Milk let her not be Melancholy but merry and chearful smiling often to divert it She must be sober not given to Wine or other strong Liquors and yet less to the excess of Venus but she may moderately use the first and not wholly abstain from the 2d if her nature require it so it be with her Husband which liberty is freely given then by the great Physitian Jubertus in the 7th chap. of the 5th book of his Popular Errors being founded upon the Experience of alâ— poor Women who bring up their Children very well notwithstanding they lye every Night with their Husbands and from his own alleging that his Wife had Nursed his Children all very well although he lay with her every Night and carressed her as he said like a good and faithful Husband but she must forbear at least an hour or two after to give the Child suck In fine if a Nurse hath all or most of thesâ— Conditions as well respecting her Person aâ— manners and that she maintains this condition by a dyet sit for the Childs temper anâ— not contrary to her own there is then greaâ— reason to believe she is very sit to make a very good Nurse of and to bring up the Soâ— of a Prince in perfect health And now good Mrs. Midwife proceed to shew your skill concerning the diseases of little Children SECT II. Of the Diseases and Symptoms which happen to Children and first of their Diseases in general Mid. SIr withal my heart I shall gladly unfold to you the very depth of my skill and knowledge in this affair and would humbly entreat you that you would be pleased to correct me if I shall at any time offer to utter any thing that may not be according to the rules of art and the practice of learned Physitians for truly Sir we Midwifes must needs acknowledge our selves to have received most of our skill and knowledge from the writings conferences and directions of learned Physitians Now then Sir I have read that Hippocrates divides Childrens diseases according to their ages When he like an Oracle lays down that in new-born Children there are Vlcers in the Mouth Vomitings Coughs Watchings Fears Inflammation of the Navil moistness of the Ears at breeding of their Teeth their Gums itch and they fall into Feavers and Convulsions and a loosness of the belly when they breed their Eye Teeth When they grow older their Tonsils are inflam'd the joints of the Neck are sprained inwardly their breath 's short they have the stone and round Worms Warts standing Yards Strangury Kings-Evil and other swellings then besides these here mentioned by the divine Hippocrates they have other Diseases at other times as that they are generally infected with the Small-Pox and Meazels none or few escaping Tongue tyed Chafing c. concerning which I shall now in particular give you my method of cure beginning first with Feavers Small-Pox and Meazels as the most general SECT III. Of Feavers Meazels and Small-Pox in little Children CHildren are subject to all sorts of Feavers but chiefly that of corrupt Milk which is commonly from Choler 1st therefore give cooling and moistening things to the Nurse as Lettice Endive Succory c. and Emulsions of Barley-water with the four cold seeds Barley cream then purge her gently with Manna Cassia Fistularis Lenitive Electuary c. then give altering remedies to the Infant as Syrup of Violets Lemons Citrons c. dissolv'd in Endive or Cichory or Borage or Bugloss water 4 ounces of water to one of Syrup to which you may add a little white Rose water to make it the more pallatable If the Feaver proceed from breeding Teeth abate the pain of which hereafter and give alterers as abovesaid In the Small-Pox and Meazels you have nothing to do but to observe Natures motions in the driving them forth and to assist her if you see her any ways weak or obstructed by giving the Child a little Claret with Syrup of Clove Gilly-flowers and a little Treacle water but be sure have a care that you encrease not the Feaver Cochenele and Bezoar and Saffron are excellent likewise SECT IV. Of the milky scab Achores Scald-Head and Lice THe milky Scab is at first sucking the Achores after the Achores are not white but the other are and possess the whole body the Achores only Head and Face but are cur'd a like They are commonly thought to be healthful when they run because they prevent Convulsions c. and they often cure of themselves in time but if the matter be very sharp they peirce the Skull Dry these up not rashly so they disfigure not the Face or endanger the Eyes but first try to drive them forth with such things as you were told in the Small Pox let the Nurse forbear sharp salt things prepare her Body with Borrage Succory Endive Bugloss Fumetory Polypody and Dock roots and then purge her with Sena Polypody Epithymum c. If you fear it will turn to a scald Head foment it with a decoction of Mallows Barley Celandine Wormwood Marsh-mallows boild in Boys urine and Barley water and then anoint with Oil of Roses and Lytharge of Gold and if the Scull come to be bare dress it with Honey of Roses and Brandy and after with Powder of round birth-wort and Balsome of Peru Turpentine and Tobacco water If you have occasion to use stronger Medicines for a scald Head take sulphur 2 drams Mustard seed half a dram Stavesacre bryony roots each 1 dram Vinegar 1 ounce Turpentine half an ounce with as much Bears Grease as will make it into an Oyntment or beat water-Cresses with Hogs Grease When the Scab is fallen off pull the hair out by the roots with instruments or Medicines commonly they use a pitch'd cap and pull it violently to bring away the Hair or take Starch or Wheat-flower 2 ounces Rosin half an ounce boil them in water to the consistence of a pultis lay it upon the several Scalds let it stick some days then pluck it off violently For Lice to prevent them let them not eat food of ill juice as Figs c. let her Head be often comb'd and wash'd and purge the Nurse or Child then give things to draw the humor out as you have been taught and then consume the superfluous moisture as with this take Elacampana 2 ounces Briony roots half an ounce Beets herb Mercury Soap-wort each an handful Nitre half an ounce Lupines 2 drams boil them for a Lotion then anoint them with this following take powder of Stavesacre 3 drams Lupines half an ounce Agaric 2 drams quick Sulphur a dram and half Oxe gaul half an ounce with oil of Wormwood as much as will suffice to make it into an Ointment SECT V. Of the watry swelling of the Head WE speake here of the water without the Scul for which take 30 snails with their shels Marjoram Mugwort each an handful with oil of Chamomil make a pultis and snuff up this water often
take Nutmegs Cloves Cubebs each a scruple Calamus Aromaticus Frankincense bark each half a dram Majoram water 3 ounces If in 20 days this doth not the cure then you must consult with the able Surgeon for the opening it SECT VI. Of Frights in the Sleep and Watching YOu must see to cure this presently for 't is the fore-runner of the Falling-sickness give good Milk and not too much to overcharge the Stomach let not the Child sleep presently after food but carry it about and Jog it to the bottom of the Stomach give it 2 or 3 spoonfuls of oil of Sweet Almonds or Honey of Roses If it come from a Feaver Teeth or Worms they are treated of a part As for the Childs watching you must take notice that a new born one sleeps more then it wakes because its brain is very moist and it slept in the Womb. If you cannot make it sleep by singing or rocking c. 