Anti-Chamber to the Womb for if in the act of Copulation he knock at the door which is the inward orifice and it be not opened all is to no purpose and this may likewise be hindred from opening by some callosity proceeding from abundance of ill humors which usually flow from the Matrix or from some swelling which may happen to it or also by some part which may so press it that it cannot open to receive the Seed as the cawl doth in fat Women according to Hippocrates who says they cannot conceive till they grow lean But the most frequent reason why this orifice opens not in this Act to receive the seed is the insensibility of some Women who take no pleasure in the Venereal Act but when they have an appetite the Womb being covetuous of the Seed opens it self to receive it The same Hippocrates seems to have noted all the signs and causes of Barrenness from the evil temper of the Womb when he saith in his 62 th Aphorism book 5. that 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 temper are fruitful Of all which in my opinion the most common is the cortinual moisture of the Womb fed by an abundance of the whites with which many are much inconvenienced the humors of the whole dody being accustomed to stear 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 unctious and slippery that the seed though glutinous cannot cleave to it nor be retained within it and that 's the cause it slips away immediately or shortly after 't is received Barrenness may also proceed from the whole habit as when a Woman is too old or too young for the Seed of the young is not prolific neither have they menstruous blood both which are requisite to fruitfulness and that of the aged is in small quantity and too cold who likewise want menstruous blood then an universal distemper though of convenient years renders them Barren as when they are Hectick Dropsical Sickly c. and especially so much the more as the whole parts are fallen from their temper and natural constitution There are however many Women which seem Barren for a long time by reason of some of the aforementioned reasons yea till 35 or 40 years old and sometimes longer who yet at last conceive being cured of the distempers which hindered them and having changed their temperament by their Age. Now some of these Barrennesses may be cured by removing their causes and procuring the dispositions needful to fertility yea of those proceeding from an universal intemperament by reducing their body by a convenient regiment to a good order according to their respective dispositions Wherefore if one have the Neck of the Womb narrow and not from some of the causes abovesaid she ought to be joyned to a Man whose Yard is proportionable and if that will not do which happens very seldom she must relax it and open it with softning oils and ointments If it be compressed by any humor it must be resolved and suppurated according to its nature and situation having always a care to prevent the corruption of these parts which are very subject to it being hot and moist because the Womb serves as a sink by which all the bad humors of the body are purged so that you must take great care that these swellings turn not to a Cancer When the Neck is not clear by reason of any scar after a rent caused by some violence or hard labor or after an Ulcer which caused the two sides to be agglutinated whether inwardly or outwardly it must be seperated which being the Chirurgeon's work I here omit it If the inward orifice of the Womb be displac'd it may be in some sort remedied by making the Woman observe a convenient posture in the act of Generation and if the whites or other impurities of the Womb cause Barrenness they must be helped by evacuations purgations and a regular dyet concerning which the learned Physitian is to be consulted Mid. Thus far Sir having heard your account of the signs and causes of Fertility and Sterility I having heard learned men discourse of Superfetation I would humbly intreat you Sir that you would please to let me hear your opinion about that matter Dr. That you shall willingly good Mrs. Eutrapelia and therefore I shall begin first to tell you what it is SECT II. Of Superfaetation Dr. SVperfaetation according to the discription of Hippocrates is a repeated conception that is when a Woman being already with Child conceives again the 2 d time now there is a great dispute about this for we see daily Bitches Sows and Rabits have divers young but with one Copulation which may make us judge the same of a Woman some will have this to be by Superfetation but there are signs by which we may know the difference whether both Children were begot at once or one after the other That which makes many believe there can be no such thing as superfetation is because as soon as a Woman hath conceived her Womb closeth firmly so that the Man's seed absolutely necessary to conception finding no place nor entry cannot be received nor contained in it so as to cause this 2d conception To this may be added That a bearing Woman dischargeth her seed which is as necessary as a Mans by a Vessel which terminates on the side of the outward part of the inward Orifice which seed by this means is shed into the Neck of the Womb and not into the bottom as it ought for this purpose However it may be said in answer to these objections which are very strong that though the Womb be clos'd c. yet this general rule may have some exception so that it may be sometimes opened to let pass some slimy excrements which by their stay offend it or chiefly when a Woman is animated with an earnest desire of Copulation in the heat of which action she sometimes dischargeth by the passage that terminates in the bottom of the Womb which being opened by the impetuous endeavor of the seed more then ordinarily over-heated and this Orifice being at the same time a little opened if the Man's seed be darted into it at the same moment 't is thought a Woman may then conceive again This may be confirmed by a story of a Servant related by Pliny who having the same day copulated with two several Persons brought forth two Children the one resembling her Master the other his Proctor and also by a story of another Woman who had two Children one like her Husband and the other like her Galant but this different resemblance doth not always prove superfetation because sometimes different
THE English Midwife ENLARGED Containing Directions to Midwives Wherein is laid down whatever is most requisite for the safe Practising her Art ALSO Instructions for Women in their Conceiving Bearing and Nursing of Children With two new Treatises one of the Cure of Diseases and Symptoms happening to Women before and after Child-birth And another of the Diseases c. of little Children and the conditions necessary to be considered in the choice of their Nurses and Milk The whole fitted for the meanest Capacities Illustrated with near 40 Copper-Cuts London Printed for Thomas Sawbridge at the Sign of the Three Flower-de-luces in Little Brittain 1682. To all English Midwives YOU are here presented with an Amendment and Supplement of what was very necessary and yet wanting in this Book formerly so that now you will find it to be wholly compleated for your purpose in every respect it being altogether grounded upon many years Experience and Observation in the Practice of deliveries most others being written by those that never practiz'd the Art and some father'd upon Persons that were no more concerned in them then the Pope of Rome such as Sir Theodore de Mayern Dr. Chamberlen and others by the Publishers of the Compleat Midwives Practice so that I may justly say of this Book as the Learned Sir Richard Baker says of his Chronicle that if all other were not to be found this alone were sufficient with your diligence For I 'll assure you I have not conceal'd one secret belonging to your Art from you neither would I have you with-hold your knowledge from others neither have I imposed upon you any thing that hath not endur'd the Test of confirm'd experience and in like manner I would not have you upon any account whatsoever to try any new experiment either upon Rich or Poor either inwardly or outwardly thus much for the Book Now as for what concerns your selves I would have you by all means to have a respect to two things above all your Consciences and Credits and principally to the first and to that end for all the Treasure in the World to give no Medicine to cause a Woman to miscarry of her Child but prudently send such kind of People to the Learned Physitian to deal with and that you may prosper in your Practise discharge your duty as well to the Poor as Rich. Have a great care whom you lay in your Houses for fear of encouraging naughty Women Lastly I would advise you not to be dismay'd if every thing in your practise fall not out just at the very instance of your expectation you performing your part but expect the event with patience for fear disorders the Senses and