to be of an opinion that the Males have sooner life than the Females because he saith their heat is greater but for my part I do not beleive that the Male is sooner formed than the Female and that which thus perswades me is because if it were so the Male must likewise be at its full term sooner than the Female proportionable to the same time that the one is animated sooner than the other which wee see the contrary in that the Women are brought to Bed indifferently both of Sons and Daughters at the ordinary terme of nine months Let us therefore say that towards the fifth or sixth week as well Males as Females have all the parts of their body though small and very tender entirely formed and figured at which time it is not longer than a finger and from thence afterwards which is our third time the blood flowing every day more and more to the Womb not by Intervals as the Courses but continually it daily grows bigger and stronger to the end of the ninth month which is the full term of ordinary labour Having explicated Conception and Generation let us now consider great Bellies and their differences CHAP. V. Of big Bellies and their differences with the signs of the true and false great Bellies THE great Belly of a Woman properly taken is a tumour caused by the Infants scituation in the Womb. There are natural great Bellies which contain a living Child and these we call true and others against nature in which instead of a Child is ingendred nothing but strange matter as Wind mixed with Waters which are called Dropsies of the Womb False-Conceptions Moles or Membranes full of blood and corrupted seed for which reason they are called false great Bellies We have already where we treated of Conception and Generation mentioned the causes and signs of a great Belly in its beginning notwithstanding we will again repeat the most certain and ordinary of them which are nauseousness vomittings loss of appetite to things the Woman was accustomed to eat and like longings for strange and naughty things suppression of the Terms without Feaver or Shiverings or other cause pains and swelling of the Breasts all which may be found in Virgins by the retention of their Courses but the most certain is if putting the finger into the Vagina you perceive the inward Orifice exactly close as also the distention of the body of the Womb considerable more or less according to the time the Woman is gone with Child and the Childs stiring in the Womb gives us indubitable proofs of it It is fit we should be alwayes careful not to be deceived by what we feel stir in the Womb forasmuch as the Infant of it self hath a total and a partial motion the total is when it removes the whole body and the partial is when it moves but one part at a time as the Head Arm or Leg the rest of the body lying still but 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 That of a Mole is rather a motion of falling down than otherwise to wit a motion by which heavy things fall downwards for a Woman who hath a Mole of any bigness considerable whatsoever side she turns her self to her belly falls immediatly the same way like a heavy bowl About the time or very near when the Infant quickens if the Woman be certainly with Child these humors which are carried to the Breasts by the stoppage of her Courses are turned to Milk which when it happens is usually an assured testimony of pregnancy though some Women have been found with Milk in their Breasts but rarely and yet not with Child nor ever having had any which Hippocrates also confirms in his 39th Aphorism of his 5th Book where he saith Si mulier quae nec praegnans nec puerpera est lac habet ei menstrua defecerunt If a Woman hath milk in her Breasts and is neither with Child nor ever had any it comes from the stoppage of her Courses But it is rather whey than milk which in that case hath not the consistence as the Milk of a Woman in Childbed nay the Milk of a Woman with Child is yet but waterish and becomes neither thick nor very white till after labour she begins to suckle her Child The Infant moves it selfe manifestly about the fourth month or sooner or later according as it is more or less strong some Women feel it from the second others about the third month yea some before that time In the beginning these first motions are very small and very like to those of a little Sparrow when first hatched but grow greater proportionably as the Infant grows bigger and stronger and at last are so violent that they force the Womb to discharge its self of its burden as in Travail The common opinion is that the Males quicken before the Females because their heat is greater but that is almost equal for there are some Women perceive their Daughters others their Sons soonest which happens indifferently to Males and Females according as there was a more or less vigorous disposition at their Generation Very often Women who daily use Copulation are subject to be deceived for they usually believe they are with Child if their Courses stop and withal are a little qualmish which is not always true for false conceptions cause almost the same accidents as true which cannot easily be distinguished but by its consequences This false great-Belly is as we have already said often caused by wind which blows up and distends the Womb and which Women oft-times discharge with as much noise as if it came from the Fundament sometimes 't is nothing but water which is gathered there in such abundance as some Women have been seen to void a pail full without any Child though they verily believed they were with Child as did that Wood-Merchant whose story you have in the end of the third Chapter who did not void it till the end of the tenth mouth till when she alwayes believed her self with Child There are others who conceive only fals-conceptions and Moles which may be known by the Infants different motions already mentioned and by the Moles continuing in the Womb often after the ordinary time of labour some Women having them a whole year yea many years according as these Moles are more or less adhering to the inner parts of the Womb and are there entertained and nourished by the blood that flows thither Moles alwayes proceed from some false-conceptions which continuing in the Womb grow there by the blood that flows to them by the accumulation of which they are by little and little augmented if the Womb expels it before two months it 's call'd a fals-conception some are only but as it were the Seed involved in a membrane like that geniture which that Woman voided after six or seven dayes of whom Hippocrates speaks
in his Book De natura Pueri The others are a little more solid and fleshy resembling in some sort the Gizard of a Foul and are greater or less according to the time they stay in the Womb and also according to the quantity of blood with which they are alwayes soaked Women expel these fals-conceptions sooner or later according as they cleave to the Womb which makes them almost alwayes flood in great quantity at those tunes It is of great importance to distinguish well between a true and a false Belly for the faults committed by a mistake are ever very considerable forasmuch as in a true great Belly the Child ought to continue in the Womb till Nature * This excludes not Art to assist Nature if not able to perform its duty in due season expels it by a natural labour but contrarily the false great-Belly indicates to us to procure the expulsion of what it contains as soon as may be Wherefore we ought to be very careful CHAP. VI. How to know the different times of Pregnancy IF prudence be necessary to enable a Chirurgeon or Midwife to assure a Woman that she is with Child or not and of a true or a false-conception it is likewise as much requisite for them to know how far she is gone to the end they may be certain whether the Infant be yet quick or no which is of great moment because according to the Law if a big-bellied Woman miscarry by a wound he that struck her deserves Death in case the Child were quick otherwise he is only condemned in a pecuniary punishment they ought likewise to take heed lest they cause the death of the Infants and sometimes of their Mother by hastening * To be understood by Medicines as appears by the word miscarry following their labour before its time by imagining that when the big-bellied Woman complains of great pains in her Back and Belly they are the pains of her Labour and instead of endeavouring to hinder them they contrarily provoke them and cause them to miscarry unfortunately before their time I knew a Woman called Martha Rolet who being six months gone with Child or thereabouts was surprized with great pains much like throws of Labour which made her send for her Midwife who as soon as she was come and understanding the case no better than they use to do endeavoured all she could to bring her to bed augmenting her pains by sharp Clysters making her walk about her Chamber as if she had been at her full time but finding at two dayes end no forwardness notwithstanding the continual pains she sent for me to know what was fit for her to do in that case I went to the Woman and found the inward orifice of the Womb dilated enough for the top of my little Finger to enter into its inward part and yet wider towards the outward part but considering that she had no other accident but those pains I caused her immediatly to go to bed where she continued eight or nine dayes in which time her pains ceased the Womb closed exactly as I found some dayes after and she went on with her Child three full months longer and was then brought to bed of a Daughter at the full time strong and robust which is yet living and now five years old or thereabouts Now had I pursued what they began this Woman without doubt would have miscarried at six months which would have * Implies Medicines as before killed the Infant in her Belly and soon after she should have miscarried It is fit to follow this example in the like occasion provided the pains are not accompanied with accidents which may endanger the life of the Mother if not presently delivered as frequent Convulsions considerable floodings of which we shall speak in its place To be well informed of the different times of pregnancy the Womans own relation may sometimes serve turn yet 't is not fit alwayes to trust it it may help to conjecture because many Women are themselves deceived concluding themselves with Child from the staying of their Courses or from their quickning which is not alwayes a certain rule We usually judge of it by the bigness of the Belly but more surely by touching the inward orifice of the Womb. When they are young with Child we can only know it by the signs of conception because what is then in the Womb is of no considerable bigness to swell a Belly but rather on the contrary at that time it grows slatter for the reasons before recited but after the second month the Belly begins by degrees to wax bigger till the ninth month At the beginning in touching the inward orifice you find it exactly close and somewhat long resembling the muzzle of a Puppy new pup'd and is then very thick but by little and little through the extension of the Womb it diminisheth so in all its proportions that when the Woman cometh near her reckoning it is perfectly flat and almost equal with the globe of the Womb and in that manner that it becomes like a small circle a little thick at its entry where the Garland is made at the time of Labour Neither may the time of pregnancy be alwayes judged by the great swelling of the Belly because some Women are bigger when they are half gone than others are at their reckoning it depending much on the bigness of the Infant and also on their number and yet again according as there is more or less water inclosed with them in the Womb but much rather by the internal Orifice which grows daily thinner and flatter and so much the more by how much the Women come nearer their reckoning much in the same manner as we see a tender skin diminish in thickness according as it is extended and dilated even so this orifice grows thinner by the extension which the head of the Infant causeth to it which usually presseth hard against it in the last months This remark is often useful to us in the admission of big-bellied Women that desire to lie in in the * An Hospital so called in Paris Hostel de Dieu at Paris which I very often observed in my practise there of Deliveries in the year 1660 through the permission which my Lord the first President was pleased to give me for there is no place so fit to perfect one in a short time in the practice of so necessary an operation because of the great number which are there daily delivered of all sorts the order is that any Women with Child shall be there charitably received fifteen dayes or thereabouts before their reckoning to which purpose they are searcht before they are admitted because many glad of a good entertainment for nothing present themselves there two or three months before they should saying and affirming they are near their time but by the above-mentioned considerations one may easily judge and know within a very little who are fit to be received and
forth many young ones who usually answer the number of the little cells of their Womb this is very true in respect of other Animals but the Womb of a Woman hath but one only cavity unless they would have the two sides taken for cavities for there is in the Womb only a simple long line without any other separation We see daily Women brought to bed of two Children at once sometimes of three and very rarely of four Yet I knew one Mr. Hebert Couverer of the King's Buildings who was so good a Couverer that his Wife about seventeen years since brought forth four living Children at a birth which the Duke of Orleans deceased coming to hear of to whom because of his jovial humour he was very welcom the Duke asked him in the presence of divers Persons of Quality whether it were true that he was so good a Fellow as to get his Wife with Child of those four at one bout He answered very coldly Yes and that he had certainly begat at the same time half a dozen if his foot had not slipt which made them all laugh very heartily But I esteem it either a Miracle or a Fable what is related in the History of the Lady Margaret Countess of Holland who in the year 1313 was brought to bed of 365 Children at one and the same time which happened to her as they say by a poor Womans Imprecation who asking an Alms of her related to her the great misery she was in by reason of those Children she had with her To which the Lady answered She might be content with the inconvenience since she had had the pleasure of getting them Now since the most usual number is two that Women have at once who have more than one Child at a time We will give the signs of it which do not appear in the first months nor sometimes till they are quick There is some likelihood of it if the Woman be extraordinary big and yet suspects no Dropsie and more if there be on each side of the Belly a little rising and as it were a line a little depressed or not so elevated about the middle and most of all if at the same time one feels many and different motions on both sides and if these motions are more frequent than usually which is because the Infants being straitned inconvenience one the other and cause each other to move in that fashion If all these signs concur 't is then very probable the Woman goes with more than one Child CHAP. VIII Of SuPERFAETATION THere is a great dispute whether a Woman who hath two or more Children at once conceived of them at one or at several Coitions We see indeed daily that Bitches Sows and Rabits have divers young with but once copulating which may very well make us judge the same of a Woman Some will have this to be by Superfaetation but there are signs by which we may know the difference whether both Children were begotten at once or successively one after the other Superfaetation according to Hippocrates in his Book which treats of it is a reiterated conception when a Woman being already with Child conceives again the second time That which makes many beleive there can be no Superfaetation is because as soon as a Woman hath conceived her Womb closeth and is exactly firm so that the Seed of the Man absolutely necessary to conception finding no place nor entry cannot as they say be received nor contained in it so to cause this second conception To this may be added that a pregnant Woman dischargeth her Seed which is as necessary for it as a Mans by a vessel which terminates on the side of the exteriour part of the inward orifice which Seed by this means is shed into the Vagina and not into the bottom of the Womb as it should for this purpose However it may be said in answer to these objections which are very strong that though the Womb be usually exactly shut and close when a Woman hath conceived and besides that she then sheds her Seed by another conveyance yet this general rule may have some exceptions and that the Womb so closed is sometimes opened to let pass some serous slimy excrements which by their stay offend it or principally 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 dilated and opened by the impetuous endeavour of the Seed agitated and over-heated more than ordinary and this orifice being at the same time a little opened if the Mans Seed be darted into it at the same moment it is thought a Woman may then again conceive which is called Superfaetation This is confirmed by a History 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 of another Woman who likewise had two Children the one like her Husband and the other like her Gallant but this different resemblance doth not altogether prove Superfaetation because sometimes different imaginations may cause the same effect This second conception is effectively as rare as we find the decision of it uncertain nor must we imagine that alwayes when a Woman brings forth two Children or more at once there is a Superfaetation because they are almost alwayes begot in the same act by the abundance of both Seeds received into the Womb nor believe neither that it may be at all times of a Womans being with Child for when it happens it cannot be either the first or second day of conception because if the last Seed be received into the Womb it would make a mixture and confusion with the first which is not yet involved with this little pellicle that might otherwise separate it nor is it formed perfectly till the sixth or seventh day as Hippocrates saw in a Woman who about that time expelled this geniture Besides the Matrix again opening it self could not hinder the first Seed from slipping out being not as yet wrapt up in this little membrane which could preserve it This makes me not believe the History of the Woman whom Pliny mentions that it happened for the reasons alledged by him to wit that she used copulation the same day with two several persons for the last would certainly have caused this confusion of Seed as I have said and so destroyed the work begun but I rather believe that this Superfaetation may happen from the sixth day of conception or thereabouts till the thirtieth or fourtieth at the most because then the Seeds are covered with membranes and that which is contained in the Womb is not yet of a considerable bigness but after this time it is impossible or at least very difficult because the Womb being extended more and more by the growth of the Child can hardly receive new Seed and as hardly
Womb being portions of the sixth pair of those of the Brain Now the Womb which hath a very exquisite sense because of its membranous composition beginning to wax bigger feels some pain which being at the same time communicated by this continuity of Nerves to the upper orifice of the Stomach cause there these nauseatings and vomitings which ordinarily happen And to prove that it is thus in the beginning and not by pretended ill humours appears in that many Women vomit from the first day of their being with Child who were in perfect health before they conceived at which time the suppression of the Terms could not cause this Accident which proceedeth from this sympathy in the very same manner as we see those that are wounded in the Head and Bowels and that have the Stone-Cholick are troubled with Loathings and Vomitings and yet have no corrupt humours in the stomach Loathings and Vomitings which are motions of the stomach contrary to nature happen to big-bellied Women from the beginning for the reasons above recited Loathing or Nauseousness is nothing but a vain desire to vomit and a motion by which the Stomach is raised towards the upper orifice without casting up any thing And Vomiting is another more violent endeavour by which it casts forth of the mouth what humour soever is contained in its capacity In the beginning Vomiting is but a single symptom not to be feared but continuing a long time it weakens the stomach very much and hindring digestion corrupts the food instead of concocting it whence afterwards are engendred those ill humours which need purging These Vomitings ordinarily continue to the third or fourth month of being with Child which is the time the Child appears manifestly to quicken in after which it begins to cease and Women to recover the appetite they had lost during their being young with Child because the Infant growing stronger and bigger having need of more nourishment consumes abundance of humours which hinders the flowing of so much superfluity to the stomach besides at that time the Womb is by degrees accustomed to extention It continues in some till they are delivered which often puts them in danger of miscarrying and the rather the nearer the Woman is to her full time Others again are more sometimes tormented with it towards the end of their reckoning than at the beginning because the stomach cannot then be sufficiently widened to contain easily the food being compressed by the large extention and bigness of the Womb. Such a Vomiting which comes about the latter end of the reckoning to Women whose Children lie high seldom ceaseth before they are brought to bed You need not wonder or be much troubled at the Vomitings in the beginning provided they are gentle and without great straining because they are on the contrary very beneficial to Women but if they continue longer than the third or fourth month they ought to be remedied because the Aliment being daily vomited up the Mother and the Child having need of much blood for their nourishment will thereby grow extreamly weak besides the continual subversion of the stomach causing great agitation nd compression of the Mothers Belly will force the Child before its time as is already mentioned To hinder this Vomiting from afflicting the Woman much or long it being very difficult to hinder it quite let her use good food such as is specified before in the Rules or Diet but little at a time that the stomach may contain it without pain and not be constrained to vomit it up as it must when they take too much because the big-belly hinders the free extension of it and for to comfort and strengthen it being alwayes weak let her season her meat with the Juice of Orenges Lemons Pomegranets or a little Verjuce or Rose-Vinegar according to her appetite She may take likewise a Decoction made of French-Barleyflower or good Wheat-flower having dryed the flower a little before in an Oven mixing the yolk of an Egg with it which is very nourishing and of easie digestion she may likewise eat after her meals a little Marmalade of Quinces or the Jelly of Goosberries let her Drink be good old Wine rather Claret than White being well mixed with good running Fountain-Water and not that which hath been long kept in Cisterns as is most of the Water of our Fountains of Paris which acquire by that stay an evil quality If she cannot get such fresh Waters let her rather use River-Water taken up in a place free from filth in which she may sometimes quench hot Iron Above all let her forbear all fat Meats and Sauces for they extreamly moisten and soften the Membranes of the Stomach which are already weak enough and relaxed by the Vomitings as also all sweet and sugered Sauces which are not convenient for her but rather such as are a little sharp with which it is delighted and comforted But if notwithstanding these Precautions and this regular Dyet the Vomiting as it sometimes happens continues still although the Woman be above half gone it is a clear sign there are corrupt humours cleaving to the inward sides of the Stomach which being impossible to be evacuated by so many preceding Vomitings because they adhere so fast must be purged away by Stool to effect which they need a Dissolvent which may be a gentle Purge made by infusing half a dram of Rhubarb a dram or two at most of good Senna and an ounce of Syrup of Succory which Purge dissolves the humours and in evacuating them comforts the parts Or it may be made with young Mallows Cassia Tamarinds or any other gentle Purgers according as the case requires alwayes adding a little Rhubarb or compound Syrup of Succory observing likewise what humours ought to be purged For as Hippocrates saith in the 12th Aphorism of his first Section In perturbationibus ventris vomitibus sponte evenientibus si quidem qualia oportet purgari purgentur confert facile ferunt sin minus contra In perturbations and dejections of the Belly and in spontaneous Vomitings if the matter be purg'd away which ought to be the Patient finds ease and comfort if not the contrary Therefore we are to consider that it is not enough to purge unless we evacuate the peccant humours for otherwise purging more weakens the Stomach which it would not if it were well ordered and convenient to evacuate the vicious humour If once be not sufficient it may be repeated giving the Woman some few dayes respit between both if the Vomiting continues daily almost without intermission although the Woman observes a good dyet and after that she hath been reasonably well purged we must rest there lest something worse happen of which we may incur the blame for she is then in great danger of miscarrying and when the Hiccough takes them through emptiness proceeding from too much evacuation caused by these continual vomitings it is very bad as the third Aphorism of the second Book teacheth us
her pallat neither will it be amiss if she eats a little good Marmalade of Quince before meals She may likewise wear upon the pit of her Stomach a Lamb-skin with the wool for to preserve it and augment its natural heat which is very necessary to digest food observing above all to give no purging Medicine when this Flux is only caused by weakness lest it be thereby augmented If it be a Diarrhaea and only an evacuation simply of such excrements as are retained in the Guts and some superfluous humours which Nature hath sent thither to be expelled and that it continue no long time and is gentle the Woman will find no inconvenience by it nor is she in that danger as when it passeth those bounds and therefore 't is good to leave the operation to Nature without interrupting it in the beginning but if it continues above four or five days it is a sign then that there are ill humours contained and cleaving to the inside of the Guts which provoke them often to be discharged and ought to be removed with some purging Medicine that may loosen and evacuate them after which the Flux will certainly cease some light infusion of Senna and Rubarb with Syrup of Succory or an ounce of Diacatholicon with a little Rubarb for a Bolus to be taken in a Waser But if notwithstanding fit purges and a regular diet this flux continues and changes into a Dysenteria the Patient voiding every moment bloody stools with much pain and needing she is then in great danger of miscarrying its prevention ought it be endeavoured if possible Therefore after having purged away the ill humour with the Medicines above mentioned which were in the Guts and hindering by a good dyet that no more be engendred to which purpose let her use good broths made of Veal or Chicken with cooling Herbs temper the acrimony of these hot humours let her eat Pap with the yolk of an Egg new layed being well boiled such dyet softens and sweetens the Guts within Let her drink be Water in which Iron or Steel was quenched with a little Wine if she be not feverish for then half a spoonful of Syrop of Quince or Pomegranats is better to mix with the foresaid Water She may likewise eat a little Marmalade of Quince or other astringents and strengtheners provided her body was well purged before and because there is always in these Fluxes great pains and gripes all over the Belly and Guts and chiefly the Rectum all the humours being discharged upon it which irritating it extreamly causeth continual stimulations that ought to be appeased if possible to prevent Abortion and may be effected by Clysters made of the Broth of a Calves-head or Sheeps-head well boyled mixing it with two ounces of the Oyl of Violets or else of good Milk mixed with the Yolk of a fresh Egg. After the use of these strengthening and anodine Clysters as long as is judged necessary which the Patient ought to keep as long as she can the better to appease these pains you must proceed to the use of Detersives made with the Decoction of Mallows and Marsh-mallows with Honey of Roses and afterwards Astringent Clysters in which must be neither Oyl nor Honey mixed because they relax instead of binding beginning first with the gentlest made with Rose-water mixed with Lettice and Plantain-water afterwards to stronger composed with the Decoction of the Roots and Leaves of Plantain Tapsus Barbatus Horse-tail with Provence-Roses the rind of Pomegranats in Smiths-water to which may be added of Terra Sigillata and Dragons-blood each two drachms You may likewise foment the Fundament but there must be care before you come to use the strong Astringents that the Woman be first well purged with the Remedies before mentioned lest as the Proverb is the Wolf be shut in with the Flock and endeavouring to prevent Abortion the death of the Mother and consequently of the Child be caused by a greater mischief retaining within abundance of ill Humours of which Nature would willingly be discharged All which may be avoided if what I have said be well observed CHAP. XIX Of the Menstruous Flux HIppocrates in the 60th Aphorism of his 5th Book saith Si Mulieri utero gerenti Purgationes prodeant impossibile est foetum esse sanum If a big-bellied Woman have her Courses it is impossible the Infant can be in health This Aphorism must not be taken literally but must be understood when they come down immoderately for though according to the most general and natural rule the Courses ought not to flow when a Woman is with Child because their ordinary passage is stopt and also because the Blood is then imployed for the nourishment of the Infant of which if it flows away it is defrauded and consequently much weakened Yet there are some Women who notwithstanding they are with Child have their Courses till the 4th or 5th month about which time the Infant being already pretty big draws a good quantity of blood for its nourishment wherefore there cannot so easily remain a superfluity as when young with Child I knew one that had four or five living Children and had of every Child her Courses duly from month to month as at other times onely in a little less quantity and was so till the 6th month yet notwithstanding she was alwayes brought to bed at her full time I likewise saw another who not believing she was with Child because she had her Courses and finding her self out of order because she had conceived imagining it was some other Distemper prevailed with her Physitian to bleed and purge her very often which he did till he had indeed cured her but 't was after she had miscarried being three months gone This evacuation usually befalls very Sanguine or Phlegmatick Women who breeding more blood than the Infant hath need of for its nourishment at the beginning discharge themselves at those times of that superfluous quantity more or less according to their dispositions but not by the bottom of the Womb as formerly when they were not breeding because those passages are effectually closed by the after-birth which adheres to it and the Womb is then exactly close but by a couple of Branches which Nature provident and careful of the preservation of Individuals as well as of the Kind hath destined to this use which proceed from the Spermatick Vessels and besides those they send to the Testicles and other parts before they arrive at the Womb divide themselves on each side into two Branches very considerable of which the one terminates in the Fund of the Womb by which the Courses pass when the Woman is not with Child and the other not entering there couching along the body of it is terminated in the side of the neck of the Womb by which the Courses are discharged whilst they are breeding in case the Woman be Plethorick When a Woman voids blood downwards it must carefully be considered whence it proceeds
as may be to be Masters of the Evacuation and to hinder it from causing a Loosness for that is more dangerous than Salivation because of the continual forcing downward in going to stool by which the Womb receives great commotion and is extreamly agitated I know very well that many will not easily be perswaded but that either it is impossible to cure a Woman of the Pox whilst she is with Child or that she and her Child cannot undergo the Remedies without inevitable danger of death however the experience I have had of it my self makes me to be of another opinion which I am vvilling to communicate for an example in the like case In the Year 1660 when I practised Midwifery in the Hostel de Dieu at Paris a young Wench not above twenty years old came thither to lie-in of her second Child that had had the Pox before ever she conceived the first time and after miscarried of a dead Child rotten with the Pox therefore being big this second time and perceiving the accidents of ber disease to augment more and more she concluded there was no hopes this great Belly would succeed any better than the first because she had all over her Body especially upon both her Breasts very many malignant Ulcers which encreased day by day and fearing it might turn to a Cancer before her Reckoning was compleat being but three months gone she resolved to submit to a thorough-Cure then and to hazard her life in that condition to save her Child's having no other hopes to effect it nor being able her self to resist the growing disease She acquainted three or four Chirurgeons both vvith her disease and design not at all concealing her great-belly who for that cause would not undertake her although she was fully resolved upon it and promised to pay them vvell telling her that their Conscience would not suffer them to do it in the condition she was in and that it would be better she would patiently submit to it aswell as she could till she was brought to bed and then they vvould very vvillingly undertake her But when she found none would undertake her unless she concealed her great-belly vvhich was not hard to be done being but three months gone and believing there was no better an expedient She met with another to whom she mentioned nothing of her great Belly that put her into the ordinary course as if there had been no Conception and besides the common Remedies used in this disease he gave her a Salivation by five or six reiterated Frictions of the Oyntment vvhich followed her very plentifully five vvhole vveeks so that she vvas vvell and perfectly cured without leaving the least ill accident behind of her disease When she was almost recovered and that all had succeeded wel she told her Chirurgeon she was four months a half gone with Child for she was three months when she came to him where she lodged six weeks intire without having it in the least perceived which at first he could hardly believe but perceiving her Belly rather grown bigger than lesser during the Evacuation the Physick had made he was immediately assured of the truth of it She informed him that the reason why she had concealed her great-Belly was the refusal four Chirurgions to whom she had confest it made to take her in hand From the time she was cured she suffered not the least inconvenience during all the remainder of her time except a little want because all the money she had was given the Chirurgeon for her Cure which made her come to the Hostel de Dieu to lie-in where I delivered her of a Child at the full time as big fat and healthy as if the Mother never had had the least touch of that disease in her whole body and which was very remarkable the Burthen which is a part very susceptable of the least impression of a Woman 's corrupt humours was as neat fair and ruddy as could be imagined This example which is very true may convince us that a big-bellied Woman may be taken in hand for the Pox and more safely if the Precautions noted above be carefully observed For it is without contradiction that if this Woman had not been cured she had this second time been brought to bed of a rotten Child as before Relating once this History to a Chirurgion a Friend of mine he told me that himself twice in two different persons had the same success who were very well cured and their Children likewise well born at the full time without having the least impression of the venom in any part of their Body Varandaeus confirms to us this truth in the second Chapter of his second Book of Womens Diseases where he precisely tells us that he had seen big-bellied Women who had had this disease eradicated by anointings with Mercury and Salivation prescribed by Empericks which may convince us that this Cure will easily have a better success when governed and managed by a knowing and methodical person In a word 't is easie to be perswaded that they can endure it although with Child because many very often have continual Feavers for twelve or fifteen dayes and other acute distempers for which they have been necessited to be nine or * Such frequent bleeding Women with Child in so short a space is not approved in England ten times blooded and yet notwithstanding have oft-times gone through with their Children to their full account and been delivered of them as well as if they never had had any ill accident CHAP. XXIV Of Abortion and its Causes WHen a Woman casts forth in the beginning what she had retained by conception in the Womb 't is called an Effluxion or a sliding away of the Seeds because they have not yet acquired any solid substance if they miscarry of a false-conception which is ordinarily from the later end of the first to the end of the second month it is called an Expulsion but when the Infant is already formed and begins to live if it comes before the time ordained and prescribed by Nature it is an abortion which may happen from the second to the beginning of the seventh month for afterwards it is accounted a Birth because the Infant being strong enough and having all its perfections may then live which is impossible if he comes before These things thus understood we then say that an Abortion is an issuing forth of the Child yet imperfect out of the Womb contrary to Nature before the term limited which is the cause that for the most part it is dead or if sometimes alive it dies in a short time after We may in general assert that every acute Disease easily makes a Woman miscarry because they destroy her fruit which being dead never stayes long in the Womb and also puts the Woman in great hazard of her life as saith Hippocrates in the 30th Aphorism of his 5th Book Mulierem gravidam morbo quopiam acuto corripi
lethale The particular causes of Abortion are all the accidents mentioned in the preceding chapters as violent and frequent vomitings because there is not only want of sufficient nourishment for Mother and Child when the food is so continually vomited up but also great reachings and endeavours by which the Womb being often compressed and as it were shaken is at last constrained to discharge it self before its time Pains of the Reins great Cholicks and Gripes may likewise cause the same accident as the Strangury also for there are then made strong compressions of the Belly every moment to expel the Urine Great Coughs by their frequent agitation suddenly thrusting the Diaphragma with force downwards give also violent shocks to the Womb. Great Loosnesses endanger a Woman to miscarry according to the 34th Aphorism of the 5th Book and sooner if a Tenesmus follows which is great needings whereby the right Gut seeks to expel the sharp humours that irritate and provoke it This makes us take notice of the 27th of the 7th Book Mulieri utero gerenti si tensio supervenerit facit abortum for in this case the Womb which is scituated upon the Rectum receives a great commotion by its continual needings If a Womans Courses flow immoderatly it is impossible her Fruit can be in health as it is in the 60th Aphorism of the 5th Book for besides that the Infant is not sufficiently nourished the Womb also by being too much moistened is easily relaxed and opened Letting Blood immoderately doth the same for the same reason especially if the Child be great according to the 31th Chapter of the same Book But one of the worst accidents which cause Abortion is that Flooding which proceeds from the separation of the After-birth from the Womb of which we treated in the 20th Chapter of this first Book The Dropsie of the Womb hinders the Child from growing to perfection for the great abundance of Water extinguisheth the natural heat which is already at that time much debilitated and the Pox in the Mother infects the Child and often Kills it in her Belly as we have demonstrated in the preceeding Chapter and whatever very much agitates and shakes the big-bellied Womans body is capable of making her miscarry as great labour strong contorsions or violent motions of what manner soever in falling leaping dancing and running or riding going in a Coach or Waggon crying aloud or laughing heartily or any blow received on the Belly because that by such agitations and commotions the ligaments of the Womb are relaxed yea and sometimes broken as also the After-birth and Membranes of the Faetus are loosned A great noise suddenly and unexpectedly heard may make some Women miscarry as the noise of a Cannon and chiefly Thunderclaps and yet more easily if to this noise be added the fear they usually have of such things which happens rather to the young than elderly Women because their bodies being more tender and transpirable the air which is strongly forced by that noise being introduced into all her pores offers a great violence by its impulsion on the Womb and on the Child within it which the elder being more robust thicker and closer resist with more ease Great watchings causing a dissipation of the Womans strength and much fasting for want of food hinders the Infant from acquiring its perfection fetid and stinking smells do much contribute to abortion and amongst others the smell of Charcoal as appears by the History recited in the 10th Chapter of this Book The indispositions of the Womb produce the same effect as when it is callous or so small or so much compressed by the Epiploon that it cannot be extended as it ought to be sufficient to contain the Child and Burthen with ease together with the Waters which may likewise happen if the Woman be too strait laced or keeps in her Belly with strong and stiff Busks for to be well shap'd or by this subtilty to conceal a great-belly as some do frequent copulation especially towards the end of her reckoning may effect the same thing because then the Womb being very full bears much downwards and its inward orifice being very near is subjected to violence If a Woman miscarries without any of these accidents and that one desires to know the cause of it Hippocrates explains it in his 46th Aphorism of the 5th Book where he saith Quae veró mediocriter corpulentae abortum faciunt secundo mense aut tertio fine occasione manifesta iis acetabula uteri mucoris sunt plena nec prae pondere faetum continere possunt sed abrumpuntur any Woman indifferently corpulent that miscarries the second or third month without manifest or apparent cause it is because the Cotylâ—dons of the Womb which are the inward closures of its vessels are full of viscous filth by reason of which they cannot retain the weight of the Faetus which is loosened from it To this accident phlegmatick Women are very subject and those who have the Whites exceedingly which by their continual affluence moisten and make the Womb within so slippery that the After-burthen cannot adhere to it which also relaxeth it and its inward orifice that the least occasion causeth abortion But if the passions of the body cause so much hurt to a big-bellied Woman those of the mind do no Iess and specially Choler which agitates inflames disperses and troubles all the Spirits and mass of Blood by which the Child suffers extreamly because of the tenderness of its body but above all sudden fear and the relation of bad news are capable to make the Women miscarry at that instant as it happened to the Mother of that Cousin of mine whom I mentioned in the 10th Chapter of this first Book which likewise the other passions may cause according as they are more or less violent but not so easily There are yet other causes of miscarrying which may be said to proceed from the Infant as when they are monstrous because they do not then follow the rule of Nature as likewise when they have an unnatural scituation which makes them torment themselves because of their incommodity and they oblige the Womb to expel them not being able to endure the pains they cause which it yet does when it is so great that it cannot contain it to the full time nor the Mother furnish it with sufficient nourishment If we find one or more of the above specified accidents and that the Woman withall hath a great heaviness in her Belly so that it falls like a ball on her side when she turns and that there proceeds out of her Womb stinking and cadaverous humors it is a sign she will soon miscarry of a dead Child moreover her Breasts will confirm it if having been hard and full in the beginning they become afterwards empty and flabby as is specified in the 37th Aphorism of the 5th Book and the 38th of the same Book saith That if one of a big-bellied Womans Breasts who hath
absolutly be found in a Delivery that it may deserve to be called legitimate or natural first that it be at full time secondly that it be speedy without any considerable accident thirdly that the Child be living and fourthly that he comes right in a good posture or scituation for if any of these four are wanting the delivery is against nature and the more by how much there are more of them wanting As to the due time of Labour most Authors assert that Nature hath appointed to all other Animals a certain limited time of going with young and bringing them forth but that Women only by a particular favour of the same nature have none prefixt neither for conceiving going with Child nor bringing forth And as to conception 't is most certain that a Woman can conceive at any time night or day summer or winter or any other season whatsoever because she can copulate when she pleaseth which few other Animals can who couple but at certain seasons when they become lustful but as to the time they are accustomed to go with young it is no more precisely determined to them than to a Woman for as she may be brought to bed either in the seventh eighth ninth tenth yea and sometimes the eleventh month which happens very rarely but for the most part in the ninth month So likewise for example though the ordinary time for a Bitch to puppy is the fourth month or thereabouts so some puppy sooner and some later and Sheep which yean their Lambs at the end of five months advance or recede from that ordinary term according to the ground where they seed and the quallity of their pasture to which contributes many particular dispositions of each of these Animals which likewise happens to all others as well as to Women We may perceive the same also in Fruit for the seasons and different Climats always more or less assist their speedy maturity which depends likewise very much on good Husbandry The first time that a Child may live when born is the seventh month compleat and it may better from that till the end of the ninth month but assoon as that time is pass'd the stay it makes after in the Womb is no wayes beneficial to it because it hath then acquired all necessary perfection and strength sufficient to resist all outward injuries The Child born before the seventh month cannot live long as we said before because of its weakness but he that is born in the eighth month may very well live yea and more likely than born in the 7th month which is contrary to the opinion of all the world because it is more perfect as I shall demonstrate afterwards in the fifth Chapter of this second Book where I will particularly shew the cause of this error Now as we sometimes see Children born two months before the ordinary time of nine months do live notwithstanding so there are some Women not brought to bed till towards the 10th month and sometimes not till the beginning of the 11th although this may happen in some yet there are many who deceive themselves in their reckoning believing that they are gone but seven or eight months and sometimes ten or more when they are but just nine that which thus abuseth them is their imagining themselves with Child precisely from the suppressing of their Courses though it be not alwayes true because some have wanted their Courses two months before they became with Child and others have them on the contrary two or three months after on the usual manner which daily happens according to their different constitutions and temperaments more or less Sanguine If as we have said the intire and perfect term be necessary to the legitimate and natural birth a good figure and scituation of the Child is no less which ought to come with the head first in a strait line having the face turned downwards that is towards the Mothers back the arms couched along its sides and the thighs stretcht upwards This figure is much the better and convenient because after the head which is the biggest part of the Child is passed all the rest coms forth easily and that being so none of the joynts of its body can be turned to hinder its passage forth but any other part that may first present to the Labour makes it unfortunate and against Nature in which case there is often great danger to Mother or Child and sometimes to both if not suddenly and duely succour'd They who have no perfect knowledge of the parts of a Womans body aqcuired by Anatomy are contented to 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 at which Galen and many other Authors have much admired many of whom are of opinion that the Womans os pubis is separated to inlarge the passage at that time without which it would be impossible for the Infant to have room enough to be born and therefore Women a little antiquated suffer more in their first Labours than others because their os pubis cannot be so easily separated which often kills their Children in the passage Others are of the opinion that it is the Os ilium which is disjoynted from the Os sacrum to the same purpose and say both the one and the other of them that these bones thus separated at the hour of Labour are thereto by degrees a little before disposed by the slimy humours which flow forth from about the Womb and then mollifie the cartilage which at other times joyn them firmly But these two opinions are as far from Truth as Reason for Anatomy convinceth us clearly that the Womb by no means toucheth these places whereby to mollifie them by its humours as also that these bones are so joyned by the cartilage that it is very difficult to separate them with a Knife especially the ilium from the sacrum and almost impossible in some elderly Women without great violence although Ambrose Paré citing many witnesses then present at the thing reports the History of a Woman in whom having been hanged fourteen dayes after she was brought to bed he found as he saith the os pubis separated in the middle the breadth of half a finger and the ossa illia themselves disjoynted from the os sacrum I will not in this case accuse him of imposture for I have too much respect for him and esteem him too sincere for it but I indeed believe that he was mistaken in this separation for there is no likelihood that being so at the time of her Labour it would remain so a fourtnight after the breadth of half a finger for then they should have been obliged to carry this Woman to Execution for she would not have been able to have supported her self to climb the Ladder of the Gibbet and to keep her self on her legs according to the custom of other Malefactors because the
the finger the abortive Eggs which have yet no shell but are only covered with a simple membrane after this the pains redoubling continually the membranes are broken by the strong impulsion of the waters which incontinently flow away and then the head of the Child is easily felt naked and presented at opening of the inward Orifice of the Womb Now all these or the greatest part of them met together at what time soever of a Womans going with Child it be whether full time or no one may be assured she will soon be delivered but great care must be taken not to hasten her Labour before the necessity of it be known by these signs for that would but torment the Woman and Child in vain and put them both in danger of their lives as that Midwife did whom I found endeavouring to put the above named Martha Rolet in Labour at six months end because of some pains she had in her Belly and Reins without any other accident answering them downwards which History is at large in the sixth Chapter of the first Book to shew that in some cases we must make no more haste than good speed Labour contrary to Nature is when the Child comes in an ill Figure and scituation as when it presents any otherwise than the Head first as also when the Waters flow away along time before it is born because it remains dry in the Womb and they are absolutely necessary to moisten the passage and render it more slippery When the After burthen comes first it is an accident which renders the Labour always dangerous by reason of the great flux of Blood usually following of which the Mother may die in a few hours and the Infant because it receives no more nourishment is quickly smotherd in the Womb for want of respiration which it then needs if it stay never so little after The Labour is also grievous when accompanied with a Feaver or any other considerable Distemper which may destroy the Child in the Womb as also when pains are small and come slow with long intervals and little profit by reason of which a Woman is extreamly tyred but the difficulty most frequent and ordinary comes from the Infant 's wrong posture We shall speak more particularly of the signs of all these different Deliveries in treating of them severally hereafter and now come to the inquiry of some particulars without which it is impossible to assist a Woman safely in her natural Labour or to help her in the unnatural ones and therefore we will examine every thing that is in the Womb with the Infant during pregnancy and first describe those that first offer themselves to pass the Orifice when the Woman is neer her delivery which are the membranes of the Infant and the waters contained in them This Figure represents the Membranes of the Infant wholly separated from the Womb in which it is contained with the Waters These Membranes in some manner resemble a great Bladder through which the figure of the Infant may be a little perceived there is likewise seen on the upper part the After-burthen marked A on that side which is fastened to the bottom of the Womb. Chap II. lib. 2 pag 150 CHAP. III. Of the Membranes of the Infant and the Waters AS soon as the two Seeds have been confusedly mixed and retained by conception the Womb immediately after by means of its heat * Extrieates disentangles separates this Chaos for to make out of it the delineation and formation of all the parts and begins to work upon these Seeds which though to the sight they appear similar and uniform yet in effect contain in them many dissimilar parts all which it separates and distinguisheth one from the other inclosing the most noble and on the * Covering outside the most glutenous and viscous of which first the Membranes are formed for to hinder the Spirits wherewith the â—…mous Seed abounds from being then dissipated to serve afterwards to contain the Infant 〈◊〉 Waters in the midst of which it swims that they may not stream away As the Membranes of the Faetus are the first parts formed so are they with the Waters the first thâ—… in time of Labour present themselves to the paâ—â—age before the Infants Head Most Authors are so dark in the descriptions they make of these Membranes that it is very hard to conceive them as they are by the explication they make of them They do not so much as agree in the number of them some account three as well for a Child as a Beast to wit the Chorion the Amnios and the Allantoides others account but two because there is no Allantoides in a humane Faetus but to speak properly if it be strictly examined what there is as I have often done there will be never found but two which are so joyned and contiguous the one to the other that it may be said to be but a double one which may indeed be separated and divided into two I will explain it on such wise as may be best understood by those that are ignorant of it for there are many who think with Galen that these Membranes are separated and distant the one from the other and that the one surrounds only the Infant and the other receives the Waters which are partly engendred from sweat and partly from the urine as they imagine and believe further that these Waters themselves are separated the one from the other by these Membranes which is quite contrary for they are both so joyned the one to the other that they compose as it were but the same body and involver which serves as we have already said to contain the Infant with the Waters which are all of a nature and shut up in the same Membranes as I shall make appear hereafter in speaking of their original it matters not to the truth after what manner this be explained provided it may be understood as it is The exteriour part of this Membrane or double * Covering Involver or if it be esteemed two the first Membrane presented without is called Chorion from the Greek word 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 signifying to contain because it immediately contains 〈◊〉 â—…ons the other which is called Amnios that is a little Lamb because it is so small and thin Galen in his 15th Book of the use of parts calls the burthen Chorion But to render this more intilligible we shall take this first Membrane for the Chorion which may be again separated and divided into two though effectively it be but one The Chorion is a little rough and unequal throughout the whole outside of it in which many small capillary vessels may be observed running quite round as also many little fibres by which it cleaves to every side of the Womb but it is a little more smooth within where it joyns every-where and unites with the Amnios in such a manner as that it appears as we have already declared but as one and
their Yards not persorated who notwithstanding have these Waters whilst they are in their Mothers Womb. It must be observed that when there is more than one Child they are never in the same Membrane unless their bodies are joyned and adhering together which is rare and monstrous when it happens but each of them have their Membranes and Waters apart and separated in which they are each wrapt up by themselves These Waters thus collected within these Membranes have divers very considerable uses They serve the Infant to move it self the more easily as it were by swimming 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 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 yeelding when they break * Right time of good Labour 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 John Claudius de la Corveé Physitian to the late Queen of Poland in his Book intituled De Nutritione Faetus would have these Waters to serve the Infant chiefly for nourishment and that it sucks them by his mouth and swallows them as he imagins whilst he continues in the Womb but the truth of the contrary being known to the least Scholar it would be but labour in vain to refute all the reasons he brings to prove and support his saying for they destroy themselves and do all of them correspond to the falshood of their principle Having thus sufficiently explained the Membrans and Waters of the Faetus we must in order inquire after the parts by means of which it is nourished whilst in the Womb which shall be our following discourse These three Figures represent the Placenta or After-birth and the umbilical vessels of the Infant The first shews the shape of the Burthen to the midst of which is fastened the Navel-string round it may be discerned the * Skins Membranes of the Infant which remain thus wrinkled when the Child is come forth of it A A A Shews the body or cake of the Burthen B B B The Skins fastened round about it C C C The Navel-string which contains the Infants umbilical vessels and proceeding from his Navel are inserted in the midst of the burthen where they produce an infinity of branches D D Certain eminencies called knots found on the string proceeding from the dilatation of the umbilical vessels more in one place than in the other The second Figure shews the Burthen turned on the outside and the Childs belly opened that the distribution of the umbilical vessels may be then considered E E E Shows the Burthen on that side which cleaves to the Womb on this side there appears no vessels as there doth on the other but only some simple interlinings and small outlets by which the Blood that transudes the Womb may distil into this parenchymatous mass F F F The Membranes Skin or Skirt H A portion of the Amnios separated from the Chorion marked I. G A part of the Chorion separated from the Amnios marked H. I I I The Navel-string in which are many knots K The Navel where the vessels enter L The umbilical veine which enters into the fissure of the Liver M The two umbilical Arteries which being conducted along the side of the Bladder are inserted into the Iliac Arteries and sometimes into the Hypogastricks N The Urachus which from the bottom of the Bladder couching between the two umbilical Arteries is fastened in the Navel without passing forth in which place it is not hollow in the least and is extreamly small The third Figure shews the burthen of Twins where each Child hath his several Navel-string and Membranes apart O O O O The fleshy substance or body of the Burthen common to both Children P P P The Skirt or Membranes which wrap up the Child on this side apart Q Q Q The other Membranes which contains the other Child apart As to the strings which are double to this After-burthen that on the right is dissected at the end to shew that there are but three vessels only in it R R Shews a strong Membrane in which these three umbilical vessels are inclosed S. The Veine which is very big T T The two Arteries much less than the Vein The other string cut on the other end where are only seen the orifices of the vessels Chap. III. lib. 2. pag 159. 160. Fig. II CHAP. IV. Of the Placenta and Umbilical Vessels of the Child SInce the Infant is only nourished with the Mothers blood whilst it is in the Womb and that big-bellyed Women never have any that is fair or good provident Nature hath formed the Placenta to serve it for a Magazin that it may alwaies 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 delicate substance if it were not first purified in the Placenta which is afterwards sent to it by meanes of the Umbilical vein and brought back as we shall shew hereafter by the Arteries which are the conduits of which the the Navel-string is composed We say then that the Placenta is nothing but a spongy and fleshy mass somewhat like the substance of the Spleen woven and interlaced with an infinity of Veins and Arteries which compose the greatest part of its body made to receive the Mothers blood appointed for the Infants nourishment which is in the Womb. This mass of spongious flesh is thus called because it resembles in figure a Cake some call it the Delivery because being come forth after the Child is born the Woman is quite delivered of the burthen of her great-belly It is likewise called the After-burthen because it is as a second labour of which the Woman is not discharged till * Sometimes in flouding it comes before the Child after the Child is born there are some which give it the name of the Uterine Liver because they say it serves as a Liver to prepare the blood appointed for the Infants nourishment and Laurentius likes rather to call it the * Sweetbread Pancreas of the Womb and appoints the same use for it as for the Pancreas of the lower belly to wit for a rest and support to the vessels of the Navel which disperseth an infinite number of branches throughout all its substance This Placenta is made of the menstruous blood of the Mother which flowes into the Womb by the accumulation of which is formed this Parenchymatous mass the shape of it is flat and round of about he bigness of a Trencher and two fingers breadth thick towards the middle of it where