't is a Disease and if not cur'd will produce Catarrhs Convulsions Feavers c. If it proceed from bad Milk that must be amended if from a Feaver or pain remove them and give sleeping Medicines to the Nurse if that will not do you may venture a little Lettice or Purcelan water SECT VII Of the Falling-sickness and Convulsion THe first is either by consent from parts below when the Milk corrupts in the Stomach or from its ill quality from the Nurses bad dyet or from Worms or Vapors or from the brain first when humors are bred there that cause it or from Tooth-ach or sudden fright To prevent it give the Child as soon as 't is born oil of Sweet Almonds Sugar-Candy and Anniseeds powdered The Florentines apply a Caustick to the hinder part of the Head the best part of the cure is the Nurses dyet If from corrupt Milk provoke vomit by holding down the Tongue and pour some Oil of sweet Almonds down the Throat The same means may be used in Convulsions only anointing the spine of the back with Oil of Chamomil St. John's wort Worms Goose-grease Foxes Oil c. SECT VIII Of pain in the Ears Moisture Ulcers and Worms THe first is allayed by using warm Milk to them or Oil of Violets or the decoction of Poppies for the moisture take Honey of Roses and Aqua Mellis and drop them into the Ears for Worms they are kil'd by washing the Ears with white Wine wherein Wormwood hath been boiled or drop in Hemp Oil with a little Wine SECT IX Of the Thrush bladders of the Gums and Inflammation of the Tonsils FOr the first wash the Mouth with Plantain water and Syrup of Mulberries with a little Sal Prunella the Bladders are cured by taking the powder of Lentils husked and laid upon them If the Tonsils of Infants chance to be inflam'd give them Honey of Roses Myrtles Pomegranates and Diamoron inwardly and oil of sweet Almonds Camomil and St. John's wort outwardly SECT X. Of the breeding of Teeth HEre the pain is great and many time kills the Child it happens about the 7th Month they breed first the fore Teeth then the Eye-Teeth and last of all the grinders 't is known by the Child 's often putting its Fingers to its Mouth by holding the Nipple faster then before and the Gum is white where the Tooth begins to come If the Teeth are long a breeding it causes Feavers and Convulsions of which many dye Their hard breeding is from thickness and hardness of the Gums therefore soften and loosen them by rubing them with your Fingers dipt in Honey and Butter or with the mucilage of Quinces made with Mallow water If the Gums be inflam'd add the juice of Houseleek and cream and let the Nurse keep a temperate dyet SECT XI Of a Catarrh Cough and difficult breathing THese proceed from much Milk that burthens the Stomach and many vapors from thence filling the Brain and if the brain be full of excrements they are dissolved either by inward heat or outward cold and so distill upon the Nose Jaws or Lungs which causes a Cough or short breathing moreover much food makes crudities in the first passages and Phlegmatick humors are bred by the Liver of crudity and thick humors whence unconcocted blood is sent by the Arterial Veins into the Lungs and pressing the pipes of the Lungs causeth difficult Breathing First let the Nurse keep a good dyet and fill not the Childs Stomach too full with Milk or other dyet and let the Nurse forbear all hot sharp salt sour things and such as fill the Head with Vapors and give her a pectoral decoction such as this take Figs and Jujubes each 10 Sebestens 30 Raisins stoned 10 drams Liquorice 2 drams Maiden hair and Violets each an ounce and half boil them in 3 pints of water till the 3d part be boiled away let her take 6 or 8 ounces of this every morning keep the belly open with Syrup of Roses Cassia or a Clyster or hold down the Tongue to provoke vomiting give syrup of Jujubes Maiden hair if the matter be thick give syrup of Hysop or Hore hound or an emulsion of oil of sweet Almonds and Pine-nuts made with Scabions water or make a Lohoc of diarios Diatragacanth frigid penids and syrup of jujubes If it be hot give Emulsions of the 4 great cold Seeds made with Barley-water and Almonds SECT XII Of the Hiccup and Vomiting THey come from corruption of the food in the Stomach or over fulness of milk or cold Air these hurt the expulsive faculty which stirs it self up to expel what offends it If from fulness of Milk the belly swells and there follows Vomiting if from corruption of Milk it may be the Nurse hath bad Milk the Child cryes and is in pain and the excrements smell of stinking Milk If from corruption put a feather dipt in oil to cause Vomiting then strengthen the Stomach with syrup of Mints Quinces or Betony c. Vomiting is from too much or bad Milk or from a moist Stomach for as dryness retains so moistness loosens If from much Milk they are better after vomiting if from corruption of milk what 's vomited is yellow green c. and stinks worms are known by their signs they that vomit from their birth are the lustiest for the Stomach not being used to meat and taking too much Milk breeds crudities or corrupts the Milk and 't is better to vomit these up but if it last long it causes a washing If from too much Milk give it less if corrupted amend it as before and cleanse the Child with Honey of Roses and then strengthen the Stomach as before and if the humor be sharp and hot give syrup of Pomegranates Currans Coral Apply Emplastrum crusta panis or the stomach cerat to the Stomach SECT XIII Of the pains and puffing of the Belly PAins are often with a Flux from corrupt Milk which breeds wind and sharp humors which gnaws the inward parts so do Worms The Child cryes
symptomatick from the weakness of her Stomach and will vanish as soon as it is fortified which may be promoted if she take before and after meals some of that burnt wine spoke of before for the Cough or a little good Hippocras or right Canary or eat a little Marmalade of quinces before meals and wear a Lamb-skin upon the pit of her Stomach be sure to give no purge for this is only caused by weakness If it be a Diarrhea simply voiding such excrements as are in the Guts and some superfluous humors which nature hath sent to be expelled and it be gentle and continue not long she will feel no damage by it and so 't is good to leave it to nature without interrupting it in the beginning but if it continue above 4 or 5 days 't is a sign there are ill humors cleaven to the inside of the Guts and ought to be expell'd by some light purge after which it will certainly cease But if for all fit purges it changes into a Dysentery she is then in danger of miscarrying which must be prevented if possible therefore having purged the ill humor and hindering that no more be engendred by Chicken or Veal broths c. with cooling herbs pap with the yelk of an Egg well boild let her quench Iron or Steel in her drink which must be small beer or water with a little strong or wine if she be not Feaverish for then half a spoonful of syrup of Quinces or Pomgranates is better and she may eat a little Marmalade of Quince or other strengtheners if she was purg'd before and because there is always great gripes they must be appeas'd by Clysters made of the broth of a Calves or Sheeps head well boild with 2 ounces of oil of Violets or good Milk and the yelk of an Egg after the use of these as long as is judged necessary which she must keep as long as she can you must proceed to clensers made with Mallows and Marsh-mallows with hony of Roses and then binding ones in which must be neither oil nor hony beginning first with gentlest made of rose-Rose-water with Lettice and Plantain water then to stronger of the roots and leaves of Plantain tapsus barbatus horse-tail province Roses rind of Pomgranates in Smiths water adding of sealed earth and Dragons blood of each 2 drams you may also foment the Fundament Of the monthly blood before and if it be from to much blood 't wil do her a kindness SECT XI Of Fluddings THe Courses come at accustomed times without pain distilling by little and little from the Wombs Neck during pregnancy and then wholly ceaseth but these come with pain from the Wombs bottom and almost on a sudden in great abundance and continue without intermission except some clods formed there seem sometimes to lessen the accident by stopping for a small time the place whence they flow but it soon returns with greater violence and after follows death to the Mother and Child if not prevented by delivering the Woman If the Fludding happen when young with Child it 's usually because of some false Conception or Mole of which the Womb endeavours to discharge it self by which it opens some of the Vessels in its bottom whence the blood ceases not to flow till it hath cast out the strange bodies it contain'd the subtiller the blood is the more it flows but when this happens to one truely