and the use of the Remedies specified in the precedent Chapter it may likewise be but an ordinary and menstruous Flux If then the Blood flows but in small quantity and continues a little while 't is good leaving the labour to the work of nature provided the Woman hath sufficient strength and that it be accompanied with no other evil accident but when it flows in so great abundance that she falls into Convulsions and Faintings then the operation must not be defer'd and 't is absolutely necessary she should be delivered whether she be at her reckoning or no whether she have pains or throws or not because there is no other way to save her life and the Childs then presently to do it Extreman fundet cum sanguine vocem she casts forth with her Blood her last breath Hippocrates knew very well the danger of it when he said in his 56th Aphorism of the 5th Book In fluxu muliebri si convulsio animi defectus advenerit malum If Convulsions and Faintings follow Floodings it is a bad sign There must not alwayes in these unfortunate accidents be expected pains and throws to force and bear down to forward labour for though they come at the beginning they usually cease assoon as the Flooding comes to Syncope's and Convulsions neither must it be defer'd till the Womb be enough opened forasmuch as this effusion of Blood very much moistens it and the weakness relaxeth it so that it may be then as easily dilated as if there had been abundance of strong throws Wherefore having placed the Woman in the situation we shall direct when we treat of deliveries let the Chirurgeon having his hands anointed with Oyle or fresh Butter introduce his Fingers joyned together by degrees into the Matrix and spread them open the one from the other when they are in the entry for to dilate it sufficiently by little and little without any violence if possible which being done and his hand quite within if he finds the Waters not broke let him break them and then whatsoever part of the Child presents though the Head provided it be not just in the Birth let him search for the Feet and draw it forth by them observing every curcumstance that shall be shewen in the 14th Chapter of the second Book where is described the way how to deliver a Woman the Child coming with the Feet first because there is better hold and more easie to deliver by them than by the Head or any other part of the body Wherefore if the Feet lie not ready the Chirurgeon must seek for them which at that time is easier done than at another because the great Flooding makes the Womb loose and slippery by its humidity so that it will not be difficult for him to turn the Child and bring it by the Feet as we have even now said after which he must fetch the after-burthen which in these cases cleaves but little being careful not to leave so much as a clod in the Womb lest it still continue the Flooding which being done it will soon after stop with all the accidents if too much time was not spent before the operation Many Women and Children have perished for want of this operation in this ill accident and many others have escaped death which else most certanly had followed by being timely succored Guillimen in Chap. 13 of his 2d Book of happy Deliveries makes mention of six or seven Histories to confirm this verity in some of which we may find the Women and their Children bloody victims of it for not having been in the like case delivered which others by a seasonable delivery escaped and the better to confirm it by my own experience I will recite you one amongst the rest very remarkable of the remembrance of which I am so sensible that the Ink I write with at present to publish it to the World for their propfit seems to me to be Blood because in this sad and fatal occasion I saw part of my self expire About three years since one of my Sisters not yet one and twenty years of age being about eight months and a half gone with her fifth Child and then very well in health was so unfortunate as to hurt her self though at first small in appearance by falling on her Knees her Belly a little touching the ground by the fall after which she passed a day or two without perceiving any great alteration which made her neglect to repose her self being very necessary for her but the third day or thereabouts after her hurt about eleven in the morning she was suddenly surprised with strong and frequent pains in the Belly which were immediatly followed with Floodings this made her presently send for her Midwife who no better understanding her Office told her she must have papatience till the Womb had dilated it self by the pains before she could be delivered assuring her further that she had no reason to be afraid and that she should be quickly freed from the danger because her Child came right she made her thus hope in vain three or four hours until the Flooding still continuing violently the pains began to cease and the poor Woman fell into frequent faintings and then the Midwife desired a Chiurgeon to advise with in this case they immediately sent to my house for me but unfortunately missing of me they sent for him whom they judged the ablest of all the Chirurgeons that practised Midwifery in Paris and immediatly conducted him to my Sisters where he arrived about four in the afternoon and having seen her * It were to be wish'd rather than hoped for that Practitioners in this and other the like dangerous cases whereof they have no certain knowledge would consult and not destroy one or more by undertaking what they cannot well perform or discourage Patients from sending