Persons that keep their wits together without suffering them to be scattered thereby are capable of Counselling in the most weighty Affairs And now I shall no longer detain you in the Porch but desire you will forthwith be pleased to walk into the Palace where I question not but you will find wherewith to satisfie your Curiosity in what concerns the premisses and so wishing you all the Prosperity imaginable I bid you Adieu THE Contents of the Sections SEct. 1. Of the True generation of the Parts and Increase of the Infant in the Womb according to the days and times till the time of the Birth p. 1 Sect. 2. Of the signs of Conception and whether the Child thrive in the Womb. p. 11 Sect. 3. Of the Nutriment of the Child in the Womb and by what nourishment it is preserved and when it groweth up to be an Infant p. 16 Sect. 2. How the Infant doth in the Womb the fifth the sixth the seventh and eighth month and of the due time and form of the Birth and causes of pain in Child-birth p. 20 Sect. 5. Rules for Child-bearing Women and how to prevent Abortion p. 28 Sect. 6. A Dialogue between the Midwife and the Doctor concerning Midwives and the delivery of Women in Child-birth p. 33 Sect. 7. Of the several natural situations of the Infant in the Mothers Womb according to the different times of Child-bearing p. 39 Sect. 8. Of difficult Births whether they proceed from Causes external or internal p. 42 Sect. 9. Of the Fashions and Figures of the Birth and how Children are born and may be born p. 50 Sect. 10. Figure the first Of unnatural Births p. 52 Sect. 11. Figure the Second p. 58 Sect. 12. Figure the Third p. 62 Sect. 13. Figure the Fourth p. 64 Sect. 14. Figure the Fifth p. 66 Sect. 15. Figure the Sixth p. 68 Sect. 16. Figure the Seventh p. 74 Sect. 17. Figure the Eighth p. 78 Sect. 18. Figure the Ninth p. 81 Sect. 19. Figure the Tenth p. 83 Sect. 20. Figure the Eleventh p. 85 Sect. 21. Figure the Twelfth p. 87 Sect. 22. Of a Birth wherein the Infant presents the Belly p. 89 Sect. 23. How to help a Woman in her Labor when the Child's Head thrusts the Neck of the the Womb forth before it p. 92 Sect. 24. How to deliver a Woman when the Child presents the side of the Head to the birth or its Face p. 95 Sect. 25. How to deliver a Woman when the Childs Head is born and the Womb closeth about its Neck p. 99 Sect. 26. When the Navil-string comes first p. 102 Sect. 27. Wherein the Burthen either first offers it self or comes first quite forth p. 107 Sect. 28. Figure the Thirteenth p. 112 Sect. 29. Figure the Fourteenth p. 115 Sect. 30. Figure the Fifteenth p. 117 Sect. 31. Figure the Sixteenth p. 123 Sect. 32. Of delivering of a Woman of a dead Child p. 129 Sect. 33. Of the extracting of a mola and false Conception p. 136 Sect. 34. Of the Secundine or After-burden and the best and safest way to draw it forth p. 151 PART II. Of Diseases happening to Big-Belly'd Women before Child-Birth SEct. 1. Of Barrenness and the several kinds thereof p. 177 Sect. 2. Of Superfaetation p. 195 Sect. 3. Of Vomitings of Women with Child p. 201 Sect. 4. Of the pains of the Back Loins Reins and Hips p. 206 Sect. 5. Of the pains of the Breasts p. 209 Sect. 6. Of involuntary voiding and stopping of Vrine p. 211 Sect. 7. Of a Cough and difficult breathing p. 214 Sect. 8. Of the swelling and pains of the Thighs and Legs p. 218 Sect. 9. Of the Hemorrhoids p. 221 Sect. 10. Of the several Flaxes happening to Women with Child p. 224 Sect. 11. Of Fluddings p. 229 Sect. 12. Of the Weight of the Womb c. p. 233 Sect. 13. Of the Dropsie of the Womb c. p. 235 Sect. 14. Of Abortion and its causes p. 238 PART III. Of Diseases and Symptoms happening to Women after Child-birth SEct. 1. Of Remedies for the Breasts and lower parts of the Belly of Women newly delivered and how to drive back the Milk p. 241 Sect. 2. Of Fludding after Child-Birth p. 244 Sect. 3. Of the bearing down and falling out of the Womb and Fundament of
in the Womb near the time of Travel H How the umbilical vessels are inserted into the Navil of the Infant SECT VII Of the several natural situations of the Infant in the Mothers Womb according to the different times of Child-bearing WHen the Woman is young with Child the little creature call'd the Embryo is always of a round Figure a little longish having the back-bone moderately turn'd inwards the thighs folded and a little raised to which the legs are so joined that the heels touch the buttocks the arms are bending and the hands placed upon the knees towards which the head is inclining forwards so that the chin toucheth the breast In this posture it resembles one sitting to void his excrements and stooping down his head to see what comes from him It s back bone is at that time placed towards the Mothers the head uppermost the face forward and the feet downward and proportionably to its growth it extends its members by little and little which were exactly folded in the first Month This posture it usually keeps till the 7th or 8th month at which time the head being grown big is carryed downwards by its weight towards the inward orifice of the Womb tumbling as it were over its head so that then the Feet are uppermost and the Face towards the Mothers great gut when the posture happens otherwise 't is unnatural and both Male and Female lie thus because the Child's face coming upwards will be extreamly bruised and its Nose wholy flatted because of the bones hardness in the passage Note further when the Child hath changed its first Situation being not yet accustomed to this last it stirs and torments it self so much sometimes that the woman by reason of the pain she feels is apt to believe she is in labor and if this circumstance be well consider'd you will find it to be that first pretended indeavour which Authors imagine the Child makes to be born the 7th month and not being able to accomplish it it stays till the 9th c. But this is a great mistake for if the Child turns it self so with the head downwards or rather is turned it is but by a natural disposition of the weight of the upper parts of the body and if it stir much at that time and soon after it is not from a desire to be born but from the inconvenience it receives from this new posture to which it was not before accustomed and it begins to turn thus sometimes from the 7th month rarely before but by accident often about the 8th and sometimes the 9th only and at other times also it doth not turn at all as we may easily perceive in those that come in their first Situation that is with their Feet foremost When there are many Children they ought to come in the same Figure if it be a natural Birth as when there is but one but usually by their different motions they incommode one another that for the most part one presents wrong in time of labour yea and before which is the cause that one comes often with the head the other with the feet or some worse posture and sometimes both come wrong However the Infant may be settled in the Mothers belly or in whatever fashion it represents it self at the birth if it be not according to the posture before said it is always against nature SECT VIII Of difficult births whether they proceed from Causes external or internal DIfficult births from external causes may be either first from excessive heat dissolving the strength of the women or secondly excessive cold condensing the womb or thirdly from sweet things often applied to the nostrils of the woman that by smelling to sweet things she may recover her strength and faintings for sweet smells do attract the womb upwards and so render the birth more difficult Difficult birth from internal causes may be either first from the woman secondly from the womb thirdly from the infant fourthly from the membranes of the womb 1. From the woman as when she is too angry too fearful or too modest or if she be in age above 40 years from whence the muscles of the womb may be concluded to be dry and so the less extenfible or when she is so thick and fat that the passages be narrow Or 2. From the womb it self as when it is so small and nature so weak and feeble that it cannot expell the birth Or if there be any inflammation or unnatural affect in the privities be it the stone or piles or extraordinary costiveness all which may so compress the womb with their weight that it cannot expel the birth 3. Is from the infant it self as if it be of an unusual bigness of a great head or a monstrous birth hydropical full of wind dead in the womb or lying there in a posture beyond nature as when it comes overthwart with the feet forward and not the head or if the thigh before the head 4. From the membranes of the womb as when they are so forcibly broken by the child in the womb that the moysture floweth thence leaving the infant behind that when the child should come forth that moysture faileth and so the membranes being dryer maketh the birth the more difficult or when it is firm and solid that it is broken with much