to its natural posture but if it come the feet forward and the legs abroad she must joyn the legs and feet together taking care that she remove not the hands from the place they should hang down close by the side If the infant with one or both the knees first strive to come forth she must put them back that both feet may first come down to the passage If the child come headlong with one hand thrust out then she must put the Child back with her hand upon the shoulders that the hand may goe to its natural place if this will not prevail lay the woman upright with her thighs and belly upwards that it may pass forth as it should do If both hands come out first she must thrust the Child back by the shoulders as formerly till the hands hang down by the sides of the Child If it would come forth arsewards the buttocks first she must return it back with her hands till the legs and feet may present themselves or the head first if it be possible which is most natural If the infant present both hands and both feet together to come forth so all at once she must take the Child carefully by the head and put the legs upward to take it forth If the shoulders come first she must put it back by the shoulders that the head may come first If it come the breast forward the legs and hands lying behind she must take it by the feet or by the head as she finds it to be most easy putting the other part upward that it may come forth right If a Woman have two Children at once that come together headlong she must take forth one after the other but beware the other retreat not back in the mean time so also must she receive them both that come together with the feet forward taking them out one after the other If they come one with his feet the other with the head forward at the same time she must receive that first which is most likely and next the passage and that which cometh with the feet first if she can receive last taking heed that they do not hurt one the other But let this general rule be observed still to annoint the passage with Ducks grease or Oyle of Lillies or sweet Almonds or such things as may smooth the passage and ease womans labour and Iikewise when she toucheth any part of the infant this will help much if there should be any aposthume in the place Particular helps to delivery are to lay the woman first all along on her back her head a little raised with a Pillow and a pillow under her back and another pillow larger than the other to raise her buttocks and rump lay her thighs and knees wide open asunder her legs must be bowed backwards toward her buttocks and drawn upwards her heels and soles of her feet must be fixed against a board to that purpose laid cross her bed Some woman must have a swathe-band above a foot broad four double this must be put under her Reins and two women standing on each side of her must hold it up straight and these two persons must lift up the swathe-band equally just when her throws come or else they may do her hurt and two more of the standers by must lay hold on the upper part of her shoulders that she may with more ease force the child forth The woman must hold her breath in and strive to be delivered and the Midwife must stroke down the birth from above the Navel easily with her hand for that will as I said before make the Infant move downwards CHAP. II. To know the fit time when the Child is ready to be born I Shall desire all Midwives to take heed how they give any thing inwardly to hasten the Birth unless they are sure the Birth is at hand many a child hath been lost for want of this knowledge and the mother put to more pain than she would have been Let not therefore the child be forced out unless there fall down an extreme flux of blood for in such cases it is best to save the Mothers life to drive forth the Child but there is great skill and care to be used or the woman were as good be set upon the Rack It is hard to know when the true time of her travel is near because many women have great pains many weeks before the time of delivery comes But I think the heat of their Reins is the cause of these pains but you may know whether the heat of their reins be the cause of it or not for if their legs swell their reins are too hot and the cure will be to annoint their backs to cool the reins with Oyl of Poppies water Lillies or Violets women whose reins are hot have alwaies hard labour A strong decoction of Plantane leaves and roots in water then strained and clarified with the white of an egg boil'd then to a sirrup with its weight in Sugar is excellent take a spoonful or two when you please or drink often the water and sirrups of Violets and water Lillies But if the birth be at hand you shall know when the skins Amnios and Allantois which as I told you serve to hold the sweat and urine of the child in the womb and by the means of which skins the infant is also supported in the Matrix do break by the violent motion of the child so that these excrements fall down to the neck of the womb Midwives call it the water and when that runs forth then the Birth is near this is the truest