But if there be twins then that which presenteth it self fairrest must be laid hold on and the other put back As to all which the next following Sections will not only furnish you with figures but with directions Hitherto having described the Midwife and her office together with the site of the infant in the womb as natural together with difficult births in general and their causes It is reasonable good Mrs. Eutrapelia that we discourse of unnatural births because those bring the greatest danger with them both to the mother and infant SECT X. Figure the first Of unnatural Births DR Courteous Mrs. Eutrapelia If you perceive a child come with its feet forwards and the hands drawn downwards to the thighs according to the next ensuing form How will you deliver the woman Mid. In this I will take care to be furnished with Oyles and convenient liniments and only to help the coming forth of the infant by anointing and cherishing it lest it go back again but that it may come forth the same way as it began But first of all I shall take care that both arms of the infant so stretched downwards be so secured by me that the infant may not have power to draw them back again but that I may compel it to come forth after the very same manner But if the infant breaking forth after this manner and by reason of its bigness as well as his arms drawn down be so streightned by the narrowness of the matrix that of it self it cannot wholly come to the birth then the womb of the woman is to be anointed with oyl of Lillies or sweet Almonds or hogs grease some sneezing Powder blowed up he nose to help the sending forth of the birth and the womb gently to be compressed with both hands that it tend not upwards but downwards as it ought until it come forth entirely Here most Authors advise to change the Figure and place the head so that it may present it self first to the birth which is very difficult and almost altogether impossible to be performed if we desire to avoid the dangers that by such violent endeavours both the Mother and the Child must inevitably be put into and I wish they would have shown us any way how it might be safely acted that we might have followed their examples wherefore 't is better to draw it forth by the feet then to venture a worse accident by turning it Now to perform this the Midwife must have her Nails well pared and no rings on her fingers but her hands well anointed with Oyl or fresh Butter then the woman being seated to the best advantage let her gently put her hand into the entry of the Womb which if it be not wide enough let her open it a little and little by degrees with her fingers by spreading them one from the other after they are entred together so continuing to do till it be sufficiently enlarged then finding the Child's feet let her draw it forth in this posture following but if there shall but one foot present it self then she shall consider whether it be the right or the left and in what fashion it comes for thefe reflections will be a means to inform her on what side the other may be which as soon as she knows let her seek for it and then gently draw it forth together with the first and then also let her be very careful and well assured that this 2d be not the foot of another Child for if it should chance to prove so she may sooner split both Mother and Children then draw them forth the which she may easily prevent it by sliding her hand up the first leg and thigh to the twist she find both thighs joined together and depending from one and the same body and which is likewise without doubt the best means to find the other foot when it comes but with one Being then secured of both the Childs feet she may draw them forth and holding them together she may bring them by little and little in this manner by taking hold of the Legs and Thighs aftewards as soon as she can come at them and drawing them so till the hips be come forth in the mean time let her observe to wrap the parts in a single napkin to the intent that her hands being already greasy slip or slide nor from the Infants body which is very slippery because of the slimy humors which are all over it and hinder her from taking fast hold of it which being done she may on both sides with her hand bring away the arms being careful that the Belly and Face be downwards lest being upwards the Head be stopt by the chin over the share-bone so that if it be not so she must turn it to that posture which is easily done if by taking hold of the body when the breast and arms are forth she shall draw it with turning it in proportion on that side it most inclines to till it be as it should be that is with the Face downwards and having brought it to the shoulders let her lose no time desiring the Women at the same instant to bear down that so in drawing the head at that very moment may take its places and not be stopt in its passage There are indeed some Children that have their Head so big that when the whole body is born yet that stops in the passage notwithstanding all the care that can be used to prevent it in this case the Midwife must not only endeavour to draw forth the Child by the shoulders least she sometimes separates the body from the Head but she must disingage it by little and little from the bones in the passage with the fingers of each hand sliding on each side oppofite the one to the other sometimes above and sometimes under until the work be ended endeavouring to dispatch it as soon as possible least the Child be cloaked or stifled as it will certainly be if it remain long in that posture wâ—ich being artificially and well effected she may soon after fetch away the after-birth SECT XI Figure the Second DR But tell me I pray Mrs. Eutrapelia What if an infant come with the feet forward and the hands lifted above the head and not drawn downwards to the thighs as in the follwing figure what course will you take with most safety Mid. Sir I am not at all to receive it so lying except the Infant be very small and little and the Womb so extensive and open that it may be hoped a safe delivery both to the Woman and to the Child neither must I receive it before the Womb and the Infant be diligently anointed But it were much better to thrust back the Infant into the Womb and to turn it to the right form which may be done after this manner Let the woman lye on her back upon a bed with her buttocks raised higher and her head lower which done I must swathe her belly
rest as before is taught when it come with its feet foremost SECT XIV Figure the Fifth DR Tell me Mrs Eutrapelia what if the Infant happen to hasten to the birth with his armes and legs distorted and crooked according to this figure How then will you help Mid. As things so stand Sir I must not endeavour the birth of the child but must bring her from the stool to the bed where I must press back the womb as before-said or must desire her to roul her self about till the Infant is turned to a more commodious posture And if this course prevail not I must endeavour to joyn both feet together and if possible must bring down the hands so to the sides that I may direct it to the birth But the safest and best way in my weak judgement Sr. must needs be that which you have taught me in the foregoing births SECT XV. Figure the Sixth DR Tell me Midwife what if the Infant fall down with both the knees bent and the hands hanging down to the thighs How will you go to work Mid. Here Sr. when an Infant not being turned towards the latter months as it ought to come with its head foromost presents its self with the knees to the birth having its legs folded towards its buttocks one may easily be deceivad touching one of them because of their hardness and roundness and take it for its head especially when being seated a little high it can be reached but with the end of a singer only but if it be touched and handled a little better the Infant being fallen a little lower it will be easily distinquished Assoon therefore Sr. as such birth is perceieved I must not suffer it to advance further in such a posture but having placed the woman must gently put back the childs knees to the intent that I may have the more liberty to unfold the legs one after another thâ—… which dextrously to effect I must put one oâ— two of my fingers under the child's hams dâ—recting them by little and little all along bâ—hind the leg until I meet with the foot anâ— drawing alwayes a little obliquely for tâ— come the easier to the end of it that so having disengaged one I may do the same to thâ— other proceeding after the same manner aâ— with the first after which having broughâ— them together I must finish the work aâ— when a child comes with its feet foremost and hands downwards to the things SECT XVI Figure the Seventh DR But Mrs. Eutrapelia what if the Infant come out hastily with one hand and the other hand down towards the side and the feet stretched out streight into