a little towards her Buttocks somewhat raised by a small Pillow underneath to the end that the Coxcyx or Rump should have more liberty to retire back and have her Feet stayed against some firm thing besides this let her hold some persons with her hands that she may the better stay her self during her Pains She being thus placed near the side of her Bed with her Midwife by the better to help upon occasion must take courage and help her Pains the best she can bearing them down when they take her which she may do by holding her breath forcing her self all she can just as when she goeth to Stool for by such endeavors the Diaphragma being strongly thrust downwards doth force down the Womb and Child in it in the mean time the Midwife must comfort her and desire her to endure her Labour bravely putting her in hopes of a speedy Delivery Some would have another Woman at that time to press the superior parts of her Belly and so to thrust gently the Child downwards but I am not of their opinion because such compressions will rather hurt then profit by indangering the bruising of the Womb which is extream sore at that time and I have seen some Women very ill afterwards for having been used in this manner But the Midwife may content her self only having neither Ring nor Bracelet on and her Hand anointed with Oyl or fresh Butter to dilate gently the inward orifice of the Womb putting her Fingers ends into its entry and stretching them one from the other when the Pains take her for to endeavour to forward the Child thrusting by little and little the sides of the Orifice towards the hinder part of the Childs Head anointing these parts also with fresh Butter if it be necessary When the Infants Head begins to advance into this inward Orifice t is commonly said it is crowned because it girds and surrounds it just as a Crown and when it is so far that the extremity begins to appear manifestly without the Privy-parts it is then said that the Child is in the Passage and the Woman in Travail imagines although untruly and it may be is not so much as touched by her that her Midwife hurts her with her Fingers finding her self as it were scratched and pricked with pins in those parts because of the violent distention and sometimes Laceration which the bigness of the Childs head causeth there When things are in this posture the Midwife must seat her self conveniently to receive the Child which will soon come and with her Fingers ends her Nails being close pared endeavour to thrust as abovesaid this crowning of the Womb back over the Head of the Child and assoon as it is advanced as far as the Ears or thereabouts she may take hold of the two sides with her two hands that when a good Pain comes she may quickly draw forth the Child taking care that the Navel-string be not then intangled about the Neck or any other part lest thereby the After-burthen be pulled with violence and possibly the Womb also to which it is fastened and so cause flooding or else break the string whereby the Woman may come to be more difficulty delivered It must also be observed that the Head be not drawn forth strait but shaking it a little from one side to the other that the Shoulders may the sooner and easier take its place immediately after it be past which must be done without losing any time lest the Head being past the Child be stopt thereby the bigness and largeness of the Shoulders and be in danger of being suffocated and strangled in the passage but assoon as the Head is born if there be need she may slide in her Fingers under the Arm-pits and the rest of the Body will follow without any difficulty Assoon as the Midwife hath in this manner drawn forth the Child she must put it on one side lest the Blood and Waters which follows immediatly after should incommode it or it may be choak it by falling into its Mouth or Nose as it would do if it were laid on the back after which there remains nothing but to free her from the After-burthen which I will show how in the next Chapter but before that let her be very careful to examine whether there be no more Children in the Womb for it happens very often that there are two and sometimes more 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 puts her Hand up the entry of the Womb and finds there another Water gathering and a Child in it presenting to the passage if it be so she must have a care not to go about to fetch the After-birth till the Woman be delivered of all her Children if she have never so many because Twins never have but one Burthen to which there are fastned as many Strings and distinct Membranes as there are Children and if one should go to draw it forth assoon as the first is born the rest would be in danger of their lives because that part is very necessary to them whilst they are in the Womb and besides it endangers a flooding Wherefore the first String must be cut being first tyed with a thread three or four double as we shall shew more exactly hereafter and fasten the other end 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 they must take care to deliver her of the rest observing all the same circumstances as was to the first which being done it will be then convenient to fetch the After-birth as we shall shew in the following Chapter CHAP. IX How to fetch the After-burthen MOst Animals when they have brought forth their young cast forth nothing else but some Waters and the Membranes which contained them but Women have an After-birth of which after Labour they must be delivered as of a thing useless and inconvenient Wherefore assoon as the Child is born before they do so much as tye or cut the Navel-string lest the Womb close they must without losing time free the Woman from this fleshy mass which was destined to furnish the Infant with Blood for its nourishment whilst it was in the Womb and which at that time is called with much reason the After-birth because it follows the Child and is to the Woman like another Birth for being brought forth she is totally delivered To perform this the Midwife having taken the string must winde it once or twice about one or two of her Fingers of her left Hand joyned together the better to hold it with which she may then draw it moderately and with the right hand she may only take a single hold of it
above the lest near the Privities drawing likewise with that very gently resting the while the Fore-finger of the same hand extended and stretched forth along the String towards the entry of the Vagina as may be seen in the annexed Figure alwaies 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 just 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 Chap IX lib. 2. pag 190 Assoon as the Woman is delivered of both Child and Burthen it must then be considered whether there be all and care had that not the least part of it remain behind not so much as the Skirts or any Clods of Blood which ought all to be brought away with the first for otherwise being retained they cause great Pains all which being done things fit for Mother and Child in this condition must be provided which we will mention in their place When a Woman hath two Children she must be delivered in the same manner as if she had but one observing only for the reasons given in the precedent Chapter not to fetch the Burthen till all the Children are born and then it may be done without danger shaking and drawing it alwaies gently sometimes by one String sometimes the other and sometimes by both together and so by turns till all is come proceeding in it according to the directions already given When the Infant comes right and naturally the Woman is brought to Bed and delivered with little help observing what hath been taught in the two last Chapters of which the meanest Midwives are capable and oft times for want of them a simple Nurs-keeper may supply the place but when it is a wrong Labour there is a greater mystery belongs to it for then the skill and prudence of a Chirurgeon is for the most part requisite Which we intend now in the remaining part of this Book to treat of CHAP X. Of laborious and difficult Labours and those against Nature their Causes and Differences together with the means to remedy them FOr the easier and better explaining these things we say that there are three sorts of bad Labours to wit the Painful or Laborious the Difficult and that which is altogether contrary to Nature The Laborious is a bad Labour in which the Mother and Child though it comes right suffer very much and are harassed more than ordinary The Difficult is not much unlike the first but besides is accompanied with some accident which retards it and causeth the difficulty but the wrong Labour or that against Nature is caused by the bad scituation of the Child and can never be helped but by manual Operation or the Chirurgeons hand In the laborious and difficult Labours Nature alwaies doth the Work being a little assisted but in that contrary to Nature all its endeavors are vain and useless and there is then no help but in an expert Chirurgeon without whom she must certainly perish The Difficulties of Labour proceed either from Mother Child or both From the Mother by reason of the indisposition of her Body or it may be from some particular part only and chiefly the Womb or also from some strong passion of the Mind with which she was before possest In respect of her Body either because she may be too Young having the Passages too strait or too old of her first Child because her parts are too dry and hard and cannot be so easily dilated as happens also to them which are too lean they who are either small short or mishapen as crooked Women have not a Breast strong enough to help their Pains and to bear them down nor those that are weak whether naturally or by accident and crooked persons have sometimes the Bones of the Passage not well conformed the tender and too apprehensive of Pain have more trouble than others because it hinders them from doing their endeavour and they likewise who have small Pains and slow or have none at all Great Cholicks hinder Labour also by preventing the true Paius all great and acute diseases make it very troublesome and of a bad consequence according to Hippocrates's opinion in the 30th Aphorism of the Fifth Book Mulierem gravidam morbo quopiam acuto corripi lethale As when she is taken with a violent Feaver a great Flooding frequent Convulsions Dysentery or any other great distemper Excrements retained cause much difficulty as a Stone in the Bladder or when it is full of Urine without being able to void it or when the great Gut is repleted with hard Ordure or the Woman troubled with great and painful Piles and their ill scituation sometimes retard it extremely As touching the difficulty proceeding from the Womb only it must either be from its bad Scituation or Conformation having its Neck too strait hard or callous whether naturally or by any accident as having had there a Tumor Apostume or Ulcer or Superfluous flesh whether on the Neck or inward Orifice or because of any Cicatrice caused by a preceding bad Travail Besides these those things which are or may be contained in the Womb with the Child do also cause difficult Travail as when the Membranes are so strong that they cannot be broken which sometimes hinders them from advancing into the Passage or so tender that the Waters break too soon for then the Womb remains dry When there is a Mole or the After-burthen comes first which alwaies causeth flooding and certainly the death of the Infant if the Woman be not presently delivered of them by Nature or Art yea and when the Navel-string comes first the Child is suffocated if not speedily after born strong Passions of the Mind do likewise contribute much to it as Fear Sorrow and others the like The Woman that miscarries hath more pain than a Woman at her full time as also than one that is hurt although she be very near her time As to the hinderances caused by the Infant they are when either its Head or whole Body are too large when the Belly is Hydropical when it is monstrous having two Heads or being joyned to another Child Mole or any other strange thing when it is dead or so weak that it contributes nothing to its Birth when it comes wrong or when there are two or more besides all these different difficulties of Labour there is yet one caused by the Midwife's ignorance who for want of understanding her business instead of helping hinders Nature in its work Let us now treat of the means by which all these may be prevented and the Woman succoured in her bad and difficult Labour as may easily be done if we perfectly know the causes of all these difficulties as when it happens by the Mothers being too young and too strait she must be gently treated and the passages anointed with Oyl Grease and fresh Butter
using these things a long time before the Hour of Labour to relax and dilate them the easier lest there should happen a rupture of any part when the Child is born for sometimes there happens a dilaceration to the Fundament by which both are rent into one outwardly If a Woman be in years of her first Child let her lower parts be likewise anointed to mollify the inward orifice and the Vagina or Neck of the Womb which being more hard and callous do not easily yield to the necessary distension of Labour which is the cause why such Women are longer in Labour than others and why their Children being forced against the inward orifice of their Womb which is as we have said a little callous and also for remaining long in the passage are born with great Bumps and Bruises on their Heads Small and mishapen Women should not be put to Bed till at least their Waters be broke but rather kept upright and walking about the Chamber if they have strength being supported under the Arms for in that manner they will breath more freely and mend their Pains better than on the Bed where they lye all on a heap Let those that are very lean also moisten these parts with Oyls and Oyntments to make them more smooth and slippery that the Head of the Infant and the Womb be not so compressed and bruised by the hardness of the Mothers bones which form the Passage The weak Woman should be strengthened the better to support her Pains giving her good jelly Broths with a little Wine and a Tost in it or other good things as the case requires If she fears the Pains let her be comforted assuring her that she will not endure many more but be speedily delivered On the contrary if her Pains be slow and small or none at all they must be provoked by frequent Clysters a little strong that so they may be excited by the needings at Stool and afterwards let her walk about her Chamber that the weight of the Child may also help a little If the Woman floods or hath Convulsions which is by many too long neglected she must be helped by a speedy Delivery as we have already declared and shall repeat hereafter in its proper place If she be costive let her use Clysters which likewise may dissipate a Cholick at those times very troublesome causing great and useless Pains very hurtful because they fleet to and again through the Belly without bearing down as they should do If she cannot make water because the Womb bears too much on the Bladder let her try by lifting up her Belly a little or else by introducing a Catheter into her Bladder draw forth her Urine If the difficulty or slowness of the Labour comes from the ill Posture of the Woman let her be placed in a better more convenient to her Habit and Stature observing the circumstances given in the First Chapter of this Second Book If she be taken with any distemper she must be treated for it according to its nature with more caution than at another time having alwaies regard to her present condition If it proceed only from the indispositions of the Womb either from its oblique scituation it must be remedied as well as can be by the placing of her Body accordingly If it be by its vitious conformation having the Neck too hard and too callous and too strait it must be anointed with Oyls and Ointments as above directed If it come from a strong Cicatrice which cannot be mollified of a preceding Ulcer or a Rupture of a former bad Labour so agglutinated it must be separated with a fit Instrument lest another Laceration happen in a new place and leave the Woman in a worse condition than before it must be made in that place where the case most requires it taking care that it be not upwards because of the Bladder If the Membranes be so strong as that the Waters do not break in due time they may be broken with the Fingers * Let the Midwife be first well assured provided the Child be come very forward into the Passage and ready to follow presently after for otherwise there is danger that by breaking these Waters too soon the Child will remain dry a long time and to supply that defect you must moisten the parts with Fomentations Decoctions and Emollient Oyls which can never be so well as when Nature doth its own work with the Waters and ordinary Slime which alwaies happen well when they come in time and place Sometimes these Membranes with the Waters press three or four Fingers breadth out of the body before the Child resembling a Bladder full of Water there is then no great danger to break them if they be not already for when it so happens the Child is alwaies ready to follow being in the Passage but above all be careful not to pull it with your Hand lest thereby you loosen before its time the After-burthen to which it adheres very strongly If the Navel-string comes first it must be presently put up again and kept up if possible or else the Woman must be immediately delivered But if the After-burthen comes first it must never be put up again for being come forth it is altogether useless to the Infant and would be but an obstacle and hinderance in the way if it were put up in this Case it must be cut off having tyed the Navel-string and afterwards draw forth the Child assoon as may be lest that he be suffocated If the Woman hath fallen or is hurt let her immediately keep her Bed and take her rest If it be any Passion that retards the Labour and cannot totally be overcome let them endeavour to moderate it If it be Shamefastness or Modesty the persons who are the cause of it must quit the Chamber and if timidity and fear of Pain she must be advised that it is the will of God it should be so and that her Labour will not be so bad as she imagines perswading her to submit to the necessity by the consolation of the unfortunate whose pain seems always more supportable by the consideration that it is common so she must be informed that others endure the same Pain and greater than hers if she be melancholy let her be diverted by some good news promising her such a Child as she desires and in a word though she suffer much she must consider it but as a bad journey which one quarter of an hour of good Weather makes one forget all past as she will when she is brougt to bed assuring her chiefly that she is in no danger especially when it is not very apparent for then one ought to acquaint her with it that she may settle both her temporal and spiritual affairs When the difficulty is only caused by a dead Child the method mentioned in the natural Labour must be observed and besides the Woman must do all she can to further her Delivery because the
before he resolves on the manner of laying the Woman to avoid the like misfortune and the disgrace of being author of such a pittiful spectacle let him do his utmost endeavour not to be so deceived and to be fully satisfied whether the Child be alive or dead alwaies remembring that in this case timidity is more pardonable than temerity that is it is better to be deceived in treating a dead Infant as if it were alive than a living one as if it were dead The Child may be known to be alive if it be at the full reckoning if the Woman hath received no hurt if she hath had her health well all her going with Child if she be at that present in good health and very sure if she feels it stir which may be known by the Mothers relation and the Chirurgeon may be better assured of it if he feels it stir himself laying his Hand on the Mothers Belly to whose relation he must not alwaies trust for I have sometimes delivered Women whose Children had been dead above four days as may easily be judged by their corruption who notwithstanding affirmed although untruly that they felt them stir but a little before they were delivered and others again who were alive yet they never perceived them to stir in three or four days before as they confessed If the Chirurgeon cannot be assured by the Infants motion that it is alive he may assoon as the Waters are broke gently put up his hand into the Womb to feel the pulsation of the Navel-string which he will find stronger the nearer he feels it to the Infants Belly or if he meets with a Hand he may feel the Pulse but their Pulsation is not so strong as the Navelstrings by which it is best to be known if then he finds thus the beating of the Pulse he may be confident the Child is alive as also if by putting his Finger into its Mouth he perceives it to stir its Tongue as if it would suck But on the contrary the Child is dead if it hath not a long time stirred if there flowes from the Womb stinking and cadaverous humours if the Woman feels great pains and a great weight in her Belly if it be not supported but tumbles alwaies on that side as she layes her self if she saints * Not alwaies a sign or hath Convusions if the Navel-string or Secondine hath been a good while in the world or if by putting his Hand into the Womb he finds the Child cold and the Navel-string without Pulse and its Tongue immoveable and feeling the Head he finds it very soft chiefly towards the Crown where likewise the Bones are open and riding the one upon the other at the Sutures because the Brains shrink and are without Pulse when the Child is dead which corrupts more in two days in the Womb than it doth in four after it is born which the Heat and Moistness of the place causeth the two principles of Corruption But one may only conjecture it if the Woman hath been hurt or floods much be not at her full time if her Waters broke four or five days before if her Breasts flag if her Complexion be of a lead colour her Countenance languishing and dejected and if her Breath stinks We say that these things may only make us conjecture it but not as the rest certainly conclude it many of which happening together in one person assures us that the Child is dead for want of which it cannot be very certain wherefore as I have said 't is good to be very careful before they undertake it that so they may avoid the abovesaid scandals CHAP. XIII How to fetch the After-burthen when the string is broke WE have placed the present way of extracting the Afterbirth amongst unnatural Deliveries because 't is not sufficient to esteem it a good Labour that the Child be well born unless also the After-birth be well come away In respect of the Child it may be called natural because after his Birth it hath no more need of the Burthen but in respect of the Woman it is very unnatural I would therefore first treat of this bad Labour because it participates of a natural Labour in respect of the Child who is in no danger being born After that I will come to those in which both Mother and Child are in very great danger if not speedily and skillfully helped I have already shewed in the Ninth Chapter of this Book how a Woman must be delivered in a natural Labour where you may find the means but sometimes the Midwife by endeavouring it breaks the String with pulling too strongly or because it is very weak or else so putrified when the Child is dead that the least pull breaks it off close at the Burthen which by that means is left behind in the Womb or because it cleaves too strongly or the Woman is weak and cannot expel it being much tired by a long Labour or because it was not speedily after Labour drawn forth the Womb closeth so as leaves it no passage nor can it without much difficulty be again dilated to have it fetch'd because it remains dry after the natural slime and humidities which usually flow in Labours are sometimes past Since it is a verity indubitable that the Afterbirth remaining behind after the Child is born becomes an useless Corps capable of destroying the Woman we must take care that it be never left if possible Wherefore having endeavoured to bring it away as we have directed in the aforenamed Chapter and the Navel-string happen to break near the Burthen you must immediately before the Womb closeth introduce your Hand into it being well anointed with Oyl or fresh Butter your Nails close pared for to separate it from the Womb gently and draw it forth together with the Clods of Blood that are there When the Navel-string is not broken it will easily conduct the Hand by following of it to the place where the Burthen is scituated but when it is broken we have no longer this guide wherefore you must be then very careful that you be not deceived in taking one part for another as I once saw a Midwife pull the Womb near the inward Orifice instead of the Burthen which was behind but when she perceived all her endeavours vain except it were to make the poor Woman to suffer extremely she yeelded her up to me confessing her incapacity although she had vaunted * It seems Midwives in other Countries as well as some in England have that dangerous vanity before that she was more capable in her Art than any Chirurgeon Assoon then as you have introduced your Hand into the Womb towards its Fund or bottom you will find the Burthen which you may 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
yet remaining so in the Womb and the Burthen also the Head ought to be extracted before the Burthen to which may be answered with distinction that if the Burthen be wholly separated from the sides of the Womb it ought to be first brought away because it may hinder the taking hold of the Head but if it be still adhering it must not be medled with till the Head be brought away for if one should then go about to separate it from the Womb it would cause a flooding which would be augmented by the violence of the Operation for the Vessels to which it is joined remain for the most part open as long as the Womb is distended which the Head causeth whilst it is retained in it and cannot close till this strange body be voided and then it doth by contracting and compressing it self together as I have heretofore more exactly explained besides the Afterbirth remaining thus cleaving to the Womb during the Operation prevents it from receiving easily either bruise or hurt This instruction may suffice for this Chapter let us pass to the rest CHAP. XVI How to help a Woman inher Labour when the Childs Heed thrusts the Neck of the Womb forth before it IF we only respect the figure the Child comes in in this Labour we may say it is natural but when we consider the disposition of the Womb which is in danger of coming quite forth of the Passage or the extraction of the Infant we shall find it not so altogether for its Head thrusting it forcibly 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 Vagina or neck of the Womb bear forth before in great wrinkles according as the Child advanceth Women troubled with a bearing down of the Womb before they conceive and whose Womb is very moist are much subject to this accident because of the relaxation of the Ligaments The same Method we have taught in the natural Travail must not now be observed for in this case the Woman must neither walk nor stand upright but keep her Bed with her body equally at least scituated and not raised a little as is requisite in a natural Labour She must by no means use strong or sharp Clysters lest they excite too great Throws neither so much humect the Womb which is already too much relaxed but to aid her at the moment each Pain takes her when the Child begins to advance his Head and consequently the Neck of the Womb let the Midwife keep her hands on each side of the 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 it till the Woman of her self hath forced the Child quite into the world for one must by no means draw it by the Head as is mentioned in the natural Labour for fear of causing the Womb to fall out at the same time to which it is then very apt If notwithstanding the Infant having the Head born and yet stops there so long as to indanger 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 her Afterbirth must be fetched as is above directed being still careful for the same reason not to shake or draw it forth too rudely and then let it be placed up in its natural scituation if it bears down CHAP. XVII How to fetch a Child when coming right it cannot pass either because it is too big or the Passages cannot be sufficiently dilated THere are some Women whose Children notwithstanding they come right remain sometimes four five and six whole days in the Passage and would continue there longer if they were left alone without being able to be born unless assisted by Art to which we are obliged if we desire to save the Mothers life this happens oftenest to little Women of their first Children and chiefly if a little too much in years because their Womb being very dry cannot be so easily dilated as others who already have had Children or are not so old When this happens after that the Chirurgeon hath done his endeavour to relax and dilate the parts for to facilitate the Childs birth and that he finds all in vain because the Head is much bigger than it should be and that besides it is certainly dead as it for the most part is when it hath continued four or five days in this condition after the Waters are broke which he may be more exactly assured of by the signs already described in the 12th Chap. of this Book * This may be connived at when the Child is dead but because the most careful may ofttimes be mistaken it cannot be approved of as appears in the Translators Epistle to the Reader he need then make no scruple to fasten a Crochet to some part of the Childs head and rather about the hinder part than any other for to draw it forth by this means directly if possible if not let him make an incision with a strait or little crooked Knife which is best about the Sutures for to empty thence some of the Brains and so lessen the bigness of this Head and immediatly after fix his Crochet fast to the Skull in the same place whereby he will easily extract the Infant It is very certain when the Child is dead one ought to do according to my direction to save the Mothers life but it is a very great * This question is out of doors for the reason given in the foresaid Epistle question Whether a live Child ought to be so dealt with to save the Mothers life after there is no more hopes that it can be born any otherwayes because of the narrowness of the Passage which cannot possibly be sufficiently dilated for its Birth or whether one ought to defer the Operation untill there is a perfect assurance that 't is dead In this case I am apt to believe that since the Infant cannot avoid death neither one way nor the other for staying in the Passage without being able to be born it must dye and being drawn forth by Crochets it is killed one must and ought fetch it out alive or dead assoon as there is opportunity to do it and when all hope is lost that it can come any otherways thereby to prevent the Mothers death which could by no other means be avoided Tertullian as Riolanus very well notes in his 38th Chap. of the 12th Book of his Anatomical Chap XVIII lib. 2 pag. â—…9 Manual saith upon this subject That it is a necessary cruelty to kill the Child in this case rather than to save it from the danger it is in of dying and so certainly cause the Mothers death
the 12th Chap. of this Book for what a horrible spectacle would it be to bring as some have sometimes done a poor Child yet living after the Arm hath been cut off or any other part of the Body wherefore let him make a double reflection on his work before he goeth about it CHAP. XXII How to deliver a Woman when Hands and Feet come together IF the Infant presents both Hands and Feet together at the Birth it is altogether impossible it should be born so the Chirurgeon therefore guiding his Hand towards the orifice of the Womb will perceive nothing but a many Fingers close together and if it be not sufficiently dilated he will be a good while before he can exactly distinguish between the Hands and Feet by reason they are sometimes so shut and prest together that they seem to be all of one and the same shape but when the Womb is open enough for to introduce the Hand into it he will easily know which are the Hands and which the Feet and having well taken notice of it let him slide his Hand and presently direct it towards the Infants Breast which he will find very near and by that * Unnecessary let him gently thrust back the Body towards the bottom of the Womb leaving the Feet in the same place where he found them having therefore placed the Woman in a convenient Posture that is her Hips a little raised above her Breast and Head which scituation ought alwaies to be observed when the Child is to be put back into the Womb let him afterwards take hold of him by the Feet and draw him forth according to the way before directed in its proper Chapter This Labour truly is a little troublesome but nothing near so much as that we have mentioned in the preceding Chapter where the Child presents only his Hands for in that the Feet must be searched a great way off and it must be quite turned about before it can be drawn forth but in this they are ready presenting themselves and there is not much to do but to lift and thrust back a little the upper part of the Body which is almost done of it self * Sufficient and the best way in this Birth by drawing it alone by the Feet Those Authors that have written of Labours and never practised them as many Physicians have done do order all by the same precept often reiterated that is to reduce all wrong Births to a natural Figure which is to turn it that it may come with the Head first but if they themselves had ever had the least experience they would know that it is very often impossible at least if it were to be done by the excess of violence that must necessarily be used to effect it it would go near to destroy both Mother and Child in the operation a Fiat in this Case is soon said and ordered but it is not so easily executed as pronounced For my part I am of an opinion cleer contrary to theirs and such as are skilfull in the Art will surely agree with me in it that is that whensoever the Infant comes wrong in what Posture soever from the Shoulders to the Feet it * A good note is the best way and soonest done to draw it forth by the Feet searching for them if they do not present themselves rather than to try to put it into a natural Posture and place the Head foremost for the great endeavours often necessary to be used in turning the Infant in the Womb which is a little harder than to turn a Pancake in a frying Pan doth so weaken both Mother and Child that there remains not afterwards strength enough for to commit the Operation to the work of Nature and usually the Woman hath no more Throwes nor Pains fit for Labour after she hath been so wrought upon for which cause it would be very tedious and difficult as also the Infant which is already very weak would certainly perish in the Passage without being able to be born Wherefore it is much better in these cases immediatly to fetch it by the Feet searching for them as I have already directed when they do not present themselves by which a tedious Labour will be prevented to the Mother and the Child will be often brought alive who without it will scarce escape death before he can be brought forth by the strength of Nature CHAP. XXIII How to deliver a Woman when the Child comes with the Knees WHen an Infant not being turned towards the latter moneths as he ought to come with his Head foremost as is mentioned in the 5th Chap. of this Book presents the Knees to the Birth having the Legs folded towards the Buttocks one may easily be deceived touching but one of them because of their hardness and roundness and take it for the Head especially when being scituated a little high it can be reached but with the end of a Finger only but if it be touched and handled a little better the Infant being fallen a little lower it will easily be distinguished Assoon then as it is perceived it must not be suffered to advance further in this Posture but having placed the Woman the Knees must gently be put back for to have the more liberty to unfold the Legs one after the other which the Chirurgeon Chap XXIII lib. 2. pag 2â—… Chap XXIV lib. 2 pag 245. may do by putting one or two of his Fingers under the Hamm directing them by little and little all along behind the Leg until he meets the Foot and drawing alwaies a little obliquely for to come the easier to the end of it that so having disengaged one he may do the same to the other proceeding in the same manner as with the first after which having brought them together he may finish the work as when a Child comes Footling alwayes observing to bring the Face of it downward and such circumstances as are noted where we treat of that Labour CHAP. XXIV Of a Delivery where the Child comes with Shoulder Back or Breast THe most difficult of these three sorts of Figures and Scituations in which Infants sometimes come is that of the Shoulders because it is furthest from the Feet of the Infant and the Chirurgeon must find them for to draw it forth The next is the Back and the Breech for the same reason causeth least trouble not only because the Feet are nearer but also because by this Figure the Head and Neck of the Infant is not so constrained and lockt as in the other scituations For to remedy this Birth of the Shoulder some advise that it should be put back to make way for the Head of the Infant that so it may be reduced to a natural Birth but it is much better for the reasons above alledged in the 22th Chap. of this Book to try to bring it by the Feet for to effect which the Chirurgeon must thrust the Shoulder a little back with his
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 Placenta and therefore there must be a free communication or for want of it that the Infant must immediatly breath by the mouth as well to be refreshed as to drive forth by exspiration the fuliginous vapours which not being possible whilst in the Womb it must unavoidably be choaked and dye in a very small time if it wants both together Wherefore in this case the Woman must without any delay be delivered which if Nature doth not speedily perform the Child must be drawn forth by the Feet Women that have great Waters and a long string to the Burthen are very subject to this mischief for the Waters coming forth in great abundance at the breaking of the 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 immediatly endeavour to put it back to prevent the cooling of it behind the Childs head lest 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 down 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 until the Head be advanced as abovesaid or in case the hand be taken away to put a piece of fine soft rag between that side of the Head and the Womb for to stop up the way it came down by alwaies leaving an end of the rag without the body for to draw it forth by at pleasure But sometimes notwithstanding all these cautions and the putting back of it it will yet come forth every Pain then without further delays the Chirurgeon must bring the Child forth by the Feet which he must search for though the Infant comes with the Head for there is but this only means to save the Childs life which it would certainly lose by the least delay in this case Wherefore having placed the Woman conveniently let him gently put the Head which offers back provided it be not engaged too low among the bones of the Passage and that it may be done without too great violence to the Woman for in that case * See the Preface it will be better to let the Child run the hazard of dying than to destroy the Mother and then slide up his Hand well anointed under the Breast and Belly to search for the Feet by which he must draw it forth according to former directions this being dispatched let him immediatly take great care of the Infant which is ever in this case very feeble CHAP. XXVIII Of a Labour wherein the Burthen either first offers or first comes quite forth THe coming forth of the Navel-string before the Infant of which we have treated in the foregoing Chapter is often cause of his death for the reasons there given but the coming first of the Burthen is yet much more dangerous for besides that the Children are then ordinarily Still-born if they be not assisted in the very instant the Mother likewise is often in very great peril of her life because of her great floodings which usually happen when it is loosened from the Womb before its due time because it leaves all the Orifices of the Vessels open to which it did cleave whence flowes incessantly Blood until the Child be born because the Womb whilst any thing continues there doth every moment strongly endeavour to expel it by which means it continually voids and epresseth the blood of the Vessels which are always open as we have already often 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 we ought to be vigilant to succour an Infant when the String comes first we ought much more to be so when the Burthen comes forth first and the least delay is ever cause of the Infants sudden death if the Woman be not speedily delivered because the Infant cannot stay then long in the Womb without suffocation standing then in need of breathing by the Mouth as is explained in the foregoing Chapter the Blood being no longer vivified by the preparation made in the Burthen the use and sunction of which then ceaseth from the instant it is separated from the Vessels of the Womb to which it was joined for which reason there immediatly follows a great flooding which is so dangerous for the Mother that without speedy help she soon loseth her life by this unlucky accident When the Burthen is not wholy come forth but lies in the Passage some advise to put it back before the Child be fetcht but I am not of that opinion for when it comes into the Passage before the Infant it is then totally divided from the Womb at the bottom of which it ought ordinarily to be scituated and fastened until the Child be born but because assoon as it is wholly loosened as it alwaies is when it comes first it becomes a Body altogether unnatural it must never be thrust back but contrarily be ferched away and at the very moment after bring the Child 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 farr from being useful that this Burthen would much hinder the Chirurgeon from being able to turn the Child as he ought for to bring it by the Feet Wherefore when it presents in the Passage which may be soon perceived if they find every where a soft substance without the least resistance to the touch of any solid part finding likewise the String fastened to the middle of it and the Woman flooding extremely as is ordinary at such times then instead of thrusting it back the Burthen must be brought away that so there may be more liberty and room to extract the Child according to former direction The Burthen being quite loosened from the Womb and coming first in the Passage must not be thrust back into it again much less must it be put back when is is quite come forth of the Body Care must be only taken 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 fetcht which is then ever in great danger as also the flooding may be the sooner stopt which happens for the most part assoon as the Woman is delivered for which reasons it must be with all possible speed dispatched Sometimes notwithstanding this dangerous accident the Child may be born alive if timely succoured but it is then so weak that 't is hard to discover at first whether it be living or dead When it so happens the Midwives do ordinarily before they separate the Burthen put it into a skellet of hot Wine and imagine with no small Superstition that in case 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 it vigour but it is more credible that being almost suffocated for want of respiration assoon as it needed it it begins now by means of it to recover from that fainting but nevertheless there is no hurt in keeping the custome though superstitious since it can do no prejudice and may satisfie preoccupied spirits provided necessaries be not neglected in being blindly carried away with this conceipt CHAP. XXIX Of Floodings or Convulsions in Labour THe best expedient and safest remedy for Mother and Child in this case who are both in great danger is to deliver the Woman presently without any delay fetching the Child away by the Feet at what time soever of the Womans being with Child whether at full reckoning or no. I have at large directed in the 20th Chap. of the first Book speaking of Floodings what ought to be done in these Cases where I related the sad Story of one of my Sisters which I shall not again repeat being too sadly affected with it but refer the Reader to that Chapter for sufficient directions in these dangerous accidents CHAP. XXX How to deliver a Woman when the Child is Hydropical or Monstrous A Child may in the Womb have either the Dropsy of the Head called Hydrocephale or of the Breast or of the Belly And when these parts are so filled with Water as I have sometimes met with that they are much too big for the Passage through which the Child must issue then notwithstanding any Throws or Endeavors the Woman may attempt to bring it forth 't is impossible she should effect it without the help of Art as likewise when the Child is monstrous either by being only too big in the whole Body or in any particular part or by being joined to another Child If the Child be living that hath the Dropsy when the Woman is in Labour it must be destroyed to save the Mother by making a hole in either the Head Breast or Belly of it where the Waters are contained that being emptied by the apertion so made the Child may the easier be drawn forth or else he must necessarily dye in the Womb not being able to be born and remaining there will also kill the Mother wherefore to save her life the Infant must be by an * See the Preface indispensable necessity brought forth by Art since 't is impossible it should come of it self which may be done with a crooked Knife sharp at the very point like that marked C among the Instruments at the end of the Second Book the Chirurgeon proceeding in the following manner After â—â—at the Woman is placed conveniently for the Operation he must slide up his left Hand on the right side of the interiour part of the Infants Head if the Waters be continued therein which he will perceive by the extraordinary bigness and extent of it the Sutures much separated and the Bones of it far distant one from the other by reason of the distension made by the inclosed Waters of which being very certain let him slide with his right Hand along the inside of his left this crooked Knife taking care that the point of it in introducing it be alwaies towards his left Hand for fear of wounding the Womb and having conducted it close up to the Head against one of the Sutures let him turn the Knife towards it and make an apertion large enough to let out the Water and then it will be very easie to bring forth the Child forasmuch as the other parts are then usually small and much consumed If these Waters were contained in the Breast or Belly then the Childs Head being no bigger than ordinary may be born but the Body being exceedingly swelled with the Waters will stay behind as it happened to that Child that had a Dropsy of the Belly which I mentioned in the 19th Chap. of this Book to which I refer you because 't is much to this purpose The case being thus let the Chirurgeon slide up his left Hand as aforesaid and the instrument with the right just to the Breast or Belly for to make an Incision just as I did in the same case related in the said 19th Chap. for to let out the Waters after which he may with much ease finish the Operation You must know that 't is much more difficult to deliver a Monstrous Birth or two joined together than one that hath the Dropsy because the bigness of the Hydropick parts may be easily lessened by a single incision which is sufficient to let out the Waters which distend and then 't is easie to dispatch the rest But when a monstrous Child is to be extracted or a double one a single apertion is not enough but sometimes 't is necessary to take off whole members from those Bodies which makes the Operation much more painful and laborious and requires more time and skill to effect it in which case the left Hand must be introduced into the Womb and the sharp Knife of the right just to the parts that are to be divided and separated and there with all the care that may be the member of the monstrous Child must if possible be taken off just at the Joint and when there are two Children joined together the Separation must be made just in the place where they join and afterwards they may be delivered one after the other always taking them by the Feet and if it hath but one the same thing may be accomplished after having lessened the bigness of it by cutting off some one of the Members I have already shown in the 15th Chap. of this Book speaking of the extraction of a Childs Head left alone behind in the Womb of what fashion this Instrument ought to be that the Operation may be conveniently performed and that it should be as long as an ordinary Crochet for the more surety and facility because that holding the handle of it with the right Hand it may be thrust drawn sloaped and turned without pain to any side at pleasure and with the left which is within the Womb it may be guided for to cut and dismember more skilfully and easily those parts which must be
separated Wherefore it ought to have a Handle so long that the Chirurgeons right Hand without the Womb may hold and govern it as abovesaid and conduct it the better in the Operation which could not be so safely and conveniently done if this instrument were so very short as all other Authors recommend because in this occasion the Chirurgeons hand is so constrained and pressed in the Womb that he can hardly there have the liberty to move his Fingers ends which is the cause why he cannot without much difficulty govern such an Instrument with one Hand only unless he would very much force and offer violence to the Womb and exceedingly endanger thereby the poor Womans life Let us now come to the extraction of a dead Child and show the several ways of doing it CHAP. XXXI Of delivering a dead Child WHen the Infant is dead in the Mothers Belly the Labour is ever long and dangerous because for the most part it comes wrong or though it comes right with the Head 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 labours so little that many times it cannot finish the business it hath begun but must yeeld without the help of Art of which at that time it hath great need However before you come to Manual Operation endeavour to stir up the Womans Pains with sharp and strong Clysters for to bring on Throws to bear down and bring forth the Child but if this prevails not she must be deliverd by Art We have declared in the 12th Chap. of this Book the signs to know a dead Child in the Womb of which the chief are if the Woman perceives it not to stir nor hath a long time before if she be very cold much pain and heaviness in the bottom of her Belly if the Child be not supported but always falls like a mass of Lead to that side on which the Woman lies if the Burthen or Navelstring hath been a long time in the World and if no Pulsation be there felt and that dark and stinking putrid matter comes away from the Womb. All these signs together or most of them shew the Child is assuredly dead which when the Chirurgeon is certain of he must do his endeavour to fetch it assoon as possibly he can and having placed the Woman according to former directions if the Child offers the Head first he must gently put it back until he hath liberty to introduce his Hand quite into the Womb and sliding it all along under the Belly to find the Feet let him draw it forth by them as is formerly taught being very careful to keep the Head from being lockt in the Passage and that it be not separated from the Body which may easily be done when the Child being very rotten and putrified the Chirurgeon doth not observe the circumstances often repeated by us that is in drawing it forth to keep the Breast and Face downwards And if nothwithstanding all these precautions the Head because of the great putrifaction should be separated and remain behind in the Womb it must be drawn forth according to the directions formerly given in the proper Chapter But when the Head coming first is so far advanced 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 certainly dead 't is better to draw it so forth than to torment the Woman too much by putting it back for to turn it and bring it by the Feet but because it being a part round and slippery by reason of the moisture the Chirurgeon cannot take hold of it with his Fingers nor put them upon the side of it because the Passage is filled with its bigness he must take a * Though this Crochet cannot hurt a dead Child yet it may endanger the Woman by slipping Wherefore the Translator of this Treatise cannot approve of it having an easier and safer way to do this Operation as he mentions in his Preface to this Book Crochet like one of those marked A and B amongst the Instrument at the end of this Second Book and put it up as far as he can without violence between the Womb and the Childs Head observing to keep the point of it towards the Head where he must fasten it endeavouring to give it good hold upon one of the Bones of the Skull that it may not slide forcing in the point of it which must be strong that it may not turn and after the Crochet is well fixed in the Head he may therewith draw it forth keeping the ends of the Fingers of his left Hand flat upon the opposite side the better to help disengage it and by wagging it by little and little to conduct it directly out of the Passage Chap IIII. lib. 2. pag 169 â—he dead Child of which above all there must â—d assurance comes with the Arm up to the â—lers so extreamly swelled that the Woman â—asser too much violence to have it put back â—st then to take it off at the Shoulder-joint â—sting it three or four times about as we have â—y taught in another place by which means 〈◊〉 is no need of either Knives Sawes or sharp â—rs as some Authors will have it it being 〈◊〉 easily performed without all that provision â—de of the softness and tenderness of the Body 〈◊〉 that the Arm so separated and no longer â—ing the Passage the Chirurgeon will have 〈◊〉 room to put up his Hand into the Womb to 〈◊〉 the Child by the Feet and bring it away as 〈◊〉 been directed Although the Chirurgeon be sure the Child is â—…ad in the Womb and that it is necessary to fetch 〈◊〉 by Art he must not therefore presently use his Crochets 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 the Child any other way because very often though he hath done all that Art directs persons present that understand not these things will believe that the Child was killed with the Crochets although it had been dead three days before and without other reasonings or better understanding of the matter for recompense of his saving the Mothers life requite him with an Accusation of which he is altogether innocent and in case the Mother by misfortune should afterwards dye lay her death also to his charge and instead of praise and thanks treat him like a Butcher or Hangman to which divers Midwives are usually very ready to contribute and are the first that make the poor Women that have need of the Men afraid of them So much they are in fear of being blamed by them for having themselves been the cause as some of them often are of the death of
the impossibility of it There are others agin who shewing the scars of some abscess they have had in their Belly would perswade that a Child hath been taken out there to which purpose I will relate what I once saw my self concerning a big-bellyed Woman that was in the Hôstel de Dieu at Paris when I there practised Deliveries This Woman whether through cunning feigning to believe the thing or through ignorance really beleeving it did testify to all the Women who were then in the said Hôstel de Dieu as also to an infinite of other persons and amongst the rest to a good old Nun that governed all whom they called Mother Bouquet and at that time did preside in the Hall of Deliveries like another goddess Lucina that she was very much afraid that they must open her side to deliver her as it had been two years before in all which time she had made the same relation to above a thousand several persons each of which it may be had again related it to as many more shewing to all of them a great Skar by which she said the Chirurgeons had drawn the Child out of her Belly Wherefore she prayed Mother Bouquet to recommend her to me desiring rather to be delivered by me who was a Chirurgeon because she might be more safely helped in such a business than by a Midwife This good Nun giving me this account which she verily beleeved according to the relation I told her that not having faith enough to imagine it I could not believe the Caesarean Section had been made on that Woman as she had perswaded her If you do not beleeve it replied she I will fetch her presently to you and she her self shall tell you every circumstance And immediatly she caused her to be fetch'd who told me the same she had told her but having particularly examined her from what part the Child was so drawn forth and whether she felt any great pain in the Operation She answered me None because she was then senseless and remained so five or six days after I asked her then how she was certain that the Child was brought away by incision in her Belly being she was not at that time sensible She answered the Chirurgeons assured her it was so and at the same time she shewed me a great Skar scituated just on the right side of her Breast about the middle of the Ribs where she had a great abscess of which this Skar remained and when I had told her that the Breast was not the place whence a Child should be fetcht and that I had with my arguments convinced her of the impossibility of what she had believed and made others to believe as the women of the Hostel de Dieu and Mother Bouquet also they began to be disabused and continued so when three days after this conference I had delivered her with the greatest facility although it was a very great Child which came quickly If one should examine well the beginning of all the Stories of this Operation strictly weighing them as I did upon this occasion they would be found to be meer fables and that that which Rousset reports of his Caesarean Labours is nothing but the ravings capriciousness and imposture of their Authors Now if because of all these reasons a Chirurgeon must never practise this cruel Operation whilst the Mother is alive although the Child be certainly so which for all that may somtimes he very doubtful I pray what infamy would it be for him if having so killed the Mother the Child should also be found dead after it was thought to be alive much more ought he to abstain from it when he is well assured it is dead wherefore he had better pull it in pieces and bits if it cannot be otherwise by the natural way than so to butcher the Mother for to have it whole and if the Womb were so little open that he could not have liberty to work there nor introduce any instrument into it he had better wait a little alwaies trying to dilate the Passages by Art as we have formerly directed than to cast her down almost in an instant with such a blow of despair as the making of this Caesarean Operation which for this reason is never to be undertaken till immediatly after the Mothers death when the Chirurgeon must be present for to act according to the following directions as well in hopes of finding the Child living as to obey an Ordinance which expresly forbids the burying a Woman with Child before it is taken out of her Belly To accomplish which as it ought to be when he perceives the Woman in the agony he must quickly make ready all things necessary for his work to lose no time because delay will certainly be the death of the Infant which else a few moments before might have been brought alive there are some that when the Woman is just a dying would have somewhat put between her Teeth to keep her Mouth open and likewise in the outward part of the Womb to the end the Infant receiving by this means some little air and refreshment may not be so soon suffocated but all this mystery will avail but little because the Child lives only by the Mothers blood whilst it is in the Womb but if he will needs do so it is rather to content the company than out of any belief of the good it will do Assoon then as the Woman hath breathed her last and that she is dead to which all the company must agree he shall begin his Operation which the Greeks call Embriulcie Most Authors would have it made on the left side of the Belly because it is more free from the Liver which is on the right but if my opinion may be authentick it will be better and more skilfully made just in the middle of the Belly between the two right Muscles because in this place there is only the Coverings and the white Line to cut when on the side it cannot be done without cutting the two oblique and cross Muscles which being couched one under the other makes a considerable thickness besides that it bleeds more than towards the middle of the Belly not that the loss of blood is of any moment which will flow when the Woman is but just dead but because it hinders by its flowing the seeing distinctly how to make the Operation as it should be To dispatch then with more ease and speed the Chirurgeon having placed the dead Body that the Belly may be a little raised let him take a good sharp incision Knife very sharp of one side like that marked E in the table of Instruments at the end of this Chap. with which he must quickly make at one stroak or at two or three at most if he will for the greater surety an incision just in the middle of the Belly between the two right Muscles unto the Peritoneum of the length and extent of the Womb or thereabouts after
that he must only pierce the Peritoneum with the point of his Instrument to make an orifice for one or two of the Fingers of his left Hand into which he must immediatly thrust them for to cut it lifting it up with them and conducting the instrument for fear of pricking the Guts in proportion to the first incision of the * Skins Coverings which having done the Womb will soon appear in which he must make an incision in the same manner as he did in the Peritoneum being careful not to thrust his instrument at once too far in thinking to find the Womb a finger or two thick as all Authors affirm contrary to truth in which he would be deceived as those are that never well considered it for it is very certain that at the time of Labour whilst it contains the Child and Waters in it it is not above a single line thick or the thickness of half a Crown although they have all sang to us that by divine Providence and a Miracle the more 't is extended with the Child the thicker it grows which is absolutely false it being only true that it is at that time a little thicker at the place where the Burthen cleaves where its substance is then as it were spongious but every where else it is very thin and becomes the more so by how much it is more extended until being emptied by the Birth of the Child it begins to grow thicker in contracting and gathering to it self all its substance which was before very much extended It being just like the Bladder which being full is very thin and being empty appears to us of half a Fingers thickness which filling again waxeth thinner in proportion to the Urine that flows to it having then so opened the Womb he must likewise make an incision in the Infants Membranes taking care not to wound it with the instrument and then he will soon see it and must immediatly take it out with the Burthen which he must nimbly separate from the bottom of the Womb and finding it to be yet living let him praise God for having so blessed and prospered his Operation But the Children so delivered in these cases are usually so weak if not quite dead as it often happens that 't is hard to know whether 't is alive or dead Yet one may be confident the Child is living if by touching the Navelstring the Umbilical Arteries are perceived to move as also the Heart by laying the Hand on the Breast and if it prove so means must be used to fetch it to it self spouting some Wine in the Nose and Mouth warming it until it begins to stir of it self Midwives usually lay the Burthen very hot on the Belly of such weak Children if that helps 't is rather because of the temperate heat of it than for any other cause for 't is impossible the Infant should receive any spirits from it after it is once separated from the Womb and yet less when the Woman is dead As to the heat of it it can no wise hurt but the weight of this mass layed on the Belly may rather choak it by the compression it makes than do it any good besides when the Burthen is grown cold they put it in a Skellet of hot Wine from whence they think the Spirits renew which being conveyed through the String into the Childs Belly gives it new force but as I have said already that is very useless and the best and speediest remedy is immediatly to separate it and open the Childs Mouth cleaning and unstopping also the Nose if there be any filth to help it so to breath freely keeping it all the while near the Fire until it hath a little recovered its weakness spouting some Wine into the Nose and Mouth of it that he may a little tast and scent it which can not hurt it in this juncture if one observes some moderation in the thing Having now at large treated in this Second Book as well of natural as unnatural Labours and given sufficient instructions to a Chirurgeon to enable him to help Women in the first and to remedy all the different accidents of the latter to which he may be dayly called there rests nothing now to finish it but to represent the Instruments proper to this Art And then we will pass to the Third Book where we must handle many things which they must necessarily know that intend to practise Deliveries Explication of the Instruments A A Crochet or Hook to draw forth a dead Child B Another Crochet for the same purpose according as the case requires either bigger or less both of them must be strong enough and very smooth and equal that the Womb may not be hurt in the Operation and above ten large Inches long or thereabouts and their Handles must be of a moderate bigness for the firmer holding of them C A crooked Knife equal in length to the Crochets fit for the separating a monstrous Child or piercing of the Belly of an hydropical Infant or opening the Head to empty the Brains or to divide it in pieces when because of its bigness or monstrousness it remaines behind in the Womb separated from the Infants Body D. Another small crooked Knife for the same purpose but not so convenient because it cannot be guided but with one Hand E. A sharp Incision-knife fit for the Caesarean Section soon after the Mothers death F A Cranes bill fitted for the drawing forth of the Womb any strange Body or false Conception when the whole Hand cannot be introduced G Another Instrument for the same purpose H A Speculum Matricis with three branches to open the Womb for to discover Ulcers or other Maladies sometimes there deeply scituated I Another of two Branches for the same purpose K Another yet more commodious L A Catheter to let out the Urine when the Woman cannot make Water M A Syringè for injections into the Womb. End of the Second Book The Third Book Treating of Women in Child bed and of the Diseases and Symptomes befalling them at that time Of Children new born and their ordinary Distempers together with necessary directions for to choose a Nurse GOing with Child is an rough Sea on which a big-bellyed Woman and her Infant floats the space of nine Months And Labour which is the only Port is so full of dangerous Rocks that very often both the one and the other after they are arrived and disembarked have yet need of much help to defend them against divers inconveniences that usually follow the Pains and Travail they have undergone in it We have directed in the First Book treating of the Diseases which are incident to Women with Child how to prevent their suffering shipwrack in this Sea during so long a Voyage In the Second we have taught how they may enter this Port and disimbarque there with safety by Delivery It remains then to compleat our work that we expound in this Third and last how the
