THE English Midwife ENLARGED Containing Directions to Midwives Wherein is laid down whatever is most requisite for the safe Practising her Art ALSO Instructions for Women in their Conceiving Bearing and Nursing of Children With two new Treatises one of the Cure of Diseases and Symptoms happening to Women before and after Child-birth And another of the Diseases c. of little Children and the conditions necessary to be considered in the choice of their Nurses and Milk The whole fitted for the meanest Capacities Illustrated with near 40 Copper-Cuts London Printed for Thomas Sawbridge at the Sign of the Three Flower-de-luces in Little Brittain 1682. To all English Midwives YOU are here presented with an Amendment and Supplement of what was very necessary and yet wanting in this Book formerly so that now you will find it to be wholly compleated for your purpose in every respect it being altogether grounded upon many years Experience and Observation in the Practice of deliveries most others being written by those that never practiz'd the Art and some father'd upon Persons that were no more concerned in them then the Pope of Rome such as Sir Theodore de Mayern Dr. Chamberlen and others by the Publishers of the Compleat Midwives Practice so that I may justly say of this Book as the Learned Sir Richard Baker says of his Chronicle that if all other were not to be found this alone were sufficient with your diligence For I 'll assure you I have not conceal'd one secret belonging to your Art from you neither would I have you with-hold your knowledge from others neither have I imposed upon you any thing that hath not endur'd the Test of confirm'd experience and in like manner I would not have you upon any account whatsoever to try any new experiment either upon Rich or Poor either inwardly or outwardly thus much for the Book Now as for what concerns your selves I would have you by all means to have a respect to two things above all your Consciences and Credits and principally to the first and to that end for all the Treasure in the World to give no Medicine to cause a Woman to miscarry of her Child but prudently send such kind of People to the Learned Physitian to deal with and that you may prosper in your Practise discharge your duty as well to the Poor as Rich. Have a great care whom you lay in your Houses for fear of encouraging naughty Women Lastly I would advise you not to be dismay'd if every thing in your practise fall not out just at the very instance of your expectation you performing your part but expect the event with patience for fear disorders the Senses and Persons that keep their wits together without suffering them to be scattered thereby are capable of Counselling in the most weighty Affairs And now I shall no longer detain you in the Porch but desire you will forthwith be pleased to walk into the Palace where I question not but you will find wherewith to satisfie your Curiosity in what concerns the premisses and so wishing you all the Prosperity imaginable I bid you Adieu THE Contents of the Sections SEct. 1. Of the True generation of the Parts and Increase of the Infant in the Womb according to the days and times till the time of the Birth p. 1 Sect. 2. Of the signs of Conception and whether the Child thrive in the Womb. p. 11 Sect. 3. Of the Nutriment of the Child in the Womb and by what nourishment it is preserved and when it groweth up to be an Infant p. 16 Sect. 2. How the Infant doth in the Womb the fifth the sixth the seventh and eighth month and of the due time and form of the Birth and causes of pain in Child-birth p. 20 Sect. 5. Rules for Child-bearing Women and how to prevent Abortion p. 28 Sect. 6. A Dialogue between the Midwife and the Doctor concerning Midwives and the delivery of Women in Child-birth p. 33 Sect. 7. Of the several natural situations of the Infant in the Mothers Womb according to the different times of Child-bearing p. 39 Sect. 8. Of difficult Births whether they proceed from Causes external or internal p. 42 Sect. 9. Of the Fashions and Figures of the Birth and how Children are born and may be born p. 50 Sect. 10. Figure the first Of unnatural Births p. 52 Sect. 11. Figure the Second p. 58 Sect. 12. Figure the Third p. 62 Sect. 13. Figure the Fourth p. 64 Sect. 14. Figure the Fifth p. 66 Sect. 15. Figure the Sixth p. 68 Sect. 16. Figure the Seventh p. 74 Sect. 17. Figure the Eighth p. 78 Sect. 18. Figure the Ninth p. 81 Sect. 19. Figure the Tenth p. 83 Sect. 20. Figure the Eleventh p. 85 Sect. 21. Figure the Twelfth p. 87 Sect. 22. Of a Birth wherein the Infant presents the Belly p. 89 Sect. 23. How to help a Woman in her Labor when the Child's Head thrusts the Neck of the the Womb forth before it p. 92 Sect. 24. How to deliver a Woman when the Child presents the side of the Head to the birth or its Face p. 95 Sect. 25. How to deliver a Woman when the Childs Head is born and the Womb closeth about its Neck p. 99 Sect. 26. When the Navil-string comes first p. 102 Sect. 27. Wherein the Burthen either first offers it self or comes first quite forth p. 107 Sect. 28. Figure the Thirteenth p. 112 Sect. 29. Figure the Fourteenth p. 115 Sect. 30. Figure the Fifteenth p. 117 Sect. 31. Figure the Sixteenth p. 123 Sect. 32. Of delivering of a Woman of a dead Child p. 129 Sect. 33. Of the extracting of a mola and false Conception p. 136 Sect. 34. Of the Secundine or After-burden and the best and safest way to draw it forth p. 151 PART II. Of Diseases happening to Big-Belly'd Women before Child-Birth SEct. 1. Of Barrenness and the several kinds thereof p. 177 Sect. 2. Of Superfaetation p. 195 Sect. 3. Of Vomitings of Women with Child p. 201 Sect. 4. Of the pains of the Back Loins Reins and Hips p. 206 Sect. 5. Of the pains of the Breasts p. 209 Sect. 6. Of involuntary voiding and stopping of Vrine p. 211 Sect. 7. Of a Cough and difficult breathing p. 214 Sect. 8. Of the swelling and pains of the Thighs and Legs p. 218 Sect. 9. Of the Hemorrhoids p. 221 Sect. 10. Of the several Flaxes happening to Women with Child p. 224 Sect. 11. Of Fluddings p. 229 Sect. 12. Of the Weight of the Womb c. p. 233 Sect. 13. Of the Dropsie of the Womb c. p. 235 Sect. 14. Of Abortion and its causes p. 238 PART III. Of Diseases and Symptoms happening to Women after Child-birth SEct. 1. Of Remedies for the Breasts and lower parts of the Belly of Women newly delivered and how to drive back the Milk p. 241 Sect. 2. Of Fludding after Child-Birth p. 244 Sect. 3. Of the bearing down and falling out of the Womb and Fundament of
well the breasts will be hard but if otherwise they will be flaccid and a waterish humor will flow out of them like to milk of its own accord Secondly if the courses flow too often out of the Womb in the time of child-bearing it is an argument of an unhealthy Child And moreover the fattest Women commonly bring forth the weakest Infants Thirdly if a woman bring Twins the one a Male the other a Female there is great danger of the Female because they are nourished by a different aliment in the Womb but if they be both Females there is the less danger Fourthly if the Child be gotten in the time of the monthly terms they are mixed with untoward humors from whence it is experienced that many leprous Infants are begotten Fifthly if there be superfaetation the last conception seldom liveth Now superfaetation is when a Woman having once conceived conceiveth again after a certain time which sometimes happeneth Sixthly if a Dropsie overtake the big-bellied Woman and that her Nose Ears and Lips look red it is a sign of a dead Child Seventhly if the infant come forth after the ninth month 't is oftentimes very weak Eightly if a virgin conceive before her first flowers it proves lusty and perfect child Dr. So much for Conception Tell me now somewhat of the nourishing of the Child in the Womb c. SECT III. Of the Nutriment of the Child in the Womb and by what nourishment it is preserved and when it groweth up to be an Infant WHilest the young one is in the womb it is nourished by blood attracted by the navil by which it is that women after they have conceived have their terms stop'd for then the infant begins to crave and attracts much blood For the blood presently after-conception is discerned by a three-fold difference The first and purest part of it the young one attracts for nourishment The second less pure and thin the wombforceth upwards by certain veins to the breasts where it becomes milk by which the infant is nourished so soon as it is born The third and more impure part of the blood remains in the womb and floweth out with the secundine both in the birth and after the birth Hence it is that Hippocates saith there is much affinity betwixt the flowers and the milk since the one happeneth to be made out of the other And Galen also by reason of this thing elegantly adviseth that the infant hath more from the mother than from the father for this reason because the seeds are first increased by the menstruous blood and then by these the Infant is presently nourished in the Womb and again being newly born it is nourished with milk And as roots have more nourishment from the earth than the plant from whence they came so also Infants receive more from the Mother than from the Father And hence he saith that it comes to pass that so much more is attributed to the Mother by how much more She contributeth more towards generation If the Infant be formed in 45 days it will stir in 90 days which is the middle time that it lies hid in the Womb for in the ninth month it will come forth and make haste to the birth although Females are oftentimes born in the tenth Month. And so much for the formation increase and perfection of the Infant according to the account of days and times SECT IV. How the Infant doth in the Womb the fifth the sixth the seventh and eighth month and of the due time and form of the Birth and causes of pain in Child-birth AFter the third and fourth month the Infant useth a more plentiful nourishment by which it groweth more and more until the time of Birth shall come Therefore it is to be understood that when it is born in the sixth month it cannot in nature live because though it be formed distinctly yet it is not arrived to its just perfection But if it be born in the seventh month it may easily live because then it is sufficiently perfect And whereas 't is a common opinion those born in the eighth month can rarely live but such as are born in the seventh are often times living because on the seventh month the Infant is ever moving towards the Birth at which time if it be strong enough it comes to the Birth but if not it remaineth in the Womb till it groweth stronger viz. the other two Months After the motion at seven Months end if it be not born it removes it self into some other place of the Womb and is so weakned by that motion that should it come to the birth in the following eighth Month it cannot live by reason of that motion This seems very probable to many but if they that practise deliveries make a rational reflection thereon they shall find that 't is the Matrix alone assisted with the compression of the Muscles of the lower belly and Midriff which cause the expulsion of the Child being stirred up by its weight and not able to be farther extended to contain it and not the Infant for want of nourishment is not able to stay any longer there and so useth its pretended endeavours to come forth and to that purpose kicking strongly it breaks the Membranes with its Feet which contain the waters insomuch as when the Child is naturally Born the skins are alwaies torn before the Head which pressing and thrusting each through the waters before it causeth them to burst out with force Hippocrates admits the 10 month and beginning of the 11. And here I do acknowledge for truth that the ordinary term of going with Child is 9 months but I cannot consent that Children born in the 7 month do oftener live than those born in the 8 but on the contrary I believe the nearer they approach to the term of 9 months the stronger they are and therefore rather live then those born in the 7th which is wholly contrary to the other opinion which they have from Hippocrates and in Egypt and Spain and other places Children born in the 8th month live But they should have considered there may be some difference about Hippocrates's Months viz. whether they were Solar or Lunar a Solar consisting of 30 or 31 days throughout the year and a Lunar of 27 days and some odd Hours and odd Minutes And then again the Women might be mistaken in their reckoning And do we not know not only in the same Country and Field but also on the same Vine grapes sometimes six weeks ripe before their ordinary Season and others not till a month after which happens according to the Territories different influence of the Sun and as the Vine is ordered So do we see Women brought to bed six weeks and 2 months before and sometimes as long after their ordinary term if it be not that the Womb not being capable of an extension beyond a certain degree cannot bear its burden but a little while after the account is out
although there have been Women as Hippocrates acknowledgeth who have gone 10 or 11 whole Months with Child which is so much the rarer by how much it exceeds its limits These things happen also to Women according to the different dispositions either of their whole body or Womb alone as well as according to their rule of living and more or less exercise they use and may also happen on the Childs part as if at 7 months it be so big that the Womb can no longer contain it nor stretch it self more without bursting it is then provoked by the pain which this violent extention causeth to discharge it self of it and so in the 8th month if there be the same reason and some weeks sooner or later according to many other circumstances as also by an outward occasion as a violent shaking of the whole body blow fall leap c. hasting the pains and that which makes these Children live a longer or shorter time is according as they are at that time more strong and perfect and the Woman nearer her time which is at the end of the 9th month There have been many Women that have believed they were brought to bed at the 7th and 8th Month and others that they went 10 or 11 whole Months which may sometimes be when notwithstanding they are effectively delivered at the due time that which deceives them usually is their believing themselves with Child from the retention of their Courses having had them the 2 first Months yea and sometimes longer and others misreckon when their Courses are stopt 2 Months before they conceive And a Woman though well regulated cannot exactly know by the suppression singly the certain time of her being with Child as for example if she lye with her Husband upon the coming down of her Courses and she conceive upon it then she may make her account from their suppression which may be very near the truth but if she conceive immediately after she hath had them which happens oftnest and that during the Month she Copulates with her Husband at the end of which time her Courses not coming down she may very well reckon her self with Child yet for all this she cannot know by this sign which Night she conceived on and so for 3 weeks or a Month more or less she may be mistaken in the time Here note there hath often been great contests amongst Physitians whether a Child born the 11th or 12th Month after its pretended Fathers death can be legitimately born and so admitted to inherit or be disinherited as a supposed Child but this having been debated by the Romans as well as us and being parties for and against I shall leave it undecided and shall not add any thing more concerning this point to what I have said before And now the Midwife is to take care that she be timely prepared for the reception of any birth with all her necessary conveniences and instruments as with a fit stool a sharp knife astringent powder a spunge swathes c. warm oyl of Lillies with which she may aptly anoint both the Womb of the Woman and her own hands but of that more hereafter And now in the next place let us make enquiry for the fittest and best Midwife for this great work and now I remember my self there was a good Woman call'd Mrs. Eutrapelia with me last night for my advice and counsel in a very difficult concern whom I found by that little discourse I had with her to be a very rational and understanding and expert woman in her art and one that was not self conceited of her self like many of her Sisters that think they know all and believe 't is below them to ask any advice of the learned Physitian or Chyrurgion when indeed they are oftenest the most ignorant for 't is the Physitian and Chyrurgion that they must be obliged to for the chief part of their Art and in France 't is the Chyrurgions employ to help Women in Child-birth anâ— she promised to be with me very early thâ— morning to give me account how it fareâ— with her Patient and of the success of mâ— directions and heark I believe 't is she knocking at the door at this instant Here note by the by that 't is romantic to say that the Males are generated in thâ— right side of the Matrix but Females in thâ— left out of the left Testicle for the righâ— side by reason of the Liver is hotter buâ— the left cooker for when there are Twins sometime they are of the same Sex but principally the abundant heat of Seed is the causâ— of the generation of Males This figure sheweth the Womb Anatomized and how the Infant lyeth in it The parts are described in the following page CC Denotes the Kidneys of each side DD The emulgent Veins on the righâ— side EE The emulgent Arteries on the righâ— side F The trunck of the hollow vein HH The emulgent Arteries on the left side LL The Spermatick Veins on the right side K The Spermatick Arterie on the right side M The Spermatick Veins on the left side aa The Ureters cut off oo The Feminine Testicles PP The broad ligament like Batts wings qq The trunck of the great Arterie BB Vessels like Vine-branches Y The shaft of the Womb. R The bottom of the Womb where the Infant lieth SECT V. Rules for Child-bearing Women and how to prevent Abortion MId According to your promise I beseech you Doctor lay me down some Rules to be observed by Child-bearing Women Dr. Good Midwife I shall and that very necessary ones too that she may know how to go on safely through by Gods blessing to the last hour or by neglecting them may make her delivery the harder and I shall reduce them under ten heads First let her be chearful for this doth exhilarate the Infant and stirs up all the faculties and confirms it in its parts and Members Secondly let her avoid all violent motion and ahstain from all hard labours not rising up too hastily not leaping running dancing riding not lacing her self too streight or carrying too heavy a burden but surely moderate sleep and rest is very fit for her And all this especially toward the latter end of her reckoning for though it be allowed them by most Authors to facilitate the Birth yet if we well consider the point we shall without doubt find it to be the cause of miscarryings and hard labors and death of many Women and Children For you must know that the Birth of a Child ought to be left to the work of Nature well regulated and not to provoke it by shaking and jolting as in a Coach or by a trotting Horse and to dislodge it before its full time which happening though it be but 7 or 8 days sooner proves sometimes as prejudicial to the Infant as we see it sometimes to Grapes which we find 4 or 5 days before they are full ripe to be yet almost half verjuice But
in the Womb near the time of Travel H How the umbilical vessels are inserted into the Navil of the Infant SECT VII Of the several natural situations of the Infant in the Mothers Womb according to the different times of Child-bearing WHen the Woman is young with Child the little creature call'd the Embryo is always of a round Figure a little longish having the back-bone moderately turn'd inwards the thighs folded and a little raised to which the legs are so joined that the heels touch the buttocks the arms are bending and the hands placed upon the knees towards which the head is inclining forwards so that the chin toucheth the breast In this posture it resembles one sitting to void his excrements and stooping down his head to see what comes from him It s back bone is at that time placed towards the Mothers the head uppermost the face forward and the feet downward and proportionably to its growth it extends its members by little and little which were exactly folded in the first Month This posture it usually keeps till the 7th or 8th month at which time the head being grown big is carryed downwards by its weight towards the inward orifice of the Womb tumbling as it were over its head so that then the Feet are uppermost and the Face towards the Mothers great gut when the posture happens otherwise 't is unnatural and both Male and Female lie thus because the Child's face coming upwards will be extreamly bruised and its Nose wholy flatted because of the bones hardness in the passage Note further when the Child hath changed its first Situation being not yet accustomed to this last it stirs and torments it self so much sometimes that the woman by reason of the pain she feels is apt to believe she is in labor and if this circumstance be well consider'd you will find it to be that first pretended indeavour which Authors imagine the Child makes to be born the 7th month and not being able to accomplish it it stays till the 9th c. But this is a great mistake for if the Child turns it self so with the head downwards or rather is turned it is but by a natural disposition of the weight of the upper parts of the body and if it stir much at that time and soon after it is not from a desire to be born but from the inconvenience it receives from this new posture to which it was not before accustomed and it begins to turn thus sometimes from the 7th month rarely before but by accident often about the 8th and sometimes the 9th only and at other times also it doth not turn at all as we may easily perceive in those that come in their first Situation that is with their Feet foremost When there are many Children they ought to come in the same Figure if it be a natural Birth as when there is but one but usually by their different motions they incommode one another that for the most part one presents wrong in time of labour yea and before which is the cause that one comes often with the head the other with the feet or some worse posture and sometimes both come wrong However the Infant may be settled in the Mothers belly or in whatever fashion it represents it self at the birth if it be not according to the posture before said it is always against nature SECT VIII Of difficult births whether they proceed from Causes external or internal DIfficult births from external causes may be either first from excessive heat dissolving the strength of the women or secondly excessive cold condensing the womb or thirdly from sweet things often applied to the nostrils of the woman that by smelling to sweet things she may recover her strength and faintings for sweet smells do attract the womb upwards and so render the birth more difficult Difficult birth from internal causes may be either first from the woman secondly from the womb thirdly from the infant fourthly from the membranes of the womb 1. From the woman as when she is too angry too fearful or too modest or if she be in age above 40 years from whence the muscles of the womb may be concluded to be dry and so the less extenfible or when she is so thick and fat that the passages be narrow Or 2. From the womb it self as when it is so small and nature so weak and feeble that it cannot expell the birth Or if there be any inflammation or unnatural affect in the privities be it the stone or piles or extraordinary costiveness all which may so compress the womb with their weight that it cannot expel the birth 3. Is from the infant it self as if it be of an unusual bigness of a great head or a monstrous birth hydropical full of wind dead in the womb or lying there in a posture beyond nature as when it comes overthwart with the feet forward and not the head or if the thigh before the head 4. From the membranes of the womb as when they are so forcibly broken by the child in the womb that the moysture floweth thence leaving the infant behind that when the child should come forth that moysture faileth and so the membranes being dryer maketh the birth the more difficult or when it is firm and solid that it is broken with much difficulty and so makes the labour the harder And here we cannot but take notice how those Authors who have not the perfect knowledge of the parts of a Womans body attained to by Anatomy do admire and cannot as they say conceive how it is possible that an Infant so big can pass in time of labour through an opening of the Womb so small some of them being of opinion that the Womans share-bone is seperated at that time to enlarge the passage without which it would be impossible for the Infant to have room enough to be born and therefore Women that are a little antiquated suffer in their first labors more than others because their share-bone cannot so easily be seperated which often kills their Children in their passage others again are of opinion that it is the flank-bone which is disjointed from the hoop-bone for the same purpose and say both the one and the other of them viz. That these bones thus separated at the hour of labor are thereto so disposed by degrees a little before by the fly my humors which flow forth from about the Womb and then mollifie the grisles and cords which at other times join them firmly together But both these opinions are as different from truth as reason for Anatomy convinceth us clearly that the Womb by no means toucheth these places whereby to moisten and soften them by its humors as likewise that these bones are so joined by the gristle that it is very difficult to seperate them with a knife especially the flank-bone from the hoop-bone and almost impossible in some elderly Women without great violence although Ambrose Parry a most
