its cavity The grosser nutricious Juice being deposited by the Umbilical Arteries in the Amnios as soon as the Mouth Gullet and Stomach and the like are formed so perfectly that the Foetus can swallow it sucks in some of the said Juice which descending into the Stomach and Intestines is received by the Lacteal Veins as in grown Persons The Infant therefore is nourished three several ways but only by one Humour First by apposition of it while it is yet an imperfect Embrio and has not the Umbilical Vessels formed But after these are perfected it then receives the same nutricious Juice by the Umbilical Vein the more Spirituous and thin part whereof it changes into Blood and sends forth the grosser part by the Umbilical Artery into the Amnios which the Infant sucks in at its Mouth and undergoing a new Concoction in its stomach is received out of the Intestines by the Lacteal Veins as is done after the birth A Child in the Womb differs from an adult Person in many parts the parts are less the colour of the whole reddish the Bones soft and many of them gristly and flexible in the Head There are several differences First the Head in respect to the proportion of the rest of the Body is bigger the Crown is not covered with Bone but only with a Membrane the Bone of the Forehead is divided as also of the under Jaw and the Os Cuneiforme is divided into four The Bone of the hinder part of the Head is distinguished into three four or five Bones The Brain is softer and more fluid and the Nerves very soft The Bones that serve the Sense of Hearing are wonderfully hard and big the Teeth lie hid in the little holes of the Jaw-bone the Dugs swell and out of them in Infants new born whether Male or Female a serous Milk issues forth sometimes of its own accord and sometimes with a gentle pressure The Vertebrae of the Back want their spinous processes and each of them made of three distinct Bones The Heart is remarkably big and its Auriculae large There are two Unions of the greater Vessels that are not conspicuous in grown Persons First the Foramen ovale by which there is a passage open out of the Cava into the Vein of the Lungs just as each of them are opening the first into the right Ventricle and the latter into the left Ventricle of the Heart and this Foramen just as it opens into the Vein of the Lungs has a Valve that hinders any thing from returning out of the said Vein into the Foramen Secondly the Arterial Channel which two fingers breadth from the Basis of the Heart joyns the Artery of the Lungs to the Aorta it has a pretty lage Cavity and ascends a little obliquely from the said Artery to the Aorta into which it conveys the Blood that was driven into the Artery of the Lungs out of the right Ventricle of the Heart so that it never comes into the left Ventricle as the Blood that is sent out of the left Venticle into the Aorta never came in the right except a little that is returned from the nutrition of the Lungs but past immediately into it out of the Vena Cava by the Foramen ovale so that the Blood passes not through both the Ventricles as it does after the Child is born You may know whether Infants killed by Whores and which they commonly affirm were still-born were really so or no by putting the Lungs of the Infant in Water for if they were still-born the Lungs will sink if alive so as to breath never so little while they will swim The Gland Thymus is very large and consists as it were of three Glands the Umbilical Vessels go out of the Abdomen the Stomach is narrower but pretty full of a whitish liquor The Caul is scarce visible the Guts are seventimes longer than the Body the Excrements in the small Guts are flegmatick and yellow but in the thick somewhat hard and blackish sometimes greenish the Caecum is larger than usual and often fill'd with Faeces the Liver is very large and extends it self into the left side and covers all the upper part of the Stomach it has a passage which is not in grown Persons called the Veiny Channel which arising out of the Sinus of the Porta carries the greatest part of what is brought by the Umbilical Vein directly and in a full stream into the Cava above the Liver But this passage presently closes as soon as the Infant is born and turns to a ligament as doth the Urachus and the two Umbilical Arteries The Spleen is small the Gall-bladder is full of yellow or green Choler the Sweet-bread is very large and white the Kidneys are bigger and unequal in their Superficies the Renes Succenturiati are exceeding large the Ureters are wide and the Bladder stretched with Urine in Females the VVomb is depressed the Tubes long and the Testes very large the little Bones of the VVrists and Instep are gristly and not firmly joyned together Its Knees are drawn up to the Belly its Legs bending backwards its Feet across and its Hands lifted up to its head one of which it holds to the Temple or Ear the other to the Cheek where there are white spots on the Skin as if it had been rubbed upon the Back-bone turns round the Head hanging down towards its Knees its Face commonly towards the Mothers Back but near the birth sometimes a VVeek or two before it alters its situation and tumbles down with its Head to the Neck of the VVomb and its Feet upwards then