for other help and advice putting Life in ballance with their Reputation contented himself with only saying she was a dead woman and that nothing was to be done to her but to give her all the Sacraments and that absolutely she could not be delivered which likewise the Midwife joyntly concluded who believed that the opinion of a Man so authentickly esteemed of all must be infallible Assoon as he had delivered this Prognostick he immediately returned home and would by no means stay any longer but left this young Woman in that deplorable condition without any succour whose life he had certainly saved with her Childs if he at that time had delivered her which was very easie to be done as will plainly appear by the sequel of the History After the advice of a person of so great reputation together with that of the Midwife since Monsieur N. * The great mischiefs which happen by the Prognosticks of such who have the luck though they want the merit to be esteemed could do nothing there was no other remedy for so great a danger but to hope in God alone who was Almighty
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
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
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
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
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
in his Book De natura Pueri The others are a little more solid and fleshy resembling in some sort the Gizard of a Foul and are greater or less according to the time they stay in the Womb and also according to the quantity of blood with which they are alwayes soaked Women expel these fals-conceptions sooner or later according as they cleave to the Womb which makes them almost alwayes flood in great quantity at those tunes It is of great importance to distinguish well between a true and a false Belly for the faults committed by a mistake are ever very considerable forasmuch as in a true great Belly the Child ought to continue in the Womb till Nature * This excludes not Art to assist Nature if not able to perform its duty in due season expels it by a natural labour but contrarily the false great-Belly indicates to us to procure the expulsion of what it contains as soon as may be Wherefore we ought to be very careful CHAP. VI. How to know the different times of Pregnancy IF prudence be necessary to enable a Chirurgeon or Midwife to assure a Woman that she is with Child or not and of a true or a false-conception it is likewise as much requisite for them to know how far she is gone to the end they may be certain whether the Infant be yet quick or no which is of great moment because according to the Law if a big-bellied Woman miscarry by a wound he that struck her deserves Death in case the Child were quick otherwise he is only condemned in a pecuniary punishment they ought likewise to take heed lest they cause the death of the Infants and sometimes of their Mother by hastening * To be understood by Medicines as appears by the word miscarry following their labour before its time by imagining that when the big-bellied Woman complains of great pains in her Back and Belly they are the pains of her Labour and instead of endeavouring to hinder them they contrarily provoke them and cause them to miscarry unfortunately before their time I knew a Woman called Martha Rolet who being six months gone with Child or thereabouts was surprized with great pains much like throws of Labour which made her send for her Midwife who as soon as she was come and understanding the case no better than they use to do endeavoured all she could to bring her to bed augmenting her pains by sharp Clysters making her walk about her Chamber as if she had been at her full time but finding at two dayes end no forwardness notwithstanding the continual pains she sent for me to know what was fit for her to do in that case I went to the Woman and found the inward orifice of the Womb dilated enough for the top of my little Finger to enter into its inward part and yet wider towards the outward part but considering that she had no other accident but those pains I caused her immediatly to go to bed where she continued eight or nine dayes in which time her pains ceased the Womb closed exactly as I found some dayes after and she went on with her Child three full months longer and was then brought to bed of a Daughter at the full time strong and robust which is yet living and now five years old or thereabouts Now had I pursued what they began this Woman without doubt would have miscarried at six months which would have * Implies Medicines as before killed the Infant in her Belly and soon after she should have miscarried It is fit to follow this example in the like occasion provided the pains are not accompanied with accidents which may endanger the life of the Mother if not presently delivered as frequent Convulsions considerable floodings of which we shall speak in its place To be well informed of the different times of pregnancy the Womans own relation may sometimes serve turn yet 't is not fit alwayes to trust it it may help to conjecture because many Women are themselves deceived concluding themselves with Child from the staying of their Courses or from their quickning which is not alwayes a certain rule We usually judge of it by the bigness of the Belly but more surely by touching the inward orifice of the Womb. When they are young with Child we can only know it by the signs of conception because what is then in the Womb is of no considerable bigness to swell a Belly but rather on the