turn it this situation being already half turn'd the feet being as neer to the passage as the head when it represents the midle of the belly then I must slip up my hand under the belly till I find the feet which I must bring to the passage to draw it forth in the same manner as if it came with the feet foremost being very careful to keep the Face downwards which must alwaies be observed before the head can be drawn forth for the reasons before given which must never be forgotten And here likewise is to be noted that the Midwife must alwaies prooceed after one and the same manner in the deliveries when a Child comes with the breast or belly But on the other hand I would have it remark'd that when at any time an Infant comes with its side it is impossible to be delivered as the two former but yet it is not so much tormented nor is its situation so cruel for it may remain in it a longer time without dying than in the two former wherein it is much more as it were upon the rack than in this in which posture the body may be bended forwards and not backwards as in the other but the Navil string doth not come forth so easily as when it comes with the belly first And in this as in the other 2 births the Midwife will find it the safest way to draw it forth by the feet by pushing back a little the Infants body with her hand the better to introduce it which she may slide along its thighs till she find the legs and feet by which she must turn it and afterwards draw it forth as I said even now nor ought she to amuse her self in any of these 3 births to place its head right that it may come naturally because 't is in great danger of dying in these unnatural positions if not drawn forth with speed which can never be effected unless it be by finding the feet as I have directed SECT XXIII How to help a Woman in her Labor when the Childs head thrusts the neck of the Womb forth before it DR Now Mrs. Eutrapelia I have another question to ask you and that is this suppose you were call'd to deliver a Woman in labor where you find the Childs head to thrust forth the neck of the Womb before it how would you go to work in such a case and what art would you use to deliver the Child with safety Mid. Why surely Sir if we only have respect to the Figure the Child comes in in this labor we may call it a natural one but if we shall on the other hand consider either the disposition of the Womb which is in danger of coming quite forth of the passage or the manner of drawing forth of the Infant we shall find it to be not so altogether for its head thrusting it forceably before it may easily cause a falling out of the Womb if the Woman be not skilfully succoured in time here may be seen the neck of the Womb bear forth before in great wrinkles according as the Child advanceth Now Women troubled with their bearing down of their Womb before they conceive and those whose Womb is very moist are much subject to this accident because of the looseness of the strings The same method must not be observed here as in the natural birth for in this case the Woman must neither walk nor stand upright but she must keep her bed with her body equally at least situated and not raised a little as is requisite in a natural labor She must by no means use strong or sharp clysters lest they procure too great throws neither must her Womb be moistned because 't is already too much loosened but she must be aided at the moment each pain takes her when the Child begins to advance its head and consequently the neck of the Womb and let the Midwife keep her hands on each side of its head to thrust back by resisting the Womans pains the Womb only giving way in the mean time for the Child to advance doing the like at every throw continuing therein till the Woman of her self hath forced the Child quite into the World for we must by no means draw it by the head as in a natural labor for fear of causing the Womb to fall out at the same time to which it is then very apt Now if notwithstanding the Infant having the head born and yet stops there so long as to endanger its suffocation then the Midwife must call a second person to her assistance to draw it gently forth by the head whilst she keeps back the Womb with both her hands to prevent its following the Infants body so drawn forth After the Woman is thus delivered and her Afterbirth fetch'd away gently and not shaking or drawing it away too rudely then let the Womb be placed up in its natural situation if it bears down SECT XXIV How to deliver a Woman when the Child presents the side of the Head to the birth or its Face DR Good Mrs. Eutrapelia I do very well approve of this your answer to my last quere now in the next place I would know of you how you would bring a Woman to bed when the Child shall present it self with the side of its Head first or its Face Mid. When the child Sir presents it self in this posture as with the side of the head though it seems a natural labor because the head comes first yet 't is very dangerous both to child and mother for the child shall sooner break its neck than ever be born in this fashion and by how much the mothers pains continue to bear it which is impossible unless the head be first right plac'd the more the passages are stopt up Therefore as soon as 't is known the woman must be lay'd with all speed lest the child advancing farther in this vicious posture it prove more difficult to thrust it back which must be done when we would place the head right in the passage as it truely and naturally should be Now to effect this I must place the woman that her hips be a little higher than her head and shoulders causing her to lean a little upon the opposite side to the childs ill posture then I must slide up my hand being well anointed with oil by the side of the child's head for to bring it right gently with my fingers between the head and the womb but if the head be so engaged that it cannot be easily done that way I must then put my hand up to its shoulders that so by thrusting them back in the womb sometimes on the one side and sometimes on the other as I see occasion so shall I give it a natural and convenient position And here it were to be wished that the midwife could put back the Infant by the shoulders with both her hands in this manner but the head doth take up so much room that she hath
of the World and than which there can hardly happen a greater defamation to the Female Sex Insomuch as some like Rachel have cry'd out to their Husbands for Children or else their Lives will lye on 't rather than endure the reproach of Barrenness and some Women have preferr'd their maids to their Husbands so that their Child might be reputed theirs to take away the blemish of Barrenness But you shall find but few Women of their minds now a days so then we shall in the first place speak of the causes of this so odious and distateful a Disease and then of their removing for you know 't is an old saying and true take away the cause and the effect will consequently cease Now the chief method of finding out all causes which do or may bring damage to the faculties of the body is no other then the knowledge of the means whereby these faculties perform their Actions in the time of health and soundness of body And whereas to the producing of any natural Conception there is a necessity of distinction of both Sexes and a conjunction and carnal Copulation of the Man and Woman without which no Generation can be effected As for that story of a certain Maids conceiving with Child by standing in a Bath where some Mans seed had been cast the Womb drawing it to it as the Load-stone doth Iron or Jet straw it was either a miracle in Nature or she so gave out to save her bacon and so no ways belongs to our purpose and having before declared the manner in other Sect. Therefore we shall here lay down the manifest causes of Barrenness from either Sex so that neither may be unjustly blamed where they happen for since the Women have in this case a great interest and damage too if the fault be in the Man because they may often help their Husbands defect and in so doing pleasure themselves we shall not therefore omit to treat of the causes thereof which may happen to men and moreover there being a necessity that both Sexes be furnished with fit and proper Instruments for the work of Generation as the man with a Yard c. and a Woman with a Womb c. Then even reason will tell you that if there chance to be any defect or dissaffection in nature in any of the Members of either Sex belonging to this work of Generation the fruitfulness or Conception must necessarily be hindred impaired or quite and clear abolished To begin then first with what belongs to the Mans side one cause of Barrenness laid down by many Authors is the over-much length of the Yard by reason whereof the Seed is too much cooled in the passage before it can be injected home into the Womb. But though this be a somewhat probable and plausable reason yet I am of opinion that it is but weak and will not hold water with those of greater reason for all Souls are not endued with a like proportion of reason for the Seed passing through the pipe of the Yard is kept hot enough the generative Spirits at that time oft flocking to the Yard to assist it in so great a work and the like being performed on the Woman's part I cannot see how it can be any ways possible it should take cold in its journey but on the contrary side it may be rationally imagin'd that the long Yard is most fit and commodious for Conception by sending Seed to the inmost and furthermost parts of the Womb and so most likely to be there retained its due time And now others on the contrary side will have the short Yard the cause of rendring Men unfruitful and these I think have more reason on their side because it cannot so well inject the Seed into the Womb as you heard before But indeed neither can this be a firm reason for unfruitfulness in Man since 't is confirmed by experience that such an one hath begot Children likewise But a greater reason of unfruitfulness in the man may be some vitiousness or defect in his Yard as if it be crooked or if any of its Ligaments be writhed or broken or bruised whereby the passages through which the seed should flow be corrupt stop'd or vitiated or some Disease or imperfection be either in the proper or Neighbor parts thereof Another cause of Barrenness by defect of the Yard is a too much weakness and tenderness thereof it being not strongly enough erected to inject the Seed into the Womb. Then another cause in Men may be some vice in the Stones as if they be oppressed with any Inflammation or swelling or wound or ulcer Also the Man may be Barren from his want of Seed or if it be nought as in the Running of the Reins or Venereal Disease Glutony or Drunkenness c. and then too frequent Carnal Copulation is a cause of Barrenness because it attracteth the Seedy moisture from the Stones before 't is sufficiently prepared and concocted as all other members of the body by institution of nature use to draw their accustomed juice to themselves so now if any one by daily Copulation draws out all the moisture of his Seed then do the Stones draw the moist humors from the upper Veins to themselves and so having but a little blood in them they are forced of necessity to cast it out raw and thus the stones being deprived of the moisture of their veins draw the same from the upper veins and the upper veins from all the parts of the body for their proper nutriment to the great damage of the body robbing the same of the vital Spirits It is therefore no wonder if those that use immoderate Copulation are very weak in their bodies seeing the whole body is thereby depriv'd of its best and purest blood and vital Spirits insomuch as those that have been too much addicted to that pleasure have killed themselves in the Act can it then be a wonder that such Seed is not fit for Generation And having now shewn the causes of Barrenness in Men we shall now discourse of those in Women Now the causes of Barrenness in Women proceed either from the Age or evil temper of the Womb and its vicious conformation and parts depending on it or the indisposition of the whole habit of the body The evil form of the womb renders Women barren according to the great Hippocrates the Prince of all Physitians as if the mouth or neck of the Womb be turned backwards towards the great Gut or a side out of its place contrary from the Privities if it appear too big or if it be fallen down before the Privities to which may be added when 't is so narrow that it cannot admit the Yard to enter and when 't is wholly or in part closed by some inward or outward skin which is very rare if at all or by a swelling collosity or cicatrice c. But then it is not sufficient that the Mans Yard enter the Neck which is the
Anti-Chamber to the Womb for if in the act of Copulation he knock at the door which is the inward orifice and it be not opened all is to no purpose and this may likewise be hindred from opening by some callosity proceeding from abundance of ill humors which usually flow from the Matrix or from some swelling which may happen to it or also by some part which may so press it that it cannot open to receive the Seed as the cawl doth in fat Women according to Hippocrates who says they cannot conceive till they grow lean But the most frequent reason why this orifice opens not in this Act to receive the seed is the insensibility of some Women who take no pleasure in the Venereal Act but when they have an appetite the Womb being covetuous of the Seed opens it self to receive it The same Hippocrates seems to have noted all the signs and causes of Barrenness from the evil temper of the Womb when he saith in his 62 th Aphorism book 5. that all such Women whose Womb is cold and close cannot conceive nor they who have it too moist because the Seed is extinguished in it and likewise such who have it too dry and hot because for want of aliment the seed corrupts but such as are of a moderate temper are fruitful Of all which in my opinion the most common is the cortinual moisture of the Womb fed by an abundance of the whites with which many are much inconvenienced the humors of the whole dody being accustomed to stear their course this way which can very hardly be turned away when inveterate and the Womb being imbued with these vicious moistures becomes inwardly so unctious and slippery that the seed though glutinous cannot cleave to it nor be retained within it and that 's the cause it slips away immediately or shortly after 't is received Barrenness may also proceed from the whole habit as when a Woman is too old or too young for the Seed of the young is not prolific neither have they menstruous blood both which are requisite to fruitfulness and that of the aged is in small quantity and too cold who likewise want menstruous blood then an universal distemper though of convenient years renders them Barren as when they are Hectick Dropsical Sickly c. and especially so much the more as the whole parts are fallen from their temper and natural constitution There are however many Women which seem Barren for a long time by reason of some of the aforementioned reasons yea till 35 or 40 years old and sometimes longer who yet at last conceive being cured of the distempers which hindered them and having changed their temperament by their Age. Now some of these Barrennesses may be cured by removing their causes and procuring the dispositions needful to fertility yea of those proceeding from an universal intemperament by reducing their body by a convenient regiment to a good order according to their respective dispositions Wherefore if one have the Neck of the Womb narrow and not from some of the causes abovesaid she ought to be joyned to a Man whose Yard is proportionable and if that will not do which happens very seldom she must relax it and open it with softning oils and ointments If it be compressed by any humor it must be resolved and suppurated according to its nature and situation having always a care to prevent the corruption of these parts which are very subject to it being hot and moist because the Womb serves as a sink by which all the bad humors of the body are purged so that you must take great care that these swellings turn not to a Cancer When the Neck is not clear by reason of any scar after a rent caused by some violence or hard labor or after an Ulcer which caused the two sides to be agglutinated whether inwardly or outwardly it must be seperated which being the Chirurgeon's work I here omit it If the inward orifice of the Womb be displac'd it may be in some sort remedied by making the Woman observe a convenient posture in the act of Generation and if the whites or other impurities of the Womb cause Barrenness they must be helped by evacuations purgations and a regular dyet concerning which the learned Physitian is to be consulted Mid. Thus far Sir having heard your account of the signs and causes of Fertility and Sterility I having heard learned men discourse of Superfetation I would humbly intreat you Sir that you would please to let me hear your opinion about that matter Dr. That you shall willingly good Mrs. Eutrapelia and therefore I shall begin first to tell you what it is SECT II. Of Superfaetation Dr. SVperfaetation according to the discription of Hippocrates is a repeated conception that is when a Woman being already with Child conceives again the 2 d time now there is a great dispute about this for we see daily Bitches Sows and Rabits have divers young but with one Copulation which may make us judge the same of a Woman some will have this to be by Superfetation but there are signs by which we may know the difference whether both Children were begot at once or one after the other That which makes many believe there can be no such thing as superfetation is because as soon as a Woman hath conceived her Womb closeth firmly so that the Man's seed absolutely necessary to conception finding no place nor entry cannot be received nor contained in it so as to cause this 2d conception To this may be added That a bearing Woman dischargeth her seed which is as necessary as a Mans by a Vessel which terminates on the side of the outward part of the inward Orifice which seed by this means is shed into the Neck of the Womb and not into the bottom as it ought for this purpose However it may be said in answer to these objections which are very strong that though the Womb be clos'd c. yet this general rule may have some exception so that it may be sometimes opened to let pass some slimy excrements which by their stay offend it or chiefly when a Woman is animated with an earnest desire of Copulation in the heat of which action she sometimes dischargeth by the passage that terminates in the bottom of the Womb which being opened by the impetuous endeavor of the seed more then ordinarily over-heated and this Orifice being at the same time a little opened if the Man's seed be darted into it at the same moment 't is thought a Woman may then conceive again This may be confirmed by a story of a Servant related by Pliny who having the same day copulated with two several Persons brought forth two Children the one resembling her Master the other his Proctor and also by a story of another Woman who had two Children one like her Husband and the other like her Galant but this different resemblance doth not always prove superfetation because sometimes different
a Woman newly layd p. 247 Sect. 4. Of the bruises and rents of the outward parts of the Womb caused by Labors p. 252 Sect. 5. Of the After-pains p. 254 Sect. 6. Of the Lochia whence they come if good or bad their stopping and what ensues p. 255 Sect. 7. Of the Inflammation c. of the Womb. p. 258 Sect. 8. Of the Inflammation and Apostemation of the Breasts p. 259 Sect. 9. Of the curdling of the Milk in the Breasts p. 262 Sect. 10. Of Choping c. and loss of the Nipples p. 265 PART IV. Of the Diseases and Symptoms happening to little Children and of the choice of a Nurse SEct. 1. What manner of Woman a Nurse ought to be and whether the Mother be the best Nurse p. 269 Sect. 2. Of the Diseases and Symptoms which happen to Children and first of their Diseases in general p. 291 Sect. 3. Of Feavers Meazels and Small-Pox in little Children p. 293 Sect. 4. Of the milky scab Achores Scald-Head and Lice p. 295 Sect. 5. Of the watry swelling of the Head p. 298 Sect. 6. Of Fright in the Sleeps and Watchings p. 299 Sect. 7. Of the Falling-sickness and Convulsion p. 301 Sect. 8. Of pain in the Ears Moisture Vlcers and Worms p. 302 Sect. 9. Of the Thrush bladders of the Gums and Inflammation of the Tonsils p. 303 Sect. 10. Of the breeding of Teeth p. 304 Sect. 11. Of a Catarrh Cough and difficult breathing p. 305 Sect. 12. Of the Hiccup and Vomiting p. 307 Sect. 13. Of the pains and puffing of the Belly p. 309 Sect. 14. Of the Flux of the Belly p. 311 Sect. 15. Of Costiveness p. 312 Sect. 16. Of Worms p. 313 Sect. 17. Of the Rupture p. 314 Sect. 18. Of Bunching out and inflammation of the Navil p. 315 Sect. 19. Of the falling out of the Fundament p. 316 Sect. 20. Of difficulty and stopping of Vrine p. 317 Sect. 21. Of not holding Vrine p. 318 Sect. 22. Of Leanness and Bewitching p. 319 SECT I. Of the True generation of it Parts and Increase of the Infant in the Womb according to the daies and times till the time of the Birth WHen the Womb whose property it is naturally to receive seed for generation as a Loadstone attracts iron or Jeat straws or feathers hath received the seed and by its virtue hath shut it up for generation Presently from the first day until the sixth or seventh there grow and arise very many and very small fibres or hairs beginning with a hot motion by which vital heat the Liver with its chiefest organs are generated as this following Figure may the more illustrate The small Fibres In the one of which branches there is a collection of blood of which first the liver is generated From whence it easily appears the liver is a congealed and concrete blood and also it may be manifest how many and various veins it hath prepared and fitted for the attractive and expulsive virtue But in the other branch are generated those webs oâ— veins with the dilatation of other veins as oâ— the stomach spleen and intestines in the lower part of the belly And from hence immediately all veins are collected together as so many branches into one trunk in the upper web of the liver towards the hollow veinâ—… and this trunk by and by sends down brancheâ— to make the midriff and directs not a few branches to the lower parts even to the very thighs and then the heart with its arteries extended into seed from the navil iâ— generated by a vital virtue and is directeâ— towards the spine of the back as is demonstrated in this figure 3. But those do attract the hottest and more subtile blood of which the heart is generated incased in a membrane naturally fleshy and thick necessary upon the account of so â—ot a member But the hollow vein extendâ—ng it self and penetrating the inward conâ—avity of the right side in the heart c. deâ—ives thence blood for the nourishment of the â—eart From the same branch also of this his vein and in the same part another vein ariseth called by some the immoveable or quiet vein because according to the account of the pulsation of other veins it beats not at all but lies quiet ordained for this end that it should let go the purest blood to the Lungs being vested with a double tunicle like an Arterie from whence it is called the Arterial vein But in the left concavity of the heart there are two Arteries that is to say the Venal Arterie and the Great Arterie which carries a great pulse with it and diffuseth the vital Spirits by the blood of the heart into all the Arteries of the Body For as the hollow vein is the original of all veins by which the Body doth attract its whole nourishment of blood so from the Aorta or great Arterie all pulsatile veins are derived diffusing the vital Spirits through the whole Body For the heart is the fountain and original of vital heat without which no creature or member can thrive Under the abovesaid Arterie in the left concavity of the heart another vein ariseth called the Venal Arterie And although that be really a pulsatile vein and doth direct the vital Spirits yet according to the manner of all pulsatile veins that have blood it hath but one coat and therefore made for that end that it should derive the cold air from the Lungs to refresh the heart as also to attemper its over-much heat And veins issuing out from both the cavities of the heart are inserted into the Lungs of which they are formed for the vein that proceeds from the right cavity of the heart produceth the most subtile blood which by small fibres dispersed here and there is changed into the fleshy substance of the lungs But from the great vein of the Liver viz. the Vena Cava or hollow vein the whole brest is generated and so successively the Arms and Thighs Within the time aforesaid also is generated the highest and chiefest part of this noble structure the Brain in the third Region of this mass for the whole mass of seed is filled with the animal Spirits that contracts a great part of the genital moysture and concludes it in a certain cavity wherein the brain may be formed but as to the out-fide it is inveloped with a certain covering which being dried with heat is brought into a boney substance and becomes a scull as appears by this precedent figure But the brain is so formed that it may conceive retain and change the natures of all the vital Spirits from whence also proceed the beginnings of all Reason and of the Senses For as veins have their original from the Liver and as arteries have their rise from the heart so also nerves being of a softer and milder natural existence arise from the brain and are not hollow as the veins are but solid for they are the first and chiefest instruments of all the senses by
