its cavity The grosser nutricious Juice being deposited by the Umbilical Arteries in the Amnios as soon as the Mouth Gullet and Stomach and the like are formed so perfectly that the Foetus can swallow it sucks in some of the said Juice which descending into the Stomach and Intestines is received by the Lacteal Veins as in grown Persons The Infant therefore is nourished three several ways but only by one Humour First by apposition of it while it is yet an imperfect Embrio and has not the Umbilical Vessels formed But after these are perfected it then receives the same nutricious Juice by the Umbilical Vein the more Spirituous and thin part whereof it changes into Blood and sends forth the grosser part by the Umbilical Artery into the Amnios which the Infant sucks in at its Mouth and undergoing a new Concoction in its stomach is received out of the Intestines by the Lacteal Veins as is done after the birth A Child in the Womb differs from an adult Person in many parts the parts are less the colour of the whole reddish the Bones soft and many of them gristly and flexible in the Head There are several differences First the Head in respect to the proportion of the rest of the Body is bigger the Crown is not covered with Bone but only with a Membrane the Bone of the Forehead is divided as also of the under Jaw and the Os Cuneiforme is divided into four The Bone of the hinder part of the Head is distinguished into three four or five Bones The Brain is softer and more fluid and the Nerves very soft The Bones that serve the Sense of Hearing are wonderfully hard and big the Teeth lie hid in the little holes of the Jaw-bone the Dugs swell and out of them in Infants new born whether Male or Female a serous Milk issues forth sometimes of its own accord and sometimes with a gentle pressure The Vertebrae of the Back want their spinous processes and each of them made of three distinct Bones The Heart is remarkably big and its Auriculae large There are two Unions of the greater Vessels that are not conspicuous in grown Persons First the Foramen ovale by which there is a passage open out of the Cava into the Vein of the Lungs just as each of them are opening the first into the right Ventricle and the latter into the left Ventricle of the Heart and this Foramen just as it opens into the Vein of the Lungs has a Valve that hinders any thing from returning out of the said Vein into the Foramen Secondly the Arterial Channel which two fingers breadth from the Basis of the Heart joyns the Artery of the Lungs to the Aorta it has a pretty lage Cavity and ascends a little obliquely from the said Artery to the Aorta into which it conveys the Blood that was driven into the Artery of the Lungs out of the right Ventricle of the Heart so that it never comes into the left Ventricle as the Blood that is sent out of the left Venticle into the Aorta never came in the right except a little that is returned from the nutrition of the Lungs but past immediately into it out of the Vena Cava by the Foramen ovale so that the Blood passes not through both the Ventricles as it does after the Child is born You may know whether Infants killed by Whores and which they commonly affirm were still-born were really so or no by putting the Lungs of the Infant in Water for if they were still-born the Lungs will sink if alive so as to breath never so little while they will swim The Gland Thymus is very large and consists as it were of three Glands the Umbilical Vessels go out of the Abdomen the Stomach is narrower but pretty full of a whitish liquor The Caul is scarce visible the Guts are seventimes longer than the Body the Excrements in the small Guts are flegmatick and yellow but in the thick somewhat hard and blackish sometimes greenish the Caecum is larger than usual and often fill'd with Faeces the Liver is very large and extends it self into the left side and covers all the upper part of the Stomach it has a passage which is not in grown Persons called the Veiny Channel which arising out of the Sinus of the Porta carries the greatest part of what is brought by the Umbilical Vein directly and in a full stream into the Cava above the Liver But this passage presently closes as soon as the Infant is born and turns to a ligament as doth the Urachus and the two Umbilical Arteries The Spleen is small the Gall-bladder is full of yellow or green Choler the Sweet-bread is very large and white the Kidneys are bigger and unequal in their Superficies the Renes Succenturiati are exceeding large the Ureters are wide and the Bladder stretched with Urine in Females the VVomb is depressed the Tubes long and the Testes very large the little Bones of the VVrists and Instep are gristly and not firmly joyned together Its Knees are drawn up to the Belly its Legs bending backwards its Feet across and its Hands lifted up to its head one of which it holds to the Temple or Ear the other to the Cheek where there are white spots on the Skin as if it had been rubbed upon the Back-bone turns round the Head hanging down towards its Knees its Face commonly towards the Mothers Back but near the birth sometimes a VVeek or two before it alters its situation and tumbles down with its Head to the Neck of the VVomb and its Feet upwards then the VVomb also settles