Conceiv'd at whatever time it proceeds likewise from the opening of the Vessels of the Womb's fund caused by some blow slip c. and chiefly because the secundine separating in part if not wholly from the inside of the Wombs bottom to which it ought to stick to receive the Mothers blood for the Childs nouriture leaves open all the Orifices of the Vessels where it joyned and so follows a great flux of blood which never ceases till she be brought a Bed yet I do not intend it should be done as soon as perceiv'd for some small fluddings have been stop'd by lying quietly in Bed bleeding i' th Arm and the use of Remedies mention'd in the menstruous Flux and it may be but an ordinary monthly Flux and then 't is good leaving the Labor to nature provided she hath strength and accompanied with no other ill accident but when she falls into Convulsions and Faintings 't is absolutely necessary she be deliver'd whether she be at her count or no pains or throws or no for there is no other way to save both their Lives You must not always expect pains and throws to force and forward Labor in these dangerous accidents for though they come at the beginning they usually cease as soon as it comes to Faintings and Convulsions neither must it be put off till the Womb be opened enough for this Flux moistens and the weakness loosens it so that it may then be as easily widen'd as if there had been abundance of strong throws Wherefore let the Midwife introduce her Fingers anointed with Oil or Butter 2 or 3 at a time and all by degrees and at last her whole Hand and if she find the waters not broke break them and then whatever part of the Child presents though the head provided it be not i' th Birth let her search for the Feet and draw it forth by them observing the circumstances in delivery of a Child with the Feet first because there 's better hold so that if the Feet lye not ready seek for them which is easier done at that time then another because the Fluddings make the Womb slippery then fetch the after-burthen which in these cases cleaves but little being careful not to leave so much as a clod i' th Womb lest it continue the Fludding In this case many Women and Children have perished for want of this operation and many escaped death by being timely succor'd Guilemeau a Famous French Chirurgion mentions 6 or 7 Histories to confirm this and Moriceau by his experience avers it and in the case of his own Sister too long here to relate You are always here to give good strengthning broths gellies and a little good Wine and smell to rose Vinegar and to prevent the blood Fludding in great quantity open a vein i' th Arm or bind her Arm with fillets above her Elbow and lay cloaths upon her Reins wet in water and Vinegar but if this proceeds from the parting of the after-burden she must be delivered as soon as may be though she were but 3 or 4 months gone because all must be broughâ— away whether false Conception Mole or Child SECT XII Of the Weight of the Womb c. THis is often caused by the stretching of the large Cords of the Womb and this will cause an hinderance of Copulation and a numness in her Hips sleepiness in her Thighs and difficulty of Urine and going to stool chiefly towards her latter reckonings because it presseth down the Bladder and great Gut being seated between both But she may be easier
when 't is thick apply it indifferently warm taking away the closures and clods of blood renew this if need be after 5 or 6 hours then make a decoction of Barley Linseed and Chervil or Marsh-Mallows and Violet leaves adding an ounce of honey of Roses to a pint and foment the bearing place Lukewarm 3 or 4 times a day for the first 5 or 6 days some use only milk and others Barley water After 10 or 12 days fortifie the parts with a decoction of Province Roses Plantan leaves and roots and Smith's water The 2d day use loose swaths with a large square bolster over the Belly till the 8th day taking it off i' th mean time often to anoint her Belly if it be sore with Oil of sweet Almonds and St. John's wort mixt then begin to swaith her streighter If she will not be a Nurse apply remedies to the Breasts to drive back the Milk if she will Nurse them keep her warm with soft clothes and if you fear too much blood carrying to them anoint them with Oil of Roses and a little Vinegar beat together and lay on fine Linnen dipt in 't let her not suck the Child the same day she 's deliver'd but stay 6 or 7 days In driving back the Milk some remedies hinder flowing of humors to the Breasts others scatter and in part dissolve the Milk therein Of the first sort are the last ointment or unguentum populeon and unguentum album equally mixt spread upon Linnen and applied Of the 2d is a Pultis made of Linseed Fenugreek Beans and Vetches powder'd boiled with the decoction of Chervil or Sage with Honey and Saffron some apply Honey only others rub the Breasts with Honey and lay on a red Cabbage leaf a little dryed the stalks taken away having great care she take not cold and above all procure ample voiding of the clensings by keeping the belly open by Clysters provoking them then the Milk will soon vanish SECT II. Of Fludding after Child-birth OF that preceding Labor before this blood now flows more abundantly by how much 't is hotter or mov'd by a long and hard Labor and the Woman 's full of blood and besides what 's said note sometimes this blood continuing to flow and remaining i' th bottom o th' Womb becomes clotted which causeth a new Flud and continues by Fits and i' th intervals there comes away some wheyishness of the imprison'd blood which dissolves and makes some ignorant People think the Flux is stop'd tho it continue flowing within wherein it stops only by the clotted blood when which comes away it begins a fresh This is a more dangerous accident then any can happen to one newly lay'd which dispatches her so soon if in great quantity that there 's often scarce time to remedy it so that you are immediately to apply remedies both to stop and turn back from the places whence it flows to which end if it be a false Conception piece of the burthen or clotted blood use all diligence to fetch them away or cause them to be speedily expell'd but if it flows and nothing remain bleed her i' th Arm not so much to empty the fulness as to turn the course lay her body equally flat not raised and keep quiet without turning from side to side nor must the upper part of her Belly be swath'd or bolstered keep her Chamber a little cool and not too warm in Bed All forbid Clysters lest they say humors be cal'd down but the contrary hath been experimentally found that great fluddings have been stopt by pretty strong clensing ones But if for all this the Flud continues then to the last Remedy which is to lay her upon fresh Straw with a single cloth upon it and no Quilt applying cloths wet in Vinegar and water along her Loins and if in the Winter a little warm give every half hour a little strong broth with a few spoonfuls of Gelly and between whiles the yelk of a new laid Egg give her not too much food at a time drinking red Wine with a little water wherein Iron hath been quenched If all this prevail not she will be in danger of her life SECT III. Of the bearing down and falling out of the Womb and Fundament of a Woman newly layd ANd here I shall make 2 sorts of Bearing down and 2 sorts of falling forth which differ but in degree for the first is when the Womb only bears down and comes not forth the 2d when it comes out of the Body The first sort of bearing down is when the full body of the Womb falls into the Neck in such manner as putting up a Finger you may feel the Orifice very near the 2d when the Womb being yet lower one can clearly perceive this Orifice quite without The falling out is twofold too in one the Womb comes quite forth but is not turn'd inside out nor can its inside be seen only its orifice which appears at the end of a great fleshy Mass which makes the body of the Womb and this is cal'd a falling forth of the Womb the other is cal'd a perversion or turning inside out most dangerous for you may perceive all even and without any Orifice and thus it seems to be