difficulty and so makes the labour the harder And here we cannot but take notice how those Authors who have not the perfect knowledge of the parts of a Womans body attained to by Anatomy do admire and cannot as they say conceive how it is possible that an Infant so big can pass in time of labour through an opening of the Womb so small some of them being of opinion that the Womans share-bone is seperated at that time to enlarge the passage without which it would be impossible for the Infant to have room enough to be born and therefore Women that are a little antiquated suffer in their first labors more than others because their share-bone cannot so easily be seperated which often kills their Children in their passage others again are of opinion that it is the flank-bone which is disjointed from the hoop-bone for the same purpose and say both the one and the other of them viz. That these bones thus separated at the hour of labor are thereto so disposed by degrees a little before by the fly my humors which flow forth from about the Womb and then mollifie the grisles and cords which at other times join them firmly together But both these opinions are as different from truth as reason for Anatomy convinceth us clearly that the Womb by no means toucheth these places whereby to moisten and soften them by its humors as likewise that these bones are so joined by the gristle that it is very difficult to seperate them with a knife especially the flank-bone from the hoop-bone and almost impossible in some elderly Women without great violence although Ambrose Parry a most
Bed-pan and sometimes when they have least expected it At the same time to prevent a Feaver or many other accidents which usually happen she may be let blood in the Arm or Foot according as it shall be convenient and strengthen'd that the cadaverous vapors coming from the putrifaction of the burthen ascend not to the heart and noble parts which must be done by good cordials often used not such as are made of Treacle and Methridate c. for which no reason can be given but their specific or rather imaginary Faculties and are fitter to cause vomiting then comfort the heart But with true Cordials which are such as yield good nourishment and at the same time comfort the stomach without offending it as those drugs do which are only good for those that sell them Wherefore I must order her good broths and gellies and to drink Orengade or Limonade or to put some Syrup of Lemons in her refreshing Liquors or if she be free from a Feaver a little wine and water mixed which is the best and most natural of all Cordials Besides other remedies must be provided according to the accidents that happen by reason of the staying behind of the burthen always remembring to bring it away as soon as possible for as long as it stays in the Womb the woman feels great pains continually almost like them before her Child was born and until the whole be voided the pains will still be repeated although in vain unless the matter be well disposed before but the lesser the piece is of the retained burthen the more difficult 't is many times to be expelled because the impulse the woman can make by helping her throws are not so great when the matter contained in the Womb is small as when 't is of a considerable bigness for then 't is more strongly thrust and compress'd which is the reason why a woman miscarries with greater difficulty then when brought to bed at her full time And here you must know there are divers Midwifes who having broken the Navil-string as before said leave their work imperfect and commit the rest to nature's work but very often the poor woman dyes because of the great mischiefs which usually happen before the suppuration of the burthen so retained The which to avoid when they meet with the like case I would advise them to fetch it away as I have directed or if they find themselves uncapable to do it because the hand must be put up into the Womb which is more properly the work of a Physitian or Chyrurgion expert in those cases then let them immediately send for one that so he may be able before the Womb closeth to introduce his hand for the longer 't is deferr'd the more difficult will the work be Dr. Hitherto very well Mrs. Eutrap have you exprest your knowledge and experience in your Art even from the first generation and formation of the Child in the Womb to the bringing of it safely forth into the world But yet good Mrs. Eutrapelia there are divers Women that will many times be asking you your advice concerning other distempers that usually attend them both before Child-birth as Barreness c. and also after they are delivered of their Child both inward and outward because their modesty prompts them rather to come to you than to the Physitian or Chyrurgion therefore I would have you to let me know how far your skill and knowledge extends as to these matters because that if you should at any time be mistaken in your measures in the cure of any of those diseases I shall freely and candidly assist you with the best of my directions to set all right and streight as they say and in good order Mid. Honoured Sir I am so extreamly oblig'd to you for this kind offer that I know not which way to express my acknowledgment and I shall most readily answer your request and therefore shall first begin with a discourse of Barrenness PART II. SECT I. Of Barrenness and the several kinds thereof MId BArrenness is 1. Natural 2. Vnnatural 3. Accidental Natural is when the instrument of Generation being perfect in both Sexes no unlawful or unskilful means used to cause it yet the Woman remains naturally Barren neither Age or Diseases or natural defect hindring yet she Conceives not The reason of this may be 1. When both Sexes are of a Complexion 2. Want of Love a 3d may be the letting Virgins blood i' th Arm before their Courses come down or other ill administration of internal and external remedies 4. A loss of carnal Copulation when Sexes come to the School of Venus either not at all or so coldly that as good never a whit as nere the better and this is from a cold Distemper and is cured by such things as heat and nourish 2. Unnatural that is diabolical to prevent which Authors have left several ways as to carry the Herb St. Johns wort about them which is call'd a driver away of Devils or a Plaister thereof applied to the Reins with many others 3. Accidental which comes by some casual infirmity upon the body of either Sex at a time the which being taken away the effect ceaseth 't is sometimes from the Man but most commonly from the Woman for Mans instruments of Generation being perfect and he in health I know no accidental cause in him And the chief cause in Women lyes in her Womb as the stopping of the flowers or overflowing the Flux of the Womb its falling down inflamation windiness heat and dryness in all which I shall be brief because if there be difficulty you are to have recourse to the learned Physitian 1. Then the Terms stop 1. Naturally 2. Vnnaturally they stop naturally in some about the 50th year in some before rarely till 55. the unnatural cause is 1. much exercise 2. in fat Women the Veins are narrow and blood turns to fat 3. by long sickness 4. when they have the piles in lieu of their Terms 5. a hot or cold distemper of the Womb 6. care fear grief c. I shall speak here only of the 5th for causes of the last being taken away the effect ceases and the rest the ingenious Midwife will remedy Now seeing these stoppings come usually from default of the Womb the best way to help it is by strengthening the Womb first then you shall prepare your way if there be occasion let blood i' th the foot if she be not full of humors if she be then in the Arm first which I have most commonly known to do alone then if need be give her a draught of White-wine wherein an handful of Centaury or stinking Arach hath been boiled and if there be a pain in the head add an handful of Verven or some Parcely roots Fennel or Lowage c. not forgetting in fulness of humors to purge with half a dram of Extractum Rudii and as much Pil. Mastichinae mixt made into 12 Pills whereof take 3 at