the womb according to this figure How will you receive it Mid. May it please you Sir I am not at all to receive it so nor to suffer it to proceed farther toward the birth but must bring her to the bed where her head must lye lower than her buttocks then I must swathe her belly gently that the Infant may fall back again into the womb but if it fall not back of its own accord I must put in my hand and press back the shoulders and must reduce the the arm that hanged out to the side that it may be disposed of to a natural from in the Womb and so may come forth easily Dr. Very well Mrs. Eutrapelia this is your way but now give me leave I pray you to give you my method in this case when an Infant therefore presents only one or both hands to the birth or an arme sometimes out to the Elbow and many times to the shoulder it is of the worst and most dangerous postures a child can come in as well for its self as its mother by reason of the violence the midwife is forced to use both to the one and the other in searching for the feet which are very far off by which I would always in these cases have it turn'd and drawn forth the which to do will often make the midwife sweat in the midst of winter because of the difficulty in this labor more then all the rest though some other of them are indeed more dangerous for the Infant as when it presents the belly and the Navil string comes forth but it is not so painful for the Midwife because the feet of the Infant being near the passage are not so hard to be found as when it comes with a hand forward for then they are high and at the very bottom sometimes of the womb where the midwife must seek them to turn it and draw it forth as I shall now direct When therefore it presents with one hand only or a whole arm first it must by no means be pulled forth by that part for it will be sooner separated and rent from the body then so brought forth by reason a child is pluck'd obliquely and a cross-way wherefore having placed the woman as is requisite the midwife must put back the Infants hand or arm into the womb again some Midwives dip in cold water or wash it with a wet cloth saying that the Infant will presently draw it in if it be living but it is usually so prest and ingag'd in the passage that this bad posture that it hath not liberty enough to draw back its hands so easily being once come forth wherefore the midwife must guide them back with her own which she must afterwards slide into the womb under the child's brest and belly so far till she finds the feet which she must gently pull towards her to turn it and draw it forth by them as before I directed always remembring to act with as little violence as may be which is much more easy sure and safe then to busy ones self in putting it to a natural situation As soon therefore as she hath turn'd the child to the feet if she hath hold but of one she must search for the other that so she may bring it to the first when holding them both she must govern herself afterwards in bringing the child into the World as we directed you before when the child comes with its feet foremost But if the Arm be far advanced almost to the shoulder and so big and sweld as it will be if it be along while forth that it cannot at all or with out great difficulty be put back then she herself or a Chirurgion being immediately sent for if the child be certainly dead must twist the arm twice or thrice about till it be wholly seperated from the body which it will easily be by reason of its tenderness and that just in the joint of the shoulder with the shoulder blade but be sure the child be dead elce what an horrible spectacle will it be to bring as some have done a poor child yet living into the World after the arm hath been cut off SECT XVII Figure the Eighth DR But Mrs Suppose the Infant come forth with both hands stretched forth above the head and the feet streight
turn it this situation being already half turn'd the feet being as neer to the passage as the head when it represents the midle of the belly then I must slip up my hand under the belly till I find the feet which I must bring to the passage to draw it forth in the same manner as if it came with the feet foremost being very careful to keep the Face downwards which must alwaies be observed before the head can be drawn forth for the reasons before given which must never be forgotten And here likewise is to be noted that the Midwife must alwaies prooceed after one and the same manner in the deliveries when a Child comes with the breast or belly But on the other hand I would have it remark'd that when at any time an Infant comes with its side it is impossible to be delivered as the two former but yet it is not so much tormented nor is its situation so cruel for it may remain in it a longer time without dying than in the two former wherein it is much more as it were upon the rack than in this in which posture the body may be bended forwards and not backwards as in the other but the Navil string doth not come forth so easily as when it comes with the belly first And in this as in the other 2 births the Midwife will find it the safest way to draw it forth by the feet by pushing back a little the Infants body with her hand the better to introduce it which she may slide along its thighs till she find the legs and feet by which she must turn it and afterwards draw it forth as I said even now nor ought she to amuse her self in any of these 3 births to place its head right that it may come naturally because 't is in great danger of dying in these unnatural positions if not drawn forth with speed which can never be effected unless it be by finding the feet as I have directed SECT XXIII How to help a Woman in her Labor when the Childs head thrusts the neck of the Womb forth before it DR Now Mrs. Eutrapelia I have another question to ask you and that is this suppose you were call'd to deliver a Woman in labor where you find the Childs head to thrust forth the neck of the Womb before it how would you go to work in such a case and what art would you use to deliver the Child with safety Mid. Why surely Sir if we only have respect to the Figure the Child comes in in this labor we may call it a natural one but if we shall on the other hand consider either the disposition of the Womb which is in danger of coming quite forth of the passage or the manner of drawing forth of the Infant we shall find it to be not so altogether for its head thrusting it forceably before it may easily cause a falling out of the Womb if the Woman be not skilfully succoured in time here may be seen the neck of the Womb bear forth before in great wrinkles according as the Child advanceth Now Women troubled with their bearing down of their Womb before they conceive and those whose Womb is very moist are much subject to this accident because of the looseness of the strings The same method must not be observed here as in the natural birth for in this case the Woman must neither walk nor stand upright but she must keep her bed with her body equally at least situated and not raised a little as is requisite in a natural labor She must by no means use strong or sharp clysters lest they procure too great throws neither must her Womb be moistned because 't is already too much loosened but she must be aided at the moment each pain takes her when the Child begins to advance its head and consequently the neck of the Womb and let the Midwife keep her hands on each side of its head to thrust back by resisting the Womans pains the Womb only giving way in the mean time for the Child to advance doing the like at every throw continuing therein till the Woman of her self hath forced the Child quite into the World for we must by no means draw it by the head as in a natural labor for fear of causing the Womb to fall out at the same time to which it is then very apt Now if notwithstanding the Infant having the head born and yet stops there so long as to endanger its suffocation then the Midwife must call a second person to her assistance to draw it gently forth by the head whilst she keeps back the Womb with both her hands to prevent its following the Infants body so drawn forth After the Woman is thus delivered and her Afterbirth fetch'd away gently and not shaking or drawing it away too rudely then let the Womb be placed up in its natural situation if it bears down SECT XXIV How to deliver a Woman when the Child presents the side of the Head to the birth or its Face DR Good Mrs. Eutrapelia I do very well approve of this your answer to my last quere now in the next place I would know of you how you would bring a Woman to bed when the Child shall present it self with the side of its Head first or its Face Mid. When the child Sir presents it self in this posture as with the side of the head though it seems a natural labor because the head comes first yet 't is very dangerous both to child and mother for the child shall sooner break its neck than ever be born in this fashion and by how much the mothers pains continue to bear it which is impossible unless the head be first right plac'd the more the passages are stopt up Therefore as soon as 't is known the woman must be lay'd with all speed lest the child advancing farther in this vicious posture it prove more difficult to thrust it back which must be done when we would place the head right in the passage as it truely and naturally should be Now to effect this I must place the woman that her hips be a little higher than her head and shoulders causing her to lean a little upon the opposite side to the childs ill posture then I must slide up my hand being well anointed with oil by the side of the child's head for to bring it right gently with my fingers between the head and the womb but if the head be so engaged that it cannot be easily done that way I must then put my hand up to its shoulders that so by thrusting them back in the womb sometimes on the one side and sometimes on the other as I see occasion so shall I give it a natural and convenient position And here it were to be wished that the midwife could put back the Infant by the shoulders with both her hands in this manner but the head doth take up so much room that she hath
