with a Decoction of emollient and cooling Herbs as the leaves of Mallows Marsh-mallows Pellitory and Violets with a little Linseed which being viscous will help the conduit of the Urine to dilate it self the easier there may be also Injections given into the Bladder of the same Decoction to which may be added Honey of Violets or else of lukewarm Milk But if the Woman notwithstanding she observes these Directions cannot make water recourse must be had to the last remedy which is to draw it forth by a Catheter represented and marked with the Letter M in the Table of Instruments at the end of the second Book which being anointed with Oyl Olive or sweet Almonds having first lifted up and thrusted the Belly a little upwards must be gently introduced by the urinary passages into the very hollow of the Bladder and then the Urine will immediately pass away which being finished the Catheter must be taken forth and if the suppression continues it may be used again in the same manner until the accident quite leave her and then they may try whether she can urine naturally If she be in very great extremity she may use an half-Bath luke-warm provided she be not too much moved by this Remedy abstaining also from all Diureticks which are very prejudicial to big-bellied Women because they provoke abortion If on the other side this evil arises from the Stone which presenting it self to the neck of the Bladder stops the urinary passage whilst with Child she must be contented to have it only thrust back with a Catheter but if it be small one may try to draw it forth with a small Probe fit for the purpose putting the fore-finger into the Vagina to keep it in subjection that it recoyl not back towards the Bladder which is only to be done to the small ones for she must be delivered before the great ones can be drawn forth it being better to leave her in that condition than to endanger her life or the Childs by drawing it CHAP. XV. Of the Cough and difficult breathing WOmen whose Children lie low are oftener troubled with difficulty of Urine as we have mentioned in the foregoing Chapter than they whose Children lie higher who are indeed exempted from this and the like inconvenience but are then more subject to a Cough and difficulty of breathing than the former A Cough if violent as sometimes even to vomiting is one of the most dangerous accidents which contributes to Abortion because it is an essay by which the Lungs endeavour to cast forth of the Breast that which offends them by a compression of all its Muscles which pressing all the inclosed air inwards with which the Lungs are much extended thrusts also by the same means with a sudden violence the Diaphragma downwards and consequently all the parts of the lower Belly but particularly the Womb of the pregnant Woman which accident continuing long and violent often causeth her to come before her time This Cough proceeds sometimes from sharp and biting rheumes which distill from the
Belly which is likewise more equally in its circumference extended than if there were a Child she will also have the Lips of the Womb her Thighs and Legs swell'd aedematous and a worse colour in her Face than when she is with Child Now as this Dropsie may come alone so likewise may often happen together with a true Conception these Waters being then contained without the membranes of the Child in the capacity of the Womb for though there may be much Water within these membranes it is not properly the Dropsie of the Womb because there must ever naturally be some in the midst of which the Faetus is contained Notwithstanding sometimes there is such a quantity of them which doth so prodigiously swell the Womans Belly that one would believe she had two or three Children when she hath but only one which is much weakned by it because the greatest part of its nourishment is resolved into these Waters which almost extinguisheth and suffocates that little natural heat which is there Some Women have evacuated three or four quarts above two months before they were brought to bed when this happens they are then contained in the Womb without the Membranes for else the Child would be necessitated to be born presently after these Evacuations * That being the right time of Labour if it were the Waters that ought naturally to be contained in the membranes that came away The best Remedy for this kind of Dropsy the Woman being vvith Child is to vvait vvith patience the hour of her delivery observing the mean time a drying dyet but vvhen it is only Water contained in the Womb she must use Diureticks to cause the Womb to open to evacuate them and her Courses must be endeavoured to be provoked having alwayes a care to destroy by convenient Purges the cause of the generation of such superfluities The Womb is sometimes so full of these humours that it dischargeth some on the outward parts and principally upon those vvhich are near as the lips of the Privities vvhich often are thereby so swelled that they become quite blown up and sometimes in some Women are so big and swelled that they cannot close their Thighs together for them vvhich hinders their vvalking unless vvith pain and great inconvenience This Swelling is then livid and almost transparant even as a Hydrocele because of the quantity of clear Water vvhich filled it and because it may be painful and inconvenient to the Woman during her labour by reason they straiten the passages it vvill be necessary to remedy it before vvhich for the greater certainty must be done by the operation of the hand making many scarrifications vvith a Lancet all along the lips vvhereby the humours will sweat out and distil forth by little and little after vvhich Compresses dipt in Aromatick and Astringent Wine must be put upon it to prevent Relapses by fortifying the parts causing the Patient to observe all the vvhile a good dyet fit for the Dropsie Some vvould apply Leeches to avoid the pain of the Lancet but they are not so proper because the small orifices they make assoon as they are taken off immediately close again which happens not so soon to the Scarrifications made as big or little as one will and may be kept open by oyntments applied to them as long as may be thought fit or necessary CHAP. XXIII Of the Venereal Disease in Women with Child IT is not very hard to imagine how a breeding-Woman that hath the Pox can communicate it to a Child in her belly because this contagious disease corrupting all the mass of the Mothers blood it is necessary the Infant which hath then no other sustenance should be infected with it converting this bad blood into its own substance the acrimony of which Blood easily causeth in an Infants tender body those malignant ulcers which all such whose Mothers are contaminated with it usually bring with them at their birth The Pox which in its essence is of the same species and is only distinguished by degrees according as it is greater or less communicating it self by the means of the Mothers blood will make more or less impression on the Infants body according to its strength or weakness and if the big-bellied Woman have Ulcers very near the Womb as in the neck and neighbouring parts by this proximity the venom will be very easily conveyed to it I do not design here to enquire into the bottom of this Venereal Disease nor to write particularly of the cure of it but intend only to shew vvhether the Woman may undergo the Cure vvhilst with Child or ought therefore to defer it till after they are brought to bed That this may be the better determined we must make some distinction for when the Woman is towards the end of her Account it ought to be deferred till after she is brought to bed when both she and the Child if infected may be taken in hand because the labour coming on when the Woman is in the midst of her Cure she may run the hazard of her life and besides if the Child should be then still-born one would be apt to think it was killed by the violence of the Medicaments and blame the Chirurgeon of rashness When the Pox is but in the first degree and hath caused no great accidents one ought then likewise to remit the eradicating Cure till after Childbed and be contented only with the palliating by a convenient dyet and gentle purgers from time to time to prevent the evils encreasing but if the Woman when young with Child hath the Pox in the highest degree accompanied with very great and continual accidents which threaten danger if her Cure be protracted till after Delivery because in so long a time these accidents augmenting more and more it would be impossible but her Fruit should be corrupted and very hard if she did not miscarry that the greatest of these two evils be avoided she having strength enough ought to be taken in hand for to imagine the worst that the Remedies make her miscarry it is no more than the greatness of the Disease would otherwise certainly do Let her then be taken in hand without suffering the accidents longer to augment vvhich by continuance render themselves much more dangerous both to her and her Child being careful to give her the gentlest Remedies and with more preparation and circumspection so that the Evacuation procured to her by Salivation be rather by little at a time and the longer than too great and sudden and above all that it be rather by anointing the upper parts only with * As Unguentum Neapolitanum Mercurial Oyntments and not by Perfumes which sooner endanger miscarrying by opening the Womb besides that they sooner cause the Fruit to perish if it had life For the same reason also no Mercurial Medicine must be taken in at the mouth vvherefore frictions of the upper parts are to be preferred endeavouring alwayes as much
lethale The particular causes of Abortion are all the accidents mentioned in the preceding chapters as violent and frequent vomitings because there is not only want of sufficient nourishment for Mother and Child when the food is so continually vomited up but also great reachings and endeavours by which the Womb being often compressed and as it were shaken is at last constrained to discharge it self before its time Pains of the Reins great Cholicks and Gripes may likewise cause the same accident as the Strangury also for there are then made strong compressions of the Belly every moment to expel the Urine Great Coughs by their frequent agitation suddenly thrusting the Diaphragma with force downwards give also violent shocks to the Womb. Great Loosnesses endanger a Woman to miscarry according to the 34th Aphorism of the 5th Book and sooner if a Tenesmus follows which is great needings whereby the right Gut seeks to expel the sharp humours that irritate and provoke it This makes us take notice of the 27th of the 7th Book Mulieri utero gerenti si tensio supervenerit facit abortum for in this case the Womb which is scituated upon the Rectum receives a great commotion by its continual needings If a Womans Courses flow immoderatly it is impossible her Fruit can be in health as it is in the 60th Aphorism of the 5th Book for besides that the Infant is not sufficiently nourished the Womb also by being too much moistened is easily relaxed and opened Letting Blood immoderately doth the same for the same reason especially if the Child be great according to the 31th Chapter of the same Book But one of the worst accidents which cause Abortion is that Flooding which proceeds from the separation of the After-birth from the Womb of which we treated in the 20th Chapter of this first Book The Dropsie of the Womb hinders the Child from growing to perfection for the great abundance of Water extinguisheth the natural heat which is already at that time much debilitated and the Pox in the Mother infects the Child and often Kills it in her Belly as we have demonstrated in the preceeding Chapter and whatever very much agitates and shakes the big-bellied Womans body is capable of making her miscarry as great labour strong contorsions or violent motions of what manner soever in falling leaping dancing and running or riding going in a Coach or Waggon crying aloud or laughing heartily or any blow received on the Belly because that by such agitations and commotions the ligaments of the Womb are relaxed yea and sometimes broken as also the After-birth and Membranes of the Faetus are loosned A great noise suddenly and unexpectedly heard may make some Women miscarry as the noise of a Cannon and chiefly Thunderclaps and yet more easily if to this noise be added the fear they usually have of such things which happens rather to the young than elderly Women because their bodies being more tender and transpirable the air which is strongly forced by that noise being introduced into all her pores offers a great violence by its impulsion on the Womb and on the Child within it which the elder being more robust thicker and closer resist with more ease Great watchings causing a dissipation of the Womans strength and much fasting for want of food hinders the Infant from acquiring its perfection fetid and stinking smells do much contribute to abortion and amongst others the smell of Charcoal as appears by the History recited in the 10th Chapter of this Book The indispositions of the Womb produce the same effect as when it is callous or so small or so much compressed by the Epiploon that it cannot be extended as it ought to be sufficient to contain the Child and Burthen with ease together with the Waters which may likewise happen if the Woman be too strait laced or keeps in her Belly with strong and stiff Busks for to be well shap'd or by this subtilty to conceal a great-belly as some do frequent copulation especially towards the end of her reckoning may effect the same thing because then the Womb being very full bears much downwards and its inward orifice being very near is subjected to violence If a Woman miscarries without any of these accidents and that one desires to know the cause of it Hippocrates explains it in his 46th Aphorism of the 5th Book where he saith Quae veró mediocriter corpulentae abortum faciunt secundo mense aut tertio fine occasione manifesta iis acetabula uteri mucoris sunt plena nec prae pondere faetum continere possunt sed abrumpuntur any Woman indifferently corpulent that miscarries the second or third month without manifest or apparent cause it is because the Cotylâ—dons of the Womb which are the inward closures of its vessels are full of viscous filth by reason of which they cannot retain the weight of the Faetus which is loosened from it To this accident phlegmatick Women are very subject and those who have the Whites exceedingly which by their continual affluence moisten and make the Womb within so slippery that the After-burthen cannot adhere to it which also relaxeth it and its inward orifice that the least occasion causeth abortion But if the passions of the body cause so much hurt to a big-bellied Woman those of the mind do no Iess and specially Choler which agitates inflames disperses and troubles all the Spirits and mass of Blood by which the Child suffers extreamly because of the tenderness of its body but above all sudden fear and the relation of bad news are capable to make the Women miscarry at that instant as it happened to the Mother of that Cousin of mine whom I mentioned in the 10th Chapter of this first Book which likewise the other passions may cause according as they are more or less violent but not so easily There are yet other causes of miscarrying which may be said to proceed from the Infant as when they are monstrous because they do not then follow the rule of Nature as likewise when they have an unnatural scituation which makes them torment themselves because of their incommodity and they oblige the Womb to expel them not being able to endure the pains they cause which it yet does when it is so great that it cannot contain it to the full time nor the Mother furnish it with sufficient nourishment If we find one or more of the above specified accidents and that the Woman withall hath a great heaviness in her Belly so that it falls like a ball on her side when she turns and that there proceeds out of her Womb stinking and cadaverous humors it is a sign she will soon miscarry of a dead Child moreover her Breasts will confirm it if having been hard and full in the beginning they become afterwards empty and flabby as is specified in the 37th Aphorism of the 5th Book and the 38th of the same Book saith That if one of a big-bellied Womans Breasts who hath
two Children begins to flag it is a sign she will miscarry of the Child of that side and of both if both flag in the same manner It is most certain a Woman is in more danger of her life when she miscarries than at her full time because as we have said before abortion is wholly contrary to Nature and very often accompanied with flooding and in more danger of miscarrying alwayes if she miscarries of the first and some apprehend then an impossibility of ever having Children after to which young married people are very subject because of the violent emotion and perturbation of the whole body excited by ardent and frequent copulations but notwithstanding they may preserve their fruit when their greater vigour is over and their loves a little moderated We have taught in each of the foregoing Chapters how to prevent all the accidents before recited any of which is sufficient to make her miscarry and the easier if many are complicated wherefore to avoid a troublesome and needless repetition you may have recourse to the Remedies there taught by which both Women and Children may escape the danger of death They that are subject to abortion ought above all to take their ease and keep in bed if they can observing a good diet and refraining copulation assoon as she believes her self to be with Child avoiding the use of all Diureticks and Aperitives which are very pernicious as also violent passions of the mind because they are very prejudicial She ought likewise to be loose in her dress that she may breath the freer and not strait laced and rackt as most of them are ordinarily with their Busks under their cloths to make their bodies strait and amongst other things they had need take heed of slipping and falling in their walking to which big-bellied Women are very subject because the bigness of their Bellies hinders them from seeing their way they will therefore do well to wear low-heeld shoos with large soals to prevent hurting themselves as too many daily do I admire in this case the superstition of many Midwives and some Authors who order a Woman with Child to take assoon as she hath hurt her Belly with a fall some Crimson Silk small minced in the yolk of an Egg or the grains of * Kermes Scarlet and treddles of several Eggs put into the yolk of one as if that entring the stomach were able to fortifie the Womb and the Child in it and to keep it there for which there is no appearance of reason or truth but quiet rest indeed contributes much to it which for this reason is usually directed for nine dayes although such a one hath need of 15 dayes or more for her hurt or commotion and to others five or six is sufficient during which time may be applied hot to the Belly Compresses steeped in Aromatick and Astringent Wine But because there are many Women so infatuated with this superstitious custom that they would not believe themselves out of danger if they took not that Crimson Silk or the Treddles of the Eggs which is a pure conceit one may give it to those that desire it to content them because these Remedies though useless can yet do no hurt It is now time to make an end of this first Book in which I have only mentioned the most ordinary distempers which have some particular indications in their cure during the Womans being with Child of which I have not treated very exactly because it may be supposed that one may elsewhere have a more perfect knowledge of them with all their circumstances let us now pass to the second Book to treat of Deliveries not only the natural but likewise all that are contrary to nature it being the principal motive that induced me to write and to teach as well as I can the best and most methodical deportment in it The End of the first Book BOOK II. Of Labours Natural and Unnatural with the way how to help Women in the first and the right means of remedying the rest AS it is very unprofitable to those that imbark on the Sea for a long Voyage as for example to the Indies or the like if after having by their prudence escaped all the dangers they could meet with in so long a Voyage they are shipwrackt in the Haven So likewise it is not sufficient that a great-bellied Woman should be preserved from all the Diseases mentioned in the preceding Book for nine whole months if at the end of that time she be not well delivered of it by a happy Labour This therefore shal be the whole subject of this second Book where we will treat as well of the Natural as Unnatural Labours and teach the manner of aiding and comforting Women in the first and the means to remedy all the rest CHAP. I. What Labour is and the diffenrences of it together with its different terms BY a Delivery we understand either an emission or extraction of the Infant at the full time out of the Womb. This definition may comprehend as well the Natural which is accomplished by emission when the Infant coming in a commodious and natural Figure the Womb sends it forth without extraordinary violence as the delivery contrary to Nature which we are often obliged to perform extracting it by manual operation Every time the Womb le ts pass or sends forth whatsoever it had retained and formed after conception must not be call'd a labour for observing what I have already noted above and what I will here again repeat that it may be more plain If a Woman voids by the Womb what is contained in the beginning after she had conceived it is properly called an effluxion or slip because at that time there is nothing formed or figured neither have the Seeds yet any firm consistence which is the cause why it flips away so easily with the least opening of the Womb as often happens between the first conceiving and the seventh and eight day only after which until the end of the second month the Woman somtimes le ts slip false-conceptions which turn to Moles if they continue any longer in the Womb which is then called an Expulsion And if after the third month or thereabouts the time when the Faetus is wholly formed and animated it is sent forth before the seventh in that case it is an Abortion which is alwayes the cause either that the Infant comes dead into the World or dies soon after But we properly call Labour or Delivery every issuing forth of an Infant which happens after the end of the seventh month to all the remaining part of the time afterwards because there is then a sufficient perfection as also strength enough to come into the World and live in it afterwards As to the general differences of Labour we must take notice that the one is legitimate or natural the other illegitimate or against nature To come to the knowledge of each we say that four conditions must