only a great piece of bloody flesh almost like a Mans Cod which hangs between her Thighs and that which is wonderful in this case is the Womb the infants house goes forth at the Gate which is the inner Orifice A loosening or breaking of the Cords causes the bearing down which comes from hard Labor who have many whites are subject to it and heavy Children Coughing Sneezings a fall going in a Coach or Horseback great lifts burdens lifting the Arms too high and putting them over their head looseness great pains and needings all which shake and thrust the Womb downwards when with Child and the cords being loosened or broken cannot keep it up so that a bearing down doth easily follow the Birth of a Child but the most ordinary cause is violent travel when a Child cometh wrong and cannot be born so or hath too big an head or the inner Orifice not enough opened for the Womb is violently forced down and yet the Child can't advance into the passage because the cords are so rent or loosen'd or when the Secondine sticking close to the bottom is pul'd away on a sudden or too violently and much sooner if putting up the hand as when the String 's broke one pulls the body of the Womb instead of the After-birth but your directions will prevent this She feels a great weight at the bottom of her Belly extream pain i' th Reins and Loins and a bloodish moisture passes through this Mass of Flesh hanging between her Legs A loosening may happen to all Women a falling out but seldom a perfect perversion never but upon or immediately after a delivery because the inner Orifice is then almost as wide as its bottom but not at other times when
closed there is no possibility of its turning inside out how to remedy it I have told you If she be young and disease new easily expect a cure for a loosening or falling out but if she old and of a long standing 't is so much the more incurable Here do two things 1. reduce the Womb to its place 2. strengthen it and keep it there for the first if it be quite out or turned first make her render Urine and give a Clyster if necessary to empty the Guts then lay her on her back her Hips raised a little higher than her Head foment all with a little wine and water luke-warm and with a soft rag put it up wagging it little and little from side to side and if this be too painful anoint it with Oil of sweet Almonds wiping off the Oil as much as may be after As to the keeping it in its place and strengthening it after let her keep in Bed on her back her Hips a little raised Legs something crossed Thighs joined but the best is to put a pessary up the neck of the Womb the Figures of which you may see some of the Figure of an Egg of the length and bigness of the Womb's neck but these are Subject to fall out and so are not so convenient as those made of a piece of Cork they are to be of a thick circular figure like a small wreath and peirc'd i' th middle with a pretty big hole they must be cover'd with white wax and pretty large pull them out with a Finger to clear them they may be made some round others somewhat square or trianguler the corners must be blunted or rounded While the Lochia flow use nothing else to strengthen and above all swath not her belly but only for a stay for many Midwifes by a strong compression force it more down use a Bed-pan and ly along if possible when she goes to stool keeping her hand all the while on the bottom of her Belly but haveing cleansed well then use astringent injections and respect must be had to the whole habit of body to dry up the humors by a course of Physick and she must keep her Bed for 5 or 6 weeks Sometimes by the great throws she endures in Labor the fundament falls out now if the Child be very forward i' th passage 't will be enough to hinder it if possible before it happens perswading her not to help her throws so much but if it be down she must stay till the Child be born for it will be difficult before without bruising the Gut then reduce it as the Womb giving no Clysters for straining will cause it SECT IV. Of the bruises and rents of the outward parts of the Womb caused by Labors THese happen from the bigness of the Child's head which makes her cry in her first-Labor that the Midwife scratches those parts when 't is the head makes a separation of the parts and bruises and somtimes rents them of which they are not insensible after Labors These must not be neglected least they turn to malignant Ulcers then as soon as she 's lay'd if there be only simple bruises apply the Pultis before directed to those parts to ease pain very warm for 5 or 6 hours then lay some few rags dipt in Oil of St. John's wort on each side and renewing them twice or thrice a day foment with Barley water and Honey of Roses and when she makes water defend them with fine rags If the bruises be great and inflam'd and an Impostume follows it must be open'd and cur'd by the Chyrurgeon as also when by an unlucky accident the Privity and Fundament is rent in one which when cur'd she will be oblig'd if she happen to be with Child to prevent the like to anoint the parts with soft'ning Oils and Ointments and forbear helping her throws too strongly at once but usually when these parts have been once rent 't is very difficult to prevent the like because the scar streightens the parts Lastly if by neglecting such a rent the Lips be cicatriz'd and the cure be desired 't is the Chyrurgeons business SECT V. Of the After-pains IF these come from wind i' th Bowels it runs from side to side and sometimes towards the Womb to prevent this some give of Oil of sweet Almonds and syrup of Maiden-hair each 2 ounces immediately after Child-birth and to those that loath Oil I prefer warm broth or caudle and give a Clyster and repeat it as need is if it cease not thus 't is maintained by some other cause If from some strange body i' th Womb see to cast it out If her clensings be suddenly stop'd give Clysters to draw down use hot foments to the bearing place bleed i' th Foot and if full i' th Arm first Rest alone will fortifie and unite the stretching or breaking o' th Womb's cords but never forget in all pains to mind the Lochia SECT VI. Of the Lochia whence they come if good or bad their stopping and what ensues THere flows waterish humors from the Womb as soon as the Child is born besides those before when the Skins break which are often bloody because mostly blood's mixt with them but immediately after the burden is loosen'd there flows pure blood but after the 1st day there comes waterish humors when the Vessels close then they become thickish by heat more or less as they come in greater or lesser quantity and the length of time they stay there and then they resemble troubled milk which makes People believe 't is Breast milk Now I believe the cause of their change of colour consistance and diminution of â—heir quantity to be no other then that in â—he suppuration of a great wound as soon â—s 't is made it bleeds fresh and much but â—fter it yeilds only bloodish humors then a white matter so you must imagine there is a kind of wound made by loosening the burden from the Womb and what comes from it is the Lochia so that they are not what hath stay'd in and about the Womb during all the time of Child-bearing for that 's the Secundine neither is their any certain rule for their quantity and continuance being according to the Season Country Age Temper more or less hot or moist the habit more or less full and Vessels remaining long or short time open but 't is finish'd commonly in 15 or 20 days but after a mischance the less the fetus is and the less time she is gone with Child the less are the Lochia If they be fresh but the 3 or 4 first days they are good else 't is a pure bloody flux which will be very dangerous if of no ill scent without sharpness so we know the Womb 's without inflammation or corruption and if they flow in so great quantity as to cause Faintings or Convulsions she 's in danger of death or very much weaken'd grows lean and pale Legs and Thighs swell and becomes Dropsical The