the VVomb also settles downwards and its Orifice relaxes and opens and the Infant moving up and down tears the Membrans wherein it is included and the waters flowing into the Sheath but sometimes the Membranes come forth whole at the same time the neighbouring parts are loosened and become fit for distension and the Bones near are so much relaxed in their Joynts that they make way for the Infant and the motion of it so much disturbs the VVomb that the Fibres of it and the Muscles of the Belly contract altogether to expel it CHAP. XIX Of the Management of a Woman with Child THE Woman ought to be kept in a good moderate and clear Air and she must Eat what she likes best and be sure not to Fast too long only she must observe not to eat too much at a time and to comfort the Stomach which is always weak in this condition she may Drink a little Wine or for want of it strong Beer at Meals As to Sleep a Woman with Child requires more sleep than she does at other times As to Exercise and Rest she must order her self according to the different times for at the beginning she ought to keep her self quiet and not to use Copulation Riding on Horse-back or in a Waggon or indeed in a Coach is not safe at any time of her being with Child especially when she
and a very considerable abscess follows in which Case it must be opened just below the Swelling in the most convenient place and after the Matter is evacuated a detersive Decoction must be injected into the Cavity made of Barly-water and Oyl of Roses to which Spirit of Wine may be added if there be any danger of Corruption and afterwards the Ulcer must be Dressed according to Art Sometimes it happens that the Perineum is so rent that the Privities and the Fundament is all in one in this case having cleansed the Womb from such Excrements as may be there with Red-wine let the Rent be strongly stitched together with three or four stiches or more according to the length of the separation taking at each stich good hold of the Flesh that so it may not break out and then dress it with Linimentum Arcaei or the like claping a Plaister on and some Linnen above to prevent as much as may be the falling of the Urine and other Excrements upon it because the acrimony of them would make it smart and cause Pain and that these parts may close together with more ease let the Woman keep her Thighs close together without the least spreading until the Cure be perfected but if afterwards she happens to be with Child she will be obliged to prevent the like mischief to anoint those parts with Emollient Oyls and Oyntments and when she is in Labour she must forbear helping her Throws too strongly at once but leave Nature to perform it by degrees together with the help of a Midwife well Instructed in her Art for usually when these parts have been once rent it is very difficult to prevent the like in the following Travail because the Scar there made does straighten the parts yet more wherefore it were to be wished for greater security against the like accidents that the Woman should have no more Children CHAP. XXII Of hard Labour MAny Causes may be assigned that occasion hard Labour as the natural weakness of the Mothers Body or her Age she being too Young or too Old or it may be occasioned by Diseases that she had with her big Belly leanness or too much dryness of the Body or Fat compressing the passages of the Womb the ill conformation of the Bones encompassing the Womb as in those that are Lame may also occasion it Wind swelling the Bowels a Stone or Preternatural Tumour in the Bladder that presses the Womb may be the occasion so may the ill constitution of the Lungs or of the parts serving respiration for the holding of the Breath conduceth much to the Exclusion of the Child Various Diseases of the VVomb may also render the Delivery difficult as swellings Ulcers Obstructions and the like The hard Labour is occasioned by the Child when by reason it is Dead or Putrified or any way Diseased it cannot confer any thing to its own exclusion also when the Body or Head is too large or when there are more than one so Twins most commonly cause hard Labour or the ill situation of the Child is the cause or when the Hands or the Feet offer first or when one Hand or one Foot comes out first or when it is doubled or when the Membranes break too soon so that the VVater flows out and leaves the Orifice of the VVomb dry at the time of Exclusion or when the Membranes are too thick so that they cannot be easily broken by the Child Cold and dry Air and a North-wind are very injurious to VVomen in Labour because they bind the Body and drive the Blood and Spirits to the inner parts and they are very injurious to the Child coming from so warm a place And hot Weather dissipates the Spirits and weakens the Child Crude Nourishment and such as is difficultly concocted and binds taken in a great quantity before Labours renders it difficult the Stomach being weakned and the common passages contracted which ought to be open in this Case Drowsiness hinders the action of the Mother The unseasonable motion of the VVoman much retards the Delivery as when she refuses upon occasion to stand walk lie or sit or slings her self about unadvisedly so that the Child cannot be Born the