oftentimes more forward then the other which is the cause why but one is felt and that 't is sometimes not discovered that the Woman will have Twins till going to fetch the after-birth the first being born the 2 d is then perceived When there are Twins Mrs. Eutrapelia one must not think that Nature is orderly in causing one to be born before the other the first or last according as it may be most convenient that is to say when the one is strong and the other weak that the strongest comes first as also when one is dead and the other living that the living one drives forth the dead one for I can assure you there is no certain or infallible rule in these cases of which I can give you an example there were once 2 women deliver'd within a week of one another and both of Twins the one of each being dead and the other living the living Child of the first Woman was born before the dead one and the dead one the 2d was expelled before the living one And the same thing we see happens very often in respect of strong and weak Children for that which is nearest the birth whether alive or dead strong or weak is always the first born or must be brought into the World the first if it cannot come of it self otherwise the difficulty of the Labor would yet be augmented as well in length of time to the Mother as the violence done to the first Child in putting it back for to fetch the 2d first Now the Midwife must always remember to have a care in all natural births to examine diligently whether there be no more Children in the Womb after the first is delivered which she may easily know by the continuance of the pains after the Child is born and the bigness of the Mothers belly besides this she may be very sure of it if she shall put her hand up the entry of the Womb and shall there find another water a gathering and a Child in it presenting to the passage and if this shall be so the Midwife is not to fetch away the after-birth till the Woman be delivered of all her Children if she chance to have never so many because Twins never have but one burthen to which there are fastened as many strings and distinct Membranes as there are Children and if one should go to draw it forth as soon as the Birth is born the rest would be in danger of their lives because that part is very necessary to them whilest they are in the Womb and besides more then that it endangers a flooding Wherefore the first string must be cut being first tyed with three or four double and the other end must be fastened with a string to the Womans thigh not so much for fear that the string should enter again into the Womb as to prevent the inconvenience it may cause to the Woman by hanging between her thighs afterwards this Child being removed the Midwife must take care to deliver her of the rest observing all the same circumstances as were belonging to the first the which being done it will be then convenient and necessary to fetch away the After-birth as we shall discourse the manner how by and by SECT XXXI Figure the Sixteenth DR Courteous Mrs. Eutrapelia I have hitherto troubled you with many Questions that I might not only be sure of your abilities but also give testimony of your sufficiency if need require I have now only one Question more and then I have done as to these postures and fashions And this though the last surely is a miraculous posture What if the Infant be so involved in the womb the head and the neck being of such a length that it is so bent back that the face lyeth betwixt the buttocks the right hand to the left region of the reins but the left hand to the knee of the same side the right legg being across the left in form of the letter X and both leggs bent up toward the breast Mid. Worthy Dr. This case is the hardest of any that hitherto you have propounded to me and though it may never fall out to be so in one amongnst 5000 yet because in your description of the best Midwife you tell me that a Midwife must have a good memory I remember a learned Doctor not long since acquainted me with such a posture which he told he had from the hands of an expert Chirurgeon and Physitian whose wife also was an expert Midwife and the course the Midwifed took in such a case he told me was this which must serve also for my answer because I think there cannot be a better After the woman had been eight daies in labour and given over by all Midwives as desperate being in a violent Fever with no throws but very weak and by reason of hot medicines given to expel the birth and strong wines given to support the spirits those humors that usually accompany the Infant had so flown out that the genitals were so dry and closed that they would scarce admit the probation of two fingers This method was used First instead of wine she gave her good store of Almond-milk and because her belly was very costive she gave her Clysters and to keep up her spirits she gave her Cordials of which in their order She laid plaisters to her hands wrists and anointed the whole region of the belly hips loins the rump-bone and privities with Oyles to appease her pain and with softning Unguents and then she made a triangular bagg stuff'd with emollient and relaxing herbs boyled in water according to this description and of which more hereafter The description of the Bagg It was of such a bigness as that it might cover the lower part of the belâ—… and the privities and with tapes fitted to the corners was applyed hot and continued on some hours after which though her hand were well anointed she could scarce thrust in the top of her finger into the orifice of the womb the womb was so closed and the Infant so depressed toward the share-bone by reason of the precedent throws and pangs But at length when with much labour and industry the genitals were somewhat dilated that she could get in her fingers farther she found the loyns and the right hand of the child first offer it self to the birth that therefore she might correct this monstrous and so inverted posture of the Infant so doubled and twisted and either perswade the head or the feet to come forward she used the best of her skill but to little purpose the genitals were so narrow and streight But yet not giving off her endeavours she did deliver her within eight hours after she came to her assistance but the child was dead Dr. Mrs. You give a very good account of an expert Midwives practice which you may follow with safety expecting the success from Heaven but it is no wonder the child should be still-born as you phrase it