sign that is for when those skins are broken the Infant can no longer stay there than a naked man in a heap of snow These waters make the parts slippery and the birth easie if the child come presently with them but if it stay longer till the parts grow dry it will be hard therefore Midwives do ill to rend these skins open with their nails to make way for the water to come nature will make it come forth only when she needs it and not before but if the water breakaway long before the birth it is safe to give medicaments to drive the birth after the water But there are other signs of the birth approaching let the Midwife look well on the womans belly for if the upper part of it be sunk and hollow and the lower part big and full it is certain the child is sunk down again if the womans Throws be quick and strong coming from the reins downward all along the belly and not staying at the Navel but falling still lower to the groins and inwardly to the bottom of the belly where lieth the inmost neck of the womb this is another sure sign Then let the Midwife her hand annointed with fresh butter or with oyl of sweet Almonds put up her hand and if she feel the inward neck of the womb open or any substance to push
the child by his calcining heat what is bred by moisture and heat is fixed by cold and dryness Mars heats with a fiery calcination but Venus she tempers the heat of Mars by her moisture for she is a cold moist Planet and fitly added to abate the courage and violent heat of warlike Mars there is a great sympathy between Mars and Venus and therefore surely the Poets speak so much of their conjunction for they are eminent in this of mans generation You may by this find out the causes of sympathy and antipathy in natural things and seeing all things are made up of such contrary qualities what is generated must in time be corrupted nothing is eternal in this world but a perpetual motion breeds mutation and not man nor any thing else can continue in the same stay Mars and Venus do here play their parts in mans production for they are the nearest of the five Planets to the earth but next to them is Mercury of a changeable disposition and applieth himself to the rest of the Planets with several aspects and he causeth the desire of knowledge in man sense and reason also some maintain to be the work of Mercury by his influence upon the child in the womb It is not denied but a piercing acute humour proceeds from him which is most likely to effect not alone the sensible but the rational part in man CHAP. IX Of the Posture the child holdeth in the Womb and after what fashion it lieth there HEre Physicians are at a stand and are never like to agree about it not two in twenty that can set their horses together the speculation is very curious insomuch that the Prophet David ascribes this knowledge as more peculiar to God Psalm 139. My reins are thine thou hast covered me in my mothers womb I will give thanks unto thee for I am fearfully and wonderfully made marvellous are thy works and that my soul knoweth right well my bones are not hid from thee though I be made secretly and fashioned beneath in the earth thine eyes did see my substance yet being unperfect and in thy Book were all my members written which day by day were fashioned whenas yet there was none of them Yet Anatomists have narrowly enquired into this secret Cabinet of nature and Hippocrates that great Physician tells us in his Book De natura Pueri that the infant lieth in the womb with his head his hands and his knees bending downward towards his feet so that he is bended round together his hands lying upon both his knees the thumbs of his hands his eyes meeting each with other so saith Bartholinus the younger of the two Likewise Columbus's opinion is that the child lieth round in the womb with the right arm bended and the fingers of the right hand lying under the ear of it above the neck the head bowed so low that the chin meets and toucheth the breast and the left arm bowed lying above the breast and the face and the right elbow bended serves to underprop the left arm lying upon it the legs are lying upwards and the right leg is lifted so high that the infants thigh toucheth its belly the knees touch the Navel and the heel toucheth the left buttock and the foot is turned backward and hides the privy members as for the left thigh that toucheth the belly and the left leg is lifted up to the breast the stomach lyeth inward But the expert Spigelius hath the fashion of a child near the birth whose figure I have here laid down and I believe it is very proper for as well as I am able to judge by the figure it is the very same with that of a child that I had once the chance to see when I was performing my office of Midwifry Here insert the Figure of the Child near its Birth The Figure Explained Being a Dissection of the WOMB with the usual manner how the CHILD lies therein near the time of its Birth BB. The inner parts of the Chorion extended and branched out C. The Amnios extended DD. The Membrane of the Womb extended and branched E. The Fleshy substance call'd