downwards and its Orifice relaxes and opens and the Infant moving up and down tears the Membrans wherein it is included and the waters flowing into the Sheath but sometimes the Membranes come forth whole at the same time the neighbouring parts are loosened and become fit for distension and the Bones near are so much relaxed in their Joynts that they make way for the Infant and the motion of it so much disturbs the VVomb that the Fibres of it and the Muscles of the Belly contract altogether to expel it CHAP. XIX Of the Management of a Woman with Child THE Woman ought to be kept in a good moderate and clear Air and she must Eat what she likes best and be sure not to Fast too long only she must observe not to eat too much at a time and to comfort the Stomach which is always weak in this condition she may Drink a little Wine or for want of it strong Beer at Meals As to Sleep a Woman with Child requires more sleep than she does at other times As to Exercise and Rest she must order her self according to the different times for at the beginning she ought to keep her self quiet and not to use Copulation Riding on Horse-back or in a Waggon or indeed in a Coach is not safe at any time of her being with Child especially when she
Chorion out of the Uterus but as soon as the Infant begins to be nourished by the Umbilical Vessels and the Urachus is permeable then presently this Membrane begins to shew it self containing a very thin Liquor which is the Urine of the Infant brought into it by the Urachus and wherewith it is filled daily more and more till the Birth It may be known from the Chorion and Amnios by this that they have numerous Vessels dispersed through them but this has not the least visible Vein or Artery it is very hard to separate the Chorion from it but towards the Birth it becomes so turgid with Urine that the Amnios which immediately contains the Infant swims 〈◊〉 〈◊〉 Liquor that it contains is the Urine 〈◊〉 〈◊〉 brought hither by the 〈◊〉 〈◊〉 soon as the Infant is perfect 〈…〉 its Kidneys must needs perform 〈…〉 Office of separating the Serum from the Blood for otherwise it would be affected with an Ansarca I say the Serum is separated in the Kidneys and glides down from thence into the Bladder wherein there is a pretty large quantity when the Infant is five or six months old Now it flows not out of the Bladder by its orifice because at that time the Sphincter is too contracted and narrow and if it should pass that way it would mix with the nourishing juice wherein the Infant swims in the Amnios and wherewith by taking it in by its mouth it is partly nourished and so would defile and corrupt it Nature therefore has provided it another passage by the Urachus inserted into the bottom of the Bladder which tho it grows solid like a Ligament after the Child is Born as the umbilical Vein does yet while the Infant is in the Womb it is open and conveighs the Urine into the Allantoides that is placed betwixt the Chorion and Amnios where it is collected and preserved till the Birth The Naval-string is membraneous wreathed and unequal and arises from the Navel it reaches to the Womb-cake it is about half an Ell long and a finger thick The Vessels contained in this string and covered with the common coat called Funiculus are four one Vein two Arteries and the Urachus the Vein is larger than the Aretries and arises from the Liver of the Infant at the trunk of the Vena porta and from thence passing out of the Navel it runs along the Funiculus to the Womb-cake into which it is implanted by innumerable Roots but before it reaches it it sends some little twigs into the Amnios The umbilical Vein serves for conveying to the Infant the nutricious juice separated in the Womb-cake from the Mothers Arteries but together with this juice returns so much of the Arterial blood that comes from the Infant as is not spent upon the nourishment of the Womb-cake or of the Chorion and Amnios In the Funiculus are included also two Arteries which are not both of them together so big as the Vein they spring out of the inner Iliacal branches of the great Artery and passing by the sides of the Bladder they rise up to the Navel out of which they are conducted to the Womb-cake in the same common cover with the Vein and Urachus wherewith they are twined and wreathed like a Rope Spirituous blood is driven from the Infant by the beating of its Heart to the Womb-cake and the Membranes for nourishment from which what Blood remains circulates back again to the umbilical Vein together with nutricious juice imbibed afresh by its Capillaries dispersed in the Womb-cake But besides Arterial Blood there flows out of the Navel by them part of the Nutricious juice that was imported by the umbilical Vein I say flows out by these Arteries which by their branches that are dispersed through the Amnios discharge it by their little mouths into it The fourth Umbilical Vessel is the Urachus or Urinary Vessel it is a small membranous round Pipe indued with a straight cavity arising from the bottom of the Bladder up to the Navel out of which it passes along within the common cover and opens into the Allantoides These four Vessels as has been said above have one common cover which also keeps each of them from touching the other it is