famous Chirurgion in his time at Paris quoting many witnesses to the thing gives us an History of a Woman in whom having been hang'd 14 days after she was delivered in Child-birth he found as he saith the share bone separated in the middle the bredth of half a finger and the flanck-bones themselves disjointed from the hoop-bone But we will not in this matter accuse him of an imposture as having too much respect and a better opinion of so worthy a person and believing him to be too sincere as to commit such a crime but do indeed believe the good man might be mistaken in this separation for we cannot probably conceive that being so at the time of her labor it would remain so a fortnight after the breadth of half a finger for then they would have been forc'd to carry this Woman to execution for they are executed at Paris within the City or Suburbs because she would not have been able to have supported her self or climbe the ladder of the Gibbet and keep her self on her Legs according to the custome of other Malefactors because the body is only supported by the stability of these bones wherefore we must believe as most probable that such a disjunction and separation was caused either from the falling of this Womans body from the high Gibbet to the ground after execution or from some blow on that place from some hard thing And if we thoroughly examine the different Figure and Structure of these bones between a Mans and a Womans Sceleton we shall find a larger empty space and distance between these bones much more considerable in women then in men and that to this purpose the least women have the bones of the hip more distant the one from the other than the biggest man and they have also the crupper-bone more outwards and the sharebone flatter which makes the passage from this capacity larger and more able to give issue to the child at the time of labour moreover they have besides this the flank bones much more turned outward that the womb being filled may have more room to stretch it self out on the sides and more at ease supported by such a disposition as you will see explain'd in the figure A shews the Man's bones B the Womans for to know the difference that the Womans is more capacious then the Mans for C and C D and D E and E are at a larger distance one from another in a Woman than in a Man And besides that Women have the rump bone marked F. more turned outwards than Men which gives way to the head to pass through the large passage between the 2 Hip-bones marked E and E without great difficulty and without any necessity for the separation of the share-bone The bladder and great gut being emptyed of the excrements they contein hinder in no wise but that the womb made membranous or skinny for that purpose can stretch forth it self as it doth to let the infaut pass in labour by this great empty space sufficient for it whithout any necessity that these bone-should be disjointed or separated for if it should so fall out indeed women could not sustain themselves on their legs as many of them do immediately after that they are brought to bed because they are instead of a support to them as is already exprest and of a middle joincture to all the other as well of the upper as the lower parts of the body Which the learned and judicious and experienced Chirurgion Mr. Francis Moriceau very well noted when he lay'd so many Women in the Hostel de dieu in Paris for when Women that are there to be brought to bed begin to be in labor they go into a little room call'd the stove where all are delivered upon a little low bed made expresly where they place them before the fire afterwards as soon as they are delivered they conduct them to their bed which sometimes is a good way off from this little chamber whither they walk very well which they could never do were their share-bone or their flanck-bone separated the one from the other Besides we often see young Women that have concealed their labour put themselves the better to hide their faults immediately to their ordinary business as if they had ailed nothing neither could this ingenious Chyrurgion in all women that ever he delivered ever perceive this pretended disjunction though he put his hand on the share bone when the child was in passage but he sayes that indeed he hath found the hip-bone which is joyned with a loose Joint to the lower extremity of the hoop-bone to bend outwards during labour in which part the women feel sometimes much pain because the coming forth of the child offers it a great violence and because its head at that time doth much press the great gut against it Moreover having often seen and dissected women being dead a few days after their delivery it hath been found a very difficult matter to seperate these bones with a strong sharp Pen-knife where could not be found any the least appearance of any forgoing separation and if those advanced in years have more pain with their first children than the younger women it doth not proceed from the difficulty of the seperation of these bones which never is from the reason aforesaid but because the membranes of their womb are dry and hard and particularly its internal orifice cannot therefore so easily be stretched open as young womens which in them is much moister SECT IX Of the Fashions and Figures of the birth and how Children are born or may be born THE postures of the infant in the womb are generally four First they offer to come with their heads forward which is the natural birth Secondly with the feet forwards Thirdly overthwart Fourthly doubled to all which the Midwives care and skill is required but especially in the three later But many other postures have been observed in practice for that child that comes with his head forward sometimes hath his head right as to the orifice of the matrix but the rest of the body crooked and sometimes overthwart and sometimes the infant pitcheth his head either in the former part from the orifice or backward or comes crooked and sometimes also it is whithout any tye as to the bottom of the matrix and sometimes with it sometimes also it puts forth one hand or both so as that they are twisted above the head sometimes it cometh forward with its feet asunder and those fixed in the parts of the womb sometimes the feet being doubled it endeavours to come forth with the knees forward sometimes it is so doubled that it shews forth its little buttocks like one that is sitting or contrarily may be so doubled that you may find the soles of the feet joyned to the head in the orifice of the matrix but those that lye o'rethwart somtimes lye on one side and sometimes with the face upwards and somtimes downwards
But if there be twins then that which presenteth it self fairrest must be laid hold on and the other put back As to all which the next following Sections will not only furnish you with figures but with directions Hitherto having described the Midwife and her office together with the site of the infant in the womb as natural together with difficult births in general and their causes It is reasonable good Mrs. Eutrapelia that we discourse of unnatural births because those bring the greatest danger with them both to the mother and infant SECT X. Figure the first Of unnatural Births DR Courteous Mrs. Eutrapelia If you perceive a child come with its feet forwards and the hands drawn downwards to the thighs according to the next ensuing form How will you deliver the woman Mid. In this I will take care to be furnished with Oyles and convenient liniments and only to help the coming forth of the infant by anointing and cherishing it lest it go back again but that it may come forth the same way as it began But first of all I shall take care that both arms of the infant so stretched downwards be so secured by me that the infant may not have power to draw them back again but that I may compel it to come forth after the very same manner But if the infant breaking forth after this manner and by reason of its bigness as well as his arms drawn down be so streightned by the narrowness of the matrix that of it self it cannot wholly come to the birth then the womb of the woman is to be anointed with oyl of Lillies or sweet Almonds or hogs grease some sneezing Powder blowed up he nose to help the sending forth of the birth and the womb gently to be compressed with both hands that it tend not upwards but downwards as it ought until it come forth entirely Here most Authors advise to change the Figure and place the head so that it may present it self first to the birth which is very difficult and almost altogether impossible to be performed if we desire to avoid the dangers that by such violent endeavours both the Mother and the Child must inevitably be put into and I wish they would have shown us any way how it might be safely acted that we might have followed their examples wherefore 't is better to draw it forth by the feet then to venture a worse accident by turning it Now to perform this the Midwife must have her Nails well pared and no rings on her fingers but her hands well anointed with Oyl or fresh Butter then the woman being seated to the best advantage let her gently put her hand into the entry of the Womb which if it be not wide enough let her open it a little and little by degrees with her fingers by spreading them one from the other after they are entred together so continuing to do till it be sufficiently enlarged then finding the Child's feet let her draw it forth in this posture following but if there shall but one foot present it self then she shall consider whether it be the right or the left and in what fashion it comes for thefe reflections will be a means to inform her on what side the other may be which as soon as she knows let her seek for it and then gently draw it forth together with the first and then also let her be very careful and well assured that this 2d be not the foot of another Child for if it should chance to prove so she may sooner split both Mother and Children then draw them forth the which she may easily prevent it by sliding her hand up the first leg and thigh to the twist she find both thighs joined together and depending from one and the same body and which is likewise without doubt the best means to find the other foot when it comes but with one Being then secured of both the Childs feet she may draw them forth and holding them together she may bring them by little and little in this manner by taking hold of the Legs and Thighs aftewards as soon as she can come at them and drawing them so till the hips be come forth in the mean time let her observe to wrap the parts in a single napkin to the intent that her hands being already greasy slip or slide nor from the Infants body which is very slippery because of the slimy humors which are all over it and hinder her from taking fast hold of it which being done she may on both sides with her hand bring away the arms being careful that the Belly and Face be downwards lest being upwards the Head be stopt by the chin over the share-bone so that if it be not so she must turn it to that posture which is easily done if by taking hold of the body when the breast and arms are forth she shall draw it with turning it in proportion on that side it most inclines to till it be as it should be that is with the Face downwards and having brought it to the shoulders let her lose no time desiring the Women at the same instant to bear down that so in drawing the head at that very moment may take its places and not be stopt in its passage There are indeed some Children that have their Head so big that when the whole body is born yet that stops in the passage notwithstanding all the care that can be used to prevent it in this case the Midwife must not only endeavour to draw forth the Child by the shoulders least she sometimes separates the body from the Head but she must disingage it by little and little from the bones in the passage with the fingers of each hand sliding on each side oppofite the one to the other sometimes above and sometimes under until the work be ended endeavouring to dispatch it as soon as possible least the Child be cloaked or stifled as it will certainly be if it remain long in that posture wâ—ich being artificially and well effected she may soon after fetch away the after-birth SECT XI Figure the Second DR But tell me I pray Mrs. Eutrapelia What if an infant come with the feet forward and the hands lifted above the head and not drawn downwards to the thighs as in the follwing figure what course will you take with most safety Mid. Sir I am not at all to receive it so lying except the Infant be very small and little and the Womb so extensive and open that it may be hoped a safe delivery both to the Woman and to the Child neither must I receive it before the Womb and the Infant be diligently anointed But it were much better to thrust back the Infant into the Womb and to turn it to the right form which may be done after this manner Let the woman lye on her back upon a bed with her buttocks raised higher and her head lower which done I must swathe her belly
upward gently that I may drive back the Infant again into the Womb by which means it may give an occasion of coming in another form but above all I must take care to turn the face of the Infant toward the back of the Mother and then I must lift up the buttocks and things of the Infant toward the Navil of the Mother that it may hasten toward a lawful birth and there cannot be a safer experiment in this case as I conceive which is also most useful in such births as come unnaturally Dr. Those Authors indeed Mrs. that have written of labors and never practised them as many Physitians and Chirurgions have done do order all by the same precept often repeated that is to reduce all unnatural and wrong births to a natural and right posture which is to turn it that it may come with the Head first but as I have said before if they themselves had ever had the least experience they would have known that it is very often impossible at least if they shall attempt to do it by the excess of violence that must necessarily be offer'd to effect it it will go near to hazard the destruction both of Mother and Child in the operation A fiat in this case â—s soon said but not so easily executed as pronounced and for my part I am of a clear contrary opinion to theirs and such as are â—kilful in the art will certainly acquiesce with me in this that is that whensoever the â—nfant comes wrong in what posture soever â—rom the shoulders to the feet it is the best â—nd safest way and soonest perform'd to draw â—t forth by the Feet diligently searching for â—hem as is before directed if they do not preâ—ent themselves rather then to make an atâ—empt to put it into a natural posture and â—lace the head foremost for the great endeaâ—ors often necessary to be used in turning the â—nfant in the Womb which is a little more â—ifficult business then to turn a pancake in a â—rying-Pan do so weaken both Mother and Child that there remains not afterwards â—trength enough to commit the operation to â—ork of Nature and usually the Woman â—ath no more throws nor pains fit for labor â—fter she hath been so wrought upon for â—hich cause it must needs be very tedious and â—ifficult as also the Infant which is already â—ery weak will certainly perish in the pasâ—age without being able to be born SECT XII Figure the Third DR Now I pray you Mrs. tell me If the Infant happen to come forth but with one foot and the arms let down to the sides but the other foot turned backwards How will you help Mid. In this case worthy Sir what hath been said before concerning the first Figure being punctually observed there will no difficulty at all remain in the operation only alwaies remembring when there is occasion to refresh the Woman in labor with such Medicinal means as may be proper for her in he condition SECT XIII Figure the Fourth DR If an Infant comes with the Shoulder first or lye a-cross on its back or with its buttocks with the hands and feet up how will you help it Mid. The most difficult of these three sorts of figures and situations in which Infants sometimes come is that of the shoulders because it is farthest from the Infant 's feet and the Midwife must find them to draw it forth the next is the back and the breech for the same reason causeth it least trouble not only because the feet are neerer but also because by this figure the Infant 's head and neck is not so lock'd as in the other postures Now to remedy this birth of the shoulders some advise that it should be put back to make way for the Infants head that thereby it may be reduced to a natural birth but it is much better for the reasons before alledged to endavour to bring it by the Feet the which dextrously to effect the Midwife must thrust the shoulder back a little with her hand that so she may have more liberty to introduce it into the Womb and sliding it then along the Childs body either by the belly or side as she shall find it easiest she shall fetch the feet and turning it bring them to the passage and so she shall deliver that Woman as is before directed If it be the back that presents to the birth it is likewise impossible it should be born in in that posture what pains soever the Mother endures and besides the child having the body folded inwards and almost double its brest and belly are so press'd together that iâ— usually wants very little to be choak'd or stifled to avoid the which dangerous inconvenience the Midwife must quickly slide up heâ— hand along the back towards the inferioâ— parts until she meets with the feet to thâ— intent she bring it forth the same way as if iâ— came footling But when the Child comes with the Breech forward if it be small and the Mother big having the passages very large it may sometimes with a little help be born so for although it comes double yet its Thighs being folded towards its belly which is soft and gives way it passeth without much trouble Now as soon as the Midwife finds the Child to come with the Buttocks formost she must not suffer it to engage lower in the passage for it will not come after that manner unless it be very small and the passage very large as we have said This being then in good time perceived the Midwife must if she can thrust back the breech and sliding up her hand along the thigh to the legs and feet of the Child she must bring them gently one after another forh of the Womb by folding stretching wagging and drawing them gently towards the side being careful not to wind them too much or cause a distocation and then let her draw forth the rest of the body as if it came with the feet formost I said Sir that the Midwife perceiving the Child to come with its breech formost ought to put it back if she can for sometimes it will be so far advanced in the passage that she may sooner destroy both Mother and Child then reduce it to the posture aforesaid it being once so strongly engaged when this happens she cannot by any means hinder it from coming in this posture in which its belly is so pressed that it often voids its ordure by its Fundament however she may much help this birth by sliding up one or 2 fingers of each hand on each side of the buttocks for to introduce them into the groins and having crooked them inward she must draw the breech just out to the thighs and then by drawing it and wagging it from side to side she will disingage them from the passage as also the feet and legs one after the other being very careful of putting any part out of joint and then she may draw forth the