of the World and than which there can hardly happen a greater defamation to the Female Sex Insomuch as some like Rachel have cry'd out to their Husbands for Children or else their Lives will lye on 't rather than endure the reproach of Barrenness and some Women have preferr'd their maids to their Husbands so that their Child might be reputed theirs to take away the blemish of Barrenness But you shall find but few Women of their minds now a days so then we shall in the first place speak of the causes of this so odious and distateful a Disease and then of their removing for you know 't is an old saying and true take away the cause and the effect will consequently cease Now the chief method of finding out all causes which do or may bring damage to the faculties of the body is no other then the knowledge of the means whereby these faculties perform their Actions in the time of health and soundness of body And whereas to the producing of any natural Conception there is a necessity of distinction of both Sexes and a conjunction and carnal Copulation of the Man and Woman without which no Generation can be effected As for that story of a certain Maids conceiving with Child by standing in a Bath where some Mans seed had been cast the Womb drawing it to it as the Load-stone doth Iron or Jet straw it was either a miracle in Nature or she so gave out to save her bacon and so no ways belongs to our purpose and having before declared the manner in other Sect. Therefore we shall here lay down the manifest causes of Barrenness from either Sex so that neither may be unjustly blamed where they happen for since the Women have in this case a great interest and damage too if the fault be in the Man because they may often help their Husbands defect and in so doing pleasure themselves we shall not therefore omit to treat of the causes thereof which may happen to men and moreover there being a necessity that both Sexes be furnished with fit and proper Instruments for the work of Generation as the man with a Yard c. and a Woman with a Womb c. Then even reason will tell you that if there chance to be any defect or dissaffection in nature in any of the Members of either Sex belonging to this work of Generation the fruitfulness or Conception must necessarily be hindred impaired or quite and clear abolished To begin then first with what belongs to the Mans side one cause of Barrenness laid down by many Authors is the over-much length of the Yard by reason whereof the Seed is too much cooled in the passage before it can be injected home into the Womb. But though this be a somewhat probable and plausable reason yet I am of opinion that it is but weak and will not hold water with those of greater reason for all Souls are not endued with a like proportion of reason for the Seed passing through the pipe of the Yard is kept hot enough the generative Spirits at that time oft flocking to the Yard to assist it in so great a work and the like being performed on the Woman's part I cannot see how it can be any ways possible it should take cold in its journey but on the contrary side it may be rationally imagin'd that the long Yard is most fit and commodious for Conception by sending Seed to the inmost and furthermost parts of the Womb and so most likely to be there retained its due time And now others on the contrary side will have the short Yard the cause of rendring Men unfruitful and these I think have more reason on their side because it cannot so well inject the Seed into the Womb as you heard before But indeed neither can this be a firm reason for unfruitfulness in Man since 't is confirmed by experience that such an one hath begot Children likewise But a greater reason of unfruitfulness in the man may be some vitiousness or defect in his Yard as if it be crooked or if any of its Ligaments be writhed or broken or bruised whereby the passages through which the seed should flow be corrupt stop'd or vitiated or some Disease or imperfection be either in the proper or Neighbor parts thereof Another cause of Barrenness by defect of the Yard is a too much weakness and tenderness thereof it being not strongly enough erected to inject the Seed into the Womb. Then another cause in Men may be some vice in the Stones as if they be oppressed with any Inflammation or swelling or wound or ulcer Also the Man may be Barren from his want of Seed or if it be nought as in the Running of the Reins or Venereal Disease Glutony or Drunkenness c. and then too frequent Carnal Copulation is a cause of Barrenness because it attracteth the Seedy moisture from the Stones before 't is sufficiently prepared and concocted as all other members of the body by institution of nature use to draw their accustomed juice to themselves so now if any one by daily Copulation draws out all the moisture of his Seed then do the Stones draw the moist humors from the upper Veins to themselves and so having but a little blood in them they are forced of necessity to cast it out raw and thus the stones being deprived of the moisture of their veins draw the same from the upper veins and the upper veins from all the parts of the body for their proper nutriment to the great damage of the body robbing the same of the vital Spirits It is therefore no wonder if those that use immoderate Copulation are very weak in their bodies seeing the whole body is thereby depriv'd of its best and purest blood and vital Spirits insomuch as those that have been too much addicted to that pleasure have killed themselves in the Act can it then be a wonder that such Seed is not fit for Generation And having now shewn the causes of Barrenness in Men we shall now discourse of those in Women Now the causes of Barrenness in Women proceed either from the Age or evil temper of the Womb and its vicious conformation and parts depending on it or the indisposition of the whole habit of the body The evil form of the womb renders Women barren according to the great Hippocrates the Prince of all Physitians as if the mouth or neck of the Womb be turned backwards towards the great Gut or a side out of its place contrary from the Privities if it appear too big or if it be fallen down before the Privities to which may be added when 't is so narrow that it cannot admit the Yard to enter and when 't is wholly or in part closed by some inward or outward skin which is very rare if at all or by a swelling collosity or cicatrice c. But then it is not sufficient that the Mans Yard enter the Neck which is the
with juice of Oranges or Lemons Verjuice or rose vinegar or eat after Meals a little Marmelade of Quinces and she must forbear fat meat and sauces for they soften the Skins of the Stomach which are weak and loose by vomitings and also sweet sauces But if for all this that it continues although the Woman be above half gone 't is a clear sign there are cleave corrupt humors to the inward sides of the Stomach which must be purged by stool to effect which give half a dram of Rhubard a dram or two at most of Sena infuss'd in posset-Ale to which streined add an ounce of Syrup of Succory which dissolves the humors and in voiding them comforts the parts or you may give her Cassia and Tamarinds always adding a little Rhubarb or syrup of Succory compound If once be not enough repeat it some few days respite between If it continues for all this you must rest here lest some worse thing happen for she is then in great danger of miscarrying and if the Hiccoup takes them from too much emptiness by vomiting and purging 't is very bad as Hippocrates Prince and oracle of Physick teacheth us As for great Cupping-glasses which some advice to be applied to the Stomach to keep it in its place I believe it 's a chip in Potage because the Stomach is loose and no way cleaving to this upper part of the Belly But since these vomitings cool and weaken it I should advise them to wear a piece of Scarlet or Flannel or Lamb-skin which would help digestion SECT IV. Of the pains of the Back Loins Reins and Hips ALL these Accidents are but the effects of the widening of the Womb and the compression it makes on the Neighboring parts by its weight These are greater the first time she is with Child for afterwards the Womb only receives the same dimensions it had before and the cords which hold it in its natural place as well round as large suffer a greater stress being much drawn and streightned by the bigness and weight of the Womb to wit the large ones those of the Back and Loins which answer to the Reins because these two strings are strongly fast'ned towards these parts and the round ones cause those of the Groins Share and Thighs where they end These are sometimes so much stretch'd by this weight and higness of the Womb that they are torn chiefly if the Woman chance to have a false step which causes very great pains and other worse accidents as it happened to a certain Woman being six months gone of her first Child who felt the like after she had stumbled and perceived at the same time something crack towards her Reins and Loins which was one of the large cords made a noise by the suddain jolt she receiv'd at the same instant she felt extream pains in her Reins and Loins and all one side of her belly which caused her immediately to vomit very often with much violence and the next day was taken with a great continued Feaver which lasted seven or eight days without being able to sleep or rest one hour all that time she vomited all she took with a strong and frequent Hiccoup and great pains which seem'd as if they would hasten her Labor which I was very apprehensive of as also of her death but by the help of God causing her immediately to be put to Bed where she rested 12 whole days she was thrice let blood in her Arm on several days and took a grain of Laudanum