blew according as the Vessels are more or less full of blood and especially the Vein which gives it that colour and is so much the more apparent as it is superficial in that place There are many Authors admit as we have said the Ourachus into the number of these Umbilical vessels saying that it serves to empty the Childs urine into its Membranes however experience shewes us it is no vessel and that it passeth not forth of the Navel but that it is only a ligament in a Child as it is in a Man which coming from the bottom of the Bladder terminates at the Navel without traversing it as they have hitherto mistaken it I have opened and dissected above thirty Foetus's in none of which did I ever find it hollow but alwaies very solid and tendinous towards the place where it it fastned to the Navel and very like as I have already said to a small Lute string Notwithstanding I ever found it manifestly hollow in an Ewe which was terminated with their other Umbilical vessels at their Cotyledons in which Animals are also two Umbilical veins to be seen going both near one the other to the Liver which makes that their Navel-string consists of five Vessels but it is not the same in a human Foetus for there is but one onely Umbilical Vein and two Arteries To understand well how the nourishment is conveyed to the Infant by the Umbilical vessels it is very necessary to conceive and know in what manner the Blood circulates which is after this manner The blood having been conveyed by the mothers Arteries which end at the bottom of the Womb in the Placenta which is there fastned makes a natural transfusion through the Umbilical Vein into the Childs Liver after which it is carried into the Vena cava and thence to the Heart whence it is sent to all the parts by means of the Arteries and very near a like portion in quantity being in the Iliac Arteries is conducted into the Umbilicals which are there terminated for to be carried back into the Placenta where this blood being again elaborated returns to make the same journey by the Umbilical Vein passing again to the Childs Liver and thence to the Heart and so alwayes successively without the least intermission But to be able to conceive easily how the blood circulates in the Placenta and how by the help of that part is made a mutual transfusion from the one to the other as well in respect of the Mother as of the Child we need but imagine it to be a common part and depending on both their bodies for as to the Mother the circulation is there made just as in her Arm or any other part of her whatsoever and as to the Child it is even the same There are no Valvules found in the Umbilical Vein though I have curiously examined it nor are any necessary these Valvules ar every frequent in the Veins of the Arms and Legs because these parts are obliged to make different motions which compressing the Vessels would trouble those of the blood if it were not so sustained and hindered from recoiling but the Umbilical Vein hath no need of any because the Navel-string is loose and floting in the midst of the waters where it cannot be comprest and therefore the motion of the Blood cannot be there intercepted as it is sometimes in the Arms and Legs or other parts where there are strong contractions Assoon as the Child is born these Vessels which are bigger in a Foetus because of their cavity than they are in a Man dry up and that part of them which is without the belly falls off and is separated close to the Navel five or six days after for which reason they lose their first use and begin afterwards to degenerate into suspending Ligaments to wit the Vein into that of the Liver and the two Arteries serve to extend and sustain the Bladder by the sides where they are joyned to it the bottom of which is yet suspended by the Ourachus which comes not through the Navel as hath been said but remains so pendant all the rest of its life We have hithereo made mention of all those things which are found with the Child in the Womb let us now show what are the different scituations of it in the Womb according to the different times of Pregnancy It is a thing of very great consequence and deserves some reflections The three following Figures represent the different natural scituations of the Child in the Womb. That which is marked B shews how it is scituated the seven first months of Pregnancy That which is marked A shews the same scituation on the back-side And the third marked C shews in what fashion it is scituated towards the end of a Womans reckoning and at the time that it is disposed to be born Explication of all the Wombs in which are contained all the Children represented in different postures as well in this place as in all the following A A A A Shews the substance of the Womb. B The Membrane called Chorion which lines the Womb within C C C C The membrane Amnios which is so united and joyned to the Chorion that both of them seem to be but one single Membrane D D D D Shews all the space which is filled with waters in the midst of which the Infant flotes and is scituated E E The After-birth fastened to the bottom of the Womb. F F F The Navel-string which fluctuates hither and thither in the waters CHAP. V. Of the several natural scituations of an Infant in the Mothers Womb according to the different times of Pregnancy WHen we shall have explained the several natural scituations of an Infant those contrary to Nature causing for the most part all ill labours will easily be conceived It may be considered that generally the Infants as well Male as Female are usually scituated in the midst of the Womb for though sometimes a Womans great Belly is a little higher on the one side than the other yet that is because the globe of the Womb inclines more that way and this scituation on the side must be understood only in respect of the Mothers belly and not of her Womb in the midst of which it is alwaies placed because there is but one only cavity in a Womans Womb marked with a small line in its length without having two or more separations as is seen in those of other Animals There are some who would have these two imaginary cavities to be the cause why Women sometimes bear Twins yea and sometimes more and that the Males are rather engendered on the right and Females on the left side which is Hypocrates's opinion in the 48th Aphorisme of his 5th Book where he saith Foetus Maris dexträ uteri parte Foeminae sinisträ magis gestantur but without any certain reason for it because some Women have the Males on the left-side others the Females on the right and when there are
it may have more space to be turned into a fit posture to be born she must then likewise observe a good diet of meat of good juyce and easie digestion rather boiled than rosted to moisten the better and keep the body thereby open rather than by Clysters which may hasten labour she may about eight or ten days before Labour anoint her privities with Goose Capon or Hogs Grease or fresh Butter or foment those parts with fomentations which may by mollifying and loosening render those passages more smooth and slippery This ought principally to be done by those that go with their first Child because their passages are more strait than others who have had Children already but they who are a little in years have much more pain and are longer in Labour of their first Child than others who are indifferent young because the Membranes of their Womb are harder and dryer wherefore they cannot yeeld so well nor the inward Orifice be so easily dilated Some Authors commend bathing the better to relax those parts but it is dangerous lest by their too much moistness and the emotion they cause to the whole Body they make her come a little before her time Many Women bleed by way of prevention when they are or believe themselves to be at their full time which custom I cannot approve if it be only for prevention but I do in case some other necessity require it provided they abstain from it after the seventh Moneth because the stirring of the Child caused by bleeding is sometimes so vehement that the Womb is constrained to open before its time to be rid of the Child If a Woman with Child observes these Rules she will have reason to hope for a good issue of her Labour in the mean time let her provide her self of a good Midwife or an expert and handy * Chyrurgeons onely Practise in France as noted before Chyrurgeon to attend upon her assoon as she perceives the least pain or throw of what kind soever for as a small wind or shake will serve turn to make ripe fruit fall so the least Cholick or any other false pain may bring forward her Labour and surprise her unprovided of help Let us now see what is necessary when she is effectively in Labour CHAP. VII What is to be done when the Woman first falls in Labour A Womans travel is only many pains with reiterated Throws by which she endeavours to bring forth her Child It is so called because both Mother and Child suffer and take much pains in this action Most people believe that there is no other reason for the cause of this evil but because God hath so ordained it and that Woman according to his Word must bring forth with pain because of her sin according to what is written in the 3d. Chap. of Genesis I will greatly multiply thy sorrow and thy conception in sorrow thou shalt bring forth Children and thy desire shall be to thy Husband This curse was indeed very great because it hath extended to all Women that have brought forth Children since that time and will continue to all that shall come hereafter However we find that all the Females of other Animals suffer as much and are in as great danger of their lives as a Woman when they bear their young This perswades us that besides this precise will of God in respect of a Woman there must be yet a natural reason wherefore it cannot happen otherwise and that is That it is impossible the Womb being very strait in comparison of the Childs bigness and very sensible because of its Membranous composition should receive a necessary dilatation for the Childs birth and such great violence without suffering considerable pains for it Now since a Woman for this cause cannot shun these pains she must endeavour to endure them with patience in the hope of being suddenly delivered from them by a fortunate labour Assoon as it is known that the Woman is certainly in Labour by the signs mentioned in the Second Chapter of this Book where both those preceding and those accompanying Labour are recited of which the principal are Pains and strong Throws in the Belly forcing downwards towards the Womb the dilatation of the inward Orifice perceived by touching it with the finger as also the gathering of the Waters which come before the Head of the Child and thrusting down the Membranes which contain them through which between the Pains one may in some manner with the Finger discover the part which presents especially if it be the Head of the Child by its roundness and hardness Then must all things necessary to comfort the Woman in her Labour be go ready and the better to help her care must be taken that she be not strait-laced a pretty strong Clyster may be given her or more than one if there be occasion which must be done at the beginning and before the Child be too forwards for afterwards it is very difficult for her to receive them because the Gut is too much compressed they serve to excite it to discharge it self of its excrements that so the Rectum being emptied there may be more space for the dilatation of the passage as also to stirr up the pains to bear the better downwards through the endeavours she makes when she is at stool and the while all necessary things for her Labour should be put in order as well for the Woman as the Child a Midwifes stool or rather a Pallet-Bed girted placed close by the fire if the season require it which Pallet ought to be so disingaged as to be turned round about the better to help the Woman when there is occasion If the Woman be * full of blood Plethorick it may be convenient to bleed her a little for by this means her Breast being disingaged and her respiration free she will have more strength to bear down her pains which she may do without danger because the Child being about that time ready to be born hath no more need of the Mothers blood for its nourishment which I have often practised with good success besides this evacuation often hinders her having a Fever after Delivery in expectation of which hour she may walk about her Chamber if her strength permits and to preserve her strength it will be convenient to give some good gelly broths new-laid eggs or some spoonfuls of burnt or brewed Wine from time to time or a Tost dipt in Wine avoiding at that time solid food Above all she must be perswaded to hold out her pains bearing them down as much as she can at the instant when they take her The Midwife must from time to time taste the inward orifice with her finger to know whether the Waters are ready to break and whether the Birth will soon after follow she must likewise anoint all the bearing place with emollient Oyles Hogs-grease or fresh Butter if she perceive that they can hardly be dilated and all the
while she must be near her Woman to observe her gestures diligently her complaints and pains for by this they guess pretty well how the Labour advanceth without being obliged to taste her body so often Mr. de la Cuisse deceased who often slept near the Woman in Labour was so used to it that he never awaked till just the Child was in the passage at which time the Woman changeth her moans into loud cries which she strongly repeats because of the greater and more frequent pains which she then feels the Patient may likewise by intervals rest her self on her bed for to regain her strength but not too long especially little or short thick Women for they have alwaies worse Labours if they lye much on their beds in their Travail and yet much worse of their first Children than when they are prevailed with to walk about the Chamber supporting them under their arms if necessary for by this means the weight of the Child the Woman being on her Legs causeth the inward orifice of the Womb to dilate sooner than in bed and her pains to be stronger and frequenter that her Labour be nothing near so long Qualms and Vomitings which often happen to Women in Labour ought not to amaze any for on the contrary it furthers the Throws and Pains provoking downwards we shewed the cause of this Vomiting in the Second Chapter of this Book and the reason why it is not dangerous When the Waters of the Child are ready and gathered which may be perceived through the Membranes to present themselves to the inward orifice of the bigness of the whole dilatation the Midwife ought to let them break of themselves and not as some that impatient of the long Labour break them intending to hasten their business which on the contrary they retard by so doing before the Infant be wholly in the passage for by the too hasty breaking of these Waters which ought to serve him to slide forth with greater facility he remains dry which hinders afterwards the Pains and Throws from being so effectual to bring forth the Infant as else they would have been it is therefore better to let them break of themselves and then the Midwife may easily feel the Child bare by the part which first presents and so judge certainly whether it comes right that is with the Head which she shall find hard big round and equal but if it be any other part she will perceive something inequal and rugged and hard or soft more or less according to the part it is Immediately after * That being the right time when all Women ought to be delivered if nature perform its office let her dispatch to deliver her Woman if she be not already and assist the Birth which ordinarily happens soon after if natural and may be done according to the directions in the next Chapter But if she finds the Child to come wrong and that she is not able to deliver the Woman * Mark 't is not enough to lay a Woman if it might be done by another with more safety and case to either or both as she ought to be by helping Nature and so save both Mother and Child who both are in danger of their lives let her send speedily for an expert and dextrous Chyrurgeon in the practice and not delay as too many of them very often do till it be reduced to extremity There are many Midwives who are so afraid that the Chirurgeons should take away their practice or to appear ignorant before them * Good avoiding such Midwives if Women value their lives that they chuse rather to put all to adventure then to send for them in necessity others are so presumptuous as to believe themselves as capable as the Chirurgeons to undertake all And some there are indeed who are not so wicked yet for want of knowledg and experience in their Art hope still in vain that the Child in time may change to a better posture and that the accidents will cease if it please God as they say and some do maliciously put such a terrour and apprehension of the Chirurgeons in the poor Woman * For the most part undeservedly characterizing them like butchers and hangmen that they choose rather to dye in Travail with the Child in their Womb than to put themselves into their hands But indeed such Midwives do more justly deserve this fair title unless they behave themselves with more prudence and equal conscience in so important an occasion and send * A necessary note in time for some help in their business before the Child be as very often engaged in a wrong posture in the passage so as it is almost impossible to give it a better without extream violence to the Woman which is also the cause of the death of the Child and they would be so far from losing their reputation that they would augment it because by so doing it would be manifest they were not ignorant of the danger both of time and place and the Chirurgeon being called assoon as necessity required it could have no just cause to impute any ill consequence of the Labour to them though it should so fall out and rheir conscience would be discharged of it for in this case as we have said both the Mothers and Childs life is at stake Assoon then as the Waters are broke and the Midwife finds the Child to come wrong she must advise the Woman not to forward her Pains lest by bearing down she engage the Child too much in the passage and so give the Chirurgeon more pains to turn it and must send for him assoon as may be for to deliver her as occasion requires and according as shall be directed hereafter in this Book It is now time after having declared what must be done whilst the Woman is in Labour to shew how she must be helped and comforted in a natural Delivery This Figure doth very well represent the globe of the Womb which is opened but in part to shew in what manner the Child is brought forth in a natural Labour A A A Shews the body of the Womb. B B A part of the Vagina or neck of the Womb opened just at the inward orifice C C The inward orifice which surrounds the Childs head like a Crown wherefore it is called the crowning or garland CHAP. VIII Of a natural Labour and the means of helping a Woman therein when there is one or more Children Chap VII lib 2. pag 184. The Bed must be so made that the Woman being ready to be delivered should lye on her back upon it having her body in a convenient Figure that is her Head and Breast a little raised so that she be neither lying nor sitting for in this manner she breathes best will have more strength to help her Pains than if she were otherwise or sunk down in her Bed Being in this posture she must spread her Thighs abroad folding her Legs
Mother and Child must afterwards be ordered and declare how at this time to prevent and remedy divers Indispositions which often happen to them both Let us first consider those that arrive to a Woman new layd and then we shall pass to those that regard a new-born Infant CHAP. I. What is fit to be done to a Woman new-laid and naturally delivered IMmediatly after the Woman is delivered and the Burthen come away care must be taken that the loosening of it be not followed with a Flooding which if it be not a soft Closure to the Womb must immediatly be applied five or six double to prevent the cold Air by entring in from sudden stopping the Vessels by which the Woman should cleanse by degrees whereby there would certainly happen many ill accidents as great Pains and Gripes of the Belly Inflammation of the Womb and divers others which we shall mention hereafter particularly and which may easily be the cause of her death When the Womb is so closed if the Woman was not delivered upon her ordinary Bed let her be presently carried into it by some strong body or more if there be need rather than to let her walk thither which Bed must be first ready warmed and prepared as is requisite because of the cleansings but if she were delivered on it which is best and safest to prevent the danger and trouble of carrying her to it then all the soul linnen and other things put there for the receiving the Blood Waters and other Filth which comes away in Labour must be presently removed and she must be placed conveniently in it for her ease and rest which she much wants to recover her of the Pains and Labour she endured during her Travail that is with her Head and Body a little raised for to breath the freer and cleanse the better especially of that Blood which then comes away that so it may not clod which being retained causes very great Pains All this will happen if they have not liberty to come freely by this convenient scituation in which she must put down her Legs and Thighs close together having a small Pillow for her greater ease if she desire it under her Hams upon which they may rest a little being so put to Bed let her lye neither of one side nor the other but just on the middle of her back that so the Womb may repossess its natural and proper place It is an ordinary custom to give the Women assoon as they are delivered two Ounces of Oyl of sweet Almonds drawn without fire and as much Syrup of Maiden-hair mixed together which is as well for to sweeten and temper the inside of the Throat which was heated and hoarse by her continual Cries and holding her Breath to bear down her Throws during her Labour as also to the end that her Stomach and Intestines being lined with it should not be so much afflicted with dolorous Gripes But this Potion goes so much against the Stomachs of some Women that being forced to take it with an aversion and disgust it may do them rather more hurt than any wise comfort them Wherefore let none have it but those that desire it and have no aversion to it I approve rather in this case of a good Broth to be given her assoon as she is a little setled after the great commotion of Labour because it will be both more pleasing and profitable than such a Potion And having thus accommodated her and provided for her Belly Breasts and lower parts after the manner we shall direct in the next Chapter leave her to rest and sleep if she can making no noise the Bed-curtains being close drawn and the Doors and Windows of her Chamber shut that so seeing no light she may the sooner fall asleep If she had endured a hard Labour she must be then ordered as the case requires and as shall be hereafter declared but what we have here directed is only for a natural Labour and where no extraordinary difficulty happens CHAP. II. Of convenient Remedies for the lower parts of the Belly and Breasts of Women newly delivered SInce the lower parts of a Woman are greatly distended by the birth of an Infant it is good to endeavour therefore the prevention of an inflammation there wherefore assoon as the Bed is cleansed from the foul linnen and other impurities of the Labour and that the Woman is therein placed according to the direction of the preceding Chapter let there be outwardly applied all over the bottom of her Belly and Privities the following Anodine Cataplasm made of two Ounces of Oyl of sweet Almonds with two or three new-laid Eggs Yolks and Whites stirring them together in an earthen Pipkin over hot Embers till it comes to the consistence of a Pultiss which being spread upon a Cloth must be applied to those parts indifferently warm having first taken away the Closures which were put to her presently after her Delivery and likewise such clods of Blood as were there left This is a very temperate remedy and fit to appease the Pains which Women ordinarily suffer in those parts because of the violence then endured by the Infants Birth it must lie on five or six Hours and then be renewed a second time if there be occasion afterwards make a Decoction of Barley Linseed and Chervil or with Marsh-mallows and Violet leaves adding to a Pint of it an ounce of Honey of Roses with which being luke warm foment three or four times a day for the first five or six days of Child-bed the bearing-place cleansing it very well from the Blood Clods and other Excrements which are there emptied This Stupe is likewise very good to temper and appease the Pains of those parts Some persons only use to this purpose luke-warm Milk and many Women only Barley-water Great care must be taken at the beginning that no stopping things be given to hinder the cleansings but when ten or twelve days are past and that she hath cleansed very sufficiently Remedies may then be used to fortifie the parts to which purpose a Decoction is very proper made of Provence-Roses Leaves and Roots of Plantane and Smiths water that Iron is quenched in and when she hath sufficiently and fully done Cleansing which is usually after the 18th or 20th day there may be made for those that desire it a very strong astringent Lotion to fortifie and settle those parts which have been much relaxed as well by the great extension they received as by the humours with which they have been so long time soaked This Remedy may be composed with an Ounce and an half of Pomegranate Peel an Ounce of Cypress Nuts half an Ounce of Acorns an Ounce of Terra Sigillata a Handful of Provence-Roses and two drachms of Roch-Allum all which being infused a whole night in five half Pints of strong red Wine or that it may not be too sharp a quantity of Smiths water mixed with that Wine afterwards boil it well to