for being so turned and doubled the child must of necessity be strangled in the womb Having tâ—…s run through births as well natural as unnatural I shall give you the reason and that in my own opinion why these births are of so various and different postures in the womb observing not alwaies the same posture and 't is because the Infant swiming in water and moving it self sometimes this way sometimes that way or moy'd by its mother as you have heard before is bent and tumbled several waies insomuch that sometimes it is strangely entangled with its own navil-cord which I am confident you have seen in your own experience oftentimes and shall now in the next place desire you to let me know which way you use to go to work when a dead Child is to be delivered from its Mother and she alive SECT XXXII Of delivering of a Woman of a dead Child MId Sir I shall most willingly consent to your demand as far as I shall be able in this always so long and dangerous a Labor which is because for the most part it comes wrong or though it comes right with the Head yet the Womans pains are so weak and slow in these cases that she cannot bring it forth and sometimes she hath none at all forasmuch as nature half overthrown by the death of the Child which cannot help it self labors so little that many times it cannot finish the business it hath begun but must yeild without the help of art of which at such a time it hath great need However before ever I may settle to your work I 'll endeavor to stir up the Womans pains with strong and sharp clysters to bring on her throws and to bear down and bring forth the Child and if these means prevail not she must then be delivered by the help of art Now if there be any case wherein a Midwife ought to make the greatest reflection and use most precaution in her Art it is this that is to know whether the Infant in the Womb be living or dead for there have been many deplorable examples of Childrens being drawn forth alive after they have been thought to have been dead with both Arms or some other limb lopt off and others miserably kill'd by the use of crotchets which might have been born alive if they had not been mistaken wherefore before the Midwife resolves on the manner of laying the Woman to avoid the like misfortune and the disgrace of being author of such a pitiful spectacle let her do her utmost endeavour not to be so deceiv'd and to be wholly satisfied whether the Child be alive or dead always remembring in this case that timidity is more pardonable then temerity that is it is better to be deceived in treating a dead Infant as if in case it were a live then a living one as if it were dead Now besides what hath been said before concerning knowing whether the Child be alive or not you must not always put your whole confidence in the first place in the Womans telling you that the Child is certainly alive because it stirs and though to be the better assur'd the Midwife may lay her hand on the Mothers belly for there have been Women sometimes delivered whose Children had been dead about 4 days as might be easily judged by their corruption who notwithstanding have affirmed though untruly that they felt them stir but a little before they were delivered and others again whose Children were alive and yet their Mothers never perceived them to stir in three or 4 days before as they confessed Now if the Midwife cannot be assured by the Childs motion that it is alive she may assoon as the waters are broke gently put up her hand into the Womb to feel for the breaking of the Navil-string the which she will find to be stronger the nearer she feels it to the Infants belly or if she meets with in hand she may feel the pulse but their pulses you must know are not so strong as their Navil-strings therefore the best to be known by it if then also by putting her finger into the Childs mouth she perceive it to stir its Tongue as if it would suck and on the contrary if no such signs and the Mother feel a great weight and great pains in her belly and it be not supported but tumbles always on the side she lays her self if she faints and have Convulsion Fits if the Navil-string or secondine hath been a good while in the World and if the Midwife by putting her hand into the Womb finds the Child cold and feeling she finds that very soft chiefly towards the crown where likewise thâ— bones are open and riding one upon the other at the clefts or Sutares because thâ— brain shrinks which corrupts more in 2 dayâ— in the Womb than it doth in 4 after it iâ— born which is caused by the heat and moistness of the place the 2 principals of corruption and if there comes a dark and stinking putrid matter from the Womb all thesâ— signs together or most of them demonstratâ— to the ingenious Midwife that the Child iâ— assuredly dead the which when she is certain of she must do her endeavor to fetch iâ— away as soon as possibly she can and having placed the Woman conveniently if thâ— Child offers its head first she must gently puâ— it back until she hath liberty to introduâ—… her hand wholly into the Womb and sliding it all along under the belly to find the Feet let her draw it forth by them being verâ— careful to keep the head from being lock'â— in the passage and that it be not separateâ— from the body which may easily happeâ— when the Child being very rotten and putrifi'd she doth not observe the circumstanceâ— that we spake of before that is in drawing forth the Child to keep its breast and face always downwards And if notwithstanding all these precautions the head because of the great putrefaction should be separated and left behind in the Womb it must be left to be drawn forth by the expert Physitian or Chyrurgion The same also is to be said when the Head is so far advanced coming first and engaged among the bones of the passage that it cannot be put back then being very sure by all the signs together or most of the chief of them that the Child is dead certainly 't is better to let the Surgeon draw it so forth it being a round slippery part with crotchets then torment the Woman to put it back Now if the dead Child whereof above all there must be good assurance comes with its arms up to it shoulders so extreamly swelled that the Woman must suffer too much violence to have it put back 't is best then as was said before to take it off at the shoulder joint by twisting it 3 or 4 times about then afterwards the Midwife will have more room to put up her hand into the Womb the arm being so separated
of all the parts of its body which is very tender wherefore I cannot conceive any necessity to oblige them more to empty the Urine which is in a small quantity in the Bladder then the excrements which are in the Guts which is not then done in any manner but only after the Child is born Bartholinus and others would have the Infant however to empty its Urine through its Yard and that these waters proceed from thence but there is a greater probability it should be vented by transpiration for before it is yet fully shaped and quick there is notwithstanding found a proportionable quantity of these waters to the bigness of its body which makes it appear that it is then neither the Urine rendred by the Vrachus nor Yard as all the World imagine and that which proves it more plainly is the example of some Children born with their Yards imperforated who notwithstanding have these waters whilst in the Womb And here it must be observed that when there is more then one Child they are never in the same Membrane unless their bodies are joined together which is rare and monstrous but each have their Membranes and waters apart Now these waters thus collected within these Membranes have divers very considerable uses First They serve the Infant to move more easily as it were by swiming from one side to the other and that it may not hurt the Womb by its frequent motions in striking dry against it which would cause great pain and often excite to Abortion and they serve also very much to facilitate its passage in the birth making the way very slippery and by that means the orifice of the Womb being moistened is better widened and yielding when they break just when the Child is ready to follow or a little before for else remaining dry it is born with greater difficulty