stretched into the Womb which is here figured and is much more dangerous than the former Mid. 'T is true Sir this posture is much more dangerous than the former but I shall take all the care I can to bring back again this birth into the womb wholly And first of all I shall anoint my hands and the womb of the woman with oyles for this purpose for this requires no small labour then if possible with my other hand shall drive it back so by the shoulders that it may wholly fall back into the womb And again lest the Infant should return to the same form of birth I must put in my hands and bring down the arms of the Infant to the sides and by that means bring it to the form of a natural birth If this course take not I must bring the woman to bed where after she hath lain quiet a while I must proceed after the same manner as I have before delivered and if this also be to no purpose and that it neither be changed to another form she must be brought to the stool and the womb by the help of the women that are assistants must be depressed on both sides and downwards And my hands being annointed as beforesaid together with the Womb and both the arms as they come I must do what I can to joyn them together and so receive it as it comes forth And in this birth there is the less danger if that I or any other Midwife do our duties with all possible diligence and in case the Infant be not too weak Dr. Very well Mrs. your way but I take mine which I mentioned in the former Section to be the safer of the two but you may use which you think best SECT XVIII Figure the Ninth DR But I pray you Mrs. Eutrap How will you deliver a woman of a child that falls down with its buttocks forwards and the hands spread over the head according to this figure Mid. Here Sir I must annoint my hands as above-said and putting it up must lift up the fundament of the child and turn the head to the Birth But in this case I must not make too much haste lest it fall into a worser form neither is it possible that a child should be so born without great loss to the Mother and Infant therefore if it cannot be turned with the hand she must be brought to the bed where if she be very weak she may be refreshed with convenient meats and cordials and then often proceeded with as is said before until the Infant shall come to a more commodious form of birth Dr. Your observations and apprehensions of danger in this operation are very good so that when the next opportunity presents you will find my former directions to be best and safest SECT XIX Figure the Tenth DR But sometimes Mrs. it happens that it offers it self with its shoulders forwards and the head turned backwards but the feet and hands lifted up as in the ensuing figure How will you help here Mid. In this case Sir I must in the first place move backward the shoulders of the Infant that it may first appear with the head forward and this may easily be done because the shoulders being but a little up the head of it self will fall down to the orifice of the womb as being nearest to it But if there must be any other way attempted she must be brought back to the bed and then so stirred and rouled and used according to those directions formerly hinted SECT XX. Figure the Eleventh DR Mrs I fear I trouble you with many Questions be pleased to satisfie me in this and four or five more and I shall forbear What then if the Infant incline to the birth with the hands and feet together as if it stood upon all four with the back upward into the womb as in this figure What I say will you do Mid. Here Sir I must take care lest some danger happen from this difficult and unshapely figure therefore I must do thus I must so move the feet of the Infant that I may handle the head and do what I can to direct that first to the birth I must also move up the arms lest of their own accord they fall down to the sides of the womb And if this way succeed not she must be brought back to the bed and the same means used for the turning of the Infant as hath been formerly described SECT XXI Figure the Twelfth DR Sometimes Mrs. it falls out that contrary to the former shape the Infant falls down upon its breast with the hands and feet cast backward into the Womb as in this figure what will you do in such a condition Mid. Truly this case is the most dangerous of all hitherto proposed First therefore I must carefully annoint both my hands and also the womb of the woman which done I must feel for the arms of the Infant and lay hold of them so till I can lay hold of the head also and with all care hold it so fast that I may direct the head first to the birth next I must dispose of them to the sieds for this done the birth will come forth the sooner and with less danger but if this succeed not it will be safest to bring the woman to the bed and to proceed as formerly shewed that if perhaps by this kind of delay the Infant may accommodate it self to a more fit posture for the birth SECT XXII Of a birth wherein the Infant presents the belly DR In the next place Mrs. Midwife let me hear from you how you will help a woman in labour of a child when it presents its belly first Mid. That you shall Sr. very willingly to the utmost of my skill And here Sr. I must note that the back-bone may easily be bent and turned forwards alittle but by no means backwards without excessive violence Wherefore the worst and most dangerous figure that a child can offer to the birth is the belly or the breast for then its body is constreined to bend backwards and what ever throws or endeavours a woman makes to bring it forth it will never be accomplish'd for she will sooner perish with her child then ever advance it in this posture into the passage wherefore 't is in great danger if not timely succourd and in case it should escape which would be very strange it would be weak in the back along time after its birth but that which augments the danger much more is that for the most part the Navil-string comes forth when the Child comes with the belly Therefore as soon as 't is discover'd to be so the Midwife must use the sole remedy of drawing it forth by the feet as speedily as may be in this following manner Having placed the woman I must gently slide up my flat hand being well anointed for the easier entrance towards the midle of the childs breast which I must thrust back to
much ado to introduce one only with which she must do her operation with the half of the fingers ends of the other hand put up as far as necessary afterwards let her excite and procure the childs birth as directed before Then sometimes the child comes with its face first having its head turn'd back in which posture it is very difficult it should be born and if it long remain so the face will be so black and blew and swell'd that at first sight it will appear monstrous which comes as well by the compression of it in that place as by the Midwives fingers handling it too rudely when she endeavor'd to place it in a better posture There was a certain Woman whose Child came with its Face so black and mishapen as soon as it was born as is usual in such cases that it looked like a black Moor as soon as the Mother saw it she said she alwaies fear'd her Child would be so monstrous because when she was young with Child of it she fixt her looks very much upon a black moor wherefore she wished or at least wise car'd not though it dyed rather than she said she should behold a Child so monstrously disfigured as it then appear'd but she soon chang'd her mind when she was made sensible that this blackness was occasion'd only by reason that it came into the World with its face forwards and that assuredly in three or four days it would wear away as accordingly it happen'd having often anointed it with oyl of sweet Almonds as she was order'd and when the Child came to be about a 12 month old you could have scarcely seen a fairer Now to deliver this birth the Midwife must observe the same manner as in that wheâ—… the Child comes with the side of the head being careful to work gently to avoid bruising the Face But here note that if it should chance thaâ— the Childs hand or hands should come with either of these births which for the mosâ— part happens rather than any other part iâ— will hinder the birth by reason it takes up part of the passage and for the most parâ— cause the head to lean on one side To remedy this as soon as 't is preceived that one hand presents together with the head it must be prevented from coming down more or ingaging farther in the passage wherefore the Midwife having plac'd the Woman on the bed with her head a little lower than her hips must in the next place put and guide back the Childs head with her own as much as may be or both hands iâ— they came both down for to give way to the Childs head which done she must proceed aâ— before SECT XXV How to deliver a Woman when the Childs Head is born and the Womb closeth about its Neck DR Very well Mrs. Eutrapelia you have now given us a farther account of your very good judgment in your Art in your dextrous ingenious way of bringing a Woman to bed in the last posture But now I would desire you to let me know how you will deliver a Woman of her Child when its head is born but yet the Womb closeth about its Neck Mid. Truely Sir to deliver this Woman is not so easie abusiness as may be imagin'd by reason that a small delay herein may cause the strangling of the Child And here you must observe that the Child comes naturally with the Head first because by its bigness and hardness the passage might be the better made and opened for the other parts of the body the which usually pass afterwards without pain but yet notwithstanding sometimes the Head is so small and the shoulders so large that without a very great difficulty they cannot pass which makes the Child remain often in the passage after the head is born And this accident may likewise happen sometimes for not having been careful to lose no time in drawing forth the Child by the head to the end the shoulders