readily drive away the Milk There are some which boil Sage and Box Leaves in Urine with which they do foment the Breasts pretty warm and lay a Cloth upon them dipt in it But great care must be taken in the application and change of these things that the Woman catch not the least cold as also that no Inflammation or Impostumation be caused instead of driving back the Milk Wherefore such Remedies are to be chosen as are restraining repercussive or resolving according to the different dispositions required I know some Women who hold it for a very great secret and most certain and fit to drive the Milk effectually back and that is to put on her Husbands shift yet warm immediatly after he hath taken it off and wear it until the Milk be gone but in case the Milk doth in the mean time vanish 't is superstitious to believe that this Shirt is the cause of it and that it can produce such an effect it happens rather because all the humours of the Body of their own accord taking another course than to the Breasts do not daily flow in so great abundance to them Wherefore in the use of all these Remedies the principal must not be forgotten which is to take care that they tend downwards procuring to that purpose a good and ample evacuation of the * Cleansings Lochia which is much furthered by keeping the Belly open by Clysters provoking them in doing whereof the Milk will soon vanish All that we have said in the former Chapters of this Third Book is only to be observed when the new-laid Woman hath no manner of Indisposition for in case that any happen she must be governed in another manner and according as the Accidents require of which we intend now to treat in the following Chapters CHAP. V. Of several Diseases and Symptomes which happen to a Woman new laid and first of Flooding WE have elsewhere mentioned the Flooding which precedes Labour and shewed the only means to remedy it which is to deliver the Woman assoon as possible let us now see what is fit to be done to that which happens immediatly or in a little time after proceeding from the late opening of the orifices of the Vessels of the Womb by the loosening of the Secondine which cleaved to it this Blood flowes then so much more abundantly by how much it is subtiler and hotter or by the agitation of a long and hard Labour and besides when a Woman is Sanguine or Plethorick This Accident may often happen by a too sudden or violent pulling away of the After-Burthen and sometimes from some part of it being left behind in the Womb or else some false Conception which then endeavouring to expel it presses and forceth forth the Blood out of the Vessels newly opened and sometimes a great Clod of Blood remaining in the bottom of the Womb will produce the same effect which by reason of the distention it often causes excites Pains like to those a Woman endures before Labour and doth not cease tormenting her until she hath voided it and then she is at ease but sometimes the Blood continuing still to flow and remaining in the bottom of the Womb becomes new Clods which is the cause why the accident renews again as before and continueth so by fits in the intervals of which there comes away some Serosities of the Blood retained which dissolves and makes some persons ignorant of the Art to think that the Flux is stopt although it still continues flowing within where it stops only by some blood so coagulated but when this Clod comes away the Flooding begins again pure Blood and in great abundance Flooding is a more dangerous Accident than any other which may happen to a Woman newly laid and which dispatches her so soon if it be in great quantity that there is not often time to prevent it Wherefore in this case convenient Remedies must be speedily applied as well to stop it as to turn it back from the places whence it flowes To which purpose 't is fit to consider what causeth this Flooding and if it be a false Conception piece of the Burthen or clodded Blood remaining behind all diligence must be used to fetch them away or to cause a speedy expulsion of them but if when nothing remains behind in the Womb the Blood doth notwithstanding continue to flow you must bleed the Woman in the Arm not so much thereby to empty the fulness as to make diversion let her Body be laid equally flat and not raised that so the Blood may not be sent down to the lower parts let her keep her self very quiet without turning from side to side that so the Humours may not be stirred the upper part of her Belly must likewise not be swathed or boulstered for such straitness augmens the evil let her Chamber be kept a little cool and let her not be too warm covered in her Bed that so the flooding through Heat may not be continued All the world forbids Clysters in this case lest as they say the humours be drawn down in great abundance but I have twice experimentally found the contrary where great Floodings have been stopt by Clysters of which I will give you a particular account that so it may be useful on the like occasion I was three years since called to a Woman who was surprized with a very great Flooding immediatly after the Midwife had delivered her which she had done with too much violence as the good Woman assured me who told me She felt a very great pain at the instant she pull'd away the After-birth and that she perceived at the loosening of it a Crack Now from the moment that she was so delivered she lost for five or six daies continually so great abundance of Blood that I could scarce believe she could without dying had I not seen it my self during all this time they had to no purpose used all the means they could imagine to stop this accident and because with it she complained of great pains in her Belly they gave her Anodine and cooling Clysters for fear lest giving her others more strong the Flooding would be more and more excited She had taken so four or five Clysters which came away as they were given without any Excrement which seeing and judging that assuredly some gross Excrements being retained in the Intestines from before the time of her Labour which could not be evacuated by these Anodine Clysters did cause so great a Chollick which she felt all over her Belly which appeared puft up I caused her to take one common and one pretty strong Clyster contrary however to the opinion of most persons who not knowing the cause of the distemper bade me have a care lest it should as they said cause a greater Flooding but the issue of it was quite otherwise than they expected for the good Woman voided with this Clyster a Pan full of gross Excrements which having staid there a long
more easie reduction of it being careful assoon as it is reduced to wipe off the Oile as much as may be to avoid a Relapse But if notwithstanding all this the Womb cannot be put up because it is very much enflamed and tumefied which happens when it hath been a long time so without the use of necessary means during which time it is continually moistened with Urine and other Excrements which contribute very much to its corruption in this case there is great danger that it will gangrene and be afterwards the death of the Woman There have however some Women escaped this accident Pareus recites the History of such an one which Rousset doth also amongst his Caesarean-births but this happens very rarely As to the second part of this Cure which consists in the retention of the Womb in its place and the strengthening of it so reduced it will be done by a convenient scituation Let the Woman for this purpose keep her self in Bed on her back having her Hips a little raised her Legs something crossed and her Thighs joined together to prevent the falling of it out again but the best way is to put up a Pessary into the Neck of the Womb for to keep it firm There are two or three sorts made for this purpose the several Figures of which are at the beginning of this Chapter Some are round and a little longish of the figure of an Egg and of the length and bigness of the Neck of the Womb where it must be left after that it is introduced into it but these are often subject to fall out again and are not so useful and convenient as the other which are made of a piece of Cork that they may be light They ought to be of a thick circular figure like to a small wreath and pierced with a pretty big hole in the middle which serves aswel for the lodging supporting and receiving of the inner orifice of the Womb as for the giving passage to the superfluous humours which are thence evacuated These kind of Pessaries must be covered with white Wax that they may be more smooth and incapable of hurting the Woman that useth them they must be pretty large that they may be the easier kept when they are put up they may also have a small String fastened to them to pull them out at any time to clean But this String is not so very necessary because they may be easily enough taken out with one Finger they may be made some of them exactly round and others something of a square Figure or triangular the corners must be rounded or blunted These sometimes hold better and fall not so easily forth as the round but either the one or the other may be used as shall be thought most fit During the flowing of the Lochia from the Womb nothing els must be used to strengthen but only to keep it so in its natural place for astringent Remedies proper for the prevention of the Relaxation of it will very much prejudice the Woman by stopping of these evacuations and above all it must be observed in this distemper that the Womans Belly be not strait swathed any more than for a stay only in which many Midwives are deceived believing they keep it the better in its place by how much they swath the Belly the straiter for by this strong compression of it they force the Womb yet more down She must use the Bed-pan in Bed lying along if possible when she goes to Stool keeping her hand all the while on the bottom of her Belly to bear it up But when the time of her Purgations is fully over and that she hath cleansed very well astringent Injections may be then used without danger respect must likewise be had to the whole habit of the Body to dry up the humours by an universal course and the Woman must not rise out of her Bed in at least five or six Weeks time that so the Womb and its Ligaments may be restored and fortified in their natural Scituation It happens also sometimes that by the great Throwes the Woman endures at her Labour the Fundament falls quite out in this case if the Child be very forward in the Passage 't will be sufficient before this accident happens to hinder it if possible persuading the Woman not to help her Throwes so strongly but if it be already fallen down they must stay till the Child be born ere it can be put up for before that it will be difficult to do without much bruising the Intestine Assoon then as the Woman is delivered let it be reduced in the same manner as that of the Womb after having fomented bathed and anointed it if necessary forbearing afterwards during her Child-bed the giving of her Clysters because the force she useth in rendring of them will again cause the falling down of the Fundament CHAP. VII Of the bruises and rents of the outward parts of the Womb caused by Labour IT is no wonder that often and especially in first Labours there happens bruises amd rents in the lower parts of a Woman the cause of which is easily known if the bigness of the Childs Head be but considered which must needs make a great distention of those strait parts by passing and coming forth of the Womb which parts being thereby extremely pressed against the hardness of the bones thar surround it are easily bruised and when they are not able to be sufficiently dilated they must necessarily be torn asunder Almost all Women in their first Labours do very much complain when the Child is in the Passage that the Midwives prick and scratch those parts and do believe that the hurts and bruises which are there after Labour do happen because the Midwives handled them too roughly but they are very much mistaken for this comes because the Childs Head in passing makes a violent distention and separation of the four Caruncles and other adjacent parts which are bruised and sometimes rent by it from hence spring the pains of which they then complain as if they were pricked and scratched whereof they are never after sensible in their following Labours because those parts having once given way to an Infant are ever after very easily relaxed and extended and every Travail with less Pain than other These contusions and rents must never be neglected lest they degenerate into malignant Ulcers for the Heat and Moisture of these parts besides the filth which continually flows thence doth easily contribute towards it if convenient Remedies be not timely applyed Wherefore assoon as a Woman is laid if there be only simple Contusions and Excoriations apply the Cataplasme formerly directed to those lower parts to ease pain made of the Yolks and Whites of new-laid Eggs and Oyl of Roses seeth'd a little over warm Embers continually stirring it till it be equally mixt and then spread upon fine Cloth it must be applyed very warm to the bearing-place for five or six hours when
being taken away lay some fine Rags dipt in Oyl of St Johns-wort on each side the bearing-place and renewing them twice or thrice a day foment these parts with Barley Water and Honey of Roses to cleanse them from the Excrements which pass and when the Woman makes Water let them be defended with fine Rags to hinder the Urine from causing smarting and pain by touching them Sometimes the Bruises are so great that the Bearing-place is inflamed and a very considerable Abscess follows which I have met with in which case it must be opened just below the swelling in the most convenient place and after the matter is evacuated a Detersive Injection must be injected into the Cavity with the same Fomentation above-mentioned viz. Barley-water and Oyl of Roses which may be a little heightned with Spirit of Wine if there be any danger of Corruption and afterwards the Ulcer must be dressed according to Art But sometimes it happens by an unlucky and deplorable accident that the Perinaeum is rent so that the Privity and Fundament is all in one if it were so let alone without reunion the Woman afterwards happening to be with Child would indeed be delivered with more ease and without danger of suffering the same again as is usual when healed after such an accident but likewise if it remains in this manner 't is so great an inconvenience that her Ordure comes both waies Wherefore having cleansed the Womb from such Excrements as may be there with red-Wine let it be strongly stitched together with three or four stitches or more according to the length of the separation and taking at each stitch good hold of the flesh that so it may not break out and then dress it with an agglutinative Balm such as is Linimentum Arcei or the like clapping a Plaister on and some linnen above it to prevent as much as may be the falling of the Urine and other Excrements upon it because their acrimony would make it smart and put it to pain and that these parts may close together with more ease let the Woman keep her Thighs close together without the least spreading until the cure be perfected But if afterwards she happen to be with Child she will be obliged to prevent the like mischief to anoint those parts with emollient Oyls and Ointments and when she is in Labour she must forbear helping her Throws too strongly at once but leave Nature to perform it by degrees together with the help of a Midwife well instructed in her Art who being warned by the first disgrace will do her best to avoid a second for usually when these parts have been once rent it is very difficult to prevent the like in the following Travail because the Scar there made doth straighten the parts yet more wherefore it were to be wished for greater security against the like accident that the Woman should have no more Children Now if by neglecting such a rent the Lips of it be cicatriced and that Cure be desired you must with a good pair of Scissers cut off those Scars in the same manner as is done in a Hare-lip and it must afterwards be drest accordingly or as if it newly happened CHAP. VIII Of after-Pains which happen to a Woman new-laid and of their several causes THe most common accident that usually troubles most Women during their lying in is after-Pains We have formerly shewed how they are accustomed to be prevented in giving the Woman immediatly after she is laid two Ounces of Oyl of sweet Almonds drawn without fire with as much Syrup of Maiden-hair but since notwithstanding this Remedy the Woman is much pained in her Belly let us enquire what may be the cause of all these gripes which are usually called without distinction After-pains and are sometimes felt about the Reins Loins and Groins sometimes in the Womb only and sometimes about the Navel and all over the Belly either continually or by fits with some remission in a certain place or sometimes on one side and somtimes on another all which reflections teach exactly their several causes and accordingly the Remedies must be varied The Pains of the Belly for the most part proceed from one only of these four causes or several of them together the first is by Wind contained in the Bowels by which they are easily filled after Labour as well because they have more room to dilate then when the Child was in the Womb by which they were comprest as also because the nourishment and matter contained as well in them as in the Stomach have been so confused and agitated from side to side during the pains of Labour by the frequent Throws which alwaies much compress the Belly that they could not be well digested whence this wind is afterwards generated and consequently the Gripes which the Woman feels running in her Belly from side to side according as the Wind moves more or less and sometimes also towards the Womb because of the compression and commotion which the Bowels make being extremely thereby agitated The Second Cause of these Gripes which torments the Woman as much as the former is that which proceeds from some strange body resting in the Womb after Labour which it endeavors to expel by continual Throws and it is sometimes a false Conception or a piece of the Burthen and very often clodded Blood which cause this torment and never cease til what is so contained in the Womb be come away these Painâ— are very like the same that a Woman endures before she is delivered and are not abated by Clysters as those are that proceed from Wind but on the contrary are rather thereby excited and augmented Thirdly These Pains are often caused by the sudden suppression of the * Childbed cleansing Lochia which abundantly filling the whole substance of the Womb causeth a great distention and by its long stay an inflammation which is communicated by means of the Peritonaeum to all the parts of the lower Belly by eason whereof it swells and is extended and grows extreamly hard which accident continuing very often kills the Woman in a short time after The Fourth and last cause of these Pains is the great extension of the Ligaments of the Womb by reason of a hard Labour here they remain more fixt about the Reins Loins and Groins than any other part because they are the places where these Ligaments are fastened however these Pains do sometimes communicate themselves by continuity to the whole Womb and the rather when it hath been bruised by a violent Labour 'T is commonly held that a Woman is not troubled with these Pains so much of her first Child as of the following but daily experience confirms us that it happens indifferently according as the present and various dispositions contribute to it either more or less there being no certain rule in respect either to first or last Labours All these Pains must be cured according to their several causes and to prevent thoes