at twice in the yelk of an Egg a little to ease her violent pains by giving her rest taking also from time to time good strengthening Cordials so that all these Symptoms which at first seemed desperate ceased by little and little and she went out her full time and then was happily delivered of a Son which lived 15 months notwithstanding all those mischievours accidents befel her which were enough to have kil'd half a dozen others but God sometimes is pleased to work Miracles by nature assisted with remedies fit for the purpose as well as by his Grace And also the Womb causeth the pains of the Hips by its weight in bearing too much upon them And assure your selves there is nothing will ease all these pains better then to rest in Bed and bleed i' th Arm if there be any great extension or breaking of any cord of the Womb as was in this case and when the Womb bears too much upon the Hips if she cannot keep her Bed she must support her Belly with a broad swaith SECT V. Of the pains of the Breasts AS soon as a Woman conceives her monthly blood wanting ordinary evatuation and she daily breeding blood there is a necessity she consuming but little whilst first with Child that the Vessels being too full should discharge part as it doth upon the parts dispos'd to receive it such as the kernelly parts especially the Breasts which suck up a great quantity of it which swelling them causes this pain which she feels and happens also to those whose Terms are only stop'd To ease her we ought in the beginning to leave it to Nature the chief Physitian and she must only have a care she receive no blows thereon nor be streight laced but after the third or fourth month the blood being still sent to the Breasts in great store 't is much better to evacuate it by bleeding in the Arm then to turn it back upon some other part by repercussive or binding Medicines because it cannot flow to any part where it can do less hurt than these and to shun the accident oâ— which Hippocrates speaks in his 40th Aphorism of the 5th book If Blood be carried in too great abundance to the Breasts it shews thâ— Woman is in danger of being Frantick because of the transport which may be madâ— thence of the brain whcih is voided by moderate bleeding i' th Arm and a regular cooling dyet moderately nourishing SECT VI. Of involuntary voiding and stoping of Urine THE seat of the Bladder which is just upon the Womb is sufficient to instruct us why Women with Child are sometimes troubled with difficulty of Urine and why often they cannot hold their water which is caused 2 ways 1. because the Womb by its bigness and weight presses the bladder so that 't is hindred from its ordinary extension and so incapable of containing a reasonable quantity of Urine which is the cause the bigger she grows and the nearer her time the oftner she's compelled to make water 2. if the weighty burthen of the Womb doth very much press the bottom of the bladder it forceth the Woman to make water every moment but if the neck of it be pressed it is fil'd full with Urine being not able to expel it because the Sphincter Muscle in this compression cannot be opened to let it out which causes great pain Sometimes by its sharpness stirs up the bladder often by pricking it to discharge it self and
cur'd of this bearing down after she 's layd than before for then the Cords will be easier strengthen'd and she may then use pessaries which she cannot so well with Child The help for this from any cause is to keep her Bed or swaith her and if she have difficulty in urining help her self by lifting up her belly with both hands but if humors cause this let her keep a drying dyet as Rost-meat c. and refrain Copulation streight lacing and above all when in Labor take care that neither by throws nor birth of the Child nor violent drawing the burthen that she get not a falling out of the Womb instead of a bearing down or weight which is soon done if the method taught in the birth of a Child when its Head thrusts the Neck of the Womb forth before it be not well observed SECT XIII Of the Dropsie of the Womb c. THese waters are either bred in the Womb or brought thither from some other parts as in the Dropsie of the belly it passes by traâ—sudation through the porous substance of the Skins of the Womb and these have deceived the Midwifes as well as patients who having along time hoped and been made to hope for a Child at length find nothing but waters whereof some have voided a pailful of which are many relations by Physitians and Chirurgeons These are bred i' th Womb when 't is too cold or weakned by a violent Labor before or from suppression of filthy humors When these are sent to the Womb from other parts they are never wrapt in a particular skin but retain'd only by its exact closure and flow away as soon as it begins to open but when bred in the Womb which is for the most part after Copulation if the seed be too cold waterish or corrupt they are then sometimes contained within the Skin which hinder the patients from a speedy discharge of them She going with it almost as long as with a Child and this is it perswades them they are with Child But 't is easie to avoid being deceiv'd if you take notice of the Signs of a true Conception for in a Dropsie her brests are fallen have no Milk nor finds her self quicken at the usual time but a bubling of moved waters a greater weight in her Belly and more equal the Womb Hips Thighs and Legs swell and worse Colour in her Face and as it may come alone so it may accompany a true Conception the waters being contained in the Womb without the Childs Skin Some have voided 3 or 4 quarts above 2 months before they were brought to Bed and then they are contained in the Womb without the Skins or else the Child would be forc'd to be born presently after they are voided The best Remedy is to wait patiently the time of delivery observing a dry dyet but if 't is only contained in the Womb use diuretics and endeavour to procure her Courses and to destroy by purges the cause of the Generation of such superfluities of which the Womb is so full sometimes that it dischargeth some on the outward parts and chiefly the nearest as the Lips of the Privities which are so swell'd that they are quite blown up and in some are so big that they can't close their Thighs and hinders walking now because this may be inconvenient to her during Labor it will be requisite to remedy it before which must be done by a Lancet all along the Lips then applying compresses dipt in astringent wine Leeches though less painful are not so proper because their small Orifices close again as soon as remov'd but the other may be made as big or little as one will and kept open by ointment as long as is fit SECT XIV Of Abortion and its causes WHen a Woman Sir i' th beginning casts forth what she had retain'd by Conception 't is an Effiuxion of the Seed if a false Conception 't is an Expulsion but when the infant's form'd and begins to live if it come before time ordain'd by Nature 't is an Abortion and we say in general that every sharp Disease easily causes it in particular all the accidents before mentioned as also a great noise as Cannon of Thunder claps watching fasting stinks c. if she Miscarries without any of these accidents Hippocrates says any Woman indifferently corpulent miscarrying the 2d or 3d month without manifest cause 't is because the inward closers of the Womb's Vessels are full of viscous filth whereby they cant retain the weight of the fetus which is loosned from it to this are Phlegmatic Women Subject and who have the whites much which make the Womb slippery and loose Likewise the passions of the mind cause great hurt chiefly Choler but above all sudden fear There are other causes which may be said to proceed from the Infant as when its monstrous or hath an unnatural Situation If we find one or more of the said accidents and she hath a great heaviness in her belly falling like a ball on that side she turns and there comes stinking humors from her 't is a sign she will miscarry of a dead Child Now she is in more danger of her Life when she miscarries then at full time and in danger of miscarrying always if she miscarry at first because of the violent motion caused by frequent Copulation but they may preserve their fruit when their love is a little moderated We have taught before to prevent each accident Who are subject to Abortion must rest or keep in Bed refrein Copulation 〈◊〉 soon as she thinks she 's with Child avoiding diuretics and openers and be loose drest wear low-heel'd Shoos with broad Soals Her rest must be 5 or 6 or 9 or 15 days during which time may be applied to her belly compresses steep'd in Aromatic and Astringent Wine Some Midwifes giving Crimson silk minc'd small in the yelk of an Egg or Scarlet grains and Treddles of several Eggs put into a yelk is superstitious as if entring the Stomach it were able to fortifie the Womb and Child and keep it there PART III. Of Diseases and Symptoms happening to Women after Child-birth SECT I. Of Remedies for the Brests and lower parts of the Belly of Women newly delivered and how to draw back the Milk Mid. AS soon Sir as the Woman is deliver'd and burthen come away I see that a fludding follow not its loosening if not apply presently a soft closure 5 or 6 double to the Womb that done carry her to Bed removing all foul Linnen a little raising her Head and Body putting down her Legs and Thighs with a small pillow if she will under her hands lying on her back Then the best thing under the Sun to give her is a good broth and so leave her to sleep waking apply this pultis over the bottom of her Belly and Privities take 2 ounces of Oil of Sweet Almonds 2 or 3 new laid Eggs stir them together in a pipkin over hot Embers