called Funiculus it is membranous round and hollow indifferent thick consisting of a double coat the inner from the Peritoneum and the outer from the Paniculus carnosus It has several knots which Dr. Wharton thinks are little Glands through which the nutricious juice distills out of the capacity of the Funiculus into the cavity of the Amnios Midwives guess by their number how many more Children the Mother shall have but without reason When the Infant is Born its Navel-rope is wont to be tyed about one or two fingers breadth from the Navel with a strong Thread cast about it several times and then about two or three fingers breadth beyond the Ligature to be cut off what is not cut off is suffered to remain till it drop off of its own accord As to the way how the Infant is nourished there has been great Disputes some affirm by Blood only and that received by the Umbilical Vein others by Chile only received in by the Mouth but indeed according to the different degrees of Perfection that an Egg passes from Conception to an Infant ready for the Birth it is nourished variously For First As soon as an Egg Impregnated descends into the Womb it presently imbibes through its outer Membrane some of that albugineous Liquor that at this time plentifully bedews the internal Superfices of the Womb so that as soon as the first Lineaments of an Embryo begin to be drawn out of that Humour contained in the Amnios they presently receive increase by the apposition of the said Liquor filtrated out of the Chorion through the Amnios into its cavity and this same Liquor that thus increases the first rudiments of the Embryo Dr. Harvey calls Coliquamentum But when the parts of the Embryo begin to be a little more perfect and the Chorion becomes so dense that not any more of the said Liquor is imbibed by it the Umbilical Vessels begin to be formed and to extend to the side of the Amnios which they penetrate and both the Vein and Arteries pass also through the Allantois and Chorion and are implanted into the Womb-Cake that at this time first gathering upon the Chorion joins it to the Womb and now the Hypogastrick and Spermatick Arteries that before cast the nutricious Juice into the cavity of the Womb open by the orifices into the Womb-cake where they deposite the said juice which is absorded by the Umbilical Vein and by it conveyed first to the Liver then to the Heart of the Infant where the thinner and the more spirituous part of it is turn'd into Blood but the more gross and earthy part of it descending by the Aorta enters the Umbilical Arteries and by those branches of them that run through the Amnios is discharged into
her Womb closes and is exactly firm so that the Seed of the Man absolutely necessary to Conception finding no place nor entry cannot as they say be received nor contained in it But it may be answered that tho' the Womb be usually exactly shut and close when a Woman has Conceived yet it may be sometimes opened to let pass some ferous slimy Excrements or especially when a Woman is much delighted in the act of Copulation But this second Conception is very rare for we must not imagine that when a Woman brings forth two or more Children at once there is a Superfoetation because they are almost always begot in the same act by the reception of abundance of Seed into the Womb. When a Woman brings forth one or more Children at a Birth begotten at once which are usually called Twins it is known by their being both almost of an equal bigness and thickness and by having but one common after-birth not separated one from the other but by their Membranes But if there are several Children and a Superfoetation they will not have a common burthen nor will they be of an equal bigness To conclude Of a hundred Women that have Twins ninety of them have but one burthen common to them both which is a certain sign they had no Superfoetation CHAP. XVIII Of the Womb-Cake of the Membranes involving the Child and of the Humours contain'd in them of the umbilical Vessels of the parts of a Child that differ from those of the adult THE Womb-Cake otherwise called the Womb-Liver for the likeness of substance is soft and has innumerable Fibres and small Vessels it is two Fingers breadth thick in its middle but thinner near the edges and a quarter of a Yard over from one side to the other when the Infant is near the Birth on that side next the Foetus it is smooth and something hollowish like Navelwort and is knit to the Chorion but on that next the Womb it is very unequal having a great many bunchings whereby it sticks fast to the Womb. VVhen there is but one Child in the Womb it is but one but if there be Twins there are two Womb-Cakes and a particular rope of Umbilical Vessels is inserted into each from each Child it grows not out of the Womb originally but its first rudiments appear like a woolly substance on the outside of the outer Membrane that invests the Embrio called Chorion about the eighth or ninth Week upon which in a short while a red fleshly and soft substance grows but unequally and a little in knobs and then it presently thereby sticks to the Womb and is very conspicuous about the twelfth or thirteenth Week till now the Infant is increased and nourished wholly by the apposition of the Cristalline or