which we say are excited by wind give the Woman immediatly after Delivery Oyl of sweet Almonds and Syrup of Maiden-hair mixt together some do more esteem Oyl of Walnuts provided it may be made of good Nuts but this hath a worse taste than the other This remedy serves to lenify and line the inside of the Intestines with its Unctuousness by means whereof that which is contained within them passeth away the easier but as we have said elsewhere this mixture is so nauseous that it doth often for that reason more hurt than good wherefore I prefer a good warm Broth for those who have an aversion to the Oyl Others give half a glass of good Hippocras but that in the condition the Woman is in may do more hurt by causing a Fever Now for the better preventing these kind of Pains let the Woman keep her Belly very hot and be careful not to drink her Drink too cold and if they torment her very much hot Clothes from time to time must be laid on her Belly or a Pan-cake fryed with Walnut-oyl may be applied to it without swathing her Belly too strait And for the better evacuating the wind out of the Intestines give her a Clyster which may be repeated as often as necessity requires but if by this means the pains of the Belly are not appeased 't is certain they are maintained by some other cause If it be known that some strange body is retained in the Womb the expulsion of it must be procured or it must be fetcht away by putting the Fingers into the Entry of it according to the direction already given for the extracting of a false Conception and if it be great Clods which retained do also cause these pains they will not fail to cease assoon as they are fetcht away but also the same accident will soon return if new Blood flowes into the cavity of the Womb and coagulates there again as it often happens for it cannot endure to keep any thing in its capacity after the Childs birth If the Womans Cleansings be suddenly stopt which a little before came down in great abundance you need not search for any other cause of the pains she endures and the speediest remedy is to bring them down which is effected by Clysters that draw downwards by hot and aperitive Fomentations to the bearing place and by bleeding in the Foot preceded by that of the Arm if the case require it As to the Pains the Woman feels in her Loins and Groins which come by reason of the great distention or in part ruption of the Ligaments of the Womb thereabouts fastened rest alone and a good scituation of the body will be sufficient to fortifie and reunite them without greater Medicines because they cannot be actually applied to the part affected alwaies observing a good Diet and not forgetting in all these several sorts of pains to provide for the natural evacuation of the Lochia for 't is one of the principal means to obtain a good issue CHAP. IX Of the Lochia which flow from the Womb in Child-bed Whence they come and the Signs when they are good or bad I Do not find that Authors have so sufficiently enquired into the cause of the Lochia which are evacuated in Child-bed as to make us truly understand what they are either in respect of their Nature affirming it to be the blood usually purged away every Moneth before they were with Child which being collected about the Womb flowes away when it opens after the birth of the Child or in respect of the quantity of this evacuation and the length of time it ought to continue Hippocrates in his Book De Naturâ Pueri would have at the beginning an Hemine and an half a day of which measure though common in his time we have no certain knowledg for some will have it to be our half Pint others a Pint or therebouts and that they continue for a Male-child thirty daies for a Female fourty diminishing every day by little and little until there comes no more and the evacuation is compleated Galen saies that these Lochia are only vitious humours and the residue superfluity of the Blood with which the Child was nourisshed in the Mothers Womb. But I will as near as I can here describe to you the manner how I conceive this evacuation to be made and the reason why they diminish day by day and change their colour consistence and quality according to the several times Assoon as the Child is born there flowes away from the Womb at the same moment some waterish humours besides those which came away before at the breaking of the Membranes These Waters then are very often bloody not that they are so by Nature but because there is for the most part Blood mixed with them which comming from the Vessels of the Womb because of the agitation and commotion they received in the Birth become so reddish but immediatly after the Burthen is compleatly loosened then pure blood flows away and the reason why these Lochia flow freely and are very red the first day is because the Vessels against which the Burthen was fastened in the Womb are but newly opened but the Blood flowing by little and little in less abundance because the greatest plenitude hath been at first evacuated doth clod in small drops on the extremitie of all those Vessels whereby they are stop'd and then there comes away onely the most serose part of it and therefore the Lochia begin the second and third day to be more pale and less coloured and after that the colour of them is less bloody every day as the Vessels close until they are at length very pale which happens when the Vessels being almost perfectly reunited there distills only the meer moisture of them as also of the whole substance of the Womb through which a quantity of it doth likewise transude Now these serose Humidities acquire by the heat of these places a consistence somewhat thick and that more or less according as they come away in greater or lesser quantity and according to the length of time they stay there And then the Lochia do almost resemble in colour and consistence troubled Milk which makes the World believe it is Breast Milk which is in that manner emptied downwards but in truth it is an Abuse as great as common For my part I know no other cause of this ordinary change of the colour and consistence of the Lochia nor of the diminution of their quantity than that which we daily find in the Suppuration of a great wound somewhat incarnated for assoon as the wound is first made it bleeds fresh and in good large quantity because the Vessels are then open but a little after during the first and second daies it yields only bloody Serosities forasmuch as some small portions of the Blood being clodded about the mouths of the Vessels do in part stop them and afterwards stopping them more it yeilds a white *
and make you yet better able to conceive these things than I have here explained them and that all may be for ever to his greater glory The End of the Third and last Book A Table of the Chapters The First Book OF the Diseases and different dispositions of Women with Child from the time of Conception to the full time of Reckoning pag. 1. Chap. 1. Of the Signs of Sterility and Fertility in Women p. 2 Chap. 2. Of Conception and the conditions necessary to it 12 Chap. 3. Of the signs of Conception 17 Chap. 4. What Generation is and what is necessary to it 24 Chap. 5. Of Big-bellies and their differences with the signs of the true and false great Bellies 31 Chap. 6. How to know the different times of Pregnancy 35 Chap. 7. Whether it may be known that a Woman is with Child of a Boy or Girl and the signs whether she shall have many Children 43 Chap. 8. Of Supersoetation 49 Chap. 9. Of a Mole and its signs 53 Chap. 10. In what manner a Woman ought to govern her self during her being with Child when it is not accompanied with other considerable accidents to endeavour to prevent them 56 Chap. 11. The means to prevent the many accidents which happen to a Woman during the whole time of her being with Child and first of Vomitings 68 Chap. 12. Of the pains of the Back Reins and Hips 74 Chap. 13. Of the pains of the Breasts 76 Chap. 14. Of Incontinence and difficulty of Urine 78 Chap. 15. Of the Cough and difficulty of of Breathing 81 Chap. 16. Of the swelling and pains of the Thighs and Legs 85 Chap. 17. Of the Hemorrhoides 89 Chap. 18. Of the several Fluxes which may happen to a Woman with Child and first of a Loosnesse 92 Chap. 19. Of a Menstruous Flux 98 Chap. 20. Of Floodings 102 Chap. 21. Of the weight bearing down or relaxation of the Matrix which hinders a Womon with Child in her walking and the freedom of coition 116 Chap. 22. Of the Dropsie of the Womb and oedemitous tumours of the lips of the Privities 119 Chap. 23. Of the Venereal Disease in Women with Child 123 Chap. 24. Of Abortion and its Causes 129. The Second Book Of Labours natural and unnatural with the way how to help Women in the first and the right means of remedying the rest p. 137 Chap. 1. What Labour is and the difference of it together with its different termes 138 Chap. 2. The Signs which precede and accompany as well a natural as an unnatural Delivery 146 Chap. 3. Of the Membranes of the Infant and the Waters 151 Chap. 4. Of the Placenta and Umbilical Vessels of the Child 161 Chap. 5. Of the several natural scituations of an Infant in the Mothers Womb according to the different times of Pregnancy 170 Chap. 6. What a Woman ought to do when she is gone her full time 174 Chap. 7. What is to be done when the Woman first falls in Labour 177 Chap. 8. Of the natural Labour and the meanes of helping Women when there is one or more Children 184 Chap. 9. How to fetch the After-burthen 189 Chap. 10. Of laborious and d fficult Labours and those against Nature their Causes and Differences together with the means to remedy them 192 Chap. 11. Of unnatural Labours where manual Operation is absolutely necessary what Observations the Chirurgeon must make before he goeth about it 201 Chap. 12. The signs to know whether the Child be alive or dead 208 Chap. 13. How to fetch the After-burthen when the String is broke 211 Chap. 14. To deliver a Woman when the Child comes Footling 218 Chap. 15. How to fetch the Head when separated from the Body and it remains behind in the Womb 222 Chap. 16. How to help a Woman in her Labour when the Head of the Child thrusts the Neck of the Womb forth before it 225 Chap. 17. How to fetch a Child when coming right it cannot pass either because it is too big or the Passages cannot sufficiently be dilated 227 Chap. 18. How to deliver a Woman when the Child presents the side of the Head to the Birth or the Face 229 Chap. 19. How to deliver a Woman when the Head of the Child is born and the Womb closeth about the Neck 231 Chap. 20. To deliver a Woman when the Child comes with one or both Hands together with the Head 232 Chap. 21. How to deliver a Woman when the Child presents one or both Hands foremost without any other part 237 Chap. 22. How to deliver a Woman when Hands and Feet come together 241 Chap. 23. How to deliver a Woman when the Child comes with the Knees 244 Chap. 24. Of a Delivery when the Child comes with Shoulder Back or Breast 245 Chap. 25. Of those Births wherein the Infant presents the Belly Breast or Side 248 Chap. 26. Of Labours wherein several Children present together in the different Postures abovenamed 250 Chap. 27. Of a Labour when the Navel-string comes first 255 Chap. 28. Of a Labour wherein the Burthen either first offers or first comes quite forth 258 Chap. 29. Of Floodings and Convulsions in Labour 261 Chap. 30. How to deliver a Woman when the Child is Hydropical or Monstrous 262 Chap. 31. Of delivering a dead Child 265 Chap. 32. Of extracting of a Mola and a false Conception 271 Chap. 33. Of the Caesarean Section 275. The Third Book Treating of Women in Child-bed and of the Diseases and Symptomes befalling them at that time Of Children new-born and their ordinary Distempers together with necessary directions for to chuse a Nurse Chap. 1. What is to be done to a new-laid Woman and naturally delivered 288 Chap. 2. Of convenient Remedies for the lower parts of the Belly and Breasts of a Woman newly delivered 290 Chap. 3. What Diet a Woman in Child-bed ought to observe during the whole time after lying in when it is accompanied with no ill accident 296 Chap. 4. How to drive back the Milk in those Women who are not willing to give suck 300 Chap. 5. Of several Diseases and Symptomes which happen to a Woman newly laid and first of Flooding 302 Chap. 6. Of the bearing down and falling out of the Womb and Fundament of a Woman new-laid 307 Chap. 7. Of Bruises and Rents on the outward parts of the Womb caused by Labour 314 Chap. 8. Of After-pains which happen to a Woman new-laid and of their several Causes 317 Chap. 9. Of the Lochia which flow from the Womb in Child-bed whence they come and the signs when they are good or bad 322 Chap. 10. Of the suppression of the Lochia and the accidents which follow thereupon 330 Chap. 11. Of the Inflammation which happens to the Womb after Delivery 334 Chap. 12. Of the Inflammation of the Breasts of the new-laid Woman 338 Chap. 13. Of the clodding and curdling of the Milk 342 Chap. 14. Of Imposthumes of the Breasts of Women new-laid 345 Chap. 15. Of excoriation and loss of the Nipples 349 Chap. 16. Of tending Children new-born and first how to bind cut and swath the Navel-string 353 Chap. 17. How a new-born Babe must be washed and cleansed from the Excrements as also how it ought to be wrapped up in Swadling-Cloaths 358 Chap. 18. Of Dieting and Ordering a new-born Babe 364 Chap. 19. Of the Indispositions of little Children and first of their weakness 372 Chap. 20. Of Contusions or bruises of the Head and other parts of toe Body of a new-born Babe 376 Chap. 21. Of the Mould of the Head and of the Sutures being too open 381 Chap. 22. Of a new-born Babe's Fundament being closed up 385 Chap. 23. Of cutting the Tongue when Tongue-ty'd 386 Chap. 24. Of Gripes and Pains of the Belly of a young Child 388 Chap. 25. Of the Ulceration or shooting forth or rupture of the Navel of a young Infant 391 Chap. 26. Of the Smartings Redness and Inflamation of the Groin Buttocks and Thighs of the Infant 395 Chap. 27. Of the Ulcers or Thrush of the Mouth of an Infant 397 Chap. 28. Of the pain in breeding the Teeth 400 Chap. 29. Of the Loosness of an Infant 404 Chap. 30. Of Vomitings in Children 406 Chap. 31. Of a Hernia or Rupture in Children 408 Chap. 32. Of the Scabs which are upon the Head and Face of young Children 412 Chap. 33. Of the Small Pox and Meazels in Infants 414 Chap. 34. How to cure the Venereal Lues in Infants 422 Chap. 35. How to hinder Childrens growing squint-eyed 428. Chap. 36. Of the requisites and necessary conditions in the choice of a good Nurse 430. FINIS
most essential and ordinary by which a Chirurgeon may be assured of it of which some may presently be perceived others not till afterwards He shall first examine and inform himself whether the Woman hath all or most part of the signs of fertility which are already named in the discourse of them if not he must impute them to some other cause and supposing she be fruitful you may then know whether she have conceived by their agreement and more then ordinary delight in the act It is not enough for a Woman to be certain she hath conceived and to yeeld and receive her seed with the Man 's into her Womb unless it close at that instant and retain it There is an Article amongst the customs of Paris in which it is said that to give and keep is not good but it is not so in Conception for a Woman gives and casts her Seed into her Womb and there retains it She may know whether she retains the Seeds if she perceives nothing flow down from the Womb after Copulation The Woman some few months after perceives also some small pain about her Navel and some little commotions in the bottom of her Belly caused by the Womb 's closing it self to retain the Seeds and contracting it self so as to leave no empty space the better to contain them and embrace them the closer The light pain of the Navel comes from the Blader of the Urine from the bottom of which proceeds the Urachus which is fastened to the Navel which is a little agitated by that contraction and kind of motion that happens to the Womb when it is closed to retain the Seeds and from the like agitation comes also those little commotions of the Belly These are the signs of Conceptions which may be known at the moment they happen and may be yet more certainly known if you perceive the inward Orifice exactly close Besides these signs there are others which cannot be known till some time after as when the Woman begins to have loathings having no other Distemper loseth her appetite to meats which she did love longs to eate strange things to which she was not accustomed which happens according to the quality of the humours predominating in her and with which her stomach abounds She hath often nauseatings and vomitings which continue a long time the Tearms stopping no other cause appearing having alwayes before been in good order her Breasts swell wax hard and cause pain from the flowing of the blood and humours to them wanting their ordinary evacuation their upper parts are firmer and larger because of the repletion the Navel starts her Nipples are very obscure or dark coloured with a yellowish livid circle round about her Eyes are dejected and hollow the whites of them dull and troubled her blood when she hath conceived some time is alwayes bad because the superfluities of it not being then purged as accustomed is altered and corrupted by their mixture Moreover there is a sign which all the Women esteem and hold in this doubtful case for very certain which is en ventre plat enfant y a in a flat Belly there is a Child Indeed there is rime in this proverb and something of reason but not as they imagin that the Womb closing it self after Conception draws in a manner the Belly inwards and flatten's it which cannot be because the Womb free and wavering not fastened forwards to the Belly whereby to draw it back after that manner but it may possibly be by reason that Women grow lean by the indispositions of their pregnancy and wax thinner and smaller not only in their Belly but also throughout their whole body as may be known the two first months of their pregnancy during which time that which is contained in the Womb is yet very small but when the Womans blood begins to flow to it in abundance then the Belly waxeth daily bigger and bigger afterwards until her reckoning be out All these signs concurring in a Woman who hath used copulation or the most part of them together and successively according to their seasons we may pass our judgment that she hath conceived notwithstanding that many of them may happen upon the suppression of the Terms which usually produce the like for every one knows that it causeth also in Virgins disgusts nauseatings and vomitings but not so frequently the swelling hardness and pains of the breasts as also extravagant appetites a livid colour of the Eyes and others to which you must have regard The Matrix may be yet exactly close and the Woman not conceived Yea there are some in whom they almost never open unless very little to give passage to the Tearms which happens to some naturally to others by accident as by some callosity proceeding from an Ulcer or other malady If all these signes of Conception which sometimes may deceive us though rarely if they concur together do not give us a sufficient assurance of it and that we desire a better Hippocrates teacheth us a way to know it which I believe to be no more certain than the rest it is in his 42d Aphorism of his 5th Book where he speaks in this sort Si velis noscere an conceperit mulier dormiturae aquam mulsam potui dato si ventris tormina patiatur concepit sin minus non concepit If you desire to know whether a Woman hath conceived or no give her going to rest a draught of Metheglin and if afterwards she feels pains in her Belly caused by wind she hath conceived if none she hath not as he saith Which is grounded as I believe upon the supposition that Metheglin breeds wind which cannot pass easily downwards because the Womb being full compresseth with its greatness the * The great Gut Intestin rectum on which it is scituated and causeth those winds to rumble which are constrained to recoyl back into the other Intestines If there be any occasion where Physicians or Chirurgeons ought to be more prudent and to make more reflections upon their Prognosticks for an affair so important as this is it is in this which concerns their Judgments as to conception and Womens being with child to avoid the great accidents and misfortunes which they cause who are too precipitate in it without a certain knowledge The faults which are committed through too much fear at such a time are in some sort excusable and to be pardoned but not those caused by temerity which are incomparably greater There are but too many poor Women who have been caused to miscarry by Medicines and bleeding not beleiving they were with Child which are so many murders they are guilty of who caused it either through ignorance or rashness besides the death which they bring to those little innocent creatures by destroying them in their Mothers belly they often thereby put the Mothers into great danger We have lately had in Paris in the year 1666 a miserable example of this kind in a Woman hanged and
to be of an opinion that the Males have sooner life than the Females because he saith their heat is greater but for my part I do not beleive that the Male is sooner formed than the Female and that which thus perswades me is because if it were so the Male must likewise be at its full term sooner than the Female proportionable to the same time that the one is animated sooner than the other which wee see the contrary in that the Women are brought to Bed indifferently both of Sons and Daughters at the ordinary terme of nine months Let us therefore say that towards the fifth or sixth week as well Males as Females have all the parts of their body though small and very tender entirely formed and figured at which time it is not longer than a finger and from thence afterwards which is our third time the blood flowing every day more and more to the Womb not by Intervals as the Courses but continually it daily grows bigger and stronger to the end of the ninth month which is the full term of ordinary labour Having explicated Conception and Generation let us now consider great Bellies and their differences CHAP. V. Of big Bellies and their differences with the signs of the true and false great Bellies THE great Belly of a Woman properly taken is a tumour caused by the Infants scituation in the Womb. There are natural great Bellies which contain a living Child and these we call true and others against nature in which instead of a Child is ingendred nothing but strange matter as Wind mixed with Waters which are called Dropsies of the Womb False-Conceptions Moles or Membranes full of blood and corrupted seed for which reason they are called false great Bellies We have already where we treated of Conception and Generation mentioned the causes and signs of a great Belly in its beginning notwithstanding we will again repeat the most certain and ordinary of them which are nauseousness vomittings loss of appetite to things the Woman was accustomed to eat and like longings for strange and naughty things suppression of the Terms without Feaver or Shiverings or other cause pains and swelling of the Breasts all which may be found in Virgins by the retention of their Courses but the most certain is if putting the finger into the Vagina you perceive the inward Orifice exactly close as also the distention of the body of the Womb considerable more or less according to the time the Woman is gone with Child and the Childs stiring in the Womb gives us indubitable proofs of it It is fit we should be alwayes careful not to be deceived by what we feel stir in the Womb forasmuch as the Infant of it self hath a total and a partial motion the total is when it removes the whole body and the partial is when it moves but one part at a time as the Head Arm or Leg the rest of the body lying still but the Womb blown up in fits of the Mother yea and some Moles have by accident a kind of total motion but never a partial one That of a Mole is rather a motion of falling down than otherwise to wit a motion by which heavy things fall downwards for a Woman who hath a Mole of any bigness considerable whatsoever side she turns her self to her belly falls immediatly the same way like a heavy bowl About the time or very near when the Infant quickens if the Woman be certainly with Child these humors which are carried to the Breasts by the stoppage of her Courses are turned to Milk which when it happens is usually an assured testimony of pregnancy though some Women have been found with Milk in their Breasts but rarely and yet not with Child nor ever having had any which Hippocrates also confirms in his 39th Aphorism of his 5th Book where he saith Si mulier quae nec praegnans nec puerpera est lac habet ei menstrua defecerunt If a Woman hath milk in her Breasts and is neither with Child nor ever had any it comes from the stoppage of her Courses But it is rather whey than milk which in that case hath not the consistence as the Milk of a Woman in Childbed nay the Milk of a Woman with Child is yet but waterish and becomes neither thick nor very white till after labour she begins to suckle her Child The Infant moves it selfe manifestly about the fourth month or sooner or later according as it is more or less strong some Women feel it from the second others about the third month yea some before that time In the beginning these first motions are very small and very like to those of a little Sparrow when first hatched but grow greater proportionably as the Infant grows bigger and stronger and at last are so violent that they force the Womb to discharge its self of its burden as in Travail The common opinion is that the Males quicken before the Females because their heat is greater but that is almost equal for there are some Women perceive their Daughters others their Sons soonest which happens indifferently to Males and Females according as there was a more or less vigorous disposition at their Generation Very often Women who daily use Copulation are subject to be deceived for they usually believe they are with Child if their Courses stop and withal are a little qualmish which is not always true for false conceptions cause almost the same accidents as true which cannot easily be distinguished but by its consequences This false great-Belly is as we have already said often caused by wind which blows up and distends the Womb and which Women oft-times discharge with as much noise as if it came from the Fundament sometimes 't is nothing but water which is gathered there in such abundance as some Women have been seen to void a pail full without any Child though they verily believed they were with Child as did that Wood-Merchant whose story you have in the end of the third Chapter who did not void it till the end of the tenth mouth till when she alwayes believed her self with Child There are others who conceive only fals-conceptions and Moles which may be known by the Infants different motions already mentioned and by the Moles continuing in the Womb often after the ordinary time of labour some Women having them a whole year yea many years according as these Moles are more or less adhering to the inner parts of the Womb and are there entertained and nourished by the blood that flows thither Moles alwayes proceed from some false-conceptions which continuing in the Womb grow there by the blood that flows to them by the accumulation of which they are by little and little augmented if the Womb expels it before two months it 's call'd a fals-conception some are only but as it were the Seed involved in a membrane like that geniture which that Woman voided after six or seven dayes of whom Hippocrates speaks