and no longer possessing the Womb and so fetch away the Child by the Feet For indeed although it be certain that the Child be quite dead in the Womb and other circumstances that will demonstrate that there is need of a Physitian or Surgeons Art yet he must not therefore presently use his crotchets 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 away the Child any other way for very often though all hath been done that art directs some persons present that understand not these things will believe that the Child was kill'd with the crotches although it had been dead 3 days before and without other reasonings and better understanding of the matter for his recompence in saving the life of the Mother requite him with an accusation of which he is altogether innocent and in case the Mother should afterwards dye by misfortune lay her death also to his charge and instead of praise and thanks treat him like a Butcher or Hangman to which divers Midwifes are commonly very ready to contribute and are the first that make the poor Women that have need of the Men afraid of them Insomuch that they are afraid of being blamed by them for having themselves been the cause as some of them often are of the death of Infants and many ill accidents which often befall the poor Women for not causing them to be helped in due time and from the very instant that they perceive the difficulty of the labor to pass their understandings I speak this by way of caution on both sides Now therefore for the Physitian or Chirurgion to avoid these calumnies let him never use his crotchets but very rarely when there is no other way as also to endeavor his utmost as much as the case will permit to bring the Child whole into the World although it be dead and not by bits and peice-meals to give the ignorant not any pretence of blame I say as much as the case will permit that is with respect to the Woman under his hands for to save her he had better sometimes to bring forth the Child with Instruments then to kill her by tormenting her with excessive violence to bring it forth whole for in a word he must and ought to do in his conscience what his Art commands without taking heed to what may be spoken afterwards and every Physitian or Chirurgion that hath a well regulated conscience will always have a greater regard to his duty then his reputation in such a case in performing of which let him expect his reward from God SECT XXXII Of the extracting of a mola and false conception DR We have hitherto Mrs. Eutrapelia discoursed of births natural and unnatural there is somewhat more not like these but often with them and without them which Physitians call a Mola but you call it a false Conception I pray Mrs. therefore what is that Mola or false Conception Mid. A Mola Sir is a hard inform tumorfull of pores like so many ugly eyes scarce to be cut by a knife of a stony substance to touch and round appearing sometimes at the entrance of the Womb sometimes over the whole Womb and is thought by very Learned Doctors to be begotten by the woman her self without the help of a man though some affirm it cannot be without the seed of the man and therefore inanimate because not generated by two without the help of a man I say by the force of her own seed mixing it self with much menstruous blood reteined in the Womb which by immoderate heat is changeth into the shape of flesh and that altogether unnatural as is the stone in the bladder and in the fingers of gouty persons c. Dr. Well Mrs since 't is so tell me I pray wherein it differs from a true Conception Mid. It may Sir be like a true Conception in three respects yet differ in six As first 'T is true that a false conception stoppeth the monthly terms as doth the true Secondly The belly also doth swell and the breasts grow big Thirdly There is an alteration both in the color and appetite but yet they differ in these six following ways as First A false conception hath no ordinary nor periodical motion neither doth it stir from side to side except it be pressed Secondly In a false conception the belly is harder and the feet are much more swelled Thirdly The woman is more heavy and unweeldy and not so nimble as with a true conception Fourthly The breasts swell not so much as in a true conception Fifthly The whole body grows soft and consumes away in a false conception Sixthly a false conception may be moved in three months but the Child stirreth not till after three months or usually in the fourth month And again the birth of an Infant never exceeds the eleventh month whereas a false conception may continue for fourteen years or as long as they live Moreover there may be a Tympany caused by air included in the Womb. Or else there may be a Dropsie by reason of the many humors contained in the Womb both which may give a false supposition of being with Child but these also are easily distinguish'd from a false conception A Tympany may be moved from place to place but not the other A Tympany will sound if lightly strucken but not the other and a Dropsie caused by those many humors as aforesaid will shew some marks being depressed with the fingers whereas a Mola is hard and yieldeth not to the pulsation or depression of the fingers And lastly in both these most commonly the Thighs swell but in a false conception or Mola the Thighs wither and are lesser Dr. Thus far have you extreamly ingeniously Mrs. Eutrapelia exprest your self concerning a Mola and now you have done I pray you give me leave to lay you down my sentiments concerning both a Mola and a false conception and the safest and best way to draw them forth of the Womb with safety First of all then Mrs. you must know that there are several sorts of great bellies belonging to Women as hath been said before there are your natural big bellies which contain a living Child and those may be called true ones and others unnatural or against nature in which in lieu of a Child is engendred nothing but strange matters as wind mixed with waters which may be called dropsies of the Womb and false conceptions and Moles or Membranes full of blood and corrupted seed for which reason they are called false great bellies Now you must know that among the signs of a true great belly one is the stirring of the Child in the Womb but here you are to observe that it is very fit we should be always careful not to be deceived by what we feel to stir in the Womb inasmuch as the Infant of it self is endued with 2 sorts of motions in its Mothers
Night going to bed or after her first sleep 2. The Terms overflow 1. when they continue longer then their usual time which is 2 or 3 days in Women that use no exercise 4 or 5 days 2. when they come oftner then once a month the cause is 1. a Rupture of some Vessel 2. immoderate purgation 3. some corroding humor 4. hard Labor in Child-bed or unkind handing the Womb if the Vessels be broken blood gusheth out in heaps and if from some knawing humor they are few but very painful the rest are easily known Let them abstain from exercise then 1. anoint the reins with Oil of Roses Myrtles or Quinces then boil the roots of Tormentil Cinquefoil Yarrow Knot-grass Comfrey dead Nettles Solomon's Seal Purslan Shepherds-purse red Roses acorn Cups bark of Oak Trees some of these in her ordinary drink or the juices of what can be had taken alone and this above all take Comfrey leaves or roots and Clowns alheal of each an handful bruise and boil them well in Ale and drink of it now and then this will do though the Vessels were open 3. Flux of the Womb is a continual droping from that part of the body if it be red like putrified blood it comes from that humor if white and pale 't is from Phlegm if yellow 't is from Choler if pure blood as if a vein were opened either a knawing of the Womb or tearing in delivery is feared The cure differs as the cause if pure blood flow let blood i' th arm then use the Medicine last mentioned of Comfrey roots and Woundworth if flegm be the cause use Cinnamon in all meats and drinks and Methridate and Treacle for Antidotes a little every Morning take a scruple of Pills of Amber going to Bed for divers Nights if from Choler purge with syrup of