contrary at that time it grows slatter for the reasons before recited but after the second month the Belly begins by degrees to wax bigger till the ninth month At the beginning in touching the inward orifice you find it exactly close and somewhat long resembling the muzzle of a Puppy new pup'd and is then very thick but by little and little through the extension of the Womb it diminisheth so in all its proportions that when the Woman cometh near her reckoning it is perfectly flat and almost equal with the globe of the Womb and in that manner that it becomes like a small circle a little thick at its entry where the Garland is made at the time of Labour Neither may the time of pregnancy be alwayes judged by the great swelling of the Belly because some Women are bigger when they are half gone than others are at their reckoning it depending much on the bigness of the Infant and also on their number and yet again according as there is more or less water inclosed with them in the Womb but much rather by the internal Orifice which grows daily thinner and flatter and so much the more by how much the Women come nearer their reckoning much in the same manner as we see a tender skin diminish in thickness according as it is extended and dilated even so this orifice grows thinner by the extension which the head of the Infant causeth to it which usually presseth hard against it in the last months This remark is often useful to us in the admission of big-bellied Women that desire to lie in in the * An Hospital so called in Paris Hostel de Dieu at Paris which I very often observed in my practise there of Deliveries in the year 1660 through the permission which my Lord the first President was pleased to give me for there is no place so fit to perfect one in a short time in the practice of so necessary an operation because of the great number which are there daily delivered of all sorts the order is that any Women with Child shall be there charitably received fifteen dayes or thereabouts before their reckoning to which purpose they are searcht before they are admitted because many glad of a good entertainment for nothing present themselves there two or three months before they should saying and affirming they are near their time but by the above-mentioned considerations one may easily judge and know within a very little who are fit to be received and
her pallat neither will it be amiss if she eats a little good Marmalade of Quince before meals She may likewise wear upon the pit of her Stomach a Lamb-skin with the wool for to preserve it and augment its natural heat which is very necessary to digest food observing above all to give no purging Medicine when this Flux is only caused by weakness lest it be thereby augmented If it be a Diarrhaea and only an evacuation simply of such excrements as are retained in the Guts and some superfluous humours which Nature hath sent thither to be expelled and that it continue no long time and is gentle the Woman will find no inconvenience by it nor is she in that danger as when it passeth those bounds and therefore 't is good to leave the operation to Nature without interrupting it in the beginning but if it continues above four or five days it is a sign then that there are ill humours contained and cleaving to the inside of the Guts which provoke them often to be discharged and ought to be removed with some purging Medicine that may loosen and evacuate them after which the Flux will certainly cease some light infusion of Senna and Rubarb with Syrup of Succory or an ounce of Diacatholicon with a little Rubarb for a Bolus to be taken in a Waser But if notwithstanding fit purges and a regular diet this flux continues and changes into a Dysenteria the Patient voiding every moment bloody stools with much pain and needing she is then in great danger of miscarrying its prevention ought it be endeavoured if possible Therefore after having purged away the ill humour with the Medicines above mentioned which were in the Guts and hindering by a good dyet that no more be engendred to which purpose let her use good broths made of Veal or Chicken with cooling Herbs temper the acrimony of these hot humours let her eat Pap with the yolk of an Egg new layed being well boiled such dyet softens and sweetens the Guts within Let her drink be Water in which Iron or Steel was quenched with a little Wine if she be not feverish for then half a spoonful of Syrop of Quince or Pomegranats is better to mix with the foresaid Water She may likewise eat a little Marmalade of Quince or other astringents and strengtheners provided her body was well purged before and because there is always in these Fluxes great pains and gripes all over the Belly and Guts and chiefly the Rectum all the humours being discharged upon it which irritating it extreamly causeth continual stimulations that ought to be appeased if possible to prevent Abortion and may be effected by Clysters made of the Broth of a Calves-head or Sheeps-head well boyled mixing it with two ounces of the Oyl of Violets or else of good Milk mixed with the Yolk of a fresh Egg. After the use of these strengthening and anodine Clysters as long as is judged necessary which the Patient ought to keep as long as she can the better to appease these pains you must proceed to the use of Detersives made with the Decoction of Mallows and Marsh-mallows with Honey of Roses and afterwards Astringent Clysters in which must be neither Oyl nor Honey mixed because they relax instead of binding beginning first with the gentlest made with Rose-water