Mother and Child must afterwards be ordered and declare how at this time to prevent and remedy divers Indispositions which often happen to them both Let us first consider those that arrive to a Woman new layd and then we shall pass to those that regard a new-born Infant CHAP. I. What is fit to be done to a Woman new-laid and naturally delivered IMmediatly after the Woman is delivered and the Burthen come away care must be taken that the loosening of it be not followed with a Flooding which if it be not a soft Closure to the Womb must immediatly be applied five or six double to prevent the cold Air by entring in from sudden stopping the Vessels by which the Woman should cleanse by degrees whereby there would certainly happen many ill accidents as great Pains and Gripes of the Belly Inflammation of the Womb and divers others which we shall mention hereafter particularly and which may easily be the cause of her death When the Womb is so closed if the Woman was not delivered upon her ordinary Bed let her be presently carried into it by some strong body or more if there be need rather than to let her walk thither which Bed must be first ready warmed and prepared as is requisite because of the cleansings but if she were delivered on it which is best and safest to prevent the danger and trouble of carrying her to it then all the soul linnen and other things put there for the receiving the Blood Waters and other Filth which comes away in Labour must be presently removed and she must be placed conveniently in it for her ease and rest which she much wants to recover her of the Pains and Labour she endured during her Travail that is with her Head and Body a little raised for to breath the freer and cleanse the better especially of that Blood which then comes away that so it may not clod which being retained causes very great Pains All this will happen if they have not liberty to come freely by this convenient scituation in which she must put down her Legs and Thighs close together having a small Pillow for her greater ease if she desire it under her Hams upon which they may rest a little being so put to Bed let her lye neither of one side nor the other but just on the middle of her back that so the Womb may repossess its natural and proper place It is an ordinary custom to give the Women assoon as they are delivered two Ounces of Oyl of sweet Almonds drawn without fire and as much Syrup of Maiden-hair mixed together which is as well for to sweeten and temper the inside of the Throat which was heated and hoarse by her continual Cries and holding her Breath to bear down her Throws during her Labour as also to the end that her Stomach and Intestines being lined with it should not be so much afflicted with dolorous Gripes But this Potion goes so much against the Stomachs of some Women that being forced to take it with an aversion and disgust it may do them rather more hurt than any wise comfort them Wherefore let none have it but those that desire it and have no aversion to it I approve rather in this case of a good Broth to be given her assoon as she is a little setled after the great commotion of Labour because it will be both more pleasing and profitable than such a Potion And having thus accommodated her and provided for her Belly Breasts and lower parts after the manner we shall direct in the next Chapter leave her to rest and sleep if she can making no noise the Bed-curtains being close drawn and the Doors and Windows of her Chamber shut that so seeing no light she may the sooner fall asleep If she had endured a hard Labour she must be then ordered as the case requires and as shall be hereafter declared but what we have here directed is only for a natural Labour and where no extraordinary difficulty happens CHAP. II. Of convenient Remedies for the lower parts of the Belly and Breasts of Women newly delivered SInce the lower parts of a Woman are greatly distended by the birth of an Infant it is good to endeavour therefore the prevention of an inflammation there wherefore assoon as the Bed is cleansed from the foul linnen and other impurities of the Labour and that the Woman is therein placed according to the direction of the preceding Chapter let there be outwardly applied all over the bottom of her Belly and Privities the following Anodine Cataplasm made of two Ounces of Oyl of sweet Almonds with two or three new-laid Eggs Yolks and Whites stirring them together in an earthen Pipkin over hot Embers till it comes to the consistence of a Pultiss which being spread upon a Cloth must be applied to those parts indifferently warm having first taken away the Closures which were put to her presently after her Delivery and likewise such clods of Blood as were there left This is a very temperate remedy and fit to appease the Pains which Women ordinarily suffer in those parts because of the violence then endured by the Infants Birth it must lie on five or six Hours and then be renewed a second time if there be occasion afterwards make a Decoction of Barley Linseed and Chervil or with Marsh-mallows and Violet leaves adding to a Pint of it an ounce of Honey of Roses with which being luke warm foment three or four times a day for the first five or six days of Child-bed the bearing-place cleansing it very well from the Blood Clods and other Excrements which are there emptied This Stupe is likewise very good to temper and appease the Pains of those parts Some persons only use to this purpose luke-warm Milk and many Women only Barley-water Great care must be taken at the beginning that no stopping things be given to hinder the cleansings but when ten or twelve days are past and that she hath cleansed very sufficiently Remedies may then be used to fortifie the parts to which purpose a Decoction is very proper made of Provence-Roses Leaves and Roots of Plantane and Smiths water that Iron is quenched in and when she hath sufficiently and fully done Cleansing which is usually after the 18th or 20th day there may be made for those that desire it a very strong astringent Lotion to fortifie and settle those parts which have been much relaxed as well by the great extension they received as by the humours with which they have been so long time soaked This Remedy may be composed with an Ounce and an half of Pomegranate Peel an Ounce of Cypress Nuts half an Ounce of Acorns an Ounce of Terra Sigillata a Handful of Provence-Roses and two drachms of Roch-Allum all which being infused a whole night in five half Pints of strong red Wine or that it may not be too sharp a quantity of Smiths water mixed with that Wine afterwards boil it well to
compression is much greater in respect of the Veins which are alwaies more outward and ought to carry back the Blood to the Heart than of the Arteries by means of which it is carried to all the parts for besides that the Arteries lye deeper they have also a continual Pulsation by the favour of which a little Blood ever slides away and this is the reason that in all Compressions or Ligatures of parts provided they be not too-hard the Blood is easily carried into them by the Arteries and but very hardly or not at all carried back by the Veins which is the reason that the part receiving much more than it sends back or consumes for its nourishment must needs swell on this fashion by Repletion If they that practise Midwifery do but well consider what I have said when occasion offers which is very often they will find that these kind of Knobs or Tumours which many Children have on their Head at their birth proceed ordinarily from no other cause than what I have here explained These Tumours many times are so great and high that the Woman not being yet delivered nor having the inner Orifice of the Womb well dilated they do hinder the discovery of the part the Infant first presents making Midwives sometimes to imagine not being able to feel any bone of the Head with their Finger that it is the Childs Shoulder or some other part nay some of them cannot tell what that swelling is they feel but they may soon know it by reason these Tumours though feeling very fleshy at the touch are notwithstanding harder than any Shoulder or Buttock of a Child which parts are alwaies more soft and without hair as the Head hath the Bones of which may also be easily perceived if having the Finger anointed with Oyl or fresh Butter it can be introduced into the inner orifice for the parts of the Head within the Womb are not swelled 't is only this which offers to the Orifice and is prest and begirt by it as we have said If a Child comes with any other part besides the Head as an Arm or a Leg and that these parts likewise remain a long time prest in the Passage and in a posture much constrained or that they be come forth they likewise swell for the same reason There must not only be Remedies applied to these Knobs and Bruises of young Childrens Heads but endeavours must be to prequent them or at least to hinder them from becoming so big the means to prevent them is to procure the Delivery assoon as may be that the Infants Head may not rest so too long and be straitned by the Garland of the inner orifice of the Womb which must be well anointed with Oile or Emollient Ointment as well to further its dilatation as that the Head may the sooner and the easier pass Some may object That if these Tumours happen from the cause I have mentioned they would disappear assoon as the Infant is born because then the Head being no longer prest nothing hinders the Blood which had rumefied the part from returning having its motion free But they must know that by its too long stay it makes in one part it looseth the spirits which are there suffocated of which being destitute it can no longer move and being extravased without the Vessels out of its natural place as it will be when the Vessels containing it are too full it slides into all the little vacuities of the part for which cause it cannot afterwards return by the ordinary waies wherefore there is a necessity in this case either that it be resolved through the part or if it stay any time that it comes to Suppuration which however must be avoided if it be possible because of the nearness of the Brain which in Infants is not covered over with the Skull at the Sutures which are alwaies very open especially towards the Mould To resolve these Tumours then assoon as the Child is born foment them with warm Wine or Aquavitae and wetting a Compress in it put it upon them some Mid-wives only dip a Compress in Oyl and Wine beat together others in Oyl of Roses onely having first fomented them with Wine but if notwithstanding this they come to Suppuration the matter must not be suffered to remain there too long for fear lest the bones of the Head which are very tender and thin in new-born Children become altered and soule in this case it must be opened with a Lancet in a proper place according to Art putting upon it afterwards a Plaister of Bettony if a Leg or an Arm be thus swelled it must likewise be wrap'd up with Compresses dipt in Wine wherein Provence-Roses Camomil-Flowers and Melilot have been boyled Sometimes also Male-children have the Scrotum very much swelled which may happen to them by reason of some Waters contained in their Membranes or because they were bruised or too rudely handled by the Chirurgeon or Midwife in the Labour In these cases Compresses dipt in Wine with Roses are very proper to both Chap XXI lib 2 pag 381 CHAP. XXI Of the Mould of the Head and of the Sutures being too open VEry often Children who come before their time not having yet acquired their full perfection as also they which are by nature weak have the Mould of their Head and the Sutures so open by the distance and separation of the Bones one from another that it is very soft and almost without any support because the Bones easily yeild to every side these Children are not usually long-lived One must not think then to bring the bones close together by binding the Head strait for this would so presse the Brain which is very tender that it would cause a worse Malady in taking away the liberty of its motion whereby its functions would be depraved and afterwards totally abolished It will be sufficient to bind them softly with a small Cross-cloth lest they should be too unsteady and commit the rest to Natures work which by degrees will close up these Sutures in finishing to ingender and dry up and unite these bones of the Head which were not hitherto perfectly formed The place where the Sagittal Suture joins and terminates in the midst of the Coronal which it alwaies in every Child divides in two continuing to the very root of the Nose is called * Mould the Fountain of the Head because 't is the softest and moistest part of it which for this reason is the last dryed and closed up The Figure of it is represented in the Head placed at the beginning of this Chapter There are Children who have it sometimes open 'till they are three years old if not longer which is a great sign of the weakness of their natural Heat It is usually quite closed up at the end of two years and sooner or later according as the Infant is more or less moist or more or less strong Until these Bones are entirely closed 't is convenenient
and make you yet better able to conceive these things than I have here explained them and that all may be for ever to his greater glory The End of the Third and last Book A Table of the Chapters The First Book OF the Diseases and different dispositions of Women with Child from the time of Conception to the full time of Reckoning pag. 1. Chap. 1. Of the Signs of Sterility and Fertility in Women p. 2 Chap. 2. Of Conception and the conditions necessary to it 12 Chap. 3. Of the signs of Conception 17 Chap. 4. What Generation is and what is necessary to it 24 Chap. 5. Of Big-bellies and their differences with the signs of the true and false great Bellies 31 Chap. 6. How to know the different times of Pregnancy 35 Chap. 7. Whether it may be known that a Woman is with Child of a Boy or Girl and the signs whether she shall have many Children 43 Chap. 8. Of Supersoetation 49 Chap. 9. Of a Mole and its signs 53 Chap. 10. In what manner a Woman ought to govern her self during her being with Child when it is not accompanied with other considerable accidents to endeavour to prevent them 56 Chap. 11. The means to prevent the many accidents which happen to a Woman during the whole time of her being with Child and first of Vomitings 68 Chap. 12. Of the pains of the Back Reins and Hips 74 Chap. 13. Of the pains of the Breasts 76 Chap. 14. Of Incontinence and difficulty of Urine 78 Chap. 15. Of the Cough and difficulty of of Breathing 81 Chap. 16. Of the swelling and pains of the Thighs and Legs 85 Chap. 17. Of the Hemorrhoides 89 Chap. 18. Of the several Fluxes which may happen to a Woman with Child and first of a Loosnesse 92 Chap. 19. Of a Menstruous Flux 98 Chap. 20. Of Floodings 102 Chap. 21. Of the weight bearing down or relaxation of the Matrix which hinders a Womon with Child in her walking and the freedom of coition 116 Chap. 22. Of the Dropsie of the Womb and oedemitous tumours of the lips of the Privities 119 Chap. 23. Of the Venereal Disease in Women with Child 123 Chap. 24. Of Abortion and its Causes 129. The Second Book Of Labours natural and unnatural with the way how to help Women in the first and the right means of remedying the rest p. 137 Chap. 1. What Labour is and the difference of it together with its different termes 138 Chap. 2. The Signs which precede and accompany as well a natural as an unnatural Delivery 146 Chap. 3. Of the Membranes of the Infant and the Waters 151 Chap. 4. Of the Placenta and Umbilical Vessels of the Child 161 Chap. 5. Of the several natural scituations of an Infant in the Mothers Womb according to the different times of Pregnancy 170 Chap. 6. What a Woman ought to do when she is gone her full time 174 Chap. 7. What is to be done when the Woman first falls in Labour 177 Chap. 8. Of the natural Labour and the meanes of helping Women when there is one or more Children 184 Chap. 9. How to fetch the After-burthen 189 Chap. 10. Of laborious and d fficult Labours and those against Nature their Causes and Differences together with the means to remedy them 192 Chap. 11. Of unnatural Labours where manual Operation is absolutely necessary what Observations the Chirurgeon must make before he goeth about it 201 Chap. 12. The signs to know whether the Child be alive or dead 208 Chap. 13. How to fetch the After-burthen when the String is broke 211 Chap. 14. To deliver a Woman when the Child comes Footling 218 Chap. 15. How to fetch the Head when separated from the Body and it remains behind in the Womb 222 Chap. 16. How to help a Woman in her Labour when the Head of the Child thrusts the Neck of the Womb forth before it 225 Chap. 17. How to fetch a Child when coming right it cannot pass either because it is too big or the Passages cannot sufficiently be dilated 227 Chap. 18. How to deliver a Woman when the Child presents the side of the Head to the Birth or the Face 229 Chap. 19. How to deliver a Woman when the Head of the Child is born and the Womb closeth about the Neck 231 Chap. 20. To deliver a Woman when the Child comes with one or both Hands together with the Head 232 Chap. 21. How to deliver a Woman when the Child presents one or both Hands foremost without any other part 237 Chap. 22. How to deliver a Woman when Hands and Feet come together 241 Chap. 23. How to deliver a Woman when the Child comes with the Knees 244 Chap. 24. Of a Delivery when the Child comes with Shoulder Back or Breast 245 Chap. 25. Of those Births wherein the Infant presents the Belly Breast or Side 248 Chap. 26. Of Labours wherein several Children present together in the different Postures abovenamed 250 Chap. 27. Of a Labour when the Navel-string comes first 255 Chap. 28. Of a Labour wherein the Burthen either first offers or first comes quite forth 258 Chap. 29. Of Floodings and Convulsions in Labour 261 Chap. 30. How to deliver a Woman when the Child is Hydropical or Monstrous 262 Chap. 31. Of delivering a dead Child 265 Chap. 32. Of extracting of a Mola and a false Conception 271 Chap. 33. Of the Caesarean Section 275. The Third Book Treating of Women in Child-bed and of the Diseases and Symptomes befalling them at that time Of Children new-born and their ordinary Distempers together with necessary directions for to chuse a Nurse Chap. 1. What is to be done to a new-laid Woman and naturally delivered 288 Chap. 2. Of convenient Remedies for the lower parts of the Belly and Breasts of a Woman newly delivered 290 Chap. 3. What Diet a Woman in Child-bed ought to observe during the whole time after lying in when it is accompanied with no ill accident 296 Chap. 4. How to drive back the Milk in those Women who are not willing to give suck 300 Chap. 5. Of several Diseases and Symptomes which happen to a Woman newly laid and first of Flooding 302 Chap. 6. Of the bearing down and falling out of the Womb and Fundament of a Woman new-laid 307 Chap. 7. Of Bruises and Rents on the outward parts of the Womb caused by Labour 314 Chap. 8. Of After-pains which happen to a Woman new-laid and of their several Causes 317 Chap. 9. Of the Lochia which flow from the Womb in Child-bed whence they come and the signs when they are good or bad 322 Chap. 10. Of the suppression of the Lochia and the accidents which follow thereupon 330 Chap. 11. Of the Inflammation which happens to the Womb after Delivery 334 Chap. 12. Of the Inflammation of the Breasts of the new-laid Woman 338 Chap. 13. Of the clodding and curdling of the Milk 342 Chap. 14. Of Imposthumes of the Breasts of Women new-laid 345 Chap. 15. Of excoriation and loss of the Nipples 349 Chap. 16. Of tending Children new-born and first how to bind cut and swath the Navel-string 353 Chap. 17. How a new-born Babe must be washed and cleansed from the Excrements as also how it ought to be wrapped up in Swadling-Cloaths 358 Chap. 18. Of Dieting and Ordering a new-born Babe 364 Chap. 19. Of the Indispositions of little Children and first of their weakness 372 Chap. 20. Of Contusions or bruises of the Head and other parts of toe Body of a new-born Babe 376 Chap. 21. Of the Mould of the Head and of the Sutures being too open 381 Chap. 22. Of a new-born Babe's Fundament being closed up 385 Chap. 23. Of cutting the Tongue when Tongue-ty'd 386 Chap. 24. Of Gripes and Pains of the Belly of a young Child 388 Chap. 25. Of the Ulceration or shooting forth or rupture of the Navel of a young Infant 391 Chap. 26. Of the Smartings Redness and Inflamation of the Groin Buttocks and Thighs of the Infant 395 Chap. 27. Of the Ulcers or Thrush of the Mouth of an Infant 397 Chap. 28. Of the pain in breeding the Teeth 400 Chap. 29. Of the Loosness of an Infant 404 Chap. 30. Of Vomitings in Children 406 Chap. 31. Of a Hernia or Rupture in Children 408 Chap. 32. Of the Scabs which are upon the Head and Face of young Children 412 Chap. 33. Of the Small Pox and Meazels in Infants 414 Chap. 34. How to cure the Venereal Lues in Infants 422 Chap. 35. How to hinder Childrens growing squint-eyed 428. Chap. 36. Of the requisites and necessary conditions in the choice of a good Nurse 430. FINIS
reflects the light which it receives so likewise I hope that this small Work may by the reflection of the Sun of your Doctrine of which I have received many rayes enlighten the young Chirurgeons and Midwives in the difficulties which they often meet with at Labours Accept then Gentlemen this small Production of one of your Children who conjures you by the love of Fathers that never disown their Children how deformed soever to defend it against Envy and Detraction which will never dare to attaque it when you have vouchsafed it your Protection which is the Favour desired from you by Gentlemen Your very affectionate Brother and Companion Francis Mauriceau The Approbation of the four Sworn Provosts and Wardens of the Master-Chirurgeons of Paris VVEE under-written Sworn Provosts and Wardens of the Master-Chirurgeons of the City of Paris do certifie that we have seen and examined a Book composed by FRANCIS MAURICEAU sworn Master-Chirurgeon of Paris intituled The Diseases of Women with Child and in Child-bed With a true Method of assisting them in their natural Labours and the means of remedying all those contrary to Nature and the Diseases of Infants new-born Likewise an exact Description of all the Parts of a Woman destin'd to generation together with many Figures suitable to the subject Which Book We esteem very profitable for the Publick and necessary for young Chirurgeons and all Midwives to learn perfectly the practice of the Art of Deliveries in confirmation of which we have signed this present Certificate Paris the 15th of March 1668. Le Filastre Vivien L'Escot L'Eaulte An Extract of the Kings Priviledge BY the Grace and Priviledge of the King given at St. Germans the 10th day of June 1668. signed Le Gross it is granted to Francis Mauriceau sworn Master-Chirurgeon of Paris to print sell and distribute by such Printers and Booksellers as he shall think good a Book composed by him entituled The Diseases of Women with Child and in Childbed c. With express Injunction and Prohibition to all persons of what quality or condition soever not to print the said Book nor to sell nor vend any other Impression than this which the said Mauriceau hath caused to be made or such as he hath authorized nor likewise to copy or counterfeit any of the Figures of the said Book for the space of Ten years commencing from the time that the Impression shall be compleated Upon pain of Confiscation of the Counterfeit Copies and of 300 l. and reimbursing all charges and damages whatsoever as it is more amply recited in the said Priviledge of which this present Extract shall serve for sufficient notice The Author to the Reader Friendly Reader SInce in the Age we live in we see that most people are govern'd rather by Opinion than Judgment I desire that if you mean to profit by reading my Book you will reade and examine it without any critical Envy and free from all sort of preoccupation which may obscure your Judgment and hinder you from acknowledging the Truth of those Things I pretend to teach Therefore be not of their humour who condemn a Conception when they understand it not and believe it false because 't is new neither imitate such who seeking alone to carp at words neglect the sense of the Discourse For even as it happens very often that Purging though proper for a Disease doth no good to a Patient when his Body is not well prepared and disposed for its Operation so the Doctrine of Books which is one of the most wholsom effectual Remedies we have to chase away ignorance is wholly useless to mens wits if they are not disposed to receive it I believe I may hope you will easily grant me this request because it is for your advantage In the mean time though I design to instruct you here in whatsoever concerns Women with Child or in Labour yet I would not divert you from reading of many learned Authors who have treated of it but only advise you that the most part of them having never practised the Art they undertake to teach resemble in my opinion those Geographers who give us the description of many Countries which they never saw and as they imagine a perfect accompt of them which makes it very difficult not to say impossible they should ever obtain their end For it is certain as Plutarch hath very well noted that the speculative part of Arts is improfitable and unfruitful when destitute of the practice You may then as to this subject relye on the Method I show you since to conduct you in it I faithfully recite what I have with very happy success observed these many years in the practice of Deliveries Furthermore blame me not for being of a Judgement different from the common opinion of many for I declare I have only bound my self to acquaint you with the truth of which I hope you will have more Satisfaction and be better pleased than if I had always blindly followed the thoughts of others having likewise endeavoured not to extend my self in superfluous discourse to the end I might be more intelligible to yong Chirurgeons and Midwives to whom this Book if I be not mistaken will be as usefull as any to teach them the safe practice of the Art of Deliveries I have not stuft it with a great number of long Receipts which serve only to swell a Volumn and confound their Wits in the uncertainty of the choice of so many different Remedies composed of Drugs which very often are unknown to them but singly contented my self to teach them the best and principally such as we ordinarily use in our practice But if in all this you find some of my Opinions not wholly Satisfactory or that others according to your Opinion are not fully agreeing with the Truth remember that as amidst the best Corn there alwayes spring Tares or some other Weeds so in like manner you meet with few Books whose doctrine is so pure as not to find something in them to reject and if I may hope for any respect from you in recompence of my pains it will be but proportionable to what you may have for many others who never had in this occasion a greater desire than my self to render you service F. M. The Translator to the Reader Courteous Reader HAving long observed the great want of necessary directions how to govern Women with Child and in Childbed and also how new-born Babes should be well ordered I designed a small Manual to that purpose but â—…ing sometime after in France with this Treatise of Mauriceau which in my opinion far exceeds all former Authors especially Culpeper Sharp Speculum Matricis Sermon c. being less erronious and inriched with divers new Observations I changed my resolution into that of translating him whom I need not much commend because he is fortified with the approbation of the Wardens of the Chirurgeons Company of Paris His Anatomy at the beginning of the Book I have omitted there being
but left for the Printer to make choice of the most familiar of them which he mistaking was to prevent further trouble suffered to be so printed I do not intend this work to incourage any to practise by it who were not bred up to it for it will hardly make a Midwife though it may easily mend a bad one Yet notwithstanding I do recommend it to the perusall of all such women as are carefull of their own and their friends safeties there being many things in it worthy their noting And designing it chiefly for the female sex I have not troubled my self to oppose or comment upon any Physical or Philosophical Position my Author proposeth I hope no good Midwives will blame me or my Author for reprehending the fault of bad ones who are onely aimed at and admonished in this work and I am confident none but the guilty will be concerned and take it to themselves which I desire they may and amend Farewell Hugh Chamberlen From my House in Prujeans-Court in the Old-Baily London this 15th of May 1672. ERRATA PAge 8. line 8. for Intestin read Intestinum Pag. 13. lin 1. r. such as P. 19. l. 3. f. upper parts r. Nipples l. 19. r. Womb is free P. 58. l. ult r. that miscarried P. 63. l. 24. r. Hypogaster P. 95. l. 9. r. Corroberatives P. 96. l. 4. r. a Wafer will be very fit P. 101. l. 18. f. Iorn r. Iron P. 132. l. 11. the Comma behind together must be before it P. 133. l. 15. f. the r. a. l. 28. f. which it yet does r. as it also doth P. 213. l. 1. f. capable r. able P. 224. l. 24. f. marked D. r. C. and the same in pag. 236. l. 9. P. 287. l. 1. f. an r. a. P. 301. l. 3. f. brannes r. meales P. 430. r. CHAP. XXXVI l. 24. r. requisite Books newly printed Aurora Chymica or A rational way of preparing Animals Vegitables and Minerals for a Physical use c. Authore Edw. Bolness Med. R. Ord. A Philosophical Essay Declaring the probable Causes whence Stones are produced in the greater World as also the Causes and Cure of the Stone in the Kidnies and Bladders of Men c. By Dr. Thomas Shirley Physician in Ordinary to his Majesty Sold by W. Cadman at the Popes-head in the lower Walk of the New-Exchange Praxis Medicorum Antiqua Nova The Antient and Modern Practice of Physick examined stated and compared By E. Manwaringe Dr. in Physick Sold by Tho. Archer Bookseller under St. Dunstans-Church in Fleetstreet The First Book Of the Diseases and different Dispositions of Women with Child from the time of Conception to the full time of Reckoning MAny Indispositions may arrive to Women from the time of Conception to the full term of Labour because they are then not only subject to those which are caused by pregnancy but to those also which happen at other times It is not my design so to enlarge as to examine all but onely to enquire into the principal and most usual Maladies that accompany Great-Bellies and have during their course some particular Indications for their Cure for as for those which have only general Indications and may happen indifferently to a Woman at any time they may easily be known and redressed by the ordinary means provided that you have all the while regard to the disposition of the Great-Belly It would be sufficient to my purpose of a through examination in pursuance of my intention of every circumstance of a Great-Belly to begin with the explication of a Conception which must precede it but since that cannot happen but to a fruitfull Woman I will before I discourse of it that you may the better understand it from its original give you some considerable Observations concerning the Fruitfulness and Barrenness of Women for Barrenness proceeds oftner from Women than Men for there are many conditions required in a Woman which Men have no occasion of who only need to provide a small quantity of their Seed and that at once to generate but Women besides their Seed must have a fit place to receive both as the Womb is when well disposed and matter appointed for the Child's nourishment during its whole stay there as is the menstruous blood This is the cause that for one impotent Man there may be above thirty barren Women found Let us therefore first of all see what are the signs of Fruitfulness and Barrenness in Women CHAP. I. Of the signs of Fertility and Sterility in Women By the Fertility of a Woman I understand a natural disposition of her Body by means of which with the assistance of a Man she may engender her like And by Sterility which is directly contrary I intend an * Incapacity Impotency which proceeds from some vice or fault either of her whole body or of some particular part We must how make some enquiries after the most notable signs of the one and the other and chiefly of those which may be perceived by our sight or touch by which we may better judge than by many others that for the most part are uncertain For those which are taken from different temperaments may easily deceive us forasmuch as we may often find Women of a very ill habit and full of ill humours notwithstanding fruitful First therefore we affirm the Womb to be a part absolutely necessary to fertility and the principal object to be represented and examined to make a judgment of it but as we find not every Ground proper to yeeld Fruit and that some are so ungrateful as to produce nothing so likewise it is not enough for a Woman to have a Womb to be capable of Conception since we find divers that have them barren We have already * In his Anatomy not yet printed shewed you exactly what the composition and natural structure of it ought to be for to serve to so admirable an end as generation Wherefore we will now speak no further of that but refer you to that place to be informed You must know then in general that the signs of fecundity in a Women are that her Womb be well disposed that she be at least thirteen or fourteen years of age and at most but 45 or 50 generally and for the most part though some yet very rarely conceive sooner or later according to their different natures and dispositions that they be of a good temperament and indifferently sanguine that they have their Courses in due time of good blood and laudable in coulour quantity quality and consistance and regularly every month at once without interruption from the time they begin to flow till the time the evacuation is compleated We say that the bloud ought to be good and laudable because it is a regurgitation and natural evacuation only of what is superfluous in Women not with Child and yet of age capable of Conception which hath no malignity in it self as many falsly imagine for in healthful women
it hardly differs either in colour consistence or quality from that which remains in the vessels except in the small alteration which is caused by the heat of the place whence it proceeds and by the mixture of some humours with which the womb is alwayes plentifully furnisht This evacuation if in order ought to be every month but once though some have them every fourtnight or at the end of three weeks according as they are more or less sanguine or cholerick or have their blood heated and to continue two or three days together or six at most and that by little and little constant without interruption and also more or less according to the difference of their particular temperaments If a Woman have few of them as when she grows in years she becomes barren forasmuch as this blood seems to nourish the Child in the Womb and likewise if she have too many because the Woman thereby grows too weak and the Womb too cold There are notwithstanding some Women who void more of them in two days than others in eight They must flow by little and little without interruption and not all at once for great and sudden evacuations cause great dissipation of spirits of which abundance are necessary for generation and the interruption of these evacuations shews some impediment in nature or some vice or evil disposition of the Womb. If all these signs concur we may very probably judge the Woman fruitful I say probably because there are many who have them all and yet cannot conceive though they do their endeavours and observe thereto all the requisite and necessary circumstances which we shall hereafter mention There are likewise others who notwithstanding they have not all these conditions are fruitful Now if all the above named patticulars are found in a Woman that is barren and that you desire to inquire more narrowly and to be informed more certainly whether she be capable of conception Hippocrates teacheth a way to know it to which I give little credit because the reasons of it are very obscure It is in his 59 Aphorism of his 5th Book where he saith Si mulier non concipiat scire placet an sit conceptura vestibus undique obvolutam subter suffito ac si odor corpus pervadere videatur ad nares os usque non sua culpa sterilem esse scito If a Woman doth not conceive and you are desirous to know whether she is capable or no wrap her close round with clothes and put a perfume under her and if she perceive the sent to pass through her body to her nose and mouth be assured saith he it is not her fault she is barren Fertility was anciently so esteemed by our fore-fathers that they believed Barrenness to be a mark of reprobation by reason of which the fruitfull Servant despised her barren Mistress as we reade in the 16th Chapter of Genesis where mention is made of Sarai Abraham's Wife who seeing that she could have no Children and being past the age of hoping for any and that her Husband was displeased at it bid him take her Aegyptian Chamber-maid named Agar to lie with him that by her means the might give him lineage which good Father Abraham quickly did and had by her afterwards a Son which was called Ishmael but from the time this Maid had conceived she began to despise her Mistress Sarai who was as yet barren The Women of our times are not so earnest to have lineage after this fashion there being but few that will suffer their Husbands to caress their Chamber-maids much less * Lovingly charitably to excite them to follow this example which custom is abolished amongst us I also admire the great passion which many have who complain of nothing with greater regret than to the without Children especially without Sons For my part I believe they that descend from Caesar or the Family of Bourbons may with some reason be led away with this superstitious and common inclination of preserving their kind and be vexed with these sorts of inquietudes which no wayes become ordinary people though excusable and may be permitted to great Monarchs and illustrious men When we perfectly understand the natural dispositions we may the easier discern those contrary to nature wherefore the signs of fruitfulness easily teach us those of barrenness The signs and causes of barrenness proceed either from the age or evil temperature and vicious conformation of the Womb and parts depending on it or the indisposition and intemperature of the whole habit The evil conformation of the Womb renders Women barren when its neck called the Vagina is so narrow that it cannot give way to penetration and when it is wholly or in part closed by some external or internal membrane which is very rare if at all or by any tumour callosity or cicatrice which may hinder the Woman from the free use of copulation But it is not sufficient that the Man's Yard enter the Vagina which is the anti-chamber to the Womb for if in the act of copulation he knocks at the door which is the internal orifice and it be not opened all is to no purpose This orifice is likewise hindred from opening by some callosity proceeding from abundance of ill humours which usually slow down from the Matrix or by some tumour which may happen to it or also by some part which may so compress it that it cannot dilate to receive the Seed as doth the Epiploon or cawl in fat Women according to the opinion of Hippocrates in his 46th Aphorism of his 5th Book where he saith Quae praeier naturam crassae non concipiunt iis os uteri ab omento comprimitur priusquam extenuentur non concipiunt Women exceeding fat do not conceive because the Cawl compresseth the orifice of their Womb neither can they till they grow lean I do not willingly admit amongst the causes of barrenness this compression of the inward orifice by the Epiploon forasmuch as Aritin hath very well remedied it by some of the postures invented by him by which this orifice need not be so compressed in the action The most frequent reason why this orifice opens not in this act to receive the Man's Seed is the insensibility of some Women who take no pleasure in the venerial act but when they have an appetite the Womb desirous and covetous of the Seed at that instant opens it self to receive it and be delighted with it But though the Vagina or neck of the Womb and the inward orifice opens to give passage to the Seed yet may they very often continue barren if the scituation of this orifice be not rightly placed but either backwards towards the * Great or right Gut Intestin rectum or towards either side all which hinders the Man from †shooting darting his Seed directly into it and consequently the Woman from conceiving Hippocrates seems to have noted all the signs and causes of barrenness which usually
proceed from the evil temper of the Womb in his 62 Aphorism of the 5th Book where he saith Quae frigidos densos habent uteros non concipiunt quae praehumidos habent uteros non concipiunt extinguitur enim in ipsis genitura Et quae plus aequo siccos adurentes Nam alimenti defectu semen corrumpitur Quae vero ex utrisque nactae sunt moderatam temperiem eae faecundae evadunt 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 temperament are fruitful Of all these which Hippocrates recites in this Aphorism the most common according to my opinion is the continual Humidity of the Womb fed by an abundance of the Whites with which many are very much inconvenienced the humours of the whole Body being accustomed to steer 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 unctuous and slippery that the Seed though viscous and glutinous cannot cleave to it nor be retained within it which is the cause that it slips immediatly away or in some short time after it is received Barrenness may also proceed from the whole habit of the Body as when a Woman is too old or too young for the Seed of the young is not yet prolifick neither have they the menstruous blood which two things are requisit to fruitfulness and that of the aged is in too small a quantity and too cold who likewise want the menstruous blood An universal intemperature though the Woman be of convenient years renders them however barren as it happens when they are hectick hydropick feaverish and sickly and especially so much the more as the noble parts are fallen from their temperament and natural constitution There are however many Women which seem barren for a long time because of some of the fore-mentioned Reasons yea till they are thirty five or forty years old and sometimes longer who yet at last conceive being cured of the indispositions which hindred them and having changed their temperament by their age of which we have had a remarkable example in the person of Queen-mother lately deceased who was above two and twenty years married and without Children and yet afterwards to the great joy and content of all France she had our invincible Monarch Lewis the 14th now reigning to whom God grant a long and happy life Some of these Barrennesses may sometimes be cured by removing their causes and procuring the dispositions we have said are necessary to fruitfulness yea of those which proceed from an universal intemperament by reducing the Body with a good and convenient regimen to a good order and this according to their respective indispositions Wherefore if a Woman have naturally the Vagina too narrow and not from some of the causes above-mentioned she ought to be joyned to a Man whose Member is proportionable if possible and if that will not do which happens very seldom she must endeavour to relax it and dilate it with emolient Oyls and Oyntments if the neck of the Womb be compressed by any humour it must be resolved and suppurated according to its nature and scituation having alwayes care to prevent the corruption of these parts which being hot and moist are very subject to it because the womb serves as a sink by which all the ill humours of the body are purged so that you must take great care that these kind of Tumours turn not to a Cancer which is a very mischievous malady and causeth the poor Women miserably to languish which are afflicted with it and which after many insupportable pains brings them almost alwayes to an inevitable death When the Vagina is not clear in its capacity because of any scar after a rent caused by some force or violence to the Woman or of some hard labour or after an ulcer which caused the two sides to be agglutinated whether inwardly or outwardly it must be separated the best that may be with a * A kind of large Incision-knife Bistory or some other Instrument according as the case requires hindring by interposed Linnen that it do not again agglutinate When a Woman hath no Vulva or outward entry of the Womb pierced which is very rare it must be opened by making a long Incision Fabricius recites the like case in a Girl of thirteen years of age who was like to die of it because her Terms could not come down there being no perforation wherefore he did the like operation which succeeded very well and made her by that means capable of generation As to the inward orifice of the Womb if it be displaced either towards the back or sides it may be in some sort remedied by making the Woman to observe in the act of generation a convenient posture that the Man's Seed may be ejaculated towards the orifice and if the Whites or other Impurities of the Womb cause barrenness as it is for the most part by the discharge of the whole habit on this place it must be helped by Evacuations Purgations and a regular Diet according to their different causes and qualities of these ill humours Having thus discovered the most certain signs of Fertility and the marks of Sterility I will now the better to pursue the order I have proposed treat of Conception CHAP. II. Of Conception and the conditions necessary for it IT is most certain according to the Rule of Nature that a Woman is incapable of conceiving if she have not the conditions requisit for fruitfulness we have mentioned them in the foregoing chapter let us now examine in this what is Conception and how it is caused Conception is nothing else but an action of the Womb by which the prolifick seeds of the Man and Woman are there received and retained that an infant may be engendred and formed out of it There are two sorts of Conceptions the one true according to Nature to which succeeds the generation of the Infant in the Womb the other false which we may say is wholly against Nature and there the seeds change into water false-conceptions moles or any other strange matter The qualifications requisit for a Woman to conceive according to Nature are that the Woman receive and retain in her Womb the Mans and her own prolifick seed without which it cannot come to pass for it is necessary that both seeds should be there nor is it at all true what Aristotle and some other of his followers affirm that the Woman neither hath nor can yeeld any seed a great absurdity to believe for the contrary may easily be discovered by seeing the Spermatick Vessels and Testicles of a fruitful Woman appointed for this use which are wholly filled with this seed which in coition
they discharge as well as Men. Such a will not open their eyes to behold a verity so clear may make reflection on the resemblance of Infants to their Mother which could not be unless her seed had been more praedominant than the Fathers when he begot them which likewise happens after the same manner when the Fathers hath more force and vertue Which may evince that the Womens seed contributes as well to the formation of the Infant as the Fathers If they will not agree to a thing so common let them make another reflection on the generation of certain Animals which participate of the nature of the Male and Female of which they are engendred though of different kind as we daily see Asses and Mares produce by their coupling Mules which are Animals of a middle nature resembling both the one and the other that produced them We may then learn by this that both Seeds are necessary for a true Conception provided they be prolifick that is containing in them the Idea of all the parts of the body and then the Womb being greedy of it delights it self in it and easily retains it when received else it soon afterwards rejects it It is not absolutely necessary that both the Seeds be received and retained intire without the loss of some part for provided there be a moderate quantity of it 't is sufficient Nor must we imagin that though all of it be not received into the Womb the Child formed out of it will want some limb as an arm a leg or other member for want of sufficient matter inasmuch as the forming faculty is whole in every part of the Seed of which the least drop contains in it potentially the idea and form of all the parts as we have lately made appear but indeed when the Seeds are received but in small quantity the Child may be the less weaker for it Or if either or both of them have not the requisit qualities or though well enough conditioned if the Womb be imbued and stuft with ill humours as the menstrues whites and other filth or any other fault if then there be a conception it will be contrary to Nature and there will be ingendred false births Moles or dropsies of the Womb mixed with some other strange bodies which are very troublesome to Women till they void them It is therefore without cause that many Women are blamed when their children are born with red and livid spots which very much disfigure the faces of some of them It is usually said but without reason that this proceeds from the mothers longing to drink Wine for though some have by chance been in effect harrassed as they affirm with these passionate desires during their being with child yet we must not superstitiously believe as many do that these spots are so caused but rather from some other cause which must be searcht for elsewhere And that which makes it appear it cannot proceed from hence is that almost throughout all Italy where nothing but white wine is drunk as also in Anjou in France I have seen divers persons marked with these red spots and in case it proceeded from their Mothers longing to drink Wine they ought to be white spots or of an Amber colour being the colour of the wine of these Countries but we ought rather to conclude that they are caused from some extravasated blood at the time the Infant is formed which marks the skin yet very tender with these spots and colours it in whatsoever part it toucheth much after the same manner as we see it marked with Gunpouder or some waters producing the like effect when it is washt and bathed with them I will not however deny that the imagination hath a power to imprint on the body of the Infant marks of this nature but that can only be when young with Child and principally at the very moment of conception for when the Child is compleatly formed the imagination can in no wise change its first figure and Women must wean themselves from these vain apprehensions which they say they have to such things every moment and serves some of them for a pretext to cover their liquorishness Since my discourse is fallen upon this subject of Marks with which oft times the bodies of Infants are spoted in their birth and which comes as is ordinarily believed from the imagination of their Mother it seems to me not much from my purpose to recite you a circumstance very particular sound on Me when I came into the world as my Father and Mother have often told me which is that my Mother being with Child of me and almost at the end of her reckoning as it appear'd afterwards the eldest of her three Sons which she then had of six years old and her first-born whom she loved with an extraordinary tenderness and passion dyed in seven dayes of the small Pox all which time she continned night and day by his bed side tending him in all his necessities not suffering any other to do it whatsoever desires were made to her not to weary and trouble her self as she did for the Childs sickness alledging that in her present condition she ought to be careful of her self and not be the cause of death to the Infant she went with in fine at the end of seven dayes her Son dyed upon which the next day she was delivered of me who brought effectively into the world with me six or seven of the small Pox. Now it is certain that it would be irrational to say that I had then contracted these small Pox in my Mothers Womb by her strong immagination But if I were asked whence they proceeded I should answer that the contagious air she breathed without discontiuuance during the whole sickness of her deceased Son had so infected the mass of her blood with which at that time I was nourished that I rather than she easily received the impression of this contagion because of the tenderness of my body Let us therefore assert that the imagination cannot produce any of the above mentioned effects but at the moment of conception or within few dayes after and that we ought for the most part to search elsewhere if we desire the truth of it the cause of most of these Spots Marks and Signes with which many Infants are born CHAP. III Of the Signs of Conception AS it is very hard and belonging only to expert Gardeners to know Plants as soon as they begin to spring forth of the Earth so likewise there are none but expert * Chirurgeons onely practise Midwifery in France Chirurgeons can give a Woman certain assurance of Conception from its beginning although some of these signs resembling those of the suppression of the Terms and other maladies in Women cause many to be deceived in it I will not trouble my self to make a recital of a great number of signs of conception which rather tend to superstition than an effective verity but only the
afterwards publickly dissected near the Kitchen-Court of the Louvre who was found four months gone with Child notwithstanding the report of such persons as had visited her by the Judges Order before her Execution who affirmed contrary to the Truth that she was not with Child That which deceived them was the Woman's having effectually her Courses though with Child Wherefore 't is not good to be too confident forasmuch as there are many with Child who have their Courses and I have known some who have had them all the time of their Great-Belly till the fifth or sixth month which happens according to the Womans being more or less sanguine though the greatest number usually have them not but there are very few general rules which may not sometimes be excepted against This accident made such a noise in Paris that it quickly came to the knowledge of the King and all his Court who very much blamed those persons that by their ignorance had caused the * Untimely or unseasonable precipitated Execution of this poor unfortunate Creature with whom perished the Infant innocent of the Mothers crimes Nor must the Chirurgeon much trust to what these sort of Women may tell him concerning it for being afraid of the punishment of their crime to delay it do almost all say they are with child which is a reason very considerable why the persons to whom such matters are committed should be very knowing There are yet another sort of Women who having been ill treated send for the Chirurgeon that he may give them a Certificate the better to be revenged on their adversary which that they may the easier obtain they also affirm themselves with child and having received blowes on their Belly feign that they find their great pain and if by chance they have at that time their Courses they endeavour to perswade that it is a flooding or showes wherefore he must be careful not to be deceived and yet that he may not be esteemed ignorant nor fall into the like disgrace when there is any cause of doubt it is better to delay a little then rashly to pronounce his prognostick at a venture for as there are Women who would be thought to be with Child though they are not so there are others who will deny it till they are brought to bed as in this following example About the year 1654 being in the Citty of Saumur there was near my Lodging a young and very handsom Daughter of a Citizen who was five whole months under a Physician 's and Apothecaries hands to be cured of a Dropsie which she complained of at length after she had taken many violent Remedies they had ordered her she was cured in a moment by bringing forth a Child at its full time notwithstanding all they had given her which much astonished the Physician and Apothecary who were so grosly deceived in trusting to the Maids relation who counterfeited the Dropsie so well that they could never perceive the truth till she was brought to bed Some Women themselves are deceived in their being with Child as lately the Wife of a Counsellour of the Court who after having been in a course of Physick of six or seven whole months for the Dropsie under an eminent Physician was at length brought to bed of a Child I knew another Woman a Merchant of Squared-Timber at Paris who never had a Child though she so passionately desired it as to be at the point of hoping for one at 55 years of age under the colour that she had still her Courses This Woman was once perswaded upon the recital of such signs as she said she had for the space of ten whole months that she was with Child of which the Midwife and many others assured her and she her self likewise believed it for it is easie to be perswaded to believe what one hopes for with a strong passion she had a big-belly and said also that she felt the Child stir and believed it so truly that finding her self one day worse than ordinarily after having prepared very fine necessaries for the Child she imagined she went with she sent for the Midwife who when she was come assured her it was her Labour but the next day having alwayes till then expected a Child she voided only a quantity of Water with some Wind from the Womb and nothing else after which she was forced to fold up her fine Toilets again which she had provided By these Examples we may learn not to be too ready to rely upon Womens Relations if there be no other Reason which may be known by the Examination of the Signs already declared Now since after Conception of which we have just done speaking there follows Generation let us consider what it is and how it is performed CHAP. IV. What Generation is and what is necessary to it IT is a very great Truth and generally known That whatsoever is in this lower World is subject to corruption and at length constrained to suffer death which hath obliged Nature provident and careful of its preservation to endue all things with a certain desire of eternizing themselves which not being possible in individuals because mortal by an indispensible necessity is therefore done by the propagation of their forms and kinds She obtains her end in respect of Animals by the means of Generation successively reiterated for so all creatures seem to immortalize themselves in some sense by producing their like And Fathers imagin themselves not quite dead if they leave their like behind them after their death to wit their Children By Generation we understand generally a progress of that which is to that which is not But this definition is a little too ample for to come to the knowledge of what we desire concerning the generation of perfect Animals and chiefly of Mankind wherefore that our intention may be the easier conceived we must search some other or rather a description which may more exactly discover the thing to this purpose we say that by the generation of Mankind we mean a proper and particular action of the Womb by which working upon both seeds there retained it forms and shapes a body out of them composed of divers parts which it disposeth in order to become in time the Organ of the Soul which must be infused into it There are many things requisit to make the Generation perfect without which it would be wholly and absolutely impossible there are usually three principally reckoned to wit diversity of sex their congression and the mixture of both Seeds which we will a little particularly examine Although some define a Woman to be an Animal which can engender in it self and that this may be true yet it is most certain that she cannot engender without a Man that hath discharg'd his Seed into her womb And though we daily see Pullets have Eggs and other Fowl without the Cocks treading them yet of those Eggs there will never come Chickens because the Male never
had made an impression on them nor given them this prolifick vertue which is absolutely necessary to this purpose This may convince us that diversity of sex is necessarily requisit as well to those Animals as to the more perfect which is Man Diversity of sex would profit little if copulation did not likewise follow though some subtile Women to cloak their shamelesness would perswade one that they were never touch'd by any Man who could get them with Child as she of whom Averroes speaks who conceived in a Bath in which a Man had washt himself a little before and had cast forth his Seed into it which was drawn and suckt in as he saith by the Womb of this Woman but this is a story fit to amuse little children Now to the end these different sexes should be obliged to come to this touch which we call Copulation besides the desire of begetting their like which naturally incites them to it the parts of Men and Women destined to Generation are endued with a delightful and mutual itch to stir them up to the action without which it would be impossible for a Man so divine an Animal born for the contemplation of heavenly things to joyn himself to a Woman in regard of the uncleanness of the parts and of the act And on the other side If Women did but think of a thousand pains and inconveniences which their great Bellies cause them of the pains they endure and the hazard of their lives when they are in labour to which may be added the loss of their beauty which is the most precious gift they have and which makes them be beloved by those that possess them certainly it might also afright them from it But neither the one nor the other make these reflections till after the action whence comes the saying Post coitum omne animal triste considering nothing before but the mutual pleasure they receive by it It is then from this voluptuous Itch and the desire of begetting their like that Nature obligeth both these sexes to this congression As to the mixture of both seeds it is certain that the diversity of sexes and their congression are but for this end without which Generation cannot be though some would have Womens seed serve to no purpose yea that they neither have any nor eject any as Aristotle saith but we have proved the contrary in the Chapter of Conception by the example of daily experience to which you may have recourse to avoid repetition All these three Circumstances to wit the diversity of sexes their congression and the mixture of their matters which is called Seeds must precede Conception to which succeeds Generation on this fashion As soon as the Woman hath conceived that is hath received and retained in her Womb the two prolifick seeds it is every way compressed to imbrace them closely and is so exactly closed that the point of a Needle as saith Hippocrates cannot enter it without violence after which it reduceth by its heat from power into action the several faculties which are in the seeds it contains making use of the Spirits with which these frothy and boyling seeds abound and are as instruments with which it begins to trace out the first lineaments of all the parts to which afterwards making use of the menstruous blood flowing to it it gives in time growth and the last perfection Generation may be divided into three different seasons which are the beginning middle and the end The beginning is when there is no other matter in the Womb but the two seeds which continue so to the sixth day as Hippocrates notes and calls them for that time the geniture as much as to say from whence generation must proceed he speaks of it in his Book De Natura Pueri and he saith that by the experiences he brings of it one may judge of the other times He relates a story of a Woman which at six dayes end cast forth with a noise at once out of her Womb the seeds she had conceived resembling a raw egg without a shell having only the small skin over it or to the abortive eggs which have no shell which little membrane was on the outside a little coloured with red and involved in it this seed which was of a round figure in the internal part might be seen white and reddish fibres with a thick humour in the midst of which was found something like the umbilick vessels Hippocrates calls this first time of generation Geniture as is already mentioned during which time neither figure nor distinction can be observed but only some beginning of a disposition to receive the form of the parts after which follows the second time which begins where the first ends that is at the sixth day and lasts to the 30th The time that the same Hippocrates assures us the males are compleatly formed and the females not till the 42d. After the first six dayes are past and the Womb hath wrought according to the fashion we have explained upon the seeds which are there yet without any mixture of blood having disposed them to receive it it is brought thither in some sooner in some later according to the Womans being nearer to or further from her time of having her Courses when she conceived which produceth effects according to these different dispositions for if they flow too soon or in too great abundance as it befals such as conceive at the point of having their purgations the seeds are drowned and corrupted by it which often causeth a flooding or at least the generation of a false-conception but if they are far from their having them the conception is so much the more stable Now then this blood distilling by little and little into the Womb of the Woman who hath sometime since conceived serves as a fit matter to form and figure out all the parts of the Infant which was only traced out by the seed and yet doth it according to my opinion much like a Painter who after he hath drawn the out-lines with a chauk upon his cloth begins to lay colour upon colour to paint by degrees all the parts of the person whose picture he draws Some little space after the beginning of this second time appears as it were the figure of those three bubbles of which Hippocrates speaks or rather three masses of this matter which grosly represent the three parts called principal the first of which composeth the Head the second in the middle the Heart and the other the Liver there may be likewise seen the after birth with the umbilick vessels fastened to it and the membranes which wrapt up the whole after which from day to day all the other parts of the body are figured in such sort that at thirty dayes end the males are compleatly formed and the females the 42th day ordinarily which is about the time the Faetus begins to be animated though as yet there is no sensible motion Hippocrates seems by these different terms
who not that is when they are near their time and by this means may likewise know when 't is necessary to forward Labour or retard it as much as ought to be when Women are not yet gone their full time As to what respects the several terms to which a Woman may go with Child there is a great controversie amongst Authors but all agree that the most ordinary terms are either the seventh or the ninth month which is known and also approved by all Hippocrates is of an opinion that the Child born in the eight month cannot live because he cannot support two such puissant endeavours so near one to another having already endeavoured to be born the seventh month which is as he saith the first legitimate term of Labour and failing then if reiterating the same endeavours the eighth month he be born he is thereby so weakned that he seldom lives as he often doth when born by the first endeavours in the seventh month his strength not being before exhausted by vain attempts This seems very likely to many but if they that practise Deliveries make a true reflection on it they will find that it is the Matrix alone assisted with the compression of the muscles of the lower Belly and Diaphragma which cause the expulsion of the Child being stirred up by it's weight and not able to be further extended to contain it and not as is ordinarily believed that the Infant being no longer able to stay there for want of the nourishment and refreshment useth his pretended indeavours to come forth thence and to that purpose kicking strongly he breaks with his feet the membranes which contain the waters inasmuch as when the Child is naturally born the membranes are alwayes rent before the head which pressing and thrusting each throw the waters before it causeth them to burst out with force The same Hippocrates likewise admits the tenth month as also the beginning of the eleventh at which time he saith the Children live but he will by no means that Children can live if born before the seventh forasmuch as they are then too feeble and not capable to support the external injuries as indeed we see and find it every day I do boldly affirm and it is also very true that the ordinary term of going with Child is nine whol months but I cannot consent that Children born in the seventh month do oftner live than those of the eighth but much to the contrary I believe that the nearer they approach to the natural term of nine months the stronger they are and therefore that Children born in the eighth month rather live than those of the seventh which is wholly contrary to the opinion of many persons who blindly follow in this the sense of Hippocrates and all Authors without making any reflection upon the thing for to disabuse themselves of this vulgar belief founded upon the pretended vain endeavours which they say are made by the Infant in the seventh month for as we see 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 above a month after which happens according to the Territories the different regards of the Sun and according as the Vine is cultivated So likewise we see Women brought to bed of their Children six weeks and two months before and sometimes as long after their ordinary tearm If it be not that the Womb not being capable of an extention beyond a certain degree cannot bear its burden but a little while aftet the reckoning is out although there have been Women as Hippocrates acknowledgeth who have gone ten or eleven whole months with Child which notwithstanding is so much the more rare by how much it exceeds its limits These things happen also to Women according to the different dispositions either of their whole body or of their Womb alone or as well according to their rule of living and the greater or lesser exercise they use and may likewise happen on the Childs part for by example if at seven months he is so big that the Womb can no longer contain him nor dilate it self more without bursting it is then provoked by the pain which this violent extention causeth to discharge it self of him and so likewise in the eighth month if there be the same reason and some weeks sooner or later according to a multitude of other circumstances or also by any outward cause as a violent shaking of the whole body blow fall leap or any other causes whatsoever hastening the pains of Delivery that which makes these Children live a longer or a lesser while 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 ninth month There are many Women that believed they were brought to bed at the 7th and 8th month as likewise others that they went 10 or 11 whole months with Child which may some times be when notwithstanding they are effectively delivered at the due time That which deceives them usually is their believing as we have already said themselves with Child from the time of the retention of their courses having had them during the two first months of their pregnancy yea and sometimes longer and others also misreckon themselves when their courses are stopped two months before they conceive It is also easie to know that a Woman though well regulated cannot exactly know by the suppression singly the certain time of her being with Child for example if she lies with her Husband upon the point of the coming down of her terms and she conceives upon it then she may make her reckoning from the time of their suppression which may be very near the truth but if she conceives immediatly after she hath had them which happens oftenest and that all along the whole month she daily 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 and so for three weeks or a month more or less she may be mistaken in the time As we have said that Children are more or less long-lived according as they approach nearer the ninth month so we may easily know that they of six months and much less those that are younger cannot be long-lived because they are yet too weak to resist the outward injuries There hath often been great contestations amongst the Physitians to determine whether a Child born the eleventh or twelfth month after its pretended Fathers death can be legitimately born and consequently admitted to Inheritance or rather disinherited as a supposed Child This question hath been well debated sometimes by the Romans as well as by us and there have been parties both for and against this opinion as for my part I will to avoid prolixity leave it undecided and add nothing upon this