rest as before is taught when it come with its feet foremost SECT XIV Figure the Fifth DR Tell me Mrs Eutrapelia what if the Infant happen to hasten to the birth with his armes and legs distorted and crooked according to this figure How then will you help Mid. As things so stand Sir I must not endeavour the birth of the child but must bring her from the stool to the bed where I must press back the womb as before-said or must desire her to roul her self about till the Infant is turned to a more commodious posture And if this course prevail not I must endeavour to joyn both feet together and if possible must bring down the hands so to the sides that I may direct it to the birth But the safest and best way in my weak judgement Sr. must needs be that which you have taught me in the foregoing births SECT XV. Figure the Sixth DR Tell me Midwife what if the Infant fall down with both the knees bent and the hands hanging down to the thighs How will you go to work Mid. Here Sr. when an Infant not being turned towards the latter months as it ought to come with its head foromost presents its self with the knees to the birth having its legs folded towards its buttocks one may easily be deceivad touching one of them because of their hardness and roundness and take it for its head especially when being seated a little high it can be reached but with the end of a singer only but if it be touched and handled a little better the Infant being fallen a little lower it will be easily distinquished Assoon therefore Sr. as such birth is perceieved I must not suffer it to advance further in such a posture but having placed the woman must gently put back the childs knees to the intent that I may have the more liberty to unfold the legs one after another thâ—… which dextrously to effect I must put one oâ— two of my fingers under the child's hams dâ—recting them by little and little all along bâ—hind the leg until I meet with the foot anâ— drawing alwayes a little obliquely for tâ— come the easier to the end of it that so having disengaged one I may do the same to thâ— other proceeding after the same manner aâ— with the first after which having broughâ— them together I must finish the work aâ— when a child comes with its feet foremost and hands downwards to the things SECT XVI Figure the Seventh DR But Mrs. Eutrapelia what if the Infant come out hastily with one hand and the other hand down towards the side and the feet stretched out streight into the womb according to this figure How will you receive it Mid. May it please you Sir I am not at all to receive it so nor to suffer it to proceed farther toward the birth but must bring her to the bed where her head must lye lower than her buttocks then I must swathe her belly gently that the Infant may fall back again into the womb but if it fall not back of its own accord I must put in my hand and press back the shoulders and must reduce the the arm that hanged out to the side that it may be disposed of to a natural from in the Womb and so may come forth easily Dr. Very well Mrs. Eutrapelia this is your way but now give me leave I pray you to give you my method in this case when an Infant therefore presents only one or both hands to the birth or an arme sometimes out to the Elbow and many times to the shoulder it is of the worst and most dangerous postures a child can come in as well for its self as its mother by reason of the violence the midwife is forced to use both to the one and the other in searching for the feet which are very far off by which I would always in these cases have it turn'd and drawn forth the which to do will often make the midwife sweat in the midst of winter because of the difficulty in this labor more then all the rest though some other of them are indeed more dangerous for the Infant as when it presents the belly and the Navil string comes forth but it is not so painful for the Midwife because the feet of the Infant being near the passage are not so hard to be found as when it comes with a hand forward for then they are high and at the very bottom sometimes of the womb where the midwife must seek them to turn it and draw it forth as I shall now direct When therefore it presents with one hand only or a whole arm first it must by no means be pulled forth by that part for it will be sooner separated and rent from the body then so brought forth by reason a child is pluck'd obliquely and a cross-way wherefore having placed the woman as is requisite the midwife must put back the Infants hand or arm into the womb again some Midwives dip in cold water or wash it with a wet cloth saying that the Infant will presently draw it in if it be living but it is usually so prest and ingag'd in the passage that this bad posture that it hath not liberty enough to draw back its hands so easily being once come forth wherefore the midwife must guide them back with her own which she must afterwards slide into the womb under the child's brest and belly so far till she finds the feet which she must gently pull towards her to turn it and draw it forth by them as before I directed always remembring to act with as little violence as may be which is much more easy sure and safe then to busy ones self in putting it to a natural situation As soon therefore as she hath turn'd the child to the feet if she hath hold but of one she must search for the other that so she may bring it to the first when holding them both she must govern herself afterwards in bringing the child into the World as we directed you before when the child comes with its feet foremost But if the Arm be far advanced almost to the shoulder and so big and sweld as it will be if it be along while forth that it cannot at all or with out great difficulty be put back then she herself or a Chirurgion being immediately sent for if the child be certainly dead must twist the arm twice or thrice about till it be wholly seperated from the body which it will easily be by reason of its tenderness and that just in the joint of the shoulder with the shoulder blade but be sure the child be dead elce what an horrible spectacle will it be to bring as some have done a poor child yet living into the World after the arm hath been cut off SECT XVII Figure the Eighth DR But Mrs Suppose the Infant come forth with both hands stretched forth above the head and the feet streight
stretched into the Womb which is here figured and is much more dangerous than the former Mid. 'T is true Sir this posture is much more dangerous than the former but I shall take all the care I can to bring back again this birth into the womb wholly And first of all I shall anoint my hands and the womb of the woman with oyles for this purpose for this requires no small labour then if possible with my other hand shall drive it back so by the shoulders that it may wholly fall back into the womb And again lest the Infant should return to the same form of birth I must put in my hands and bring down the arms of the Infant to the sides and by that means bring it to the form of a natural birth If this course take not I must bring the woman to bed where after she hath lain quiet a while I must proceed after the same manner as I have before delivered and if this also be to no purpose and that it neither be changed to another form she must be brought to the stool and the womb by the help of the women that are assistants must be depressed on both sides and downwards And my hands being annointed as beforesaid together with the Womb and both the arms as they come I must do what I can to joyn them together and so receive it as it comes forth And in this birth there is the less danger if that I or any other Midwife do our duties with all possible diligence and in case the Infant be not too weak Dr. Very well Mrs. your way but I take mine which I mentioned in the former Section to be the safer of the two but you may use which you think best SECT XVIII Figure the Ninth DR But I pray you Mrs. Eutrap How will you deliver a woman of a child that falls down with its buttocks forwards and the hands spread over the head according to this figure Mid. Here Sir I must annoint my hands as above-said and putting it up must lift up the fundament of the child and turn the head to the Birth But in this case I must not make too much haste lest it fall into a worser form neither is it possible that a child should be so born without great loss to the Mother and Infant therefore if it cannot be turned with the hand she must be brought to the bed where if she be very weak she may be refreshed with convenient meats and cordials and then often proceeded with as is said before until the Infant shall come to a more commodious form of birth Dr. Your observations and apprehensions of danger in this operation are very good so that when the next opportunity presents you will find my former directions to be best and safest SECT XIX Figure the Tenth DR But sometimes Mrs. it happens that it offers it self with its shoulders forwards and the head turned backwards but the feet and hands lifted up as in the ensuing figure How will you help here Mid. In this case Sir I must in the first place move backward the shoulders of the Infant that it may first appear with the head forward and this may easily be done because the shoulders being but a little up the head of it self will fall down to the orifice of the womb as being nearest to it But if there must be any other way attempted she must be brought back to the bed and then so stirred and rouled and used according to those directions formerly hinted SECT XX. Figure the Eleventh DR Mrs I fear I trouble you with many Questions be pleased to satisfie me in this and four or five more and I shall forbear What then if the Infant incline to the birth with the hands and feet together as if it stood upon all four with the back upward into the womb as in this figure What I say will you do Mid. Here Sir I must take care lest some danger happen from this difficult and unshapely figure therefore I must do thus I must so move the feet of the Infant that I may handle the head and do what I can to direct that first to the birth I must also move up the arms lest of their own accord they fall down to the sides of the womb And if this way succeed not she must be brought back to the bed and the same means used for the turning of the Infant as hath been formerly described SECT XXI Figure the Twelfth DR Sometimes Mrs. it falls out that contrary to the former shape the Infant falls down upon its breast with the hands and feet cast backward into the Womb as in this figure what will you do in such a condition Mid. Truly this case is the most dangerous of all hitherto proposed First therefore I must carefully annoint both my hands and also the womb of the woman which done I must feel for the arms of the Infant and lay hold of them so till I can lay hold of the head also and with all care hold it so fast that I may direct the head first to the birth next I must dispose of them to the sieds for this done the birth will come forth the sooner and with less danger but if this succeed not it will be safest to bring the woman to the bed and to proceed as formerly shewed that if perhaps by this kind of delay the Infant may accommodate it self to a more fit posture for the birth SECT XXII Of a birth wherein the Infant presents the belly DR In the next place Mrs. Midwife let me hear from you how you will help a woman in labour of a child when it presents its belly first Mid. That you shall Sr. very willingly to the utmost of my skill And here Sr. I must note that the back-bone may easily be bent and turned forwards alittle but by no means backwards without excessive violence Wherefore the worst and most dangerous figure that a child can offer to the birth is the belly or the breast for then its body is constreined to bend backwards and what ever throws or endeavours a woman makes to bring it forth it will never be accomplish'd for she will sooner perish with her child then ever advance it in this posture into the passage wherefore 't is in great danger if not timely succourd and in case it should escape which would be very strange it would be weak in the back along time after its birth but that which augments the danger much more is that for the most part the Navil-string comes forth when the Child comes with the belly Therefore as soon as 't is discover'd to be so the Midwife must use the sole remedy of drawing it forth by the feet as speedily as may be in this following manner Having placed the woman I must gently slide up my flat hand being well anointed for the easier entrance towards the midle of the childs breast which I must thrust back to
much ado to introduce one only with which she must do her operation with the half of the fingers ends of the other hand put up as far as necessary afterwards let her excite and procure the childs birth as directed before Then sometimes the child comes with its face first having its head turn'd back in which posture it is very difficult it should be born and if it long remain so the face will be so black and blew and swell'd that at first sight it will appear monstrous which comes as well by the compression of it in that place as by the Midwives fingers handling it too rudely when she endeavor'd to place it in a better posture There was a certain Woman whose Child came with its Face so black and mishapen as soon as it was born as is usual in such cases that it looked like a black Moor as soon as the Mother saw it she said she alwaies fear'd her Child would be so monstrous because when she was young with Child of it she fixt her looks very much upon a black moor wherefore she wished or at least wise car'd not though it dyed rather than she said she should behold a Child so monstrously disfigured as it then appear'd but she soon chang'd her mind when she was made sensible that this blackness was occasion'd only by reason that it came into the World with its face forwards and that assuredly in three or four days it would wear away as accordingly it happen'd having often anointed it with oyl of sweet Almonds as she was order'd and when the Child came to be about a 12 month old you could have scarcely seen a fairer Now to deliver this birth the Midwife must observe the same manner as in that wheâ—… the Child comes with the side of the head being careful to work gently to avoid bruising the Face But here note that if it should chance thaâ— the Childs hand or hands should come with either of these births which for the mosâ— part happens rather than any other part iâ— will hinder the birth by reason it takes up part of the passage and for the most parâ— cause the head to lean on one side To remedy this as soon as 't is preceived that one hand presents together with the head it must be prevented from coming down more or ingaging farther in the passage wherefore the Midwife having plac'd the Woman on the bed with her head a little lower than her hips must in the next place put and guide back the Childs head with her own as much as may be or both hands iâ— they came both down for to give way to the Childs head which done she must proceed aâ— before SECT XXV How to deliver a Woman when the Childs Head is born and the Womb closeth about its Neck DR Very well Mrs. Eutrapelia you have now given us a farther account of your very good judgment in your Art in your dextrous ingenious way of bringing a Woman to bed in the last posture But now I would desire you to let me know how you will deliver a Woman of her Child when its head is born but yet the Womb closeth about its Neck Mid. Truely Sir to deliver this Woman is not so easie abusiness as may be imagin'd by reason that a small delay herein may cause the strangling of the Child And here you must observe that the Child comes naturally with the Head first because by its bigness and hardness the passage might be the better made and opened for the other parts of the body the which usually pass afterwards without pain but yet notwithstanding sometimes the Head is so small and the shoulders so large that without a very great difficulty they cannot pass which makes the Child remain often in the passage after the head is born And this accident may likewise happen sometimes for not having been careful to lose no time in drawing forth the Child by the head to the end the shoulders might at the same instant follow in the same place the head possest Now when I meet with this Figure I must by all possible means seek speedily to deliver the poor Child out of this prison or rather snare or collar in which it is caught for fear as I said before it come by delay to be strangl'd to prevent which I must endeavour to cause the shoulders immediately to follow by gently drawing its Head sometimes by the sides of it and sometimes with one hand under the chin and the other behind its head and so doing by turns on the one side and the other to facilitate the operation the better being very careful and circumspect that the Navil-string be not entangled about its Neck as also not to draw it forth with too much violence for fear least it may happen as I once saw the Head to be pulled from the Shoulders But if the Shoulders come not with gentle pulling then I must slide up my fingers on both sides under the Arm-pits with which turning them inwards I may by little and little draw forth the Soulders but if when they are in the passage and totally disengaged if I cannot get the rest forth by still keeping my fingers under the Arm-pits I may be very confident there is some other hindrance and that it is certainly monstrous in some part of its body or that as it for the most part happens in this case it is hydropical in the belly for which cause it is impossible it should be born before the belly be pierced to evacuate the waters and then it will easily be accomplish'd but this being the expert Physitian or Chirurgion's parts to perform I shall leave it wholly to them SECT XXVI When the Navil-string comes first DR Now Mrs. Eutrapelia I would know of you how you behave your self when you have a labor presented to you wherein the Childs Navil-string comes first Mid. Here Sir you must note That an Infant doth not always present with the belly when the navil-string comes first for though it presents naturally as to the Figure of its body that is with its Head first yet sometimes the Navil-string falls down and comes before it for which cause the Child is in much danger of death especially if the labor be not very quick because the blood that ought to pass and repass through those Vessels which compose it for to nourish and keep the Child alive whilst it continues in the Womb being coagulated hinders the circulation which ought to be there made which happens as well by the contusion as the cold those Vessels receive being much pressed in the passage when it comes together with the Head or any other part as also because the blood doth there coagulate as is said by reason of the cold which it takes by the coming forth of the Navil-string But though this accident may cause the Infants sudden death 't is not so much for lack of nourishment without which it may pass a whole
day or more there being blood enough in its body for that purpose but because the blood can be no longer enliven'd and renewed by circulation as it hath continual need which being obstructed always causeth the creatures sudden death sooner or later according as it is more or less obstructed I know it may be objected that though the circulation be so hindred and intercepted by the coming forth of the string it need not therefore cause such a sudden death to the Child because the blood may notwithstanding circulate in all the other parts of the body To which I answer that in respect to the Infant 't is either absolutely necessary that the blood for want of respiration should be elaborated or prepared in the thick part of the burthen call'd the placenta and therefore must be a free communication or for want of it that the Infant must immediately breathe at the mouth as well to be refreshed as to drive out the fuliginous or sooty Vapors by expiration which not being possible whilst in the Womb it must unavoidably be choaked and dye in a very short time if it wants both together Wherefore in this case the Woman must without any delay be deliver'd the which if nature doth not speedily perform the Child must be drawn forth by its feet Women that have great waters and along string to the burthen are very subject to this mischief for the waters coming forth in great abundance at the breaking of the skins or membranes do often at that instant draw the string which swims in the midst forth along with them and much the easier if the Infants head be not advanced very forward into the passage for to hinder the coming forth of it in this manner Assoon as 't is perceived you must immediately endeavor to put it back to prevent the cooling of it behind the Childs head least it be bruised as we have already noted whereby the blood may coagulate there keeping it in that place where it was thrust back until the head being fully come forth into the passage may hinder the coming down of it again which may be effected by holding it up with the fingers of one hand on that side it comes down untill the head be advanced as aforesaid or in case the hand be taken away to put a piece of fine soft rag between the side of the head and the Womb to stop up the way it came down by always leaving an end of the rag without the body to draw it forth by at pleasure But sometimes notwithstanding all these cautions and the putting of it back it will for all that come forth every pain and then without any more delays at all the Midwife must bring the Child forth by the Feet which she must make a diligent search and enquiry after although the Infant comes with the head foremost for there is but this only means left remaining to save the Childs life which it would certainly lose by the least delay in such a case Wherefore having placed the Woman conveniently let her gently put back the Head which offers provided it be not engaged too low amongst the bones of the passage and that it may be done without too great violence to the Woman for in that case it will be better to let the Child run the hazard of dying than to destroy the Mother for Tertullian as my learned Mr. Riolanus very well observes upon a like Subject saith That it is a necessary cruelty to kill the Child in such a case rather then to save it from the danger it is in of dying and so certainly cause the Mothers death and then let her slide up her hand being well anointed under the breast and belly to search for the Feet by which she must draw it forth according as hath been formerly discoursed the which being perform'd let her immediately take care of the Infant which is ever in this case very feeble SECT XXVII Wherein the Burthen either first offers it self or comes first quite forth DR Very well and excellently have you given us demonstrations of your skill and knowledge hitherto good Mrs. Eutrapelia now pray will you inform me how you act your part in a Labor wherein the burthen either first offers or else comes first quite forth Mid. That I shall Sir to the best of my Talent and therefore first of all Sir I must note that the coming forth of the Navil-string before the Infant whereof we discoursed in our foregoing Section is oftentimes the cause of its death for the reason there alleadged but the coming forth of the burthen first is yet much more dangerous for that besides that the Children are then commonly Stil-born if they be not assisted in the very instant the Mother likewise is in great peril of her life also because of her great floodings which usually happen when it is loosened from the Womb before its due time by reason that it leaves all the orifices of the Vessels to which it did cleave open whence incessantly flows blood until the Child be born by reason that the Womb as long as any thing continues there doth every moment strongly endeavour to expell it by which means it continually voids and expresseth the blood of the Vessels which are alwaies open as we have already explained when the burthen is so separated as long as the Womb remains extended and cannot be closed until it hath voided all that it did contain and comes by the contraction of its Membranous substance to stop them by pressing them together wherefore if the Midwife ought to be vigilent and diligent to succour an Infant when the Navil-string comes first how much more ought she to be so when burthen comes forth first and wherein the least delay is ever the cause of the Infants sudden death if the Woman be not speedily delivered because the Infant cannot then remain long in the Womb without being choaked or stifled being it stands in need at that time of breathing at the mouth as we explain'd the foregoing discourse the blood being no longer enlivened by the preparation made in the burthen the use and function of which then ceasing from that very instant that it is separated from the Vessels of the Womb to which it was joined for which reason there immediately follows a great fludding which is so dangerous for the Mother that without speedy help she quickly looseth her life by this unlucky accident Now when the Burthen is not wholly come forth but lies in the passage some advise to put it back before the Child be fetch'd but I am not of their opinion for when it comes into the passage before the Infant it is at that time totally divided from the Womb at the bottom whereof it ought to be commonly situated and fastened until the Child be born but because as soon as it is wholly loosened as it always is when it comes first it becomes a body altogether unnatural therefore it is never to be