and the Mother also more tormented by it And now Mrs. Eutrap having thus sufficiently as I hope explained the Membranes of the fetus and the waters contained in them I think it may not be amiss to say something in order of inquiring after the parts by which it is nourished whilst in the Womb and and here Mrs. Eutrap since as was said in the beginning that it is only nourished by its Mothers blood and that I am of opinion that big-bellied Women have none that is fair or good provident nature hath formed the placenta to serve it for a Magazine that it may always have sufficient and be there again elaborated and perfected to render it more convenient for its nourishment for without doubt so gross a blood as the Mothers cannot possibly be converted into its substance if it were not first purified in the placenta which is afterwards sent to it by means of the umbelical veins and brought back as we shall shew hereafter by the Arteries which are the conduits of which the Navil-string is composed We say then that the placenta is nothing but a spungy and fleshy mass somewhat like the substance of the spleen woven and interlaced with an infinite number of Veins and Arteries which compose the greatest part of the body made to receive the Mothers blood appointed for the Infants nourishment This mass is so called because it resembles a cake also it may be call'd the delivery because being come forth after the Child is born the Woman is quite delivered of her burthen it is also call'd the after-burthen because it is as a 2d Labor of which the Woman is not discharged till after the Child be born some give it the name of liver of the Womb because they say it serves as a liver to prepare the blood appointed for the Infants nourishment and Laurentius calls it the sweet bread of the Womb and appoints it the same use as that of the lower belly to wit for a rest and support to the Vessels of the Navil which disperseth an infinite number of branches throughout all its substance Now this placenta is made of the menstruous blood of the Mother which flows into the Womb by the accumulation of which it is formed its shape is flat and round about the bigness of a Trencher and 2 fingers breadth thick about the middle where the umbilical Vessels are fastened but is thinner towards the edges It is covered with the Chorion and Amnios on the side next the Infant and on the other side 't is joined and fastned to the bottom on the inside of the Womb It is strongest fastned to the Womb with its circumference by the Chorion which cleaves so close to it by the interlacings of an infinity of Vessels which appear very large in its surface that it cannot be separated from it without tearing its substance Though there be 2 or 3 Children in the Womb begot in the same act they have usually but one common after-burthen which hath as many Navil-strings as Children which are notwithstanding separated from one another by their several Membranes in each being the Children and waters but if they be superfetations there will be as many burthens as Children and as superfetations happen but rarely so there are few Women that have their burthens separated when they are delivered of several Children We scarce find any Creature but a Woman that hath an Afterburthen like this described and dischargeth it as useless as soon as the Child is born for most other Animals cast forth nothing after their young except the waters only and some slimes with the skins which surround them and in lieu of this fleshy mass those which as a Woman have but one at a time have only some cotyledones or many spungy kernels joyn'd inwardly to the proper substance of their Womb which terminates all the branches of the umbelical Vessels of their Young which Kernels as I have often observed in cutting up Sheep when they were not with young are not bigger then hemp-seed but when they were with young they swell'd as big as one thumb one bigger and one lesser and then they resembled the Figure of a round mushrome on the outside not yet spread after it 's cut from its stalk and to each of these kernels are fastned the branches of the umbilical Vessels however those that have more then one at a time as Bitches Rabbits c. have no kernels instead of which each young hath in its celule a kind of particular placenta which the dam eats as soon as she voids it after she hath knawn off the umbilical Vessels that hold it But these thing being fitter for Physitians and Chyrurgions to be contemplated on I shall proceed no farther to discourse thereon and shall only desire you to note that those Vessels appointed for the nouriture of the fetus are bigger then they are in Men because of their hollowness and as soon as the Child is born dry up and that part of them which is without the belly falls off and is separated close to the Navil 5 or 6 days after for which
reason they lose their first use and begin after to degenerate into suspending ligaments to wit the vein into that of the liver and the 2 Arteries serve to extend and sustain the bladder by the side where they are joined to it the bottom of which is yet suspended by the Vrachus which comes not through the Navil as hath been said but remains so pendent all the rest of its life and now Mrs. I come to know how you use to fetch away the after-burthen with the string and when 't is broken Mid. That I shall freely do Sir withal my heart and therefore Sir you must note that the afterbirth being a useless thing to the Woman when the Child is born she must immediately after be freed of that also wherefore as soon as the Child is born before I do so much as tye or cut the Navil-string lest the Womb close I must without time looseing ease the Woman of this fleshy mass To perform which having taken the string I must wind it once or twice about one or 2 of her fingers of her left hand joyn'd together the better to hold it with which she may then draw it moderately and with her right hand she may only take a single hold of it about the left near the Privities drawing likewise with that very gently resting the while the fore finger of the same hand stretched forth along the string towards the entry of the sheath of the Womb as may be seen in the annexed Figure always observing for the more facility to draw it from the side where the burthen cleaves least for in so doing the rest will separate the better as we see a card which is glewed to any thing is better separated from the place where it begins to part then where it is close joyned But above all things care must be had that it be not drawn forth with two much violence lest breaking the string near the burthen I be oblig'd to put up my whole hand into the Womb to deliver the Woman or that the Womb to which it is very strongly fastned sometimes be not drawn forth with it or a very great flooding be caus'd wherefore for these reasons it shall be gently shaken and drawn forth by little and little and to facilitate the better its expulsion the Woman may the whilst blow strongly into her hands shut as one does into the mouth of a bottle to know if it be broke or put her finger into her Throat as if she would cause vomiting or strive as if she were going to stool bearing always down and holding her breath as she did to bring forth her Child and if after all this I meet with difficulty you may if need be after you know on which side it is seated desire an experienced Nurse keeper to press the belly lightly with her flat hand directing it gently downwards by way of chaffing not too boistrously But if all this be in vain then I must direct my hand into the Womb to separate it as you shall hear anon Then I must consider if there be all and take care that the least part remain not not so much as the skirts or any clods of blood and this is the way to deliver a woman of her after-birth but sometimes the Midwife by endeavouring it breaks the string by pulling too strongly or because 't is very weak or else so putrified when the Child is dead that the least pull breaks it off close to the burthen the which by that means is left behind in the Womb or because it cleaves to strongly or the Woman is weak and cannot