point to what I have mentioned before CHAP. VII Whether it may be known that a Woman is with Child of a Boy or a Girl and the signs whether she shall have many Children IT is no great matter to satisfie the curiosity and disquiet of a Woman who desires often to know whether she be with Child or no but there are many and almost all that would have one proceed further and tell them whether it be a Boy or a Girl which is absolutely impossible though there is hardly a Midwife which will not boast her self able to resolve it in effect it is easier to guess than to find the truth for when it happens it is certainly rather by chance than by any knowledge or reason they could have to enable them to foretell it But sometimes one is so pressed and importuned to give judgment chiefly by Women who never had Children and often by their Husbands who are not less curious that one is obliged to satisfie them as much as possible in that case by the examen of some signs very incertain There are many signs upon which this knowledge is grounded if there can be any which I do not believe of which the two principal are taken out of Hippocrates the first is in his 42th Aphorism of the fifth book which is Mulier gravida si marem gerit bene colorate est si vero faeminam male calorata A Woman with Child of a Boy is well coloured but of a Girl ill coloured And the other is in his 48th Aphorism of the same book which is Faetus mares dextra uteri parte faeminae finistra magis gestantur For the most part the Male Children lye in the right side and the Females in the left Moreover they say a Woman with Child of a Boy is more merry and jockond goes with it much better is not so disgusted finds it quicken sooner and her right Breasts fill before the left and is also more firm and that all the right parts of her body are stronger and more active as for example if she sate kneeled or stood upright she would make her self first step with her right foot but if it be a Girl she would have all the signs contrary to these above mentioned There are some persons pretend to know it by inspecting of Urines which is as uncertain for we daily find Women well coloured and they have all the signs of being with Child of a Boy and yet are brought to bed of Girles contrary to the hopes given them And others though they have signs directly opposit bring forth Boys Some believe they understand it better than any other by considering the time of conception for say they if the Woman conceives at the increase of the Moon she shall have a Boy and contrarily a Girl if at the decrease but this falls out as seldom as may easily be known by the observation I have made of it at the Hostel de Dieu at Paris and may be daily observed by others as wel as my self which is that having in one and the same day delivered 11 Women there all at their full time five of them had Boys and the other six Girls Now we may well judge that they all conceived at one time because all were brought to bed at the same time and ought if this rule were true and that they were all governed by this Planet to have had either all Boys or all Girls and not some Boys and some Girls as here it happened and doth every day in the same place whereas in all other places are indifferently born both Boys and Girls Others again believe the Males to be begotten of the Seed which comes rather from the right Testicle than the left esteeming it hotter and not so waterish because the right Spermatick vein comes from the trunck of the Vena cava and that of the left side takes its rise from the Emulgent but if they know after what manner the blood is circulated they would find that the blood of the emulgent is not more serous than that of the vena-cava forasmuch as it is purged of its superfluous serosity by the Reines before it enters this emulgent they would likewise know that the Seed of both Testicles is the same exactly being made of the same blood brought to them not by the Reins but only by the two Arteries which arise out of the trunck Aorta otherwise called the great Artery wherefore the left is as well disposed to produce Males as Females and therefore those Husbandmen abuse themselvs in knitting up one of the testicles of their Bulls according as they desire either Males or Females I knew an Italian at Rome who had but only his left Testicle having lost the right upon a good occasion who after that accident married and begat two Children which I saw alive and very well one of which was a Boy and the other a Girle besides all those he may have begotten since that time nor needed he to suspect his Wife had the assistance of any other in that business as it very often happens in this Country Such persons as desire to foretell before the Child be born whether it will be Boy or Girl do usually adhere by complacency to the desires of the big-bellied Woman and her Husband in this case for if the Midwife knows they desire a Boy she will assure them it will be a Boy and swear to it also And if they wish for a Girl as it also happens to some Women who love Girls best they will say it shall be a Girl and lay wagers of it too If this happens luckily according to her pronostick she will not be backwards to affirm she knew it very well but when it happens contrary to her prediction she makes her self reputed ignorant and presumptuous and remains ashamed For my part I should do quite otherwise for knowing beforehand the desires of the persons I should give my advice alwayes quite contrary to them because if it happen to be true although by chance what was foretold they will then conclude me to be knowing and to have said well and if otherwise which may be once in twice the Woman and her Husband obtaining what they desired will not take so much notice of it because one alwayes receives with a good welcom what they desire though unhoped for Having shewed that it is impossible to know whether a big-bellied Woman shall have a Boy or Girl because of the uncertainty of the signs upon which they ground their predictions We will assert that it is not the same in the knowledge one may have whether a Woman is conceived of more than one There are many Authors who have affirmed that a Woman cannot bring forth above two Children at once because they have but two Breasts as also because that there are but two cavities in the Womb different from most other Animals which hath many little cells in it and also many teats wherefore they bring
retain it or hinder it from being cast forth by reason of its fulness having received it in that estate When a Woman brings forth one or more Children at a birth begotten at once which usually are called Twins and differs from Superfaetation 't is known by their being both 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 membranes which wrap each apart with their waters and not both in the same membrane and waters as some have believed contrary to the truth but if there are several Children and a Superfaetation they will be also separated by their membranes but not have a common burthen but each his apart neither will they be of an equal bigness for that which is the Superfaetation will alwayes be lesser and weaker than that which was engendred at first 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 the nourishment from their neighbours who did but blossom when the first had already acquired some bigness Sometimes Twins are not of an equal bigness which happens according as the one or the other hath more strength to draw to it in greater abundance the best part of the common nourishment Six years since I layed a Woman at her full time whom I delivered of a very great living Girl by the feet which first came to the birth and fetching the after-birth I brought with it another Child a dead Boy as little again as the first Girl and which seemed not to be respecting his bigness above five or six months although they were both begotten at one and the same act of Copulation as was manifest by their both having but one and the same burthen which is the true sign of it as I have already said and this second Child was so little that it came together with the burthen and wrapt up in the membranes which I presently opened to see whether it were alive but it had been a long time dead as appeared by its corruption I am not willing to say that there never is any Superfaetation but I say that it happens very rarely for of an hundred Women that have Twins ninety of them have but one burthen common to both which is a very certain sign they had no Superfaetation and much more certain than the Indications taken from the greatness or strength of the Child which is but conjectural CHAP. IX Of a MOLE and its Signs OF all the several sorts of Great-Bellies in Women there remains that yet to be examined which is caused by a Mole of which we must alwayes endeavour the expulsion assoon as we come to know it being altogether contrary to nature The Mole is nothing else but a fleshy substance without bones 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 of both the Man and Woman Notwithstanding there are sometimes some that have some rudiments of a rough form It is very certain Women never engender Moles without the use of copulation both Seeds being required to it as well as for a true generation There are some truly who never having had to do with a Man do naturally cast forth after a flouding some strange bodies which in appearance seem to be flesh but if one take special notice thereof they will find it but clods of blood coagulated without consistence or fleshy texture or membranous as are the Moles and false-Conceptions Moles are ordinarily engendred when either the Man or the Womans Seed or both together are weak or corrupted the Womb not labouring 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 the small quantity found in it is extinguished and as it were choaked or drowned by 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 meer Chaos call'd a Mole not usually engendred but in the Womb of a Woman and never or very rarely found in that of other Animals because they have no menstruous blood as she hath A Mole hath no burthen nor navel-string fastned to it as a Child alwayes hath forasmuch as the Mole it self adheres to the Womb by which means it receives nourishment from its vessels it is likewise cloathed usually with a kind of membrane in which is found 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 according to its disposition and also according to the temperature of the Womb and the time it stayes there for the longer it stayes the harder it grows and becomes schirrous and difficult to be expell'd For the most part there is but one yet sometimes more of which some cleave very strongly others very slightly to the Womb. When Women miscarry of them before the second month they are called false-Conceptions when they keep them longer and that this strange body begins to grow bigger they are called Moles False-Conceptions are more membranous and sometimes full of corrupted Seed but Moles are altogether fleshy One may find in a Woman that hath a Mole almost all the signs of Conception and of a Woman with Child but there are likewise some other which differ because her belly is harder and sorer than when she is with Child The Mole being contrary to Nature is very troublesome to a Woman and as it hath no true life nor animal motion so it is very painful to go with for the Mole falls on whatsoever side she turns when she is a little big just like a heavy Bowl She hath a great weariness in her legs and thighs and suppression of urine from time to time and finds a great heaviness in the bottom of her belly forasmuch as this mass of flesh by its weight weighs down the Womb which compresseth the bladder of urine her breasts are not so swell'd neither have they any or very little milk It may be yet easier known if with all these signs she finds no motion after the 4th or 5th month of her Great-Belly and certainly if after her reckoning is out all the aforesaid signs remain and continue in the same manner These Moles are nourished in the womb to which they almost alwayes adhere and are sustained by the blood with which it is alwayes furnished just as Plants are by the moisture of the Earth Sometimes there is a Child together with a
into her Broths those herbs which purifie it as Sorrel Lettice Succory and Borrage she must avoid hot-seasoned Pyes and baked Meats and especially Crust because being hard of digestion it extreamly overchargeth the stomach If she hath a mind to Fish let it be new and not salted Fish of Rivers and running streams forasmuch as Pond-Fish tasts of mud and breeds ill juyce But if big-bellied Women cannot absolutely refrain their extravagant longings it is better as we have already said to suffer them to deviate a little from this rule or dyet provided it be moderate than too much to oppose their appetites They may drink at their meals a little good old Wine well temper'd with Water and rather Claret than White-wine which will help make a good digestion and comfort the stomach which is alwayes weak during prenancy and if they were not used to drink it before let them accustom themselves to it by degrees and as well in drinking as eating they must shun all things hot and diurectick because they provoke the courses which is very prejudicial to the Child By moderate sleep all the natural functions of a Woman are fortified and particularly the concoction of food in the stomach which then is very subject to loathings and vomitings We say it must be moderate because as excessive watchings dissipate the Spirits so too much sleep choak them Let therefore Women with Child sleep nine or ten hours at least in four and twenty and twelve at most and let it be rather in the night-time as most fit for rest than in the day as persons of quality are accustomed who frequenting the Court ordinarily turn night into day However they who have gotten this ill habit had better continue it than change too suddenly because this custom is become natural to them For what respects exercise and rest let them govern themselves according to the different time of their being with Child for at the beginning of the conception if the Woman perceives it she ought if she can to keep her bed at least till the fifth or sixth day and by no means to use copulation all the time forasmuch as the Seeds being not yet covered with the membrane which is formed in that time as we have said already are in the beginning by the agitation of the body very apt in some persons to slip forth She ought neither to go in Coach Chariot or Waggon nor on Horseback whilst with Child and much less the nearer she comes to her time because this kind of exercise doubles the weight of what is contained in the Womb by the jolts she receives and often makes her miscarry But she may walk gently go in a Sedan or Litter She ought neither to carry or lift heavy burdens nor lift up her arms too high and therefore she ought not to dress her own head as she used to do because it cannot be done without stretching her arms too much above her head which hath caused many to miscarry before their time because the ligaments of the Womb are at once loosned by these violent extensions Let her exercise be gentle walking and the heels of her shoes low because Women cannot for the bigness of their bellies see their feet and so are subject to stumble and fall In short she must govern her self in these exercises rather to err in too much rest than in too much exercise for the danger is greater by immoderate motion than in too much rest It is impossible for me in this point to be of the opinion of all Authors although all the World follows them in this their evil and dangerous counsel who would have a pregnant Woman exercise her self more than ordinary toward the latter end of her reckoning that so as they say the Child may sink lower But if they consider the point well they would without doubt find it to be the cause of more than half of the hard Labours and that on the contrary rest would be more advantagious to them as I shall prove by the following explication First We must know and take for granted that the birth of a Child ought to be left to the work of Nature well regulated and not to provoke it by shaking it with this exercise for to dislodge it before its full time which hapning though it be but seven or eight dayes sooner proves sometimes as prejudicial to the Infant as we see it is sometimes to Grapes which we find four or five dayes before they are full ripe to be yet almost half Verjuice But to explain more clearly than by this comparison that these kind of exercises often cause hard labours as we have already said consider that the Infant is naturally scituated in the Womb with the head uppermost and the feet downwards with its face towards the Mothers belly just till it hath attained to the eighth month at which time and sometimes sooner and sometimes also later his head being very great and heavy he turns over his head downward and his heels upwards which is the sole and true scituation in which he ought to come into the World all other postures being contrary to Nature Now just when the Child is about to turn according to custom into his intended posture Instead of giving her self rest she falls a jumping walking running up and down stairs and exercising her self more than ordinary which very often causes it to turn cross and not right as it ought to be and sometimes the Womb is depressed so low and engaged in such sort towards the last month in the cavity of the Hypagastres by these 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 worse Moreover it would be very convenient that the Woman to this end should abstain from Coition during the two last months of her reckoning forasmuch as the body is thereby much moved and the belly compressed in the action which likewise causeth the Child to take a wrong posture I believe that they that will seriously reflect on these things will make no difficulty to quit this old error which hath certainly caused the death of many Women and Children and much pain to divers others for the reasons above-mentioned Some Women have miscarried only with the noise of a Cannon as also with the sound of a great Bell but especially with a clap of Thunder when of a sudden it surpriseth them and frights them Big-bellied Women are sometimes subject to be costive because the Womb by its weight pressing the Rectum hinders the Belly from discharging its excrements with ease They that are troubled with this inconvenience may use Damask-Prunes stewed Veal-Broth and Herb-Pottage with which they may gently moisten and loosen the Belly If these things are not sufficient they may give her gentle Clysters of Mallows Marsh-mallows Pellitory and Anise-seeds with two ounces of brown Sugar dissolved in it adding a
little Oyl of Violets or else a Decoction made with a handful of Bran two ounces of Honey of Violets and a piece of fresh Butter or any other as occasion might require but there must be great care taken that no sharp Clysters be given her to this purpose nor other Drugs to cause a loosness or too great an evacuation lest it endanger her to miscarry as Hippocrates very well warns us in the 34th Aphorism of his fifth Book where he sayes Mulieri in utero gerenti si alvus plurimum profluat periculum est ne abortiat If a big-bellied Woman have a violent loosness she will be in danger of miscarrying If she ought to govern her self well in the observation of what we have lately mentioned she ought no less to be careful to overcome and moderate her passions as not to be excessive angry and above all that she be not afrighted nor that any melancholly news be suddenly told her for these passions when violent are capable to make a Woman miscarry at the moment even at any time of her going with Child as it hapned to my Cousins Mother named Mris Dionis a Merchant dwelling in the Street Quinquampois whose Father being suddenly killed with a Sword by one of his Servants who meeting him in the Street traiterously run him through out of spite and rage because he had some few dayes before turned him out of doors they brought immediatly this ill news to his Wife then eight months gone and presently after brought her dead Husband at which sudden fright she was immediatly surprised with a great trembling so that she was presently delivered of the said Dionis who is to this day which is very remarkable troubled with a shaking in both hands as his Mother had when she was delivered of him having yet no other inconvenience notwithstanding he was born in the eighth month by such an extraordinary accident nor doth he seem to be above fourty years old though near fifty When he signed his Contract of Marriage they who knew not the reason of it when they saw his hands shake thought it was through fear of his ill Bargain of which they were disabused when they had heard the Catastrophe that hastened his birth Wherefore if there be any news to tell a big-bellied Woman let it rather be such as may moderately rejoyce her for excessive joy may likewise prejudice her in this condition and if there be an absolute necessity to acquiant her with bad news let the gentlest means be contrived to do it by degrees and not all at once Assoon as a Woman finds her self with Child or mistrusts it let her not lace her self so close as she ordinarily doth with Bodies stifned with Whalebone to make her Body shapely which very often injures her Breast and so inclosing her Belly in so strait a mould she hinders the Infant from taking its free growth and very often makes it come before its time and misshapen Those Women are so foolish as not to mind that making themselves slender when they are with Child quite spoils their Belly which therefore after Childbed remains wrinkled and pendent as a Bag and then they cry It is the Midwife or Nurse that did them that mischief in not swathing and looking to them as they ought to do not considering that it came by their strait lacing whilst they were big upwards which causeth the Belly finding no place to be equally extended on all sides to dilate it self onely downwards whither all the burthen is in that manner thrust and carried to avoid which let them use habits more large and easie and wear no Busks with which they presse their Bellies to bring them into shape Let them also forbear Bathing in any manner after they know they have conceived lest the Womb be excited to open before the time Almost all big-bellied Women are so infatued with the custom to bleed when they are half gone and in the seventh month that if they should neglect it although they were otherwise well they vvould never believe they could be well delivered I will not in the mean time justifie and make them believe by that what Hippocrates saith in his 31th Aphorism of his 5th Book Mulier in utero ferens secta vena abortit eoque magis si sit faetus grandior If saith he a Woman be blooded she miscarries and the rather if she be far gone This Aphorism must not prohibit us the use of bleeding when the case requires but only warns us to use it with great prudence forasmuch as some Women want bleeding three or four times yea and oftner sometimes whilst they are with Child when twice may be sufficient to others For as there have been some that have been blooded nine or ten times for diseases during their pregnancy and yet go on with their Infant to their full account so others have miscarried by bleeding but once a little too copiously as in this Aphorism speaks Hippocrates Now since all are not of the same nature they must not be all governed after the same manner nor believe that it is necessary to bleed all big-bellied Women one may judge of the necessity according as they are more or less sanguine It is the same in purging which ought to be prudently administred as well as bleeding according to the exigency of the case using alwayes gentle and benign remedies when they are necessary as Cassia Rhubarb Manna with the weight of a dram or two at most of good Senna These Purgatives may serve turn for a Woman with Child she ought not to use others more violent If she observes all that we have above mentioned she may then hope for a good issue of her great-Belly Having amply enough declared how a Woman with Child should be governed when accompanied with no ill accident and given the Rules she ought to keep to prevent them We will now examine several Indispositions to which she is subject particularly during her pregnancy CHAP. XI The means to prevent the many Accidents which happen to a Woman during the whole time of her being with Child and first of Vomitings VOmiting with the suppression of the Terms is for the most part the first Accident which happens to Women and the means by which they themselves perceive their pregnancy It is not alwayes caused as is believed from ill humours collected in the stomach because of this stoppage of their Courses these corrupted humours do often cause a depraved appetite in pregnant Women when either they flow thither or are there engendred but not this Vomiting which happens immediately after Conception and which comes by succession it cannot be meant of those which are there afterwards corrupted but these first Vomitings proceed from the sympathy between the Stomach and the Womb because of the similitude 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
A Vomitu singultus malum Some advise that after all these things have been tryed in vain great Cupping-glasses should be applyed to the region of the stomach to keep it firm in its place but I believe it to be a Chip in Pottage which doth neither good nor hurt because the stomach is loose and no wayes adhering to this upper part of the belly but since these Vomitings cool it and daily weaken it I should advise a big-bellied Woman to wear in the Winter upon its region a good piece of warm Serge or soft Lambskin which would a little warm those parts and help digestion which is alwayes weak The Italians have a Custom which is not bad they wear to the same purpose a fair piece of Stuff under their Doublets upon the region their stomach of which they are so careful that if they should leave it off but two dayes in the Winter nay even in the Summer they would think themselves sick and they are so grear lovers and so curious of it that this Stomacher is often their greatest bravery enriching it with Gold and Silver Embroidery and Ribonds of very fine colours We have discoursed enough about Vomiting caused by Pregnancy wherefore we will pass forwards to some other Accidents CHAP. XII Of Pains of the Back Reins and Hips ALL these Accidents are but the effects of the dilatation of the Womb and the compression it makes by its greatness and weight on the neighbouring parts which are much greater the first time the Woman is with Child than afterwards when the Womb only receives the same dimensions it had already before but when it hath not yet been dilated it is more sensible of this extention and the ligaments which hold it in its natural scituation suffer a greater stress in the first pregnancy having never before been forced to lengthen to answer the extent of the Womb than in the following Great-Bellies to which it obeys more easily the second time These ligaments as well round as large cause these pains being much straitned and drawn by the bigness and weight of the Womb which contains a Child to wit the large ones those of the back and loyns which answer to the reins because these two ligaments are strongly fastened towards these parts the round ones cause those of the groins share and thighs where they terminate They are sometimes so violently extended by this extream bigness and great weight of the Womb especially of the first Child as I said before that they are lacerated and torn being not able to yeeld or stretch any farther and chiefly if the Woman in that condition makes a false step which causeth in them almost insupportable pains and other worse accidents as it happened two years since to a near Kinswoman of mine who being six months gone or thereabouts of her first Child felt the like after she had stumbled and perceived at the same moment something crack in her Belly towards the region of the Reins and Loins which was one of these large ligaments with a kind of noise by the sudden jolt she received At the same instant she felt extream pains in her Reins and Loins and all the one side of her Belly which made her immediately vomit very often with much violence and the next day she was taken with a great continued Feaver which lasted seven or eight dayes without being able to sleep or rest one hour all which time she continued to vomit all she took with a strong and frequent Hiccough having also great pains which seemed as if they would hasten her Labour which for her sake I was very apprehensive of as also of her death but with the help of God having put her immediatly to bed where she continued twelve whole dayes in which time I bled her thrice in her Arm on several dayes and made her take at two several times a small grain of Laudanum in the yolk of an Egg a little to ease her violent pains by giving her rest alwayes ordering her from time to time good strengthning Cordials all these symptoms which at first seemed desperate ceased by little and little and she went on her full time when she was happily delivered of a Son which lived fifteen months notwithstanding all those mischievous accidents she met with which were enough to have kill'd half a dozen others but God sometimes is pleased to work Miracles by Nature aided with Remedies fit for the purpose as well as by his Grace This History informs us I think very well how these Pains of the Loins Back and Reins come and the pregnant Womb causeth also those of the Hips by its greatness and weight in compressing them and bearing too much upon them There is nothing will ease all these sorts of Pains better than to rest in Bed and bleed in the Arm if there were any great extension or rupture of any ligament of the Womb as was in the case recited And when the Womb bears and weighs too much upon the Hips if the Woman cannot keep her Bed she ought to support and comfort her Belly with a broad Swaith well fitted for the purpose and to bear it as patiently as she can to the time of her Labour which will free her from all these accidents CHAP. XIII Of the Pains of the Breasts AS soon as a Woman conceives her Tearms wanting the ordinary evacuation the passages being stopt and the Woman breeding daily blood there is a necessity she consuming but little whilst young with Child the fruit being yet very little also that the vessels which are too full should disgorge part as it doth upon the parts disposed to receive it such as are the kernels and glandulous parts especially the Breasts which imbibe and receive a great quantity of it which filling and extreamly swelling them causeth this Pain in them which Women feel when they are with Child and happens also to those whose Terms are only suppressed In the beginning we ought to leave the whole work to Nature and the Woman must only have a care she receives no blows upon those parts which are then very tender nor be straight laced with her Bodies or other stiff Wastcoats that might bruise and wound her upon which follow Inflamations and Abscess But after the third or fourth month of going with Child the blood being still sent to the Breasts in great abundance 't is much better to evacuate it by bleeding in th' Arm than to turn or drive it back on some other part of the Body by repercussive or astringent Medicines because it cannot flow to any part where it can do less hurt than in these Wherefore I should rather prefer the Woman being very plethorick to evacuation by bleeding in the Arm than any other way because of shunning thereby the Accident of which speaks Hippocrates in his 40th Aphorism of the 5th Book Quibus Mulierilbus in Mammas sanguis colligitur furorem significat If the blood be carried in too great abundance to
the Breasts it signifies that the Woman is in danger of being frantick because of the transport which may be made thence to the Brain which accident is avoided by moderate bleeding in the Arm as also by a regular cooling dyet moderately nourishing for to diminish the quantity and temper the heat of the humours of the whole habite CHAP. XIV Of Incontinence and difficulty of Urine THe scituation of the Bladder which is placed just upon the Womb is sufficient to instruct us wherefore pregnant Women are sometimes troubled with difficulty of urine and the reason why they cannot often hinder nor scarce retain their water which is caused two wayes 1. Because the Womb with Child by its bigness and weight compresseth the Bladder so that it is hindred from having its ordinary extension and so incapable of containing a reasonable quantity of urine Which is the cause that the bigger the Woman grows and the nearer her time she approaches the oftner she is compelled to make water which for that reason they cannot keep 2. If the weighty burden of the Womb doth very much compress the bottom of the Bladder it forceth the Women to make water every moment but contrarily if the neck of it be pressed it is filled so extreamly with urine which stayes there with great pain being not able to expel it forasmuch as the Sphincter because of this compression cannot be opened to let it out Sometimes also the urine by its acrimony excites the Bladder very often by pricking it to discharge it self and sometimes by its heat it makes an inflamation in the neck of the Bladder which causeth its suppression It may be likewise that this Accident is caused by some Stone contained in the Bladder then the pains of it are almost insupportable and much more dangerous to Woman with Child than to one that is not because the Womb by its swelling causeth perpetually the stone to press against the Bladder and so much the violenter are these pains as the stone is greater or the figure of it unequal and sharp It is of great consequence to hinder these violent and frequent endeavours of a big-bellied Woman to make water and to remedy it if possible both in one and the other indispositions because by long continuance of alwayes forcing downwards to make water the Womb is loosned and bears very much down and sometimes is forced the inconvenience not ceasing to discharge it self of its burden before the ordinary time This is that should be endeavoured to be hindred having respect to the different cause of the distemper as when it comes from the bigness and weight of the Womb pressing the Bladder as it is for the most part the Woman may remedy it and ease her self if when she would make water she lift up with both her hands the bottom of her belly she may wear a large Swaith accommodated to this use which will bear it up if there be occasion and hinder it from bearing too much upon the Bladder or to do better she may keep her Bed If it be the acrimony of the urine that makes the inflammation on the neck of the Bladder it may be appeased by a regular cooling dyet drinking only Ptisan and forbearing the use of Wine and all sorts of Purgations because they send the filth of the whole body to the part affected and by their heat do yet more augment the acrimony and inflammation but she will do well to use mornings and evenings Emulsions made with the cold Seeds or Whey mixt with Syrup of Violets This Remedy is proper by refreshing gently to cleanse the urinary passages without prejudicing either the Mother or Infant If the inflammation and acrimony of the Urine be not removed by this Rule of Dyet they may let her blood a little in the Arm to prevent any ill accident that may happen they may likewise bath her outward entry of the neck of her Bladder with a Decoction of emollient and cooling Herbs as the leaves of Mallows Marsh-mallows Pellitory and Violets with a little Linseed which being viscous will help the conduit of the Urine to dilate it self the easier there may be also Injections given into the Bladder of the same Decoction to which may be added Honey of Violets or else of lukewarm Milk But if the Woman notwithstanding she observes these Directions cannot make water recourse must be had to the last remedy which is to draw it forth by a Catheter represented and marked with the Letter M in the Table of Instruments at the end of the second Book which being anointed with Oyl Olive or sweet Almonds having first lifted up and thrusted the Belly a little upwards must be gently introduced by the urinary passages into the very hollow of the Bladder and then the Urine will immediately pass away which being finished the Catheter must be taken forth and if the suppression continues it may be used again in the same manner until the accident quite leave her and then they may try whether she can urine naturally If she be in very great extremity she may use an half-Bath luke-warm provided she be not too much moved by this Remedy abstaining also from all Diureticks which are very prejudicial to big-bellied Women because they provoke abortion If on the other side this evil arises from the Stone which presenting it self to the neck of the Bladder stops the urinary passage whilst with Child she must be contented to have it only thrust back with a Catheter but if it be small one may try to draw it forth with a small Probe fit for the purpose putting the fore-finger into the Vagina to keep it in subjection that it recoyl not back towards the Bladder which is only to be done to the small ones for she must be delivered before the great ones can be drawn forth it being better to leave her in that condition than to endanger her life or the Childs by drawing it CHAP. XV. Of the Cough and difficult breathing WOmen whose Children lie low are oftener troubled with difficulty of Urine as we have mentioned in the foregoing Chapter than they whose Children lie higher who are indeed exempted from this and the like inconvenience but are then more subject to a Cough and difficulty of breathing than the former A Cough if violent as sometimes even to vomiting is one of the most dangerous accidents which contributes to Abortion because it is an essay by which 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 with which the Lungs are much extended thrusts also by the same means with a sudden violence the Diaphragma downwards and consequently all the parts of the lower Belly but particularly the Womb of the pregnant Woman which accident continuing long and violent often causeth her to come before her time This Cough proceeds sometimes from sharp and biting rheumes which distill from the
brain upon the sharp Artery and the Lungs and sometimes from a blood of the like nature which flowes from the whole habit towards the Breast upon the suppression of the Terms as also from having breathed in too cold an air which irritates the parts and excites them to move in that manner but being begun by these causes it is very often augmented by the compression the Womb of the pregnant Woman makes upon the Diaphragma which cannot have its free 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 principally the Stomach and Liver forcing them against the Diaphragma which is thereby compressed as we have said This may be remedied by the Womans observing a good diet something cooling if sharp humours cause it avoiding all meats salted spiced or hautgoust she must forbear sharp things as Orenges Citrons Pomgranats Vinegar and others of the like nature because they yet more and more by their pricking quality excite the Cough but she may make use of Lenitives and such as sweeten the passages as juice of Liquorish Sugarcandy and Syrup of Violets or Mulberries of which they may mix some spoonfuls with a Ptysan made with Jujubes Sebestens Raisons of the Sun and French Barly alwayes adding a little Liquorish to it It may not likewise be amiss to turn the abundance of these humours and draw them downwards by some gentle Clyster If this regimen prevails nothing and that there appears signs of fulness of blood it will be necessary at whatsoever time it be of her going with Child to bleed her in the Arm and though this remedy be not usually practised when they are young with Child yet in this case it must for a continual Cough is much more dangerous than moderate bleeding If the Cough comes of cold let her be kept in a close Chamber with a Napkin three or four times double about her Neck or a Lambskin that it may keep her warm and going to bed let her take three or four spoonfuls of Syrup of burnt Wine which is very pectoral and causeth a good digestion if it be made in the following manner Take half a pint of good Wine two drams of good Cinamon bruised half a dozen Cloves with four ounces of Sugar put them together in a Silver Porenger and cause them to boil upon a Chafindish of coals burn it and afterwards boil it to the consistence of a Syrup which let the Woman take at night an hour or two after a light supper It must alwayes be observed from whatsoever cause the Cough proceeds that the Woman go loose in her clothes for being strait-laced the Womb is the more thrust down by the endeavours the Cough causeth it to make And because sleep is very proper to stay defluxions it may be procured if there be occasion by some small Julip using by no means the strong Stupesactives which are dangerous to a Woman with Child if there be not a very great neceâ—sity as there was in my Kinswoman who had furious accidents by the hurt she got from the stumble of which I gave you an account in the 12th Chapter of this Book There are Women that carry their Children so high especially their first because the large Ligament which support the Womb are not yet relaxed that they think them to be in their Breast which causeth so great an oppression and difficulty of breathing that they fear they shall be choaked assoon as they have either eaten a little walked or gone up a pair of Stairs which comes as I said before by reason the Womb is much enlarged and greatly presseth the Stomach and the Liver which forces the Diaphragma upwards leaving it no free liberty to be moved whence is caused this difficulty of breathing Sometimes also their Lungs are so full of blood which is driven thither from all parts of the body when with Child 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 because by that means the Lungs are emptied and have more liberty to be moved But if this difficulty of breathing comes from a compression made by the Womb against the Diaphragma in forcing the parts of the lower Belly against it the best remedy is to wear their clothes loose about them and rather eat little and often than to fill their Bellies too much at once because it is thereby more pressed against the Diaphragma and so augments the accident Neither must she use any viscous or windy meats as Pease c. but only such as are of an easie digestion she must all the while avoid any occasion of grief and fear because these two passions drive the blood to the Heart and Lungs in too great abundance so that the Woman who can hardly already breath and hath her Breast stuft will be in danger of being suffocated for the abundance of blood filling at once and above measure the Ventricles of the Heart hinders its motion without which one cannot live CHAP. XVI Of the swelling and pains of the Thighs and Legs IT is very easie for them that are acquainted with the Circulation of the Blood to conceive the reason why many big-bellied Women have their Legs and Thighs swelled and pained and sometimes full of red spots from the swelling of the Veins all along the inside of them which extreamly hinders their going Many think which is in some measure true that the Woman having more Blood than the Infant needs for its nourishment Nature by vertue of the expulsive faculty of the upper parts which are alwayes most strong drives the superfluity of it upon the lower which are the Legs as most feeble and aptest to receive it because of their scituation to explain it thus is something to purpose but I think the Circulation of the Blood will teach us better how this comes than that we need to have recourse to this expulsive faculty It is then thus according to my opinion Following the ordinary motion of the Blood the Crural and the Saphene Veins receive into them what is brought to the lower parts by the Arteries and convey it along the Leg and Thigh ascending still by the Iliacks towards the Heart which are emptied into the Cava to ascend again by it to the Heart and so successively This being so de facto as need not be doubted since it is a verity founded upon experience when a Woman is with Child and chiefly towards the last months and the Womb is much extended and possesseth a great part of the lower Belly then it begins to press the Iliack Veins by its greatness and heaviness and so hinders the Blood from following its course and having its motion so free as before she was with Child which being so the inferior parts which are the Crural and Saphene Veins become swelled much in the same manner as the
and Linseed Oil of sweet Almonds Poppies and Water-Lillies well beaten together with the yolk of an Egg and ground in a leaden Mortar are very anodine and proper to ease pain and if the inflammation be great anoint it a little with Uuguentum Refrigerans Galeni and Populean equally mixed After a good diet bleeding and the application only of these cooling and anodine Remedies Repercussives being not then to be used lest they repel the impure Blood or harden the Piles if their swelling doth not abate Leeches must be applied to draw and empty the Blood there gathered or they may be opened with a Lancet if soft or any kind of inundation but Leeches is more proper for hard Piles and as it were fleshy because they do not put one to so much pain as the Lancet Although some men by the help of these Piles have an evacuation almost natural being relieved by it when they bleed moderately Nature being accustomed to it yet it is not so in Women but alwayes contrary to Nature because the evacuation which happens to those men by the Piles ought always to be made by the Womb in Women if not with Child but if they are it may in some manner in case the Woman be plethorick supply also the defect of the natural for provided they bleed moderately and without pain she may thereby be also relieved but if they flow in too great quantity there is danger that both Mother and Infant will be weakened by it and to avoid it 't is convenient to make astringent Fomentations with the Decoction of Granat flowers the rinds of Pomegranates and Province-Roses made with Smiths-water and a little Alum or this Cataplasm may be applyed to it made with Bole-armonack Dragons-blood and Terra Sigillata with the white of an Egg As also to turn back the Blood from these parts by bleeding in the Arm and by dry cupping-glasses applied to the region of the Reines and other remedies convenient for this distemper and such as the accident requires CHAP. XVIII Of the several Fluxes which may happen to a Woman with Child and first of a Loosness THree several Fluxes may befall a great-bellied Woman to wit the Flux of the Belly the Flux of the Terms and Floodings We shall first speak of the Flux of the Belly and afterwards we will examine the other two in the two following Chapters There are ordinarily reckoned three sorts of Loosnesses which in general is a frequent dejection of what is contained in the Guts by stool the first is called Lienteria by which the Stomach and the Guts not having digested the nourishments received lets it pass almost quit raw The second is called Diarrhaea by which they simply discharge the humours and excrements which they contain And the third which is the worst is Dysenteria by which the Patient together with the humours and excrements voids Blood with violent pains caused by the ulceration of the Guts Of what kind soever the Flux is if it be great and continue long it puts the Woman in great danger of miscarrying which Hippocrates tells us in the 34th Aphorism of his 5th Book Mulieri in utero gerenti si alvus plurimum profluat periculum est ne abortiat For if it be a Lienteria the Stomach not containing the Food received and letting it immediatly pass away before it be turned into Chyle of which Blood ought to be made for the nourishment of Mother and Child it is not possible but they must be both thereby extreamly weakned for want of nourishment If it be a Diarrhaea and continues long it will occasion the same accident because there is a great dissipation of the Spirits together with the evacuation of humours But the danger is much greater when a Dysenteria forasmuch as the Woman hath then great pains and gripes in the Guts caused by their ulceration which excites them continually by constant stimulations to discharge themselves of the sharp and bilious humours with which they are extreamly annoyed which causeth a great disturbance and violent commotion of the Womb being placed upon the right Gut and to the Child contained in it and by the compression which the Muscles of the Belly make on all sides as also those that are made by them of the Diaphragma which force themselves downwards in the endeavours a Woman makes so often to go to stool with pain the Child is constrained because of this violence to come before its time which arrives so much the oftner by how much these stimulations and needings are greater as the same Hippocrates notes in the 27th Aphorism of his 7th Book Mulieri utero gerenti si tentio supervenerit facit abortum If there happens a tenesme saith he to a Woman with Child it make her miscarry This tenesme is a great passion of the right Gut which forceth it to make these violent endeavours to discharge it self without being able to avoid any thing but cholerick humors mixt with Blood with which it is continually irritated When this Flux of the Belly happens to a big-bellied Woman it is ordinarily because they have alwayes the digestion of their stomach weak by reason of their bad dyet which their strange appetites cause them often to long for by the continual use of which being at length weakned it suffers the food to pass immediately without digestion or if it stay longer it is converted into a corrupted Chyle which descending into the Guts irritates them by its acrimony to discharge themselves as soon as they can Now to proceed safely to the cure of these different Fluxes of the Belly to which 't is fit care should be taken in good time lest the Woman miscarry as we have already said the nature of it must be considered to the end the cause which maintains it should be remedied If it be a Lienteria following as is usual continual Vomitings which have so debilitated the Stomach and relaxed its membranes that having no longer strength to vomit up that food it suffers it to pass downwards without digestion In this case a Woman must abstain from all those irregular appetites and accustom her self to good food of easie digestion and little at a time that so her Stomach may be able the easier to concoct and digest it she should drink a little deep Claret-Wine mixed with Water in which Iron hath been quenched instead of Ptysan which is not proper in this case provided she have not a strong Feaver for if it be but a small Feaver Wine on this manner is to be preferred forasmuch as the fewer she hath at that time is but symptomatick caused by this debility of Stomach and will vanish as soon as this is fortified which will be yet more promoted if the Woman before and after meals takes some Corroberatives as a little of that Burnt-Wine we mentioned for the Cough in the 15th Chapter of this Book or a little good Hippocras or right Canary of any of them according to
and in what manner whether it is the ordinary Courses or a real Flooding If it be the ordinary Courses the blood comes away periodically at the accustomed times and flows by degrees from the neck near the inward Orifice of the Womb and not from its Fund as may be discovered if trying with a finger one finds the inward Orifice exactly closed which could not be if the blood proceeded from the bottom as also if it proceeds without pain all which circumstances do not meet in a flooding but others very different as will appear in the following Chapter It must likewise be considered whether these Courses flow onely because of the superfluity or because of the acrimony of the Blood or the weakness of the Vessels which contain it that so fit Remedies may be applyed If they proceed from the sole abundance being more than the Fruit can consume for its nourishment it is so far from hurting either Mother or Child that being moderate it is very profitable to them because if the Womb were not discharged of this superfluous blood the Fruit which is as yet but little would be drowned by it or as it were suffocated And if it should chance that they were unduely stopt or retained bleeding will supply the defect of the natural evacuation which ought to have been but if there be no sign of abundance or plenitude and that before she was with Child she had her Courses in a small quantity which still continue to flow after she hath conceived it is a sign that the flux proceeds from the heat and acrimony of the blood or the weakness of the Vessels appointed to receive it It is of this sort of Women that Hippocrates pretends to speak in the 6th Aphorism before mentioned whose Children cannot be healthful when their Courses flow whilst they are breeding because there remains not blood enough behind for her and the nourishment of her Infant which puts her in great danger of miscarrying for as the proverb saith Hunger drives the Wolf out of the Wood so likewise want of nourishment forceth the little prisoner out of his hiding-place before his time To hinder this Flux from effecting so evil and sinister an accident the Woman must keep her self very quiet in bed abstaining from all things that may heat her Blood shunning Choler above all the passions of the mind using a strengthening and a cooling diet feeding on meat that breeds good Blood and thickens it as are good broths made with Poultry necks of Mutton knuckles of Veal in which may be boiled cooling Pot-herbs newlayd Eggs Gelly's Rice-milk Barly-broths which are proper for her let her Drink be Water in which Iorn is quenched with a little Syrup of Quince she must refrain from Copulation because by heating the Blood it excites it to flow more If notwithstanding all this the Flux continues some commend large cupping-glasses under the Breasts to make a revulsion and to turn the Blood according to Hippocrates Aphorism 50 of the 5th Book Mulieri si velis menstrua sistere cucurbitulam quam maximam ad Mammas appone but it will do no great matter however to satisfie the Patient and to shew that nothing is omitted that may make for her cure they may be applied I should rather choose to make this Revulsion by bleeding in the Arme if her strength permitted And because in this condition the Child is very weak through this great evacuation it must be fortified by applying to the Mothers Belly about the region of the Womb Compresses steeped in strong Wine in which is boyled a Pomegranat with its peel Provence-Roses and a little Cinamon but the best way to strengthen it is to correct the Mothers Blood and hinders its evacuation CHAP. XX. Of Floodings THere is a great difference between the menstruous Blood of which we have discoursed in the preceeding chapter which happens sometimes to Women with Child and this Flooding which we have now in hand for as I have said the Courses come periodically at the times accustomed without pain destilling by little and little from the neck of the Womb during pregnancy after which it totally ceaseth but much the contrary this loss of Blood comes from the bottom of the Womb with pain and almost of a sudden and in great abundance and continues flooding daily without intermission except that some clods formed there which seem somtimes to lessen the accident by stopping for a little time the place whence it flows but soon after it returns with greater violence after which follows death both to Mother and Child if not timely prevented by delivering the Woman as shall be hereafter declared If this Flooding happens when young with Child it is usually because of some Fals-conception or Mole of which the Womb endeavours to discharge it self by which it opens some of the Vessels in the bottom of it from whence the Blood ceaseth not to flow until in hath cast forth the strange bodies it contained in its capacity and the hotter and subtiller the Blood is then the more abundantly it flows But when this Flouding happens to a Woman truly conceived at whatsoever time it be it proceeds likewise from the opening of the Vessels of the fund of the Womb caused by some blow slip or other hurt and chiefly because the Secundine in such cases and sometimes in others separating in part if not totally from the inside of the bottom of the Womb to which it ought to adhere that it might receive the Mothers Blood appointed for the Infants nouriture by which separation it leaves open all the orifices of the vessels where it was joyned and so follows a great flux of Blood which never ceaseth if so caused till the Woman be brought to bed for the Secundine being once loosened although but part of it never joyns again to the Womb to close those Vessels which can never shut till the Womb hath voided all that it contained for then compressing and closing its self and as it were entering within it self as it happens presently after delivery the orrifices of the vessels are closed and stopt up by this contraction whereby also this flooding ceaseth which alwayes continues as long as the Womb is distended by the Child or any thing else it contains for the reason aforesaid much like to a Spunge whose pores or holes being very large when swelled disappear and close with their own substance when squeezed and compressed so likewise by this contraction of the Matrix which during pregnancy became as it were spongeous in the place whence the Secundine was separated the orifices of the vessels are closed assoon as it is cleansed from whatsoever it contained in its capacity Although I have said that a Woman in this condition for the reasons alledged must necessarily be delivered that the Flooding may be stopt I do not intend it should be done assoon as perceived because some small Floodings have sometimes been suppressed by keeping quietly in bed bleeding in the Arme
the Child I brought it alive and it was presently baptized by a Priest that was in the Chamber The poor Patient and all the company present which were in great number found then manifestly that the Chirurgion and Midwife who said she could not be delivered had but little reason to assure any such thing The Operation was finished time enough for the Childs baptism which praised be God it received but too late to save the Mothers life who having before lost all her Blood dyed an hour after she was so delivered by the same weakness that she often fell into before she was delivered The flooding indeed ceased presently but she had not Blood enough left to enable her to resist those frequent faintings which she might have done as may probably be conjectured if the Chirurgion that first saw her had delivered her three long hours before as without doubt he might as easily have done as I in which time she lost above twenty * each Porenger contains about four ounces small porengers of Blood of which four or five possibly might have been sufficient to have saved her life she being a young Woman of a very good constitution having no inconvenience or sickness when she was surprised with this fatal accident which befel her as aforesaid about eleven in the morning and she was delivered about seven at night and because she had lost so much Blood before the Operation it proved unprofitable she dying an hour after having her perfect senses to the moment she expired which was about eight the same night I will upon this lamentable Subject to the end more care may be taken in the like cases examine by way of digression what might be the motive of this proceeding of the Chirurgeon and of some others of the same humour It must necessarily be agreed that it was for one or more of these three causes why either he would not or could not lay this Woman when he saw her two hours before me which as I noted before might easily have been done It was either through Ignorance Malice or Policy To imagine it his Ignorance I cannot perswade my self because he hath too great Reputation for that although many persons that understand the Art very well easily agree with me that he is of the number of those of whom may justly be said Minuit praesentia famam That it was through Malice who can imagine a man of so detestable a resolution could be found but if it were neither Ignorance nor Malice it is easy to guess it a damnable Policy qualified by some with the name of Prudence * A good Warning not to rely too much upon the advice of such famous Practitioners or Midwives that prefer their Reputations above their Consciences this false Prudence they ordinarily use that are in great reputation ever endeavouring to their utmost to shun dangerous Cures lest they that understand not the Art should quit the good opinion they had of them when it happens that the Patient dies under their hands although they were carefully and duly delivered This was just our misfortune for this Chiurgeon who was very much esteemed by many Women of quality whom he delivered avoided all he could dangerous labours subject to ill success as this was and the rather then because there was in my Sisters Chamber a Lady of quality Wife to one of the chief Captains of the Guards who dwelt in the same house and whom he ordinarily delivered which was the cause that believing the issue of the Operation doubtful he chose rather to preserve the esteem of his ancient practice amongst such as understood not the business well enough to be judge of his proceedings than to do in this case his Christian duty to which one ought alwayes to have more regard than to all these Interests of vain Reputation which usually corrupts the Conscience They that make use of this Policy are often accessory to the death of poor Women who call for their assistance and of their Children also I was willing to recite every circumstance of this Tragedy that one may know in the like case the necessity of a speedy delivery I have since that had many in the same case to whom by the assistance of God I warranted the lives of the Women and saved the Children of which I had in my self more satisfaction than I could have gained by all the honour the World could procure me by so wicked a policy which neither Chirurgeon nor Midwife of an upright Conscience will ever use Now since in all floodings there ever follows weakness and faintings we must endeavour to preserve that little strength the Patient hath left and augment it if possible that so they may have sufficient to endure the operation and to escape afterwards to which purpose there ought to be given her from time to time good strengthening Broths Gelly's and a little good Wine she must alwayes smel to Rose-vinegar and have a warm toast dipt in Wine and Cinamon applied to the region of her Heart which will do her more good than solid food for as Hippocrates saith in the eleventh Aphorism of his second Book Facilius est potu refici quam cibo one is sooner nourished by drink than meat because the liquid aliments are much sooner distributed than the solid And to prevent the Blood from flooding in great abundance till she can be delivered * Rather Ligatures above the elbows because too much Blood is already lost a Vein in her Arm may be opened to turn a little the course backwards and apply all along her Reins Napkins wet in Water and Vinegar But if the flooding proceds from the separation of the after-burthen from the Womb as my Sisters was all these things are to little purpose and the best expedient is to deliver the Woman assoon as may be though she were but three or four months gone with Child or less because all ought as well to be brought away whatever is within the Womb whether it be Fals-conception Mole or Child without leaving any thing behind which when it is quite cleared closing and contracting it self stops the flooding for the reasons above alledged and all accidents which were caused by it wherby the Woman afterwards recovers if there be but sufficient strength remaining after delivery as certainly will be if not delayed too long CHAP. XXI Of the weight bearing down or relaxation of the Matrix which hinders a Woman with Child in her walking and the freedom of coition MAny Women with Child find an extraordinary weight at the bottom of their Bellies which comes because the Womb by the weight it contains in its capacity bears down upon the neck and sometimes so low that they cannot walk without pain and stradling at which time also they cannot use copulation but with great inconvenience The bearing down of the Womb is when it only falls into the Vagina without coming in the least without the Privities for then it