thrust back but contrarywise be fetch'd away and at that very moment after bring the Child away by the Feet although it came naturally with the Head first for what reason can there be to put it back since it is of no use to the Infant from the moment it is separated from the Womb as cannot be denied And such a proceeding is so far from being useful that this burthen would much hinder the Midwife from being able to turn the Child as she ought in bringing it forth by the Feet Wherefore when it presents it self in the passage which may soon be perceived if the Midwife find every where a soft substance without the least resistance of any solid part to the touch and finding likewise the string fastned to the middle of it and the Woman fludding extreamly as is ordinary at such times then in lieu of thrusting it back the burthen must be brought away that so there may be the more liberty and room to draw forth the Child according as hath been before directed The Burthen then being quite loosened from the womb and coming first in the passage must not be thrust back again into it much less must it be put back when it is quite come forth of the body The midwife must only take care not to cut the string till the child be born not out of hopes of any benefit from it to the Infant during the delivery but that so much time may not be lost before the Infant be fetch away which is then ever in great danger as also the flooding may be the sooner stopt which happens for the most part as soon as the woman is delivered for which reasons it will be dispatched with all possible speed Sometimes notwithstanding this dangerous accident the child may be born alive if timely succoured but it is then so weak that it is hard to discover at first whether it be alive or dead When it so happens some midwies do ordinarily before they seperate the burthen put it into a Skillet of hot wine and imagine with no small superstition that in case it it comes to it self the vapours of the warm wine was the cause of it being conveyed by means of the string into the Infants belly and so giving vigor but it is more credible that being almost stifled for want of breathing as it needed it it begins now by means of it to recover from that fainting but nevertheless there may be no hurt in continuing the old custom since it can do no perjudice and may satisfie fine occupied Spirits provided necessaries be not neglected in being blindly carried away with this conceit SECT XXVIII Figure the Thirteenth DR There being the same reason in twins as in a single birth except that the single birth is natural and the twins not so certainly the same method must be observed Mrs. Tell me then if there be two or more and and all come fair with their heads toward the birth What is to be done Mid. Here Sir I must observe that which lyeth readiest and fittest in the Womb and first receive that and not to let the other go till the first is born lest it turn into another shape by sliding back again into the Womb but the one being born I must presently lay hold on the other Now this birth will be easier and without danger because the first birth hath made the way for the second so plain that it may come forth without any difficulty at all But in this birth I must take care that I bring forth the after-burden timely enough lest that the Womb being freed from her Infants presently fall down and so keep in the after-burden with great danger SECT XXIX Figure the Fourteenth DR But Mrs. What if there be Twins and they both come unnaturally with their Feet forward as in this Figure what course will you take Mid. This birth Sir is dangerous enough and yet it is to be mended by the prudence of a discreet Midwife Wherefore I must anoint the womb of the woman that the passages may be the easier for the Infant which being done I must take care to lay hold of the arms of one of them and bringing them down to the sides secure them so that I may lightly promote the head to the birth and the first being born I must presently proceed with the other after the same manner but if I can lay hold of neither of their arms so that there is no good hopes of a happy birth I must have recourse to the former method if at least the Infants may come into the World by that pains and conversion which is wrought upon the bed SECT XXX Figure the Fifteenth DR I come now to my last unnatural birth of Twins If then there be Twins these forms being compound as of a natural and unnatural birth the one comeing down with the Feet what is to be done in this case Mid. Where Infants offer themselves after this manner I must first bring forth that which presents it self with a natural form and must move up the other which is with the Feet forward and if possible cause it so to return into the Womb that that form also may be disposed of to a natural birth but if it cannot be turned to be in a better posture I must lay hold presently on the hands and encourage it to the birth But it were safer that this should be brought to a natural form to which end I must diligently endeavour it by anointing directing moving it tumbling and rouling the Woman lest perhaps the Womb be hurt by the form of such an unnatural birth and the privities swell with wind from whence the birth cannot come forth without danger or be hindred too long All which danger may with provident care be avoided or at the least very much corrected and amended Dr. So far concerning your way and method of Labors wherein several Children in different postures present themselves together but now good Mrs. Eutrapelia I would have you to hear a little what I have to offer you concerning these deliveries and first of all be pleased to consider seriously with me that if all those unnatural Figures and Situations which we have hitherto described that a single Child may come in do cause those many difficulties and dangers mentioned certainly the Labor wherein several come together in those bad Situations must be much more painful not only to the Mother and Children but also to the Midwife for they are then so pressing that for the most part they trouble and hinder one another moreover the Womb is so filled with them that the Midwife can scarce introduce her hand without much violence which she must do if they are to be turned or thrust back to the end that she may give them a better position then that wherein they present Where note then that when a Woman hath 2 Children they do not ordinarily both present to the birth together but one is
oftentimes more forward then the other which is the cause why but one is felt and that 't is sometimes not discovered that the Woman will have Twins till going to fetch the after-birth the first being born the 2 d is then perceived When there are Twins Mrs. Eutrapelia one must not think that Nature is orderly in causing one to be born before the other the first or last according as it may be most convenient that is to say when the one is strong and the other weak that the strongest comes first as also when one is dead and the other living that the living one drives forth the dead one for I can assure you there is no certain or infallible rule in these cases of which I can give you an example there were once 2 women deliver'd within a week of one another and both of Twins the one of each being dead and the other living the living Child of the first Woman was born before the dead one and the dead one the 2d was expelled before the living one And the same thing we see happens very often in respect of strong and weak Children for that which is nearest the birth whether alive or dead strong or weak is always the first born or must be brought into the World the first if it cannot come of it self otherwise the difficulty of the Labor would yet be augmented as well in length of time to the Mother as the violence done to the first Child in putting it back for to fetch the 2d first Now the Midwife must always remember to have a care in all natural births to examine diligently whether there be no more Children in the Womb after the first is delivered which she may easily know by the continuance of the pains after the Child is born and the bigness of the Mothers belly besides this she may be very sure of it if she shall put her hand up the entry of the Womb and shall there find another water a gathering and a Child in it presenting to the passage and if this shall be so the Midwife is not to fetch away the after-birth till the Woman be delivered of all her Children if she chance to have never so many because Twins never have but one burthen to which there are fastened as many strings and distinct Membranes as there are Children and if one should go to draw it forth as soon as the Birth is born the rest would be in danger of their lives because that part is very necessary to them whilest they are in the Womb and besides more then that it endangers a flooding Wherefore the first string must be cut being first tyed with three or four double and the other end must be fastened with a string to the Womans thigh not so much for fear that the string should enter again into the Womb as to prevent the inconvenience it may cause to the Woman by hanging between her thighs afterwards this Child being removed the Midwife must take care to deliver her of the rest observing all the same circumstances as were belonging to the first the which being done it will be then convenient and necessary to fetch away the After-birth as we shall discourse the manner how by and by SECT XXXI Figure the Sixteenth DR Courteous Mrs. Eutrapelia I have hitherto troubled you with many Questions that I might not only be sure of your abilities but also give testimony of your sufficiency if need require I have now only one Question more and then I have done as to these postures and fashions And this though the last surely is a miraculous posture What if the Infant be so involved in the womb the head and the neck being of such a length that it is so bent back that the face lyeth betwixt the buttocks the right hand to the left region of the reins but the left hand to the knee of the same side the right legg being across the left in form of the letter X and both leggs bent up toward the breast Mid. Worthy Dr. This case is the hardest of any that hitherto you have propounded to me and though it may never fall out to be so in one amongnst 5000 yet because in your description of the best Midwife you tell me that a Midwife must have a good memory I remember a learned Doctor not long since acquainted me with such a posture which he told he had from the hands of an expert Chirurgeon and Physitian whose wife also was an expert Midwife and the course the Midwifed took in such a case he told me was this which must serve also for my answer because I think there cannot be a better After the woman had been eight daies in labour and given over by all Midwives as desperate being in a violent Fever with no throws but very weak and by reason of hot medicines given to expel the birth and strong wines given to support the spirits those humors that usually accompany the Infant had so flown out that the genitals were so dry and closed that they would scarce admit the probation of two fingers This method was used First instead of wine she gave her good store of Almond-milk and because her belly was very costive she gave her Clysters and to keep up her spirits she gave her Cordials of which in their order She laid plaisters to her hands wrists and anointed the whole region of the belly hips loins the rump-bone and privities with Oyles to appease her pain and with softning Unguents and then she made a triangular bagg stuff'd with emollient and relaxing herbs boyled in water according to this description and of which more hereafter The description of the Bagg It was of such a bigness as that it might cover the lower part of the belâ—… and the privities and with tapes fitted to the corners was applyed hot and continued on some hours after which though her hand were well anointed she could scarce thrust in the top of her finger into the orifice of the womb the womb was so closed and the Infant so depressed toward the share-bone by reason of the precedent throws and pangs But at length when with much labour and industry the genitals were somewhat dilated that she could get in her fingers farther she found the loyns and the right hand of the child first offer it self to the birth that therefore she might correct this monstrous and so inverted posture of the Infant so doubled and twisted and either perswade the head or the feet to come forward she used the best of her skill but to little purpose the genitals were so narrow and streight But yet not giving off her endeavours she did deliver her within eight hours after she came to her assistance but the child was dead Dr. Mrs. You give a very good account of an expert Midwives practice which you may follow with safety expecting the success from Heaven but it is no wonder the child should be still-born as you phrase it
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
and no longer possessing the Womb and so fetch away the Child by the Feet For indeed although it be certain that the Child be quite dead in the Womb and other circumstances that will demonstrate that there is need of a Physitian or Surgeons Art yet he must not therefore presently use his crotchets because they are never to be used but when hands are not sufficient and that there is no other remedy to prevent the Womans danger or to bring away the Child any other way for very often though all hath been done that art directs some persons present that understand not these things will believe that the Child was kill'd with the crotches although it had been dead 3 days before and without other reasonings and better understanding of the matter for his recompence in saving the life of the Mother requite him with an accusation of which he is altogether innocent and in case the Mother should afterwards dye by misfortune lay her death also to his charge and instead of praise and thanks treat him like a Butcher or Hangman to which divers Midwifes are commonly very ready to contribute and are the first that make the poor Women that have need of the Men afraid of them Insomuch that they are afraid of being blamed by them for having themselves been the cause as some of them often are of the death of Infants and many ill accidents which often befall the poor Women for not causing them to be helped in due time and from the very instant that they perceive the difficulty of the labor to pass their understandings I speak this by way of caution on both sides Now therefore for the Physitian or Chirurgion to avoid these calumnies let him never use his crotchets but very rarely when there is no other way as also to endeavor his utmost as much as the case will permit to bring the Child whole into the World although it be dead and not by bits and peice-meals to give the ignorant not any pretence of blame I say as much as the case will permit that is with respect to the Woman under his hands for to save her he had better sometimes to bring forth the Child with Instruments then to kill her by tormenting her with excessive violence to bring it forth whole for in a word he must and ought to do in his conscience what his Art commands without taking heed to what may be spoken afterwards and every Physitian or Chirurgion that hath a well regulated conscience will always have a greater regard to his duty then his reputation in such a case in performing of which let him expect his reward from God SECT XXXII Of the extracting of a mola and false conception DR We have hitherto Mrs. Eutrapelia discoursed of births natural and unnatural there is somewhat more not like these but often with them and without them which Physitians call a Mola but you call it a false Conception I pray Mrs. therefore what is that Mola or false Conception Mid. A Mola Sir is a hard inform tumorfull of pores like so many ugly eyes scarce to be cut by a knife of a stony substance to touch and round appearing sometimes at the entrance of the Womb sometimes over the whole Womb and is thought by very Learned Doctors to be begotten by the woman her self without the help of a man though some affirm it cannot be without the seed of the man and therefore inanimate because not generated by two without the help of a man I say by the force of her own seed mixing it self with much menstruous blood reteined in the Womb which by immoderate heat is changeth into the shape of flesh and that altogether unnatural as is the stone in the bladder and in the fingers of gouty persons c. Dr. Well Mrs since 't is so tell me I pray wherein it differs from a true Conception Mid. It may Sir be like a true Conception in three respects yet differ in six As first 'T is true that a false conception stoppeth the monthly terms as doth the true Secondly The belly also doth swell and the breasts grow big Thirdly There is an alteration both in the color and appetite but yet they differ in these six following ways as First A false conception hath no ordinary nor periodical motion neither doth it stir from side to side except it be pressed Secondly In a false conception the belly is harder and the feet are much more swelled Thirdly The woman is more heavy and unweeldy and not so nimble as with a true conception Fourthly The breasts swell not so much as in a true conception Fifthly The whole body grows soft and consumes away in a false conception Sixthly a false conception may be moved in three months but the Child stirreth not till after three months or usually in the fourth month And again the birth of an Infant never exceeds the eleventh month whereas a false conception may continue for fourteen years or as long as they live Moreover there may be a Tympany caused by air included in the Womb. Or else there may be a Dropsie by reason of the many humors contained in the Womb both which may give a false supposition of being with Child but these also are easily distinguish'd from a false conception A Tympany may be moved from place to place but not the other A Tympany will sound if lightly strucken but not the other and a Dropsie caused by those many humors as aforesaid will shew some marks being depressed with the fingers whereas a Mola is hard and yieldeth not to the pulsation or depression of the fingers And lastly in both these most commonly the Thighs swell but in a false conception or Mola the Thighs wither and are lesser Dr. Thus far have you extreamly ingeniously Mrs. Eutrapelia exprest your self concerning a Mola and now you have done I pray you give me leave to lay you down my sentiments concerning both a Mola and a false conception and the safest and best way to draw them forth of the Womb with safety First of all then Mrs. you must know that there are several sorts of great bellies belonging to Women as hath been said before there are your natural big bellies which contain a living Child and those may be called true ones and others unnatural or against nature in which in lieu of a Child is engendred nothing but strange matters as wind mixed with waters which may be called dropsies of the Womb and false conceptions and Moles or Membranes full of blood and corrupted seed for which reason they are called false great bellies Now you must know that among the signs of a true great belly one is the stirring of the Child in the Womb but here you are to observe that it is very fit we should be always careful not to be deceived by what we feel to stir in the Womb inasmuch as the Infant of it self is endued with 2 sorts of motions in its Mothers
Womb that is to say a total motion and a partial motion the total motion is when it removes the whole body and that is when it moves only but one part at a time as the Head Arms or Legs all the rest of its body lying unmoved now the Womb blown up in fits of the Mother yea and some moles have by accident a kind of total motion but never a partial one for that motion of a mole is rather a falling down then otherwise to wit a motion by which heavy things do use to fall downwards for a Woman who hath a mole of any considerable bigness whatsoever side she turns her self to her belly will fall the very self same way immediately even like unto an heavy bowl Then again you may remember that another sign of a great belly was the stopping of the courses and withal a little qualmishness which is not always true and women who daily use copulation are very often subject to be deceived hereby thinking that then they are with child whenas indeed false conception shall cause you almost the same accidents as true ones the which cannot easily be distinguished but by its consequences For this false great belly is often caused by wind which blows up and stretcheth out the womb like a bladder the which women often discharge with as much noise as if it came from the fundament and sometimes t is nothing but water which is gath'red there in such abundance as some women have been known to void a pail-ful without any child though they veryly believed they had been with child Now your moles always proceed from some false conceptions which continuing in the womb grow there by the blood that flows to them and by the accumulation of which they are by little and little encreased and if the womb chance to expell it before 2 months it may be called a false conception and some of them are only but as it were the seed involv'd in a membrane the others are alittle more solid and fleshy resembling in some sort the Gizard of a foul and are greater or less according to the time they remain in the womb and also according to the quantity of blood with which they are always soaked and women expell these false conceptions sooner or later according as they cleave to the womb the which makes them almost always to flood in great quantity at those times but for your moles they often continue in the womb after the ordinary time of labor some women having had them a whole year yea many years as happened to a certain Peuterors wife of whom the great Chirurgion Ambrose Parry makes makes mention in his book of generation who had a mole 17 years and at last dyed of it for if they keep it so long they go in danger of their lives for their long or short continuance is according as they are more or less adhering to the inward parts of the womb and are there entertained and nourished by the blood that flows thither And here I pray you note that it is of great importance to distinquish well betwixt a true and a false great belly for the faults committed by a mistake are always very considerable forasmuch as in a true great belly the child ought to continue in the womb till nature endeavors to expell it by a natural labor but contrarily the false great belly dictates to us to procure the expulsion of what it conteins as soon as may be wherefore we ought to be very careful And if there be any occasions wherein the Physitians and Chirurgions and Midwives ought to be more prudent and to make more reflections upon their prognostics for an affair of so great an importance as this is it is in this which concerns their judgments as to conceptions and womens being with child to the intent that they may avoid the great accidents and misfortunes which they may cause which are too precipitate in it without a certain knowledge Now the faults which are and may be committed at such a time through too much fear are in some sort excusable and to be pardoned but not those caused by rashness which are incomparably greater And now to return to my discourse of moles I take a mole to be nothing elce but a fleshy substance without bones or joynts or distinction of members without form or figure regulated and determined engendred against nature in the womb after copulation out of the corrupted seed both of the man and the woman notwithstanding there are some sometimes which have some lineamens of a rought form And here I take it to be very certain that a woman never engenders a mole without the use of copulation both seeds being required to it as well as for a true generation though it may be otherways imagined as you said by very learned Drs. for truely though there may be some women who though never having carnally had to do with any man yet do naturally cast forth some strange bodies after a flooding which in a appearance seems to be flesh yet notwithstanding if you shall take more diligent and special notice thereof you will find it to prove to be but some clods of blood coagulated either without consistance or fleshy texture or any ways membranous as are your moles and false conceptions and that stony hardness was caused through its long stay in the womb being there baked as in an hot oven Now as to the manner of the engendring of moles I take it to be ordinarily this that it is when either the mans or the womans seed or both together are weak or corrupted the womb not laboring for a true conception but by the help of the spirits with which the seed ought to be replenished but so much the easier as that small quantity found in it is extinguished and as it were choaked and drowned by an abundance of the gross and corrupted menstruous blood which sometimes flows thither soon after conception and gives not leisure to nature to perfect what she hath with great pains begun and so troubling its work bringing thither confusion and disorder there is made of the seeds and blood a mere Chaos called a Mole not usually engendred but in the Womb of a Woman and never or very rarely found in that of other animals by reason that they have no menstruous blood as a woman that divine creature hath A mole moreover you are to note hath no burthen nor navil-string fastned to it as a childs always hath for as much as the mole it self sticks close to the womb by which means it receives nourishment from its vessels it is also likewise usually clothed with a kind of skin in which is formed a piece of flesh confusedly interlaced with many Vessels it is of a bigness and consistence more or less according to the abundance of blood it receives and according to its disposition and also according to the temperature of the Womb and the time it remains there For the