right way being turned preposterously by the restlesness of the Mother Urine in the Bladder or Excrements in the right Gut or the Piles when they are much swell'd hinder Natures endeavours by narrowing the Neck of the VVomb Fear Sorrow Anger make the Labour difficult A Blow a Fall or a Wound may also much obstruct the Labour Want of good assistance to lift the Woman up just at the time of Delivery and an Ignorant Midwife who orders the Woman to endeavour an expulsion and to stop her breath when the ligaments of the Fetus stick firmly to the Womb so that the Woman is tired before the time of her Delivery In hard Labour Women commonly give a Spoonful or two of Cinamon-water or Cinnamon powder'd with a little Saffron or half a Dram of Confection of Alkermes in Broth or half a Scruple of Saffron alone in some Broth or every hour a lit-VVine If these things are not sufficient the following may be used which have been frequently found very effectual Take of Dittany of Creet and both the Birthworts and of Troaches of Mirrh each half a Scruple of Saffron and Cinnamon each Twelve Grains of confection of Alkermes half a Dram of Cinnamon-water half an Ounce of Orange-flower-water and of Mugwort-water each one Ounce make a Potion Oyl of Amber and of Cinnamon and extract of Saffron are very effectual in a small quantity namely five Grains of extract of Saffron four or five drops of Oyl of Cinnamon twelve or fifteen drops of Oyl of Amber in Wine Broth or some other Liquor and let the Woman take Sneesing Powder for it hastens delivery The Midwife must frequently anoint the Womb with the Oyls of Lilies or of Sweet Almonds and the Belly must be fomented with a Decoction of the Roots of Marshmallows and Lilies of the Leaves of Mallows Violets Mugwort of the Seeds of Fenugreek and Flax of the Flowers of Camomile and Melilote Sharp Glisters must be also injected to stimulate the Womb and to carry off the Excrements Anoint the Navel with Oyl of Amber If the Child begins to come forth preposterously as with one Arm or Foot the Midwife must thrust them back and turn the Child right which may be done by placing the Woman on her Back upon a Bed with her Head low and Feet high CHAP. XXIII Of a dead Child WHEN the Child is dead the motion of it ceases which either the Woman felt before in the Womb or the Midwife with her Hand a sense of weight with pain afflicts the Belly and the Child falls like a Stone from side to side the Belly feels cold the Eyes are Hollow the Face and Lips pale the extream parts cold and livid the Breasts flaccid and at length the Child putrifying stinking matter Flows from the Womb
may be found out by the hand of a Skilful Midwife As to the prognostick if the Closure be in the Orifice of the Privities it is easily Cured by a small Section But if it be in the inner Parts the Cure is much more difficult When a Membrane shuts the passage it is easily Cured but when the Closure is from fleshy Matter as it happens after Ulcers then the Cure is much more difficult The Closure of the inner Orifice of the Womb is Incurable for Chirurgcial Instruments cannot work upon it If the Closure of the Womb be contracted from the Birth it must be opened by simple Section but if it takes its rise from an Ulcer as it often happens in the French-Pox we must consider whether it be an Excrescence of Flesh that does not wholly stop the passage and whether it quite stops For if it be only an Excrescence we must endeavour convenient Evacuations going before first to hinder the increase of the Flesh by drying and discussing Medicines and afterwards we must lessen the Flesh by Medicines made of Frankincense Birthwort the Bark of Frankincense Roses Balaustins Mastick Myrrh Aloes and the like and if these things are not sufficient we must use burnt Allom Unguentum Aegyptiacum and the like or the Flesh may be cut off by that Instrument that is used for extirpating a Polipus But if the Neck of the Womb be wholly shut we must endeavour to renew the Ulcer and to take off the superfluous Flesh by the foresaid Medicines or it must be cut If a Tumour shut the passage of the Womb it must be removed by proper Remedies If it be occasioned by a Compression of the Neck of the Womb that which causes the Compression must be removed namely a Stone in the Bladder a Tumour of the right Gut or the like When the passage is too narrow it most commonly proceeds from hardness and dryness and therefore you must use moistning emollient and relaxing things as half Baths Fomentations Liniments and Pessaries and so the part being relaxed you must put a leaden Pipe or white Wax fitted for the purpose moistened with Butter or some emollient Oyl and she must always wear it or at least a-nights and a-days let a Pessary made of Cotten be used anointed with Oyntment Marsh-mallows or the like CHAP. X. Of Suppression of the Courses THere is said to be a Suppression of the Courses when in Women of a mature Age that neither give suck nor are with Child the Evacuation of Blood by the Womb which is Naturally wont to be Monthly flows seldom or sparingly or is wholly stopt Because this Suppression proceeds from Natural and Preternatural Causes the signs of both shall be distinctly proposed lest the Practitioner should be