is called the falling-out or Praecipitation which is a more troublesom and dangerous Disease and doth not usually befal Women with Child because the extent and bigness of the Womb hinders it that it cannot fall out but only bears down The Precipitation is discerned by the view and the bearing down easily by puting up a Finger into the Vagina for there the Womb will be soon met with and its inner Orifice which is very near the Privities especially when the Woman stands upright This bearing down is often caused by the relaxation of the ligaments of the Womb and chiefly the large ones which ought to fasten it on each side towards the loins to prevent it which relaxation comes either from the weight of the burthen it bears and contains within which constrains these ligaments to be extended more than ordinary or from some fall which by much shaking of it produceth the same effect and so much the easier by how much the burthen is greater and likewise from some great pains or bad labour which preceeded the present pregnancy or very often it is caused or at least facilitated by abundance of humours which moistening the ligaments relax them in that manner to which the phlegmatick are very subject who usually are much troubled with the Whites Besides the hinderance which the bearing down of the Womb causeth to the Womans walking and use of coition as we have above mentioned it causeth likewise by its weight principally towards the latter end of her reckoning a numness in her Hips sleepiness in her Thighs as also difficulty of Urine and going to stool because by bearing down it presseth down the Bladder and the great Gut between both which it is scituated The Patient may be much easier cured of this bearing-down after she is brought to bed than whilst she is with Child for being freed from its burthen its ligaments will be the easier fortified besides she may then use peffaries to keep it in its place which cannot so well be done when she is with Child From what cause soever this bearing-down proceeds the best remedy for a big-bellied Woman is to keep her bed because the weight of it doth more and more relax the ligaments when she is up And if she have neither the means nor convenience so to take her rest at least let her if her belly be big enough as it is towards the later end of her reckoning wear a Swaith very broad and fit for the purpose that by this means the burthen being a little supported the ligaments may not be so much stretched and lengthened and if she have a difficulty in making water let her when she would do it help her self by lifting up with both hands her Belly before which will be a great ease and hinder the neck of the Bladder from being so much compressed but if the humours cause this relaxation of the ligaments of the Womb she must keep her self to a drying dyet her food being rather rosted than boiled and must refrain from copulation The Woman must not be straight laced because that also forceth down the Matrix and above all when she is in labour care must be taken that neither by means of the throwes which strongly force down the Womb nor by the birth of the Child nor the violent extraction of the burthen she gets a precipitation instead of a bearing down which is soon done as is seen often when the method I teach in the 16th chapter of the second Book where I treat of this Labour is not well observed CHAP. XXII Of the Dropsie of the Womb and the oedemitous Tumours of the Lips of the Privities THere are many phlegmatick Women who certainly believe themselves with Child void nothing but water which was collected together in their Womb and called the Dropsie of the Womb. It hath often happened that such a Disease hath deceived the Midwives as well as the Patient who having a long time hoped and been made to hope for a Child at length instead of it finds nothing but clear waters as it once did to that Woodmerchant I mentioned in the 13th chapter of this first Book who at the end of nine or ten months of such a false Belly voided a quantity of these waters which was all that was contained and inclosed in the Womb. Guillemeau in the first chapter of his first Book of Labours makes mention of the like History of one named Madam du Pescher who voided a pailfull of it certainly believing her self to be with Child And Fernelius in the 15th chapter of his 6th Book of Pathologie recites a case much more wonderful concerning these Dropsies He tells us that he saw a Woman who at the times of her purgations cast forth by the neck of the Womb so great a quantity of water very hot and yellowish that she filled six or seven Basins and voided so much of it that her Belly grew quite flat after which her Courses came immediatly in order and that the following months the like quantity was again amassed which afterwards came away as before and that this Woman which is most notorious being cured of this indisposition became with Child and was brought to bed of a living Child These Waters are either bred in the Womb or brought thither from some other part as in the dropsie of the Belly it passeth by transudation through the porous substance of the membranes of the Womb. They are bred in the Womb when it is too cold or too much debilitated by an ill and violent Labour preceeding or because the filth as Whites or other superfluities which it was accustomed to discharge it self of hath a long time been suppressed When the Waters contained in the capacity of the Womb have been sent thither from elsewhere they are then never wrapt in a particular membrane but only retained by the exact closure of its Orifice and flows away as soon as it begins to open but when they are bred in the Womb which is for the most part after copulation if the Seed be either too cold waterish or corrupted they are then sometimes contained within membranes which hinders the Patient from a speedy discharging of it she going with it as long almost as with a Child and this is the Dropsie which perswades them sometimes they are with Child 'T is easie to avoid being deceived by taking the Dropsie of the Womb for a Child if one takes but good notice of all the signs mentioned in treating of a true Conception which concur not in this disease The Patient hath indeed her Belly swell'd and her Courses stopt in this case as well as if she were with Child but there are many things which will discover to us the difference for in the Dropsie her Breasts are flabby soft and fallen she will have no Milk in them nor find her self quicken at the ordinary time but only as it were a bubbling of agitated Waters she will have a greater pain and weight in her
Belly which is likewise more equally in its circumference extended than if there were a Child she will also have the Lips of the Womb her Thighs and Legs swell'd aedematous and a worse colour in her Face than when she is with Child Now as this Dropsie may come alone so likewise may often happen together with a true Conception these Waters being then contained without the membranes of the Child in the capacity of the Womb for though there may be much Water within these membranes it is not properly the Dropsie of the Womb because there must ever naturally be some in the midst of which the Faetus is contained Notwithstanding sometimes there is such a quantity of them which doth so prodigiously swell the Womans Belly that one would believe she had two or three Children when she hath but only one which is much weakned by it because the greatest part of its nourishment is resolved into these Waters which almost extinguisheth and suffocates that little natural heat which is there Some Women have evacuated three or four quarts above two months before they were brought to bed when this happens they are then contained in the Womb without the Membranes for else the Child would be necessitated to be born presently after these Evacuations * That being the right time of Labour if it were the Waters that ought naturally to be contained in the membranes that came away The best Remedy for this kind of Dropsy the Woman being vvith Child is to vvait vvith patience the hour of her delivery observing the mean time a drying dyet but vvhen it is only Water contained in the Womb she must use Diureticks to cause the Womb to open to evacuate them and her Courses must be endeavoured to be provoked having alwayes a care to destroy by convenient Purges the cause of the generation of such superfluities The Womb is sometimes so full of these humours that it dischargeth some on the outward parts and principally upon those vvhich are near as the lips of the Privities vvhich often are thereby so swelled that they become quite blown up and sometimes in some Women are so big and swelled that they cannot close their Thighs together for them vvhich hinders their vvalking unless vvith pain and great inconvenience This Swelling is then livid and almost transparant even as a Hydrocele because of the quantity of clear Water vvhich filled it and because it may be painful and inconvenient to the Woman during her labour by reason they straiten the passages it vvill be necessary to remedy it before vvhich for the greater certainty must be done by the operation of the hand making many scarrifications vvith a Lancet all along the lips vvhereby the humours will sweat out and distil forth by little and little after vvhich Compresses dipt in Aromatick and Astringent Wine must be put upon it to prevent Relapses by fortifying the parts causing the Patient to observe all the vvhile a good dyet fit for the Dropsie Some vvould apply Leeches to avoid the pain of the Lancet but they are not so proper because the small orifices they make assoon as they are taken off immediately close again which happens not so soon to the Scarrifications made as big or little as one will and may be kept open by oyntments applied to them as long as may be thought fit or necessary CHAP. XXIII Of the Venereal Disease in Women with Child IT is not very hard to imagine how a breeding-breeding-Woman that hath the Pox can communicate it to a Child in her belly because this contagious disease corrupting all the mass of the Mothers blood it is necessary the Infant which hath then no other sustenance should be infected with it converting this bad blood into its own substance the acrimony of which Blood easily causeth in an Infants tender body those malignant ulcers which all such whose Mothers are contaminated with it usually bring with them at their birth The Pox which in its essence is of the same species and is only distinguished by degrees according as it is greater or less communicating it self by the means of the Mothers blood will make more or less impression on the Infants body according to its strength or weakness and if the big-bellied Woman have Ulcers very near the Womb as in the neck and neighbouring parts by this proximity the venom will be very easily conveyed to it I do not design here to enquire into the bottom of this Venereal Disease nor to write particularly of the cure of it but intend only to shew vvhether the Woman may undergo the Cure vvhilst with Child or ought therefore to defer it till after they are brought to bed That this may be the better determined we must make some distinction for when the Woman is towards the end of her Account it ought to be deferred till after she is brought to bed when both she and the Child if infected may be taken in hand because the labour coming on when the Woman is in the midst of her Cure she may run the hazard of her life and besides if the Child should be then still-born one would be apt to think it was killed by the violence of the Medicaments and blame the Chirurgeon of rashness When the Pox is but in the first degree and hath caused no great accidents one ought then likewise to remit the eradicating Cure till after Childbed and be contented only with the palliating by a convenient dyet and gentle purgers from time to time to prevent the evils encreasing but if the Woman when young with Child hath the Pox in the highest degree accompanied with very great and continual accidents which threaten danger if her Cure be protracted till after Delivery because in so long a time these accidents augmenting more and more it would be impossible but her Fruit should be corrupted and very hard if she did not miscarry that the greatest of these two evils be avoided she having strength enough ought to be taken in hand for to imagine the worst that the Remedies make her miscarry it is no more than the greatness of the Disease would otherwise certainly do Let her then be taken in hand without suffering the accidents longer to augment vvhich by continuance render themselves much more dangerous both to her and her Child being careful to give her the gentlest Remedies and with more preparation and circumspection so that the Evacuation procured to her by Salivation be rather by little at a time and the longer than too great and sudden and above all that it be rather by anointing the upper parts only with * As Unguentum Neapolitanum Mercurial Oyntments and not by Perfumes which sooner endanger miscarrying by opening the Womb besides that they sooner cause the Fruit to perish if it had life For the same reason also no Mercurial Medicine must be taken in at the mouth vvherefore frictions of the upper parts are to be preferred endeavouring alwayes as much
two Children begins to flag it is a sign she will miscarry of the Child of that side and of both if both flag in the same manner It is most certain a Woman is in more danger of her life when she miscarries than at her full time because as we have said before abortion is wholly contrary to Nature and very often accompanied with flooding and in more danger of miscarrying alwayes if she miscarries of the first and some apprehend then an impossibility of ever having Children after to which young married people are very subject because of the violent emotion and perturbation of the whole body excited by ardent and frequent copulations but notwithstanding they may preserve their fruit when their greater vigour is over and their loves a little moderated We have taught in each of the foregoing Chapters how to prevent all the accidents before recited any of which is sufficient to make her miscarry and the easier if many are complicated wherefore to avoid a troublesome and needless repetition you may have recourse to the Remedies there taught by which both Women and Children may escape the danger of death They that are subject to abortion ought above all to take their ease and keep in bed if they can observing a good diet and refraining copulation assoon as she believes her self to be with Child avoiding the use of all Diureticks and Aperitives which are very pernicious as also violent passions of the mind because they are very prejudicial She ought likewise to be loose in her dress that she may breath the freer and not strait laced and rackt as most of them are ordinarily with their Busks under their cloths to make their bodies strait and amongst other things they had need take heed of slipping and falling in their walking to which big-bellied Women are very subject because the bigness of their Bellies hinders them from seeing their way they will therefore do well to wear low-heeld shoos with large soals to prevent hurting themselves as too many daily do I admire in this case the superstition of many Midwives and some Authors who order a Woman with Child to take assoon as she hath hurt her Belly with a fall some Crimson Silk small minced in the yolk of an Egg or the grains of * Kermes Scarlet and treddles of several Eggs put into the yolk of one as if that entring the stomach were able to fortifie the Womb and the Child in it and to keep it there for which there is no appearance of reason or truth but quiet rest indeed contributes much to it which for this reason is usually directed for nine dayes although such a one hath need of 15 dayes or more for her hurt or commotion and to others five or six is sufficient during which time may be applied hot to the Belly Compresses steeped in Aromatick and Astringent Wine But because there are many Women so infatuated with this superstitious custom that they would not believe themselves out of danger if they took not that Crimson Silk or the Treddles of the Eggs which is a pure conceit one may give it to those that desire it to content them because these Remedies though useless can yet do no hurt It is now time to make an end of this first Book in which I have only mentioned the most ordinary distempers which have some particular indications in their cure during the Womans being with Child of which I have not treated very exactly because it may be supposed that one may elsewhere have a more perfect knowledge of them with all their circumstances let us now pass to the second Book to treat of Deliveries not only the natural but likewise all that are contrary to nature it being the principal motive that induced me to write and to teach as well as I can the best and most methodical deportment in it The End of the first Book BOOK II. Of Labours Natural and Unnatural with the way how to help Women in the first and the right means of remedying the rest AS it is very unprofitable to those that imbark on the Sea for a long Voyage as for example to the Indies or the like if after having by their prudence escaped all the dangers they could meet with in so long a Voyage they are shipwrackt in the Haven So likewise it is not sufficient that a great-bellied Woman should be preserved from all the Diseases mentioned in the preceding Book for nine whole months if at the end of that time she be not well delivered of it by a happy Labour This therefore shal be the whole subject of this second Book where we will treat as well of the Natural as Unnatural Labours and teach the manner of aiding and comforting Women in the first and the means to remedy all the rest CHAP. I. What Labour is and the diffenrences of it together with its different terms BY a Delivery we understand either an emission or extraction of the Infant at the full time out of the Womb. This definition may comprehend as well the Natural which is accomplished by emission when the Infant coming in a commodious and natural Figure the Womb sends it forth without extraordinary violence as the delivery contrary to Nature which we are often obliged to perform extracting it by manual operation Every time the Womb le ts pass or sends forth whatsoever it had retained and formed after conception must not be call'd a labour for observing what I have already noted above and what I will here again repeat that it may be more plain If a Woman voids by the Womb what is contained in the beginning after she had conceived it is properly called an effluxion or slip because at that time there is nothing formed or figured neither have the Seeds yet any firm consistence which is the cause why it flips away so easily with the least opening of the Womb as often happens between the first conceiving and the seventh and eight day only after which until the end of the second month the Woman somtimes le ts slip false-conceptions which turn to Moles if they continue any longer in the Womb which is then called an Expulsion And if after the third month or thereabouts the time when the Faetus is wholly formed and animated it is sent forth before the seventh in that case it is an Abortion which is alwayes the cause either that the Infant comes dead into the World or dies soon after But we properly call Labour or Delivery every issuing forth of an Infant which happens after the end of the seventh month to all the remaining part of the time afterwards because there is then a sufficient perfection as also strength enough to come into the World and live in it afterwards As to the general differences of Labour we must take notice that the one is legitimate or natural the other illegitimate or against nature To come to the knowledge of each we say that four conditions must
Body is only supported by the stability of these Bones wherefore we must rather believe as most probable that such a disjunction and separation was caused either by the falling of this Womans Corps from the high Gibbet to the ground after execution or rather by some impetuous blow on that place received from some hard or solid thing If we examine well the different figure and structure of these Bones between a Man and a Womans Sceleton we shall find a larger empty space and distance between these Bones much more considerable in Women than Men and that to this purpose the least Women hath the Bones of the Ischion more distant the one from the other than the biggest Man they have all likewise the os sacrum more outwards and the pubis flatter which makes the passage from this capacity larger and more able to give issue to the Child at the time of Labour they have besides this the Bones illia much more turned outward that the Womb being impregnated may have more room to be extended on the sides and be more at ease supported by such a disposition as is here represented These two Figures of Bones represent the Bones that form the whole capacity of the Hypogastrium A shews the Mans Bones B the Womans for to know the difference that the Womans is more capacious and spacious than the Mans for C C D D E E are at a larger distance one from the other in the Womans than they are in the Mans and besides that Women have the Coccyx marked F more turned outwards than the Men which gives way to the Infants Head to pass without great difficulty through the large passage there is between the two Bones of the Ischion marked E E without any necessity for the separation of the Os pubis as some have imagined contrary to truth Chap I. lib. 2. pag. 144. Moreover having often seen and dissected Women dead a few dayes after delivered I found it very difficult to separate these bones with a strong sharp Penknife where I could never find the least appearance of any preceding separation And if the advanced in years have more pain with the first Children than younger Women it doth not proceed from the difficulty of the separation of these bones which never is for the reasons above but because the membranes of their Womb are dry hard and callous and particularly its internal orifice which therefore cannot so easily be dilated as young Womens being more moist Having sufficiently explained what is Delivery and all its differences we must now examine what signs usually precede and what accompany a natural Delivery and an unnatural which shall be the subject of the next Chapter CHAP. II. The Signs that precede and accompany aswel a natural as an unnatural Delivery WHen Women with Child chiefly of their first perceive any extraordinary pains in their Belly they immediately send for their Midwife taking it for their Labour who when she is come ought to be well informed of the matter and careful not to put her in Labour before there is a disposition to it for many times both Mother and Child lose their lives when it is excited before the due time Those pains which may be called false are usually caused by a Cholick proceeding from Wind which come and go griping the whole Belly without any forcing downwards or into the Womb as those do which proceed or accompany Labour and this Cholick is dissipated by warm clothes applied to the Belly and a Clyster or two by which true Labour-pains are rather furthered than hindered A Woman may feel other kind of pains coming from an emotion caused by the Flux of the Belly which are easily known by the frequent stools that follow The signs preceding a natural Labour few dayes before are that the Belly which before lay high sinks down hinders a Woman at that time from walking as easie as she used and there flows from the Womb slimy humours appointed by nature to moisten and smooth the passage that its inward orifice may the more easily be dilated when it is necessary which beginning to open a little at that time suffers that slime to flow away which proceeds from the humours that strain through the thin substance of the Infants membranes and acquires a viscous consistence by the heat of the place The signs accompanying present Labour that is shewing that the Woman is effectively in Labour are great pains about the region of the Reins and Loins which coming and redoubling by intervals answers in the bottom of the Belly with reiterated throws The face red and inflamed because the Blood is much heated by the continual endeavours a Woman makes to bring forth her Child as also because that during these strong throws her respiration is ever intercepted for which reason much Blood hath recourse to the Face Her privy parts are swell'd because the Infants Head lying in the Birth often thrusts and causeth the neighbouring parts to distend outwards which thence appear swelled in this manner She is often subject to vomitting which makes many believe who know not the cause of it that the Women to whom it happens are in danger but on the contrary it is ordinarily a signe of speedy delivery because the good pains are then excited and redoubled every moment until the business be finished This Vomitting comes from a sympathy between the Womb and Stomach by reason of the ramifications of the nerves of the sixth pair of the Brain which are distributed to both the one and the other and by which it communicates the pain it feels at that time arising from the agitation the violent and frequent motions of the Child causeth and the strong compression the muscles of the lower Belly makes during the throws for to help the issue of the Child besides when the birth is very near Women are troubled with an universal trembling and principally of the Legs and Thighs not with cold as at the beginning of an Ague-fit but with the heat of the whole body and the humours which then flow from the Womb are often discoloured with Blood which with the signs above mentioned is an infallible mark of the nearness of the birth 't is that the Midwives usually call Shows and if one then puts up their finger into the neck of the Womb they will find the inner Orifice dilated at the opening of which the membranes of the Infant containing the Waters present themselves and are strongly forced downwards with every pain the Woman hath at which time one may perceive them to resist and appear to the finger so much the more or less hard and extended as the pains are stronger or weaker These membranes with the waters in them when gathered that is when they are advanced before the head of the Child which makes the Midwives call it the gathering of the waters presenting themselves at this inward Orifice do then resemble very well to the touch of
the umbilical vessels are fastned but it is thinner towards the edges of all its whole circumference It is covered with the Chorion and Amnios on the side next the Infant and on the other side it is joined and fastened to the bottom on the inside of the Womb It is strongest fastened to the Womb with its circumference by means of the Chorion as we have hinted already in the preceding Chapter 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 laceration of its substance If one considers diligently as I have done the Placenta on that side which joyns to the Mother they may perceive that it is also indued with a kind of light membrane which is so frail and small that it is almost imperceptible however it may manifestly be discerned by wiping away the blood with which it is alwaies coloured There may be again observed that all the superficies on this side is as it were much interlined not unlike in some measure those of an Oxes reins and there appears likewise many small out-lets by which the blood that transudes through the pâ—rous substance of the Womb distills into this fleshy mass Although there be two Children in the Womb nay three if twins that is to say begotten in the same act they have usually but one common After-burthen which hath as many Navel-strings fastened to it as there are Children which notwithstanding are separated one from the other by their several membranes in each of which the Children are apart with their Waters if at least as I have said in the precedent Chapters their bodies be not joyned and adhering one to the other in which case the Twins of this kind have as well their Waters in common as that they are involved in the same membranes but if they be superfetations there will be as many burthens as Children and as superfetation if there are as many as may possibly be happen but very 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 After-burthen like what we have described and dischargeth it as useless assoon as the Child is born for most other Animals cast forth nothing after their young except the waters only and some slime with the membranes which surround them and instead of this fleshy mass those which ordinarily as a Woman bring forth but one young at a time have only some Cotyledons which are many spongious kernells joyned inwardly to the proper substance of their Womb where terminates all the branches of the Umbilical vessels of their young which kernells as I have often observed in the dissecting of sheep are not bigger than Hemp seed when they are not with young but when they are with young they swell extremely and become of the bigness of a thumb the one bigger the other lesser they then resemble much the Figure of a round Mushroom not yet spread on the wrong side after it be cut from its stalk and to each of those Cotyledons or kernels are fastened the ramifications of the umbilical Vessels however it is certain that the Animals which have ordinarily more than one at a time as Bitches Rabbits and others have no Cotyledons instead of which each young hath in its Cellule a kind of particular Placenta which the dam eats asson as she voids it after she hath gnawed and cut off with her teeth the Umbelical vessel which held it When a big-bellyed Woman hath the least indisposition of her whole habit there is almost ever some mark and impression either in colour or substance on the after-burthen which she voids in her labour because it being of a very soft substance easily imbibes the ill humours of the body which used to be voided by the Womb. Its natural colour ought to be red and so much the fairer and better coloured as the Woman is in good health its substance must be whole and equally soft without the least schirrous hardness From the midst of the Burthen proceeds a string composed of many vessels joined together which serve to conduct the blood appointed for the Infants nouriture the number of them is disputed amongst Authors some reckon four that is two Veins and two Arteries others five adding the Ourachus to them but it is very certain that there are but three only in a humane Foetus as I have found by many dissections to wit one Vein and two Arteries the vein having sent forth into the Placenta an infinity of branches like to the roots of a tree is conducted by a single channel all along the string to the Infants navel which it passeth to be at last terminated in the midst of the Fissure which is in the inferiour part of the Liver and the two Arteries taking their rise out of the same Placenta from a great number of the like roots pass along the same string by two conduits piercing also the Infants Navel and end in its Iliac Arteries and sometimes in the Hypogastricks The Vein is much bigger than the Arteries its cavity is capable to admit a writing-quil into it and those of the Arteries only a small bodkin about half the bigness of the Vein These three Vessels composing the string are wrapt up in one Membrane thick and strong enough proceeding from the Chorion which likewise is clothed about with a production from the Amnios and may easily be separated but besides that this first serves them as a sheath in which they are all three lodged it separates them again one from the other by its duplications When the vessels of the string are full of blood it is then of about the bigness of a finger and ordinarily of the length of a good half Ell and sometimes of two thirds or three quarters It is necessary it should be of this length that the Infant may have liberty to move it self in the Womb and to go forth of it at its birth without tearing the After-burthen to which it is fixed There are many very plain inequalities like unto knots which only proceed from the dilatation of the Vessels which being varicose and fuller of blood in one place than another causeth these eminences Some Midwives believe superstitiously or would make others believe that the number of these pretended knots answers the number of Children the Woman shall have afterwards which is without reason because Women delivered at forty years of age and of their last Child as we find by daily experience have as many knots on the Navel-string as a Woman of twenty years who may yet have a dozen Children they say further That if the first knot be red the next Child the Woman shall have will be a Boy if white a Girl but this Proposition is as ill grounded as the other for these Knots appear only red or to speak more properly of a dark
blew according as the Vessels are more or less full of blood and especially the Vein which gives it that colour and is so much the more apparent as it is superficial in that place There are many Authors admit as we have said the Ourachus into the number of these Umbilical vessels saying that it serves to empty the Childs urine into its Membranes however experience shewes us it is no vessel and that it passeth not forth of the Navel but that it is only a ligament in a Child as it is in a Man which coming from the bottom of the Bladder terminates at the Navel without traversing it as they have hitherto mistaken it I have opened and dissected above thirty Foetus's in none of which did I ever find it hollow but alwaies very solid and tendinous towards the place where it it fastned to the Navel and very like as I have already said to a small Lute string Notwithstanding I ever found it manifestly hollow in an Ewe which was terminated with their other Umbilical vessels at their Cotyledons in which Animals are also two Umbilical veins to be seen going both near one the other to the Liver which makes that their Navel-string consists of five Vessels but it is not the same in a human Foetus for there is but one onely Umbilical Vein and two Arteries To understand well how the nourishment is conveyed to the Infant by the Umbilical vessels it is very necessary to conceive and know in what manner the Blood circulates which is after this manner The blood having been conveyed by the mothers Arteries which end at the bottom of the Womb in the Placenta which is there fastned makes a natural transfusion through the Umbilical Vein into the Childs Liver after which it is carried into the Vena cava and thence to the Heart whence it is sent to all the parts by means of the Arteries and very near a like portion in quantity being in the Iliac Arteries is conducted into the Umbilicals which are there terminated for to be carried back into the Placenta where this blood being again elaborated returns to make the same journey by the Umbilical Vein passing again to the Childs Liver and thence to the Heart and so alwayes successively without the least intermission But to be able to conceive easily how the blood circulates in the Placenta and how by the help of that part is made a mutual transfusion from the one to the other as well in respect of the Mother as of the Child we need but imagine it to be a common part and depending on both their bodies for as to the Mother the circulation is there made just as in her Arm or any other part of her whatsoever and as to the Child it is even the same There are no Valvules found in the Umbilical Vein though I have curiously examined it nor are any necessary these Valvules ar every frequent in the Veins of the Arms and Legs because these parts are obliged to make different motions which compressing the Vessels would trouble those of the blood if it were not so sustained and hindered from recoiling but the Umbilical Vein hath no need of any because the Navel-string is loose and floting in the midst of the waters where it cannot be comprest and therefore the motion of the Blood cannot be there intercepted as it is sometimes in the Arms and Legs or other parts where there are strong contractions Assoon as the Child is born these Vessels which are bigger in a Foetus because of their cavity than they are in a Man dry up and that part of them which is without the belly falls off and is separated close to the Navel five or six days after for which reason they lose their first use and begin afterwards to degenerate into suspending Ligaments to wit the Vein into that of the Liver and the two Arteries serve to extend and sustain the Bladder by the sides where they are joyned to it the bottom of which is yet suspended by the Ourachus which comes not through the Navel as hath been said but remains so pendant all the rest of its life We have hithereo made mention of all those things which are found with the Child in the Womb let us now show what are the different scituations of it in the Womb according to the different times of Pregnancy It is a thing of very great consequence and deserves some reflections The three following Figures represent the different natural scituations of the Child in the Womb. That which is marked B shews how it is scituated the seven first months of Pregnancy That which is marked A shews the same scituation on the back-side And the third marked C shews in what fashion it is scituated towards the end of a Womans reckoning and at the time that it is disposed to be born Explication of all the Wombs in which are contained all the Children represented in different postures as well in this place as in all the following A A A A Shews the substance of the Womb. B The Membrane called Chorion which lines the Womb within C C C C The membrane Amnios which is so united and joyned to the Chorion that both of them seem to be but one single Membrane D D D D Shews all the space which is filled with waters in the midst of which the Infant flotes and is scituated E E The After-birth fastened to the bottom of the Womb. F F F The Navel-string which fluctuates hither and thither in the waters CHAP. V. Of the several natural scituations of an Infant in the Mothers Womb according to the different times of Pregnancy WHen we shall have explained the several natural scituations of an Infant those contrary to Nature causing for the most part all ill labours will easily be conceived It may be considered that generally the Infants as well Male as Female are usually scituated in the midst of the Womb for though sometimes a Womans great Belly is a little higher on the one side than the other yet that is because the globe of the Womb inclines more that way and this scituation on the side must be understood only in respect of the Mothers belly and not of her Womb in the midst of which it is alwaies placed because there is but one only cavity in a Womans Womb marked with a small line in its length without having two or more separations as is seen in those of other Animals There are some who would have these two imaginary cavities to be the cause why Women sometimes bear Twins yea and sometimes more and that the Males are rather engendered on the right and Females on the left side which is Hypocrates's opinion in the 48th Aphorisme of his 5th Book where he saith Foetus Maris dexträ uteri parte Foeminae sinisträ magis gestantur but without any certain reason for it because some Women have the Males on the left-side others the Females on the right and when there are
Twins sometimes both are of the same Sex sometimes not and indifferently scituated on the right or the left This is all can be said in general of the scituation of Children in the Womb. But in particular when we consider the several Figures it makes it differs according to the different times of Pregnancy for when the Woman is young with Child the little Foetus called Embryo is alwaies found of a round Figure a little oblong having the Spine moderately turned 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 It resembles in this posture very well one sitting to void his Excrements and stooping down his head to see what comes from him The Spine of its Back is at that time placed towards the Mothers the head uppermost the face forwards and the feet downwards and proportionable to its growth and grandeur it extends by little and little its members which were exactly folded in the first months It keeps usually this posture till the seventh or eighth month at which time the head being grown very big is carried 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 Some believe that only Males are so turned downwards when they are born and that the Females are with their face upwards but both the one and the other are alwaies turned downwards with their face towards the Rectum of their Mother as is abovesaid and when it happens otherwise it is unnatural for the Childs face coming upwards will be extremely bruised and the nose wholly flatted because of the bones hardness in the passage It may be noted that when the Child hath thus changed its first scituation being not yet accustomed to this last it stirs and torments it self so much sometimes that the Woman by reason of the pains she feels is apt to believe it her Labour And if this circumstance be well considered they will find it to be that first pretended endeavour which Authors imagine the Child makes for to be born in the Seventh moneth and not being able to accomplish it remains so till the Ninth and that reiterating it in the eighth if it be born it lives not long because it was not able to endure two such puissant endeavors so near together But it is a meer abuse for if the Child turnes 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 stirs 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 as already hath been mentioned And it begins to turn thus sometimes from the Seventh month rarely before but by accident oftenest about the eighth Moneth and sometimes in the ninth only and at other times also it doth not turn at all as we way easily perceive in those that come in their first scituation that is with their feet foremost From whence it is easie to conjecture and I hold it for a certain truth that the Children are the more strong and robust and consequently may more likely live by how much the nearer they approach to the more natural and perfect time which is at the end of the ninth Month. The Infant then is turned on this manner with his Head downwards towards the latter end of the Reckoning to the end only that he may be the better disposed for its easier passage into the world at the time of Labour which is not then far off For in this posture all its joints are easily extended in comming forth and the Arms and Legs cannot hinder its birth because they cannot be bended against the inward orifice of the Womb and the rest of the body which is very supple passeth very easily after the Head which is hard and big be once quite born When there are many Children they ought if it be natural to come in the same Figure as when there is but one but usually by their different motions they do so incommode one the other that almost alwaies one of them presents wrong at the time of Labour yea and before which is the cause that one comes often with the Head the other with the Feet or any other worse posture and sometimes both come wrong However the Infant may be scituated in the Mothers belly or in whatsoever fashion it be that it presents at the birth if it be not according to the posture above described it is alwaies against Nature and the natural scituation is so necessary to a good and legitimate Delivery that those which are against nature do cause for the most part bad Labours When a big-bellyed Woman is happily arrived near her haven she ought then to take great care she suffers not shipwrack there which she will avoid if she observes exactly at the end of her reckoning the Rules which follow CHAP. VI. What a Woman ought to do when she hath gone her full time I Am not of the opinion of most Mid-wives who advise Women with Child that they may as they say have the better labour to use more than ordinary exercise towards the end of their reckoning as Liebaut also directs who orders them to ride in Coaches or trotting Horses which is a very dangerous advice and causeth daily many wrong Births for as we said in the precedent Chapter 't is about that time that ordinarily the Child turns its head downwards and its heels upwards for to be born right and the poor Women often believing they may procure an easie labour make it by this extraordinary exercise very unhappy which because of the agitation and commotion of the body causeth the Child to take a wrong posture or makes the Womb so to bear down and be engaged in the cavity of the Hypogastrium that afterwards it hath not at due time liberty to be turned which is often the reason why it comes in its first posture that is with the feet besides that labour which ought to be Natures work if the Child come right is thereby excited before the full time and though it were but four or five days it hinders not as I have said elsewhere from being as prejudicial to them as we see it is to the taste goodness and conservation of Fruit gathered but few days before its perfect maturity Wherefore I counsel a Woman though almost contrary to the unreasonable opinion of every one to keep her self more quiet than ordinary when she draws near her time that so her Child may be able to turn it self directly right and that she by all means avoids being strait laced that so
it may have more space to be turned into a fit posture to be born she must then likewise observe a good diet of meat of good juyce and easie digestion rather boiled than rosted to moisten the better and keep the body thereby open rather than by Clysters which may hasten labour she may about eight or ten days before Labour anoint her privities with Goose Capon or Hogs Grease or fresh Butter or foment those parts with fomentations which may by mollifying and loosening render those passages more smooth and slippery This ought principally to be done by those that go with their first Child because their passages are more strait than others who have had Children already but they who are a little in years have much more pain and are longer in Labour of their first Child than others who are indifferent young because the Membranes of their Womb are harder and dryer wherefore they cannot yeeld so well nor the inward Orifice be so easily dilated Some Authors commend bathing the better to relax those parts but it is dangerous lest by their too much moistness and the emotion they cause to the whole Body they make her come a little before her time Many Women bleed by way of prevention when they are or believe themselves to be at their full time which custom I cannot approve if it be only for prevention but I do in case some other necessity require it provided they abstain from it after the seventh Moneth because the stirring of the Child caused by bleeding is sometimes so vehement that the Womb is constrained to open before its time to be rid of the Child If a Woman with Child observes these Rules she will have reason to hope for a good issue of her Labour in the mean time let her provide her self of a good Midwife or an expert and handy * Chyrurgeons onely Practise in France as noted before Chyrurgeon to attend upon her assoon as she perceives the least pain or throw of what kind soever for as a small wind or shake will serve turn to make ripe fruit fall so the least Cholick or any other false pain may bring forward her Labour and surprise her unprovided of help Let us now see what is necessary when she is effectively in Labour CHAP. VII What is to be done when the Woman first falls in Labour A Womans travel is only many pains with reiterated Throws by which she endeavours to bring forth her Child It is so called because both Mother and Child suffer and take much pains in this action Most people believe that there is no other reason for the cause of this evil but because God hath so ordained it and that Woman according to his Word must bring forth with pain because of her sin according to what is written in the 3d. Chap. of Genesis I will greatly multiply thy sorrow and thy conception in sorrow thou shalt bring forth Children and thy desire shall be to thy Husband This curse was indeed very great because it hath extended to all Women that have brought forth Children since that time and will continue to all that shall come hereafter However we find that all the Females of other Animals suffer as much and are in as great danger of their lives as a Woman when they bear their young This perswades us that besides this precise will of God in respect of a Woman there must be yet a natural reason wherefore it cannot happen otherwise and that is That it is impossible the Womb being very strait in comparison of the Childs bigness and very sensible because of its Membranous composition should receive a necessary dilatation for the Childs birth and such great violence without suffering considerable pains for it Now since a Woman for this cause cannot shun these pains she must endeavour to endure them with patience in the hope of being suddenly delivered from them by a fortunate labour Assoon as it is known that the Woman is certainly in Labour by the signs mentioned in the Second Chapter of this Book where both those preceding and those accompanying Labour are recited of which the principal are Pains and strong Throws in the Belly forcing downwards towards the Womb the dilatation of the inward Orifice perceived by touching it with the finger as also the gathering of the Waters which come before the Head of the Child and thrusting down the Membranes which contain them through which between the Pains one may in some manner with the Finger discover the part which presents especially if it be the Head of the Child by its roundness and hardness Then must all things necessary to comfort the Woman in her Labour be go ready and the better to help her care must be taken that she be not strait-laced a pretty strong Clyster may be given her or more than one if there be occasion which must be done at the beginning and before the Child be too forwards for afterwards it is very difficult for her to receive them because the Gut is too much compressed they serve to excite it to discharge it self of its excrements that so the Rectum being emptied there may be more space for the dilatation of the passage as also to stirr up the pains to bear the better downwards through the endeavours she makes when she is at stool and the while all necessary things for her Labour should be put in order as well for the Woman as the Child a Midwifes stool or rather a Pallet-Bed girted placed close by the fire if the season require it which Pallet ought to be so disingaged as to be turned round about the better to help the Woman when there is occasion If the Woman be * full of blood Plethorick it may be convenient to bleed her a little for by this means her Breast being disingaged and her respiration free she will have more strength to bear down her pains which she may do without danger because the Child being about that time ready to be born hath no more need of the Mothers blood for its nourishment which I have often practised with good success besides this evacuation often hinders her having a Fever after Delivery in expectation of which hour she may walk about her Chamber if her strength permits and to preserve her strength it will be convenient to give some good gelly broths new-laid eggs or some spoonfuls of burnt or brewed Wine from time to time or a Tost dipt in Wine avoiding at that time solid food Above all she must be perswaded to hold out her pains bearing them down as much as she can at the instant when they take her The Midwife must from time to time taste the inward orifice with her finger to know whether the Waters are ready to break and whether the Birth will soon after follow she must likewise anoint all the bearing place with emollient Oyles Hogs-grease or fresh Butter if she perceive that they can hardly be dilated and all the
while she must be near her Woman to observe her gestures diligently her complaints and pains for by this they guess pretty well how the Labour advanceth without being obliged to taste her body so often Mr. de la Cuisse deceased who often slept near the Woman in Labour was so used to it that he never awaked till just the Child was in the passage at which time the Woman changeth her moans into loud cries which she strongly repeats because of the greater and more frequent pains which she then feels the Patient may likewise by intervals rest her self on her bed for to regain her strength but not too long especially little or short thick Women for they have alwaies worse Labours if they lye much on their beds in their Travail and yet much worse of their first Children than when they are prevailed with to walk about the Chamber supporting them under their arms if necessary for by this means the weight of the Child the Woman being on her Legs causeth the inward orifice of the Womb to dilate sooner than in bed and her pains to be stronger and frequenter that her Labour be nothing near so long Qualms and Vomitings which often happen to Women in Labour ought not to amaze any for on the contrary it furthers the Throws and Pains provoking downwards we shewed the cause of this Vomiting in the Second Chapter of this Book and the reason why it is not dangerous When the Waters of the Child are ready and gathered which may be perceived through the Membranes to present themselves to the inward orifice of the bigness of the whole dilatation the Midwife ought to let them break of themselves and not as some that impatient of the long Labour break them intending to hasten their business which on the contrary they retard by so doing before the Infant be wholly in the passage for by the too hasty breaking of these Waters which ought to serve him to slide forth with greater facility he remains dry which hinders afterwards the Pains and Throws from being so effectual to bring forth the Infant as else they would have been it is therefore better to let them break of themselves and then the Midwife may easily feel the Child bare by the part which first presents and so judge certainly whether it comes right that is with the Head which she shall find hard big round and equal but if it be any other part she will perceive something inequal and rugged and hard or soft more or less according to the part it is Immediately after * That being the right time when all Women ought to be delivered if nature perform its office let her dispatch to deliver her Woman if she be not already and assist the Birth which ordinarily happens soon after if natural and may be done according to the directions in the next Chapter But if she finds the Child to come wrong and that she is not able to deliver the Woman * Mark 't is not enough to lay a Woman if it might be done by another with more safety and case to either or both as she ought to be by helping Nature and so save both Mother and Child who both are in danger of their lives let her send speedily for an expert and dextrous Chyrurgeon in the practice and not delay as too many of them very often do till it be reduced to extremity There are many Midwives who are so afraid that the Chirurgeons should take away their practice or to appear ignorant before them * Good avoiding such Midwives if Women value their lives that they chuse rather to put all to adventure then to send for them in necessity others are so presumptuous as to believe themselves as capable as the Chirurgeons to undertake all And some there are indeed who are not so wicked yet for want of knowledg and experience in their Art hope still in vain that the Child in time may change to a better posture and that the accidents will cease if it please God as they say and some do maliciously put such a terrour and apprehension of the Chirurgeons in the poor Woman * For the most part undeservedly characterizing them like butchers and hangmen that they choose rather to dye in Travail with the Child in their Womb than to put themselves into their hands But indeed such Midwives do more justly deserve this fair title unless they behave themselves with more prudence and equal conscience in so important an occasion and send * A necessary note in time for some help in their business before the Child be as very often engaged in a wrong posture in the passage so as it is almost impossible to give it a better without extream violence to the Woman which is also the cause of the death of the Child and they would be so far from losing their reputation that they would augment it because by so doing it would be manifest they were not ignorant of the danger both of time and place and the Chirurgeon being called assoon as necessity required it could have no just cause to impute any ill consequence of the Labour to them though it should so fall out and rheir conscience would be discharged of it for in this case as we have said both the Mothers and Childs life is at stake Assoon then as the Waters are broke and the Midwife finds the Child to come wrong she must advise the Woman not to forward her Pains lest by bearing down she engage the Child too much in the passage and so give the Chirurgeon more pains to turn it and must send for him assoon as may be for to deliver her as occasion requires and according as shall be directed hereafter in this Book It is now time after having declared what must be done whilst the Woman is in Labour to shew how she must be helped and comforted in a natural Delivery This Figure doth very well represent the globe of the Womb which is opened but in part to shew in what manner the Child is brought forth in a natural Labour A A A Shews the body of the Womb. B B A part of the Vagina or neck of the Womb opened just at the inward orifice C C The inward orifice which surrounds the Childs head like a Crown wherefore it is called the crowning or garland CHAP. VIII Of a natural Labour and the means of helping a Woman therein when there is one or more Children Chap VII lib 2. pag 184. The Bed must be so made that the Woman being ready to be delivered should lye on her back upon it having her body in a convenient Figure that is her Head and Breast a little raised so that she be neither lying nor sitting for in this manner she breathes best will have more strength to help her Pains than if she were otherwise or sunk down in her Bed Being in this posture she must spread her Thighs abroad folding her Legs
to draw forth the Child by the shoulders lest he sometimes separates the Body from the Head but he must disengage it by little and little from the bones in the Passage with the fingers of each Hand sliding them on each side opposite the one to the other sometimes above and sometimes under until the work be ended endeavouring to dispatch it assoon as possible lest the Child be suffocated as it will certainly be if he should remain long in that Posture which being well and duly effected he may soon after fetch the After-birth as above directed CHAP. XV. How to fetch the Head when separated from the Body it remains behind in the Womb. NOtwithstanding all the care possible had in the fetching a Child by the Feet yet sometimes one meets them so putrified and corrupted that with the least pull the Body separates from the Head which remains alone in the Womb and cannot be extracted but with much difficulty forasmuch as it is extremely slippery by reason of the place where it is and of a round Figure on which no hold can be taken The difficulty usually met with upon the like occasion hath been so great that sometimes two or three Chirurgeons one after the other have forsaken the Operation not being able to accomplish it after all their industry in vain employed together with their strength so that necessarily the death of the Woman ensued but I am of opinion they had escaped this misfortune if they had done what I shall now direct When then the Infants Head separated from its Body remains alone behind whether because of putrifaction or otherwise let the Chirurgeon immediatly without delay whilst the Womb is yet open direct up his right Hand to find the Mouth of this Head for there is then no other hold and having found it let him put one or two of his Fingers into it and his Thumb under the Chin and then by little and little let him draw it holding it so by the Jaw but if that fails as it often will when putrified then let him pull forth his right Hand and slide up his left with which he must support the Head and with the right let him take a narrow Crochet but strong and with a single branch which he must guide along the inside of his other Hand keeping the point of it towards it for fear of hurting the Womb and having thus introduced it let him turn it towards the Head for to strike it into either an Eye-hole or the hole of an Ear or behind the Head or els between the Sutures as he finds it most easie and convenient and then draw forth the Head so fastened with the Crochet still helping to conduct it with his left Hand but when he hath brought it near the Passage being strongly fastened to the Crochet as is already directed in one of the mentioned places let him remember to draw forth his Hand that the Passage being not filled with it may be the larger and easier keeping still a Finger or two on the side of the Head the better to disengage it You may try for the same purpose an * Doubtful expedient expedient which appears to me very ingenious and thinking on this subject came lately into my mind by which without doubt one may effect this painful and laborious Operation without tormenting the Woman so much as she is when either the Crochet or crooked Knife are used which is a soft Fillet or linnen slip of the breadth of four Fingers and the length of three quarters of an Ell or thereabouts and taking the two ends with the left Hand and the middle with the right let him so put it up with his right as that it may be beyond the Head to embrace it as a sling doth a stone and afterwards drawing the fillet by the two ends together it will easily be drawn forth the fillet not hindering in the least the passage because it takes up little or no place But if the Chirurgeon cannot by either of these different means draw forth the Head because 't is too big he will be necessitated if he will finish his work to lessen it with a crooked knife marked D. in the representations of the instruments at the end of the Second Book For to do this let him slide up his left hand into the Womb and with his right guide up the Knife always observing that the point be turned towards the inside of the left hand for fear of hurting the Womb and afterwards let him turn * A dangerous Operation not rashly to be undertaken it to the Sutures of the Head and chiefly the Crown where he must make the incision with this Instrument that having separated some pieces he may the easier draw forth the Head or at least having emptyed some part of the Brain by the Orifice so made the bigness of the Head will be much diminished by it and consequently the extraction of it less painful The left hand being thus in the Womb will be very usefull to help strike the knife into the Head for to divide and separate its parts as the Chirurgeon judges necessary as also to hinder that by inadvertancy the Womb receive no hurt and the right without for to hold the handle of this instrument which therefore must be long enough and will serve him to move and guide it on which side he pleaseth in turning thrusting drawing or slanting it as the case requires Ambrose Parè and Guillemeau would have this Knife to be so short as to be hid in the right Hand for to do the Operation after it is so introduced into the Womb but it is certain that when it is filled with a monstrous Child or a Head as abovesaid the Chirurgeons hand will be so pressed in the Womb that it will be very difficult for him to use it skilfully with one Hand alone and do no violence to the Womb which is the reason why if I may be credited this instrument ought to have a long Handle that being introduced the Womb it may be conducted to do the Operation with the left Hand within as we have mentioned and governed by the right which holds the Handle of it without which ought to be as long as the handle of an ordinary Crochet They that will take the pains to conceive my Arguments and try this Instrument when they have occasion will confess it to be much more useful and commodious being thus long than so short as the said Parè and Guillemeau recomend For my part having caused one to be made of that fashion I found it very convenient when I had the like occasion to use it Now when the Head is thus fetcht out of the Womb care must be taken that not the least part of it be left behind as also to cleanse the Woman well of her After-birth if yet remaining But a question of great consequence and much to the purpose may be here started Whether the Childs Head
Notwithstanding this must not alwaies be put in practice by the Chirurgeon but in such an extremity and then he may do the work as dextrously as he can For my part I had rather do this in the like occasion than resolve upon that cruelty and barbarousness of the Caesarean Section in which 't is absolutely impossible though many Impostures whom Rousset favours assure the contrary that a Woman should ever escape as I shall make more particularly appear hereafter when I come to it for by this Operation I can save the Mother who would perish with the Child And as it is always better of two evils to choose the least so we ought always to prefer the Mothers life before the * This Chapter might be very well spared if every Practitioner had the art the Translator professeth in his Epistle of fetching a Child when it comes right without hooks or turning it Childs CHAP. XVIII How to deliver a Woman when the Child presents the side of the Head to the Birth or the Face WHen the Child presents the side of the Head though it seems a natural Labour because the Head comes first yet 't is very dangerous both to Child and Mother for he shall sooner break his Neck than ever be born in that fashion and by how much the Mothers pains continue to bear him which is impossible unless the Head be first right placed the more the Passages are stopt up * A good Note for though some possibly not unlike this Birth may in time be born yet 't is for the most part dangerous delaying it because many Children and some Women have been so lost Therefore assoon as it is known the Woman must be laid with all speed lest the Child advancing further in this vicious Posture it prove more difficult to thrust him back which must be done when we would place the Head right in the Passage as it truly and naturally should be For to effect this 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 Child 's ill posture then let the Chirurgeon slide up his Hand well anointed with Oyl by the side of the Childs head for to bring it right gently with his Fingers between the Head and the Womb but if the Head be so engaged that it cannot be easily done that way he must then put his Hand up to its Shoulders that so by thrusting them back a little in the Womb sometimes on the one side and sometimes the other as he sees occasion he may give it a natural and convenient Position It were to be wished that the Chirurgeon could put back the Infant by the Shoulders with both his Hands in this manner but the Head doth then take up so much room that he hath much ado to introduce but one with which he must do his Operation with the help of the Fingers ends of the other Hand put up as far as necessary afterwards let him excite and procure the Childs birth as directed in the natural Labour At other times a Child comes with the Face first having its Head turned back in which Posture it is very difficult it should be born and if it remain so long the Face will be so black and blew and swelled that at first sight it will appear monstrous which comes as well by the compression of it in that place as by the Midwifes fingers handling it too rudely when she would place it in a better Posture I remember about six years ago in the like Case a Woman whose Child came with the Face so black and mishapen assoon as it was born as usually in such cases that it lookt like a Blackmoor however I delivered her of it alive assoon as the Mother saw it she told me that she always fear'd her Child would be so monstrous because when she was young with Child of it she fixed her looks very much upon a Blackmoor belonging to the Duke de Guise who alwaies kept several of them wherefore she wished or at lest cared not though it dyed rather than to behold a Child so disfigured as it then appeared But she soon changed her mind when I satisfied her that this blackness was only because it came Faceling and that assuredly in three or four days it would wear away as it happened having often anointed it with Oyl of sweet Almonds by expression and when I saw the Child about a year after me thought I had not seen a fairer Now to deliver this Birth the same manner as when a Child comes with the side of the Head must be observed being careful to work gently to avoid as much as may be the bruising of the Face CHAP. XIX How to deliver a Woman when the Head of the Child is born and the Womb closeth about the Neek THe Child comes naturally with the Head first because that by the hardness and bigness of it the Passage might be the better made and opened for the other parts of the Body which usually pass afterwards without pain but 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 This accident may likewise happen somtimes for not having been careful to lose no time to draw forth the Child by the Head as directed in the Discourse of natural Labours to the end the Shoulders might at the same instant succeed in the place the Head possest Chap XIX lib. 2. pag 232. In the year 1660 whilst I practised Midwifery in that Hospital it happened that the Deputy had a Woman whose Child she could not possibly bring into the world further than its Head where it so remained and seing she could not after all her endeavours finish the work she called the Midwife of the place to her aid which was then Madam de France who likewise used her utmost skill but in vain and when they were both thus tired in pulling the Head so as the Vertebra's of the Neck were separated and that it hung only by a little of the Skin I came in the interim when they desired me to examine the business and to find the cause why the Child could not be drawn forth with all their strengths which was sufficient to have drawn forth the Shoulders if they had been as big again as they were which having considered I immediatly conceived the difficulty to proceed from something else wherefore I put my hand into the Womb up to the Childs shoulders which seemed not too big to pass with ease therefore I concluded that the hinderance was not there After that I put my hand further up directing it all along his Breast at the bottom of which near the grisle Xiphoïde I found his Belly hydropical and full of Water so that it was impossible ever to deliver the Woman until the Water was