Violets and Cassia Fistularis of each an ounce after take powder of Ivory and Missleto of the oak of each one scruple mixt with half an ounce of conserve of Roses every Morning for a Week if from putrified blood having first let blood i' th Foot then strengthen the Womb as before always forbearing violent motions and passions and sharp and salt meats and provokers of Urine for dead Nettles there are three sorts white red and yellow the flowers of that colour the white help the white the red the red the yellow the yellow flux 4. The Womb fallen out is cured if it be swell'd by bathing it with a decoction of Mallows Linseed and Fennigreek boil'd in water 2 or 3 times and when 't is got up let her keep her Legs close or else tye them with a swath apply stinking things to the Womb as Assa Foetida oil of Amber her own Hair burnt and let her smell of Civet c. the rest is before and after 5. The Womb is inflamed by many causes a blow stopping of the Terms Abortion Ulceration Immoderate Lechery overmuch walking cold For cure strengthen the Womb first then first clarifie Whey and boil Plantain leaves or roots in it and drink it then inject the juice of Plantain into the Womb with a Syringe if in Winter when you cannot get the juice make a strong decoction of the leaves and roots in water if the body be costive use a Clyster and here note that in all Inflammations blood-letting is the chiefest remedy first i' th Arm then if need i' th Foot if it be near the Neck of the Womb make a pessary of wool and anoint it with unguent album or populeon or mixt 6. The Womb is sometimes troubled with wind which is cured as the fits of the Mother and moistness of the Womb is cured as a flux of flegm 7. Heat and dryness of the Womb is incident to Women of a Cholerick complexion is cured by cool and moistning herbs of which stinking Arach is chief neither are Plantan and Mallows much behind milk is good for such to drink first purging with an ounce of Cassia Fistula new drawn going to bed and follow your business the next day Dr. Thus far good Mrs. Eutrap but now hear me a little concerning this matter All rational men know that the generation of mankind as also of other irrational Animals is the most perfect excellent and exquisite work of God's Vicegerent Nature the which is most excellently and elegantly demonstrated and set forth by Aristotle that great Secretary of Nature in his second Book which he hath written of the Generation of living Creatures for whereas it is impossible by the decree of Nature that any humane Creature should live always or have an immortal Being in this World much less should we imagine that should be granted to Bruits and other Souls of an inferior rank therefore for the continuance and propagation of each sort it hath otherwise ordained that during the continuance of this World there should be likewise maintained a successive generation of both Sexes by the Action of procreation and from hence after him Galen the greatest Luminary of Physick next Hippocrates says that it comes to pass that Creatures are furnished with Instruments of Generation proper for the quality of their Sex and are consequently indued with natural Instincts prompting them to the use thereof Therefore we shall at this time discourse of this wonderful operation of Nature and endeavour as far forth as our Talent will afford us to seek out the causes that may hinder and from thence prescribe means to remove them and so consequently assist and further her in so miraculous a concern and this partly upon our Dame nature's account whose Servants only we are and in the next place for the sakes of those Ladies Gentlewomen and others who are often disconsolate and dejected upon their being accounted barren Now then you must note that as conception hath some alliance with every part of the Body as being undoubtedly concern'd therein so the same Conception may be quite abolished diminished or deprived as it happens in all other actions and motions of the body so that if Conception be quite abolish'd in a Woman in such sort that she can never be able to conceive this affection is then called Barrenness or such a Woman may be called a barren Woman which you please But if she Conceive sometimes though seldome here the Conceptive faculties may be said to be diminished or weakened by some cause or other and to this kind of diminished Conception may be referr'd untimely births called Abortion And lastly a depraved Conception is when in the Womb is contained some unnatural Conception such as Monsters and Mola's c. The causes and remedies of all which it hath and shall be our duty to lay open to the Females Sex according to the best of our skil and knowledge first to the end we may further the propagation of humane kind and secondly that we make if possibly remove the reproaches laid upon Barrenness which hath been in all ages and continues to this day and will do to end
thrust back but contrarywise be fetch'd away and at that very moment after bring the Child away by the Feet although it came naturally with the Head first for what reason can there be to put it back since it is of no use to the Infant from the moment it is separated from the Womb as cannot be denied And such a proceeding is so far from being useful that this burthen would much hinder the Midwife from being able to turn the Child as she ought in bringing it forth by the Feet Wherefore when it presents it self in the passage which may soon be perceived if the Midwife find every where a soft substance without the least resistance of any solid part to the touch and finding likewise the string fastned to the middle of it and the Woman fludding extreamly as is ordinary at such times then in lieu of thrusting it back the burthen must be brought away that so there may be the more liberty and room to draw forth the Child according as hath been before directed The Burthen then being quite loosened from the womb and coming first in the passage must not be thrust back again into it much less must it be put back when it is quite come forth of the body The midwife must only take care not to cut the string till the child be born not out of hopes of any benefit from it to the Infant during the delivery but that so much time may not be lost before the Infant be fetch away which is then ever in great danger as also the flooding may be the sooner stopt which happens for the most part as soon as the woman is delivered for which reasons it will be dispatched with all possible speed Sometimes notwithstanding this dangerous accident the child may be born alive if timely succoured but it is then so weak that it is hard to discover at first whether it be alive or dead When it so happens some midwies do ordinarily before they seperate the burthen put it into a Skillet of hot wine and imagine with no small superstition that in case it it comes to it self the vapours of the warm wine was the cause of it being conveyed by means of the string into the Infants belly and so giving vigor but it is more credible that being almost stifled for want of breathing as it needed it it begins now by means of it to recover from that fainting but nevertheless there may be no hurt in continuing the old custom since it can do no perjudice and may satisfie fine occupied Spirits provided necessaries be not neglected in being blindly carried away with this conceit SECT XXVIII Figure the Thirteenth DR There being the same reason in twins as in a single birth except that the single birth is natural and the twins not so certainly the same method must be observed Mrs. Tell me then if there be two or more and and all come fair with their heads toward the birth What is to be done Mid. Here Sir I must observe that which lyeth readiest and fittest in the Womb and first receive that and not to let the other go till the first is born lest it turn into another shape by sliding back again into the Womb but the one being born I must presently lay hold on the other Now this birth will be easier and without danger because the first birth hath made the way for the second so plain that it may come forth without any difficulty at all But in this birth I must take care that I bring forth the after-burden timely enough lest that the Womb being freed from her Infants presently fall down and so keep in the after-burden with great danger SECT XXIX Figure the Fourteenth DR But Mrs. What if there be Twins and they both come unnaturally with their Feet forward as in this Figure what course will you take Mid. This birth Sir is dangerous enough and yet it is to be mended by the prudence of a discreet Midwife Wherefore I must anoint the womb of the woman that the passages may be the easier for the Infant which being done I must take care to lay hold of the arms of one of them and bringing them down to the sides secure them so that I may lightly promote the head to the birth and the first being born I must presently proceed with the other after