to explain this more clearly consider the Infant is naturally seated in the Womb with Head uppermost and the Feet downwards with its Face towards the Mothers belly just till it hath attained the 8th Month at which time and sometimes sooner and sometimes later its head being very great and heavy it turns over its Head downward and its heels upward which is the sole and true posture in which it ought to come into the World Now just when the Child is about to turn according to custome into its intended posture instead of giving her self rest she fall a jumping walking running up and down staires and exercising her self more then ordinary which very often causes it to turn cross and not right as it ought to be and sometimes the Womb is depressed to low and engaged in such sort towards the last Month in cavity of the flanks by those 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 worser moreover it would be very convenient that the Woman should abstain from having to do with a Man carnally during the 2 last months of her reckoning forasmuch as the body is thereby much moved and the belly pressed in the action which likewise causeth the Child to take a wrong posture Now I believe that those that will seriously reflect and confider of these things will be ready to quit this their old error which hath certainly caused the death of many Women and Children and much pain to divers others Thirdly let her beware of sharp and cold winds of excessive heat anger troubles of the mind affrights and terrors over-much venery and of intemperancy of eating and drinking Fourthly let her diet be frugal and moderate abstaining from gross meats hard of digestion let her eat Eggs Chickens Land-fowl birds of the Mountains c. variety of broths grewels panadoes Mutton Veal Lamb Kid Rabbets she may use in her meats Nutmeg and Cinnamon she may drink wine moderately Fifthly in the first four Months let her open no vein use no cupping or scarrifications fontanells nor use any pills or other Physick without the advice of a prudent Physitian for in these Months the ligaments of the Child are very tender soft and feeble and therefore the easier destroyed and the nourishment kept from it Sixthly if it shall happen that the Woman be too costive by which many miscarry let her boyl Spinage and Lettuce in Veal broth well buttered with salt or wine which if they will not move the belly let her use suppositories with honey and salt or of Castile-soap and if these common things will not do let her advise with an expert Physitian Seventhly if it happen that she conceive with grievous symptoms and after conception is troubled with faintings let her take this Cordial following Take of Sorrel-water and red-Rose-water of each one ounce of Cinamon-water one ounce of Manus Christi pearled half an ounce or as much Diamargariton this may be taken as need requires Eighthly if she fear that she may come before her time as in the seventh Month or some other unseasonable time and feels throws as of Child-bearing let her sit over a fume of Frankincense for that contributes no small strength both to the Womb and to the Infant also Ninthly if she nauseate her meat she may use a plaister of Mastich to her Stomach and take this following Cordial every morning fasting to strengthen her Stomach Take Syrup of Pomegranates one ounce and half of Mosch and Ambergreece of each two grains of Lignum Aloes finely powdered one scruple of Cinamon half a scruple the water of Sorrel three ounces let these be mingled and drank off blood-warm Lastly if whilst she go with Child she perceive her terms let her eat milk made boyl with red-hot steel and in that let Plantain and Comfrey be boyled But in all these cases let her advise with learned Physitians which will direct her with medicines from time to time I shall hereafter treat of some distempers incident to Child-bed and leave you some choice Remedies in the following Sections and then wind up all SECT VI. A Dialogue between the Midwife and the Doctor concerning Midwifes and the delivery of Women in Child-birth MId A good morning to you good Mr. Dr. Sir I am come according to my promise to give you an account of the event of the directions you was pleased to give me last Night concerning Mrs. Styles the which indeed Sir have succeeded marveilous prosperously and she now thinks her self in Paradise to what she was before and hath sent you Sir a small gratuity according to her ability in acknowledgment of the great benefit she hath received by your Counsel And for my own part Sir I so well approve of your last Nights discourse that I must humbly entreat you that you would be pleased to afford me your Instructions in the safe performance of my Art Dr. Very willingly good Mrs. and truly your name bespeaks you a fit Woman for your Employ as being a well bred Woman therefore I shall in the first place take occasion to tell you what kind of person a Midwife ought to be and that in the subsequent description The best Midwife is she that is ingenious knowing letters and having a good memory is studious neat and cleanly over the whole body healthful strong and laborious and well instructed in Womens conditions not soon angry nor turbulent or hasty unsober unchaste but pleasant quiet prudent not covetous but like the Hebrew Midwives such as fear God that God may deal with them and that people may multiply and increase after their hands and that the Lord may build them Houses By this description I tell you only how the best Midwife must be qualified now let me hear somewhat of your skill that I may the better judge thereof First then let me know how Women are delivered A Naturall Birth As to the washing of the Child and swathing I need not give you any account I suppose you take it for granted that most women understand that I only here shew you the shape of the stool I use which I hope you will not disapprove of though few Midwives have them or use them B. the Back of the Stoole oooo the feete aa rests for the hands rr the ring in shape like the Moone cccc the Cloth round the ring to keepe out the Aire etc AA Shews the parts of the Chorion dissected and removed from their proper place B a Portion of the Membrane Amnios CC The Membrane of the Womb dissected DD The placenta Vteri or hepar uterinum being a fleshy substance full of many Vessels by which the Infant receives its nourishment E The varication of the Vessels which makes up the Navil string FF The Navil string by which the Vmbilick vessels are carried from the placenta to the Navil GG The Infant as it lies perfect