the Cake or Placenta which nourishes the Infant it is full of Vessels F. The Vessels appointâ—d for th◠〈…〉 This is a general observation that the Male Child most commonly lyeth on the right side in the womb and the Female on the left side but Hippocrates layeth it down as the most universal way to have his hands knees and head bending down toward the feet his nose betwixt his knees his hands upon both knees and his face between them each eye touching each thumb but he is wrapt as he lieth in two mantles or garments as I said for a boy hath no more that which immediately covers him and lieth next to his skin is called Amnios the skirt or Lamb-skin it is wonderful soft and thin and is loose on all sides only it grows so fast to the Cake that it can hardly be parted from it the use of it farther is to receive the Childs sweat and Urine which moisteneth the mouth of the Matrix also and makes the birth more easie but the outward coat called Chorion is very strong and sinewy and encloseth the child round about and like a soft pillow or bed bears up all the veins and Arteries of the Navel which would have been in danger to have been carried so far without some soft bolster to sustain them These coats growing fast together seem to be but one coat or one to be the beginning of the other and this altogether taken is called the after-burden or Secundine for when the Child is grown strong enough to come out of the womb and the time of his birth is at hand he breaks through these coverings and the coverings come forth after the child is born yet sometimes a piece of the Amnios covers the childs face and head when he is born and women call it the caule and hold it to be a Sign of some great happiness that will befall the child in the following part of his life but some think it is neither here nor there one born without this caule may be as happy as he that is born with it There belong to the child whilest it lieth in the womb some things that are proper for it some to cloath it and are only for that time that it lieth in that place and afterwards of no known use though some have tried to make use of them in Physick and Chirurgery but commonly they cast it away Some things again serve to nourish and feed it in the womb and those are the Navel-vessels which are four in number two arteries one vein and that vessel which is called Vrachos which carrieth away the childs water in the womb to that skin that is prepared to hold that water so long as the child staies in the womb and it is called Allantois The vein I speak of comes from the Infants Liver and
life and motion cease the childs must needs cease that depends upon it but it is an error for the child hath a Soul and life of its own and may live a while without the Mother but the Midwife must keep the womb open that it be not stifled till the Chirurgeon cuts it out you shall feel the Child leap when the Mother is dead Charles Stephen shews how to cut out a dead Child And Francis Ruset saith a live Child may be cut out of the womb both child Mother do well it is possible and sometimes necessary to be done and it stands by reason for women receive sometimes wounds in the Peritoneum and the Muscles of the lower belly more dangerous than the Cesarian cut and yet escape well enough A Child may be sometimes very weak yet not dead take heed you do not force delivery in such occasions till you be sure it is time for children may be sick and faint in their Mothers bellies But to prevent danger burn half a pint of white-wine adding no Spice to it but half an ounce of Cinnamon and drink it off if your Travel and throws come upon you be sure it is dead but if it be but sick and weak it will refresh it and strengthen it If the Child be dead in the womb the juyce of Garden Tansey annointed on the secrets or an oyl made in Summer with the herbs before it run to flower and boil'd in oyl till the juyce be wasted and set in the Sun a moneth before you boil it is an especial oyl for Midwives The Eagle-stone held near the privy parts will draw forth the Child as the Loadstone draws Iron but be sure so soon as the Child and after burthen are come away that you hold the stone no longer for fear of danger Any of these herbs half a dram in powder drunk in white-wine will do much viz of Bettony or Sage or Penny-Royal Fetherfew or Centory Ivy-berries and leaves or drink a strong decoction of Master-wort or of Hysop in hot water it soon will bring the dead Child forth because the afterbirth is corrupted in such cases and comes forth by pieces it is fit to drink of the same drink till all be come away or the roots of Polipody stamped and warm'd laid to the soles of her feet presently works the effect The same things almost all are proper when the Child is living and comes to be born but if her Travel be long the Midwife must refresh her with some Chickens broth of the Yolk of a potched Egg with a little bread or some wine or strong water but moderately taken and withal to cheer her up with good words stroaking down her belly above her Navel gently with her hand for that makes the Child