mixed with Lettice and Plantain-water afterwards to stronger composed with the Decoction of the Roots and Leaves of Plantain Tapsus Barbatus Horse-tail with Provence-Roses the rind of Pomegranats in Smiths-water to which may be added of Terra Sigillata and Dragons-blood each two drachms You may likewise foment the Fundament but there must be care before you come to use the strong Astringents that the Woman be first well purged with the Remedies before mentioned lest as the Proverb is the Wolf be shut in with the Flock and endeavouring to prevent Abortion the death of the Mother and consequently of the Child be caused by a greater mischief retaining within abundance of ill Humours of which Nature would willingly be discharged All which may be avoided if what I have said be well observed CHAP. XIX Of the Menstruous Flux HIppocrates in the 60th Aphorism of his 5th Book saith Si Mulieri utero gerenti Purgationes prodeant impossibile est foetum esse sanum If a big-bellied Woman have her Courses it is impossible the Infant can be in health This Aphorism must not be taken literally but must be understood when they come down immoderately for though according to the most general and natural rule the Courses ought not to flow when a Woman is with Child because their ordinary passage is stopt and also because the Blood is then imployed for the nourishment of the Infant of which if it flows away it is defrauded and consequently much weakened Yet there are some Women who notwithstanding they are with Child have their Courses till the 4th or 5th month about which time the Infant being already pretty big draws a good quantity of blood for its nourishment wherefore there cannot so easily remain a superfluity as when young with Child I knew one that had four or five living Children and had of every Child her Courses duly from month to month as at other times onely in a little less quantity and was so till the 6th month yet notwithstanding she was alwayes brought to bed at her full time I likewise saw another who not believing she was with Child because she had her Courses and finding her self out of order because she had conceived imagining it was some other Distemper prevailed with her Physitian to bleed and purge her very often which he did till he had indeed cured her but 't was after she had miscarried being three months gone This evacuation usually befalls very Sanguine or Phlegmatick Women who breeding more blood than the Infant hath need of for its nourishment at the beginning discharge themselves at those times of that superfluous quantity more or less according to their dispositions but not by the bottom of the Womb as formerly when they were not breeding because those passages are effectually closed by the after-birth which adheres to it and the Womb is then exactly close but by a couple of Branches which Nature provident and careful of the preservation of Individuals as well as of the Kind hath destined to this use which proceed from the Spermatick Vessels and besides those they send to the Testicles and other parts before they arrive at the Womb divide themselves on each side into two Branches very considerable of which the one terminates in the Fund of the Womb by which the Courses pass when the Woman is not with Child and the other not entering there couching along the body of it is terminated in the side of the neck of the Womb by which the Courses are discharged whilst they are breeding in case the Woman be Plethorick When a Woman voids blood downwards it must carefully be considered whence it proceeds
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
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
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
Infants and many ill accidents which after befal the poor Women not causing them to be helped in due time and from the moment they perceive the difficulty of the Labour to pass their understandings To avoid therefore these calumnies let the Chirurgeon never use the Crochets but very rarely and when there is no other way as also to endeavour his utmost as much as the case will permit to bring the Child whole although dead and not by bits and pieces to give the wicked and ignorant no 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 bring the dead Child with * Those Instruments very unsafe for the Woman and having a better way cannot pass them without manifesting my dislike Instruments than kill her by tormenting her with excessive violence for to bring it whole but in a word we must in conscience do what Art commands without heed to what may be spoken afterwards and every Chirurgeon that hath a well ordered conscience will ever have a greater regard to his duty than reputation in performing of which let him expect his reward from God CHAP. XXXII Of extracting a Mola and false Conception HAving at large spoken in another place of the Causes Signs and Differences of Mola's and false Conceptions and shewed that a Mola alwaies ariseth from a false Conception there remains nothing to be demonstrated but the manner how it ought to be extracted Now since these things contained in the Womb are totally preternatural their expulsion must be procured assoon as possible which is very difficult when these strange Bodies cleave to it and especially the Mola which not being drawn forth will often continue so fastened two or three whole years nay sometimes the whole remaining part of the Womans life as Paré tells us in the Story of the Pewterers wife that had one seventeen years whom he opened after her death To avoid