much ado to introduce one only with which she must do her operation with the half of the fingers ends of the other hand put up as far as necessary afterwards let her excite and procure the childs birth as directed before Then sometimes the child comes with its face first having its head turn'd back in which posture it is very difficult it should be born and if it long remain so the face will be so black and blew and swell'd that at first sight it will appear monstrous which comes as well by the compression of it in that place as by the Midwives fingers handling it too rudely when she endeavor'd to place it in a better posture There was a certain Woman whose Child came with its Face so black and mishapen as soon as it was born as is usual in such cases that it looked like a black Moor as soon as the Mother saw it she said she alwaies fear'd her Child would be so monstrous because when she was young with Child of it she fixt her looks very much upon a black moor wherefore she wished or at least wise car'd not though it dyed rather than she said she should behold a Child so monstrously disfigured as it then appear'd but she soon chang'd her mind when she was made sensible that this blackness was occasion'd only by reason that it came into the World with its face forwards and that assuredly in three or four days it would wear away as accordingly it happen'd having often anointed it with oyl of sweet Almonds as she was order'd and when the Child came to be about a 12 month old you could have scarcely seen a fairer Now to deliver this birth the Midwife must observe the same manner as in that wheâ—… the Child comes with the side of the head being careful to work gently to avoid bruising the Face But here note that if it should chance thaâ— the Childs hand or hands should come with either of these births which for the mosâ— part happens rather than any other part iâ— will hinder the birth by reason it takes up part of the passage and for the most parâ— cause the head to lean on one side To remedy this as soon as 't is preceived that one hand presents together with the head it must be prevented from coming down more or ingaging farther in the passage wherefore the Midwife having plac'd the Woman on the bed with her head a little lower than her hips must in the next place put and guide back the Childs head with her own as much as may be or both hands iâ— they came both down for to give way to the Childs head which done she must proceed aâ— before SECT XXV How to deliver a Woman when the Childs Head is born and the Womb closeth about its Neck DR Very well Mrs. Eutrapelia you have now given us a farther account of your very good judgment in your Art in your dextrous ingenious way of bringing a Woman to bed in the last posture But now I would desire you to let me know how you will deliver a Woman of her Child when its head is born but yet the Womb closeth about its Neck Mid. Truely Sir to deliver this Woman is not so easie abusiness as may be imagin'd by reason that a small delay herein may cause the strangling of the Child And here you must observe that the Child comes naturally with the Head first because by its bigness and hardness the passage might be the better made and opened for the other parts of the body the which usually pass afterwards without pain but yet notwithstanding sometimes the Head is so small and the shoulders so large that without a very great difficulty they cannot pass which makes the Child remain often in the passage after the head is born And this accident may likewise happen sometimes for not having been careful to lose no time in drawing forth the Child by the head to the end the shoulders might at the same instant follow in the same place the head possest Now when I meet with this Figure I must by all possible means seek speedily to deliver the poor Child out of this prison or rather snare or collar in which it is caught for fear as I said before it come by delay to be strangl'd to prevent which I must endeavour to cause the shoulders immediately to follow by gently drawing its Head sometimes by the sides of it and sometimes with one hand under the chin and the other behind its head and so doing by turns on the one side and the other to facilitate the operation the better being very careful and circumspect that the Navil-string be not entangled about its Neck as also not to draw it forth with too much violence for fear least it may happen as I once saw the Head to be pulled from the Shoulders But if the Shoulders come not with gentle pulling then I must slide up my fingers on both sides under the Arm-pits with which turning them inwards I may by little and little draw forth the Soulders but if when they are in the passage and totally disengaged if I cannot get the rest forth by still keeping my fingers under the Arm-pits I may be very confident there is some other hindrance and that it is certainly monstrous in some part of its body or that as it for the most part happens in this case it is hydropical in the belly for which cause it is impossible it should be born before the belly be pierced to evacuate the waters and then it will easily be accomplish'd but this being the expert Physitian or Chirurgion's parts to perform I shall leave it wholly to them SECT XXVI When the Navil-string comes first DR Now Mrs. Eutrapelia I would know of you how you behave your self when you have a labor presented to you wherein the Childs Navil-string comes first Mid. Here Sir you must note That an Infant doth not always present with the belly when the navil-string comes first for though it presents naturally as to the Figure of its body that is with its Head first yet sometimes the Navil-string falls down and comes before it for which cause the Child is in much danger of death especially if the labor be not very quick because the blood that ought to pass and repass through those Vessels which compose it for to nourish and keep the Child alive whilst it continues in the Womb being coagulated hinders the circulation which ought to be there made which happens as well by the contusion as the cold those Vessels receive being much pressed in the passage when it comes together with the Head or any other part as also because the blood doth there coagulate as is said by reason of the cold which it takes by the coming forth of the Navil-string But though this accident may cause the Infants sudden death 't is not so much for lack of nourishment without which it may pass a whole