into her Broths those herbs which purifie it as Sorrel Lettice Succory and Borrage she must avoid hot-seasoned Pyes and baked Meats and especially Crust because being hard of digestion it extreamly overchargeth the stomach If she hath a mind to Fish let it be new and not salted Fish of Rivers and running streams forasmuch as Pond-Fish tasts of mud and breeds ill juyce But if big-bellied Women cannot absolutely refrain their extravagant longings it is better as we have already said to suffer them to deviate a little from this rule or dyet provided it be moderate than too much to oppose their appetites They may drink at their meals a little good old Wine well temper'd with Water and rather Claret than White-wine which will help make a good digestion and comfort the stomach which is alwayes weak during prenancy and if they were not used to drink it before let them accustom themselves to it by degrees and as well in drinking as eating they must shun all things hot and diurectick because they provoke the courses which is very prejudicial to the Child By moderate sleep all the natural functions of a Woman are fortified and particularly the concoction of food in the stomach which then is very subject to loathings and vomitings We say it must be moderate because as excessive watchings dissipate the Spirits so too much sleep choak them Let therefore Women with Child sleep nine or ten hours at least in four and twenty and twelve at most and let it be rather in the night-time as most fit for rest than in the day as persons of quality are accustomed who frequenting the Court ordinarily turn night into day However they who have gotten this ill habit had better continue it than change too suddenly because this custom is become natural to them For what respects exercise and rest let them govern themselves according to the different time of their being with Child for at the beginning of the conception if the Woman perceives it she ought if she can to keep her bed at least till the fifth or sixth day and by no means to use copulation all the time forasmuch as the Seeds being not yet covered with the membrane which is formed in that time as we have said already are in the beginning by the agitation of the body very apt in some persons to slip forth She ought neither to go in Coach Chariot or Waggon nor on Horseback whilst with Child and much less the nearer she comes to her time because this kind of exercise doubles the weight of what is contained in the Womb by the jolts she receives and often makes her miscarry But she may walk gently go in a Sedan or Litter She ought neither to carry or lift heavy burdens nor lift up her arms too high and therefore she ought not to dress her own head as she used to do because it cannot be done without stretching her arms too much above her head which hath caused many to miscarry before their time because the ligaments of the Womb are at once loosned by these violent extensions Let her exercise be gentle walking and the heels of her shoes low because Women cannot for the bigness of their bellies see their feet and so are subject to stumble and fall In short she must govern her self in these exercises rather to err in too much rest than in too much exercise for the danger is greater by immoderate motion than in too much rest It is impossible for me in this point to be of the opinion of all Authors although all the World follows them in this their evil and dangerous counsel who would have a pregnant Woman exercise her self more than ordinary toward the latter end of her reckoning that so as they say the Child may sink lower But if they consider the point well they would without doubt find it to be the cause of more than half of the hard Labours and that on the contrary rest would be more advantagious to them as I shall prove by the following explication First We must know and take for granted that the birth of a Child ought to be left to the work of Nature well regulated and not to provoke it by shaking it with this exercise for to dislodge it before its full time which hapning though it be but seven or eight dayes sooner proves sometimes as prejudicial to the Infant as we see it is sometimes to Grapes which we find four or five dayes before they are full ripe to be yet almost half Verjuice But to explain more clearly than by this comparison that these kind of exercises often cause hard labours as we have already said consider that the Infant is naturally scituated in the Womb with the head uppermost and the feet downwards with its face towards the Mothers belly just till it hath attained to the eighth month at which time and sometimes sooner and sometimes also later his head being very great and heavy he turns over his head downward and his heels upwards which is the sole and true scituation in which he ought to come into the World all other postures being contrary to Nature Now just when the Child is about to turn according to custom into his intended posture Instead of giving her self rest she falls a jumping walking running up and down stairs and exercising her self more than ordinary which very often causes it to turn cross and not right as it ought to be and sometimes the Womb is depressed so low and engaged in such sort towards the last month in the cavity of the Hypagastres by these joltings that there is no liberty left the Infant to turn it self naturally wherefore it is constrained to come in its first posture to wit by the feet or some other worse Moreover it would be very convenient that the Woman to this end should abstain from Coition during the two last months of her reckoning forasmuch as the body is thereby much moved and the belly compressed in the action which likewise causeth the Child to take a wrong posture I believe that they that will seriously reflect on these things will make no difficulty to quit this old error which hath certainly caused the death of many Women and Children and much pain to divers others for the reasons above-mentioned Some Women have miscarried only with the noise of a Cannon as also with the sound of a great Bell but especially with a clap of Thunder when of a sudden it surpriseth them and frights them Big-bellied Women are sometimes subject to be costive because the Womb by its weight pressing the Rectum hinders the Belly from discharging its excrements with ease They that are troubled with this inconvenience may use Damask-Prunes stewed Veal-Broth and Herb-Pottage with which they may gently moisten and loosen the Belly If these things are not sufficient they may give her gentle Clysters of Mallows Marsh-mallows Pellitory and Anise-seeds with two ounces of brown Sugar dissolved in it adding a
brain upon the sharp Artery and the Lungs and sometimes from a blood of the like nature which flowes from the whole habit towards the Breast upon the suppression of the Terms as also from having breathed in too cold an air which irritates the parts and excites them to move in that manner but being begun by these causes it is very often augmented by the compression the Womb of the pregnant Woman makes upon the Diaphragma which cannot have its free liberty in those that bear their Children high because by its great extension it bears up almost all the parts of the lower Belly towards the Breast and principally the Stomach and Liver forcing them against the Diaphragma which is thereby compressed as we have said This may be remedied by the Womans observing a good diet something cooling if sharp humours cause it avoiding all meats salted spiced or hautgoust she must forbear sharp things as Orenges Citrons Pomgranats Vinegar and others of the like nature because they yet more and more by their pricking quality excite the Cough but she may make use of Lenitives and such as sweeten the passages as juice of Liquorish Sugarcandy and Syrup of Violets or Mulberries of which they may mix some spoonfuls with a Ptysan made with Jujubes Sebestens Raisons of the Sun and French Barly alwayes adding a little Liquorish to it It may not likewise be amiss to turn the abundance of these humours and draw them downwards by some gentle Clyster If this regimen prevails nothing and that there appears signs of fulness of blood it will be necessary at whatsoever time it be of her going with Child to bleed her in the Arm and though this remedy be not usually practised when they are young with Child yet in this case it must for a continual Cough is much more dangerous than moderate bleeding If the Cough comes of cold let her be kept in a close Chamber with a Napkin three or four times double about her Neck or a Lambskin that it may keep her warm and going to bed let her take three or four spoonfuls of Syrup of burnt Wine which is very pectoral and causeth a good digestion if it be made in the following manner Take half a pint of good Wine two drams of good Cinamon bruised half a dozen Cloves with four ounces of Sugar put them together in a Silver Porenger and cause them to boil upon a Chafindish of coals burn it and afterwards boil it to the consistence of a Syrup which let the Woman take at night an hour or two after a light supper It must alwayes be observed from whatsoever cause the Cough proceeds that the Woman go loose in her clothes for being strait-laced the Womb is the more thrust down by the endeavours the Cough causeth it to make And because sleep is very proper to stay defluxions it may be procured if there be occasion by some small Julip using by no means the strong Stupesactives which are dangerous to a Woman with Child if there be not a very great neceâ—sity as there was in my Kinswoman who had furious accidents by the hurt she got from the stumble of which I gave you an account in the 12th Chapter of this Book There are Women that carry their Children so high especially their first because the large Ligament which support the Womb are not yet relaxed that they think them to be in their Breast which causeth so great an oppression and difficulty of breathing that they fear they shall be choaked assoon as they have either eaten a little walked or gone up a pair of Stairs which comes as I said before by reason the Womb is much enlarged and greatly presseth the Stomach and the Liver which forces the Diaphragma upwards leaving it no free liberty to be moved whence is caused this difficulty of breathing Sometimes also their Lungs are so full of blood which is driven thither from all parts of the body when with Child that it hardly leaves passage for the air if so they will breath more easily as soon as a little blood is taken from the Arm because by that means the Lungs are emptied and have more liberty to be moved But if this difficulty of breathing comes from a compression made by the Womb against the Diaphragma in forcing the parts of the lower Belly against it the best remedy is to wear their clothes loose about them and rather eat little and often than to fill their Bellies too much at once because it is thereby more pressed against the Diaphragma and so augments the accident Neither must she use any viscous or windy meats as Pease c. but only such as are of an easie digestion she must all the while avoid any occasion of grief and fear because these two passions drive the blood to the Heart and Lungs in too great abundance so that the Woman who can hardly already breath and hath her Breast stuft will be in danger of being suffocated for the abundance of blood filling at once and above measure the Ventricles of the Heart hinders its motion without which one cannot live CHAP. XVI Of the swelling and pains of the Thighs and Legs IT is very easie for them that are acquainted with the Circulation of the Blood to conceive the reason why many big-bellied Women have their Legs and Thighs swelled and pained and sometimes full of red spots from the swelling of the Veins all along the inside of them which extreamly hinders their going Many think which is in some measure true that the Woman having more Blood than the Infant needs for its nourishment Nature by vertue of the expulsive faculty of the upper parts which are alwayes most strong drives the superfluity of it upon the lower which are the Legs as most feeble and aptest to receive it because of their scituation to explain it thus is something to purpose but I think the Circulation of the Blood will teach us better how this comes than that we need to have recourse to this expulsive faculty It is then thus according to my opinion Following the ordinary motion of the Blood the Crural and the Saphene Veins receive into them what is brought to the lower parts by the Arteries and convey it along the Leg and Thigh ascending still by the Iliacks towards the Heart which are emptied into the Cava to ascend again by it to the Heart and so successively This being so de facto as need not be doubted since it is a verity founded upon experience when a Woman is with Child and chiefly towards the last months and the Womb is much extended and possesseth a great part of the lower Belly then it begins to press the Iliack Veins by its greatness and heaviness and so hinders the Blood from following its course and having its motion so free as before she was with Child which being so the inferior parts which are the Crural and Saphene Veins become swelled much in the same manner as the
Veins of the Arm do upwards when bound with a Ligature for bleeding or by any strong compression upon the upper parts which happens because the Veins being compressed the Blood is there stopt finding its passage more difficult The Iliack Veins being then so pressed by the bigness and heaviness of the Womb all those of the Legs and Thighes swell in such a manner as that they empty themselves into the substance of the parts and throughout the five Coverings which thence become swelled yea and these Veins and amongst the rest the Saphenes dilated and become varicose sometimes from the inward and upper parts of the Thigh to the very extremity of the Foot in which the Blood stagnating without its free circulation is altered and corrupted which causeth great pains and swellings in all these parts This oftner befalls Women that are very sanguine walk much and use great exercise which aided with a fulness of the Vein makes a rupture of the Valvules which serve to facilitate the motion of the Blood as the suckers of a Pump which retain the water when it is raised thither which Blood falling down again not being so supported causeth by its quantity and stay these dilatations of the Veins which are called Varices For to remedy this when a Woman hath her Veins dilated let her only use whilst she is with Child a palliative cure in swaithing this Varicos-part with a swaith three or four fingers broad according to the bigness of it beginning to swaith from the bottom and conducting it upwards to the beginning of the Varices that by this means these varicos Veins which are alwayes outward being moderately closed should be hindred by this compression from further dilating and the Blood not be corrupted by the stay it makes there which after this will not want its circular motion because the greatest part of it passeth then by the Vessels deeper placed A Woman in this condition should likewise keep her bed if she can because by this scituation her body being equally layed the Blood circulates much the easier and is not then so much troubled to return by these Veins to the Heart as when it must ascend by them the Woman standing upright which is the cause the Legs alwayes are more swell'd at night than mornings if there be in any other parts of the Body signs of plenitude and abundance of Blood they may bleed her without danger There are other Women whose Legs only swell because of their weakness and not for the reason just above mentioned and are so oedematous that when you press them with your Finger the print of it remains there which is because they want natural heat sufficient to concoct and digest all the nourishment sent to them and to expell the superfluities of it which by that means remaining there in great quantity leaves them so oedematous For to resolve these sort of Tumours you may use a Lee made with the Ashes of Vines and the Decoction of Melilot Camomile and Lavender afterwards they may be somented with Aromatick Wine in which they may moisten their compresses to be laid upon them repeating them three or four times a day to fortifie them which may be made with Rosemary Bayes Tyme Marjoram Sage and Lavender of each an handful of Province-Roses half a handful Pomegranat flowers and Alum each an ounce boil them together in strong Red-Wine three pints to the consumption of a third part strain it and keep it for the use above mentioned But since Pregnancy for the most part causeth these tumours they likewise ordinarily cease when the Woman is brought to bed because then she purgeth forth the superfluity of her whole habit by means of her Lochia CHAP. XVII Of the Hemorrhoids THe menstrous Blood that used to be purged away every month being collected in a great quantity near the Womb which permits it not now to be evacuated by the usual passage being so exactly closed during Pregnancy is forced to flow back into the whole habit and chiefly upon the neighbouring parts of the Womb and causeth in many the Hemorrhoids both internal and external All the several sorts of them which we shall not describe may as well happen to them at this time as at another but we will only speak of that sort which is caused by pregnancy because our design is only to make known some particulars of the maladies Women are in this condition subject to Hemorrhoids are tumours and painful inflammations ingendred by a flux of humours upon the extremities of the Hemorrhoid Veins and Arteries and are caused in great-bellied Women by the abundance of Blood which is cast upon these parts because the body at this time is not purged of its superfluities as it was accustomed before It is likewise very often caused by the great endeavours that Women sometimes make to go to stool when they are costive because the Womb being placed upon the Rectum hinders by pressing it the excrements contained in it from being easily extruded and by these endeavours the Blood which is in the neighbouring Vessels being likewise expressed swells and blows up their extremities upon which comes these painful inflamations call'd Hemorrhoids of which some are internal some external some small and with little or no pain and some extreamly big and painful This may suffice for their general differences without coming to their particulars which would require a more ample explication If they are small and without pain either internal or external it is easie enough to prevent their further growth by Remedies which hinder and turn the flux from those parts but there is more reason to cure the great and painful ones by easing first the great pain for as long as that continues the Flux is ever augmented To this purpose if the big-bellied Woman have in the rest of her body other signs of repletion she may safely be once let blood in the Arm and sometimes if there be great necessity twice for to turn away the humours and to evacuate the fulness by which the pain will likewise be appeased If the gross excrements retained in the right Gut be the cause of it and that she be costive let her take an emollient Clyster of the Decoction of Mallows Marshmallows Pellitory and Violets with Hony of Violets to which may be added Oyl of sweet Almonds or sweet Butter being careful to add nothing that may irritate lest it augment the Disease especially when they are inward Piles And to the end the Women may then the better receive the Clyster t is fit that a small end of a Pullets gut be put upon the end of the pipe to cover it on the outside that so it may be put up the Fundament with less pain afterwards let her keep a moderate and cooling diet and continue in bed till this flux of humours be passed and the mean time anoint the Piles with hot stroakings from the Cow or foment them with the Decoction of Marsh-mallows White-broth