move downwards She must bid her hold in her breath as much as she can for that will cause more force to bring out the Child Place here the Picture of all sorts of postures of Children Take notice that all women do not keep the same posture in their delivery some lye in their beds being very weak some sit in a stool or chair or rest upon the side of the bed held by other women that come to the Labor If the Woman that lyeth in be very fat fleshly or gross let her ly groveling on the place for that opens the womb and thrusts it downwards The Midwife must annoint her hands with Oyl of Lillies and the Womans Secrets or with Oyl of Almonds and so with her hands handle and unloose the parts and observe how the Child lyeth and stirreth and so help as time and occasion direct But above all take heed you force not the birth till the time be come and the Child come forward and appears ready to come forth Now the danger were much to force delivery because when the woman hath laboured sore if she rest not a while she will not be able presently to endure it her strength being spent before Also when you see the after-buthen then be sure the Birth is at hand but if the coats be so strong that they will not break to make way for the Child to come forth the Midwife must gently and prudently break and rend it with her nails if she can raise it she may cut a piece of it with a knife or pair of Sciffers but beware of the infant Then follows presently a flux of humours and the Child after that but if all the humours that should make the place slippery chance to run forth by this means before the child come the parts within and without must be annointed with Oyl of Almonds or Lillies and a whole Egg Yelk and white beaten and poured into the privy passage to to make it glib instead of the waters that are run forth too soon If the child have a great head and stick by the way the Midwife must annoint the place with Oyl as before and enlarge the part as much as may be the like must be done when Twins offer themselves if the head comes first the birth is natural but if it come any other way the Midwife must do what she can to bring it to this posture Sometimes the infant comes with the legs forwards and both arms downwards close to the sides this way the Midwife may endeavour to take it forth if it continue the same posture by annointing and gently handling the place but it is safer if she can to turn the Legs upward again by the Belly that the head may first come down by the back of the womb for that is the natural way If the child come forth with both legs and feet first and the Childs hands both lifted above the head this is the worst for danger of all the rest she must strive to turn the Child and if she cannot she must try to bring the hands down to the sides and to keep the legs close that it may come forth or else to bind the feet as they come out with some linnen Cloath and tenderly to help delivery but it will be hard to it Sometimes the Child will come forth with one foot and the other lifted upward Then let the woman in Child-bed be laid upright on her back hold up her thighs and belly that her head be lower than her body then let the Midwife with her hand gently put back the leg that is come forth into the womb again and bid the labouring woman to stir and move her self that by her stirring the birth may offer it self the head downward and if so you may then set her in a Chair as she was at first that she may have a natural delivery but if this cannot be done then the Midwife with her hand must discreetly bring forth that leg that is not yet come forth but beware she put not the Childs hands that lye close down by its sides out of their place if the side of the child come towards the passage she must turn the child
vein Cut a great hole in an onion fill the hole with Oyl roast it and stamp it and lay it warm to the Fundament Also take snails without or with shells I mean either kind and bruise them with some Oyl warm it and lay it to the place Sows or wood-lice called Hog-lice so bruised with Oyl are as effectual The Menstrual blood stopt We read Levit. 12. that a woman delivered of a Boy must continue in her purification thirty three dayes and for a girl sixty six days Hippocrates de Natura pueri saith a woman must continue purging her blood forth so long as the child was forming in the womb that is thirty dayes for a Male and forty two dayes for a Female Hippocrates rules may be calculated chiefly for his own Country of Greece and the Levitical Law most concerns the seed of Abraham but this is to be observed though not so precisely to a day by all women after delivery for women that give their own children suck have their purgations not so long as those that do not It is not good for a woman presently to suckle her child because those unclean purgations cannot make good milk the first milk is naught for even the first Milk of a Cow is salt and brackish and will turn to curds and whey You shall know if a woman be well cleansed by her health for if she be not she cannot be well and lusty I shewed you before what