the same manner but if I can lay hold of neither of their arms so that there is no good hopes of a happy birth I must have recourse to the former method if at least the Infants may come into the World by that pains and conversion which is wrought upon the bed SECT XXX Figure the Fifteenth DR I come now to my last unnatural birth of Twins If then there be Twins these forms being compound as of a natural and unnatural birth the one comeing down with the Feet what is to be done in this case Mid. Where Infants offer themselves after this manner I must first bring forth that which presents it self with a natural form and must move up the other which is with the Feet forward and if possible cause it so to return into the Womb that that form also may be disposed of to a natural birth but if it cannot be turned to be in a better posture I must lay hold presently on the hands and encourage it to the birth But it were safer that this should be brought to a natural form to which end I must diligently endeavour it by anointing directing moving it tumbling and rouling the Woman lest perhaps the Womb be hurt by the form of such an unnatural birth and the privities swell with wind from whence the birth cannot come forth without danger or be hindred too long All which danger may with provident care be avoided or at the least very much corrected and amended Dr. So far concerning your way and method of Labors wherein several Children in different postures present themselves together but now good Mrs. Eutrapelia I would have you to hear a little what I have to offer you concerning these deliveries and first of all be pleased to consider seriously with me that if all those unnatural Figures and Situations which we have hitherto described that a single Child may come in do cause those many difficulties and dangers mentioned certainly the Labor wherein several come together in those bad Situations must be much more painful not only to the Mother and Children but also to the Midwife for they are then so pressing that for the most part they trouble and hinder one another moreover the Womb is so filled with them that the Midwife can scarce introduce her hand without much violence which she must do if they are to be turned or thrust back to the end that she may give them a better position then that wherein they present Where note then that when a Woman hath 2 Children they do not ordinarily both present to the birth together but one is
oftentimes more forward then the other which is the cause why but one is felt and that 't is sometimes not discovered that the Woman will have Twins till going to fetch the after-birth the first being born the 2 d is then perceived When there are Twins Mrs. Eutrapelia one must not think that Nature is orderly in causing one to be born before the other the first or last according as it may be most convenient that is to say when the one is strong and the other weak that the strongest comes first as also when one is dead and the other living that the living one drives forth the dead one for I can assure you there is no certain or infallible rule in these cases of which I can give you an example there were once 2 women deliver'd within a week of one another and both of Twins the one of each being dead and the other living the living Child of the first Woman was born before the dead one and the dead one the 2d was expelled before the living one And the same thing we see happens very often in respect of strong and weak Children for that which is nearest the birth whether alive or dead strong or weak is always the first born or must be brought into the World the first if it cannot come of it self otherwise the difficulty of the Labor would yet be augmented as well in length of time to the Mother as the violence done to the first Child in putting it back for to fetch the 2d first Now the Midwife must always remember to have a care in all natural births to examine diligently whether there be no more Children in the Womb after the first is delivered which she may easily know by the continuance of the pains after the Child is born and the bigness of the Mothers belly besides this she may be very sure of it if she shall put her hand up the entry of the Womb and shall there find another water a gathering and a Child in it presenting to the passage and if this shall be so the Midwife is not to fetch away the after-birth till the Woman be delivered of all her Children if she chance to have never so many because Twins never have but one burthen to which there are fastened as many strings and distinct Membranes as there are Children and if one should go to draw it forth as soon as the Birth is born the rest would be in danger of their lives because that part is very necessary to them whilest they are in the Womb and besides more then that it endangers a flooding Wherefore the first string must be cut being first tyed with three or four double and the other end must be fastened with a string to the Womans thigh not so much for fear that the string should enter again into the Womb as to prevent the inconvenience it may cause to the Woman by hanging between her thighs afterwards this Child being removed the Midwife must take care to deliver her of the rest observing all the same circumstances as were belonging to the first the which being done it will be then convenient and necessary to fetch away the After-birth as we shall discourse the manner how by and by SECT XXXI Figure the Sixteenth DR Courteous Mrs. Eutrapelia I have hitherto troubled you with many Questions that I might not only be sure of your abilities but also give testimony of your sufficiency if need require I have now only one Question more and then I have done as to these postures and fashions And this though the last surely is a miraculous posture What if the Infant be so involved in the womb the head and the neck being of such a length that it is so bent back that the face lyeth betwixt the buttocks the right hand to the left region of the reins but the left hand to the knee of the same side the right legg being across the left in form of the letter X and both leggs bent up toward the breast Mid. Worthy Dr. This case is the hardest of any that hitherto you have propounded to me and though it may never fall out to be so in one amongnst 5000 yet because in your description of the best Midwife you tell me that a Midwife must have a good memory I remember a learned Doctor not long since acquainted me with such a posture which he told he had from the hands of an expert Chirurgeon and Physitian whose wife also was an expert Midwife and the course the Midwifed took in such a case he told me was this which must serve also for my answer because I think there cannot be a better After the woman had been eight daies in labour and given over by all Midwives as desperate being in a violent Fever with no throws but very weak and by reason of hot medicines given to expel the birth and strong wines given to support the spirits those humors that usually accompany the Infant had so flown out that the genitals were so dry and closed that they would scarce admit the probation of two fingers This method was used First instead of wine she gave her good store of Almond-milk and because her belly was very costive she gave her Clysters and to keep up her spirits she gave her Cordials of which in their order She laid plaisters to her hands wrists and anointed the whole region of the belly hips loins the rump-bone and privities with Oyles to appease her pain and with softning Unguents and then she made a triangular bagg stuff'd with emollient and relaxing herbs boyled in water according to this description and of which more hereafter The description of the Bagg It was of such a bigness as that it might cover the lower part of the belâ—… and the privities and with tapes fitted to the corners was applyed hot and continued on some hours after which though her hand were well anointed she could scarce thrust in the top of her finger into the orifice of the womb the womb was so closed and the Infant so depressed toward the share-bone by reason of the precedent throws and pangs But at length when with much labour and industry the genitals were somewhat dilated that she could get in her fingers farther she found the loyns and the right hand of the child first offer it self to the birth that therefore she might correct this monstrous and so inverted posture of the Infant so doubled and twisted and either perswade the head or the feet to come forward she used the best of her skill but to little purpose the genitals were so narrow and streight But yet not giving off her endeavours she did deliver her within eight hours after she came to her assistance but the child was dead Dr. Mrs. You give a very good account of an expert Midwives practice which you may follow with safety expecting the success from Heaven but it is no wonder the child should be still-born as you phrase it