Infants and many ill accidents which after befal the poor Women not causing them to be helped in due time and from the moment they perceive the difficulty of the Labour to pass their understandings To avoid therefore these calumnies let the Chirurgeon never use the Crochets but very rarely and when there is no other way as also to endeavour his utmost as much as the case will permit to bring the Child whole although dead and not by bits and pieces to give the wicked and ignorant no 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 bring the dead Child with * Those Instruments very unsafe for the Woman and having a better way cannot pass them without manifesting my dislike Instruments than kill her by tormenting her with excessive violence for to bring it whole but in a word we must in conscience do what Art commands without heed to what may be spoken afterwards and every Chirurgeon that hath a well ordered conscience will ever have a greater regard to his duty than reputation in performing of which let him expect his reward from God CHAP. XXXII Of extracting a Mola and false Conception HAving at large spoken in another place of the Causes Signs and Differences of Mola's and false Conceptions and shewed that a Mola alwaies ariseth from a false Conception there remains nothing to be demonstrated but the manner how it ought to be extracted Now since these things contained in the Womb are totally preternatural their expulsion must be procured assoon as possible which is very difficult when these strange Bodies cleave to it and especially the Mola which not being drawn forth will often continue so fastened two or three whole years nay sometimes the whole remaining part of the Womans life as Paré tells us in the Story of the Pewterers wife that had one seventeen years whom he opened after her death To avoid the like accident and abundance of inconveniences which a Mola brings it must be endeavoured to be expelled assoon as may be trying before you come to Manual Operation to cause the Woman to expel it of her self to which purpose give her strong and sharp Clysters to stir up Throwes for to open the Womb to give way to it relaxing and moistening it with emollient Ointments Oyls and Grease not omitting bleeding in the Foot and half Baths if there be occasion The Mola will certainly be excluded by these means provided it be but of an indifferent bigness or that it adheres little or not at all to the Womb but if it cleaves very strongly to the bottom of the Womb or that it be very big the Woman will hardly be rid of it without the help of a Chirurgeons hand in which case after that he hath placed the Woman conveniently as if he were to fetch a dead Child let him slide his Hand into the Womb and with it draw forth the Mola using if it be so big as that it cannot be brought whole which is very rare because it is a soft tender body much more plyable than a Child a Crochet or Knife to draw it forth or divide it into two or more parts as the case shall require If the Chirurgeon finds it joined and fastened to the Womb he must gently separate it with his Fingers ends his Nailes being well pared putting them by little and little between the Mola and the Womb beginning on that side where it doth not stick so fast and pursuing it so until it be quite loosened being very careful if it grows too fast not to rend nor hurt the proper substance of the Womb proceeding according to the directions we have given for the extraction of a Burthen staying behind in the Womb when the String is broke off This Mola never hath any String fastened to it nor any Burthen from whence it should receive its nourishment but it doth of it self immediatly draw it from the Vessels of the Womb to which it is almost alwaies joined and sticking in some place The substance of its Flesh is also much more hard than that of the Burthen and sometimes it is schirrous which is the cause why it is not so easily separated from the Womb. As to a false Conception though it be much less than a Mola yet it often puts a Woman in hazard of her life because of great Floodings which very often happens when the Womb would discharge it self of it and endeavors to expel it which seldom ceaseth until it be come away because it doth still endeavour to exclude it by which the Blood is excited to flow away and in a manner squeesed out of the open Vessels The best and safest remedy for the Woman in this case is to fetch away the false Conception assoon as may be because the Womb can often very hardly void it without 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 more strongly compressed with the Throws Many times 't is exceeding difficult to fetch these false Conceptions because the Womb doth not open and dilate it self ordinarily beyond the proportion of what it contains and that being very little so is its opening which is the reason why the Chirurgeon sometimes is so far from introducing his whole Hand that he can scarce put in a few Fingers with which he is obliged to finish the Operation as well as he can proceeding in the following manner when he hath introduced them Having well anointed his Hand he must slide it up the Vagina unto the inward Orifice which he will find sometimes but very little dilated and then very gently put in one of his Fingers which 〈◊〉 must presently turn and bend on every side unâ—…â—e hath made way for a second and afterwards third or more if it may be done without violence but many times one hath enough to do to get in but two between which he must take hold as Crabs do with their Claws when they take any thing of the false Conception which he must gently draw forth and also the clodded Blood which he there finds afterwards the Flooding will undoubtedly cease if no part of this Conception be left behind as I have often found by experience when I have taken the same course but if the inward Orifice cannot be more dilated than to admit but one Finger and that the Flooding is so violent as to endanger the Womans life the Chirurgeon then having introduced his Fore-finger of his left Hand must take with his right an Instrument called a Cranes-bill or rather a Forceps like that marked G among the Instruments at the end of this Second Book and guide the end of it along his Finger for to fetch with this Instrument the strange Body out of the
Womb taking heed not to pinch the Womb and that the Instrument be alwaies conducted by the Finger first introduced which will judg and distinguish by the touch between this Conception and the substance of the Womb in doing which there being no other way he will certainly accomplish his business I thought of causing such an Instrument to be made upon an occasion where it would have stood me in good stead if I had had it with which I have since proceeding according to the directions I have just now given lately drawn forth a false Conception of the bigness of a Walnut which without doubt had else that day been the death of one named Madam le Roy dwelling near the great Stairs at the place Maubert by reason of the horrible loss of Blood which it occasioned and which ceased assoon as I had drawn forth this Conception which I could never have done any other way because the inner Orifice of the Womb was not open nor could be dilated more than for one Finger alone after the manner I have declared besides the pressing danger of the accident the delay of the Operation had indubitably been the death of this Woman who thanks be to God is since well recovered CHAP. XXXIII Of the Caesarean Section WHen a big-bellyed Woman is effectively in Labour 't is very rare but that an expert Chirurgeon can deliver the Child dead or alive whole or in pieces in a word that he may do the work completely if he behaves himself as the case requires and according to the directions given in each particular Chapter foregoing treating of the several unnatural Labours without being necessitated in a very inhuman cruel and barbarous manner to have recourse to the Caesarean Operation during the Mothers life as some Authors have too inconsideratly ordered and somtimes practised themselves In truth there would seem some pretext of a lawful excuse to make Martyrs of these poor Women if it were to bring a second Caesar from them whom they say was born in that manner or some great and new Prophet In the times of the ancient Pagans they did use to sacrifice innocent Victims for the publick good but never for a private I know very well that they palliate it with a pretence of baptizing the Infant which else would be deprived of it because the Mothers death is for the most part cause of the Childs but I do not know that there ever was any Law Christian or Civil which doth ordain the martyring and killing the Mother for to save the Child 'T is rather to satisfie the avarice of some people who care not much whether their Wives die provided they have a Child to survive them not so much for the sake of Children but to inherit by them afterwards for which cause they do easily consent to this cruel Operation which is a damnable policy If they say to render the fact less horrible in appearance that it must never be undertaken but when the Woman is reduced to the utmost extremity to that I answer that a Woman often recovers beyond hope or probability And if they object that she may likewise escape after this Operation I do utterly deny it by the testimony of the most expert Chirurgeons that have practised it who alwaies had bad success all the Women ever dying in a short time after I do highly commend Guillemeau who to disabuse the world for such a wicked and pernicious practise confesseth speaking of this fatal Operation and ownes by way of repentance that he did himself twice in the presence of Ambrose Parê put it into practise and saw it thrice done more by three several very expert Chirurgeons who omitted never a circumstance to make it succeed well and notwithstanding all the Women died As for Parê he will not acknowledg that he saw those two Operations of Guillemean because he will not have Posterity know that he was able to consent to so great a cruelty but contents himself with advising only that it should never be undertaken till the Woman is dead because there is no possibility she should escape it not only because of the irregular wound which is convenient to make for this purpose in the Belly but chiefly for that in the Womb and for the excessive Flux of Blood which will immediatly follow However contrary to the opinion of two such famous Chirurgeons there are some rash persons who do obstinately maintain though with but as little reason as Rausset that it is not impossible for a Woman to escape because they have seen some that have had the Bones of their dead Children come forth by an abscess of the Belly after that the Flesh of them had passed the natural way in Supâ—uration which Bones by little and little had pierced the Womb and the Belly also and after that they were so drawn forth yet the Women recovered As also others did not dye whose Wombs after Precipitation and perfect putrefaction and Gangrene was totally cut away Indeed we must acknowledg what experience hath many times taught us as it hath these things which I believe have happened and may again as well as those though rarely but it doth not follow that this Caesarean Operation must needs succeed as well because here is made at one stroak a very great wound in the Belly and Womb which is ever the death of the poor Woman immediatly or soon after But when Nature it self begins to separate and pierce these parts by means of these Bones to cast them forth by some new way which it makes not being able to do it by the common and natural for want of the help in due time of skilful persons it doth it by degrees and not all at once and according to the measure it drives these preternatural Bodies forth of the Womb so it reunites and rejoins it at the same time proportionably and without the least Flux of Blood which happens quite otherwise in the artificial Operation and if it be true that some Women have ever escaped it we must believe it a Miracle and the express hand of God who can when He pleaseth raise the dead as he did Lazarus and change the course of Nature when 't is his good pleasure rather than an effect of humane prudence There are many good Women who for having only heard some Gossips speak of it are very confident that they know such and such yet living whose sides had been so opened to fetch the Child so out of their Belly Nay more there are some that affirm they know those that have had this Operation practised on them three or four times successively and yet alive and the better to confirm so notable a lye which they had only heard recited by others and after having three or four times told it believe it themselves for truth as much as if they had seen it with their own eyes will tell so many circumstances and particulars that they easily perswade those that do not understand
a Quart then strain it squeezing of it strongly and with this Decoction foment those inferiour parts Nights and Mornings to the end they may as much as possible be strengthened and confirmed I say as much as possible because there is no probability that they can ever be reduced to the same estate they were in before she had Children So much for this Wee 'l now pass to convenient Remedies for the Belly of a new-laid Woman All Authors do appoint immediatly after Delivery the skin of a black Sheep slaid alive for this purpose to be laid all over her Belly and to lie on four or five Hours others will have a Hare-skin Truly I believe that by reason of the natural heat of such Skins the remedy is not bad but I also fear lest in some small time after it may do the Woman more hurt than good and that by its Moistness cooling of her it may make her to shake which would be very prejudicial in stopping her Cleansings which ought to flow besides it is a remedy or too much trouble for there must always be a Butcher ready for every Woman that is laid or some other person that can do it as readily who must be for this purpose in the very Chamber or at least in the House that so they may have the Skin very hot according to directions They likewise direct a small Plaister of Galbanum with a little Civet in the middle to be applied to the Womans Navil which as they imagine is very proper to keep the Womb in its place because being delighted with that smell it drawes neer to it of its self but this remedy is a little * Practice and success commends it nor is there reason wanting to defend it wherefore notwithstanding the Authors sense it may be successfully continued Superstitious wherefore I am not for it it being sufficient to keep the Belly very warm in the situation we have directed and prevent the least cold As for Swaths convenient to a Woman new laid they need not be us'd the first day or at least but very loosely especially when there hath been a hard Labour because the least compression of the Womans Belly which is then very sore as the Womb also is having been much harrassed proves a great inconveniency to her wherefore let her not be swathed until the Second day and that very gently at the beginning Midwives believe that they serve instead of Boulster as well for the keeping the Womb up in its place as to squeeze out from all parts the Cleansings which are necessary to be evacuated And Nursekeepers abused with this belief do sometimes swath their Bellies so strait that they do bruise the Womb which is very painful in the beginning of Child-bed and from whence often follows very dangerous Inflamations These Swaths and Boulsters can have no hold to support the Womb as they imagine forasmuch as its * Bottom of the Womb. Fund which is the principal part being flitting in the Cavity of the †Lower Belly Hypogaster cannot be kept stable and firm by that which is applied upon the Belly and beside the interposition of the Bladder which is upon it will not permit it As to their opinion that such Swathings help to cleanse the Womb 't is fit they should be disabused of this Error for it is not the same thing in these Cleansings as pressing the juice out of boil'd meat in a Napkin for these are wholly a work of Nature which a strong compression instead of helping hinders by the pain it causes to the Womb and the Inflamations that follow Without dwelling then upon the ordinary manner of Swathing let us be guided according to the dictates of Reason and not according to the Nurs-keepers naughty Customs whose Method is first to put upon the Belly a Swath four or five double of a triangular Figure to support as they pretend the Womb and sometimes two others Roulers very strait on each side towards the Groine to keep it in its place lest it be shaken and encline more to one side than t'other with yet another broad square Swath for the whole Belly which they put upon the first afterwards they make a Swath of a Napkin folded two or three double of the breadth of a quarter of an Ell with which they do very much girt and compress the Belly I do very well approve of the use of these Swaths and of a good large square Boulster over the whole Belly provided they be very loose the first seven or eight daies only to keep it a little steady observing in the mean time to take it off and remove it often to anoint the Womans Belly all over if it be sore and that she have After-Pains with Oile of sweet Almonds and St Johns Wort mixed together which may be done every day But after that time they may by degrees begin to swath her straighter to contract and gather together the parts which were greatly extended during her going with Child which may be then very safely done because the Womb by those former cleansings is so diminished and lessened that it cannot be too much compressed by the Swaths Let us now see what is fit to be done to the Breasts Proper Remedies may be applied to them for to drive back the Milk if the Woman will not be a Nurse of which we shall speak hereafter but if she intends to be a Nurse 't will be sufficient to keep her Breasts very close and well covered with gentle and soft Clothes for to keep them warm lest the Milk curdle in them and if there be danger of too much Blood being carried thither anoint the Breasts with Oile of Roses and a little Vinegar beat together and put upon them some fine Linnen dipt in it observing that if the Woman do suckle her Child she gives it not the Breast the same day she is brought to Bed because then all her Humours are extremely moved with the Pains and agitation of the Labour wherefore let her defer it at least till next day and it would be yet better to stay four or five days or longer to the end the fury of the Milk and the abundance of humours which flow to the Breasts in the begining may be spent in which time another Woman may give it suck Let us now discourse of a fit Diet for the Woman to keep during her whole Child-bed CHAP. III. What Diet a Woman in Child-bed ought to observe during the whole time of her lying-in when it is accompanied with no ill accident ALthough a Woman be naturally delivered yet notwithstanding she must observe a good Diet to prevent many ill accidents which may happen to her during her Child-bed at the begining of which she must be directed in her Meat and Drink almost as if she had a Fever that so it may be prevented inasmuch as she is then very subject to it so likewise it often happens to her by the least
time and being thereby hardened had stopt the Passage of much Wind which passed away at this time Now the Intestines full of this gross matter being every moment agitated by this Wind did likewise agitate and continually compress the Womb by means of which the Flooding was always maintained which did cease immediatly after this Chollck was dissipated by the evacuation of these Excrements and since that time being again called upon the like occasion of loss of Blood proceeding from the same cause and having taken the same course the issue of it was likewise the same Wherefore if there be the least appearance of Excrements contained in the Intestines make no scruple to give Clysters to evacuate them forbearing in this case those that are Astringent because they harden and retain yet more that which augments the distemper Chap VI. lib. 3. pag 307. These three Figures represent several Pessaries fit for the supporting and keeping up of the Womb that it may not fall out as it doth in a bearing down CHAP. VI. Of the bearing down and falling out of the Womb and Fundament of a Woman new-laid I Shall the better to explain the thing make two sorts of Bearings down or Relaxations as also two sorts of Fallings forth or Precipitations of the Womb all which differ but in the degree according as they fall down more or less for the Relaxation is when the Womb only bears down and comes not forth and the Precipitation is when it comes out of the Body The first sort of Bearing down is that in which the whole body of the Womb falls into the Vagina in such manner that putting up the Finger one may feel the orifice very neer The second sort of Bearing down is when the Womb being yet lower one can manifestly perceive this Orifice quite without The Falling-out is also of two sorts in the first the Womb comes quite forth but is not turned inside out nor can the inside of it be seen but only its Orifice which appears at the end of a great fleshy mass which makes the body of the Womb and this is called Prolapsus Uteri that is A falling forth of the Womb. And the other falling out of all is most dangerous and is called Perversio or turning inside out for then it is not only fallen forth but the bottom of it is turned quite out that so you may perceive it all even and without an Orifice because it is so turned The Womb turned on this fashion appears to be only a great piece of bloody flesh and almost like the * A mans Cod. Scrotum which hangs between the Womans Thighs and that which is wonderful in this case is that the Infants house which is the Womb goes forth at the Gate which is the inner Orifice The Bearing down of the Womb proceeds either from a Relaxation or Ruption of the Ligaments Women that have abundance of the Whites are subject to these Relaxations and the Ligaments are extended or broken by hard and violent Labour as also by too frequent bearing of great and heavy Children sometimes by a great Cough by strong and frequent Sneezings or having leaped or fallen from high places by going in a Coach Cart on Hors-back or in other rude and shaking Carriages by having lifted up beyond their strength heavy burthens by lifting up the Arms too much and putting them over the Head by a tedious loosness with great Pains and Needing forasmuch as all these things do shake and extremely thrust the Womb downwards when it is with Child and the Ligaments being by this means loosened or broken cannot keep it up any longer which is the cause that a bearing down doth easily follow the birth of a Child but the most ordinary cause of these Bearings down or fallings out of the Womb is violent and hard Travails which usually happens when a Child comes wrong so that it cannot be born and when it hath too big a Head or when the inner Orifice is not dilated sufficiently for to give it passage at that time for the Womb is then forced down with so much violence and yet the Child cannot advance into the Passage because the Ligaments are extremely rent or loosened and likewise when the Secondine cleaving closely to the bottom of the Womb is pulled away of a sudden or with too much violence and much the sooner if that putting up the Hand into it as it is necessary when the String is broke one takes hold and pulls the body of the Womb itself instead of the After-birth We have in the 13th Chap. of the Second Book given such directions as will prevent this mistake and bring it away safely A Woman troubled with this falling out of the Womb feels a great weight at the bottom of her Belly with an extreme pain in her Reins and Loins towards the place where these Ligaments are fastned and a reddish bloody moisture is perceived to pass through this mass of Flesh which hangs between her Legs A Relaxation may happen to all sorts of Women from any of the causes above mentioned but a falling out but seldom and a perfect Perversion never but upon a Delivery or immediatly after because then the inner Orifice is almost as wide as the bottom of it which is not so at other times when being closed there is no possibility for it to be thus turned inside out I have shown in the 16th Chap. of the Second Book how to prevent this Accident at the time of Labour in a Woman that is subject to it to which place you may have recourse to avoid repetition If a speedy remedy be applied to the Relaxation and falling out of the Womb by reducing and remitting it into its natural place a Cure may be easily expected and so much the rather by how much the Woman is young and the Malady fresh but if she be old and this Disease be already of a long standing she is so much the more incurable For the Cure of this distemper regard must be had to two things the First is to reduce the Womb into its natural place and the Second is to strengthen it and keep it there For the execution of the first which is to reduce it if the Womb be quite out or turned the Woman must first of all be made to render her Urine and a Clyster must be given her if it be necessary for to empty the gross Excrements that are in the Rectum that so the reduction may be the easier performed then place her on her Back with her Hips raised a little higher than her Head and then foment all that is fallen forth with a little Wine and Water luke-warm and having taken a soft Rag put it up into its proper place thrusting it back not all at once but wagging it by little and little from side to side and in case this be too painful because it is already too big and swelled anoint it with Oile of sweet Almonds for the
more easie reduction of it being careful assoon as it is reduced to wipe off the Oile as much as may be to avoid a Relapse But if notwithstanding all this the Womb cannot be put up because it is very much enflamed and tumefied which happens when it hath been a long time so without the use of necessary means during which time it is continually moistened with Urine and other Excrements which contribute very much to its corruption in this case there is great danger that it will gangrene and be afterwards the death of the Woman There have however some Women escaped this accident Pareus recites the History of such an one which Rousset doth also amongst his Caesarean-births but this happens very rarely As to the second part of this Cure which consists in the retention of the Womb in its place and the strengthening of it so reduced it will be done by a convenient scituation Let the Woman for this purpose keep her self in Bed on her back having her Hips a little raised her Legs something crossed and her Thighs joined together to prevent the falling of it out again but the best way is to put up a Pessary into the Neck of the Womb for to keep it firm There are two or three sorts made for this purpose the several Figures of which are at the beginning of this Chapter Some are round and a little longish of the figure of an Egg and of the length and bigness of the Neck of the Womb where it must be left after that it is introduced into it but these are often subject to fall out again and are not so useful and convenient as the other which are made of a piece of Cork that they may be light They ought to be of a thick circular figure like to a small wreath and pierced with a pretty big hole in the middle which serves aswel for the lodging supporting and receiving of the inner orifice of the Womb as for the giving passage to the superfluous humours which are thence evacuated These kind of Pessaries must be covered with white Wax that they may be more smooth and incapable of hurting the Woman that useth them they must be pretty large that they may be the easier kept when they are put up they may also have a small String fastened to them to pull them out at any time to clean But this String is not so very necessary because they may be easily enough taken out with one Finger they may be made some of them exactly round and others something of a square Figure or triangular the corners must be rounded or blunted These sometimes hold better and fall not so easily forth as the round but either the one or the other may be used as shall be thought most fit During the flowing of the Lochia from the Womb nothing els must be used to strengthen but only to keep it so in its natural place for astringent Remedies proper for the prevention of the Relaxation of it will very much prejudice the Woman by stopping of these evacuations and above all it must be observed in this distemper that the Womans Belly be not strait swathed any more than for a stay only in which many Midwives are deceived believing they keep it the better in its place by how much they swath the Belly the straiter for by this strong compression of it they force the Womb yet more down She must use the Bed-pan in Bed lying along if possible when she goes to Stool keeping her hand all the while on the bottom of her Belly to bear it up But when the time of her Purgations is fully over and that she hath cleansed very well astringent Injections may be then used without danger respect must likewise be had to the whole habit of the Body to dry up the humours by an universal course and the Woman must not rise out of her Bed in at least five or six Weeks time that so the Womb and its Ligaments may be restored and fortified in their natural Scituation It happens also sometimes that by the great Throwes the Woman endures at her Labour the Fundament falls quite out in this case if the Child be very forward in the Passage 't will be sufficient before this accident happens to hinder it if possible persuading the Woman not to help her Throwes so strongly but if it be already fallen down they must stay till the Child be born ere it can be put up for before that it will be difficult to do without much bruising the Intestine Assoon then as the Woman is delivered let it be reduced in the same manner as that of the Womb after having fomented bathed and anointed it if necessary forbearing afterwards during her Child-bed the giving of her Clysters because the force she useth in rendring of them will again cause the falling down of the Fundament CHAP. VII Of the bruises and rents of the outward parts of the Womb caused by Labour IT is no wonder that often and especially in first Labours there happens bruises amd rents in the lower parts of a Woman the cause of which is easily known if the bigness of the Childs Head be but considered which must needs make a great distention of those strait parts by passing and coming forth of the Womb which parts being thereby extremely pressed against the hardness of the bones thar surround it are easily bruised and when they are not able to be sufficiently dilated they must necessarily be torn asunder Almost all Women in their first Labours do very much complain when the Child is in the Passage that the Midwives prick and scratch those parts and do believe that the hurts and bruises which are there after Labour do happen because the Midwives handled them too roughly but they are very much mistaken for this comes because the Childs Head in passing makes a violent distention and separation of the four Caruncles and other adjacent parts which are bruised and sometimes rent by it from hence spring the pains of which they then complain as if they were pricked and scratched whereof they are never after sensible in their following Labours because those parts having once given way to an Infant are ever after very easily relaxed and extended and every Travail with less Pain than other These contusions and rents must never be neglected lest they degenerate into malignant Ulcers for the Heat and Moisture of these parts besides the filth which continually flows thence doth easily contribute towards it if convenient Remedies be not timely applyed Wherefore assoon as a Woman is laid if there be only simple Contusions and Excoriations apply the Cataplasme formerly directed to those lower parts to ease pain made of the Yolks and Whites of new-laid Eggs and Oyl of Roses seeth'd a little over warm Embers continually stirring it till it be equally mixt and then spread upon fine Cloth it must be applyed very warm to the bearing-place for five or six hours when
which we say are excited by wind give the Woman immediatly after Delivery Oyl of sweet Almonds and Syrup of Maiden-hair mixt together some do more esteem Oyl of Walnuts provided it may be made of good Nuts but this hath a worse taste than the other This remedy serves to lenify and line the inside of the Intestines with its Unctuousness by means whereof that which is contained within them passeth away the easier but as we have said elsewhere this mixture is so nauseous that it doth often for that reason more hurt than good wherefore I prefer a good warm Broth for those who have an aversion to the Oyl Others give half a glass of good Hippocras but that in the condition the Woman is in may do more hurt by causing a Fever Now for the better preventing these kind of Pains let the Woman keep her Belly very hot and be careful not to drink her Drink too cold and if they torment her very much hot Clothes from time to time must be laid on her Belly or a Pan-cake fryed with Walnut-oyl may be applied to it without swathing her Belly too strait And for the better evacuating the wind out of the Intestines give her a Clyster which may be repeated as often as necessity requires but if by this means the pains of the Belly are not appeased 't is certain they are maintained by some other cause If it be known that some strange body is retained in the Womb the expulsion of it must be procured or it must be fetcht away by putting the Fingers into the Entry of it according to the direction already given for the extracting of a false Conception and if it be great Clods which retained do also cause these pains they will not fail to cease assoon as they are fetcht away but also the same accident will soon return if new Blood flowes into the cavity of the Womb and coagulates there again as it often happens for it cannot endure to keep any thing in its capacity after the Childs birth If the Womans Cleansings be suddenly stopt which a little before came down in great abundance you need not search for any other cause of the pains she endures and the speediest remedy is to bring them down which is effected by Clysters that draw downwards by hot and aperitive Fomentations to the bearing place and by bleeding in the Foot preceded by that of the Arm if the case require it As to the Pains the Woman feels in her Loins and Groins which come by reason of the great distention or in part ruption of the Ligaments of the Womb thereabouts fastened rest alone and a good scituation of the body will be sufficient to fortifie and reunite them without greater Medicines because they cannot be actually applied to the part affected alwaies observing a good Diet and not forgetting in all these several sorts of pains to provide for the natural evacuation of the Lochia for 't is one of the principal means to obtain a good issue CHAP. IX Of the Lochia which flow from the Womb in Child-bed Whence they come and the Signs when they are good or bad I Do not find that Authors have so sufficiently enquired into the cause of the Lochia which are evacuated in Child-bed as to make us truly understand what they are either in respect of their Nature affirming it to be the blood usually purged away every Moneth before they were with Child which being collected about the Womb flowes away when it opens after the birth of the Child or in respect of the quantity of this evacuation and the length of time it ought to continue Hippocrates in his Book De Naturâ Pueri would have at the beginning an Hemine and an half a day of which measure though common in his time we have no certain knowledg for some will have it to be our half Pint others a Pint or therebouts and that they continue for a Male-child thirty daies for a Female fourty diminishing every day by little and little until there comes no more and the evacuation is compleated Galen saies that these Lochia are only vitious humours and the residue superfluity of the Blood with which the Child was nourisshed in the Mothers Womb. But I will as near as I can here describe to you the manner how I conceive this evacuation to be made and the reason why they diminish day by day and change their colour consistence and quality according to the several times Assoon as the Child is born there flowes away from the Womb at the same moment some waterish humours besides those which came away before at the breaking of the Membranes These Waters then are very often bloody not that they are so by Nature but because there is for the most part Blood mixed with them which comming from the Vessels of the Womb because of the agitation and commotion they received in the Birth become so reddish but immediatly after the Burthen is compleatly loosened then pure blood flows away and the reason why these Lochia flow freely and are very red the first day is because the Vessels against which the Burthen was fastened in the Womb are but newly opened but the Blood flowing by little and little in less abundance because the greatest plenitude hath been at first evacuated doth clod in small drops on the extremitie of all those Vessels whereby they are stop'd and then there comes away onely the most serose part of it and therefore the Lochia begin the second and third day to be more pale and less coloured and after that the colour of them is less bloody every day as the Vessels close until they are at length very pale which happens when the Vessels being almost perfectly reunited there distills only the meer moisture of them as also of the whole substance of the Womb through which a quantity of it doth likewise transude Now these serose Humidities acquire by the heat of these places a consistence somewhat thick and that more or less according as they come away in greater or lesser quantity and according to the length of time they stay there And then the Lochia do almost resemble in colour and consistence troubled Milk which makes the World believe it is Breast Milk which is in that manner emptied downwards but in truth it is an Abuse as great as common For my part I know no other cause of this ordinary change of the colour and consistence of the Lochia nor of the diminution of their quantity than that which we daily find in the Suppuration of a great wound somewhat incarnated for assoon as the wound is first made it bleeds fresh and in good large quantity because the Vessels are then open but a little after during the first and second daies it yields only bloody Serosities forasmuch as some small portions of the Blood being clodded about the mouths of the Vessels do in part stop them and afterwards stopping them more it yeilds a white *
curdled or clotted Blood that they have no ill Scent that they be without Acrimony and that they flow in a moderate quantity We say that they must not be fresh but the four first days because they will not be else the true Lochia but a pure flux of Blood which will be very dangerous and that they must lose by degrees this reddish colour to become pale this sign teacheth us that the Vessels which have been opened are by degrees closed again that they be of an equal consistence without curdled or clodded Blood by this means we are assured that there is no mixture of any strange matter and that they are governed and regulated by Nature they must have no Foetor or ill scent and be without Acrimony in this case we know that there is no danger of corruption or inflammation in the Womb they must flow in a moderate quantity that so the superfluous humours may be evacvated for if the Lochia flow in so great an abundance as to cause Fainting or Convulsions the Woman will be in danger of death as Hippocrates in the six and fiftieth Aphorism of his Fifth Book assures us Si Muliebri profluvio convulsio animi defectus superveniunt malo est If saies he Faintings and Convulsions follow the Lochia it is dangerous and he adds in the following Aphorism Menstruis abundantibus Morbi eveniunt subsistentibus accidunt ab utero Morbi If the Courses or Lochia flow too much Diseases follow and if they stop Diseases happen from the Womb. Diseases proceeding from too great abundance of the Lochia are as we have said in the first Aphorism Convulsions and Syncopes or Faintings and if they do not kill the Woman they weaken her very much she grows lean she remains a long time pale her Legs and Thighs swell and afterwards she becomes Hydropick As to the distempers which follow the suppression of the Lochia we will mention them in the next Chapter CHAP. X. Of the suppression of the Lochia and the Accidents which follow thereupon THere is so great a flux of Humours from all parts to the Womb when a Woman is with Child and during the commotion in her Labour that in case there be not afterwards sufficient evacuation of them the Woman is in great danger of very ill Accidents and sometimes of death it self because these humours corrupting by their stay there will certainly cause a great inflammation and this is the reason why the suppression of the Lochia is one of the worst and most dangerous Symptoms which can befall a Woman after Delivery especially if they happen to be totally and suddenly stopt the first three or four days which is the time when they should come down plentifully for then follows an acute Fever great pains in the Head pains in the Breast Reins and Loins suffocation of the Mother and an Inflammation which is suddenly communicated all over the lower Belly which becomes very much swelled and blown up there happens also a great difficulty of Breathing Choakings Palpitations of the Heart Syncopes and Faintness Convulsions and often Death if the suppression continue or if the Woman escapes it she is in danger of an Abscess in the Womb yea and afterwards a Cancer or there may happen great Imposthumes in the lower Belly which is usual because of the nearness of the place as also Gouts Sciaticas and Lameness or Inflammation or Abscess in the Breast if the Humours be carried towards those parts The Câ—uses of the stoppage of the Lochia proceed either from a great Loofness because a great Evacuation that way turns the Lochia and makes them stop or any strong Passions of the Mind as great Fear or Grief or any Anger or Soundings for these things do cause the humours to retire suddenly inwards and by this quick motion they often cause Suffocations Great Cold stops the Lochia because it closes the Vessels and Pores of the Womb the use of astringent Remedies produces the same effect as also cold Drink because by condensing and thickning the humours they hinder their easie flowing strong and frequent agitations of the Body by rarifying and dispersing them throughout every part doth likewise not permit them to be evacuated by the Womb. To bring the Lochia well down let the Woman avoid all perturbations of spirit which may stop them let her lye in Bed with her Head and Breast a little raised keeping her self very quiet that so the Humours may be the easier carried downwards by their natural tendency let her observe a a good Diet somewhat hot and moist let her rather use boiled Meats than roast and if she be any thing feaverish let her use Broaths only with a little Jelly let her avoid all binding things let her Ptysan be made with Aperitives such as are the Roots of Succory Dogs-grass and Asparagus with a little Aniseed and Hops and every other time let her take a little Syrup of Maiden-hair in a glass of this Ptysan and above all let her carefully shun cold Drink Clysters may likewise be given her to draw the Humours downwards and her lower parts may be fomented with an emollient and aperitive Decoction made with Mallows Marshmallows Pellitory of the wall Camomil Melilot the roots of Asparagus and Linseed with which Decoction the Womb may likewise be injected and with the Herbs being well boiled and strained through a very course Cloth let a Cataplasme be made with the addition of Oyl of Lillies or Hogs-grease and applyed very hot to the lower Belly together with these let her Thighs and Legs be strongly rub'd downwards bathing them very hot with the same Emollient Decoction there may be likewise applyed large Cupping-glasses to the uppermost part of the inside of her Thighs It would not be much amiss to use an Aromatick Perfume if it were not that it caused a heaviness of the Head as Hippocrates notes in the 28th Aphorism of the Fifth Book where he saith Sufficus Aromatum muliebria educit saepius verò ad alia utilis esset nisi Caepitis induceret gravitatem Now whilst all these things are put in practice bleeding in the Foot or Arm must not be forgot according as the accidents caused by this suppression of the Lochia require neither must we blindly follow the opinion of many Women who believe that bleeding in the Arm in this case is very pernicious This Imagination is so firmly rooted in the heads of almost all of them that if in case a Child-bed Woman happens to dye after bleeding in the Arm they sail not absolutely to condemn that as the cause But this their opinion is not according to knowledg for sometimes Bleeding in the Arm is better than in the Foot and at other times that in the Foot is more certain than bleeding in the Arm As for example suppose a Woman be very full of Humours throughout the whole habit of her Body and her Lochia be supprest by reason of which there happens an Inflammation
her mouth will draw them out and by this means unstop the root of the old Nipples or using a fit Instrument of glass such as is figured at the begining of this Chapter with which the Woman her self may also suck them five or six times a day and to shape them and so preserve them being thus drawn out from sinking into the Breasts again let her put upon them a small Cap of wood or other matter such as is abovementioned and doing so by degrees after the Nipples are quite form'd and unstop'd she may again give her Child suck What we have hitherto writ in this third Book shall suffice for directions concerning a new-laid Woman and also for the knowledg and cure of distempers which usually happen to them upon which we need not further enlarge for if any other happen than what we have mentioned and which do not properly belong to the care of a Chirurgeon a Physitian must be sent for to remedie them by his prudence and according as Art requires Let us now treat of Infants new-born and run through the Diseases they are most subject to CHAP. XVI Of tending Children new-born and first how to bind cut and swath the Navel-string IF the Infant as we have said before discoursing of Deliveries hath often need whilest he is in his Mothers belly of the good conduct and dexterity of a Chirurgeon or Midwife to deliver him and bring him happily forth out of that Dungeon wherein he hath been a long time inclosed their assistance is nothing less necessary to him assoon as he is born as well to remedy such indispositions which sometimes he brings into the world as to defend him from many infirmities to which the weakness of his Age and tenderness of his Body renders him subject We have in the whole foregoing-Book very particularly shown how to help him in his coming into the world there remaines now only directions what is to be done afterwards to this purpose we will first shew how to tye cut and bind up the Navel-string There are some persons who assoon as the Infant is come into the World do bind and cut the Navel-string before the burthen be come away but it is better if possible without too-long stay to deser it until the Secondine be likewise drawn forth for the Womb which is extreamly wide and open after the coming forth of the Child would be in danger of taking cold by the outward aire during the delay made for the Ligature of the Umbilical Vessel besides that the Orifice closeing a little it would afterwards be more difficult to bring the After-birth away To make this Ligature as it behooveth let the Midwife do as followeth assoon then as all is come away from the Woman she must immediately close up the Womb with clouts according to directions already given and then carry away the Child and Burthen to the fire having put it into a warm Bed and Blancket let her take a brown Thread four or five double of a quarter of an Ell long or thereabouts tyed with a single knot at each of the ends to prevent their entangling and with this thread so accommodated which the Midwife must have in a readiness before Labour as also a good pair of Scissers that so no time may be lost let her tye the string within an Inch of the Belly with a double knot and turning about the ends of the thread let her tye two more on the other side of the string reiterating it again if it be necessary for greater surety then let her cut off the Navel-string another Inch below the Ligature towards the After-birth so that there only remain but two inches of the string in the midst of which will be the knot we speak of which must be so strait knit as not to suffer a drop of blood to squeez out of the Vessels but not so strait as to cut it in two For which reason the Thread must be pretty thick and pretty strait knit it being better too-strait than too-loose for some Children have miserably lost their lives with all their blood before it was discovered because the Navel-string was not well tyed Now that so great a Mischief may not happen great care must be taken after it is cut that no blood squeez through for if there do new knots must be made with the rest of the string which for this reason must be left a little long to close it more exactly this being done wrap up the end of the String thus cut and tyed three or four times about with a small rag drie or dipt in Oile of Roses if you please then having put another small Rag three or four double upon the Belly of the Child above the Navil lay the String so wrapp'd up upon it that it may not touch the naked Belly on the top of all put another small Boulster and then swathe it with a linnen Swath four Fingers broad to keep it steady lest by rowling too much or by being continually stirr'd from side to side by the motion of the Belly it comes to fall off before the Vessels be quite closed up and healed 'T is very convenient as we have said to lay the remaining part of the String on the upper part of the Belly that so if by chance the Vessels be not sufficiently closed the Blood may not so soon slide away as if it were turned downwards for we find sometimes this String to be so great in some Children that although it were very close tyed at first yet coming afterwards to wither and dry the Ligature is rendred looser by means of which 't will afterwards easily bleed if care be not taken This Accident hapned lately to a poor Child who died the twelfth day by such a flux of Blood although the Midwife protested to me that she had tyed the String very exactly and being astonished how that could happen she told me that it must assuredly be which indeed was the truth because the Knot was loosened in proportion to the withering of the String wherefore to avoid such a Misfortune let a new Knot be knit the first time the Child is opened The String thus tyed begins daily to dry away and is separated from the Belly at the end of the sixth or seventh day ordinarily and sometimes sooner but rarely longer than the eighth or ninth it must alwaies fall off of it self without any provocation lest that being separated too soon and before the Vessels shall be entirely closed and healed up a flux of Blood follow which is very dangerous as we have said or that it cause an Ulcer very hard to be cured There are some good Gossips who are a little superstitious in the tying of this String longer or shorter according to the difference of the Sex for some pleasant reasons they give but it is a meer abuse for at whatsoever distance they tye the Knot either nearer or further though half a foot from the Belly yet it
THE DISEASES OF VVomen with Child AND In Child-bed AS ALSO The best Directions how to help them in Natural and Unnatural Labours With fit Remedies for the several Indispositions of New-born Babes Illustrated with divers fair Figures newly and very correctly engraven in Copper A Work much more perfect than any yet extant in English being very necessary for all Chirurgeons and Midwives that practise this Art Written in French by FRANCIS MAVRICEAV Translated and enlarged with some Marginal-Notes by HVGH CHAMBERLEN M. D. and Physician in Ordinary to his Majesty LONDON Printed by John Darby in St. Bartholomew-Close to be sold by R. Clavel in Cross-keys-Court and W Cooper at the Pelican in Little-Britain by Benj. Billingsly at the Printing-Press in Cornhil near the Royal Exchange and W. Cadman at the Popes-head in the lower Walk of the New-Exchange 1672. The Author's Epistle Dedicatory To all my dear Brethren the Sworn Master-Chirurgeons of the City of Paris GENTLEMEN HAving need of a firm and solid Prop for the weakness of my Conceptions I shall imitate most Authors who ordinarily choose the protection of some Person of Credit under whose Names they publish their Works to the World But I shall not follow the custom of many who dedicate them for the most part to persons who have no manner of knowledge of the matter of which they treat induced thereto rather in hopes of some mercinary recompence than any other motive This is Gentlemen that which obligeth me to address my self to you as to those who alone are fit Judges of it and to offer you the first fruits of my Labours which might run the hazard of being gnawed by the Worm of Envy if not put into your hands to protect I offer it to you in acknowledgment of the honour you did me when some time since you received me into your famous Company and to acquit my self of the Obligation I owed you for being a Member of your Body all my pains ought to be for you This is the reason why I could not present it to any other person without being guilty of a domestick larciny By giving it you I am liberal of your proper Goods or rather I render you an account only of the Talent you entrusted me with to improve I mean the true Precepts of this noble Art of Chirurgery of which you have a knowledge and experience so perfect that every one is obliged openly to confess that you are alone amongst all the Chirurgeons of Europe of whom it may be justly said Vos Sol alios umbra regit I shall refrain Gentlemen to praise you upon this subject for besides that it deserves a Pen more able than mine to acquit it self according to your merits I may fear that I should be silenced by such as would alledge to me for so doing that with which he once was reproached who undertook to praise Hercules in publishing his Heroick Actions to the People of Lacedemonia Who anâ—wered one is he that knows him not 〈◊〉 â—…th not esteem him to be in the number of the immortal Gods So likewise may it be said to me Who is he that knoweth not the Master-Chirurgeons of Paris Is it not manifest that you are that fruitful Spring to which they come from all places of Europe to draw the perfection of so fair an Art and whither many Princes and Princesses of strange Countries are obliged to have recourse for the preservation and recovery of their health which they believe cannot be obtained so easily and with so much assurance from any other as from you Is it not known likewise that our puissant Monarch hath this many years entrusted wholly his Sacred Person into the hands of him who through his merits is at present the Head of your illustrious Body Neither can it be forgotten that this great King did through a fatherly goodness which he had for the preservation of all the Nobility that accompanied him the last year in his Conquests in Flanders command three or four of you to stanch the blood which was spilt before that mighty City de L'Isle which he brought under his obedience Was it not then seen how divers persons of great quality who were mortally wounded in signalizing themselves at the Attaque of that strong Place seem'd wholly reviv'd at the instant they received the news of the arrival of these excellent Chirurgeons upon the confidence they had to receive from them a speedy and a certain help One might at the same time likewise perceive the Generosity of others extraordinarily augmented through the Confidence they had in their safe hands Let us therefore treat no longer of that of which none are ignorant but rather make some few reflections on your Charity which renders you every-where so famous in assisting gratis with your sage and prudent Counsels an infinity of Sick who meet from all parts at St. Come the first Monday of every Month in the year to consult with you upon many Diseases to all others except you incurable despairing ever to obtain a cure for their Maladies if it do not descend from your famous Magazine This Charity also plainly appears in the Instruction you bestow gratis upon all Students in Chirurgery appointing some from amongst you to make them Demonstrations in Anatomy and teach them the true Method how well to perform all the Operations of Chirurgery of which Commission I have had the honour to acquit my self as well as it was possible for me during three years in pursuance of the Order you gave me to that purpose But since in those Exercises so ordered by you we do not usually discourse of Women with Child nor of their different Labours I have thought that to discharge my self intirely of my duty you will not judge amiss my publishing this Book to the world which I present you in which I endeavour to demonstrate exactly the means of remedying many Indispositions of Women with Child and in Childbed with an exact Method of well-practising the Art of Midwifery being perswaded that it may be very profitable to many young Chirurgeons who live in the Country where but very few sufficiently instructed in all things necessary to be known can be met with I have also the rather undertaken this that the Midwives may finde in it that which they ought to know to enable them the better to exercise their Ar and undergo the Examination which at present they are obliged to before you for their Reception I hope likewise Gentlemen you will have the goodness to excuse it though it hath not so fair a form as the matter requires and though I do not express the contents so perfectly as you conceive them for I have I confess with a little too much confidence undertaken to open divers secrets of Nature which being very abstruse and as difficult to be comprehended create yet incomparably more trouble to explain them significantly to be well understood notwithstanding as it is often seen that a dark body
already severall in English as also here and there a passage that might offend a chast English Eye and being not absolutely necessary to our purpose the rest I have as carefully as I could rendred into English for the benefit of our Midwives some of whom may yet very well admit of an additional Knowledge The principal thing worthy their observation in this Book is accurately to discover what is properly their work and when it is necessary to send for advice and assistance that so many Women and Children may be preserved that now perish for want of seasonable help My Author marks out the breaking of the right Waters for the proper season of a naturall Delivery and when ever a Child is not born thou or soon after Nature is so much short of performing her office This is certainly a great truth and all wrong births should never be longer delaied and for the most part Floodings and Convulsions not so long lest the Woman lose her life before ever the Water breaks but if no dangerous Accident intervene in a right labour one may lengthen out their expectation to 12 hours after and though some may have been happily delivered 24 hours or two dayes after yet should I not advise any to run that hazard provided they can have an expert Physician to deliver them without destroying the Child because many have perished in that case and it is not prudent to venture where but one of many escapes for the longer the Labour continues after the Watters are broke the weaker both Woman and Child grow and the drier her bodie which renders the birth the more difficult and 't is over good taking time by the foâ—eâ—…p And that Midwifes skill is certainly the greatest and she deserves most commendation who can soonest discover the success of the Labour and accordingly either wait with patience or timely send for advice and help Nor can it be so great a discredit to a Midwife let some of them imagine what they please to have a Woman or Child saved by a Man's assistance as to suffer either to die under her own hand although delivered for that Midwife mistakes her office that thinks she hath performed it if she do but lay the Woman because her principal duty is to take care that she and her Child be well with safety and convenient speed parted and if this be impossible for her and feasible by another it will justifie her more to wave her imaginary Reputation and to send for help to save the Woman and Child than to let any perish when possibly to be prevented As in the case of my Author's Sister in the 20th Chapter of his first Book Yet in Countries and places where help and good advice is not seasonably to be had Midwives are compelled to do their best as God shall enable them which dangerous and uncertain tryals would not become them to put in practice upon Women where no timely assistance need be wanting Most wrong Births with or without pain all Floodings with Clods though little or no pain whether at full time or not all Convulsions and many first Labours and some others though the Child be right if little or no pain after the breaking of the Waters and the Child 's not following them in some six or ten houres after requires the good advice of and peradventure speedy delivery by those Physicians that are expert in this practice for though some few may escape in these cases yet far the greater number would perish if not aided by them And let me therefore advise good Women not to be too ready to blame those Midwives skill who are not backward in dangerous cases to desire advice lest it cost them dear by discouraging them and forcing them to presume beyond their knowledge or strength especially there being already but too-too-many over confident Those few things wherein I dissent from my Author if of dangerous consequence I note in the Margent if not I passe it by leaving it to the election of the Reader I must confess he is in many places too prolix a fault that many of the French affect however I chose rather to translate him according to his own stile than contract him and also to leave unaltered some things not very well expressed being of no great moment I find also that he doth not distinguish between the words Plaister and Ointment but useth them promiscuously one for the other In the 17 Chap. of the second Book my Author justifies the fastning Hooks in the head of a Child in a difficult Labour where it comes right which I confesse hath been and is the practice of the most expert Artists in Midwifry not onely in England but throughout Europe and hath very much caused the report that where a man comes one or both must necessarily dye and makes many for that reason forbear sending untill either be dead or dying But I can by no means approve of that practice or those delaies because my Father Brothers and my Self though none else in Europe that I know have by Gods blessing and our industry attained to and long practised a way to deliver a Women in this case without any prejudice to her or her Infant though all others being reduced for want of such an expedient to imploy the common way do and must endanger if not destroy one or both by the use of these Crochets By this manuell operation we can also both shorten the time and lessen the number of pains in a right Labour if there be the least difficulty without danger and with advantage to both Woman and Child If therefore the use of Hooks by Physicians and Chirurgeons be condemned without thereto necessitated through some monstrous birth we can much lesse approve of a Midwifes using them as some here in England boast they do which rash presumption in France would call them in question for their lives In the 15th Chapter of this Book my Author proposeth the conveying sharp Instruments into the womb to extract a head which is a dangerous operation and may be much better done by our fore-mentioned Art as also the inconvenience and hazard of a Child dying thereby prevented which he supposeth in the 27th Chapter of this 2d Book I will now take leave to offer an Apology for not publishing the secret I mention we have to extract Children without hooks where other Artists use them which is that there being my Father and two Brothers living that practise this Art I cannot esteem it my own to dispose of nor publish it without injury to them and think I have not been unserviceable to my Country although I do but inform them that the forementioned three persons of our family and my self can serve them in these extremities with greater safety than others The Reader also may please to know that some explanations in the Margent as lovingly p. 6. and untimely unseasonably p. 22. with some others were never intended to have been inserted