albugineous liquor wherein it swims loose in the inner Membrane called Amnios having no Umbilical Vessels whereby to receive any thing from the Womb-Cake But when it grows bigger and begins to want nourishment the extremities of the Umbilical Vessels begin to grow out of the Navel by little and little and are extended towards the Womb-cake that they may draw out of it a more nourishing juice and carry it to the Infant as Plants do from the Earth by their roots It has Vessels from the Womb and from the Chorion the former are of four kinds Arteries Veins Nerves and Lympheducts all which tho' they be very large and visible in the Womb and also where the Womb-Cake is joyned to it yet they send the smallest Capilaries to the Womb it self Those that come from the Chorion are Arteries and Veins The Arteries and Veins that come from the Womb spring from the Hypogastricks and also that branch of the Supermaticks that is incerted into the bottom of the Womb those that come from the Chorion are the Umbilical Vessels of the Infant The Womb-Cake after it is joyned to the Womb sticks most firmly to it for the first Months as unripe Fruit does to the Tree but as the Infant becomes bigger and riper and nearer to the Birth by so much the more easily will it part from the Womb and at length it falls out of the Womb and makes part of the After-birth Next to the Womb-Cake follow the two Membranes viz. Chorion the outer and Amnios the inner wherein the Child is wrapt Betwixt these two after the Child is perfectly formed there is a third viz. Allantois The Chorion is pretty thick smooth on the inside but without somewhat unequal and rough and in that part of it which sticks to the Womb-cake and by it to the Womb it has very many Vessels which spring from the Womb it self and the Umbilical Vessels Twins are both inclosed in one Chorion but have each a particular Amnios it invests the Egg orriginally which Egg being brought to the Womb and becoming a Conception this Membrane imbibes the moisture that bedews the Womb plentifully at that time This Liquor that it imbibes is thought to be the Nutritious Juice that ouzes out of the Capilary Orifices of the Hypogastrick and Spermatick Arteries and is of the same nature with that which afterward is separated in the Womb-cake and carried to the Infant by the Umbilical Vein and with that also which abounds in the Amnios even till the Birth The Amnios is the inmost Membrane that immediately contains the Child it is not knit to the Chorion in any place save where the Umbilical Vessels pass through them both into the Womb-cake it is very thin soft smooth and pellucid and encompasses the Infant very loosly it has Vessels from the same Origins as the Chorion From a limpid Liquor contained in this Membrane the first lineaments of the Embrio are drawn But because this Liquor is so very little there sweats through this Membrane presently part of that Nutritious Albugineous Humour that is contained in the Chorion which it had imbibed out of the Womb and by the addition of this Humour to the undiscernible Rudiments of the Embrio it receives its increase But tho' the Amnios have its additional Nutricious Liquor at first only by Transudation yet when the Umbilical Vessels and the Womb-cakes are formed it receives it after another manner for then being separated from the Mothers Arteries by the Placenta and imbibed by the Umbilical Veins of the Infant passes directly to its Heart from whence being driven a great part of it down the Aorta it is sent forth again by the Umbilical Arteries out of whose Capillaries dispersed plentifully through the Amnios it issues into its cavity A third Membrane which invests the whole Infant is the Allantoides it has the same Figure as the Chorion and Amnios betwixt which it is placed in their whole circumference Now tho' it must be supposed that this as well as the other two is originally in the Egg yet there is no appearance of it till after the Umbilical Vessels and the Womb-cake are formed and the albugineous Liquor ceases to be imbibed by the
and an ill and strong smell exhales from the Womans Body and her Breath stinks If the Secundine be excluded first it is a certain sign that the Child is dead The whole cure consists in the exclusion or extraction of the Child Take of the Leaves of Savine dryed of the roots of round Birthwort of the Troches of Myrrh and of Castor each one Dram of Cinnamon half a Dram of Saffron one Scruple mingle them make a Powder whereof let her take one Dram in Savine Water Foment the Pubes Privities and Perineum with an Emollient Decoction made of the Leaves of Mallows and Marsh-mallows and the like and let a Pessary be put up the Privities Take of the Roots of round Birthwort Orris Black Hellebore of Coloquintida and Myrrh each one Dram of Galbanum and Opopanax each half a Dram with Ox Gall make a Pessary If after having tried Medicines a long while the Child cannot be ejected it must be extracted by a Surgeon either with Instruments or with the Hand alone CHAP. XXIV Of the Caesarian Delivery THE Caesarian Delivery is a dextrous extraction of a Living or Dead Child from the Mothers Womb which cannot be other ways excluded and that without endangering the Life of both or of either and without spoiling the