deceived by Women being with Child by Illegitimate Coition and so rashly prescribe Medicines to provoke the Courses First therefore Women with Child most commonly retain their Natural Colour and others do not Secondly the Symptoms which do happen to Women with Child at the beginning abate Daily but on the contrary in Suppression of the Courses the longer they are stop'd so much the more the Symptoms are increased Thirdly In Women with Child after the third Month the motion and situation of the Child may be sensibly perceived by laying the hand on the Belly But in others the Swelling is not at all hard nor is it always contained within the Limits of the Womb. Fourthly If the inward Mouth of the Womb be touched by a Skilful Midwife she will find it not exactly closed as it is in Women with Child but rather hard contracted and somewhat painful Fifthly Women with Child are most commonly cheerful but on the contrary in a Suppression they are most commonly sorrowful and sad A Suppression of the Courses is very dangerous and many desperate Diseases arise from it The Cure of this Disease must be varied according to the variety of the Causes and first if it proceed from too great a quantity of Blood bleeding must be ordered in the Arm and a large quantity of Blood must be taken away afterwards it must be drawn downwards by opening the lower Veins about the time the Woman used to have her Courses before she was ill If by reason of want of Blood the Courses stop as after long Fevers after great Evacuations and when the Body is much wasted you must not endeavour to provoke the Courses till the Body is replenish'd and a sufficient quantity of Blood is bred which being done they generally flow of their own accord but if it happens that Nature forforgets her Office she must be rous'd up by opening the lower Veins and by Medicines proposed in the Chapter of Hysterick Diseases But the quantity of Blood must be moderate lest the strength should be dejected and the Sick should fall into a Consumption yet it must be carefully noted that every wasting of the Body does not shew a want of Blood but only that which succeeds great Evacuations and the like For sometimes it happens that the Courses being suppressed and detained in the Veins occasion an ill quality whereby the Blood is rendred unfit to nourish the Parts upon which account the Body wasts tho the Veins are full of Blood in which Case large bleeding is required As to the suppression of the Courses which happens by a preposterous motion of the Blood when it is evacuated by bleeding at Nose by Vomiting Spitting or Hemorrhoids and other parts the Cure of it is perform'd by repelling the Blood from the parts through which it flows contrary to Nature and by drawing it back to the passage of the Womb. The first is performed when the Blood rushes out of the upper parts by washing the Arms Head and Face with cold Water and by forbearing the exercise of those parts especially singing and speaking aloud The second is perform'd by opening the lower Veins three or Four days before the Blood breaks out and by Cuping-Glasses applied to the Thighs and Legs sometimes with sometimes without Scarification by provoking the Hemorrhoids by Running by Walking Fomentations and Baths made of opening Herbs but the Bath water is especially commended and the Sick must bath in them often a good while after Meals but the water must not rise above the Navel and at the same time the upper parts be cool'd by fanning them If the Blood flow by the Hemorrhoids the Cure is very difficult for if you use things to draw downwards they bring them also to the Fundament and if you use astringent things to it they by nearness of the parts repell what should be brought to the Womb so that the only way of Cure is to apply such things to the Womb as may allure the Blood thither after you have used such things as draw the Blood downwards CHAP. XI Of an Immoderate Flux of the Courses AN immoderate Flux of the Courses comes either in Child-bed or at other times as to the first that afflicts Women most on
is near her time for such Exercises often cause Miscarriage But she may Walk gently or be carried in a Chair She must not carry or lift heavy Burdens or lift up her Arms too high and therefore ought not to dress her own Head Let her Exercise be gentle walking in low-heel'd Shoes but she had better Rest too much than Exercise too much for more hard Labours are occasioned by violent Exercise than by any other thing Moreover it is convenient that the Woman should abstain from Copulation the last two months for the Body is very much moved and the Belly compressed in the action which causes the Child to take a wrong posture If the Belly be bound as it is often at this time Prunes stewed or Veal Broath may be often used or the following Glister may be used Boyl an Handful of Mallow Leaves in three quarters of a Pint of Milk let the Milk just boyl up add to it two Ounces of brown Sugar and a little fresh Butter strain it for use She must moderate her Passions and great care must be taken that she be not Frighted and that Melancholy News be not suddenly told her but you must endeavour to keep her as chearful as possibly you can the sudden surprizes of joy must be also avoided