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
Night going to bed or after her first sleep 2. The Terms overflow 1. when they continue longer then their usual time which is 2 or 3 days in Women that use no exercise 4 or 5 days 2. when they come oftner then once a month the cause is 1. a Rupture of some Vessel 2. immoderate purgation 3. some corroding humor 4. hard Labor in Child-bed or unkind handing the Womb if the Vessels be broken blood gusheth out in heaps and if from some knawing humor they are few but very painful the rest are easily known Let them abstain from exercise then 1. anoint the reins with Oil of Roses Myrtles or Quinces then boil the roots of Tormentil Cinquefoil Yarrow Knot-grass Comfrey dead Nettles Solomon's Seal Purslan Shepherds-purse red Roses acorn Cups bark of Oak Trees some of these in her ordinary drink or the juices of what can be had taken alone and this above all take Comfrey leaves or roots and Clowns alheal of each an handful bruise and boil them well in Ale and drink of it now and then this will do though the Vessels were open 3. Flux of the Womb is a continual droping from that part of the body if it be red like putrified blood it comes from that humor if white and pale 't is from Phlegm if yellow 't is from Choler if pure blood as if a vein were opened either a knawing of the Womb or tearing in delivery is feared The cure differs as the cause if pure blood flow let blood i' th arm then use the Medicine last mentioned of Comfrey roots and Woundworth if flegm be the cause use Cinnamon in all meats and drinks and Methridate and Treacle for Antidotes a little every Morning take a scruple of Pills of Amber going to Bed for divers Nights if from Choler purge with syrup of Violets and Cassia Fistularis of each an ounce after take powder of Ivory and Missleto of the oak of each one scruple mixt with half an ounce of conserve of Roses every Morning for a Week if from putrified blood having first let blood i' th Foot then strengthen the Womb as before always forbearing violent motions and passions and sharp and salt meats and provokers of Urine for dead Nettles there are three sorts white red and yellow the flowers of that colour the white help the white the red the red the yellow the yellow flux 4. The Womb fallen out is cured if it be swell'd by bathing it with a decoction of Mallows Linseed and Fennigreek boil'd in water 2 or 3 times and when 't is got up let her keep her Legs close or else tye them with a swath apply stinking things to the Womb as Assa Foetida oil of Amber her own Hair burnt and let her smell of Civet c. the rest is before and after 5. The Womb is inflamed by many causes a blow stopping of the Terms Abortion Ulceration Immoderate Lechery overmuch walking cold For cure strengthen the Womb first then first clarifie Whey and boil Plantain leaves or roots in it and drink it then inject the juice of Plantain into the Womb with a Syringe if in Winter when you cannot get the juice make a strong decoction of the leaves and roots in water if the body be costive use a Clyster and here note that in all Inflammations blood-letting is the chiefest remedy first i' th Arm then if need i' th Foot if it be near the Neck of the Womb make a pessary of wool and anoint it with unguent album or populeon or mixt 6. The Womb is sometimes troubled with wind which is cured as the fits of the Mother and moistness of the Womb is cured as a flux of flegm 7. Heat and dryness of the Womb is incident to Women of a Cholerick complexion is cured by cool and moistning herbs of which stinking Arach is chief neither are Plantan and Mallows much behind milk is good for such to drink first purging with an ounce of Cassia Fistula new drawn going to bed and follow your business the next day Dr. Thus far good Mrs. Eutrap but now hear me a little concerning this matter All rational men know that the generation of mankind as also of other irrational Animals is the most perfect excellent and exquisite work of God's Vicegerent Nature the which is most excellently and elegantly demonstrated and set forth by Aristotle that great Secretary of Nature in his second Book which he hath written of the Generation of living Creatures for whereas it is impossible by the decree of Nature that any humane Creature should live always or have an immortal Being in this World much less should we imagine that should be granted to Bruits and other Souls of an inferior rank therefore for the continuance and propagation of each sort it hath otherwise ordained that during the continuance of this World there should be likewise maintained a successive generation of both Sexes by the Action of procreation and from hence after him Galen the greatest Luminary of Physick next Hippocrates says that it comes to pass that Creatures are furnished with Instruments of Generation proper for the quality of their Sex and are consequently indued with natural Instincts prompting them to the use thereof Therefore we shall at this time discourse of this wonderful operation of Nature and endeavour as far forth as our Talent will afford us to seek out the causes that may hinder and from thence prescribe means to remove them and so consequently assist and further her in so miraculous a concern and this partly upon our Dame nature's account whose Servants only we are and in the next place for the sakes of those Ladies Gentlewomen and others who are often disconsolate and dejected upon their being accounted barren Now then you must note that as conception hath some alliance with every part of the Body as being undoubtedly concern'd therein so the same Conception may be quite abolished diminished or deprived as it happens in all other actions and motions of the body so that if Conception be quite abolish'd in a Woman in such sort that she can never be able to conceive this affection is then called Barrenness or such a Woman may be called a barren Woman which you please But if she Conceive sometimes though seldome here the Conceptive faculties may be said to be diminished or weakened by some cause or other and to this kind of diminished Conception may be referr'd untimely births called Abortion And lastly a depraved Conception is when in the Womb is contained some unnatural Conception such as Monsters and Mola's c. The causes and remedies of all which it hath and shall be our duty to lay open to the Females Sex according to the best of our skil and knowledge first to the end we may further the propagation of humane kind and secondly that we make if possibly remove the reproaches laid upon Barrenness which hath been in all ages and continues to this day and will do to end
imaginations may cause the like effect The 2d Conception is effectively as sure as we find the decision thereof uncertain nor must we imagine that always when a Woman brings forth two Children or more at once there is a superfetation because they are always almost begot in the same Act by the abundance of both Seeds received into the Womb neither must we believe that it may be at all times of a Womans being with Child for it cannot be either the first or second day of Conception because if the last Seed be received into the Womb it would make confusion with the first which is not yet enwrapt with this little skin that might otherwise separate it nor is formed perfectly till the sixth or seventh day as Hippocrates saw in a Woman who about that time expelled this geniture Besides the Matrix opening it self again could not hinder the first Seed from slipping out being not as yet invellopt with this little skin which could preserve it This may make one not to believe Pliny's story that it happened for his reasons to wit that she used Copulation with two several Persons the same day for the last would certainly have caused this confusion of Seeds and also have destroyed the work begun But I rather believe that this superfetation may happen from the 6th day of Conception till the 30th or 40th at most because then the Seeds are covered with Skins and that which is contained in the Womb is not of a considerable bigness but after this time it is impossible or yet at least very difficult because the Womb being extended more and more by the growth of the Child can hardly receive new Seed as hardly retain it but casts it forth by reason of its fulness and 't is a true Maxim intus existens prohibet alienum Now when a Woman brings forth one or more Children at a Birth begotten at once which usually are called Twins and differs from superfetation 't is known by their being almost of an equal thickness and bigness and having but one only and common after-birth not separated the one from the other but by their Skins which wrap each a part with their waters and not both in the same waters and skin as some have believed but if there be several Children and a superfetation they will also be separated by their Skins but not have a common burthen but each a part neither will they be of an equal bigness for that which is the superfetation is always lesser and weaker then that which was first engendred who because of its force and vigor draws to it self the greatest and best part of the nourishment just as we find in fair and great fruit that have often near them very little ones which happens because those that are first knotted and fastned to the Tree take away all their nourishment from their Neighbours which did but blossom when the first had acquir'd ground and bigness and sometimes Twins are not of an equal bigness which happens as the one or other hath more strength to draw to it in greater abundance the best part of the common nourishment Now I am not willing to say that there is never any superfetation but I say that it happens very rarely for of an hundred Women that have Twins ninety have but one burthen common to both which is a very certain sign they had no superfetation and much more certain then the observations taken from the greatness or strength of the Child which is but conjectural And thus have I given you Mrs. my full sentiments concerning this so much disputed and intricate matter Now I pray you proceed to the other distempers accompanying Women before Child-Birth Mid. That I shall Sir and the next shall be concerning their vomitings SECT III. Of Vomitings of Women with Child Mid. VOmitting with suppression of the Terms are for the most part the first accident and the means by which they perceive they have conceived 'T is not always caused from ill humors in the stomach because of the stopping of the courses for these corrupted humors cause rather a depraved appetite then this vomiting which happens immediately after Conception and comes by succession but these first vomitings proceed from the Sympathy between the stomach and the Womb because of the likeness of their substance and by means of the Nerves inserted in the upper Orifice of the Stomach which have communication by continuity with those that pass to the Womb being portions of the 6th pair of those of the brain Now the Womb being a very sensible part beginning to grow bigger feels some pain which being communicated by this continuity of Nerves to the upper Orifice of the Stomach causes these loathings and vomitings And to prove that it is thus and not by the pretended ill humors it appears in that many Women begin to vomit from the first day of their being with Child who were in perfect health before they conceived which the suppression of the Courses could not cause Now loathing or nauseousness is a desire to vomit and a motion by which the stomach is drawn towards its upper orifice without casting up any thing and vomiting is a more violent motion by which is cast forth of the mouth whatsoever is contained in it At first vomiting is but a single symptome not to be feared but continuing long it weakens the Stomach very much and hindring digestion corrupts the food in lieu of concocting it whence succeed ill humors which require purging These vomitings commonly continue till the 3d or 4th month of being with Child which is the time the Child appears manifestly to be quick then they begin to cease and Women recover the appetite they had lost because the Infant in growing hath need of more nourishment and so consumes those humors which flew to the Stomach and besides the Womb is then accustomed to its extension these continue in some till they are delivered which often endangers miscarriages and the rather the nearer they are to their full time and others are tormented more towards the end of their reckoning then at first because then the Stomach cannot be widened enough easily to contain the food being pressed by the bigness of the Womb such a vomiting to Women whose Children lye high seldom ceases before they are deliver'd Be not troubled at vomitings in the beginning if they be gentle without straining for they are beneficial but if they continue longer then the 3d or 4th month they are to be remedied because for want of nourishment the Mother and Child will both grow weak and the continued subversion of the Stomach causing great motion of the belly will force the Child before its time Now to hinder this vomiting from afflicting the Woman long for 't is very hard to stop it quite let her use good dyet but little at a time that she may keep it without pain and not be forced to vomit it and to strengthen it let her eat it
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-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
cur'd of this bearing down after she 's layd than before for then the Cords will be easier strengthen'd and she may then use pessaries which she cannot so well with Child The help for this from any cause is to keep her Bed or swaith her and if she have difficulty in urining help her self by lifting up her belly with both hands but if humors cause this let her keep a drying dyet as Rost-meat c. and refrain Copulation streight lacing and above all when in Labor take care that neither by throws nor birth of the Child nor violent drawing the burthen that she get not a falling out of the Womb instead of a bearing down or weight which is soon done if the method taught in the birth of a Child when its Head thrusts the Neck of the Womb forth before it be not well observed SECT XIII Of the Dropsie of the Womb c. THese waters are either bred in the Womb or brought thither from some other parts as in the Dropsie of the belly it passes by traâ—sudation through the porous substance of the Skins of the Womb and these have deceived the Midwifes as well as patients who having along time hoped and been made to hope for a Child at length find nothing but waters whereof some have voided a pailful of which are many relations by Physitians and Chirurgeons These are bred i' th Womb when 't is too cold or weakned by a violent Labor before or from suppression of filthy humors When these are sent to the Womb from other parts they are never wrapt in a particular skin but retain'd only by its exact closure and flow away as soon as it begins to open but when bred in the Womb which is for the most part after Copulation if the seed be too cold waterish or corrupt they are then sometimes contained within the Skin which hinder the patients from a speedy discharge of them She going with it almost as long as with a Child and this is it perswades them they are with Child But 't is easie to avoid being deceiv'd if you take notice of the Signs of a true Conception for in a Dropsie her brests are fallen have no Milk nor finds her self quicken at the usual time but a bubling of moved waters a greater weight in her Belly and more equal the Womb Hips Thighs and Legs swell and worse Colour in her Face and as it may come alone so it may accompany a true Conception the waters being contained in the Womb without the Childs Skin Some have voided 3 or 4 quarts above 2 months before they were brought to Bed and then they are contained in the Womb without the Skins or else the Child would be forc'd to be born presently after they are voided The best Remedy is to wait patiently the time of delivery observing a dry dyet but if 't is only contained in the Womb use diuretics and endeavour to procure her Courses and to destroy by purges the cause of the Generation of such superfluities of which the Womb is so full sometimes that it dischargeth some on the outward parts and chiefly the nearest as the Lips of the Privities which are so swell'd that they are quite blown up and in some are so big that they can't close their Thighs and hinders walking now because this may be inconvenient to her during Labor it will be requisite to remedy it before which must be done by a Lancet all along the Lips then applying compresses dipt in astringent wine Leeches though less painful are not so proper because their small Orifices close again as soon as remov'd but the other may be made as big or little as one will and kept open by ointment as long as is fit SECT XIV Of Abortion and its causes WHen a Woman Sir i' th beginning casts forth what she had retain'd by Conception 't is an Effiuxion of the Seed if a false Conception 't is an Expulsion but when the infant's form'd and begins to live if it come before time ordain'd by Nature 't is an Abortion and we say in general that every sharp Disease easily causes it in particular all the accidents before mentioned as also a great noise as Cannon of Thunder claps watching fasting stinks c. if she Miscarries without any of these accidents Hippocrates says any Woman indifferently corpulent miscarrying the 2d or 3d month without manifest cause 't is because the inward closers of the Womb's Vessels are full of viscous filth whereby they cant retain the weight of the fetus which is loosned from it to this are Phlegmatic Women Subject and who have the whites much which make the Womb slippery and loose Likewise the passions of the mind cause great hurt chiefly Choler but above all sudden fear There are other causes which may be said to proceed from the Infant as when its monstrous or hath an unnatural Situation If we find one or more of the said accidents and she hath a great heaviness in her belly falling like a ball on that side she turns and there comes stinking humors from her 't is a sign she will miscarry of a dead Child Now she is in more danger of her Life when she miscarries then at full time and in danger of miscarrying always if she miscarry at first because of the violent motion caused by frequent Copulation but they may preserve their fruit when their love is a little moderated We have taught before to prevent each accident Who are subject to Abortion must rest or keep in Bed refrein Copulation 〈◊〉 soon as she thinks she 's with Child avoiding diuretics and openers and be loose drest wear low-heel'd Shoos with broad Soals Her rest must be 5 or 6 or 9 or 15 days during which time may be applied to her belly compresses steep'd in Aromatic and Astringent Wine Some Midwifes giving Crimson silk minc'd small in the yelk of an Egg or Scarlet grains and Treddles of several Eggs put into a yelk is superstitious as if entring the Stomach it were able to fortifie the Womb and Child and keep it there PART III. Of Diseases and Symptoms happening to Women after Child-birth SECT I. Of Remedies for the Brests and lower parts of the Belly of Women newly delivered and how to draw back the Milk Mid. AS soon Sir as the Woman is deliver'd and burthen come away I see that a fludding follow not its loosening if not apply presently a soft closure 5 or 6 double to the Womb that done carry her to Bed removing all foul Linnen a little raising her Head and Body putting down her Legs and Thighs with a small pillow if she will under her hands lying on her back Then the best thing under the Sun to give her is a good broth and so leave her to sleep waking apply this pultis over the bottom of her Belly and Privities take 2 ounces of Oil of Sweet Almonds 2 or 3 new laid Eggs stir them together in a pipkin over hot Embers
which the motions of all the senses by reason of the vital spirit are justly made After the nerves from the brain also is formed the pith of the back-bone not of an unlike nature from the brain so that it scarce can be called marrow because it hath no likeness to marrow either by sight or in substance for the marrow is a kind of superfluous aliment arising from the blood of the members appointed to moisten and make the bones of the body grow but the brain and pith of the back have their original from the seed not deputed for the nourishment and growth of the other members but that by themselves they might make private parts of the body for the use and motion of the Senses that from thence all the other nerves may take their rise For from the pith of the back many nerves arise from which the body hath sense and motion as may appear by the difference betwixt the vital and animal faculties as hath been before hinted Moreover here it is to be observed that from the seed it self gristles bones coats of the veins of the Liver and of the arteries of the heart the brain with the Nerves and again the tunicles and as well other pannicles or membranes as those that wrap up the infant are generated but from the proper blood of the infant is the flesh it self ingendred and all those parts that are of a fleshy substance as the Heart the Liver and Lungs And then at length all these grow together by the menstruous blood attracted by the small veins of the Navil which are observed to be directed with their orifices into the Womb. All which are distinctly made by the eighteenth day of the first month from the very conception at which time it may be called seed but afterwards it becometh to be and is called a child which the Ancients have comprehended in these two verses Six daies in milk thrice three the seed's in blood Twice six makes flesh thrice six makes members good The lesser figure denotes the Nerves derived frō the Back and dispersed through the whole The explanation of the larger figure see in the following page FF Sheweth a young one of 18 daies though some hold it but 14 dayes in which all the members may be discerned apart GG The four Umbilical Vessels meeting in one HH How the Umbilical Vessels become thick by degrees that that doubt amongst some may be resolved whether they spring from the Womb or no. III Sheweth how the Umbilical veins and arteries are spread throughout the Chorion by infinite branches KKK Sheweth the membrane called Amnios in which sweat and urine are gathered together in which the Infant swimmeth and sits as safe as in a Bath SECT II. Of the signs of Conception and whether the Child thrive in the Womb. DR Good Mrs. Eutrapelia vouchsafe me your observations about Conceptions and let me understand what are the signs of Conception in general and what signs distinguish the Sexes Mid. Although Sir 't is hard to know whether a woman hath conceived yea or no yet it may be conjectured by many experienced Arguments as for instance First it is thought a credible sign of Conception if a woman either the tenth day after coition or sooner perceive not by reason of any humors any of her terms be they whites or reds And though the stopping of those be accounted for a sign yet that fails often because it may be as well before conception as after But waving this let us find out other marks and prognosticks of a true conception gathered from the state and condition of the woman her self being seriously examined from head to foot Secondly pains and giddiness in the head and a mist over the sight if they meet together these portend conception Thirdly the apples of the Eyes are lessened the Eyes swell and become swarthy the veins of the Eyes grow red and are full with blood the Eyes sink the Eye-lids are remiss divers colors are seen in the Eyes and are observed in a looking-glass the veins betwixt the Eyes and the Nose are swoln with blood and are seen clearer the veins under the Tongue are somewhat greenish Fourthly the chest is warm and the back cold Fifthly the Veins and Arteries are swoln and the pulse easier the veins in the breast are first black then either yellow or blew Sixthly The breasts grow big and hard with pain the nipple grows red if she drinketh that which is cold she feels cold in her breast Seventhly there is a great loathing of meat and drink and destruction of the natural appetite with longings after various meats with an absurd appetite a continual vomiting and weakness of stomach sower belching loathing of wine an inordinate pulsation of the heart sudden joy and after that as sudden grief pains about the navil heaviness about the loins swelling towards the bottom of the belly inward pricking in the body chilness of the outward parts after coition retention of the seed seven daies after copulation about the beginning of conception a shooting pain about the back and belly The courses are stop'd for those veins from which they flow carry the blood through certain holes that are at the end of them for the nourishment of the infant by the navil and part of it is conveyed upwards into the breasts and there is prepared for milk Eightly the thighs swell with pain but the body is weaker and the face pale Ninthly the belly is costive by reason of the compressure of the intestines The urine is white with a cold swimming at the top wherein are to be seen many atomes like those observable in the beams of the sun but when in the first Month many of these sink to to the bottom the vessel in which it is being shaken it seems to be drawn out like to wooll In the later months the urine is redrish or yellow it becomes blackish with a red cloud at the top I will here-with relate to you two experiments by which it may be known whether or no a woman hath conceived And the first is this Stop up a womans urine three daies in an urinal at the end of which strain it or rather drop it through fine linnen and if she hath conceived you shall see little creatures like to lice if these be red 't is a token of a male but if white they say portend a female If a womans urine be put in a brass Bason and stand there one night if you put into it a bright needle if she hath conceived that needle will be bespeckled with red spots but if otherwise it will be rusty all over The Signs whereby most pretend to know whether Male or Female be conceived being altogether Falacious and Ridiculous I have wholly omitted Dr. Since you have given such signs of Conception let me know by what signs you apprehend the Infant to be well and thrive in the Womb or not Mid. I shall Sir And first if it be