might at the same instant follow in the same place the head possest Now when I meet with this Figure I must by all possible means seek speedily to deliver the poor Child out of this prison or rather snare or collar in which it is caught for fear as I said before it come by delay to be strangl'd to prevent which I must endeavour to cause the shoulders immediately to follow by gently drawing its Head sometimes by the sides of it and sometimes with one hand under the chin and the other behind its head and so doing by turns on the one side and the other to facilitate the operation the better being very careful and circumspect that the Navil-string be not entangled about its Neck as also not to draw it forth with too much violence for fear least it may happen as I once saw the Head to be pulled from the Shoulders But if the Shoulders come not with gentle pulling then I must slide up my fingers on both sides under the Arm-pits with which turning them inwards I may by little and little draw forth the Soulders but if when they are in the passage and totally disengaged if I cannot get the rest forth by still keeping my fingers under the Arm-pits I may be very confident there is some other hindrance and that it is certainly monstrous in some part of its body or that as it for the most part happens in this case it is hydropical in the belly for which cause it is impossible it should be born before the belly be pierced to evacuate the waters and then it will easily be accomplish'd but this being the expert Physitian or Chirurgion's parts to perform I shall leave it wholly to them SECT XXVI When the Navil-string comes first DR Now Mrs. Eutrapelia I would know of you how you behave your self when you have a labor presented to you wherein the Childs Navil-string comes first Mid. Here Sir you must note That an Infant doth not always present with the belly when the navil-string comes first for though it presents naturally as to the Figure of its body that is with its Head first yet sometimes the Navil-string falls down and comes before it for which cause the Child is in much danger of death especially if the labor be not very quick because the blood that ought to pass and repass through those Vessels which compose it for to nourish and keep the Child alive whilst it continues in the Womb being coagulated hinders the circulation which ought to be there made which happens as well by the contusion as the cold those Vessels receive being much pressed in the passage when it comes together with the Head or any other part as also because the blood doth there coagulate as is said by reason of the cold which it takes by the coming forth of the Navil-string But though this accident may cause the Infants sudden death 't is not so much for lack of nourishment without which it may pass a whole
day or more there being blood enough in its body for that purpose but because the blood can be no longer enliven'd and renewed by circulation as it hath continual need which being obstructed always causeth the creatures sudden death sooner or later according as it is more or less obstructed I know it may be objected that though the circulation be so hindred and intercepted by the coming forth of the string it need not therefore cause such a sudden death to the Child because the blood may notwithstanding circulate in all the other parts of the body To which I answer that in respect to the Infant 't is either absolutely necessary that the blood for want of respiration should be elaborated or prepared in the thick part of the burthen call'd the placenta and therefore must be a free communication or for want of it that the Infant must immediately breathe at the mouth as well to be refreshed as to drive out the fuliginous or sooty Vapors by expiration which not being possible whilst in the Womb it must unavoidably be choaked and dye in a very short time if it wants both together Wherefore in this case the Woman must without any delay be deliver'd the which if nature doth not speedily perform the Child must be drawn forth by its feet Women that have great waters and along string to the burthen are very subject to this mischief for the waters coming forth in great abundance at the breaking of the skins or membranes do often at that instant draw the string which swims in the midst forth along with them and much the easier if the Infants head be not advanced very forward into the passage for to hinder the coming forth of it in this manner Assoon as 't is perceived you must immediately endeavor to put it back to prevent the cooling of it behind the Childs head least it be bruised as we have already noted whereby the blood may coagulate there keeping it in that place where it was thrust back until the head being fully come forth into the passage may hinder the coming down of it again which may be effected by holding it up with the fingers of one hand on that side it comes down untill the head be advanced as aforesaid or in case the hand be taken away to put a piece of fine soft rag between the side of the head and the Womb to stop up the way it came down by always leaving an end of the rag without the body to draw it forth by at pleasure But sometimes notwithstanding all these cautions and the putting of it back it will for all that come forth every pain and then without any more delays at all the Midwife must bring the Child forth by the Feet which she must make a diligent search and enquiry after although the Infant comes with the head foremost for there is but this only means left remaining to save the Childs life which it would certainly lose by the least delay in such a case Wherefore having placed the Woman conveniently let her gently put back the Head which offers provided it be not engaged too low amongst the bones of the passage and that it may be done without too great violence to the Woman for in that case it will be better to let the Child run the hazard of dying than to destroy the Mother for Tertullian as my learned Mr. Riolanus very well observes upon a like Subject saith That it is a necessary cruelty to kill the Child in such a case rather then to save it from the danger it is in of dying and so certainly cause the Mothers death and then let her slide up her hand being well anointed under the breast and belly to search for the Feet by which she must draw it forth according as hath been formerly discoursed the which being perform'd let her immediately take care of the Infant which is ever in this case very feeble SECT XXVII Wherein the Burthen either first offers it self or comes first quite forth DR Very well and excellently have you given us demonstrations of your skill and knowledge hitherto good Mrs. Eutrapelia now pray will you inform me how you act your part in a Labor wherein the burthen either first offers or else comes first quite forth Mid. That I shall Sir to the best of my Talent and therefore first of all Sir I must note that the coming forth of the Navil-string before the Infant whereof we discoursed in our foregoing Section is oftentimes the cause of its death for the reason there alleadged but the coming forth of the burthen first is yet much more dangerous for that besides that the Children are then commonly Stil-born if they be not assisted in the very instant the Mother likewise is in great peril of her life also because of her great floodings which usually happen when it is loosened from the Womb before its due time by reason that it leaves all the orifices of the Vessels to which it did cleave open whence incessantly flows blood until the Child be born by reason that the Womb as long as any thing continues there doth every moment strongly endeavour to expell it by which means it continually voids and expresseth the blood of the Vessels which are alwaies open as we have already explained when the burthen is so separated as long as the Womb remains extended and cannot be closed until it hath voided all that it did contain and comes by the contraction of its Membranous substance to stop them by pressing them together wherefore if the Midwife ought to be vigilent and diligent to succour an Infant when the Navil-string comes first how much more ought she to be so when burthen comes forth first and wherein the least delay is ever the cause of the Infants sudden death if the Woman be not speedily delivered because the Infant cannot then remain long in the Womb without being choaked or stifled being it stands in need at that time of breathing at the mouth as we explain'd the foregoing discourse the blood being no longer enlivened by the preparation made in the burthen the use and function of which then ceasing from that very instant that it is separated from the Vessels of the Womb to which it was joined for which reason there immediately follows a great fludding which is so dangerous for the Mother that without speedy help she quickly looseth her life by this unlucky accident Now when the Burthen is not wholly come forth but lies in the passage some advise to put it back before the Child be fetch'd but I am not of their opinion for when it comes into the passage before the Infant it is at that time totally divided from the Womb at the bottom whereof it ought to be commonly situated and fastened until the Child be born but because as soon as it is wholly loosened as it always is when it comes first it becomes a body altogether unnatural therefore it is never to be