herbs will bring her purgations down She may if she please take every morning two or three spoonfuls of Briony water to be had at the Apothecaries or a dram of the powder of Gentian roots every morning in a cup of Wine the roots of Birth-wort are as good or take twelve Peony seeds powdered in a little Carduus posset drink to sweat and if it cures not do it again three hours after Against the too great running down of the Menstrual blood This disease seldom troubles women after delivery if it should Comfrey and Knot-grass are good remedies or else take Shepherds-pouch boyled in drink and powdered or bramble leaves a dram of either every morning in a little wine or a decoction made of the same Women when they ly in use to be cost ive because they keep their bed and some foolish Nurses are so bold as to purge them with Sena before nature be setled whereby many sad accidents have followed but neither loosning broths nor Prune broths nor bak'd Apples are then good but rather gentle Glisters and suppositories taken twice a week will prevent mischief and make the breasts abound with good milk CHAP. II. Of looseness of the Womb. THis may proceed from sundry causes as when great fluxes of humours take the ligaments and relax them falls or great burdens carried in the womb will unloosen them or chiefly when women travel before their time they overstrein themselves because the passage is then shut but unskilful Midwives often make it so when they thrust in their hand to pull forth the Secundine they tear part of the womb a way with it for the Secundine is fastened to its bottom sometimes they cause the woman to cast out the Secundine by strong vomit or by holding Bay salt in her mouth All causes except those that come from strong defluxions which must first be removed will be cured by the same remedies Take Nuts of Cypress and Galls and flowers of Pomegranates and Roch Allum two ounces of each Province Roses four ounces Scarlet Grains Rinds of Pomegranates and Cassia Rinds of each three ounces waters of Myrtles of Sloes an ounce and half Smiths water wine of each 4 ounces and a half then boil two little bags each a quarter of a yard long in the said waters in a new pot then hold the womans head and Reins low and apply these bags first one and then the other upon the os pubis and chafe her often Let her take in the morning a little Mastick in an egg or some Plantan seed but if the disease be long confirmed then make a Pessary half round and half oval of a thick Cork with a great hole in the middle for her Terms and ill vapours to come out by tye a pack threed to the end of it to pull it out by cover it over with white wax that it may not be offensive dip it in sallet Oyl to make it go in it must be strait that it may not quickly fall out when she doth her need let her hold it with her hand take it not away till her purgations be over the thickness of the Cork makes the Matrix mount higher if she be in Child-bed the Midwife or Nurse must not suffer the woman to strain but must keep her with her hand or finger to keep back the Matrix laying her head low and her Reins high with a pillow under her hips Women that are troubled with this disease must not lace themselves too strait for that thrusts down the womb makes the woman gor-bellied makes her carry her Child upon her hips hinders it from lying as it should in the womb and though the womans wast may be made slender by it her belly is as great and ill favoured But somtimes there happens a relaxation of the skin that covers the right gut when the head of the child when the woman begins to travel falls downward and draws it low lacing Childing women too hard is a frequent cause of it also for this makes so much wind fly to those parts that some are deceived and think it is the head of the child and the women can hardly stand or go let her then be kept soluble and eat Annis Coriander seed to dispell wind a fume of Sage Agrimony Balm Motherwort wormwood Rue Marjoram a little Time and Cammomile pick out the stalks cut the herbs small mingled put them into a maple platter put hot cinders upon them and another handful of herbs upon them cover the platter close with a cloth and let her take the fume beneath The womb falls out of its place when the ligaments by which it is bound to other parts of the body are by any means relaxed it is bound with four ligaments two broad membraces and above that spring from the Peritoneum and two round hollow nervous productions below also it is tied to the great vessels by veins and Arteries and to the back by Sinews but the Bottom of the womb is not tied the ligaments being onely upon the sides of it sometimes it falls forward quite out of the Privities but whether it can ascend and go upward is doubted by some Physicians say it will if sweet things be held to the nose if to the secrets it will fall downward if stinking things be put to them it flyes from them it may be discerned by their breathing and by some meats the womb greedily accepts But Galen saith it is very little that the womb can go upward it cannot reach the stomach the