and Linseed Oil of sweet Almonds Poppies and Water-Lillies well beaten together with the yolk of an Egg and ground in a leaden Mortar are very anodine and proper to ease pain and if the inflammation be great anoint it a little with Uuguentum Refrigerans Galeni and Populean equally mixed After a good diet bleeding and the application only of these cooling and anodine Remedies Repercussives being not then to be used lest they repel the impure Blood or harden the Piles if their swelling doth not abate Leeches must be applied to draw and empty the Blood there gathered or they may be opened with a Lancet if soft or any kind of inundation but Leeches is more proper for hard Piles and as it were fleshy because they do not put one to so much pain as the Lancet Although some men by the help of these Piles have an evacuation almost natural being relieved by it when they bleed moderately Nature being accustomed to it yet it is not so in Women but alwayes contrary to Nature because the evacuation which happens to those men by the Piles ought always to be made by the Womb in Women if not with Child but if they are it may in some manner in case the Woman be plethorick supply also the defect of the natural for provided they bleed moderately and without pain she may thereby be also relieved but if they flow in too great quantity there is danger that both Mother and Infant will be weakened by it and to avoid it 't is convenient to make astringent Fomentations with the Decoction of Granat flowers the rinds of Pomegranates and Province-Roses made with Smiths-water and a little Alum or this Cataplasm may be applyed to it made with Bole-armonack Dragons-blood and Terra Sigillata with the white of an Egg As also to turn back the Blood from these parts by bleeding in the Arm and by dry cupping-glasses applied to the region of the Reines and other remedies convenient for this distemper and such as the accident requires CHAP. XVIII Of the several Fluxes which may happen to a Woman with Child and first of a Loosness THree several Fluxes may befall a great-bellied Woman to wit the Flux of the Belly the Flux of the Terms and Floodings We shall first speak of the Flux of the Belly and afterwards we will examine the other two in the two following Chapters There are ordinarily reckoned three sorts of Loosnesses which in general is a frequent dejection of what is contained in the Guts by stool the first is called Lienteria by which the Stomach and the Guts not having digested the nourishments received lets it pass almost quit raw The second is called Diarrhaea by which they simply discharge the humours and excrements which they contain And the third which is the worst is Dysenteria by which the Patient together with the humours and excrements voids Blood with violent pains caused by the ulceration of the Guts Of what kind soever the Flux is if it be great and continue long it puts the Woman in great danger of miscarrying which Hippocrates tells us in the 34th Aphorism of his 5th Book Mulieri in utero gerenti si alvus plurimum profluat periculum est ne abortiat For if it be a Lienteria the Stomach not containing the Food received and letting it immediatly pass away before it be turned into Chyle of which Blood ought to be made for the nourishment of Mother and Child it is not possible but they must be both thereby extreamly weakned for want of nourishment If it be a Diarrhaea and continues long it will occasion the same accident because there is a great dissipation of the Spirits together with the evacuation of humours But the danger is much greater when a Dysenteria forasmuch as the Woman hath then great pains and gripes in the Guts caused by their ulceration which excites them continually by constant stimulations to discharge themselves of the sharp and bilious humours with which they are extreamly annoyed which causeth a great disturbance and violent commotion of the Womb being placed upon the right Gut and to the Child contained in it and by the compression which the Muscles of the Belly make on all sides as also those that are made by them of the Diaphragma which force themselves downwards in the endeavours a Woman makes so often to go to stool with pain the Child is constrained because of this violence to come before its time which arrives so much the oftner by how much these stimulations and needings are greater as the same Hippocrates notes in the 27th Aphorism of his 7th Book Mulieri utero gerenti si tentio supervenerit facit abortum If there happens a tenesme saith he to a Woman with Child it make her miscarry This tenesme is a great passion of the right Gut which forceth it to make these violent endeavours to discharge it self without being able to avoid any thing but cholerick humors mixt with Blood with which it is continually irritated When this Flux of the Belly happens to a big-bellied Woman it is ordinarily because they have alwayes the digestion of their stomach weak by reason of their bad dyet which their strange appetites cause them often to long for by the continual use of which being at length weakned it suffers the food to pass immediately without digestion or if it stay longer it is converted into a corrupted Chyle which descending into the Guts irritates them by its acrimony to discharge themselves as soon as they can Now to proceed safely to the cure of these different Fluxes of the Belly to which 't is fit care should be taken in good time lest the Woman miscarry as we have already said the nature of it must be considered to the end the cause which maintains it should be remedied If it be a Lienteria following as is usual continual Vomitings which have so debilitated the Stomach and relaxed its membranes that having no longer strength to vomit up that food it suffers it to pass downwards without digestion In this case a Woman must abstain from all those irregular appetites and accustom her self to good food of easie digestion and little at a time that so her Stomach may be able the easier to concoct and digest it she should drink a little deep Claret-Wine mixed with Water in which Iron hath been quenched instead of Ptysan which is not proper in this case provided she have not a strong Feaver for if it be but a small Feaver Wine on this manner is to be preferred forasmuch as the fewer she hath at that time is but symptomatick caused by this debility of Stomach and will vanish as soon as this is fortified which will be yet more promoted if the Woman before and after meals takes some Corroberatives as a little of that Burnt-Wine we mentioned for the Cough in the 15th Chapter of this Book or a little good Hippocras or right Canary of any of them according to
as may be to be Masters of the Evacuation and to hinder it from causing a Loosness for that is more dangerous than Salivation because of the continual forcing downward in going to stool by which the Womb receives great commotion and is extreamly agitated I know very well that many will not easily be perswaded but that either it is impossible to cure a Woman of the Pox whilst she is with Child or that she and her Child cannot undergo the Remedies without inevitable danger of death however the experience I have had of it my self makes me to be of another opinion which I am vvilling to communicate for an example in the like case In the Year 1660 when I practised Midwifery in the Hostel de Dieu at Paris a young Wench not above twenty years old came thither to lie-in of her second Child that had had the Pox before ever she conceived the first time and after miscarried of a dead Child rotten with the Pox therefore being big this second time and perceiving the accidents of ber disease to augment more and more she concluded there was no hopes this great Belly would succeed any better than the first because she had all over her Body especially upon both her Breasts very many malignant Ulcers which encreased day by day and fearing it might turn to a Cancer before her Reckoning was compleat being but three months gone she resolved to submit to a thorough-Cure then and to hazard her life in that condition to save her Child's having no other hopes to effect it nor being able her self to resist the growing disease She acquainted three or four Chirurgeons both vvith her disease and design not at all concealing her great-belly who for that cause would not undertake her although she was fully resolved upon it and promised to pay them vvell telling her that their Conscience would not suffer them to do it in the condition she was in and that it would be better she would patiently submit to it aswell as she could till she was brought to bed and then they vvould very vvillingly undertake her But when she found none would undertake her unless she concealed her great-belly vvhich was not hard to be done being but three months gone and believing there was no better an expedient She met with another to whom she mentioned nothing of her great Belly that put her into the ordinary course as if there had been no Conception and besides the common Remedies used in this disease he gave her a Salivation by five or six reiterated Frictions of the Oyntment vvhich followed her very plentifully five vvhole vveeks so that she vvas vvell and perfectly cured without leaving the least ill accident behind of her disease When she was almost recovered and that all had succeeded wel she told her Chirurgeon she was four months a half gone with Child for she was three months when she came to him where she lodged six weeks intire without having it in the least perceived which at first he could hardly believe but perceiving her Belly rather grown bigger than lesser during the Evacuation the Physick had made he was immediately assured of the truth of it She informed him that the reason why she had concealed her great-Belly was the refusal four Chirurgions to whom she had confest it made to take her in hand From the time she was cured she suffered not the least inconvenience during all the remainder of her time except a little want because all the money she had was given the Chirurgeon for her Cure which made her come to the Hostel de Dieu to lie-in where I delivered her of a Child at the full time as big fat and healthy as if the Mother never had had the least touch of that disease in her whole body and which was very remarkable the Burthen which is a part very susceptable of the least impression of a Woman 's corrupt humours was as neat fair and ruddy as could be imagined This example which is very true may convince us that a big-bellied Woman may be taken in hand for the Pox and more safely if the Precautions noted above be carefully observed For it is without contradiction that if this Woman had not been cured she had this second time been brought to bed of a rotten Child as before Relating once this History to a Chirurgion a Friend of mine he told me that himself twice in two different persons had the same success who were very well cured and their Children likewise well born at the full time without having the least impression of the venom in any part of their Body Varandaeus confirms to us this truth in the second Chapter of his second Book of Womens Diseases where he precisely tells us that he had seen big-bellied Women who had had this disease eradicated by anointings with Mercury and Salivation prescribed by Empericks which may convince us that this Cure will easily have a better success when governed and managed by a knowing and methodical person In a word 't is easie to be perswaded that they can endure it although with Child because many very often have continual Feavers for twelve or fifteen dayes and other acute distempers for which they have been necessited to be nine or * Such frequent bleeding Women with Child in so short a space is not approved in England ten times blooded and yet notwithstanding have oft-times gone through with their Children to their full account and been delivered of them as well as if they never had had any ill accident CHAP. XXIV Of Abortion and its Causes WHen a Woman casts forth in the beginning what she had retained by conception in the Womb 't is called an Effluxion or a sliding away of the Seeds because they have not yet acquired any solid substance if they miscarry of a false-conception which is ordinarily from the later end of the first to the end of the second month it is called an Expulsion but when the Infant is already formed and begins to live if it comes before the time ordained and prescribed by Nature it is an abortion which may happen from the second to the beginning of the seventh month for afterwards it is accounted a Birth because the Infant being strong enough and having all its perfections may then live which is impossible if he comes before These things thus understood we then say that an Abortion is an issuing forth of the Child yet imperfect out of the Womb contrary to Nature before the term limited which is the cause that for the most part it is dead or if sometimes alive it dies in a short time after We may in general assert that every acute Disease easily makes a Woman miscarry because they destroy her fruit which being dead never stayes long in the Womb and also puts the Woman in great hazard of her life as saith Hippocrates in the 30th Aphorism of his 5th Book Mulierem gravidam morbo quopiam acuto corripi
above the lest near the Privities drawing likewise with that very gently resting the while the Fore-finger of the same hand extended and stretched forth along the String towards the entry of the Vagina as may be seen in the annexed Figure alwaies observing for the more facility to draw it from the side where the Burthen cleaves least for in so doing the rest will separate the better just as we see a Card which is glewed to any thing is better separated from the place where it begins to part then where it is close joyned Chap IX lib. 2. pag 190 Assoon as the Woman is delivered of both Child and Burthen it must then be considered whether there be all and care had that not the least part of it remain behind not so much as the Skirts or any Clods of Blood which ought all to be brought away with the first for otherwise being retained they cause great Pains all which being done things fit for Mother and Child in this condition must be provided which we will mention in their place When a Woman hath two Children she must be delivered in the same manner as if she had but one observing only for the reasons given in the precedent Chapter not to fetch the Burthen till all the Children are born and then it may be done without danger shaking and drawing it alwaies gently sometimes by one String sometimes the other and sometimes by both together and so by turns till all is come proceeding in it according to the directions already given When the Infant comes right and naturally the Woman is brought to Bed and delivered with little help observing what hath been taught in the two last Chapters of which the meanest Midwives are capable and oft times for want of them a simple Nurs-keeper may supply the place but when it is a wrong Labour there is a greater mystery belongs to it for then the skill and prudence of a Chirurgeon is for the most part requisite Which we intend now in the remaining part of this Book to treat of CHAP X. Of laborious and difficult Labours and those against Nature their Causes and Differences together with the means to remedy them FOr the easier and better explaining these things we say that there are three sorts of bad Labours to wit the Painful or Laborious the Difficult and that which is altogether contrary to Nature The Laborious is a bad Labour in which the Mother and Child though it comes right suffer very much and are harassed more than ordinary The Difficult is not much unlike the first but besides is accompanied with some accident which retards it and causeth the difficulty but the wrong Labour or that against Nature is caused by the bad scituation of the Child and can never be helped but by manual Operation or the Chirurgeons hand In the laborious and difficult Labours Nature alwaies doth the Work being a little assisted but in that contrary to Nature all its endeavors are vain and useless and there is then no help but in an expert Chirurgeon without whom she must certainly perish The Difficulties of Labour proceed either from Mother Child or both From the Mother by reason of the indisposition of her Body or it may be from some particular part only and chiefly the Womb or also from some strong passion of the Mind with which she was before possest In respect of her Body either because she may be too Young having the Passages too strait or too old of her first Child because her parts are too dry and hard and cannot be so easily dilated as happens also to them which are too lean they who are either small short or mishapen as crooked Women have not a Breast strong enough to help their Pains and to bear them down nor those that are weak whether naturally or by accident and crooked persons have sometimes the Bones of the Passage not well conformed the tender and too apprehensive of Pain have more trouble than others because it hinders them from doing their endeavour and they likewise who have small Pains and slow or have none at all Great Cholicks hinder Labour also by preventing the true Paius all great and acute diseases make it very troublesome and of a bad consequence according to Hippocrates's opinion in the 30th Aphorism of the Fifth Book Mulierem gravidam morbo quopiam acuto corripi lethale As when she is taken with a violent Feaver a great Flooding frequent Convulsions Dysentery or any other great distemper Excrements retained cause much difficulty as a Stone in the Bladder or when it is full of Urine without being able to void it or when the great Gut is repleted with hard Ordure or the Woman troubled with great and painful Piles and their ill scituation sometimes retard it extremely As touching the difficulty proceeding from the Womb only it must either be from its bad Scituation or Conformation having its Neck too strait hard or callous whether naturally or by any accident as having had there a Tumor Apostume or Ulcer or Superfluous flesh whether on the Neck or inward Orifice or because of any Cicatrice caused by a preceding bad Travail Besides these those things which are or may be contained in the Womb with the Child do also cause difficult Travail as when the Membranes are so strong that they cannot be broken which sometimes hinders them from advancing into the Passage or so tender that the Waters break too soon for then the Womb remains dry When there is a Mole or the After-burthen comes first which alwaies causeth flooding and certainly the death of the Infant if the Woman be not presently delivered of them by Nature or Art yea and when the Navel-string comes first the Child is suffocated if not speedily after born strong Passions of the Mind do likewise contribute much to it as Fear Sorrow and others the like The Woman that miscarries hath more pain than a Woman at her full time as also than one that is hurt although she be very near her time As to the hinderances caused by the Infant they are when either its Head or whole Body are too large when the Belly is Hydropical when it is monstrous having two Heads or being joyned to another Child Mole or any other strange thing when it is dead or so weak that it contributes nothing to its Birth when it comes wrong or when there are two or more besides all these different difficulties of Labour there is yet one caused by the Midwife's ignorance who for want of understanding her business instead of helping hinders Nature in its work Let us now treat of the means by which all these may be prevented and the Woman succoured in her bad and difficult Labour as may easily be done if we perfectly know the causes of all these difficulties as when it happens by the Mothers being too young and too strait she must be gently treated and the passages anointed with Oyl Grease and fresh Butter
Child can do nothing nor can it when it is very weak She must take the while some Comfortatives to prevent fainting because of the putrid vapours ascending from the dead Child but when it hath so great a Dropsy either in the Head or Belly as that it cannot be born because of the great distension and bigness of these parts then we are obliged to open these parts to let out the Water And if it be of such enormons bigness either Head or Body or that it have two Heads or is joined to another Child or to a big Mole there is a necessity for to save the Mother either to dilate the passage proportionable to the bigness of the monstrous Child if it be possible or else which is better to draw forth the Child by pieces to prevent the Mothers perishing together with the Child which else would certainly happen if this course be not taken And if there be two Children the Rules given in the Eighth Chapter of this Second Book must be observed But if the Midwife cannot remedy all these accidents she must then readily send for * By all which may be learnt That if the Midwife cannot lay the Woman assoon as or soon after the Water is broke she ought in time to send for advice and help an expert Chirurgeon for his advice or to do what he thinks fit Let us now pass to Labours contrary to Nature which can never be done without Manual Operation and show what is then to be done CHAP. XI Of unnatural Labours where Manual Operation is absolutely necessary and what Observations the Chirurgeon must make before he goeth about it THose Labours which absolutely require Manual Operation are when the Child comes wrong Hippocrates in his Book De Naturâ Pueri and in that De Superfoetatione admits but of three general ways for a Child to be born to wit with the Head first which is the sole * For if any part but the Crown so that the Body follow not in a strait line 't is a wrong difficult Birth though the Head presents first natural Figure when it comes right the second with the Feet and the third with the Side or across which two last are quite contrary to Nature But to make it more plain we say That a Child may come wrong four several general waies which are First any of the fore-parts of the Body Secondly any of the hinder-parts Thirdly either side And Fourthly the Feet Now just as there are four Cardinal points to which all the rest of the thirty two Winds may be reduced on the Compass and to one of the four more than to the other according as they participate of more or less of that Point so likewise all the particular and different wrong Postures that a Child may present can be reduced to the abovenamed four general waies according as they approach more to the one than the other of them And as the number of the several wrong Births is very great we will be contented only to treat particularly of each of the principal of them because if one be well informed of these they may easily remedy the rest which are of no great consequence but before we mention the means how it will be convenient to shew what conditions are requisite in a * Physician or any else that practiseth this art Chirurgeon that would apply himself to this Operation and the observations he ought to make before he undertakes it These conditions either respect his Body or his Mind in respect of his person he must be healthful strong and robust because this is the most laborious and painful of all the operations of Chirurgery for it will make one sometimes sweat that he shall not have a dry thread though it were the coldest day in Winter because of the great pains and difficulty he ordinarily meets with as Fabricius of Aquapendente testifies confessing that he hath often been so weary and tired as that he hath been forced to leave the work for his men to finish He ought to be well shaped at least to outward appearance but above all to have small hands for the easier introduction of them into the Womb when necessary yet strong with the Fingers long especially the Forefinger the better to reach and touch the inner Orifice He must have no Rings on his Fingers and his Nails well pared when he goeth about the work for fear of hurting the Womb He ought to have a pleasant countenance and to be as neat in his clothes as in his person that the poor Women who have need of him be not affrighted at him Some are of opinion that a Practitioner of this Art ought on the contrary to be slovenly at least very careless wearing a threat Beard to prevent the occasion of the Husbands jealousy that sends for him Truely some believe this policy augments their practice but 't is fit they should be disabused for such a Posture and Dress resembles more a Butcher than a Chirurgeon whom the Woman apprehends already too much that he needs not such a Disguise above all he must be sober no Tipler that so he may at all times have his wits about him he must be discreet modest and secret never discovering to strangers those incommodities and diseases of Women which come to his knowledge He must be sage prudent and judicious to conduct him alwayes in his Operations with good reason He must be pittiful yet not so as to distract or hinder him from his duty when the case requires as also so patient as not to precipitate any thing but taking time sufficient to consider what is fit to be done He must not be angry with the poor Woman though she exclaims against him or the other Women during the Operation for the Pains of the one and the compassion of the rest oblige them to it without other cause He should be a good Christian of a well regulated Conscience and do his best endeavour to bring the Children * And therefore undertake what he can safely perform and what he cannot leave to others that may for life is not to be played with alive He must deliver poor Women gratis and treat them as tenderly and with as much humanity as the Rich extorting nothing from them but be content with reasonable satisfaction as they are willing and able to give and not use them like a Turk or Arab as some do who assoon as they have done their work whether well or ill will be paid without delay and that with so much ill manners and importunity that they force the poor people presently to borrow the money when they have not enough to satisfie their desires and take from them to the last Penny to satisfie their tyrannical avarice which proceedings are very unworthy an honest man In fine a Chirurgeon indued with all these good qualities must be for his accomplishment and intire perfection very knowing and expert in his Art and chiefly