to explain this more clearly consider the Infant is naturally seated in the Womb with Head uppermost and the Feet downwards with its Face towards the Mothers belly just till it hath attained the 8th Month at which time and sometimes sooner and sometimes later its head being very great and heavy it turns over its Head downward and its heels upward which is the sole and true posture in which it ought to come into the World Now just when the Child is about to turn according to custome into its intended posture instead of giving her self rest she fall a jumping walking running up and down staires and exercising her self more then ordinary which very often causes it to turn cross and not right as it ought to be and sometimes the Womb is depressed to low and engaged in such sort towards the last Month in cavity of the flanks by those joltings that there is no liberty left the Infant to turn it self naturally wherefore it is constrained to come in its first posture to wit by the Feet or some other worser moreover it would be very convenient that the Woman should abstain from having to do with a Man carnally during the 2 last months of her reckoning forasmuch as the body is thereby much moved and the belly pressed in the action which likewise causeth the Child to take a wrong posture Now I believe that those that will seriously reflect and confider of these things will be ready to quit this their old error which hath certainly caused the death of many Women and Children and much pain to divers others Thirdly let her beware of sharp and cold winds of excessive heat anger troubles of the mind affrights and terrors over-much venery and of intemperancy of eating and drinking Fourthly let her diet be frugal and moderate abstaining from gross meats hard of digestion let her eat Eggs Chickens Land-fowl birds of the Mountains c. variety of broths grewels panadoes Mutton Veal Lamb Kid Rabbets she may use in her meats Nutmeg and Cinnamon she may drink wine moderately Fifthly in the first four Months let her open no vein use no cupping or scarrifications fontanells nor use any pills or other Physick without the advice of a prudent Physitian for in these Months the ligaments of the Child are very tender soft and feeble and therefore the easier destroyed and the nourishment kept from it Sixthly if it shall happen that the Woman be too costive by which many miscarry let her boyl Spinage and Lettuce in Veal broth well buttered with salt or wine which if they will not move the belly let her use suppositories with honey and salt or of Castile-soap and if these common things will not do let her advise with an expert Physitian Seventhly if it happen that she conceive with grievous symptoms and after conception is troubled with faintings let her take this Cordial following Take of Sorrel-water and red-Rose-water of each one ounce of Cinamon-water one ounce of Manus Christi pearled half an ounce or as much Diamargariton this may be taken as need requires Eighthly if she fear that she may come before her time as in the seventh Month or some other unseasonable time and feels throws as of Child-bearing let her sit over a fume of Frankincense for that contributes no small strength both to the Womb and to the Infant also Ninthly if she nauseate her meat she may use a plaister of Mastich to her Stomach and take this following Cordial every morning fasting to strengthen her Stomach Take Syrup of Pomegranates one ounce and half of Mosch and Ambergreece of each two grains of Lignum Aloes finely powdered one scruple of Cinamon half a scruple the water of Sorrel three ounces let these be mingled and drank off blood-warm Lastly if whilst she go with Child she perceive her terms let her eat milk made boyl with red-hot steel and in that let Plantain and Comfrey be boyled But in all these cases let her advise with learned Physitians which will direct her with medicines from time to time I shall hereafter treat of some distempers incident to Child-bed and leave you some choice Remedies in the following Sections and then wind up all SECT VI. A Dialogue between the Midwife and the Doctor concerning Midwifes and the delivery of Women in Child-birth MId A good morning to you good Mr. Dr. Sir I am come according to my promise to give you an account of the event of the directions you was pleased to give me last Night concerning Mrs. Styles the which indeed Sir have succeeded marveilous prosperously and she now thinks her self in Paradise to what she was before and hath sent you Sir a small gratuity according to her ability in acknowledgment of the great benefit she hath received by your Counsel And for my own part Sir I so well approve of your last Nights discourse that I must humbly entreat you that you would be pleased to afford me your Instructions in the safe performance of my Art Dr. Very willingly good Mrs. and truly your name bespeaks you a fit Woman for your Employ as being a well bred Woman therefore I shall in the first place take occasion to tell you what kind of person a Midwife ought to be and that in the subsequent description The best Midwife is she that is ingenious knowing letters and having a good memory is studious neat and cleanly over the whole body healthful strong and laborious and well instructed in Womens conditions not soon angry nor turbulent or hasty unsober unchaste but pleasant quiet prudent not covetous but like the Hebrew Midwives such as fear God that God may deal with them and that people may multiply and increase after their hands and that the Lord may build them Houses By this description I tell you only how the best Midwife must be qualified now let me hear somewhat of your skill that I may the better judge thereof First then let me know how Women are delivered A Naturall Birth As to the washing of the Child and swathing I need not give you any account I suppose you take it for granted that most women understand that I only here shew you the shape of the stool I use which I hope you will not disapprove of though few Midwives have them or use them B. the Back of the Stoole oooo the feete aa rests for the hands rr the ring in shape like the Moone cccc the Cloth round the ring to keepe out the Aire etc AA Shews the parts of the Chorion dissected and removed from their proper place B a Portion of the Membrane Amnios CC The Membrane of the Womb dissected DD The placenta Vteri or hepar uterinum being a fleshy substance full of many Vessels by which the Infant receives its nourishment E The varication of the Vessels which makes up the Navil string FF The Navil string by which the Vmbilick vessels are carried from the placenta to the Navil GG The Infant as it lies perfect
most part there is but one yet sometimes there are more whereof some cleave very strongly to the Womb others very slightly if women miscarry of them before the 2d Month as I said before they are call'd false Conceptions and when they keep them longer and that this strange body begins to grow bigger then they are called Moles and here you must know that your false Conceptions are more Membranous and sometimes full of corrupted Seed but your Moles are altogether fleshy they cleave to the Womb almost always and are sustained by the blood with which it is always furnished just as plants are by the moisture of the Earth Sometimes there is a Child together with a Mole from which it is sometimes divided and sometimes cleaving to its body which puts it in great danger of being Monstrous or mishaken because of the Compression which this strange body causeth to the little Infant as yet being but very tender Thus having at large given you my Opinion concerning Moles and false Conceptions their causes signs and differences there remains now nothing more concerning this matter to be demonstrated but the manner how they ought to be drawn forth of the Womb. And now seeing that these things contained in the Womb are wholly unnatural their expulsion must be procured as soon as possible may be the which is very difficult to be performed when these strange Bodies cleave so fast to the Womb and especially the Mole therefore to avoid the abundance of accidents and inconveniences as near as may be that these unnatural things will produce they must be endeavoured to be expell'd as soon as may be and for the Mola you must before you come to the Manual Operation try if by any means you can to cause the Woman to expel it of her self to the which purpose you are to administer to her strong and sharp clysters to stir up throws for to open the Womb to give way to it moistning also and loosening the Womb with softening Oyntments Oyls and Grease not omitting bleeding in the foot if there be occasion Now the Mole will certainly be excluded by these means provided it be but of an indifferent bigness or that it cleave but very little or not at all to the Womb but if it shalâ— stick strongly to the bottom of the Womb or that it be very big the Womam wilâ— hardly be rid of it without the help of a Physitian Chyrurgions or Midwifes hand iâ— which case after that you have placed thâ— Woman conveniently as if you were to fetcâ— a dead Child then slide up your hand into the Womb and therewith draw forth the Mole but if it be so big that it cannot be brought forth whole then 't is wholly the man's work who for this purpose use your crotchet or knife but this is very rare because it is of a tender soft substance much more plyable then a Child's but if you find it be only joyned to the Womb and close fasten'd you must separate it gently with your fingers ends your Nails being paired by putting them by little and little between the Mole and the Womb beginning on that side where it doth not stick so fast to the Womb and so pursuing it until it be quite loosened being mighty careful if you find it grow to too fast of rending or bursting the proper substance of the Womb and proceeding as hereafter I shall speak of for the extraction of a Burthen staying behind in the Womb when the string is broken off For these same Moles never have any string fastened to them nor any burthen from whence they should receive their nourishment but they do of themselves immediately draw their nourishment from the Vessels of the Womb to which they are almost allways joined and sticking in some place and as for the substance of their flesh 't is also much more hard then that of the burthen and sometimes Schyrrhous which is the cause why it is difficult to be separated from the Womb. As to a false Conception although it be much less then a Mole yet it often puts a woman in hazard of her Life by reason of great fluddings which very often happens when the Womb would discharge it self of it and endeavours to expel it the which seldom cease till it be come away because it doth continually endeavour to exclude it whereby the blood is excited to flow away and in a manner squeesed out of the open Vessels Now the safest and best way and remedy for a Woman in this case is to fetch away the false Conception as soon as may be because the Womb can very hardly avoid it of its own nature without artificial help for it being very small the Womans impulse in bearing downwards cannot be so effectual when the Womb is but little distended by so small a body as when it contains a considerable bulk in it for then it is the more strongly compressed with the throws Many times 't is very difficult to fetch away these false Conceptions because the Womb doth not open and dilate it self ordinarily beyond the proportion of what it contains and that being but very little so is its opening which is the reason why the Midwife is sometimes so far from introducing her whole hand that she can scarce get in a few Fingers with which she will be obliged to finish the Operation as well as she may or can by proceeding in the following manner when she hath introduced them Having then very well anointed her hand she must slide up the neck of the Womb into the inward Orifice the which she will find sometimes to be but very little dilated and then very gently put in one of her Fingers the which she must presently turn and bend on every side until that she hath made way for a second and afterwards for a 3d or more if it may be done without violence but many times she hath enough to get in but 2 between which she must take hold of the false Conception as Crabs do with their claws when they fasten upon any thing and then she must gently draw it forth as also the clodded blood which she there shall find and then afterwards undoubtledly the fludding will cease if no part of the Conception be left behind but if the inward Orifice cannot be more dilated then to admit of one Finger and that the fludding is so violent as to endanger the Womans life then is matter and manner to be wholly committed to care and artful industry of the skilful Physitian or Chirurgeon Mid. Now Sir having discoursed so learnedly of these things let us in the next place if you please discourse of the Afterbith SECT XXXIV Of the Secundine or Afterburden and the best and safest way to draw it forth DR Come then Mrs. if you please tell me what the Secundine is Mid. The Secundine is that in which the Infant lyeth in the Womb and may be called a second house or covering made by the
with juice of Oranges or Lemons Verjuice or rose vinegar or eat after Meals a little Marmelade of Quinces and she must forbear fat meat and sauces for they soften the Skins of the Stomach which are weak and loose by vomitings and also sweet sauces But if for all this that it continues although the Woman be above half gone 't is a clear sign there are cleave corrupt humors to the inward sides of the Stomach which must be purged by stool to effect which give half a dram of Rhubard a dram or two at most of Sena infuss'd in posset-Ale to which streined add an ounce of Syrup of Succory which dissolves the humors and in voiding them comforts the parts or you may give her Cassia and Tamarinds always adding a little Rhubarb or syrup of Succory compound If once be not enough repeat it some few days respite between If it continues for all this you must rest here lest some worse thing happen for she is then in great danger of miscarrying and if the Hiccoup takes them from too much emptiness by vomiting and purging 't is very bad as Hippocrates Prince and oracle of Physick teacheth us As for great Cupping-glasses which some advice to be applied to the Stomach to keep it in its place I believe it 's a chip in Potage because the Stomach is loose and no way cleaving to this upper part of the Belly But since these vomitings cool and weaken it I should advise them to wear a piece of Scarlet or Flannel or Lamb-skin which would help digestion SECT IV. Of the pains of the Back Loins Reins and Hips ALL these Accidents are but the effects of the widening of the Womb and the compression it makes on the Neighboring parts by its weight These are greater the first time she is with Child for afterwards the Womb only receives the same dimensions it had before and the cords which hold it in its natural place as well round as large suffer a greater stress being much drawn and streightned by the bigness and weight of the Womb to wit the large ones those of the Back and Loins which answer to the Reins because these two strings are strongly fast'ned towards these parts and the round ones cause those of the Groins Share and Thighs where they end These are sometimes so much stretch'd by this weight and higness of the Womb that they are torn chiefly if the Woman chance to have a false step which causes very great pains and other worse accidents as it happened to a certain Woman being six months gone of her first Child who felt the like after she had stumbled and perceived at the same time something crack towards her Reins and Loins which was one of the large cords made a noise by the suddain jolt she receiv'd at the same instant she felt extream pains in her Reins and Loins and all one side of her belly which caused her immediately to vomit very often with much violence and the next day was taken with a great continued Feaver which lasted seven or eight days without being able to sleep or rest one hour all that time she vomited all she took with a strong and frequent Hiccoup and great pains which seem'd as if they would hasten her Labor which I was very apprehensive of as also of her death but by the help of God causing her immediately to be put to Bed where she rested 12 whole days she was thrice let blood in her Arm on several days and took a grain of Laudanum at twice in the yelk of an Egg a little to ease her violent pains by giving her rest taking also from time to time good strengthening Cordials so that all these Symptoms which at first seemed desperate ceased by little and little and she went out her full time and then was happily delivered of a Son which lived 15 months notwithstanding all those mischievours accidents befel her which were enough to have kil'd half a dozen others but God sometimes is pleased to work Miracles by nature assisted with remedies fit for the purpose as well as by his Grace And also the Womb causeth the pains of the Hips by its weight in bearing too much upon them And assure your selves there is nothing will ease all these pains better then to rest in Bed and bleed i' th Arm if there be any great extension or breaking of any cord of the Womb as was in this case and when the Womb bears too much upon the Hips if she cannot keep her Bed she must support her Belly with a broad swaith SECT V. Of the pains of the Breasts AS soon as a Woman conceives her monthly blood wanting ordinary evatuation and she daily breeding blood there is a necessity she consuming but little whilst first with Child that the Vessels being too full should discharge part as it doth upon the parts dispos'd to receive it such as the kernelly parts especially the Breasts which suck up a great quantity of it which swelling them causes this pain which she feels and happens also to those whose Terms are only stop'd To ease her we ought in the beginning to leave it to Nature the chief Physitian and she must only have a care she receive no blows thereon nor be streight laced but after the third or fourth month the blood being still sent to the Breasts in great store 't is much better to evacuate it by bleeding in the Arm then to turn it back upon some other part by repercussive or binding Medicines because it cannot flow to any part where it can do less hurt than these and to shun the accident oâ— which Hippocrates speaks in his 40th Aphorism of the 5th book If Blood be carried in too great abundance to the Breasts it shews thâ— Woman is in danger of being Frantick because of the transport which may be madâ— thence of the brain whcih is voided by moderate bleeding i' th Arm and a regular cooling dyet moderately nourishing SECT VI. Of involuntary voiding and stoping of Urine THE seat of the Bladder which is just upon the Womb is sufficient to instruct us why Women with Child are sometimes troubled with difficulty of Urine and why often they cannot hold their water which is caused 2 ways 1. because the Womb by its bigness and weight presses the bladder so that 't is hindred from its ordinary extension and so incapable of containing a reasonable quantity of Urine which is the cause the bigger she grows and the nearer her time the oftner she's compelled to make water 2. if the weighty burthen of the Womb doth very much press the bottom of the bladder it forceth the Woman to make water every moment but if the neck of it be pressed it is fil'd full with Urine being not able to expel it because the Sphincter Muscle in this compression cannot be opened to let it out which causes great pain Sometimes by its sharpness stirs up the bladder often by pricking it to discharge it self and