the like accident and abundance of inconveniences which a Mola brings it must be endeavoured to be expelled assoon as may be trying before you come to Manual Operation to cause the Woman to expel it of her self to which purpose give her strong and sharp Clysters to stir up Throwes for to open the Womb to give way to it relaxing and moistening it with emollient Ointments Oyls and Grease not omitting bleeding in the Foot and half Baths if there be occasion The Mola will certainly be excluded by these means provided it be but of an indifferent bigness or that it adheres little or not at all to the Womb but if it cleaves very strongly to the bottom of the Womb or that it be very big the Woman will hardly be rid of it without the help of a Chirurgeons hand in which case after that he hath placed the Woman conveniently as if he were to fetch a dead Child let him slide his Hand into the Womb and with it draw forth the Mola using if it be so big as that it cannot be brought whole which is very rare because it is a soft tender body much more plyable than a Child a Crochet or Knife to draw it forth or divide it into two or more parts as the case shall require If the Chirurgeon finds it joined and fastened to the Womb he must gently separate it with his Fingers ends his Nailes being well pared putting them by little and little between the Mola and the Womb beginning on that side where it doth not stick so fast and pursuing it so until it be quite loosened being very careful if it grows too fast not to rend nor hurt the proper substance of the Womb proceeding according to the directions we have given for the extraction of a Burthen staying behind in the Womb when the String is broke off This Mola never hath any String fastened to it nor any Burthen from whence it should receive its nourishment but it doth of it self immediatly draw it from the Vessels of the Womb to which it is almost alwaies joined and sticking in some place The substance of its Flesh is also much more hard than that of the Burthen and sometimes it is schirrous which is the cause why it is not so easily separated from the Womb. As to a false Conception though it be much less than a Mola yet it often puts a Woman in hazard of her life because of great Floodings which very often happens when the Womb would discharge it self of it and endeavors to expel it which seldom ceaseth until it be come away because it doth still endeavour to exclude it by which the Blood is excited to flow away and in a manner squeesed out of the open Vessels The best and safest remedy for the Woman in this case is to fetch away the false Conception assoon as may be because the Womb can often very hardly void it without help for it being very small the Womans impulse in bearing downwards cannot be so effectual when the Womb is but little distended by so small a body as when it contains a considerable Bulk in it for then it is more strongly compressed with the Throws Many times 't is exceeding difficult to fetch these false Conceptions because the Womb doth not open and dilate it self ordinarily beyond the proportion of what it contains and that being very little so is its opening which is the reason why the Chirurgeon sometimes is so far from introducing his whole Hand that he can scarce put in a few Fingers with which he is obliged to finish the Operation as well as he can proceeding in the following manner when he hath introduced them Having well anointed his Hand he must slide it up the Vagina unto the inward Orifice which he will find sometimes but very little dilated and then very gently put in one of his Fingers which 〈◊〉 must presently turn and bend on every side unâ—…â—e hath made way for a second and afterwards third or more if it may be done without violence but many times one hath enough to do to get in but two between which he must take hold as Crabs do with their Claws when they take any thing of the false Conception which he must gently draw forth and also the clodded Blood which he there finds afterwards the Flooding will undoubtedly cease if no part of this Conception be left behind as I have often found by experience when I have taken the same course but if the inward Orifice cannot be more dilated than to admit but one Finger and that the Flooding is so violent as to endanger the Womans life the Chirurgeon then having introduced his Fore-finger of his left Hand must take with his right an Instrument called a Cranes-bill or rather a Forceps like that marked G among the Instruments at the end of this Second Book and guide the end of it along his Finger for to fetch with this Instrument the strange Body out of the
the impossibility of it There are others agin who shewing the scars of some abscess they have had in their Belly would perswade that a Child hath been taken out there to which purpose I will relate what I once saw my self concerning a big-bellyed Woman that was in the Hôstel de Dieu at Paris when I there practised Deliveries This Woman whether through cunning feigning to believe the thing or through ignorance really beleeving it did testify to all the Women who were then in the said Hôstel de Dieu as also to an infinite of other persons and amongst the rest to a good old Nun that governed all whom they called Mother Bouquet and at that time did preside in the Hall of Deliveries like another goddess Lucina that she was very much afraid that they must open her side to deliver her as it had been two years before in all which time she had made the same relation to above a thousand several persons each of which it