for excesses on either hand are prejudicial The Cloaths of a Woman with Child should sit easie for any immoderate pressure is apt to make the Child deformed and hurts the Breasts and very often causes miscarriage Unnecessary Bleeding must be avoided so must all strong Purges but if Purging is requisite only such things as Purge gently must be used as Cassia Rubarb and Manna The Cassia is best sucked out of the Canes the Rubarb may be chewed and an Ounce and a half or two Ounces of Manna may be dissolved in Posset-drink and used upon occasion in the Morning Vomiting often afflicts Women with Child but if it be moderate and at the beginning and without great straining it is beneficial if it continues longer than the third or fourth Month it ought to be remedied in order to which let the Woman use good food and a little at a time and let her use with her meat the juice of Oranges she may eat now and then Broth mixed with the yolk of an Egg for it 's very nourishing and of easie digestion and after meals let her eat a little Marmalade of Quinces and she may drink a Glass of Claret she must forbear fat meat and Sauces and sweet and sugar'd Sauces But if the Vomiting continues notwithstanding this regular Diet till the Woman is above half gon she must take the following Purge Take of Tamarinds half an Ounce of Sena one Dram of Rubarb one Dram and an half boyl them in a sufficient quantity of water in three Ounces of the strained Liquor dissolve an Ounce of Manna and an Ounce of Syrup of Succory with Rubarb make a purging potion to be taken in the Morning It may be repeated once or oftener upon occasion And it may be proper for the Woman in the Winter time to were a Lambskin or the like upon her Stomach and Belly If pains of the Back Reins and Hips are violent the Woman must be blooded and take at bed-time sixteen drops of the Liquid Laudanum mentioned at the latter end of the Chapter of Hysteric Diseases in a glass of Canary Wine or in any thing else she likes and she must keep her Bed till the pain abates if the pain is continual the Belly must be supported with a Swaith fitted for the purpose If after the third or fourth Month the Breasts are very painful 't is convenient the Woman shou'd bleed in the Arm if she be full of blood and use a Diet that is moderately cooling and nourishing but if the pain comes at the beginning we ought to leave the whole business to nature only the Woman must have a care that she receives no blows on those parts nor must she be strait laced for fear the Breasts shou'd impostumate If incontinence or difficulty of Urin be occasion'd by the weight and bigness of the Belly the Woman may remedy it and ease her self if when she wou'd make water she lift up with both her hands the bottom of her Belly or she may wear a large Swaith fitted for this use to bear up the Belly but the best way is to keep her in Bed If a sharpness of Urin causes an Inflammation on the Neck of the Bladder it may be appeased by a regular cooling Diet and emulsions of the cold Seeds used Morning and Evening Take of blanched Almonds number twelve of the four greater cold Seeds each one Dram and an half of the Seeds of Lettice and white Poppies each half a Dram beat them in a Marble Mortar and pour on them gently three quarters of a pint of Poppy Water make an emulsion for two doses add one Ounce of Syrup of Violets and half a Dram of Sal Prunella If the Inflammation and Sharpness of Urine be not removed by the things above-mention'd a little Blood may be taken from the Arm and the neck of the Bladder may be bathed with the following Decoction with Flannels dipt in it and pressed out Take of the roots of Marsh-mallows one Ounce of the Leaves of Mallows Marsh-mallows Pellitory and Violets each one handful of the Flowers of Melilote one handful of the Seeds of Flax and Fenugreek each two Drams boyl them in a sufficient quantity of Water to a pint and half But if the Woman notwithstanding she observes these directions cannot make water it must be drawn out with a Catheter by an Artist If the Woman be troubled with a violent Cough she must be blooded in the Arm at any time of her being with Child for this is apt to occasion miscarriage and all salted and spiced meat and sharp things must be forborn She may now and then use juice of Liquorish Sugar Candy and Syrup of Violets and if the Body be bound a Glister of Milk and Sugar may be injected The following Syrup is very proper in this case Take half a pint of Claret Wine one Dram of Cinnamon half a Dozen Cloves and four Ounces of Sugar burn the Wine and boyl it to the consistence of a Syrup whereof let the Woman take three spoonfuls at Bedtime The Woman must go loose in her Clothes and if the Rheum be very thin and the Cough tickles much Sixteen drops of the Liquid Laudanum mentioned in the Chapter of Hysteric Diseases must be now and then taken at bedtime in some liquor she uses to drink If the Legs and Thighs swell and are painful they must be swaithed with a Swaith three or four Fingers broad beginning to swaith from the bottom but in this case 't is best for the Woman to be kept in Bed if there be signs of fulness of blood she must be blooded in the Arm. If the big bellied Woman be troubled with the Piles and abound