thrust back but contrarywise be fetch'd away and at that very moment after bring the Child away by the Feet although it came naturally with the Head first for what reason can there be to put it back since it is of no use to the Infant from the moment it is separated from the Womb as cannot be denied And such a proceeding is so far from being useful that this burthen would much hinder the Midwife from being able to turn the Child as she ought in bringing it forth by the Feet Wherefore when it presents it self in the passage which may soon be perceived if the Midwife find every where a soft substance without the least resistance of any solid part to the touch and finding likewise the string fastned to the middle of it and the Woman fludding extreamly as is ordinary at such times then in lieu of thrusting it back the burthen must be brought away that so there may be the more liberty and room to draw forth the Child according as hath been before directed The Burthen then being quite loosened from the womb and coming first in the passage must not be thrust back again into it much less must it be put back when it is quite come forth of the body The midwife must only take care not to cut the string till the child be born not out of hopes of any benefit from it to the Infant during the delivery but that so much time may not be lost before the Infant be fetch away which is then ever in great danger as also the flooding may be the sooner stopt which happens for the most part as soon as the woman is delivered for which reasons it will be dispatched with all possible speed Sometimes notwithstanding this dangerous accident the child may be born alive if timely succoured but it is then so weak that it is hard to discover at first whether it be alive or dead When it so happens some midwies do ordinarily before they seperate the burthen put it into a Skillet of hot wine and imagine with no small superstition that in case it it comes to it self the vapours of the warm wine was the cause of it being conveyed by means of the string into the Infants belly and so giving vigor but it is more credible that being almost stifled for want of breathing as it needed it it begins now by means of it to recover from that fainting but nevertheless there may be no hurt in continuing the old custom since it can do no perjudice and may satisfie fine occupied Spirits provided necessaries be not neglected in being blindly carried away with this conceit SECT XXVIII Figure the Thirteenth DR There being the same reason in twins as in a single birth except that the single birth is natural and the twins not so certainly the same method must be observed Mrs. Tell me then if there be two or more and and all come fair with their heads toward the birth What is to be done Mid. Here Sir I must observe that which lyeth readiest and fittest in the Womb and first receive that and not to let the other go till the first is born lest it turn into another shape by sliding back again into the Womb but the one being born I must presently lay hold on the other Now this birth will be easier and without danger because the first birth hath made the way for the second so plain that it may come forth without any difficulty at all But in this birth I must take care that I bring forth the after-burden timely enough lest that the Womb being freed from her Infants presently fall down and so keep in the after-burden with great danger SECT XXIX Figure the Fourteenth DR But Mrs. What if there be Twins and they both come unnaturally with their Feet forward as in this Figure what course will you take Mid. This birth Sir is dangerous enough and yet it is to be mended by the prudence of a discreet Midwife Wherefore I must anoint the womb of the woman that the passages may be the easier for the Infant which being done I must take care to lay hold of the arms of one of them and bringing them down to the sides secure them so that I may lightly promote the head to the birth and the first being born I must presently proceed with the other after the same manner but if I can lay hold of neither of their arms so that there is no good hopes of a happy birth I must have recourse to the former method if at least the Infants may come into the World by that pains and conversion which is wrought upon the bed SECT XXX Figure the Fifteenth DR I come now to my last unnatural birth of Twins If then there be Twins these forms being compound as of a natural and unnatural birth the one comeing down with the Feet what is to be done in this case Mid. Where Infants offer themselves after this manner I must first bring forth that which presents it self with a natural form and must move up the other which is with the Feet forward and if possible cause it so to return into the Womb that that form also may be disposed of to a natural birth but if it cannot be turned to be in a better posture I must lay hold presently on the hands and encourage it to the birth But it were safer that this should be brought to a natural form to which end I must diligently endeavour it by anointing directing moving it tumbling and rouling the Woman lest perhaps the Womb be hurt by the form of such an unnatural birth and the privities swell with wind from whence the birth cannot come forth without danger or be hindred too long All which danger may with provident care be avoided or at the least very much corrected and amended Dr. So far concerning your way and method of Labors wherein several Children in different postures present themselves together but now good Mrs. Eutrapelia I would have you to hear a little what I have to offer you concerning these deliveries and first of all be pleased to consider seriously with me that if all those unnatural Figures and Situations which we have hitherto described that a single Child may come in do cause those many difficulties and dangers mentioned certainly the Labor wherein several come together in those bad Situations must be much more painful not only to the Mother and Children but also to the Midwife for they are then so pressing that for the most part they trouble and hinder one another moreover the Womb is so filled with them that the Midwife can scarce introduce her hand without much violence which she must do if they are to be turned or thrust back to the end that she may give them a better position then that wherein they present Where note then that when a Woman hath 2 Children they do not ordinarily both present to the birth together but one is
Womb for a receptacle of the Infant and it hath with it three membranes but how Physitians name them I know not Dr. I will inform you then if you please with their names and uses and describe them to you in these two figures following which are explained by letters also as may appear The Explanation of the first Figures BBB Signifies that part of the Secundine called the Chorion which is the prop of all the Vessels of the young one CCC Denotes the branches of the Umbilical Veins and Arteries dispersed through the Chorion EEE The Membrane called Amnios and is the thinnest of all the Membranes and is white soft and shining with few and those very small Veins and Arteries dispersed among the folds and this is the very next coat to the Infant and is the receptacle for sweat and Urine that Membrane called Allantois not to be found in men though an Vrachus may be found DD Denotes all the Vessels meeting about the Navil by which the Infant is nourished Chorion Amnios P. Q Denotes the Membrane called Amnios and is the first that involveth the Infant RRRR The Liver or cake of the womb or after-burden by which the Infant receives nourishment and this is fastned to the Womb. SS The inward and outward Veins m. m. m. The Umbilical vein with its branches dispersed into the after-burden by which the Child is nourished and upon which it lyeth as upon a pillow though in the Amnios it swimeth as in a bath VV How all the Vessels meet about the Navil b. b.b Denotes the Infant newly born annexed to the secundine the Navil-string not cut Dr. You see Mrs. these Figures with their uses and explanation I shall now discourse more particularly of the membranes themselves The after-burden commonly called the secundine is so named either because it is as it were a second place mansion and receptacle of the Infant from the Womb or else because this Membrane is called the after-birth or