most essential and ordinary by which a Chirurgeon may be assured of it of which some may presently be perceived others not till afterwards He shall first examine and inform himself whether the Woman hath all or most part of the signs of fertility which are already named in the discourse of them if not he must impute them to some other cause and supposing she be fruitful you may then know whether she have conceived by their agreement and more then ordinary delight in the act It is not enough for a Woman to be certain she hath conceived and to yeeld and receive her seed with the Man 's into her Womb unless it close at that instant and retain it There is an Article amongst the customs of Paris in which it is said that to give and keep is not good but it is not so in Conception for a Woman gives and casts her Seed into her Womb and there retains it She may know whether she retains the Seeds if she perceives nothing flow down from the Womb after Copulation The Woman some few months after perceives also some small pain about her Navel and some little commotions in the bottom of her Belly caused by the Womb 's closing it self to retain the Seeds and contracting it self so as to leave no empty space the better to contain them and embrace them the closer The light pain of the Navel comes from the Blader of the Urine from the bottom of which proceeds the Urachus which is fastened to the Navel which is a little agitated by that contraction and kind of motion that happens to the Womb when it is closed to retain the Seeds and from the like agitation comes also those little commotions of the Belly These are the signs of Conceptions which may be known at the moment they happen and may be yet more certainly known if you perceive the inward Orifice exactly close Besides these signs there are others which cannot be known till some time after as when the Woman begins to have loathings having no other Distemper loseth her appetite to meats which she did love longs to eate strange things to which she was not accustomed which happens according to the quality of the humours predominating in her and with which her stomach abounds She hath often nauseatings and vomitings which continue a long time the Tearms stopping no other cause appearing having alwayes before been in good order her Breasts swell wax hard and cause pain from the flowing of the blood and humours to them wanting their ordinary evacuation their upper parts are firmer and larger because of the repletion the Navel starts her Nipples are very obscure or dark coloured with a yellowish livid circle round about her Eyes are dejected and hollow the whites of them dull and troubled her blood when she hath conceived some time is alwayes bad because the superfluities of it not being then purged as accustomed is altered and corrupted by their mixture Moreover there is a sign which all the Women esteem and hold in this doubtful case for very certain which is en ventre plat enfant y a in a flat Belly there is a Child Indeed there is rime in this proverb and something of reason but not as they imagin that the Womb closing it self after Conception draws in a manner the Belly inwards and flatten's it which cannot be because the Womb free and wavering not fastened forwards to the Belly whereby to draw it back after that manner but it may possibly be by reason that Women grow lean by the indispositions of their pregnancy and wax thinner and smaller not only in their Belly but also throughout their whole body as may be known the two first months of their pregnancy during which time that which is contained in the Womb is yet very small but when the Womans blood begins to flow to it in abundance then the Belly waxeth daily bigger and bigger afterwards until her reckoning be out All these signs concurring in a Woman who hath used copulation or the most part of them together and successively according to their seasons we may pass our judgment that she hath conceived notwithstanding that many of them may happen upon the suppression of the Terms which usually produce the like for every one knows that it causeth also in Virgins disgusts nauseatings and vomitings but not so frequently the swelling hardness and pains of the breasts as also extravagant appetites a livid colour of the Eyes and others to which you must have regard The Matrix may be yet exactly close and the Woman not conceived Yea there are some in whom they almost never open unless very little to give passage to the Tearms which happens to some naturally to others by accident as by some callosity proceeding from an Ulcer or other malady If all these signes of Conception which sometimes may deceive us though rarely if they concur together do not give us a sufficient assurance of it and that we desire a better Hippocrates teacheth us a way to know it which I believe to be no more certain than the rest it is in his 42d Aphorism of his 5th Book where he speaks in this sort Si velis noscere an conceperit mulier dormiturae aquam mulsam potui dato si ventris tormina patiatur concepit sin minus non concepit If you desire to know whether a Woman hath conceived or no give her going to rest a draught of Metheglin and if afterwards she feels pains in her Belly caused by wind she hath conceived if none she hath not as he saith Which is grounded as I believe upon the supposition that Metheglin breeds wind which cannot pass easily downwards because the Womb being full compresseth with its greatness the * The great Gut Intestin rectum on which it is scituated and causeth those winds to rumble which are constrained to recoyl back into the other Intestines If there be any occasion where Physicians or Chirurgeons ought to be more prudent and to make more reflections upon their Prognosticks for an affair so important as this is it is in this which concerns their Judgments as to conception and Womens being with child to avoid the great accidents and misfortunes which they cause who are too precipitate in it without a certain knowledge The faults which are committed through too much fear at such a time are in some sort excusable and to be pardoned but not those caused by temerity which are incomparably greater There are but too many poor Women who have been caused to miscarry by Medicines and bleeding not beleiving they were with Child which are so many murders they are guilty of who caused it either through ignorance or rashness besides the death which they bring to those little innocent creatures by destroying them in their Mothers belly they often thereby put the Mothers into great danger We have lately had in Paris in the year 1666 a miserable example of this kind in a Woman hanged and
Mole from which it is sometimes divided and sometimes cleaving to its body which puts it in great danger of being mishapen or monstrous because of the compression which this strange body causeth to the Infant yet very tender In the year 1665 being at Mr. Bourdelots Doctor in Physick of the Faculty of Paris where was every Monday held Academical Conferences As they fell upon the discourse of the Circulation of the Blood which I explained according to my opinion they brought thither the Infant of a Woman newly brought to bed at her full time which wanted all the upper part of the head having no skull no brain no nor any hairy scalp but had only in lieu of all those parts a Mole or fleshy mass flat and red of the thickness and bigness of an after-burthen covered with a simple membrane strong enough This Infant had however all the other parts of the body fat and well composed and shap'd This monstrous disposition was the cause of its death assoon as it was born and yet it was very wonderful and astonishing to consider how it could live so without brain as also very difficult to understand how this fleshy mass could serve in stead of it whilst it was in the Mothers belly It was interwoven with many vessels like a kind of * The fleshy part of the burthen Placenta yet of a more firm substance Mr. Clerk and Mr. Juillet my Brethren and good Friends were then present and saw this Prodigy as well as my self A Woman having a Mole hath a much worse colour and is every way more inconvenienced than a Woman with Child and if she keeps it long she lives all the while in danger of her life Some have them two or three years and sometimes all the rest of their lives As hapned to a Peuterer's Wife of whom Ambrose Paré makes mention in his Book of Generation who had one seventeen years and at last died of it We will declare the Remedies convenient for it in another place where we speak of its extraction CHAP. X. In what manner a Woman ought to govern her self during her being with Child when it is not accompanied with other considerable accidents to endeavour to prevent them A Woman with Child in respect of her present disposition although in good health yet ought to be reputed even as though she were sick during that neuter estate for to be with Child is also vulgarly called a sickness of nine months because she is then in daily expectation of many inconveniences which pregnancy usually causes to those that do not govern themselves well She should in this case resemble a good Pilot who being imbarqued on a rough Sea and full of Rocks shuns the danger if he steers with prudence if not 't is by chance if he escapes Shipwrack So a Woman with Child is often in danger of her life if she doth not her best endeavour to shun and prevent many accidents to which she is then subject all which time there must be care taken of two to wit her self and the Child she goes with for from one single fault results double mischief inasmuch as the Mother cannot be any wayes inconvenienced but the Child partakes with her Now to the end she may maintain her self in good health as much as can be in that condition which alwayes keeps a middle state let her observe a good dyet suitable to her temperament custom condition and quality which the right use of all the six non-natural doth effect The Air where she ordinarily dwells ought to be well temper'd in all its qualities if it be not so naturally it must be corrected as much as may be by different means she must avoid that which is too hot because it often causeth by dissipating too much the humours and spirits many weaknesses to Women with Child particularly also that which is too cold and foggy for causing great Rhumes and distillations upon the lungs it exciteth a cough which by its sudden and impetuous motions forcing downwards may make the Woman miscarry She ought not to dwell in narrow Lanes very dirty nor near common Dunghils For some Women are so nice that the stink of a Candle not well extinguisht is enough to bring them before their time as Liebaut assures us he himself had seen which likewise may be caused if not sooner by the smell of Charcoal as hapned once to a Laundress whom I knew hat miscarried the fourth mouth being in extream haste to finish some Linen on a Saturday night she had not patience to kindle the Charcoal in the Chimney but in the Room in a Chafingdish which flew up into her head and made her miscarry the same night and in danger of dying Let the Woman therefore endeavour as much as her convenience will permit to live in an Air free from these inconveniencies The greatest part of Women with Child have so great loathings and so many different longings and strong passions for strange things that it is very difficult to prescribe an exact dyet for them but I shall advise them in this case to follow the opinion of Hippocrates in his 38th Aphorism 2d Book where he saith Paulo deterior potus cibus suavior tamen melioribus quidem sed insuavioribus praeferendus Meat and Drink though not so wholsome if it be but pleasant is to be preferred before that which is wholsom if not so pleasant which in my opinion is the rule they ought to observe provided what they long for is commonly used for dyet and not strange and extraordinary things and that they have a care of excess If the Woman be not troubled with these loathings let her then use such a dyet which breeds good juyce and in quantity sufficient for her and her Child her appetite may regulate that She must not then fast nor be abstemious because overheating the Mothers blood thereby renders it unfit to nourish the Child which ought to be sweet and mild and makes it tender and weak or constraius it to come before its time to search what is fit for it elsewhere she must not eat too much at a time and chiefly at nights because the Womb by its extent possessing a great part of the belly hinders the stomach from containing much which causeth thereby a difficulty of breathing because it compresseth the Diaphragma which as then hath not an intire liberty to be moved Wherefore let her rather eat a little and often let her bread be pure Wheat well baked and white as is that of Gonesse at Paris or the like and not course houshold Bread or Bisket which swells up the stomach nor any other of the like nature that 's very stuffing Let her eat good nourishing meat as are the tenderest parts of Beef and Mutton Veal Fowl as fat Pullets Capons Pidgeons and Partridge either roast or boyled as she likes best fresh Egs are also good And because big-bellied Women have never good blood let her put
Veins of the Arm do upwards when bound with a Ligature for bleeding or by any strong compression upon the upper parts which happens because the Veins being compressed the Blood is there stopt finding its passage more difficult The Iliack Veins being then so pressed by the bigness and heaviness of the Womb all those of the Legs and Thighes swell in such a manner as that they empty themselves into the substance of the parts and throughout the five Coverings which thence become swelled yea and these Veins and amongst the rest the Saphenes dilated and become varicose sometimes from the inward and upper parts of the Thigh to the very extremity of the Foot in which the Blood stagnating without its free circulation is altered and corrupted which causeth great pains and swellings in all these parts This oftner befalls Women that are very sanguine walk much and use great exercise which aided with a fulness of the Vein makes a rupture of the Valvules which serve to facilitate the motion of the Blood as the suckers of a Pump which retain the water when it is raised thither which Blood falling down again not being so supported causeth by its quantity and stay these dilatations of the Veins which are called Varices For to remedy this when a Woman hath her Veins dilated let her only use whilst she is with Child a palliative cure in swaithing this Varicos-part with a swaith three or four fingers broad according to the bigness of it beginning to swaith from the bottom and conducting it upwards to the beginning of the Varices that by this means these varicos Veins which are alwayes outward being moderately closed should be hindred by this compression from further dilating and the Blood not be corrupted by the stay it makes there which after this will not want its circular motion because the greatest part of it passeth then by the Vessels deeper placed A Woman in this condition should likewise keep her bed if she can because by this scituation her body being equally layed the Blood circulates much the easier and is not then so much troubled to return by these Veins to the Heart as when it must ascend by them the Woman standing upright which is the cause the Legs alwayes are more swell'd at night than mornings if there be in any other parts of the Body signs of plenitude and abundance of Blood they may bleed her without danger There are other Women whose Legs only swell because of their weakness and not for the reason just above mentioned and are so oedematous that when you press them with your Finger the print of it remains there which is because they want natural heat sufficient to concoct and digest all the nourishment sent to them and to expell the superfluities of it which by that means remaining there in great quantity leaves them so oedematous For to resolve these sort of Tumours you may use a Lee made with the Ashes of Vines and the Decoction of Melilot Camomile and Lavender afterwards they may be somented with Aromatick Wine in which they may moisten their compresses to be laid upon them repeating them three or four times a day to fortifie them which may be made with Rosemary Bayes Tyme Marjoram Sage and Lavender of each an handful of Province-Roses half a handful Pomegranat flowers and Alum each an ounce boil them together in strong Red-Wine three pints to the consumption of a third part strain it and keep it for the use above mentioned But since Pregnancy for the most part causeth these tumours they likewise ordinarily cease when the Woman is brought to bed because then she purgeth forth the superfluity of her whole habit by means of her Lochia CHAP. XVII Of the Hemorrhoids THe menstrous Blood that used to be purged away every month being collected in a great quantity near the Womb which permits it not now to be evacuated by the usual passage being so exactly closed during Pregnancy is forced to flow back into the whole habit and chiefly upon the neighbouring parts of the Womb and causeth in many the Hemorrhoids both internal and external All the several sorts of them which we shall not describe may as well happen to them at this time as at another but we will only speak of that sort which is caused by pregnancy because our design is only to make known some particulars of the maladies Women are in this condition subject to Hemorrhoids are tumours and painful inflammations ingendred by a flux of humours upon the extremities of the Hemorrhoid Veins and Arteries and are caused in great-bellied Women by the abundance of Blood which is cast upon these parts because the body at this time is not purged of its superfluities as it was accustomed before It is likewise very often caused by the great endeavours that Women sometimes make to go to stool when they are costive because the Womb being placed upon the Rectum hinders by pressing it the excrements contained in it from being easily extruded and by these endeavours the Blood which is in the neighbouring Vessels being likewise expressed swells and blows up their extremities upon which comes these painful inflamations call'd Hemorrhoids of which some are internal some external some small and with little or no pain and some extreamly big and painful This may suffice for their general differences without coming to their particulars which would require a more ample explication If they are small and without pain either internal or external it is easie enough to prevent their further growth by Remedies which hinder and turn the flux from those parts but there is more reason to cure the great and painful ones by easing first the great pain for as long as that continues the Flux is ever augmented To this purpose if the big-bellied Woman have in the rest of her body other signs of repletion she may safely be once let blood in the Arm and sometimes if there be great necessity twice for to turn away the humours and to evacuate the fulness by which the pain will likewise be appeased If the gross excrements retained in the right Gut be the cause of it and that she be costive let her take an emollient Clyster of the Decoction of Mallows Marshmallows Pellitory and Violets with Hony of Violets to which may be added Oyl of sweet Almonds or sweet Butter being careful to add nothing that may irritate lest it augment the Disease especially when they are inward Piles And to the end the Women may then the better receive the Clyster t is fit that a small end of a Pullets gut be put upon the end of the pipe to cover it on the outside that so it may be put up the Fundament with less pain afterwards let her keep a moderate and cooling diet and continue in bed till this flux of humours be passed and the mean time anoint the Piles with hot stroakings from the Cow or foment them with the Decoction of Marsh-mallows White-broth
and the use of the Remedies specified in the precedent Chapter it may likewise be but an ordinary and menstruous Flux If then the Blood flows but in small quantity and continues a little while 't is good leaving the labour to the work of nature provided the Woman hath sufficient strength and that it be accompanied with no other evil accident but when it flows in so great abundance that she falls into Convulsions and Faintings then the operation must not be defer'd and 't is absolutely necessary she should be delivered whether she be at her reckoning or no whether she have pains or throws or not because there is no other way to save her life and the Childs then presently to do it Extreman fundet cum sanguine vocem she casts forth with her Blood her last breath Hippocrates knew very well the danger of it when he said in his 56th Aphorism of the 5th Book In fluxu muliebri si convulsio animi defectus advenerit malum If Convulsions and Faintings follow Floodings it is a bad sign There must not alwayes in these unfortunate accidents be expected pains and throws to force and bear down to forward labour for though they come at the beginning they usually cease assoon as the Flooding comes to Syncope's and Convulsions neither must it be defer'd till the Womb be enough opened forasmuch as this effusion of Blood very much moistens it and the weakness relaxeth it so that it may be then as easily dilated as if there had been abundance of strong throws Wherefore having placed the Woman in the situation we shall direct when we treat of deliveries let the Chirurgeon having his hands anointed with Oyle or fresh Butter introduce his Fingers joyned together by degrees into the Matrix and spread them open the one from the other when they are in the entry for to dilate it sufficiently by little and little without any violence if possible which being done and his hand quite within if he finds the Waters not broke let him break them and then whatsoever part of the Child presents though the Head provided it be not just in the Birth let him search for the Feet and draw it forth by them observing every curcumstance that shall be shewen in the 14th Chapter of the second Book where is described the way how to deliver a Woman the Child coming with the Feet first because there is better hold and more easie to deliver by them than by the Head or any other part of the body Wherefore if the Feet lie not ready the Chirurgeon must seek for them which at that time is easier done than at another because the great Flooding makes the Womb loose and slippery by its humidity so that it will not be difficult for him to turn the Child and bring it by the Feet as we have even now said after which he must fetch the after-burthen which in these cases cleaves but little being careful not to leave so much as a clod in the Womb lest it still continue the Flooding which being done it will soon after stop with all the accidents if too much time was not spent before the operation Many Women and Children have perished for want of this operation in this ill accident and many others have escaped death which else most certanly had followed by being timely succored Guillimen in Chap. 13 of his 2d Book of happy Deliveries makes mention of six or seven Histories to confirm this verity in some of which we may find the Women and their Children bloody victims of it for not having been in the like case delivered which others by a seasonable delivery escaped and the better to confirm it by my own experience I will recite you one amongst the rest very remarkable of the remembrance of which I am so sensible that the Ink I write with at present to publish it to the World for their propfit seems to me to be Blood because in this sad and fatal occasion I saw part of my self expire About three years since one of my Sisters not yet one and twenty years of age being about eight months and a half gone with her fifth Child and then very well in health was so unfortunate as to hurt her self though at first small in appearance by falling on her Knees her Belly a little touching the ground by the fall after which she passed a day or two without perceiving any great alteration which made her neglect to repose her self being very necessary for her but the third day or thereabouts after her hurt about eleven in the morning she was suddenly surprised with strong and frequent pains in the Belly which were immediatly followed with Floodings this made her presently send for her Midwife who no better understanding her Office told her she must have papatience till the Womb had dilated it self by the pains before she could be delivered assuring her further that she had no reason to be afraid and that she should be quickly freed from the danger because her Child came right she made her thus hope in vain three or four hours until the Flooding still continuing violently the pains began to cease and the poor Woman fell into frequent faintings and then the Midwife desired a Chiurgeon to advise with in this case they immediately sent to my house for me but unfortunately missing of me they sent for him whom they judged the ablest of all the Chirurgeons that practised Midwifery in Paris and immediatly conducted him to my Sisters where he arrived about four in the afternoon and having seen her * It were to be wish'd rather than hoped for that Practitioners in this and other the like dangerous cases whereof they have no certain knowledge would consult and not destroy one or more by undertaking what they cannot well perform or discourage Patients from sending for other help and advice putting Life in ballance with their Reputation contented himself with only saying she was a dead woman and that nothing was to be done to her but to give her all the Sacraments and that absolutely she could not be delivered which likewise the Midwife joyntly concluded who believed that the opinion of a Man so authentickly esteemed of all must be infallible Assoon as he had delivered this Prognostick he immediately returned home and would by no means stay any longer but left this young Woman in that deplorable condition without any succour whose life he had certainly saved with her Childs if he at that time had delivered her which was very easie to be done as will plainly appear by the sequel of the History After the advice of a person of so great reputation together with that of the Midwife since Monsieur N. * The great mischiefs which happen by the Prognosticks of such who have the luck though they want the merit to be esteemed could do nothing there was no other remedy for so great a danger but to hope in God alone who was Almighty
They therefore endeavoured to comfort my poor Sister as well as they could who longed for nothing more then to see me to know whether I would pass the same sentence and whether her danger which still augmented more and more was without remedy for her Blood flowed away continually in great abundance At length I returned home where they had been long before to tell me this bad news though by misfortune could not find me as I said before which as soon as I understood I immediately hastened to her with all possible speed where I saw assoon as I came in so pittiful a spectacle that all the passions of my Soul were at the instant agitated with many and different commotions having afterwards a little recovered my senses I drew near to my Sisters Bed where they had just given her the last Sacraments and she conjured me very often to give that succour which she said she only expected from me After that I had understood from the Midwife all that had passed and the opinion of the Chirurgeon that had seen her above two hours before for it was then six a clock I perceived the Blood to flood continually in great abundance and without intermission of which she had already lost above * French quarts are English pottles three quarts and which was very remarkable above twelve small Porengers in the two hours after the Chirurgeon was returned as it seemed to me by the number of Napkins and other Clothes which were all muck wet with it which Blood had stayed in her body and saved her life if she had been then delivered I saw likewise that she grew every moment weaker and weaker which convinced me that she was then in more danger than she would have been if they had not let slipt the opportunity of delivering her two or three hours before as it was possible and easie because she had then almost all her strength which she afterwards lost with the rest of her Blood which all along flooded away and desirous to know whether they could have delivered her I found by trying her body that the inward orifice of the Womb was dilated in such sort that I could easily introduce two or three fingers and having marked it I made the Midwife try again to see whether the orifice was so disposed when the Chirurgeon said that she could not be delivered and whether she was of his opinion She told me it was so and that it had been alwayes in the same condition from the time of his departure Assoon as she had made me this declaration I easily perceived his ignorance and where the shoe wring'd him Wherefore I told her that I woundred much they were both of that opinion seeing that in truth it seemed quite contrary to me because it was at that time most certainly very easie for him to have delivered her if he had pleased as it stil was what indeed I would have done at that very moment if it had been possible for me to have had power enough over my Spirit which wavered a long while about the resolution I was constrained to take after I had lost the hopes of all other help That which hindered me was not so much the Prognostick that so famous a Chirurgeon had made in perswading all the Assistants that she could not be delivered though it might seem rash to oppose the sayings of such as are esteemed Oracles neither was it the little strength the Patient had then left but it was chiefly the relation of the Person being my Sister whom I tenderly loved which troubled my spirits with such different passions to see her before me ready to expire through the prodigious loss of blood which proceeded from the same spring as mine own that it was impossible for me at that moment to resolve and obliged me to send again to the Chirurgeon who was long since returned home to entreat him to come back again to the House that my self demonstrating to him the facility I found for the operation and making him understand and confess that in those cases there is no hope unless it be undertaken as soon as may be I might perswade him to deliver her rather than to abandon the Mother so to the dispair of her life as he had done and to suffer the Infant to perish with her unbaptized which had been prevented if he had done what Art required which is at least when both cannot be saved to save the Child if possible without prejudice to the Mother which was very easie as you shall presently understand But no prayers nor sollicitations could ever prevail with him to return excusing himself that it was impossible for him to do any thing in the case When this was related to me I sent yet again to another Chirurgeon one of my Companions being a little more obliging and serviceable whom if he had come time enough I would have convinced of the necessity of the operation and made him acknowledge the facility of it but by misfortune he was abroad During all these goings and comings there was an hour and half spent which time she flooded without intermission and her weakness grew more and more wherefore seeing my self without hopes of getting the persons I sent for I resolved to deliver her presently which before was beyond my power for the reasons recited and indeed was now a little too late for the Mother for if I could have commanded my passions to have done it at the instant I arrived there would then have been great bopes to have saved her as well as I did the Child After I had thus prepared my self for it that is having directed two of my fingers into the inner orifice of the Womb being open enough to admit them into it I did in a little while after introduce a third and by degrees the ends of all the five of my right hand with which I dilated the orifice sufficiently to admit it quite in as it is very easie in the like cases because the abundance of Blood moistens and relaxeth extreamly as is already mentioned the whole Womb into which having so gently entred my hand I found the Child came right and the Waters not yet broken wherefore I presently broke the membranes with my nails and fingers and then turning the Child I took it by the feet and brought it forth very easily after the manner I shall teach in the forementioned 14th Chapter of the 2d Book all which I finished in less time than a hundred could be counted and do conscientiously protest never to have delivered a Woman sooner in all my life of those whose Children came against Nature nor easier and with less violence to the Mother who did not in the least complain during the Operation although she had her senses very well and exactly knew all I did to her and found her self very much comforted as soon as ever she was delivered and immediately after the flooding began to cease As to
Child can do nothing nor can it when it is very weak She must take the while some Comfortatives to prevent fainting because of the putrid vapours ascending from the dead Child but when it hath so great a Dropsy either in the Head or Belly as that it cannot be born because of the great distension and bigness of these parts then we are obliged to open these parts to let out the Water And if it be of such enormons bigness either Head or Body or that it have two Heads or is joined to another Child or to a big Mole there is a necessity for to save the Mother either to dilate the passage proportionable to the bigness of the monstrous Child if it be possible or else which is better to draw forth the Child by pieces to prevent the Mothers perishing together with the Child which else would certainly happen if this course be not taken And if there be two Children the Rules given in the Eighth Chapter of this Second Book must be observed But if the Midwife cannot remedy all these accidents she must then readily send for * By all which may be learnt That if the Midwife cannot lay the Woman assoon as or soon after the Water is broke she ought in time to send for advice and help an expert Chirurgeon for his advice or to do what he thinks fit Let us now pass to Labours contrary to Nature which can never be done without Manual Operation and show what is then to be done CHAP. XI Of unnatural Labours where Manual Operation is absolutely necessary and what Observations the Chirurgeon must make before he goeth about it THose Labours which absolutely require Manual Operation are when the Child comes wrong Hippocrates in his Book De Naturâ Pueri and in that De Superfoetatione admits but of three general ways for a Child to be born to wit with the Head first which is the sole * For if any part but the Crown so that the Body follow not in a strait line 't is a wrong difficult Birth though the Head presents first natural Figure when it comes right the second with the Feet and the third with the Side or across which two last are quite contrary to Nature But to make it more plain we say That a Child may come wrong four several general waies which are First any of the fore-parts of the Body Secondly any of the hinder-parts Thirdly either side And Fourthly the Feet Now just as there are four Cardinal points to which all the rest of the thirty two Winds may be reduced on the Compass and to one of the four more than to the other according as they participate of more or less of that Point so likewise all the particular and different wrong Postures that a Child may present can be reduced to the abovenamed four general waies according as they approach more to the one than the other of them And as the number of the several wrong Births is very great we will be contented only to treat particularly of each of the principal of them because if one be well informed of these they may easily remedy the rest which are of no great consequence but before we mention the means how it will be convenient to shew what conditions are requisite in a * Physician or any else that practiseth this art Chirurgeon that would apply himself to this Operation and the observations he ought to make before he undertakes it These conditions either respect his Body or his Mind in respect of his person he must be healthful strong and robust because this is the most laborious and painful of all the operations of Chirurgery for it will make one sometimes sweat that he shall not have a dry thread though it were the coldest day in Winter because of the great pains and difficulty he ordinarily meets with as Fabricius of Aquapendente testifies confessing that he hath often been so weary and tired as that he hath been forced to leave the work for his men to finish He ought to be well shaped at least to outward appearance but above all to have small hands for the easier introduction of them into the Womb when necessary yet strong with the Fingers long especially the Forefinger the better to reach and touch the inner Orifice He must have no Rings on his Fingers and his Nails well pared when he goeth about the work for fear of hurting the Womb He ought to have a pleasant countenance and to be as neat in his clothes as in his person that the poor Women who have need of him be not affrighted at him Some are of opinion that a Practitioner of this Art ought on the contrary to be slovenly at least very careless wearing a threat Beard to prevent the occasion of the Husbands jealousy that sends for him Truely some believe this policy augments their practice but 't is fit they should be disabused for such a Posture and Dress resembles more a Butcher than a Chirurgeon whom the Woman apprehends already too much that he needs not such a Disguise above all he must be sober no Tipler that so he may at all times have his wits about him he must be discreet modest and secret never discovering to strangers those incommodities and diseases of Women which come to his knowledge He must be sage prudent and judicious to conduct him alwayes in his Operations with good reason He must be pittiful yet not so as to distract or hinder him from his duty when the case requires as also so patient as not to precipitate any thing but taking time sufficient to consider what is fit to be done He must not be angry with the poor Woman though she exclaims against him or the other Women during the Operation for the Pains of the one and the compassion of the rest oblige them to it without other cause He should be a good Christian of a well regulated Conscience and do his best endeavour to bring the Children * And therefore undertake what he can safely perform and what he cannot leave to others that may for life is not to be played with alive He must deliver poor Women gratis and treat them as tenderly and with as much humanity as the Rich extorting nothing from them but be content with reasonable satisfaction as they are willing and able to give and not use them like a Turk or Arab as some do who assoon as they have done their work whether well or ill will be paid without delay and that with so much ill manners and importunity that they force the poor people presently to borrow the money when they have not enough to satisfie their desires and take from them to the last Penny to satisfie their tyrannical avarice which proceedings are very unworthy an honest man In fine a Chirurgeon indued with all these good qualities must be for his accomplishment and intire perfection very knowing and expert in his Art and chiefly
in these Operations There are many who believe it an easie matter to deliver a Woman because Women usually practise it In effect there is no great mystery when all things come right and well But when they come wrong and contrary to Nature it is most certain that it is the most difficult and laborious of all Chirurgical Operations as is well known to such as practise it It is very good to consider the consequences of it for in all others for which recourse is had to a Chirurgeon the single life of the Patient only is under his care but in Deliveries there is the Mothers and one Childs life at least and sometimes more at stake And it hath been often seen that one single fault in this Operation hath caused many disorders at one time so that one may say very justly touching delivering of Women in wrong Labours Hoc opus hic labor est Now the Chirurgeon qualified as abovesaid who is only fit for the work to behave himself as he ought must make some Observations before he undertakes it first whether the Woman hath strength enough to endure the Operation which he may guess by the Pulse if strong or weak unequal or intermittent Whether her Face and chiefly her Eyes be dejected her Speech faint the extremities of her Body cold Whether she often faints away with cold Sweats hath Convulsions with loss of sence in short If every circumstance perswades that the Operation would be in vain 't is better to let it alone than she should dye under his hand and he be blamed for it and incur the name of Butcher as is most certain when such a misfortune happens however if there be any hope though never so little either for Mother or Child we are obliged in Conscience to do what Art commands and not as some Politicians who will rather suffer a poor Woman to dye without assistance than undertake a doubtful Operation Wherefore 't is better to attempt an Operation of an incertain consequence than to abandon the Sick to a certain despair * A sufficient justification for conscientious Practisers against the malignant tongues of the ignorant for sometimes Nature recovers beyond hope but before the Chirurgeon undertakes it let him give his Prognostick of the great danger of death both Woman and Child is in which he must acquaint the Husband and Friends with and the Woman her self if he thinks that she is able to bear it that so she may receive the Sacrament before the Operation lest she be not capable of it afterwards because of the laboriousness of the Operation in which she may possibly dye as it hath sometimes happened but when the Woman hath strength enough the Chirurgeon must not delay his help for fear it abate or be totally dissipated To which purpose being well assured of her strength he must enquire of the Woman her Midwife and Friends Whether she be at her full time or hath received any hurt which he may also perceive by the Signs observing in what posture the Child presents what circumstances Whether alive or dead and but one or more all which being examined he must try to perswade the Woman of the impossibility of her being delivered without his help and to resolve to put her self into his hands which he may do by fair words without frighting of her perswading her that the Operation is nothing so painful as she may imagine and in fine that for Gods sake her own and the Childs she is obliged to suffer it for else she and her Child may both perish The Woman being thus resolved he must place her cross the Bed that he may operate the easier she must lie on her Back with her Hips raised a little higher than her Head or at least the Body equally placed when it is necessary to put back or turn the Infant to give it a better posture but if he resolves to draw it forth he must place the Woman so as we have directed in the natural Labour which is with her Head and Breast a little elevated above the rest of her Body that she may fetch her breath with more facility and help to the exclusion of the Infant by bearing down when the Chirurgeon bids her Being thus scituated she must fold her Legs so as her Heels be towards her Buttocks and her Thighs spread and held so by a couple of strong persons There must be likewise others to support her under her Arms that her Body may not slide down when the Child is drawn forth for which sometimes a great strength is required the Sheet and Blankets must cover her Thighs for decency sake in respect of the Assistants and also to prevent her catching cold the Chirurgeon herein governing himself as well with respect to his own convenience the facility and surety of his Operation as to these things Some would have the Woman bound in this posture that as they say she being more firm and stable the work may be done with greater certainty but such Ligatures are so far from that that on the contrary they are very prejudicial for the Woman being so fixed and constrained as on a Rack she cannot raise her self nor slide down or be lifted up when the Chirurgeon finds occasion for it to render his Operation less difficult which usually he doth by partly putting back partly drawing forth sometimes directly sometimes obliquely for which reason her Body ought to be at liberty only held in a posture convenient to these several intentions by her Friends according to his directions but if she must needs be bound let it be with good reasons to perswade her patiently to endure her Labour and to contribute her whole strength to the Operation promising her the speediest Delivery possible Let the Chirurgeon then anoint the entrance of the Womb with Oyl or fresh Butter if it be necessary that so he may with more ease introduce his hand which must likewise be anointed having the conditions above specified after which he must manage his Operations after the manner I shall direct in each of the following Chapters having first recited the marks by which may be known whether the Child be alive or dead CHAP. XII The Signs to know whether the Child be alive or dead IF there be any Case wherein a Chirurgeon ought to make the greatest reflection and use most precaution in his Art it is this * This is not so necessary to those Practitioners which can fetch a Child coming right or with the arm without hooks or sharp instruments as the Translator of this Book and his Father and Brother can to know whether the Infant in the Womb be alive or dead for there have been many deplorable examples of Children being drawn forth alive after they have been thought to be dead with both Arms or some other Limb lopt off and others miserably killed by the use of Crochets which might have been born alive if they had not been mistaken Wherefore
cleave to it notwithstanding that it is then a little wrinkled and uneven because its Membranes which were very much enlarged contract themselves immediatly after the Child and its Waters which kept them extended are excluded * Be careful of those that are not but they that are expert in this Art can easily judge of it If you find the Burthen wholly loosened from the Womb it will not be difficult to draw it forth when you have got it in your Hand but if it cleaves finding the side where it sticks least begin there to separate it gently by putting some of your Fingers between it and the Womb continuing by little and little to do so till it be quite loose and afterwards to draw it forth very carefully observing the whilst if it cannot be otherwise rather to leave some part of it 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 preserving it as whole as these reflections will permit because of shewing it to the company that they know the Operation is well done When the Chirurgeon finds not the Womb open enough for to direct his hand immediatly into it let him * Danger in delays presently anoint all the Womans Privities with Hogs-grease that they may be dilated with more ease afterwards let him by little and little put up his Hand but without much violence the Woman may likewise contribute to this dilatation as also to the exclusion of the Burthen if she bears strongly down holding her Breath and exciting her self to vomit or sneeze and do those other things directed in the above mentioned Chapter but if notwithstanding all this she cannot void the Afterbirth and if the Womb cannot be dilated enough to fetch it or that it cleaves so fast as it cannot be separated then to avoid a greater mischief we must leave it to Nature assisting her with remedies which suppurates wherefore Injections into the Womb are proper made of Mallows Marsh-mallows Pellitory and Linseed in which is mixed a good quantity of Oyl of Lillies or fresh Butter This injection softens and tempers and by moistning and mollifying makes the Orifice to be the easier dilated and helps by Suppuration the loosenings of the Burthen And to hasten the expulsion of it 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 rendered it in the Bed-pan and sometimes when they have least expected it One may at the same time to prevent a Fever and many other accidents which usually happen bleed her in the Arm or Foot according as it may be necessary and convenient and strengthen her that the Foetus and cadaverous Vapours coming from the putrifaction of the Burthen ascend not to the Noble parts which may be done by good Cordials often used not such as are made of Theriacle Mithridate or the like for which no reason can be given but their specifick or rather imaginary Faculties and are fitter to cause Vomiting than comfort the Heart but true Cordials are such as yeeld good nourishment and at the same time comfort the Stomach without nauseating it as those Drugs do which are only good for them that sell them Wherefore let her have good Broaths and Gellies she may drink Limonade or Orengade or have in her Ptisan Syrup of Limons or Pomgranats or from time to time if she be weak and free from a Fever a little Wine and Water mixed which we say is the best in some cases but not alwaies and most natural of all Cordials besides other Remedies may be provided according to the accidents which happen by reason of the staying behind of the Burthen always endeavouring to bring it away assoon as possible for as long as it stays in the Womb the Woman feels continually great Pains almost like to them before her Child was born although there remained but a small piece of it 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 Burthen retained the more difficult it is sometimes to be expelled because the impulses which the Woman can make by helping her Throwes are not so great when the matter contained in the Womb is small as when it is of a considerable bigness for then it is more strongly thrust and compressed which is the reason why a Woman miscarries with greater difficulty than when brought to Bed at her full time There are many Midwives who having broken the Navel-string as * This may happen to a good Midwife but the fault is when they do not discover it that seasonable help may be applied abovesaid leave their work imperfect and commit the rest to Natures work but very often the poor Woman dies because of the great mischiefs which happen usually before the suppuration of the Burthen so retained To avoid which assoon as they meet with the like case they must endeavour to fetch it according as we have directed or if they find themselves not capable to do it because the Hand must be put up into the Womb which is more properly the work of a Chirurgeon expert in those cases let them presently send for one that so he may be yet able before the Womb closeth to introduce his hand for the longer it is deferred the more difficult will be the work There are other Midwives bold enough to undertake this Operation but for want of industry or necessary knowledg they cannot effect it and leave the Woman oftentimes in a worse condition than if they had never medled with it as happened about a year or little more since to a poor Woman in the Fauxbourgh Sâ— Marcel whom I helped three days after she was delivered being half gone by a Midwife of the same Fauxbourgh at the desire of Mr. Bessier a Chirurgeon and my good Friend who conducted and accompanied me to her where I found her in continual pain all over her Belly which held her like throws of another Travail voiding black humours extremely stinking and offensive with which she had also a great pain in her Head and a Fever which in a short time would without doubt have augmented if I had not presently fetched what remained wherefore having enquired of the persons present in her Chamber how she was delivered and when they told me not yet three whole days but that the Midwife not being able to fetch all did only bring away some small pieces of the Burthen told them * An excuse of some of our Midwives that they need not be troubled at what remained perswading them alwaies that it would come away of it self and that nothing more was to be
done but patience Truly she was not so much to be blamed for not having delivered this Woman as she was in not acquainting her that she needed more help when she found that it was beyond her skill After this information having put up two of my Fingers into the Vagina to understand the present estate of things I found the inward orifice of her Womb almost quite closed into which however I got my Fore-finger where by moving it to and again without taking it away by little and little I dilated her Orifice so as to introduce another Finger with which two alone being not able to get in the rest I brought away three pieces of the Afterbirth of the bigness of a Walnut which were left behind taking them one after the other with my two fingers as Crabs do when they gripe any thing with one of their forked Claws by which means in a small time I delivered this Woman quite who immediatly after felt no more pain and recovered soon after but otherwise she had certainly been in danger of her life because of the great corruption of what was left behind in the Womb for that which I fetcht away smelt so ill that my Hands stank of it above two days after although I washed them three or four times with Vinegar This Chapter may suffice to show how one should behave himself in this Case We will now teach what is fit to be done in each of the other Labours against Nature CHAP. XIV To deliver a Woman when the Child comes footling Chap XIV lib. 2. pag 218 Now since he is obliged very often because of these ill scituations to draw the Children forth by the Feet I am therefore resolved before I speak of the rest to most of which that must be a guide to show how a Child must be brought forth which comes either with one or both Feet first Most Authors advise in this case to change the Figure and place the Head so as it may present first to the Birth but if they would show how it should be done we might follow their counsel which is very difficult if not altogether impossible to be performed if we desire to avoid the dangers that by such violent endeavors the Mother and Child must necessarily be put in wherefore 't is better to draw it forth by the Feet when it comes Footling than to venture a worse accident by turning it * That is assoon as the Waters are broke Assoon then as 't is known the Child comes thus and the Womb is open enough to admit the Chirurgeons hand into it or else by anointing the Passages with Oyl or Hogs grease to endeavour to dilate it by little and little using to this purpose his Fingers spreading them one from the other after they are together entred and continuing so to do 'till it be sufficiently dilated then having his Nails well pared and no Rings on his Fingers his Hands well anointed with Oyl or fresh Butter as also the Woman placed after the manner as we have already often directed let him gently introduce his Hand into the entry of the Womb where finding the Childs Feet let him draw it forth in that posture we shall now direct but if it presents but one Foot he should consider whether the right or left and in what fashion it comes for these reflexions will easily inform him on what side the other may be which assoon as he knows let him seek it and gently draw it forth together with the first but let him also be very careful that this second be not the Foot of another Child for if so he may sooner split both Mother and Children then draw them forth which may easily be prevented if having slid his hand up the first Leg and Thigh to the Twist he finds both Thighs joined together and depending from one and the same Body which is likewise the best means to find the other Foot when it comes but with one All Authors for fear of losing hold of the first Foot advise to fasten a Ribban to it with a running knot that so it may not be sought a second time when the other is found but that is not absolutely necessary because usually when one hath hold of one * Not alwaies the other is not far off they that will may use this precaution but such as are expert use it but seldom Assoon then as the Chirurgeon hath found both the Childs feet he may draw them forth holding them together he may bring them by little and little in this manner taking afterwards hold of the Legs and Thighs assoon as he can come at them and drawing them so till the Hips be come forth the whilst let him observe to wrap the parts in a single Napkin to the end that his Hands being already greasy slide not on the Infants body which is very slippery because of the viscous humours which are all over it and hinder that one cannot take good hold of it which being done he may take hold under the Hips to draw it so forth to the beginning of the Breast and then let him on both sides with his hand bring down the Arms along the Childs body which he may then easily find and be careful that the Belly and Face be downwards lest being upwards the Head be stopt by the Chin over the Share-bone wherefore if it be not so he must turn it to that Posture which is easily done if taking hold on the body when the Breast and Arms are forth in the manner we have said he draws it with turning it in proportion on that side which 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 him lose no time desiring the Woman at the same time to bear down that so in drawing the Head at that instant may take its place and not be stopt in the passage Some Authors to prevent this inconvenience advise that one Arm only should be drawn forth and the other left to prevent the closing of the Womb on the Neck of the Child this reason is plausible yet if the Chirurgeon knows how to catch his opportunity he will not need this shift to prevent this accident which may sooner happen when one Arm is left above for besides that by its bigness it would take up so much place which is already too little causing the Head to lean more on one side than the other it will stop it certainly on that side where there is no Arm and when I have sometimes tryed to deliver a Woman leaving one of the Arms above with the Head I could not till I fetched both Arms and then I finished my operation with more ease 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 to prevent it in this case he must not endeavour only
emptied by piercing the Belly but there wanting a fit instrument for the purpose I immediatly sent to advertise one of the Chirurgeons of the same Hospital to whom I declared the case as I found it adding withal that the Child could not be born unless an orifice was made to empty the Belly but he would by no means follow my opinion whether it was out of policy believing it may be that he very well understood his business without needing my advice or that he would not or could not believe the Child to be hydropical as I informed him wherefore he contented himself without an exact examination of the case to endeavour only the extraction of it after his manner and to effect it he immediatly pulled and separated the Head wholy from the Body which hung then but by a skin because the Midwives as I said before had pulled it with so much violence Afterwards with his Crochets he pull'd away both the Arms and some of the Ribs part of the Lungs and the Heart one piece after another for above three quarters of an hour that he was very wet with Sweat although it were cold weather and having thus tired both his mind and body he was constrained to quit the work to rest a while leaving the Midwife to endeavour what she could the whilst who wearied her self also in vain as well as he had done by pulling some of the Childs Ribs with her hands only * Though some here in England blindly adventure on the use of them to the loss of many lives which cannot be approved for the reason given in the Translators Epistle to the Reader for it is not a Midwifes work to use Crochets After this he returns the second time with all his strength to the work without effecting any more because he had not yet opened the lower belly nor the Diaphragma nor would not as I advised him every moment without which it was absolutely impossible to draw forth the rest of the Body When he saw that his second endeavors were as ineffectual as his first he gave me at length his Crochet telling me that I might weary my self as well as the others which I willingly and with joy accepted for I was very certain I could finish the operation knowing very well that instead of amusing my self as they had done about pulling of it I ought only to pierce the Infants belly to let out the Waters after which all the rest would very easily follow For which purpose I put up my left Hand into the Womb just to the right side of the swelled Belly and then with my right Hand I guided the Crochet like to that marked A amongst the representation of the Instruments at the end of this Second Book instead of which it were better to use the crooked Knife marked there D along my left hand into the Womb and then I turned the point of it towards the Infants Belly in which I struck it so that I made a hole big enough to receive two of my Fingers ends which I put into it after it was in the world and then stretching it a little all the Waters were immediatly emptied so that with one Hand I easily drew forth the rest of the Body to the astonishment of this Chirurgeon whom I could never perswade that the Infant was so full of the Dropsy After it was thus drawn forth I had the curiosity to fill up the Belly with Water by the hole I had made to the end we might see what quantity of Water had been there contained and of what bigness it might be when filled I poured in without lying above five Quarts which I should hardly have believed if I had not seen it my self and when the Belly was filled with Water it was of the bigness and figure of a very great Foot-ball I have set down here all the circumstances of this History that the Chirurgeon may know how to behave himself on the like occasion Chap XX. lib. 2. pag 237. CHAP. XX. How to help a Woman when the Child comes with one or both Hands together with the Head FOr the most part when an Infant presents any part of his Body together with the Head it is usually one or both the Hands rather than any other which hinders its Birth because the Hands take up part of the Passage and for the most part they cause the Head to lean on one side When the Child comes thus it is quite contrary to Nature To remedy this assoon as 't is perceived that one Hand presents together with the Head it must be prevented from coming down more or ingaging further in the Passage wherefore the Chirurgeon having placed the Woman on the Bed with her Head a little lower than her Hips must put and guide back the Infants Hand with his own as much as may be or both of them if they both come down for to give way to the Childs Head which having done if the Childs Head be on one side it must be brought into its natural Posture in the middle of the Passage that it may come in a strait line proceeding further as I have directed before in the 18th Chap. of this Book which treats of the Childs Head coming on one side CHAP. XXI How to deliver a Woman when the Child presents one or both Hands foremost without any other part WHen an Infant presents only one or both Hands to the birth or an Arm sometimes out to the Elbow and many times to the Shoulder it is one of the worst and most dangerous Postures a Child can come in as well for himself as for his Mother because of the violent force the Chirurgeon is * Not alwaies though often times alwaies obliged to use both to the one and the other in searching for the Feet which are very far off by which he must alwaies in these Cases turn and draw him forth which will often make him sweat in the midst of Winter because of the difficulty in this Labour more than in all the rest though some others of them indeed are more dangerous for the Infant as when it presents the Belly and the Navel-string comes forth but not so painful for the Chirurgeon because the Feet of the Infant being near the Passage are not so hard to be found as when he comes with a Hand for then they are high at the very bottom sometimes of the Womb where he must seek them for to turn it and draw it forth as I am going to direct Chap XXI lib. 2. pag 238. Chap XXII lib. 2. pag 241. But above all when the dismembring of an Infant is thus intended or to draw it forth with a Crochet * This caveat unnecessary to those who understand the Art aright let the Chirurgeon take great care that he be not deceived well considering whether it be assuredly dead and not to operate on this wise unless he be very certain of it by all the signs mentioned in
Hand that so he 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 he finds it easiest he shall fetch the Feet and turning it bring them to the Passage and so deliver the Woman as is already directed If it be the Back which presents to the Birth it is also impossible to be born in that Posture what Pains soever the Mother endures and besides the Child having the Body folded inwards and almost double his Breast and Belly are so prest together that he usually wants little of being suffocated to avoid which the Chirurgeon must quickly slide up his Hand along the Back towards the inferiour parts until he meets the Feet for to bring it forth the same way as if it came Footling But when the Child comes with the Breech if it be small and the Mother big having the Passages very large he may sometimes with a little help be born so for though he comes double yet the Thighs being folded towards the Belly which is soft and gives way it passeth without much trouble Assoon as the Chirurgeon finds the Child to come with the Buttocks foremost he must not permit it to engage lower in the Passage for it will not come so unless it be very small and the Passage very large as we have already said This being then in good time perceived he must if he can thrust back the Breech and sliding up his Hand along the Thighs to the Legs and Feet of the Child he must bring them gently one after the other forth of the Womb by folding stretching wagging and drawing them gently towards the side being careful not to winde them too much or cause a dislocation and then let him draw forth the rest of the Body as if it came with the Feet foremost I have said that the Chirurgeon perceiving the Child to come with the Breech foremost ought to put it back if he can for sometimes he will be advanced so forward in the Passage that you may sooner destroy both Mother and Child than reduce it back when once strongly engaged When this happens he cannot hinder it from coming in this Posture in which his Belly is so pressed that he often voids the * Childs ordure meconium by his Fundament However he may much help this Birth by sliding up one or two Fingers of each Hand on each side of the Buttocks for to introduce them into the Groins and having crooked them inward he must draw the Breech just out to the Thighs then by drawing and wagging it from side to side he will disengage them from the Passage as also the Feet and Legs one after the other being careful of dislocating any part and then he may extract the rest as before when coming with the Feet The first Woman I ever layd was of a Child which I drew †This way ought to be avoided if possible thus forth with the Buttocks foremost being constrained to it because assoon as ever the Waters broke which happened before I could arrive to hinder it they were so forward that it was impossible to do it otherwise which I performed very well and in short time without prejudice to the Mother or Child doing as I have directed CHAP. XXV Of those Births wherein the Infant presents Belly Breast or Side THe Back-bone may easily be bent and turned forwards a little but by no means backwards without excessive violence Wherefore the worst and most dangerous Figure that a Child can offer in the Womb to the Birth is the Belly or the Breast for then its Body is constrained to bend backwards and whatever Throws or endeavours the Woman makes to bring it forth it will never be accomplished for she will sooner perish with her Child than ever advance it in this posture into the Passage wherefore it is in great danger if not timely succoured And in case it should escape which would be very strange it would be a long while after its birth weak in the Back But that which augments the danger much more is that for the most part the Navel-string comes forth when the Child comes with the Belly Therefore assoon as it is discovered to be so the Chirurgeon must apply the sole remedy of drawing it forth by the Feet as speedily as may be in the following manner Chap XXV lib. 2. page 248. When a Child comes with Breast or Belly the Chirurgeon must always proceed after the same manner in both inasmuch as they require the same circumstances An Infant may likewise come with the Side which way it is as impossible to pass as the two former but it is not so much tormented nor is this scituation so cruel for it may remain in it a longer time without dying than in the two former wherein it is much more racked than in this in which the Body may be bended forward and not backward as in the other neither doth the Navel-string come forth so easy as when it comes with the Belly first In this as in the other two Births the Chirurgeon must draw the Child forth by the Feet on this fashion having placed the Woman as she ought to be he may push back a little with his hand the Infants body the better to introduce it which he may slide along the Thighs till he finds the Legs and Feet by which he must turn it and afterwards draw it forth just in the same manner as before with the same observations Nor ought he to amuse himself in any of these three Births for to place the Head right that it might come naturally because it 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 CHAP. XXVI Of Labours wherein several Children present together in the different Postures above named IF all the unnatural Figures and Scituations which we have hitherto described that a single Child may come in do cause those many difficulties and dangers mentioned surely the Labour wherein several together come in these bad scituations must be much more painful not only to the Mother and Children but to the Chirurgeon also for they are then so constrained and pressed that for the most part they trouble each other and hinder both their births besides the Womb is then so filled with them that the Chirurgeon can scarce introduce his Hand without much violence which he must do if they are to be turned or thrust back for to give them a better position than wherein they present Chap XXVI lib. 2. pag 250. Sometime since I delivered two Women within a Week one of the other both of Twins one of each being dead and the other living the living Child of the first Woman was born before the dead and the dead of the second was expelled before the living And the same thing happens every day in respect