Faculty of conceiving and by this Art the first Scipio Africanus of the Romans was cut out of his Mothers Womb and therefore was called Caesar This Caesarian Section is thought to be necessary when the Mother and the Child are so weak that they cannot be preserved any other way The use of it is twofold one that a living Child may be extracted the other that the Mother may be preserved alive and tho' it is very hazardous yet in a desperate case it is better to do something than nothing especially when a confederacy is like to be broken by the death of a Wife or when a Family is like to be extinguished or some Kingdom or Principality is like to be lost In this manner we find in the Annals of Spain the King of Navar was preserved for his Mother being wounded in the Belly by the Saracens as she was Hunting a Noble Man coming to her help saw the Child put its hand out of the Wound and drew it forth and educated it privately and afterwards when the Nobility was contending about the Election of a Prince he brought out the young King and so the Controversie ended The causes which require this operation are a too great Child or Twins or more that endeavour to be born together or if a fleshy Mole join to the Child the ill posture of it and if it cannot be reduced to a better either by its own help or the help of others or because it is dead or so much swell'd by a Disease that the Naturall passage is too narrow But in this case it is best to take it away peece-meal The causes on the Mothers part are the narrowness of the passages either naturally by reason she is too young or too old or because the VVomb is shut either by a Cicatrix or a Callous Moreover many tumours in the Womb or the Mouth of it may be the cause In these cases tho it be very dangerous yet it is very necessary to use Section and the operation may be happily performed as may appear by several Experiments to him that reads Rousel But before you enter upon this Operation you must consider whether the Child can be Extracted any other way that is safer and easier You must moreover consider whether there are Signs of Death and if so you must not enter upon the Operation lest the Womans Death be laid upon the Section and your rashness But when you have througly weighed all things if the Woman be of a strong Nature tho by reason of the Labour she is weak you may venture upon the Operation Most Authors would have it made on the left side of the Belly because it is more free from the Liver but I says Mauriceau think it will be better and more skilfully made just in the middle of the Belly between the two right Muscles because in this place there is only the coverings and the white line to cut To dispatch then with more ease and speed the Chyrugeon having placed the Woman so that the Belly may be a little raised let him take a good sharp incision Knife very sharp on one side with which he must quickly make an Incision just in the middle of the Belly between the two right Muscles unto the Peritoneum of the length and extent of the Womb or thereabouts after that he must only peirce the Peritoneum with the point of his Knife to make an Orifice for one or two of the Fingers of his left hand into which he must immediately thrust them to cut it lifting it up with them and conducting the Instrument for fear of pricking the Guts in proportion to the first incision of the coverings which having done the Womb will soon appear into which he must make an Incision in the same manner as he did in the Peritoneum being careful not to thrust his Instrument at once too far in having then so opened the VVomb he must likewise make an incision in the Infants Membranes taking care not to wound it with the Instrument and then he will soon see it and must immediatly take it out of the burthen which he must nimbly separate from the bottom of the VVomb and finding it to be yet living let him praise God for having so blessed and prospered his Operation But the Children so delivered are usually so weak if not quite dead as it often happens that it is hard to know whether it is alive or dead yet one may be confident the Child is living if by touching the Navel-string the Umbilical Arteries are perceived to move as also the Heart by laying the Hand on the Breast and if it prove so means must be used to fetch it to it self by spouting some VVine into the Nose and Mouth and by warming it until it begins to stir of it self But it is to be noted that Mauriceau much disapproves this cruel Operation and says it ought not to be performed until the VVoman is dead for that the VVoman always dies in the operation or presently after CHAP. XXV Of the Secundine retained IN a natural Birth the Secundine is usually excluded presently after the Child and when it is not the Life of the Woman is much indangered It is retained by the too great thickness of the Coats the swelling of them and by an afflux of Humours occasion'd by hard Labour also by the strutting of the Mouth of the Womb after the exclusion of the Child The External Causes are Coldness of the Air whereby the Secundine is repelled and the Orifice of the Womb shut Certain perfumes whereby the Womb is allured upwards violent passions of the Mind as Fear and sudden Frights the perverseness of the Woman who will not