second birth as coming forth after the Infant which if it stay behind brings great mischief as shall be spoken to at the latter end of this Treatise and Section The first membrane is called Amnios and this membrane covers the Infant from the head to foot insomuch that part of it sticks to the head of the Infant when it is born which they call a helmet though not always being left behind with the secundine in difficult labours this is so called from its softness and thinness others resemble it to white Paper or a shirt and is the thinnest of all in which is found great plenty of humors caused of urine and sweat in which the Infant swimeth as in a bath and lyeth so easie and secure lest it should fall foul against those neighbouring parts that are harder and besides that when the membrane is broken in the birth this water breaking out may make the passages by the neck of the Womb more plain and slippery for the Infant and this membrane also is every where included within the second which is called Chorion because it wraps the Infant like a ring and this immediately compasseth the former to which it is joyned as it were in a round figure like to a cake whose inward and hollow part it covers and involves and doth extend it self to its dimensions and can scarce be separated from it but doth firmly knit and bear up the vessels of the afterburden which immediately sticks to the womb by a certain fleshy mass that is formed being round and of somewhat a ruddy colour not compassing the whole infant by reason of innumerous springs of veins and atteries by which the blood is interwoven as if it were poured in and by which the infant is nourished This towards the infant is smooth but that part which is towards that fleshy round mass is rougher This round fleshy substance is called the liver of the womb or the cake of the womb which having such a substance as the liver hath no wonder if it should make and prepare blood for the nourishment of the infant On that side towards the womb it is rough and unequal like clefts in a bak'd cake and being cut in this part it sheweth an infinite company of hairs which if you trace they will bring you to the orifice of the veins themselves And although there be twins or more yet there is but one cake for into one cake so many navil strings are inserted in divers places as there are young ones though it may differ as to the bigness according to the body and condition of the infant yet the ground is still the same in the diameter This serves as a support of the umbilical vessels like a pillar it is also called the secundine The third is called Allantoides 't is a coat betwixt the Chorion and Amnios 't is very thin weak and narrow it covers but half the young one this is properly like a swathe or girdle and some say it is the receptacle of urine but it being not to be found in mankind there may be an Vrachus found instead of it I say no more of it Dr. These are the opinions of Physitians good Mrs. Eutrapelia that have written of these things now if you please I will tell you candidly and freely what my opinion is concerning these things As soon as the 2 seeds have been confusedly mixt and retained by conception the Womb immediately after by means of its heat separates this Chaos to make out thereof the delineation and formation of all the parts and begins to work upon these Seeds which though to the sight they may appear of a like nature and uniforme notwithstanding in effect they contain many dissimilar parts in them which it separates and distinguisheth one from another inclosing the noblest and on the outside the most glutinous of which first are formed the Membranes to hinder the Spirits wherewith the frothy Seeds abound from being at that time dissipated and afterwards to serve to contain the Infant and the waters therein in the midst whereof it swims that they may not stream away Now as the Membranes of the Infant are the first part formed so are they with the waters the first that present themselves to the passage in time of labour before the Infants head Concerning these Membranes and the descriptions most Authors have made of them I find them to be so dark therein that methinks 't is an hard matter to conceive them as they are by the explication they make of them for in the first place they do not agree in the number of them some accounting 3 as well for a Child as a Beast to wit the Chorion the Amnios and the Alantoides Others accounting but 2 because there is no Alantoides in an humane fetus But if this matter shall be strictly examined as hath been often done there will never be found any more then 2 the which being so closely joyned the one to the other they may be said to be but
a double one the which indeed may be divided and separated into 2 and this I will explain to you and others on such a manner as may be best understood by such as are ignorant of this matter For there are many who think with Galen that these Membranes are separate and distant the one from the other and that the one surrounds only the Infant and the other receives the waters the which are partly engendred from sweat and partly from the Urine as they imagine and believe farther that these waters themselves are separated the one from the other by these Membranes the which is quite contrary for they are joyned so close the one to the other that they compose as it were but the same body and invelloper the which serves as we have said to contain the Infant with the waters which are all of a nature and shut up in the Membranes as I shall make appear in speaking of their original but it matters not as to the truth after what manner this be explained provided it may be understood as it is The outward part then of this Membrane or double covering or involver call it what you please or if it be esteemed 2 the first Membrane presented without is called Chorion from the Greek word Chorein which signifies to contain because it immediately environs the other which is called Amnios that is a little lamb because 't is to small and thin Galen in his 11th book of the use of the parts calls the Burthen Chorion But to render this more intelligible we shall take this first Membrane for the Chorion the which may again be separated into 2 though effectively it be but one This Chorion is a little rough and unequal throughout the whole outside of it in which many small captillary Vessels may be observed running quite round as also many little strings by which it cleaves to every side of the Womb but it is a little more smooth within where it joyns every where and unites with the Amnios in such a manner as it appears as we said but as one and the same Membrane This Chorion covers the placenta and cleaves close to the fore part of it which respects the Infant by means of the interlacing of an infinity of Vessels and 't is also principally fastned to the Womb by the whole circumference of the placenta in which part this Membrane is a little thicker Then the Amnios which is the 2d Membrane is 3 times thinner then the Chorion and is within very smooth but not just so much where 't is joyned to the Chorion This Membrane is so thin that 't is quite transparent and hath no Vessels in it the which makes it so thin as cannot be imagined without seing This Amnios doth no ways touch the placenta though it covers it but it only lines all the inner part of the Chorion which is between and from which it may be wholly separated if it be done with care The better to conceive this as it is and after what manner these Membranes are in the Womb consider the composition of a foot-ball imagining the leather which covers it to be the Womb of a pregnant Woman and the bladder blown up with wind within the foot-ball to be this double Membrane of the Chorion and Amnois in which are contained together the Child and the waters and even as the outside of this bladder toucheth every where because 't is blown up the leather of the foot-ball so in like manner the Membranes of the fetus are joyned on all sides to the Womb except where the burthen cleaves to it in which place it passeth above it As to the 3d or rather pretended Membrane which Authors call Alantoides and say 't is like a sausage or girdle which surrounds and clothes the Infant from the sword-like gristle to just below the flanks only 't is very certain there never was any such thing in any of those Animals whose dams have but one young at a time no more then Women as Sheep Cows Mares Asses nor any other for ought could ever be learned from many curious enquiries Sometimes Infants at their birth bring forth these Membranes upon their head and then 't is said they will be fortunate which is a mere kind of superstition because it happens from the strength of their substance so that they cannot break by the impulse of the waters or the Womens throws in Labor or because the passages being very large and the Infant very little it