the 12th Chap. of this Book for what a horrible spectacle would it be to bring as some have sometimes done a poor Child yet living after the Arm hath been cut off or any other part of the Body wherefore let him make a double reflection on his work before he goeth about it CHAP. XXII How to deliver a Woman when Hands and Feet come together IF the Infant presents both Hands and Feet together at the Birth it is altogether impossible it should be born so the Chirurgeon therefore guiding his Hand towards the orifice of the Womb will perceive nothing but a many Fingers close together and if it be not sufficiently dilated he will be a good while before he can exactly distinguish between the Hands and Feet by reason they are sometimes so shut and prest together that they seem to be all of one and the same shape but when the Womb is open enough for to introduce the Hand into it he will easily know which are the Hands and which the Feet and having well taken notice of it let him slide his Hand and presently direct it towards the Infants Breast which he will find very near and by that * Unnecessary let him gently thrust back the Body towards the bottom of the Womb leaving the Feet in the same place where he found them having therefore placed the Woman in a convenient Posture that is her Hips a little raised above her Breast and Head which scituation ought alwaies to be observed when the Child is to be put back into the Womb let him afterwards take hold of him by the Feet and draw him forth according to the way before directed in its proper Chapter This Labour truly is a little troublesome but nothing near so much as that we have mentioned in the preceding Chapter where the Child presents only his Hands for in that the Feet must be searched a great way off and it must be quite turned about before it can be drawn forth but in this they are ready presenting themselves and there is not much to do but to lift and thrust back a little the upper part of the Body which is almost done of it self * Sufficient and the best way in this Birth by drawing it alone by the Feet Those Authors that have written of Labours and never practised them as many Physicians have done do order all by the same precept often reiterated that is to reduce all wrong Births to a natural Figure which is to turn it that it may come with the Head first but if they themselves had ever had the least experience they would know that it is very often impossible at least if it were to be done by the excess of violence that must necessarily be used to effect it it would go near to destroy both Mother and Child in the operation a Fiat in this Case is soon said and ordered but it is not so easily executed as pronounced For my part I am of an opinion cleer contrary to theirs and such as are skilfull in the Art will surely agree with me in it that is that whensoever the Infant comes wrong in what Posture soever from the Shoulders to the Feet it * A good note is the best way and soonest done to draw it forth by the Feet searching for them if they do not present themselves rather than to try to put it into a natural Posture and place the Head foremost for the great endeavours often necessary to be used in turning the Infant in the Womb which is a little harder than to turn a Pancake in a frying Pan doth so weaken both Mother and Child that there remains not afterwards strength enough for to commit the Operation to the work of Nature and usually the Woman hath no more Throwes nor Pains fit for Labour after she hath been so wrought upon for which cause it would be very tedious and difficult as also the Infant which is already very weak would certainly perish in the Passage without being able to be born Wherefore it is much better in these cases immediatly to fetch it by the Feet searching for them as I have already directed when they do not present themselves by which a tedious Labour will be prevented to the Mother and the Child will be often brought alive who without it will scarce escape death before he can be brought forth by the strength of Nature CHAP. XXIII How to deliver a Woman when the Child comes with the Knees WHen an Infant not being turned towards the latter moneths as he ought to come with his Head foremost as is mentioned in the 5th Chap. of this Book presents the Knees to the Birth having the Legs folded towards the Buttocks one may easily be deceived touching but one of them because of their hardness and roundness and take it for the Head especially when being scituated a little high it can be reached but with the end of a Finger only but if it be touched and handled a little better the Infant being fallen a little lower it will easily be distinguished Assoon then as it is perceived it must not be suffered to advance further in this Posture but having placed the Woman the Knees must gently be put back for to have the more liberty to unfold the Legs one after the other which the Chirurgeon Chap XXIII lib. 2. pag 2â—… Chap XXIV lib. 2 pag 245. may do by putting one or two of his Fingers under the Hamm directing them by little and little all along behind the Leg until he meets the Foot and drawing alwaies a little obliquely for to come the easier to the end of it that so having disengaged one he may do the same to the other proceeding in the same manner as with the first after which having brought them together he may finish the work as when a Child comes Footling alwayes observing to bring the Face of it downward and such circumstances as are noted where we treat of that Labour CHAP. XXIV Of a Delivery where the Child comes with Shoulder Back or Breast THe most difficult of these three sorts of Figures and Scituations in which Infants sometimes come is that of the Shoulders because it is furthest from the Feet of the Infant and the Chirurgeon must find them for to draw it forth The next is the Back and the Breech for the same reason causeth least trouble not only because the Feet are nearer but also because by this Figure the Head and Neck of the Infant is not so constrained and lockt as in the other scituations For to remedy this Birth of the Shoulder some advise that it should be put back to make way for the Head of the Infant that so it may be reduced to a natural Birth but it is much better for the reasons above alledged in the 22th Chap. of this Book to try to bring it by the Feet for to effect which the Chirurgeon must thrust the Shoulder a little back with his
separated Wherefore it ought to have a Handle so long that the Chirurgeons right Hand without the Womb may hold and govern it as abovesaid and conduct it the better in the Operation which could not be so safely and conveniently done if this instrument were so very short as all other Authors recommend because in this occasion the Chirurgeons hand is so constrained and pressed in the Womb that he can hardly there have the liberty to move his Fingers ends which is the cause why he cannot without much difficulty govern such an Instrument with one Hand only unless he would very much force and offer violence to the Womb and exceedingly endanger thereby the poor Womans life Let us now come to the extraction of a dead Child and show the several ways of doing it CHAP. XXXI Of delivering a dead Child WHen the Infant is dead in the Mothers Belly the Labour is ever long and dangerous because for the most part it comes wrong or though it comes right with the Head the Womans Pains are so weak and slow in these cases that she cannot bring it forth and sometimes she hath none at all forasmuch as Nature half overthrown by the death of the Child which cannot help it self labours so little that many times it cannot finish the business it hath begun but must yeeld without the help of Art of which at that time it hath great need However before you come to Manual Operation endeavour to stir up the Womans Pains with sharp and strong Clysters for to bring on Throws to bear down and bring forth the Child but if this prevails not she must be deliverd by Art We have declared in the 12th Chap. of this Book the signs to know a dead Child in the Womb of which the chief are if the Woman perceives it not to stir nor hath a long time before if she be very cold much pain and heaviness in the bottom of her Belly if the Child be not supported but always falls like a mass of Lead to that side on which the Woman lies if the Burthen or Navelstring hath been a long time in the World and if no Pulsation be there felt and that dark and stinking putrid matter comes away from the Womb. All these signs together or most of them shew the Child is assuredly dead which when the Chirurgeon is certain of he must do his endeavour to fetch it assoon as possibly he can and having placed the Woman according to former directions if the Child offers the Head first he must gently put it back until he hath liberty to introduce his Hand quite into the Womb and sliding it all along under the Belly to find the Feet let him draw it forth by them as is formerly taught being very careful to keep the Head from being lockt in the Passage and that it be not separated from the Body which may easily be done when the Child being very rotten and putrified the Chirurgeon doth not observe the circumstances often repeated by us that is in drawing it forth to keep the Breast and Face downwards And if nothwithstanding all these precautions the Head because of the great putrifaction should be separated and remain behind in the Womb it must be drawn forth according to the directions formerly given in the proper Chapter But when the Head coming first is so far advanced and engaged among the Bones of the Passage that it cannot be put back then being very sure by all the Signs together or most of the chief of them that the Child is certainly dead 't is better to draw it so forth than to torment the Woman too much by putting it back for to turn it and bring it by the Feet but because it being a part round and slippery by reason of the moisture the Chirurgeon cannot take hold of it with his Fingers nor put them upon the side of it because the Passage is filled with its bigness he must take a * Though this Crochet cannot hurt a dead Child yet it may endanger the Woman by slipping Wherefore the Translator of this Treatise cannot approve of it having an easier and safer way to do this Operation as he mentions in his Preface to this Book Crochet like one of those marked A and B amongst the Instrument at the end of this Second Book and put it up as far as he can without violence between the Womb and the Childs Head observing to keep the point of it towards the Head where he must fasten it endeavouring to give it good hold upon one of the Bones of the Skull that it may not slide forcing in the point of it which must be strong that it may not turn and after the Crochet is well fixed in the Head he may therewith draw it forth keeping the ends of the Fingers of his left Hand flat upon the opposite side the better to help disengage it and by wagging it by little and little to conduct it directly out of the Passage Chap IIII. lib. 2. pag 169 â—he dead Child of which above all there must â—d assurance comes with the Arm up to the â—lers so extreamly swelled that the Woman â—asser too much violence to have it put back â—st then to take it off at the Shoulder-joint â—sting it three or four times about as we have â—y taught in another place by which means 〈◊〉 is no need of either Knives Sawes or sharp â—rs as some Authors will have it it being 〈◊〉 easily performed without all that provision â—de of the softness and tenderness of the Body 〈◊〉 that the Arm so separated and no longer â—ing the Passage the Chirurgeon will have 〈◊〉 room to put up his Hand into the Womb to 〈◊〉 the Child by the Feet and bring it away as 〈◊〉 been directed Although the Chirurgeon be sure the Child is â—…ad in the Womb and that it is necessary to fetch 〈◊〉 by Art he must not therefore presently use his Crochets because they are never to be used but when Hands are not sufficient and that there is no other remedy to prevent the Womans danger or to bring the Child any other way because very often though he hath done all that Art directs persons present that understand not these things will believe that the Child was killed with the Crochets although it had been dead three days before and without other reasonings or better understanding of the matter for recompense of his saving the Mothers life requite him with an Accusation of which he is altogether innocent and in case the Mother by misfortune should afterwards dye lay her death also to his charge and instead of praise and thanks treat him like a Butcher or Hangman to which divers Midwives are usually very ready to contribute and are the first that make the poor Women that have need of the Men afraid of them So much they are in fear of being blamed by them for having themselves been the cause as some of them often are of the death of
neglect committed towards her in her tending For this Reason one must not be of the opinion of many Nurse-keepers who will have a new-laid Woman to be well fed as well to restore her lost strength by the tediousness of the Labour and by the quantity of Blood then evacuating for which cause they believe the Woman must be well nourished to make more Blood as also to fill up her Belly which is very much emptied by the Birth of the Child but it is much better to follow in this the counsel which Hippocrates gives us in his Tenth Aphorism of the Second Book where he saies Impura corpora quo plus nutriveris eo magis laeseris The more you nourish impure Bodies the more you hurt them Now it is certain that a Woman newly delivered is of this sort as you may know by the quantity of Cleansings and Superfluities which flow from her Womb at this time when for this reason they must be very regular in their Diet especially the three or four first daies in which time she must be nourished only with good Broaths new laid Eggs and Jellies without using at the beginning more solid Meats but when the great abundance of her Milk is a little past she may with more safety eat a little Broath at her Dinner or a small piece of boil'd Chicken or Mutton as she likes best afterwards if no accident happens they may by degrees nourish her more plentifully provided in the mean time that it be a third part less than she was accustomed to take in her perfect Health and that her Food be of good and easie digestion not suffering her to eat any of those Cakes Tarts or other Pastries which are usually provided at the Childs Baptism As for her Drink let it be Ptysan which is Liquorish Figs and Aniseeds boiled in Water or at least boil'd Water being careful not to give it her too cold she may also provided she be not Feaverish drink a little white Wine well mixed with Water but not till after the first Five or Six days Although I prescribe this Rule in general for all those who are newly brought to Bed yet there are some who must not observe it so exactly as laborious Women who being of a very strong and rebust constitution require a more plentiful feeding to whom notwithstanding if they do not change the quality they must at least retrench the quantity of their ordinary food having alwaies respect to what every person accustom themselves to which the same Hippocrates doth likewise teach us in the 17th Aphorism of the first Book where he saith Animadvertendi sunt quibus semel aut bis quibus copiosior aut parcior aut per partes Cibus est offerendus dandum verò aliquid tempori regioni aerati consuetudini Great care and notice must be taken to whom to give meat once only or twice as also to whom to give more or to whom less or by little and little but some allowance must be made in respect of Time Countrey Age and Custome What we have already said shall suffice for direction in their Meat and Drink The Child-bed Woman must likewise keep her self very quiet in her Bed lying on her Back with her Head a little raised and not turning often from side to side that so the Matrix may be the better setled in its first Scituation she must free her self at that time from all care of business leaving it to the management of some of her Kindred or Friends let her talk as little as may be and that with a low voice and let no ill news be brought to her which may affect her because all these things do cause so great a commotion or perturbation of her Humours that Nature not being able to overcome them cannot make the necessary evacuation of them which hath been the death of many The Citizens Wives have a very ill Custom which they would do very well to refrain that is they cause their Children to be baptized the second or third day after their Labour at which time all their Relations and Friends have a Collation in the Child-bed Room with whom she is obliged to discourse and make answers to the Gossips and all Comers a whole After-noon together with the usual Complements of those Ceremonies enough to distract her and though there is scarce any of the Company which do not drink her Health yet by the noise they make in her Ears she loses it besides all this she is often constrained out of respect to forbear the use of her Bed-pan and other necessaries which are very prejudicial to her and this happens just at the time when she ought to have most rest because about the third day the Milk flowes in greatest quantity to the Breasts this is the reason why ordinarily the next day they have a very great Feaver She ought alwaies to keep her Body open with Clysters taking one once in two daies which not only evacuate the gross Excrements but also by drawing downwards cause her to cleanse the better When she hath observed this Rule a fortnight or three weeks which is very near the time of having cleansed sufficiently that those parts may be throughly cleansed before she goes abroad and begins upon a New score let her take a gentle Purge made of Senna Cassia Syrup of Succory with Rhubarb which is good to purge the Stomach and Bowels of those ill Humours Nature could not evacuate by the Womb as it did the other Superfluities this Purge may be repeated if necessary all which being done and that no indisposition remain she may bath once or twice or to wash and cleanse her Body and afterwards she may govern her self according to her former Custome CHAP. IV. How to drive back the Milk in those Women who are not willing to give suck THere are many Remedies used to this purpose some of which hinder the afflux of humours to the Breast and others dissipate and in part dissolve the Milk therein contained Those which hinder the Humours from plentifully flowing thither are Oile of Roses well mixt with Vinegar with which the Breasts are to be anointed all over or Unguentum Populeum with Ceratum refrigerans Galeni equally mixt and extended upon a piece of Linnen or gray Paper and so applyed to the Breasts Others use Linnen dipt in luke-warm Verjuce in which a little Allom is dissolved that so it may be more Astringent and others lay to them the Lees of Red Wine alone or mixt with Oyl of Roses Those Remedies which dissolve and dissipate the Milk from the Breast is a Cataplasme of the four * Of Linseed Fenugreek Beans and Fitches Branns Honey and Saffron boiled with the Decoction of Chervil or Sage Others apply Honey only and some others rub the Breast alone with Honey and put upon it the Leaves of Red-Cabbadg the great Stalks first being taken away and they a little deadned before the fire this remedy doth very