day or more there being blood enough in its body for that purpose but because the blood can be no longer enliven'd and renewed by circulation as it hath continual need which being obstructed always causeth the creatures sudden death sooner or later according as it is more or less obstructed I know it may be objected that though the circulation be so hindred and intercepted by the coming forth of the string it need not therefore cause such a sudden death to the Child because the blood may notwithstanding circulate in all the other parts of the body To which I answer that in respect to the Infant 't is either absolutely necessary that the blood for want of respiration should be elaborated or prepared in the thick part of the burthen call'd the placenta and therefore must be a free communication or for want of it that the Infant must immediately breathe at the mouth as well to be refreshed as to drive out the fuliginous or sooty Vapors by expiration which not being possible whilst in the Womb it must unavoidably be choaked and dye in a very short time if it wants both together Wherefore in this case the Woman must without any delay be deliver'd the which if nature doth not speedily perform the Child must be drawn forth by its feet Women that have great waters and along string to the burthen are very subject to this mischief for the waters coming forth in great abundance at the breaking of the skins or membranes do often at that instant draw the string which swims in the midst forth along with them and much the easier if the Infants head be not advanced very forward into the passage for to hinder the coming forth of it in this manner Assoon as 't is perceived you must immediately endeavor to put it back to prevent the cooling of it behind the Childs head least it be bruised as we have already noted whereby the blood may coagulate there keeping it in that place where it was thrust back until the head being fully come forth into the passage may hinder the coming down of it again which may be effected by holding it up with the fingers of one hand on that side it comes down untill the head be advanced as aforesaid or in case the hand be taken away to put a piece of fine soft rag between the side of the head and the Womb to stop up the way it came down by always leaving an end of the rag without the body to draw it forth by at pleasure But sometimes notwithstanding all these cautions and the putting of it back it will for all that come forth every pain and then without any more delays at all the Midwife must bring the Child forth by the Feet which she must make a diligent search and enquiry after although the Infant comes with the head foremost for there is but this only means left remaining to save the Childs life which it would certainly lose by the least delay in such a case Wherefore having placed the Woman conveniently let her gently put back the Head which offers provided it be not engaged too low amongst the bones of the passage and that it may be done without too great violence to the Woman for in that case it will be better to let the Child run the hazard of dying than to destroy the Mother for Tertullian as my learned Mr. Riolanus very well observes upon a like Subject saith That it is a necessary cruelty to kill the Child in such a case rather then to save it from the danger it is in of dying and so certainly cause the Mothers death and then let her slide up her hand being well anointed under the breast and belly to search for the Feet by which she must draw it forth according as hath been formerly discoursed the which being perform'd let her immediately take care of the Infant which is ever in this case very feeble SECT XXVII Wherein the Burthen either first offers it self or comes first quite forth DR Very well and excellently have you given us demonstrations of your skill and knowledge hitherto good Mrs. Eutrapelia now pray will you inform me how you act your part in a Labor wherein the burthen either first offers or else comes first quite forth Mid. That I shall Sir to the best of my Talent and therefore first of all Sir I must note that the coming forth of the Navil-string before the Infant whereof we discoursed in our foregoing Section is oftentimes the cause of its death for the reason there alleadged but the coming forth of the burthen first is yet much more dangerous for that besides that the Children are then commonly Stil-born if they be not assisted in the very instant the Mother likewise is in great peril of her life also because of her great floodings which usually happen when it is loosened from the Womb before its due time by reason that it leaves all the orifices of the Vessels to which it did cleave open whence incessantly flows blood until the Child be born by reason that the Womb as long as any thing continues there doth every moment strongly endeavour to expell it by which means it continually voids and expresseth the blood of the Vessels which are alwaies open as we have already explained when the burthen is so separated as long as the Womb remains extended and cannot be closed until it hath voided all that it did contain and comes by the contraction of its Membranous substance to stop them by pressing them together wherefore if the Midwife ought to be vigilent and diligent to succour an Infant when the Navil-string comes first how much more ought she to be so when burthen comes forth first and wherein the least delay is ever the cause of the Infants sudden death if the Woman be not speedily delivered because the Infant cannot then remain long in the Womb without being choaked or stifled being it stands in need at that time of breathing at the mouth as we explain'd the foregoing discourse the blood being no longer enlivened by the preparation made in the burthen the use and function of which then ceasing from that very instant that it is separated from the Vessels of the Womb to which it was joined for which reason there immediately follows a great fludding which is so dangerous for the Mother that without speedy help she quickly looseth her life by this unlucky accident Now when the Burthen is not wholly come forth but lies in the passage some advise to put it back before the Child be fetch'd but I am not of their opinion for when it comes into the passage before the Infant it is at that time totally divided from the Womb at the bottom whereof it ought to be commonly situated and fastened until the Child be born but because as soon as it is wholly loosened as it always is when it comes first it becomes a body altogether unnatural therefore it is never to be