expell it being much tired by a long Labor or because it was speedily drawn forth after Labor the Womb closeth so as it leaves it no passage and cannot without much difficulty be dilated to fetch it away because it remains dry after the natural slime and humidities are past and seeing that if it remain behind 't is capable of destroying the Woman we must see to get it away as before and if the Navil-string happen to break near the burthen I must immediately introduce my hand into the Womb before it close being anointed with oyl or fresh butter to separate it from the Womb gently and draw it forth with the clods of blood that remain When the Navil string is not broken it will easily conduct the hand but when 't is we have no longer this guide wherefore I must be then very careful that I be not deceived in taking one part for another as I once saw a Midwife pull the Womb near the inward orifice in lieu of the burthen Assoon then as I have introduced my hand into the Womb towards its bottom I shall find the burthen which I shall know by a great number of little inequalities which are always made there by the roots of the umbilical Vessels on the side where they terminate which makes it to be easily distinguished from the Womb if it yet cleave to it notwithstanding 't is then a little wrinkled and uneven because its Membranes which were very much inlarged contract themselves immediately after the Child and its waters which kept them extended are excluded and they that are expert can easily judge of it Now if I find the burthen wholly loosen'd from the Womb it will be easy to draw it forth when I have got it into my hands but if it cleaves finding the side to which it sticks least I must begin there to separate it gently by putting some of my Fingers betwixt it and the Womb continuing by little and little to do so till it be quite loose and then draw it forth very carefully observing the whilst if it cannot be otherwise rather to leave some part thereof behind than to scrape or scratch the least part of the Womb for fear of a flooding inflammation or Gangrene which cause death being also careful not to draw it forth till it be wholly or the most part of it separated for fear of drawing forth the Womb with it and to preserve it as whole as these cautions will permit because of shewing it to the company that they may know I have performed my office well But if the Midwife shall not find the Womb open enough to direct her hand immediately into it let her presently anoint the Womans Privities with hogs grease then by little and little put up her hand and let the Woman contribute as before but if for all this she cannot void the After-birth to avoid a greater mischief I must leave it to nature assisting her with remedies which suppurate wherefore injections into the womb are proper made of Mallows Marsh-mallows Pellitory of the Wall and Linseed in which is to be mixed a good quantity of Oil of Lillies or fresh butter and to hasten the work give her a strong Clyster that so by the Motions to go to stool it may cause it to be voided as it hath arrived to many that have rendred it in the
Bed-pan and sometimes when they have least expected it At the same time to prevent a Feaver or many other accidents which usually happen she may be let blood in the Arm or Foot according as it shall be convenient and strengthen'd that the cadaverous vapors coming from the putrifaction of the burthen ascend not to the heart and noble parts which must be done by good cordials often used not such as are made of Treacle and Methridate c. for which no reason can be given but their specific or rather imaginary Faculties and are fitter to cause vomiting then comfort the heart But with true Cordials which are such as yield good nourishment and at the same time comfort the stomach without offending it as those drugs do which are only good for those that sell them Wherefore I must order her good broths and gellies and to drink Orengade or Limonade or to put some Syrup of Lemons in her refreshing Liquors or if she be free from a Feaver a little wine and water mixed which is the best and most natural of all Cordials Besides other remedies must be provided according to the accidents that happen by reason of the staying behind of the burthen always remembring to bring it away as soon as possible for as long as it stays in the Womb the woman feels great pains continually almost like them before her Child was born and until the whole be voided the pains will still be repeated although in vain unless the matter be well disposed before but the lesser the piece is of the retained burthen the more difficult 't is many times to be expelled because the impulse the woman can make by helping her throws are not so great when the matter contained in the Womb is small as when 't is of a considerable bigness for then 't is more strongly thrust and compress'd which is the reason why a woman miscarries with greater difficulty then when brought to bed at her full time And here you must know there are divers Midwifes who having broken the Navil-string as before said leave their work imperfect and commit the rest to nature's work but very often the poor woman dyes because of the great mischiefs which usually happen before the suppuration of the burthen so retained The which to avoid when they meet with the like case I would advise them to fetch it away as I have directed or if they find themselves uncapable to do it because the hand must be put up into the Womb which is more properly the work of a Physitian or Chyrurgion expert in those cases then let them immediately send for one that so he may be able before the Womb closeth to introduce his hand for the longer 't is deferr'd the more difficult will the work be Dr. Hitherto very well Mrs. Eutrap have you exprest your knowledge and experience in your Art even from the first generation and formation of the Child in the Womb to the bringing of it safely forth into the world But yet good Mrs. Eutrapelia there are divers Women that will many times be asking you your advice concerning other distempers that usually attend them both before Child-birth as Barreness c. and also after they are delivered of their Child both inward and outward because their modesty prompts them rather to come to you than to the Physitian or Chyrurgion therefore I would have you to let me know how far your skill and knowledge extends as to these matters because that if you should at any time be mistaken in your measures in the cure of any of those diseases I shall freely and candidly assist you with the best of my directions to set all right and streight as they say and in good order Mid. Honoured Sir I am so extreamly oblig'd to you for this kind offer that I know not which way to express my acknowledgment and I shall most readily answer your request and therefore shall first begin with a discourse of Barrenness PART II. SECT I. Of Barrenness and the several kinds thereof MId BArrenness is 1. Natural 2. Vnnatural 3. Accidental Natural is when the instrument of Generation being perfect in both Sexes no unlawful or unskilful means used to cause it yet the Woman remains naturally Barren neither Age or Diseases or natural defect hindring yet she Conceives not The reason of this may be 1. When both Sexes are of a Complexion 2. Want of Love a 3d may be the letting Virgins blood i' th Arm before their Courses come down or other ill administration of internal and external remedies 4. A loss of carnal Copulation when Sexes come to the School of Venus either not at all or so coldly that as good never a whit as nere the better and this is from a cold Distemper and is cured by such things as heat and nourish 2. Unnatural that is diabolical to prevent which Authors have left several ways as to carry the Herb St. Johns wort about them which is call'd a driver away of Devils or a Plaister thereof applied to the Reins with many others 3. Accidental which comes by some casual infirmity upon the body of either Sex at a time the which being taken away the effect ceaseth 't is sometimes from the Man but most commonly from the Woman for Mans instruments of