sometimes by its heat it makes an inflammation in the neck of the bladder which causes its stopping and if it be from a stone in the bladder 't is more in supportable and dangerous to a Woman with Child then one that is not because the Womb by its swelling causeth the stone perpetually to press against the bladder and the pains are violenter if it be greater or of an unequal or sharp shape 'T is of great moment to hinder these violent endeavors to make water and to remedy them if possible in all indispositions because by long continuance of forcing downwards to make water the Womb is loosened and bears down and is sometimes forced to discharge its self of its burthen before its time which we must endeavour to hinder having respect to its different causes as when it comes from the weight of the Womb pressing the bladder as for the most part now she may remedy it if with both her hands when she would make water she lift up the bottom of her belly or wear a large swath or keep her bed If it be sharpness of Urine that makes an inflammation i' th neck o th' bladder appease it by a cooling dyet forbearing strong drinks using emulsions made of the 4 cold seeds or whey with syrup of Violets use not purging because its heat augments the inflammation these are proper to cleanse the Urinary passages without either prejuding Mother or Child taken Morning and Evening If all this prevail not let her blood a little i' th Arm and bath the outward entry of the neck of the bladder with a decoction of Mallows Marsh-mallows Pellitory and Violets with a little Linfeed and inject some of the same into the bladder to which you may add Hony of Violets or luke warm Milk abstaining from all diuretics for fear they provoke Abortion And when all fails she must send for a Physitian or Chyrurgeon to make use of his Catheter And also if it arise from the stone in the neck of the bladder they may thrust it back with it but if small draw it forth for a great one cannot be drawn forth before she be delivered being better to leave her so then endanger her life or the Childs SECT VII Of a Cough and difficult breathing THey whose Infants lye low are more troubled with difficulty of Urine then they whose lye higher who are free from that and the like distemper but are more subject to a Cough and difficult breathing If a Cough be violent to vomiting 't is one of the chiefest things which cause Abortion because 't is an essay whereby the Lungs endeavour to cast forth of the Breast that which offends them by a compression of all its Muscles which pressing all the inclosed air inwards wherewith the Lungs are much stretched thrusts also downwards by the same means the midriff and consequently all the parts of the lower belly but particularly the Womb which continuing long and violent often causeth Abortion Sometimes it proceeds from sharp rheums which distil from the brain upon the Artery and Lungs and sometimes from such blood which flows towards the Breast upon stopping the Terms also from too cold air breathing which stirs up the parts to motion but being begun by these causes 't is often augmented by the compression the Womb makes upon the Midriff which cannot have its liberty in those that bear their Children high because by its great extension it bears up almost all the parts of the lower belly towards the Breast and chiefly the Stomach and Liver forcing them against the Midriff You must remedy this by keeping good dyet somewhat cooling if from sharp humors avoiding all Salt and Spice meats Oranges Lemons Vinegar c. but she may use juice of Liquorice Sugar-candy syrup of Violets or Mulberries which she may mix with a Ptysan made with Jujubs Sebestens French Barley and a little Liquorice and it may not be amiss to divert and draw down these humors by a gentle Clyster If these prevail not and there appears signs of fulness of blood bleed her in the Arm at what time soever of going with Child and though it be not usually practis'd when they are young with Child yet here it must for a continual Cough is much more dangerous then a moderate bleeding If it come of cold keep in a close Room with a napkin doubled about her Neck or a Lamb-Skin and going to bed take 3 or 4 spoonfuls of this syrup of burnt wine following which is very Pectoral and causeth good digestion Take half a pint of French wine 2 drams of Cinnamon bruised half a dozen cloves 4 ounces of white Sugar or Sugar-candy put them together in a Porrenger and boil them upon a Chaffing dish of Coals burn it and then boil it to the consistence of a Syrup You must not from whatever cause it proceeds that she must go loose in her cloaths and because sleep is proper to stay fluxions it may be procured by the Physitian using no strong stupefactives of opium which are dangerous if there be not very great necessity as in the patient mentioned in the Section of the pain of Back Loins Reins and Hips Some Women carry their first Child chiefly so high because the cords which support the Womb are not stretch'd that they think them to be in their Breasts which causes a difficult breathing as soon as they have eaten a little walked or gone up the stairs so that they fear they shall be choaked which comes from the Wombs being enlarged and pressing the Stomach and the Liver which forces the Midriff upward leaving it no room to be moved sometimes their Lungs are so full of blood driven thither from all parts that it hardly leaves passage for the air if so they will breath more easily as soon as a little blood is taken from the Arm but if it comes from a compression made by the womb against the Midriff the best remedy is to wear her clothes loose and eat little and often eating no windy meats as pease and avoiding all grief and fear because they drive the blood to the Heart and Lungs in too great quantity so that she having her Breast already stuffed and hardly breathing will be in danger of being choak'd for the abundance of blood filling the Ventricles of the Heart above measure and at once hinders its motion without which she cannot live SECT VIII Of the swelling and pains of the Thighs and Legs MAny think which is in part true that the Woman having more blood then the Infant needs to nourish it nature by virtue of the expulsive faculty of the upper parts which are always strongest drives the superfluity upon the lower as the Legs c. as most feeble and apt to receive it and so are caused their swelling and pain and sometimes red spots from the swelling of the Veins along the inside which extreamly hinders her going but the doctrine of the circulation of the blood invented by our
Country-man the immortal Dr. Harvey the English Hippocrates will teach us better how this comes then that we need have have recourse to this expulsive faculty but because 't is fitter for Physitians and Chyrurgeons that are learned in Anatomy then Midwifes being they may help them without such curious knowledge I shall omit it and if you would be satisfied see what the learned and expert French Chirurgeon Moricean hath written on this Subject 't is put into English by Dr. Chamberlain Now to remedy these let her only use a palliative cure in swathing the parts with a rowler 3 or 4 fingers broad beginning at the bottom and she should most keep her bed if she can and if there be signs of abundance of blood in other parts she may bleed without danger Some Womens Legs swell only from weakness and are so Flegmatick that when you press them with your finger the print remains because they want Natural heat sufficient to concoct all the nourishment sent to them and expel its superfluities which remaining makes them so Hydropical To resolve these swellings make a Lee made with the ashes of Vines or other wood ashes and Melilote Camomil and Lavender boild in it if that do not foment them with this Take Rosemary Bays Time Merjoram Sage and Lavender of each a handful Province Roses half a handful Pomgranat flowers and Alum each an ounce boil them in 3 pints of strong red wine to the wasting of a 3d part and use it But these swellings commonly cease when she brought to Bed because she purgeth the superfluity of her whole habit by her Lochia SECT IX Of the Hemorrhoids THese are swellings and painful Inflammations caused by a flux of humors upon the extremities of the Hemorrhoid veins and Arteries caused by a bundance of blood cast upon these parts because the body is not purged as before and sometimes by endeavors they have to go to stool when costive If they be small and without pain either inward or outward 't is easie to prevent their farther growth by remedies which hinder and turn the flux from those parts but the great ones are cured by first easing the pain so that if she have other signs of fulness in the rest of her body she may safely be once let blood i' th Arm and if great necessity twice if she be costive let her take a Clyster of Violets Mallows Marsh-mallows and hony of Violets with some fresh Butter or Oil of Almonds adding no sharp thing especially in inward Piles after let her keep a moderate and cooling dyet and rest in her Bed if she may till the flux be past in that while anointing them with strokings from the Cow and foment them with the decoction of her Clyster adding some Linseed your Oil of sweet Almonds Oil of Poppies and Oil of water Lillies well beaten together with the yelk of an Egg in a leaden morter are very good to ease pain and if that Inflammation be great anoint a little with Vnguentum refrigerens Galeni or anguentum album populeon equally mixed After all this if the swelling abates not apply Leeches or if soft or any kind of inundation use a Lancet but Leeches are properer for hard Piles because they pain not so much Women are not here eased by Piles as Men are because 't is contrary to nature for this evacuation ought always to be made by the Womb if not with Child but if she be it may in some measure if full of blood supply the natural if they bleed moderately and without pain she may be eased but if they flow too much there 's danger of both Mother and Child being weakned to avoid which make binding fomentations with the decoction of Pomgranate flowers and Vines and Province Roses made in Smiths water and a little Allum or this pultis made of Bole-Armenac Dragons-blood and sealed earth with the white of an Egg and to turn the blood by bleeding i' th Arm and Cupping-Glasses to the Reins c. as you may consult the Physitian SECT X. Of the several Fluxes happening to Women with Child SHE is Subject to three sorts of Fluxes the Flux of the Belly of the Terms and Fludings Of the Belly are three kinds the first Lienteria when the Stomach and Guts not digesting the nourishments received let it pass away raw 2. Diarrhea when they simply discharge the humours and excrements which they contain The 3d and worst is a Dysenteria when with the humors and excrements she voids blood with violent pains caus'd by an ulceration of the Guts Any of these if they continue long put her in great danger of Aborting if the first the Stomach letting the food pass before it be turned into juice whereof blood is made to nourish Mother and Child they must both be weakened if the 2d it will cause the same accident because of voiding the Spirits with the humors but most danger's i' th last because she hath then great pains and Gripes i' th Guts from their Ulcer which excites them continually by constant prickings to discharge themselves of the sharp humors which causes a violent motion of the Womb being plaâ—ed upon the right gut and to the Child and by the compression the Muscles of the belly make on all sides as also those that are made by them of the Midriff which force themselves downwards in the endeavors she makes with pain so often to go to stool the Child is constrained to come before its time and the oft'ner by how much the prickings are greater for according to Hippocrates Aphorism 27 book 7. If a tenasm happen to one with Child it makes her Miscarry Now this tenasm is a great passion of the right Gut which forceth it to make those violent endeavours to discharge it self without being able to avoid any thing but Cholerick humors mixt with blood by which 't is perpetually pricked This Flux happens to her commonly from a weak digestion of the Stomach because of her bad dyet which her strange appetite causes her often to long for by the constant use whereof at last being weakened it suffers the food to pass without digestion or if it stay longer 't is turn'd into a corrupt juice which descending into the Guts iritates them by its sharpness to discharge themselves as soon as they can To proceed safely in the cure of these Fluxes their nature must be consider'd that the cause that maintains them may be remov'd If it be a Lienteria following Vomitings as is usual which have so weakn'd the Stomach and loosn'd its Skins that haveing no longer strength to vomit up the food it suffers it to pass downward without digestion then she must refrain all irregular appetites and eat food of good digestion and little at a time she may drink a little deep Claret wine in which Iron hath been quenched if she have not a strong Feaver for in a small one wine is to be prefer'd because her Feaver is but
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
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
let it slip out of the mouth and cannot handsomely hold it so that the infant being frustrated of suck and yet still exercising suckling hurts the cheek and attracts some kind of humors thither which oftentimes become unnatural Tumors and oftentimes the cheeks of the infant seem as if they were moved out of their places Thirdly by the consent of all the Nurse must have a large breast though some think that not so material because there is more milk collected together in great breasts than ought and being there is corrupted to the prejudice of the Nurse Wherefore lest the milk should continue there too long it is best to have a young lusty child to suck it away or else to use it some other way as by the use of young whelps whom I have seen dye with sucking Womens milk surely the reason must be because the milk was of another nature or else because curdled and corrupted or milked out some other way especially when the Nurse perceives her self prejudiced by it But it is ever best that she abound rather than want Milk and then in this case it is best they be big though all Nurses need not have big breasts for there may be as much Milk if not more in a lesser breast than in a great one The next enquiry will be into the manners and behaviour of a Nurse The best Nurse then is she that is mild chaste sober courteous chearful lively neat cleanly and handy because bad conditions as well as good are suck'd in with the milk and so radicated that it is a hard matter to pull out the bad conditions and leave the good behind but that there will be a remainder of the bad conditions perhaps so long as they live wherefore let not the Nurse be of an angry malepert and saucy disposition shameless scolding or quarrelsome not gluttonous but so careful of her Nursery that she neither eat or drink that which may be hurtful to the Infant That she do nothing to anger her self to grieve or sad her self for such passions will presently distribute themselves to the prejudice of the Infant than which there is nothing of more efficacy to destroy the goodness of the Milk Neither is it sufficient that they abstain from the use of their husbands but when they have wanton thoughts and lascivious minds wholly upon Luxury and Venery they cast off all care of the Nurseries and dreaming at night of that which their minds run on in the day and by other filthy pollutions they infect the milk So also by the use of their Husbands the Courses are stirred up by which both the plenty and goodness of milk is derived another way and so the Child robbed of its nutriment or else the Nurse conceiveth with Child and so the Infant becometh diseased and Ricketty by sucking curdy and unwholsome milk and is worse for it during life Therefore let all those things be avoided that either do or are supposed to provoke lust as junkets made with spices also Onions Leeks Garlick and all salt meats are to be avoided Persly and Smallage some say have a peculiar malice to the increase of milk besides that it doth increase lust and is an enemy to the growth of Infants Again that Nurse were best that hath lately been brought to bed of a Boy if to Nurse a Boy the milk of such a Nurse being better tempered For the milk of a Male Child will make a Female Nursery more spritely and a man like Virago and the milk of a girl will make a boy the more effeminate As to the milk let it be a mean betwixt thick and thin which you may perceive by dropping it upon the Thumb-Nails for if it be too thin it will run off the sooner but if thicker it will stay the longer let it be sweet and pleasant both to the smell and taste not offending the palate with rancidness sourness sharpness or saltness or the nostrils with any strange quality Let it be candid to the sight in it self equal in each particles not infested with brown yellow green blue or any other evil colour or as sometimes with various colours and substance as with lines and streaks upon it but let that milk be most praise-worthy that makes as much curd as whey which may be tryed by this Experiment viz. Put some of this milk into a glass and puâ— in some Myrrh or Rennet which being stirred together will curd and then may the contents be separated the tryal is that iâ— there be most whey then is the milk thinneâ— in its substance but if most of curd 't is thicker yet all these may be corrected and amended for that which is too thick may be mended by an extenuating diet and the flegmatick matter may be avoided by a vomit of Oxymel and Exercise before meat the better to consume and attenuate the thickness of it The thinness of Milk is amended by contrary food such as doth incrassate it as Fromenty of Wheat and Rice Hogs-feet Calves-feet Trotters and sweet Wine unless somewhat else be in the way to hinder it Sometimes it happens that the Milk is more tart than it ought to be wherefore then all diligence must be had to feed upon such meats as are of the best juice till that acrimony at least be attempered Sometimes there is little or no milk in the breasts as after some sickness or notable distemper now turned into a bad habit or any other of what kind soever that possesseth those parts or is the cause but that shall not be our business to consider of now Now if these be not the causes let the Nurse use supping meats as Broths Possets c. and eat plentifully and use rubbings to her Breasts and Duggs exercising her hands and her Arms by domestick Employments or instead thereof let her dance the Child by which the aliment may be recalled into those parts Sometimes cupping-glasses to the Breasts with a fomentation of emollient herbs boiled in water and applied warm either with sponges or wollen-clothes after which chafe them with oyl of Lillies The seeds of Fennel and the roots of Parsnips boiled in Barley-water and buttered The broth of Hens or Capons with Cinnamon and Mace Or Poch'd-eggs with the seeds of Annis and Dill and all things else that are hot in the first and second degree are good Earth Worms not dung-hill ones six or seven of them dried and powdered and drank in Barley-water sugared for a fortnight together All these may be of good use in the defect of Milk As to the inconveniency if there be any in too much Milk If the Milk abound too much which sometimes is though seldome blamable Then use the decoction of Myrtleberries and red Roses and with clothes dipped in it lay them on the Breasts Or else clothes imbibed in Vinegar wherein Cummin-seeds bruised have been infused with Myrrh and Camphire By reason of the thickness of the Milk all those excrements that the Child
should send forth are intercepted as by Stool by Urine c. The passages for transpiration are stuffed up so that the progress of the aliment being stop'd of necessity the Milk must be vomited up after which will follow much flegmatick matter a sure argument of crudities Sometimes there will arise botches about the Body much matter and snot and quittor will come out of the Nose and cornerâ— of the Eyes and Eyelids and the appetitâ— will be lost Contrarily from the thinner and sharpeâ— sort of Milk the Belly is looser than iâ— ought being troubled with pinches anâ— gripes in the belly of the infant Also very angry pustules and whelks will arise about the body like the small Pox and the body groweth weak by little and little the Infant not caring for food for the strength of the appetite will be more remiss by reason of the sharpness of that which the Infant desires so that it is not much sensible of that aliment which it hath and that aliment of which it is sensible is naught and vicious Now as from the over-bundance of Milk the Infant oftentimes when it sucks is overwhelmed being so puffed up and the belly distended as if it would break until by much pissing or breaking wind it is slacker So where there is too much scarcity of milk there the Infant being altogether destitute of its nourishment will pine away and all the parts of the body being starved in those years when it most wants nourishment by reason of vehemency of the innate heat and that habit of body that the least blast will puff down which requires much and constant aliment By all which Women ought to be the more provident lest all these mischiefs happen especially not to make choice of such a Nurse whose poverty must needs starve her self and her Nursery and if they should so happen to amend them as hath been said before e're they grow incurable and require the help of another Artist that may cure it Or if the fault in the milk cannot be cured and amended in the Nurse which she hath contracted Then you have no more to do but presently to look for another Nurse that hath none of these inconveniencies that so the Infant may have suck enough which is all it requires for want of which you may hear sad crying and weeping And this may be discovered by their dreams as by the often motion of the lips in the cradle as if they were sucking when they are a sleep Neither is it strange that the Infant should be sensible of and Participate of whatsoever food as meat drink and Physick that the Nurse taketh which maketh Physitians purge the Nurse to cure the Child if a woman take any purging Physick she purgeth her Child also So Galen reports that of Goats feeding in Asia where Scammony grow did communicate a purging faculty to their milk And so the milk of Asses generally accounted best in Consumptions is counted better if the Asse be fed with such herbs as Maiden-hair c. And again when young Goats suck Sheeps-milk the rough hair shall lose its coursness and become like a fleece of wooll and so contrarily when Lambs are brought up by Goats their wooll groweth the more hairy If then the qualities of the milk pass into those that suck them as without doubt they do it is easie to gather that other impurities follow thither also neither is it improbable Surely then we ought to take no less care of the Nurse than of the Child as in her diet exercise physick c. since whatsoever conduceth to the benefit of the Nurse tends to the good and welfare of the Infant I have been the larger upon this Sir of Nurses and Milk because tender Infants can neither make choice of their Nurses themselves nor discover or plead for their wants Their own Mothers surely if they are able both by duty and nature being the most fit to Nurse their own Children which the greatest Ladies may do with the greatest conveniences by reason of their plenty of all things besides their attendance of servants who can bring their Nurseries to them at all hours be it by night or day and take it from them again not to disturb their rest which also they may tend at their own pleasures The longest time that a Child need be suckled is till it have teeth to chew with I shall leave only one caution for Nurses and and so wind up and 't is this Let Nurses ever milk out some Milk e're they suckle the Child and after it is suckled that they rock it not too much presently after lest violent rocking disturb the meat in the stomach or the other parts draw away the Milk in the stomach as yet unconcocted Dr. Thus far have you done very well good Mrs. Eutrapelia as in all other things so as to what concerns the Choice and office of Nurses and now if you please you shall hear a few of my observations about the same matter which it may be may not be unwelcome to you Then you must know that I have taken notice of 2 sorts of Nurses which I have observ'd in the World The one sort is such as are of an ill humor or blood the which settle in their Milk being the place at that time where they discharge themselves Now you must note that these sort of Women are in a better condition when they are Nurses then when they are not for when they are not Nurses they are subject to pains in their Arms sometimes and sometimes in their Shoulders and sometimes in their Legs or Thighs or elce they are subject to waterish Eyes or swelling in their Eyes or Nose Now the Infants which suck these Nurses if they be fat 't is not good but soft fat and they are dull and sottish and coming to breed Teeth they are very sickly and commonly dye by reason of the reum pushing out of too many Teeth at once and if they escape this they are more troubled with bad juices in their Infancy then their Parents in their old age and if the reum be salt the Milk is of a blackish and blewish colour but if it be of Choler 't is yet the more dangerous and venemous to the Children There is another sort of Nurses and they are such as who after they have layen in about some 3 or 4 or 5 or 6 months are taken with their purgations a thing which never happens to good Nurses and when this does happen they are more dangerous then the former and the Child must presently be taken away for they are more apt to conceive then to Nurse and if they do continue Nurses they do but ruine the Children for there dyes a third part of the Children for want of taking care in this particular which yet seem fat and in good case for this is the cause of great colic and windiness in Infants which kils them in a moment for the least Feaver that takes them