may be had again related it to as many more shewing to all of them a great Skar by which she said the Chirurgeons had drawn the Child out of her Belly Wherefore she prayed Mother Bouquet to recommend her to me desiring rather to be delivered by me who was a Chirurgeon because she might be more safely helped in such a business than by a Midwife This good Nun giving me this account which she verily beleeved according to the relation I told her that not having faith enough to imagine it I could not believe the Caesarean Section had been made on that Woman as she had perswaded her If you do not beleeve it replied she I will fetch her presently to you and she her self shall tell you every circumstance And immediatly she caused her to be fetch'd who told me the same she had told her but having particularly examined her from what part the Child was so drawn forth and whether she felt any great pain in the Operation She answered me None because she was then senseless and remained so five or six days after I asked her then how she was certain that the Child was brought away by incision in her Belly being she was not at that time sensible She answered the Chirurgeons assured her it was so and at the same time she shewed me a great Skar scituated just on the right side of her Breast about the middle of the Ribs where she had a great abscess of which this Skar remained and when I had told her that the Breast was not the place whence a Child should be fetcht and that I had with my arguments convinced her of the impossibility of what she had believed and made others to believe as the women of the Hostel de Dieu and Mother Bouquet also they began to be disabused and continued so when three days after this conference I had delivered her with the greatest facility although it was a very great Child which came quickly If one should examine well the beginning of all the Stories of this Operation strictly weighing them as I did upon this occasion they would be found to be meer fables and that that which Rousset reports of his Caesarean Labours is nothing but the ravings capriciousness and imposture of their Authors Now if because of all these reasons a Chirurgeon must never practise this cruel Operation whilst the Mother is alive although the Child be certainly so which for all that may somtimes he very doubtful I pray what infamy would it be for him if having so killed the Mother the Child should also be found dead after it was thought to be alive much more ought he to abstain from it when he is well assured it is dead wherefore he had better pull it in pieces and bits if it cannot be otherwise by the natural way than so to butcher the Mother for to have it whole and if the Womb were so little open that he could not have liberty to work there nor introduce any instrument into it he had better wait a little alwaies trying to dilate the Passages by Art as we have formerly directed than to cast her down almost in an instant with such a blow of despair as the making of this Caesarean Operation which for this reason is never to be undertaken till immediatly after the Mothers death when the Chirurgeon must be present for to act according to the following directions as well in hopes of finding the Child living as to obey an Ordinance which expresly forbids the burying a Woman with Child before it is taken out of her Belly To accomplish which as it ought to be when he perceives the Woman in the agony he must quickly make ready all things necessary for his work to lose no time because delay will certainly be the death of the Infant which else a few moments before might have been brought alive there are some that when the Woman is just a dying would have somewhat put between her Teeth to keep her Mouth open and likewise in the outward part of the Womb to the end the Infant receiving by this means some little air and refreshment may not be so soon suffocated but all this mystery will avail but little because the Child lives only by the Mothers blood whilst it is in the Womb but if he will needs do so it is rather to content the company than out of any belief of the good it will do Assoon then as the Woman hath breathed her last and that she is dead to which all the company must agree he shall begin his Operation which the Greeks call Embriulcie Most Authors would have it made on the left side of the Belly because it is more free from the Liver which is on the right but if my opinion may be authentick it will be better and more skilfully made just in the middle of the Belly between the two right Muscles because in this place there is only the Coverings and the white Line to cut when on the side it cannot be done without cutting the two oblique and cross Muscles which being couched one under the other makes a considerable thickness besides that it bleeds more than towards the middle of the Belly not that the loss of blood is of any moment which will flow when the Woman is but just dead but because it hinders by its flowing the seeing distinctly how to make the Operation as it should be To dispatch then with more ease and speed the Chirurgeon having placed the dead Body that the Belly may be a little raised let him take a good sharp incision Knife very sharp of one side like that marked E in the table of Instruments at the end of this Chap. with which he must quickly make at one stroak or at two or three at most if he will for the greater surety an incision just in the middle of the Belly between the two right Muscles unto the Peritoneum of the length and extent of the Womb or thereabouts after