Generation being perfect and he in health I know no accidental cause in him And the chief cause in Women lyes in her Womb as the stopping of the flowers or overflowing the Flux of the Womb its falling down inflamation windiness heat and dryness in all which I shall be brief because if there be difficulty you are to have recourse to the learned Physitian 1. Then the Terms stop 1. Naturally 2. Vnnaturally they stop naturally in some about the 50th year in some before rarely till 55. the unnatural cause is 1. much exercise 2. in fat Women the Veins are narrow and blood turns to fat 3. by long sickness 4. when they have the piles in lieu of their Terms 5. a hot or cold distemper of the Womb 6. care fear grief c. I shall speak here only of the 5th for causes of the last being taken away the effect ceases and the rest the ingenious Midwife will remedy Now seeing these stoppings come usually from default of the Womb the best way to help it is by strengthening the Womb first then you shall prepare your way if there be occasion let blood i' th the foot if she be not full of humors if she be then in the Arm first which I have most commonly known to do alone then if need be give her a draught of White-wine wherein an handful of Centaury or stinking Arach hath been boiled and if there be a pain in the head add an handful of Verven or some Parcely roots Fennel or Lowage c. not forgetting in fulness of humors to purge with half a dram of Extractum Rudii and as much Pil. Mastichinae mixt made into 12 Pills whereof take 3 at
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
and sometimes these chops do so encrease by the Childs sucking that the Niple's taken quite off the Breast and there rests an Ulcer very hard to be cur'd This may happen from the Childs being so dry and hungry that it hath not patience to suck softly but finding the Milk not speedily to follow as they desire bite and pinch the Niple so hard that it becomes raw and at last take it quite away This happens also when Infants have hot mouths or thrushes or the pox soonest These must not be neglected as well because of the great pain as to avoid their growing worse and worse Therefore as soon as they begin forbear giving suck keeping back her milk for a small time and if but one Niple be sore she may suckle with the other Applying Allum or Lime-water or only bath them with Plantain water puting soft rags dipt in any of them or a ceruse plaister or Diapompholigos or a little starch powdred but chiefly take care that nothing be apply'd to distate the Child wherefore many use only Honey of Roses Softening remedies are fit to preserve from chops but when they are already made dryers are best and to prevent her from hurts in these parts and that the rags may not stick to them put upon them a little Wax or wooden caps or leaden ones they being more drying like these in the Figure having several small holes on their tops as well to give issue to the matter as that the Milk may pass away If the Nipples are wholly suck'd off then dry the Milk up and if the Child have the pox put it to another who must use preservatives against it but if they be only small simple Ulcers i' th Mouth without any Malignity wash them only with Barley water with a little juice of Citrons or Lemons and let the Nurse use a cooling dyet and bleed and purge if necessary The Child can take no hold when the Nipples are quite gone and the small holes are closed up but if she shall desire to give suck let Woman by degrees make her new Nipples after the Ulcer's perfectly heal'd and unstop the root of the old ones or using an Instrument of Glass as in the Figure she may suck them her self 5 or 6 times a day and to preserve them and shape them thus drawn out from sinking into the Breasts again let her put a small cap upon them as before and so by degrees she may give suck again Dr. Thus far good Mrs. Eutrapelia have you expressed your self very knowingly in your Art as to what we have hitherto treated of concerning Women there now remains something that I would be satisfied of how far your skill consists in and that is concerning the Diseases of little Children because you coming often to visit the Mother if any thing be a miss about her Infant it is a common custome to desire the advice of the Midwife in such cases rather then run presently to the Physitian or Chirurgion But first let me hear your opinion about the choice of a Nurse Mid. Sir as I have been very happy to have satisfied you to the best of my knowledge in what concerns Women before in and after their Lying in Child-bed so likewise shall I answer your request as to what concerns little Children and the Distempers and Symptoms happening to them and first of the nature and qualities of the Nurse and if the Mother be the fittest Nurse PART IV. Of the Diseases and Symptoms happening to little Children and of the choice of a Nurse SECT I. What manner of Woman a Nurse ought to be and whether the Mother be the best Nurse Mid. FIrst of all Sir there is and hath been always divers opinions concerning Nurses whether the Mother be fittest for that office or a stranger as for what my thoughts are concerning the matter with submission to your better judgment in this and all other cases I shall fully disclose them to you Now Sir some are for the Mothers sucking her own Child and will bring you Scripture for it too for say they did not Sarah Nurse Isaac therefore every Woman ought to Nurse her own Child but this is but a weak Argument for from Scripture to retort their Argument on them David was a King and a Prophet therefore every man must be a King and every King a Prophet others again give you profound reasons as they imagine as that the Mothers milk is most convenient for the Child because it partakes of her nature But I would ask these People whether every Cholerick Woman hath Cholerick Children or every Phlegmatick Woman Phlegmatick Children and so of the rest Another reason is because the Woman they say cannot love her Child unless she give it suck her own self But if she do not for all that in my opinion she is very inhumane and unnatural Others again are of a quite contrary opinion and thwart all this for first say these the Child draws its conditions from its Nurse to prove which they quote several examples as Alcibiades being an Athenian was so strong and valiant because he suck'd a Spartan Woman but Cornelius Tacitus says the Germans were such strong bon'd men because they suck'd their own Mothers then why had not Alciliades been so if he had suck'd his But all Authors generally describing of what complexion and condition a Nurse ought to be if every Woman then must Nurse her own Child any complexion must then of necessity serve the turn Since the choice of a Nurse is of so great a concernment as upon which the future being of the infant consists surely this then requires many serious considerations For though she may have milk enough yet perhaps not good enough or the woman either sluttish or unhandy or careless in the swathing and the dressing of the Child by which many children like new vessels which will keep the savour of that liquor they are first seasoned withal are sluttish or slovenly so long as they live or else being abused at Nurse are Crooked and Ricketty full of botches nasty and nauseous to their own Parents And many through their intemperancy by drinking to encrease their milk and perhaps make it bad enough sleep so securely and profoundly that they overlay their Nurseries in the night and the Children are dead by their sides in the morning Therefore let nurses sleep so often that they may hear the least cry of the infant Let the Nurse then be of middle stature and good complexion active not fat and of a sanguine complexion if possible and not in poverty not under twenty years of Age not above forty but rather of twenty five or thirty Let not her nipples be great least it make the child of a wide mouth because it cannot suck without the contraction of the lips together and lest by forcing the Tongue into too narrow a compass it hinders the swallowing of the milk Next if the nipple be too small the child is apt to