time and being thereby hardened had stopt the Passage of much Wind which passed away at this time Now the Intestines full of this gross matter being every moment agitated by this Wind did likewise agitate and continually compress the Womb by means of which the Flooding was always maintained which did cease immediatly after this Chollck was dissipated by the evacuation of these Excrements and since that time being again called upon the like occasion of loss of Blood proceeding from the same cause and having taken the same course the issue of it was likewise the same Wherefore if there be the least appearance of Excrements contained in the Intestines make no scruple to give Clysters to evacuate them forbearing in this case those that are Astringent because they harden and retain yet more that which augments the distemper Chap VI. lib. 3. pag 307. These three Figures represent several Pessaries fit for the supporting and keeping up of the Womb that it may not fall out as it doth in a bearing down CHAP. VI. Of the bearing down and falling out of the Womb and Fundament of a Woman new-laid I Shall the better to explain the thing make two sorts of Bearings down or Relaxations as also two sorts of Fallings forth or Precipitations of the Womb all which differ but in the degree according as they fall down more or less for the Relaxation is when the Womb only bears down and comes not forth and the Precipitation is when it comes out of the Body The first sort of Bearing down is that in which the whole body of the Womb falls into the Vagina in such manner that putting up the Finger one may feel the orifice very neer The second sort of Bearing down is when the Womb being yet lower one can manifestly perceive this Orifice quite without The Falling-out is also of two sorts in the first the Womb comes quite forth but is not turned inside out nor can the inside of it be seen but only its Orifice which appears at the end of a great fleshy mass which makes the body of the Womb and this is called Prolapsus Uteri that is A falling forth of the Womb. And the other falling out of all is most dangerous and is called Perversio or turning inside out for then it is not only fallen forth but the bottom of it is turned quite out that so you may perceive it all even and without an Orifice because it is so turned The Womb turned on this fashion appears to be only a great piece of bloody flesh and almost like the * A mans Cod. Scrotum which hangs between the Womans Thighs and that which is wonderful in this case is that the Infants house which is the Womb goes forth at the Gate which is the inner Orifice The Bearing down of the Womb proceeds either from a Relaxation or Ruption of the Ligaments Women that have abundance of the Whites are subject to these Relaxations and the Ligaments are extended or broken by hard and violent Labour as also by too frequent bearing of great and heavy Children sometimes by a great Cough by strong and frequent Sneezings or having leaped or fallen from high places by going in a Coach Cart on Hors-back or in other rude and shaking Carriages by having lifted up beyond their strength heavy burthens by lifting up the Arms too much and putting them over the Head by a tedious loosness with great Pains and Needing forasmuch as all these things do shake and extremely thrust the Womb downwards when it is with Child and the Ligaments being by this means loosened or broken cannot keep it up any longer which is the cause that a bearing down doth easily follow the birth of a Child but the most ordinary cause of these Bearings down or fallings out of the Womb is violent and hard Travails which usually happens when a Child comes wrong so that it cannot be born and when it hath too big a Head or when the inner Orifice is not dilated sufficiently for to give it passage at that time for the Womb is then forced down with so much violence and yet the Child cannot advance into the Passage because the Ligaments are extremely rent or loosened and likewise when the Secondine cleaving closely to the bottom of the Womb is pulled away of a sudden or with too much violence and much the sooner if that putting up the Hand into it as it is necessary when the String is broke one takes hold and pulls the body of the Womb itself instead of the After-birth We have in the 13th Chap. of the Second Book given such directions as will prevent this mistake and bring it away safely A Woman troubled with this falling out of the Womb feels a great weight at the bottom of her Belly with an extreme pain in her Reins and Loins towards the place where these Ligaments are fastned and a reddish bloody moisture is perceived to pass through this mass of Flesh which hangs between her Legs A Relaxation may happen to all sorts of Women from any of the causes above mentioned but a falling out but seldom and a perfect Perversion never but upon a Delivery or immediatly after because then the inner Orifice is almost as wide as the bottom of it which is not so at other times when being closed there is no possibility for it to be thus turned inside out I have shown in the 16th Chap. of the Second Book how to prevent this Accident at the time of Labour in a Woman that is subject to it to which place you may have recourse to avoid repetition If a speedy remedy be applied to the Relaxation and falling out of the Womb by reducing and remitting it into its natural place a Cure may be easily expected and so much the rather by how much the Woman is young and the Malady fresh but if she be old and this Disease be already of a long standing she is so much the more incurable For the Cure of this distemper regard must be had to two things the First is to reduce the Womb into its natural place and the Second is to strengthen it and keep it there For the execution of the first which is to reduce it if the Womb be quite out or turned the Woman must first of all be made to render her Urine and a Clyster must be given her if it be necessary for to empty the gross Excrements that are in the Rectum that so the reduction may be the easier performed then place her on her Back with her Hips raised a little higher than her Head and then foment all that is fallen forth with a little Wine and Water luke-warm and having taken a soft Rag put it up into its proper place thrusting it back not all at once but wagging it by little and little from side to side and in case this be too painful because it is already too big and swelled anoint it with Oile of sweet Almonds for the
curdled or clotted Blood that they have no ill Scent that they be without Acrimony and that they flow in a moderate quantity We say that they must not be fresh but the four first days because they will not be else the true Lochia but a pure flux of Blood which will be very dangerous and that they must lose by degrees this reddish colour to become pale this sign teacheth us that the Vessels which have been opened are by degrees closed again that they be of an equal consistence without curdled or clodded Blood by this means we are assured that there is no mixture of any strange matter and that they are governed and regulated by Nature they must have no Foetor or ill scent and be without Acrimony in this case we know that there is no danger of corruption or inflammation in the Womb they must flow in a moderate quantity that so the superfluous humours may be evacvated for if the Lochia flow in so great an abundance as to cause Fainting or Convulsions the Woman will be in danger of death as Hippocrates in the six and fiftieth Aphorism of his Fifth Book assures us Si Muliebri profluvio convulsio animi defectus superveniunt malo est If saies he Faintings and Convulsions follow the Lochia it is dangerous and he adds in the following Aphorism Menstruis abundantibus Morbi eveniunt subsistentibus accidunt ab utero Morbi If the Courses or Lochia flow too much Diseases follow and if they stop Diseases happen from the Womb. Diseases proceeding from too great abundance of the Lochia are as we have said in the first Aphorism Convulsions and Syncopes or Faintings and if they do not kill the Woman they weaken her very much she grows lean she remains a long time pale her Legs and Thighs swell and afterwards she becomes Hydropick As to the distempers which follow the suppression of the Lochia we will mention them in the next Chapter CHAP. X. Of the suppression of the Lochia and the Accidents which follow thereupon THere is so great a flux of Humours from all parts to the Womb when a Woman is with Child and during the commotion in her Labour that in case there be not afterwards sufficient evacuation of them the Woman is in great danger of very ill Accidents and sometimes of death it self because these humours corrupting by their stay there will certainly cause a great inflammation and this is the reason why the suppression of the Lochia is one of the worst and most dangerous Symptoms which can befall a Woman after Delivery especially if they happen to be totally and suddenly stopt the first three or four days which is the time when they should come down plentifully for then follows an acute Fever great pains in the Head pains in the Breast Reins and Loins suffocation of the Mother and an Inflammation which is suddenly communicated all over the lower Belly which becomes very much swelled and blown up there happens also a great difficulty of Breathing Choakings Palpitations of the Heart Syncopes and Faintness Convulsions and often Death if the suppression continue or if the Woman escapes it she is in danger of an Abscess in the Womb yea and afterwards a Cancer or there may happen great Imposthumes in the lower Belly which is usual because of the nearness of the place as also Gouts Sciaticas and Lameness or Inflammation or Abscess in the Breast if the Humours be carried towards those parts The Câ—uses of the stoppage of the Lochia proceed either from a great Loofness because a great Evacuation that way turns the Lochia and makes them stop or any strong Passions of the Mind as great Fear or Grief or any Anger or Soundings for these things do cause the humours to retire suddenly inwards and by this quick motion they often cause Suffocations Great Cold stops the Lochia because it closes the Vessels and Pores of the Womb the use of astringent Remedies produces the same effect as also cold Drink because by condensing and thickning the humours they hinder their easie flowing strong and frequent agitations of the Body by rarifying and dispersing them throughout every part doth likewise not permit them to be evacuated by the Womb. To bring the Lochia well down let the Woman avoid all perturbations of spirit which may stop them let her lye in Bed with her Head and Breast a little raised keeping her self very quiet that so the Humours may be the easier carried downwards by their natural tendency let her observe a a good Diet somewhat hot and moist let her rather use boiled Meats than roast and if she be any thing feaverish let her use Broaths only with a little Jelly let her avoid all binding things let her Ptysan be made with Aperitives such as are the Roots of Succory Dogs-grass and Asparagus with a little Aniseed and Hops and every other time let her take a little Syrup of Maiden-hair in a glass of this Ptysan and above all let her carefully shun cold Drink Clysters may likewise be given her to draw the Humours downwards and her lower parts may be fomented with an emollient and aperitive Decoction made with Mallows Marshmallows Pellitory of the wall Camomil Melilot the roots of Asparagus and Linseed with which Decoction the Womb may likewise be injected and with the Herbs being well boiled and strained through a very course Cloth let a Cataplasme be made with the addition of Oyl of Lillies or Hogs-grease and applyed very hot to the lower Belly together with these let her Thighs and Legs be strongly rub'd downwards bathing them very hot with the same Emollient Decoction there may be likewise applyed large Cupping-glasses to the uppermost part of the inside of her Thighs It would not be much amiss to use an Aromatick Perfume if it were not that it caused a heaviness of the Head as Hippocrates notes in the 28th Aphorism of the Fifth Book where he saith Sufficus Aromatum muliebria educit saepius verò ad alia utilis esset nisi Caepitis induceret gravitatem Now whilst all these things are put in practice bleeding in the Foot or Arm must not be forgot according as the accidents caused by this suppression of the Lochia require neither must we blindly follow the opinion of many Women who believe that bleeding in the Arm in this case is very pernicious This Imagination is so firmly rooted in the heads of almost all of them that if in case a Child-bed Woman happens to dye after bleeding in the Arm they sail not absolutely to condemn that as the cause But this their opinion is not according to knowledg for sometimes Bleeding in the Arm is better than in the Foot and at other times that in the Foot is more certain than bleeding in the Arm As for example suppose a Woman be very full of Humours throughout the whole habit of her Body and her Lochia be supprest by reason of which there happens an Inflammation
be a greater hinderance to the Childs sucking and that it turn not into an ill natured Ulcer CHAP. XXIV Of Gripes and Pains of the Belly of a young Child MAny Children are so griped that they cannot forbear crying night nor day for the great pains they feel in their Belly with which some are so vext and tormented that they dye of it 'T is very often the first and most common distemper which happens to little Infants after their Birth which in general and for the most part comes from the sudden change of their nourishment forasmuch as having alwaies received it by the Umbilical Vessels whiles they were in their Mothers Belly they come to change it of a sudden not only the manner of receiving it but the nature and quality of it assoon as they are born for instead of purified Blood only which was conveyed to them by means of the Umbilical Vein they are obliged for want of it to be nourished with their Mothers Breast-milk which they suck with their Mouth and from which are engendered many Excrements causing the Gripes as well because it is not so pure as the Blood with which it was fed in the Womb as because the Stomach and Intestines cannot yet make a good Digestion nor an easie Distribution being not accustomed to it The particular causes of these Gripes are either when the Moeconion amassed during all the time of Pregnancy is not evacuated soon after the Infants birth and that by its too-long stay in the Intestines it acquires a sharp and pricking Acrimony or that becoming hard the Infant cannot void it nor the new Excrements which proceed from the Milk which he hath taken at the first 't is also sometimes because the Child not being able to suck with ease he swallows in sucking the Milk with difficulty much air and wind which being retained in the Stomach and sliding into the Intestines doth painfully distend them This Wind sometimes is caused when a Child takes a greater quantity of Milk than he can digest or because of its ill quality as when the Woman gives her Breast-milk assoon as she is delivered without staying to have it purified Cold may also make it suffer the same But very often it is for giving him Pap too soon as also when it is not enough boiled because this nourishment which is gross and viscous cannot be easily digested by a new-born Babe whose Stomach is not yet accustomed to it and Worms that are engendred in the Intestines by their stirring and biting do also much torment them Besides all these things already mentioned the Midwife also may cause great pains in the Childs Belly by driving back into it the cold and clodded Blood out of the Navel-string before it be tyed For to remedy all these pains in the Belly which Women usually call all by one common name of Gripes respect must be had to their different causes as to that which is the general cause the too sudden change of the nourishment To avoid it one must forbear giving the Child suck until the next day lest the Milk being mixt with the Phlegm which is then in the Stomach corrupt and at first it must suck but little until it be accustomed to digest it If it be the Moeconion of the Intestines which by its long stay causeth these pains for to help to discharge them of it give them at the Mouth a little Oyl of sweet Almonds and Syrup of Roses as we have directed before and to provoke it further give it Beets-stalk covered over with Honey for a Suppository or a sugar'd Almond also dipt in common Honey or one may give it a small Clyster If a Child cannot suck with ease regard must be had to that which hinders it for if it be Tongue-tyed it must be cut as is above directed and if it be because the Nurse is hard milcht change her for one whose Milk is better purified and let her rather suckle it a little and often than more at once than the little Stomach can easily digest at a time And above all whiles the Child is griped give it no Pap because this food by its viscositie doth easily cause obstructions which afterwards engender Wind. If it be Wormes lay a cloath dipt in Oyle of Wormwood mixt with Ox-gall upon the Belly or a small Cataplasme mixt with Powders of Rue Wormwood Coloquint Aloes and the seed of Citrons incorporated with Ox-gal and flower of Lupines and to draw drive them more downwards if the little Infant can take any thing by the Mouth give it a small infusion of Rhubarb or half an Ounce of compound Syrup of Succory having before given it a small Clyster of sugar'd Milk for by this means the Wormes which shun the bitterness of the Medicines and seek after the sweetness of the Milk are easily brought away by Stool When these Gripes are caused by Wind as it often happens or by any sharp Humours in the Intestines anoint the Childs Belly all over with Oyl of Violets or with Oyl of sweet Almonds or else with Oyl of Walnuts Camomil and Melilot mixt together having first warm'd them in which also a Cloath may be dipt to lay upon it or a small Pancake may be made with an Egg or two fried in Oyl of Walnuts for to be applied to it and they may take a little Anodine or Carminative Clyster according as the cause of the Gripes is known above all ever keeping the Child very warm CHAP. XXV Of the Inflamation Ulceration or shooting forth or rupture of the Navel of a young Infant THe continual cries of little Children because of the Pains and Gripes which they feel at the beginning doth somtimes cause such an agitation of the Belly that the Navel-string falling off too soon and before it be entirely closed and cicatrized there happens there an Inflammation and Ulceration at other times also for the same reason although it be outwardly healed not being so within it is dilated and thrust outward the bignesse of a small Egg and sometimes bigger which is usually called Exomphale or shooting forth of the Navel There are some who imagine when it is so inflamed and ulcerated that it was because the String was tied too-near the Belly which caused a great pain and inflamation to follow Others say that Nature having used to discharge the Urine by this part during the Childs being in the Mothers Belly doth at first still continue to send it this way and that it causeth this Accident by its acrimony for which there is no reason for 't is impossible the Urine should regorge from the Bladder to the Navel by the Urachus forasmuch as it is not hollow in an humane Foetus as we have elsewhere made appear And how near the Belly soever the Navel-string is tied and how hard provided some of the true skin which is sensible be not also tied with it it can cause no manner of pain to the Child because it is a dead and
much more credible that the cause of the small Pox is the corruption of a contagious Air which doth principally infect and spoil the blood of Infants and Youth who are more disposed to it than they that are further advanced in years because of the tenderness and softness of their Bodies and more at certain years and some seasons than at others as it may easily be perceived every day for in pestilential times the small Pox is much more common in the Spring and Summer than at the end of Autumn or in Winter The small Pox doth differ from the Meazels though they are so like in the beginning that often it is difficult to distinguish them one from the other 'till after the second or third day when the small Pox which at first appeared like the Meazels begins to rise into Pustules and to whiten The Meazels are caused of a Blood bilious and over-heated which only makes red spots throughout the Skin without or with but very little elevation which comes soonest and principally on the Face but the small Pox proceeds from a sanguine and pituitous matter which being more thick and viscous produceth many Pustules rising high and by degrees growing white and ripening after which their matter drying away they are converted into Scabs Of the Signs of the small Pox some precede and others accompany them they that precede are a Fever Sottishness Dizziness and Pain in the Head very troubled Urine weariness and pains in the Reins and Loins reachings and vomitings difficulty of breathing frequent Yawnings Sneezing itching of the Nose redness of the Eyes and universal weariness all over the Body but when the small Pox begins to come forth there appears about the third or fourth day many Pimples rising every where which grow and augment as well in bigness as number 'till the eighth or ninth day during which time they ripen and whiten by degrees the Head and Face swells the Eyes are closed by a great flux of humours thither the Nose is stopped with excrements which there dry the Patient is troubled with a hoarse Voice a dry Cough sore Throat and great difficulty to breath and then all the parts of the Body are so swelled through the abundance of Pimples that it appears blown up and monstrous There may be two kinds of small Pox according as it is more or less malignant the first is that which is accompanied with but a simple emotion of a Fever only stirred up by an ebullition of Blood and Humours soon ceasing from the beginning without any evil accident which ripens suppurates and is easily and speedily cured the Pustules of these do rise full and the matter is white smooth and well concocted and the Infants easily escape it if they are but well tended But the other sort of small Pox totally malignant is that which is caused from some contagious and pestilential humour where the Pustules are flat brown obscure or livid having small black spots in their middle they come forth but slowly and no Suppuration follows or 't is very bad sanious watry and accompanied with pernitious accidents as a malignant Feaver Phrenzy great difficulty of Breathing Faintness Dysenterie and others which often are mortal or at least malignant Ulcers foulness of the bone loss of sight disfigurement and great deformity of the Face or lameness of some member according to the places where these vitious humours are conveyed and retained These havocks are caused by that which all Women call usually the Master-pock which is nothing else but many Pimples by their neerness and bigness joining together and mixing their matter which being thus in great quantity amassed into one place gnawes and corrodes the part deeper than if they were spread and disperst in many distinct Pustules for which cause its cavity remains much more hollow and deformed by reason of the great loss of substance there usually made and depositing or transporting this villanous matter upon the Bones or other parts it foules them or causes their other accidents as we have recited The Prognostick is drawn from the different nature which we have now explicated for if the Fever be small and that it ceases proportionably to the coming forth of the Pimples if they be not in too great quantity and that they ripen and whiten speedily it is a good sign but if the Feaver be violent in the beginning and augments every day with difficulty of Breathing and other accidents according as the Pimples come forth if they are in great number black flat dry and without Suppuration it is a sign of death besides Infants are not in so great danger as elder persons in as much as this Disease is more agreeable to their Age and Nature and that they also have a thinner and softer Skin through which this matter is easier expelled than through theirs that is harder and whose Pores are less open As to the Meazels they are never so dangerous as the small Pox because its matter being more subtile is much easier and sooner evaporated which usually terminates in three or four daies at the end of which sometimes follows the small Pox which often makes some as we have said take them one for another in the beginning at which time they appear almost the same The Cure of the small Pox particularly consists in the force and vertue of nature that endeavours to expel these malignant humours wherefore it must be assisted to overcome them as much as may be and fortified that it may be able to finish the work it hath undertaken being very careful not to divert it from its operation by an untimely bleeding or a Medicine unseasonably given To remedie this Malady keep the Child to a good diet avoiding solid meats all the time giving it only Spoon-meats as Broaths made with Veale and Fowl or a little of a good Jelly let his drink be Ptysan made with cleansed French-Barly the roots of Dogs-grass and Liquorice and a few Raisons of the Sun If it be a sucking Infant he must have no Pap 'till he be perfectly cured and since then by reason of his age he cannot receive Remedies often enough nor other food at the Mouth than Nurses milk let her observe a good Diet her self to refresh and temper her Milk as much as may be let her not carry the Child into the Aire but keep it in a close Room neither too hot nor cold for too hot Air weakens it extreamly by greatly resolving and dissipating the spirits and a too cold Air drives the Humours back into the Body and hinders the coming forth of the small Pox. Some advise it to be kept in a Bed hung round with Red Curtains because this Colour doth ordinarily move the Humours from the Centre outwards but this often hurts the Eyes and inflames them by its vivacity to which also in this disease there happens a great flux wherefore I believe a softer Colour what ever it be ought to be preferred but custome