passeth easily without any violence and in this respect they may be said to be fortunate in being born so easily and the mother also for being so speedily delivered For in difficult Labors Children are never born with such caps because being tormented and pressed in the passage these Membranes are broken and remain still there Within the Infants Membranes thus disposed as I have said are the Waters contained in the midst whereof it swims and is seated the original of which seems very incertain if we regard the different opinions of Authors upon this subject some will have them to be the Urine emptied out of the Bladder by the Vrachus because they cannot find the true and easie way for it and because their color and savor much resembles the Urine contained in the Bladder But 't is very certain that it cannot be so as they aver because the Vrachus is not perforated in the fetus and it comes not forth of the Navil for the place where 't is fastened is always very like a small Lute-string through which it is most certain nothing can pass though never so subtile There are others also that will have these waters to be the Urine but they are of an opinion that it passeth through the Yard whose passage is always open and not by the Vrachus which is never hollow Now for my part as it appears to me with more reason and as indeed it is these waters are only generated out of vaporous humidities which sweat out and exhale continually out of the Infants body and meeting these Membranes through which they cannot pass because they are too thick and close are turned into water which is thus by little and little collected as well during the first months of Conception the Child not yet quick as all the remaining part of the time after it is quick for vapors pass forth and exhale out of all porous bodies that are hot and moist as is that of an Embrio and the reason is very weak by which they maintain these waters to proceed from the Urine because they are salt as the urine is For sweat tears and other humors which distill and sweat out of the body are as well salt as the Urine of which the Infant whilst it is in the Womb cannot have much no more then dung in the Guts because it receives no nourishment at the mouth at that time that all its superfluous humors may easily pass away by transpiration through the substance
diseases ensue upon their stopping are almost innumerable so that to bring them down let her avoid all troubles of Spirit lye quiet with her Head and Breast a little rais'd if Feaverish use only broths with a little gelly above all shun cold drink give Clysters and foment her lower parts rub her Thighs and Legs downwards and bath them too and apply large Cupping-Glasses to the uppermost part of the inside of her Thighs bleed i' th Arm first if very full of humors for i' th Foot would draw too much to the Womb. SECT VII Of the Inflammation c. of the Womb. THis is very dangerous and the death of most caused from the Lochia stopt or bruise by two hard swathes falling out o' th Womb c. an Impostume or Cancer follows a bruise if not death wherefore temper the heat and humors first extracting or causing the expulsion of strange things remaining i' th Womb using not the least violence with Veal or Pullet broth with Lettice Purselan Succory Sorrel abstain from Wine keep quiet in Bed with anodine Clysters and bleed i' th Arm not i' th Foot reiterate it because 't is very pressing till the greatest part of fulness be a little evacuated an inflammation diminished then i' th Foot if need injecting in the Womb Barley water with Oil of Violets or milk An Apostume Schyrrhus or Cancer is the Physitians or Chyrurgions work SECT VIII Of the Inflammation and Apostemation of the Breasts THe Breasts being made of a spungy substance easily receive in too great abundance the humors flowing to them from all parts by blood being over-heat by throws and pains in travel and so are soon inflam'd being then painfully stretch'd to which helps the suppression of the Lochia and a fulness of the whole Body or it may happen from having been too streight lac'd some blow or bruise by lying upon them or for not giveing the Child milk Now convenient remedies are speedily to be applied lest dangerous symptoms follow wherefore the certainst means to hinder the Flux of so great quantity of blood to the Breasts is to procure a large evacuation of the Lochia the habit of the body is to be emptied by bleeding i' th the Arm after i' th Foot chasing into the breasts Oil of Roses and Vinegar beat together laying upon them unguentum refrigerens Galeni or unguentum album and a 3d part of populeon mixt or a pultis of the setlings in a Cutler's Grinstone-trough Oil of Roses and a little Vinegar mixt together If the pain continue great take the crums of white bread and milk with Oil of Roses and the yelks of raw Eggs upon all these may compresses be laid dipt in Vinegar and water or plantain water When you have emptied the greatest part of the humors and the height of the Inflammation is past then draw the milk or else unless it be turn'd to matter pure Honey laid to them resolves milk or a Cabbage leaf anointed therewith being first a little wither'd and the hard stalks and veins taken away lace not too streight nor apply course clothes A whole red Cabbage boil'd in River water to a pap and well bruised in a wooden or Marble Mortar and pulp'd through a Sieve adding Oil of Comomil is a very good pultis Let her dyet be cool not very nourishing keep her body open lying on her Back in Bed all the while stir her Arms as little as may be and after the 14th or 15th day of her delivery being sufficiently cleansed and inflammation abated and no longer Feaverish purge her once or twice and if for all these the swelling goes not down but she feels great beating and pain a hardness more in one place then another of a livid color and soft i' th middle 't is certain 't will apostemate then apply ripening Medicines as a pultis of Mallows Marsh-Mallows with their roots Lilly roots and Linseed bruis'd boil'd to pap and pulp'd through a sieve then add a good quantity of Hogs Grease or Basilicon laying a little cloth thick spread with Basilicon upon the place where 't is likely soonest to break and the pultis all over it renewing it 12 hours after continuing till it be full ripe then if it open not of it self it must be open'd by a Lancet or Incision knife which being the Chirurgeon's work he is to do it SECT IX Of the curdling of the Milk in the Breasts BEcause her Body was much mov'd dureing Labor in the beginning of Child-bed her Milk is not well purified and is mixt with many other humors which if 01 they are then sent to the Breasts in too great quantity cause an Inflammation but when the Child hath suck'd 15 or 20 or more days then only the Milk without other mixture contain'd there which sometimes curdles and the Brests become hard and rugged without any redness and the separation of all the kernels fill'd with curdled Milk may easily be perceived she finds a great pain and cannot milk them with a shivering chiefly about the middle of her Back like Ice which is usually follow'd by a Feaver of 24 hours long and sometimes less if it do not turn into an Inflammation of the Breasts which it will undoubtedly do if it be not emâ—ied scater'd and dissolv'd This clodding comes mostly because the Breasts are not fully drawn either for that she hath too much Milk or the Child is too weak to such all or because she doth not desire to be a Nurse for the Milk staying in the Breasts looseth its sweetness and by sowring curdles This may also happen from taking cold or not covering her Breasts The readiest and surest remedy from what cause soever is speedily to draw the Breasts till they be empty'd and if the Child cannot because she is hard milched let a Woman till it comes freely and then the Child will and that she may not after breed more Milk then the Child can draw let her dyet breed but little nourishment and keep her body always open But when she neither can nor will be Nurse then her Breasts must not be drawn for drawing more humors the Disease will return if not again emptied Wherefore 't is necessary to prevent comeing of any more Milk and to scatter that which is there by empting the fulness of the body by bleeding i' th Arm and Foot and strong Clysters and purging if needfull and to resolve the curdled Milk apply a pultis of pure Honey or of powder of Linseed Fenugreek Beans and Vetches boild in a decoction of Sage Smallage Fennel Milk adding Oil of Camomil anointing with the Oil first SECT X. Of Choping c. and loss of the Nipples WOmen are subject the first time to have their Niples chop'd which is unsufferable and the more if hard milch'd as the first time when the Milk hath not yet made way through the small holes of the Niples which are not yet thorowly open'd and then the Child takes more pains to suck