of strong and weak Children for that which is nearest the Birth whether alive or dead strong or weak is always first born or must be brought first if it cannot come of it self otherwise the difficulty of the Labour 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 second first In the 8th Chap. we shewed speaking of natural Labours how a Woman should be delivered of Twins coming both right it now remains to direct what ought to be done when they come either both wrong or one of them only as it is for the most part the first coming right the second Footling or any other worse Posture and then must the Birth of the first be hastened as much as may be that so there may be presently way for the second which hath suffered much by this unnatural Position to fetch it by the Feet without trying to place it right although it were somewhat inclined to it because it hath been already so tired and weakened as also the Woman by the Birth of the first that there would be more danger that it would sooner dye than come of it self Sometimes when the first is born naturally the second offers the Head likewise to the Birth in this Case 't is good committing a work so well begun to Nature to finish provided she be not too slow for a Child may dye although right by lying too long in the Birth and the Woman who hath been much tormented with bearing the first is usually so tyred and discouraged when she thinks that but half her work is over that she hath no more Pains or very few and slow nor any considerable Throws to bear the Second as she had done the First Wherefore if the birth of the Second proves tedious and the Woman grows weaker let the Chirurgeon defer it no longer but direct his Hand gently into the Matrix to find the Feet and so draw forth the second Child which will easily be effected because there is way made sufficient by the birth of the first and if the second Waters be not broke as it often happens yet intending to fetch it Footling he need not scruple to break * Skins or skirts the Membranes with his Fingers although elswhere we have forbidden it but that must be understood with distinction for when a Labour is left to Natures work they must break of themselves but when a Child shall be extracted by Art there is no danger in breaking them nay contrarily they must be broke that the Child may be the easier turned which else would be almost impossible Above all the Chirurgeon must be careful not to be deceived when both Children together offer to the Birth either their Hands or Feet and must well consider in the Operation whether they be not joined together or any otherways monstrous as also which part belongs to one Child and which to the other that so they may be fetcht one after the other and not both together as would be if it were not duely considered taking the right Foot of the one and the left of the other and so drawing them together as if they belonged both to one Body because there is a left and a right by which means it would be impossible ever to deliver them but it may easily be prevented if having found two or three Feet of several Children presenting together in the Passage and taking aside two of the forwardest a right and a left and sliding his Hand along the Legs and Thighs up to the Twist if forwards or to the Buttocks if backwards he finds they both belong to one Body and being certain of it he may then begin to draw forth the nearest without regard which is strongest or weakest bigger or less living or dead having first put a little aside that part of the other Child which offers to have the more way and so dispatch the first whatever it is assoon as may be observing the same Rules as if there were but one that is keeping the Breast and Face downwards with every circumstance directed where the Child comes Footling and not fetch the Burthen till the second Child be born because there is commonly but one for both which if it were loosened from the sides of the Womb would cause a flooding for the reasons already alledged that the orifices of the Vessels to which it was joined would continue open by this separation as long as the Womb was dîstended by the other Child yet within it and never close as it often happens till being quite emptied of all it begins to contract it self and retire as a man may say within it self When therefore the Chirurgeon hath drawn forth one Child he must separate it from the Burthen having tyed and cut the Navel-string and then fetch the other by the Feet in the same manner and afterwards bring the Burthen with the two strings as hath been shewed in the proper place If the Children offer any other part than the Feet the same course must be taken as is directed in the foregoing Chapters where the several unnatural Figures are discoursed of alwayes observing for the reasons abovementioned to begin the Operation with the Child that is lowest in the Passage and in the most commodious Figure for extraction Chap XXVII lib 2. pag 255. CHAP. XXVII Of a Labour when the Navel-string comes first AN Infant doth not alwaies present with the Belly when the Navel-string comes first for though he presents naturally as to the Figure of his Body that is with the Head first yet sometimes the Navel-string falls down and comes before it for which cause the Child is in much danger of death at least if the Labour be not very quick because the Blood that ought to pass and repass through those Vessels which compose it for to nourish and enliven the Child whilst he continues in the Womb being coagulated hinders the circulation wh ch 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 Navel-string But though this accident may cause the Infants suddain death 't is not so much for wart of nourishment without which he might pass a day or more there being blood enough in his Body for that purpose but because the Blood can be no longer vivified and renewed by Circulation as it hath continual need which being obstructed alwaies 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 hindered and intercepted by the coming forth of the String it need not therefore cause such a sudden death to the Child because
neglect committed towards her in her tending For this Reason one must not be of the opinion of many Nurse-keepers who will have a new-laid Woman to be well fed as well to restore her lost strength by the tediousness of the Labour and by the quantity of Blood then evacuating for which cause they believe the Woman must be well nourished to make more Blood as also to fill up her Belly which is very much emptied by the Birth of the Child but it is much better to follow in this the counsel which Hippocrates gives us in his Tenth Aphorism of the Second Book where he saies Impura corpora quo plus nutriveris eo magis laeseris The more you nourish impure Bodies the more you hurt them Now it is certain that a Woman newly delivered is of this sort as you may know by the quantity of Cleansings and Superfluities which flow from her Womb at this time when for this reason they must be very regular in their Diet especially the three or four first daies in which time she must be nourished only with good Broaths new laid Eggs and Jellies without using at the beginning more solid Meats but when the great abundance of her Milk is a little past she may with more safety eat a little Broath at her Dinner or a small piece of boil'd Chicken or Mutton as she likes best afterwards if no accident happens they may by degrees nourish her more plentifully provided in the mean time that it be a third part less than she was accustomed to take in her perfect Health and that her Food be of good and easie digestion not suffering her to eat any of those Cakes Tarts or other Pastries which are usually provided at the Childs Baptism As for her Drink let it be Ptysan which is Liquorish Figs and Aniseeds boiled in Water or at least boil'd Water being careful not to give it her too cold she may also provided she be not Feaverish drink a little white Wine well mixed with Water but not till after the first Five or Six days Although I prescribe this Rule in general for all those who are newly brought to Bed yet there are some who must not observe it so exactly as laborious Women who being of a very strong and rebust constitution require a more plentiful feeding to whom notwithstanding if they do not change the quality they must at least retrench the quantity of their ordinary food having alwaies respect to what every person accustom themselves to which the same Hippocrates doth likewise teach us in the 17th Aphorism of the first Book where he saith Animadvertendi sunt quibus semel aut bis quibus copiosior aut parcior aut per partes Cibus est offerendus dandum verò aliquid tempori regioni aerati consuetudini Great care and notice must be taken to whom to give meat once only or twice as also to whom to give more or to whom less or by little and little but some allowance must be made in respect of Time Countrey Age and Custome What we have already said shall suffice for direction in their Meat and Drink The Child-bed Woman must likewise keep her self very quiet in her Bed lying on her Back with her Head a little raised and not turning often from side to side that so the Matrix may be the better setled in its first Scituation she must free her self at that time from all care of business leaving it to the management of some of her Kindred or Friends let her talk as little as may be and that with a low voice and let no ill news be brought to her which may affect her because all these things do cause so great a commotion or perturbation of her Humours that Nature not being able to overcome them cannot make the necessary evacuation of them which hath been the death of many The Citizens Wives have a very ill Custom which they would do very well to refrain that is they cause their Children to be baptized the second or third day after their Labour at which time all their Relations and Friends have a Collation in the Child-bed Room with whom she is obliged to discourse and make answers to the Gossips and all Comers a whole After-noon together with the usual Complements of those Ceremonies enough to distract her and though there is scarce any of the Company which do not drink her Health yet by the noise they make in her Ears she loses it besides all this she is often constrained out of respect to forbear the use of her Bed-pan and other necessaries which are very prejudicial to her and this happens just at the time when she ought to have most rest because about the third day the Milk flowes in greatest quantity to the Breasts this is the reason why ordinarily the next day they have a very great Feaver She ought alwaies to keep her Body open with Clysters taking one once in two daies which not only evacuate the gross Excrements but also by drawing downwards cause her to cleanse the better When she hath observed this Rule a fortnight or three weeks which is very near the time of having cleansed sufficiently that those parts may be throughly cleansed before she goes abroad and begins upon a New score let her take a gentle Purge made of Senna Cassia Syrup of Succory with Rhubarb which is good to purge the Stomach and Bowels of those ill Humours Nature could not evacuate by the Womb as it did the other Superfluities this Purge may be repeated if necessary all which being done and that no indisposition remain she may bath once or twice or to wash and cleanse her Body and afterwards she may govern her self according to her former Custome CHAP. IV. How to drive back the Milk in those Women who are not willing to give suck THere are many Remedies used to this purpose some of which hinder the afflux of humours to the Breast and others dissipate and in part dissolve the Milk therein contained Those which hinder the Humours from plentifully flowing thither are Oile of Roses well mixt with Vinegar with which the Breasts are to be anointed all over or Unguentum Populeum with Ceratum refrigerans Galeni equally mixt and extended upon a piece of Linnen or gray Paper and so applyed to the Breasts Others use Linnen dipt in luke-warm Verjuce in which a little Allom is dissolved that so it may be more Astringent and others lay to them the Lees of Red Wine alone or mixt with Oyl of Roses Those Remedies which dissolve and dissipate the Milk from the Breast is a Cataplasme of the four * Of Linseed Fenugreek Beans and Fitches Branns Honey and Saffron boiled with the Decoction of Chervil or Sage Others apply Honey only and some others rub the Breast alone with Honey and put upon it the Leaves of Red-Cabbadg the great Stalks first being taken away and they a little deadned before the fire this remedy doth very
readily drive away the Milk There are some which boil Sage and Box Leaves in Urine with which they do foment the Breasts pretty warm and lay a Cloth upon them dipt in it But great care must be taken in the application and change of these things that the Woman catch not the least cold as also that no Inflammation or Impostumation be caused instead of driving back the Milk Wherefore such Remedies are to be chosen as are restraining repercussive or resolving according to the different dispositions required I know some Women who hold it for a very great secret and most certain and fit to drive the Milk effectually back and that is to put on her Husbands shift yet warm immediatly after he hath taken it off and wear it until the Milk be gone but in case the Milk doth in the mean time vanish 't is superstitious to believe that this Shirt is the cause of it and that it can produce such an effect it happens rather because all the humours of the Body of their own accord taking another course than to the Breasts do not daily flow in so great abundance to them Wherefore in the use of all these Remedies the principal must not be forgotten which is to take care that they tend downwards procuring to that purpose a good and ample evacuation of the * Cleansings Lochia which is much furthered by keeping the Belly open by Clysters provoking them in doing whereof the Milk will soon vanish All that we have said in the former Chapters of this Third Book is only to be observed when the new-laid Woman hath no manner of Indisposition for in case that any happen she must be governed in another manner and according as the Accidents require of which we intend now to treat in the following Chapters CHAP. V. Of several Diseases and Symptomes which happen to a Woman new laid and first of Flooding WE have elsewhere mentioned the Flooding which precedes Labour and shewed the only means to remedy it which is to deliver the Woman assoon as possible let us now see what is fit to be done to that which happens immediatly or in a little time after proceeding from the late opening of the orifices of the Vessels of the Womb by the loosening of the Secondine which cleaved to it this Blood flowes then so much more abundantly by how much it is subtiler and hotter or by the agitation of a long and hard Labour and besides when a Woman is Sanguine or Plethorick This Accident may often happen by a too sudden or violent pulling away of the After-Burthen and sometimes from some part of it being left behind in the Womb or else some false Conception which then endeavouring to expel it presses and forceth forth the Blood out of the Vessels newly opened and sometimes a great Clod of Blood remaining in the bottom of the Womb will produce the same effect which by reason of the distention it often causes excites Pains like to those a Woman endures before Labour and doth not cease tormenting her until she hath voided it and then she is at ease but sometimes the Blood continuing still to flow and remaining in the bottom of the Womb becomes new Clods which is the cause why the accident renews again as before and continueth so by fits in the intervals of which there comes away some Serosities of the Blood retained which dissolves and makes some persons ignorant of the Art to think that the Flux is stopt although it still continues flowing within where it stops only by some blood so coagulated but when this Clod comes away the Flooding begins again pure Blood and in great abundance Flooding is a more dangerous Accident than any other which may happen to a Woman newly laid and which dispatches her so soon if it be in great quantity that there is not often time to prevent it Wherefore in this case convenient Remedies must be speedily applied as well to stop it as to turn it back from the places whence it flowes To which purpose 't is fit to consider what causeth this Flooding and if it be a false Conception piece of the Burthen or clodded Blood remaining behind all diligence must be used to fetch them away or to cause a speedy expulsion of them but if when nothing remains behind in the Womb the Blood doth notwithstanding continue to flow you must bleed the Woman in the Arm not so much thereby to empty the fulness as to make diversion let her Body be laid equally flat and not raised that so the Blood may not be sent down to the lower parts let her keep her self very quiet without turning from side to side that so the Humours may not be stirred the upper part of her Belly must likewise not be swathed or boulstered for such straitness augmens the evil let her Chamber be kept a little cool and let her not be too warm covered in her Bed that so the flooding through Heat may not be continued All the world forbids Clysters in this case lest as they say the humours be drawn down in great abundance but I have twice experimentally found the contrary where great Floodings have been stopt by Clysters of which I will give you a particular account that so it may be useful on the like occasion I was three years since called to a Woman who was surprized with a very great Flooding immediatly after the Midwife had delivered her which she had done with too much violence as the good Woman assured me who told me She felt a very great pain at the instant she pull'd away the After-birth and that she perceived at the loosening of it a Crack Now from the moment that she was so delivered she lost for five or six daies continually so great abundance of Blood that I could scarce believe she could without dying had I not seen it my self during all this time they had to no purpose used all the means they could imagine to stop this accident and because with it she complained of great pains in her Belly they gave her Anodine and cooling Clysters for fear lest giving her others more strong the Flooding would be more and more excited She had taken so four or five Clysters which came away as they were given without any Excrement which seeing and judging that assuredly some gross Excrements being retained in the Intestines from before the time of her Labour which could not be evacuated by these Anodine Clysters did cause so great a Chollick which she felt all over her Belly which appeared puft up I caused her to take one common and one pretty strong Clyster contrary however to the opinion of most persons who not knowing the cause of the distemper bade me have a care lest it should as they said cause a greater Flooding but the issue of it was quite otherwise than they expected for the good Woman voided with this Clyster a Pan full of gross Excrements which having staid there a long
being taken away lay some fine Rags dipt in Oyl of St Johns-wort on each side the bearing-place and renewing them twice or thrice a day foment these parts with Barley Water and Honey of Roses to cleanse them from the Excrements which pass and when the Woman makes Water let them be defended with fine Rags to hinder the Urine from causing smarting and pain by touching them Sometimes the Bruises are so great that the Bearing-place is inflamed and a very considerable Abscess follows which I have met with in which case it must be opened just below the swelling in the most convenient place and after the matter is evacuated a Detersive Injection must be injected into the Cavity with the same Fomentation above-mentioned viz. Barley-water and Oyl of Roses which may be a little heightned with Spirit of Wine if there be any danger of Corruption and afterwards the Ulcer must be dressed according to Art But sometimes it happens by an unlucky and deplorable accident that the Perinaeum is rent so that the Privity and Fundament is all in one if it were so let alone without reunion the Woman afterwards happening to be with Child would indeed be delivered with more ease and without danger of suffering the same again as is usual when healed after such an accident but likewise if it remains in this manner 't is so great an inconvenience that her Ordure comes both waies Wherefore having cleansed the Womb from such Excrements as may be there with red-Wine let it be strongly stitched together with three or four stitches or more according to the length of the separation and taking at each stitch good hold of the flesh that so it may not break out and then dress it with an agglutinative Balm such as is Linimentum Arcei or the like clapping a Plaister on and some linnen above it to prevent as much as may be the falling of the Urine and other Excrements upon it because their acrimony would make it smart and put it to pain and that these parts may close together with more ease let the Woman keep her Thighs close together without the least spreading until the cure be perfected But if afterwards she happen to be with Child she will be obliged to prevent the like mischief to anoint those parts with emollient Oyls and Ointments and when she is in Labour she must forbear helping her Throws too strongly at once but leave Nature to perform it by degrees together with the help of a Midwife well instructed in her Art who being warned by the first disgrace will do her best to avoid a second for usually when these parts have been once rent it is very difficult to prevent the like in the following Travail because the Scar there made doth straighten the parts yet more wherefore it were to be wished for greater security against the like accident that the Woman should have no more Children Now if by neglecting such a rent the Lips of it be cicatriced and that Cure be desired you must with a good pair of Scissers cut off those Scars in the same manner as is done in a Hare-lip and it must afterwards be drest accordingly or as if it newly happened CHAP. VIII Of after-Pains which happen to a Woman new-laid and of their several causes THe most common accident that usually troubles most Women during their lying in is after-Pains We have formerly shewed how they are accustomed to be prevented in giving the Woman immediatly after she is laid two Ounces of Oyl of sweet Almonds drawn without fire with as much Syrup of Maiden-hair but since notwithstanding this Remedy the Woman is much pained in her Belly let us enquire what may be the cause of all these gripes which are usually called without distinction After-pains and are sometimes felt about the Reins Loins and Groins sometimes in the Womb only and sometimes about the Navel and all over the Belly either continually or by fits with some remission in a certain place or sometimes on one side and somtimes on another all which reflections teach exactly their several causes and accordingly the Remedies must be varied The Pains of the Belly for the most part proceed from one only of these four causes or several of them together the first is by Wind contained in the Bowels by which they are easily filled after Labour as well because they have more room to dilate then when the Child was in the Womb by which they were comprest as also because the nourishment and matter contained as well in them as in the Stomach have been so confused and agitated from side to side during the pains of Labour by the frequent Throws which alwaies much compress the Belly that they could not be well digested whence this wind is afterwards generated and consequently the Gripes which the Woman feels running in her Belly from side to side according as the Wind moves more or less and sometimes also towards the Womb because of the compression and commotion which the Bowels make being extremely thereby agitated The Second Cause of these Gripes which torments the Woman as much as the former is that which proceeds from some strange body resting in the Womb after Labour which it endeavors to expel by continual Throws and it is sometimes a false Conception or a piece of the Burthen and very often clodded Blood which cause this torment and never cease til what is so contained in the Womb be come away these Painâ— are very like the same that a Woman endures before she is delivered and are not abated by Clysters as those are that proceed from Wind but on the contrary are rather thereby excited and augmented Thirdly These Pains are often caused by the sudden suppression of the * Childbed cleansing Lochia which abundantly filling the whole substance of the Womb causeth a great distention and by its long stay an inflammation which is communicated by means of the Peritonaeum to all the parts of the lower Belly by eason whereof it swells and is extended and grows extreamly hard which accident continuing very often kills the Woman in a short time after The Fourth and last cause of these Pains is the great extension of the Ligaments of the Womb by reason of a hard Labour here they remain more fixt about the Reins Loins and Groins than any other part because they are the places where these Ligaments are fastened however these Pains do sometimes communicate themselves by continuity to the whole Womb and the rather when it hath been bruised by a violent Labour 'T is commonly held that a Woman is not troubled with these Pains so much of her first Child as of the following but daily experience confirms us that it happens indifferently according as the present and various dispositions contribute to it either more or less there being no certain rule in respect either to first or last Labours All these Pains must be cured according to their several causes and to prevent thoes
Mater Pus which proceeding from the moisture sweats through the substance of the flesh and of these Vessels which have been but newly closed acquires a thick and whitish consistence by the heat of the part and the stay it makes there Now the better to conceive this by a comparison you must imagine that there is a kind of a wound made by the loosening of the Burthen from the Womb by reason of which there happens if it may be so said a kind of Suppuration the Pus and excretions of which are the Lochia They which believe that when the Lochia ar◠pale it is the Milk of the Breasts which flowes by the Womb judge so because the Milk usually abates in proportion to this evacuation and say besides that by the Colour and Consistency it must needs be Milk but if they were acquainted with Anatomy they would know that there was no passage which hath to this purpose a communication from the Breasts to the Womb unless they think it is done by the means of this imaginary * The communication of Veins without Arteries whereby they help one another Anastomosis of the †Belonging to the Breasts Mamillary Veins with the * Belonging to the Flanks Epigastrick which cannot possibly be because neither of them have any tendency either to the Breasts or the Womb as Anatomy makes manifest for the Mamillar comes from the Subclavicular under the Sternum without yielding any sign to the Breasts nor so much as touching them and the Epigastrick ariseth from the Iliacks without having the least communication with the Womb. Laurentius who knew very well it was for this reason impossible Milk should pass from the Breasts to the Womb by this passage finds out another way which is as far from the truth as the first His opinion as he saith is that the Milk and Blood flow back from the Veins of the Thorax which bedew the Breast to the Axillary Veins and from thence to the Trunk of the Vena-cava by the continuity of which they flow down into the Hypogastrick Branch and from thence finally into the Womb but besides that it would be very difficult for the Milk after so long a way to come forth without being perfectly mixed with Blood the Circulation of the Blood which he knew not shewes us plainly that it is impossible because it doth mount back by the lower parts of the Body from the Vena cava to the Heart without a possibility of carrying any thing into the Womb whence it appears that he is as far as others from informing us how it can be done For my part I believe with much more reason and I think that it is not Breast milk which is thus evacuated by the Lochia but this abundance and superfluous humidity which distills from and transudes the Vessels and substance of the Womb as I have explained by means of which the whole habit of body being much emptied there remains not sufficient to be carried to the Breasts and little or none flowing to them that which is contained in them is dissipated by transpiration and digested by the natural heat of the parts Now the Milk by this evacuation is dried up just as we see a Pond is that one would drain out of which it is not absolutely necessary to let the water run which fills it but it sufficeth to turn back the stream that feeds it to another place which being done and no more new water falling into the Pond it will soon be dried up as well because the water is dissipated in Vapours as drunk in by the Earth which contains it And for the same reason when we see Milch-nurses want their ordinary courses it is because that all the redundant humours in their body being sent to the Breasts and emptied by the sucking of the Infant there remains no superfluities for matter for the Terms and for this cause it is not necessary that the Menstrual blood should be carried from the Womb to the Breast for Nurses Milk to be made of it but it is enough that the humours flow towards them without going at all to the Womb so likewise it is not necessary the Breast Milk should be sent to the Womb to be evacuated with the Lochia it being sufficient that the humours are drawn towards it without going to the Breasts We must not think as some imagine that the Blood flowing after Labour is bad and corrupted and the reliques of that good which the Infant hath taken for his Nourishment nor that it hath remained in and about those places during the whole time of being with Child for this Blood coming immediatly out of the Vessels opened by the separation of the Burthen from the Womb is the very same with all the rest of the body in which immediatly after Labour no great change is observed unless it be by so much alteration as the disposition of the place from whence it proceeds may cause and according as it flowes abundantly or slowly and as it is mixt with other impurities which are emptied at that time or that it makes some stay in the Womb after it is out of the Vessels and if it had so staid in and about the Womb as some would have it without Circulation during the whole time of Pregnancy 't is most certain it would have putrified even as we see the water of a Lake for want of Agitation and Motion is infected and corrupted but there is no other superfluity nor relique of the Childs nourishment but the gross blood with which the whole mass of the Secondine is replenished After having considered the nature and quality of these evacuations we say that for their quantity and time of continuance there is no certain and particular Rule for some Women have many a long time and others but few and of a short continuance which usually happens according to the Season Country and Age according to the Temperament more or less Hot or Moist the Habit more or less replete and according to the Vessels remaining a long or a short time open But in general this Evacuation is for the most part finished in fifteen or twenty days and sooner or later according to the circumstances lately mentioned and indifferently the same to a Woman delivered of a Boy or a Girl during which time the Lochia diminish in quantity from day to day until they totally cease at the end of the same afterwards the parts remain yet somewhat moist without any manifest evacuation except in Women subject to the Whites This discourse must be understood of Labours at full time for after a Mischance the less the Foetus is and the less time the Woman is gone with Child the less ordinarily are her Evacuations The Signs when the Lochia are good and commendable are that they be fresh the three or four first days and that they lose this bloody tincture by degrees and become pale that they be of an equal consistence without any
in her Womb and besides a great Fever and difficulty of Breathing as it ordinarily arrives in these Cases 'T is most certain that if she were immediatly blooded in the Foot being very Plethorick as we have supposed there would be so great abundance of Humours drawn down into the Womb that the Inflammation would be thereby much augmented and consequently all the Accidents of the Distemper but 't would be much better in this case rather to alter the Habit first by bleeding in the Arm and afterwards the most pressing Accident being partly diminished it will be very much to the purpose to bleed in the Foot for by this means Nature which was almost overcome under the burthen of these redundant humours being eased of some part of them doth the more easily command and govern the rest but on the other side if there be a stoppage without the appearance of a great plenitude in the Body and without any notable accident Bleeding in the Foot if it be desired may be then presently put in practice However I think it most convenient that it should * Not ncessary except for reasons abovementioned alwaies be preceded with bleeding in one of the Arms. CHAP. XI Of the Inflammation which happens to the Womb after Delivery VEry often the stopping of the Lochia of which we have lately discoursed and especially at the beginning of Child-bed doth cause an inflammation to the Womb which is a very dangerous Disease and the death of most of the Women to whom it happens It is also very often caused from some hurt or bruise of the Womb by any Blow or Fall and especially for having been too rudely handled in a bad and violent Labour or by the falling out of the Womb after Labour or else because of some false Conception or other strange Body remaining behind in it which corrupts there and likewise because it might have been too much compressed in the beginning of the Labour by the great Swathes and Napkins wherewith the Midwives and Nurs-keepers usually swathe the Belly of a new-laid Woman to keep it as they say in its place which happens also very often when the Blood being stirred and over-heated by the agitation of a rude Travail is carried thither in too great abundance and there stays without evacuation An Inflammation of the Womb may be known by being much more swelled after Labour than is requisite and when the Woman feels very great heaviness in the bottom of her Belly and that it is swelled and blown up almost as big as before Delivery if she have a difficulty in making Water and going to Stool or that she perceives her pain augment when she is voiding her Excrements because the Womb presses the right Gut upon which it is placed and to which by its proximity it communicates the Inflammation as well as to the Bladder she hath then also besides a great Fever with a very great difficulty of Breathing a Hiccough Vomiting Convulsions and in the end Death if the Disease be not soon cured A Woman that hath received a bruise or any violent compression of the Womb is in great danger that after the Inflammation if she do no die of it an Abscess will be there made or that there will remain some Scirrhous Tumour and it may be an incurable Cancer which will make her lead a miserable and languishing life the rest of her daies Wherefore assoon as an Inflammation is perceived the Cure of it must be endeavoured by tempering the heat of the humours and turning and emptying the superfluities of them assoon as may be first extracting or procuring the expulsion of such strange things as may remain in the Womb after Labour according to the directions given in its proper place and above all treating her at this time with very great tenderness using not the least violence for fear the evil may be thereby augmented The Humours may be tempered by a cooling Diet using food that nourishes little wherefore let her be contented with only Broath for her nourishment made of Veal or Pullet but not too strong of the Flesh together with cooling Herbs such as Lettice Purslane Succory Borrage Sorrel and the like let her abstain from Wine and drink Ptysan made of the roots of Succory and Dogs-grass Barley and Liquorish let her keep her self very quiet in her bed let her not be swathed too strait and let her body be kept open with simple Anodine Clysters because if there be any Acrimony in the humours they will cause Throwes which extreamly pains the inflamed Womb and amongst all the passions of her mind let her especially avoid Anger The redundancy of Humours may be evacuated and diverted by Bleeding which at first must be in the Arm and not in the Foot for the reasons given in the foregoing Chapter reiterating it without loss of much time for the accident is very pressing until that the greatest part of the plenitude be a little evacuated and the Inflammation something diminished and then bleeding in the Foot will not be amiss if the case require it It may be convenient to anoint the Belly with Vnguentum refrigerans Galeni or Oyl of Roses or Oyl of sweet Almonds mixt with a little Vinegar Injections may likewise be given into the Womb provided they be not Restringent lest making a greater stoppage of the Lochia which alwaies flow a little in this case the distemper be not augmented for which reason let temperate Medicines be only used without any manner of astriction as Barley water with Oyle of Violets or luke-warm Milk Sometimes an Inflammation of the Womb converts into an Aposthume which yeilds a great quantity of matter there is then much danger of corruption in that part as well by reason of its Heat and Moisture which are the principals of it ' as because no proper Remedies can be applied or easily kept to it since therefore nothing else can be done we must be contented with an universal Regimen and Detersive Injections to cleanse off the matter that so the corruption be not augmented by its long stay there which may be effected by a Decoction of Barley and Agrimony mixt with Oyle of Roses and Syrup of Wormwood and heightned with some Spirit of Wine if there be a great putrifaction But if the Imposthume turnes to an ulcerous Cancer then notwithstanding the use of any Remedies whatsoever this mischeivous disease will endure 'till death wherefore we must be contented with Palliative Medicines a good Diet and in this follow the precept of Hippocrates in the 38th Aphorisme of his Eighth Book Quibus occulti Cancri fiunt non curare melius curati enim citius intereunt non curati vero longius vitam trahunt It is better saies he not to take an occult and hidden Cancer in hand for it hastens the death of the Patient and they which let it alone live longest Now he means by an occult Cancer that which breeds within the Body and especially that
in the Womb. CHAP. XII Of the Inflammation of the Breasts of the new-laid Woman UNtil of late it was alwaies believed that the Blood was the matter whereof the Milk was made in the Breasts but it is much more probable that the Chyle onely and not the Blood is destined to its generation as well as it is the true matter out of which all the Blood of the Body is made That which easily makes us judg so is the new discovery of the Channel of the Thorax which conveighs the Chyle into the Subclavian Vein found out by Monsieur Pecquet Physician of the Faculty of Montpelier to whom all posterity will be eternally indebted for having means hereby of being disabused of several notable Errors which for want of so fair and necessary a knowledg was slid and entertained into the Practice of Physick until this time However since the Vessels which may for this purpose conveigh part of this Chyle to the Breasts are not yet manifestly known we will content our selves to explain after the following manner the cause of the Inflammation of the Breasts which doth very often happen to Women newly delivered All the Blood and Humours are so heated and agitated during Travail by the Pains and Throws of Labour that the Breasts composed of glandulous and spongious bodies easily receiving in too great abundance of these Humours which flow to them from all parts are soon inflamed thereby because this Repletion doth very sensibly and painfully distend them to this contributes very much the suppression of the Lochia and an universal fulness of the Body This Inflamation may likewise happen by the Womans having been too strait laced by some blow received upon the Breasts or for having lain upon them which easily bruise them as also for want of having given Milk to the Child in as much as by this means the Milk which is in great quantity in the Breasts not being evacuated is overheated corrupts by too-long stay there But from whatsoever cause this Inflamation of the Breasts in a Woman new-laid may proceed convenient Remedies must be speedily applyed lest it afterwards aposthumates or else that not suppurating there remains a scirrhous hardness which in time may degenerate into a Cancer a very pernitious Malady and for the most part incurable when confirmed Besides the danger that an Inflamation of the Breasts may be converted into these dangerous distempers there happens usually to the Woman in those parts which are very sensible an extream pain which often causeth shaking Fits and afterwards a Fever with so great a burning of the whole Body that she can scarce endure any Cloaths upon her and when she doth never so little uncover her self or put her Arms out of the Bed she hath new shaking fits which afterwards augment the heat of her Feaver it is no great wonder that a Feaver soon happens upon this occasion because the Breasts by their nearness to the Heart do easily communicate their Inflamation which sometimes excite Fury and Phrenzy if the Blood be suddenly and in great abundance carried thither as Hippocrates assures us in the 40th Aphorism of his 5th Book Quibuscunque Mulieribus ad Mammas sanguis colligitur furorem significat If saies he the blood be carried to and in great abundance collected in the Breasts it signifies that Fury and Phrenzy will follow Now the principal and most certain means to hinder the afflux of so great a quantity of Humours to the Breasts and prevent the coming of an Inflamation there is to procure a good and ample evacuation of the Locbia by the Womb. Wherefore if they are supprest they must be provoked by the means elswhere directed for by this evacuation all the Humours will take their course towards the lower parts The whole habit of Body may be emptied by bleeding in the Arm afterwards for a greater diversion and the better to bring down the Lochia bleed in the Foot during which Topical Remedies to the Breast must not be forgot as in the beginning to chase well into them Oile of Roses and Vinegar beat together laying upon them afterwards Unguentum refrigerans Galeni and a third part of Populion mixt with it or a Cataplasme made of the setlings found in a Cutlers Grin-stone-Trough Oile of Roses and a little Vinegar mixt together if the pain continue very great another Cataplasm may be made of the Crum of white Bread and Milk mixt with Oile of Roses and the Yolks of raw Eggs upon all these may be laid Compresses dipt in Vinegar and Water or in Plantane Water but great care must be taken that these Remedies applied to the Breast be only cooling and repressing without any great Adstriction for it may cause a scirrhous tumor which would remain a long time and it may be a worse distemper After the height of the Inflammation shall be past and the greatest part of the antecedent Humours evacuated and turned aside let Medicines a little resolving be used to digest resolve and consume the Milk which abounds in the Breasts to prevent corruption by its stay wherefore let them be drawn by the Child or some other person or else resolved unless that it be suppurated It may be resolved by the application of pure Honey to the Breasts which in this case is very effectual or else a red Cabbadg-leaf may be anointed with it and applyed to the Breasts having first withered it a little before the Fire and all the hard Stalks and Veins taken out do not lace the Breasts too strait nor apply any course or rough Clothes to them that they may not be therewith scratched and bruised A very good remedy for the same is a whole red Cabbage boiled in River water to a Pap and then well bruised in a wooden or marble Mortar and pulp'd through a Sieve which mixt with Oyle of Camomil may be applied as a Poultis to the Breasts In the use of all these means let the Woman observe a cooling Diet not very nourishing that too much Blood and Humours may not be engendered of which there is already too great a quantity she must alwaies keep her Body open that the Humours may be so much the more carried downwards and consequently turned from the Breasts During the whole time the Inflammation continues let her keep her Bed lying on her back that she may have the more ease for being raised the Breasts which are gross and heavy because of the abundance of humours with which they are repleted do very much pain her when they hang down let her stir her Arms as little as may be and after the fourteenth or fifteenth day of her Child-bed when she hath sufficiently cleansed and the Inflammation is abated and she no longer Feverish purge her once or twice as the case shall require to empty the ill humours which remain in the whole habit of her Body If notwithstanding all these Remedies the swelling of the Breast doth not go down and that she still
feels much pain and a great Pulsation with a hardness more in one place than another is is certain it will aposthumate there of which we will treat hereafter CHAP. XIII Of the Curdling and Clodding of the Milk IN the beginning of Child-bed the Womans Milk is not well purified because of the great commotion her Body suffered during Labour and it is then mixt with many other Humours now if they are then conveyed to the Breasts in too great abundance they cause an Inflammation treated in the foregoing Chapter but when the Infant hath already sucked fifteen or twenty days or more the Milk then only without this mixture of humours is contained there and sometimes curdles and clods And then the Breasts which before were soft and even become hard uneven and rugged without any redness and the distinction and separation of all the Kernels fill'd with curdled Milk may easily be perceived The Woman finds a great pain there and cannot milk them as before she finds a shivering especially about the middle of her Back which seems to her like Ice This Shivering is usually followed by a Fever of four and twenty Hours continuance and sometimes less if the clodding of the Milk do not turn to an Inflammation of the Breasts which will undoubtedly happen if it be not emptyed or dissipated and resolved This Clodding of the Milk for the most part proceeds because the Breasts are not fully drawn either for that she hath too much Milk or the Infant is too small and weak to suck all or because she doth not desire to be a Nurse for the Milk in these cases remaining in the Breasts after concoction without being drawn loseth the Sweetness and Benignity it had and by means of the Heat that it there acquires and the too long stay it there makes sowring it curdles and clods just as we see Rennet put into ordinary Milk turneth it into Curds this accident may likewise happen from having taken a great Cold or keeping the Breasts not well covered From whatsoever cause this Curdling proceeds the readiest and most certain Remedy is speedily to draw the Breasts until they are emptied and dried but because the Infant being weak and small cannot draw strong enough by reason the Woman is not soft milcht when the Milk is so curdled let another Woman draw them until the Milk comes freely and then she may give the Child suck and to the end she may not afterwards breed more Milk than the Child can draw let her use Diet that gives but little nourishment and keep her body alwaies open But when it happens that the Woman neither can nor will be a Nurse 't is necessary to use other means for the curing of this distemper Then her Breasts must not be drawn for attracting more humours the disease will ever recur if they be not again emptied Wherefore 't is necessary to prevent the coming of any more Milk into them and to resolve and dissipate that which is there for this purpose the plenitude of the Body must be emptied by bleeding in the Arm and besides this evacuation let the Humours be drawn down by strong Clysters and bleeding in the Foot purging also if it be necessary and to resolve digest and dissipate the curdled Milk apply the Gataplasme which we said was proper as that of pure Honey or that of the four Brans boiled in a Decoction of Sage Milk Smallage and Fennel mixing with it Oile of Camomil with which Oile the Breasts may likewise be well anointed I have sometimes seen Women apply to their Breasts with no small success the Linnen-covers of Salt-butter-pots it is a drying Remedy and lie to soak up the moisture of these parts and may be used provided the Remedies before mentioned have discuss'd the Milk but it notwithstanding all this it cannot be dissipated nor resolved there is great danger by its long stay there that it will cause an Inflammation of the Breasts If it so happen it may be remedied according to the directions of the foregoing Chapter Let us now treat of Aposthumes of the Breasts which often follow their inflammation CHAP. XIV Of Aposthumes of the Breasts of a Woman new-laid THere may at all times happen to Maids as well as Wives Aposthumes of the Breasts either hot or cold the cure of which doth not differ as saith Guido except that too strong Repercussives must not be used because of their nearness to the Heart and that the retention of the Courses contributes much to the breeding of them and their provocation to their Cure as also bleeding in the Saphaena but our intention is only to treat of those which happen to a new-laid Woman and ordinarily succeeds an Infiammation of the Breasts caused by corruption of the Milk and too great abundance of Blood and Humours conveighed thither After all possible endeavours have been used to cause this Inflammation to cease whether by universal evacuation of the Body as well by bleeding in the Arm and Foot as the provocation of the Lochia or also by Medicines restraining repelling or simply-dissolving applyed to the Breasts if the Woman still suffers great pain there and hath astrong Pulsation more in one place than another where a hardness of a livid colour may also be perceived and soft in the middle 't is a sign that they will aposthumate Then the application of all the former Topicks must be forborn and ripening Medicines applyed it being much better to make a perfect Suppuration than longer to use Repellers or Resolvers lest the matter be more confirmed in driving back and only resolving the more subtile parts leaving the thicker behind in the Breasts which will become scirrhous and be very difficult to dissipate or by its long continuance as it often happens may turn to a Cancer To suppurate the Aposthume put an emollient and ripening Poultis upon the Breasts such as that made of Mallows and Marsh-mallows with their Roots Lilly-roots and Linseed bruised boiled to a Pap that it may be pulp'd through a Sieve that so no hardness may be left to hurt the Breasts which are then in great pain afterwards mix a good quantity of Hogs-grease or Basilicon with it and lay a little Cloath thick spread with the same Basilicon upon the place where it is likely soonest to break and the Poultis all over it nenewing it twelve hours after or at furthest next day continuing this Remedy 'till the Aposthume be fully ripe It is much better to use this Cataplasme or the like than Plaisters for a Poultis closeth better by its softness and is more equally applyed to the Breasts it mollifies it also and keeps it much more supple besides it is easier changed and cleansed than Plaisters which by their sticking do very much incommode these parts Assoon as the Aposthume is ripe it must be opened if it open not of it self The time when it is fit may be known by the ceasing of the beating the Woman felt before
in her Breasts and that the pain and Fever is much diminished and then besides the middle of the Aposthume is a little elevated to a point and very soft and the contained matter may by the Finger be perceived to fluctuate When these signs shall appear the Aposthume must be opened in the fittest place to give issue to this matter being careful not to do it too soon and before the matter is fully ripe because of too much pain for the Breasts are very sensible parts and easily receive a Defluxion because of their thin and spongious substance interlaced with an infinite number of Vessels Wherefore it must be permitted to ripen yet not suffered to stagnate there too long This apertion may be made with a Lancet or with a grain of potential Cantery making it large enough to evacuate such Clods as are there usually met with but it is best to use the Lancet because there is no loss of substance and the Scar is not so deformed as that which succeeds the application of a Cautery Guido would have this Incision made in the form of an Half-moon to follow the round Figure of the Breast but it is no matter of what fashion it is provided it be in a place convenient for the emptying the matter and that care be taken that some great Vessels be not opened the principal of which are towards the Arm-pits After that all the matter and putrified clodded Milk there found be emptied the Aposthume after the usual manner must be cleansed and mundified observing not to make the Tents too long nor too hard but only very soft pledgits of Lint without thrusting them too deep in fastening a Thread to the first if there be occasion the better to draw it out because these Aposthumes ordinarily are hollow If there be much pain dip the Boulsters in Oile of Eggs or Basilicon mixt with a Digestive if there remain any thing yet to Suppurate afterwards use Detersives and Mundifiers as Honey of Roses or Unguentum Apostolorum according as the case requires laying upon it a good Plaister de Mucilaginibus to soften that hardness which may yet remain Chap XV. lib. 3. pag 349 CHAP. XV. Of Excoriation and loss of the Nipples VEry often Women that are Nurses and especially the first time are subject to have their Nipples which are endued with an exquisite sence because that many small nervous Filaments do there terminate chopped and excoriated which is very painful to them and insupportable when notwithstanding this indisposition they give suck to their Children and so much the more by how much they are hard milch't as it happens the first time the Milk not yet having made way through the small Holes of the Nipples which are not yet throughly opened and then the Child takes more pains to suck than when the Breasts do almost run of themselves and sometimes these Chops and Excoriations do so encrease by the Child 's continual sucking that in the end it takes the Nipple quite off from the Breasts and the Woman is no longer capable of giving suck and there remains sometimes an Ulcer very hard to be cured This may sometimes happen from Childrens being so dry and hungry that they have not patience to suck softly and finding the Milk not speedily to follow as they desire they do bite and mump the Nipple so strongly thinking to draw Milk down the better whether they have Teeth or no that they become raw and in fine still continuing it they are quite taken away as we have said It happens also that other Infants have their Mouths so hot that they make the Nipples sore as when the Children have those little Ulcers called * Thrush Apthae and much sooner if they have the Pox with which also they may infect the Nurses and then those Ulcers so caused do not easily yield to ordinary Remedies but on the contrary grow daily worse and worse These Chops and Excoriations must not be neglected as well by reason of the great pain they put the Woman to when she gives suck as to avoid their dayly growing worse and worse and at length their turning to malignant Ulcers Wherefore assoon as they begin let the Woman forbear giving her Child suck until they are quire cured for with continual sucking it will be very difficult to hinder its return by irritating of them during which the Milk must for a small time be kept back lest by being no longer drawn it cause an Inflammation in the Breast through its great abundance However if but one Nipple be sore she may give suck with the other to these sore Nipples Desiccative Medicines may be applyed as Allum or Lime-water or they may be only bathed with Plantain water putting upon them small soft Rags dipped in any of them or use a small Ceruse Plaister or some Ointment as Dia Pompholygos or a little powder Amylon but especially care must be taken that nothing be applyed to disgust the Child wherefore many content themselves to use only honey of Roses Some will instead of Desiccatives use Emolients but there must be a distinction for Emollients are fit to preserve from such Fissures but when they are already made Desiccatives are best and to prevent the Woman from hurts in these parts which are very painful and that the Rags may not stick to them one ought to put upon them a little Wax or Wooden Caps or Leaden ones they being more Desiccative like to those represented in the begining of the Chapter which must have several small holes on the tops of them as well to give issue to the Sanies which proceeds from the small Ulcers as that the Milk which often distills out of the Nipples may by this means pass away If the Child hath wholly suck'd off the Nipples the Milk must then be quite dried away that so the Ulcers which remain may be the sooner healed for else one shall hardly obtain their end and in time they may become callous and malignant and if the Child hath the Pox it will be very difficult to heal those Ulcers of the Nurses Nipples if it continues to suck wherefore the Child must be put to another who must use Preservatives against this Malady but if they be only small simple Ulcers in the Mouth without any malignity 't is enough to wash them with Barley-water mixt with a little Juice of Citrons and the better to temper these Humours which are over-heated let the Nurse take a cooling Diet that her Milk may become of the same temperament and let her be blooded and purged if it be necessary When the Nipples are quite lost it is very difficult to give a Child longer suck because it can take no hold to suck the Milk and also the small holes of the Nipples are closed up by the Ulcers But if notwithstanding she shall desire to give suck another Woman must by degrees make her new Nipples after the Ulcer shall be perfectly healed whose sucking with
will alwaies be separated in the very same place just close to the Belly because it is a part which remains wholly * Without life inanimate after the Child is come into the World wherefore whether Boies or Girles let the Knot be made at least an inch from the Belly as we have already directed and not nearer lest it pain or inflame the Childs Navel It will not be from the purpose to mention here a business of great consequence which is sometimes capable to kill the new-born Babe without almost knowing the cause of it 't is a very bad custome some Midwives have before they make the Knot they drive all the blood out of the String into the Infants Belly believing that by this means they fetch it to it self and strengthen it when it is weak but 't is no such matter for assoon as these Vessels are never so little cooled the blood it contains quickly loses its spirits and is half coagulated in an instant which is the reason that being driven back into the Infants Liver it is enough to cause very great Accidents not because of its abundance but because having quite lost its natural heat it is afterwards soon corrupted and changeth and spoileth the Childs Blood with which it comes to mix They commonly put this ill custome in practice when the Child is weak but this doth sooner suffocate them for if they need Blood to give them vigour it must be good and laudable and not that which is half clodded and destitute of its natural heat Wherefore whether the Child be strong or weak if you will not put it in danger of its life or at least cause to him great oppressions pains and gripes forbear driving his blood thus out of the String into the Infants body Now having thus tyed and cut the String wash the Child presently all over for to swaddle it afterwards as we shall direct CHAP. XVII Hôw a new-born Babe must be washed and cleansed from the Excrements as also how it ought to be wrapped up in swadling Cloaths WHen the Midwife hath ordered the Childs Navel-string just as we have directed in the foregoing Chapter let her presently cleanse it from the Excrements it brings with it into the world of which some are within the body as the Urine in the Bladder and the Moeconion found in the Guts and others without which are thick whitish and viscous proceeding from the slimyness of the Waters there are Children sometimes so covered all over with this that one would say they were rubbed over with soft Cheese and certain Women of easie belief do really imagine it was because they had often eaten some while they were with Child that their Infants are thus full of this thick white Excrement which in colour and consistence is not unlike white Cheese Let the Child then be cleansed from all these Excrements with Wine and Water a little warmed and every part of his body where this Excrement is as principally the Head because of the Hair and the folds of the Groins and Arm-pits and the Cods which parts must be gently cleansed with a soft Rag or a soft Spung dipt in this luke-warm Wine If this viscous Excrement stick so close that it will not easily be wash'd off of these places it may be fetcht off with Oile of sweet Almonds or a little fresh Butter melted with the Wine and afterwards well dried off one must also cleanse and unstop with tents of fine Rags wet in this liquour the Ears and Nostrils for the Eyes they may be wiped with a soft dry rag not dipt in this Wine that it may not pain them and make them smart After the Child is thus washed and cleansed from these Impurities and Blood which comes away in the Labour with which sometimes its whole Body is besmeared all the parts of it must be visited to see if there be any fault or dislocation whether the Nose be straight or its Tongue tyed whether there be no bruise or tumor of the Head or whether the Mould be not overshotten or whether the Scrotum in case it be a Male be not blown up and swelled in short whether it suffered any violence in any part of its Body and whether they be well and duely shaped that so Remedies may be used according to the nature of the indisposition discovered But as it is not sufficient to cleanse the outside of the Childs body you must above all observe that it must discharge the Excrements retained within wherefore examine whether the Conduits of the Urine and Stool be opened for some have been born without having them perforated who have died for want of voiding their Excrements because timely care was not taken of it as to the Urine all Children as well Males as Females do render it assoon as they are born especially when they feel the heat of the fire and sometimes also the Maeconion of the Guts but nevertheless usually a little after If the Infant doth not render it the first day that it may not remain too long in his Belly and cause very painful Gripes put up into his fundament a small Suppository to stir it up to be discharged to this purpose a sugar'd Almond may be used anointed over with a little boiled Honey or else a small piece of Castile-soap rubb'd over with fresh Butter you may also give the Child to this purpose at the Mouth a little Syrup of Roses or Violets mixt with some Oyl of Sweet Almonds drawn without fire anointing the Belly also with the same Oyl or a little fresh Butter It may be known when the Child hath voided all its Maeconion if the Stools change from black and become pale which is about the second or third day losing by degrees this tincture in proportion to the generation of new Excrements from the Milk which about this time mixes with the first As to the Maeconion which is an Excrement in colour and consistence like to the Pulp of Cassia found in the Childs Guts when it comes into the World 't will be enough to the purpose to examine what it is and from whence it proceeds wherefore without dwelling upon the different explications of Authors touching its generation I will ingeniously give my thoughts of it which is that it comes from the superfluous Blood daily discharged as it doth in all persons and of all ages by means of the Hepatick channel which coming from the hollow of the Liver goeth and emptyeth into the Intestine Duodenum out of which is formed the Moeconion which afterwards serves to keep the Intestines of the Foelus open and dilated that so they may the better perform their office after its birth and to make it appear that it is truely thus made and that the superfluous Blood is continually discharged by the Hepatick channel into the Duodenum as I do say there are some people of Fourscore years of age that were never let Blood nor never lost any outwardly who nevertheless
shall take from corrupting being mixt with this viscous Phlegme wherefore it is best to stay until the next day before you give it suck that so it may be wholly evacuated or digested and consumed and then you may safely give him the Breast It were to be wished that the Mother should not give it suck until the eighth day of her Child-bed at soonest if not three Weeks or a Month that so all the humours of her Body being well tempered and having recovered the agitation they received in the Travail as also their Superfluities having been wholly purged by means of the Lochia her Milk be thereby so much the more purified besides this the small holes of the Nipples not yet being sufficiently opened a new-born Babe cannot ordinarily at first easily draw her Breasts during that time therefore let a Woman suck her But often poor people cannot observe so many Precautions and such Mothers are obliged to give their Children suck from the first day and likewise others will not suffer any but themselves to do it in this case let their Breasts be a little drawn by some old persons or some lusty sucking Child or they may draw them themselves with a Glass figured like that in the beginning of the 15th Chap. and afterwards they may give their Children suck when the Milk is a little brought down let them continue to do thus 'till the Milk be easy for the new-born Child to draw There are some who believe that the Milk of a Woman new-laid is better at the beginning than when it is purified and that it opens the Belly and purgeth the Moeconion from the Guts but the gripes which this overheated and foul Milk also causeth in him is much more prejudicial than the good it otherwise doth wherefore it is best not to give it such new-milk if possible As to the fittest time then of giving the Breast to the new-born Babe it must not be till after the first day for the reasons above given and to make him take it because there are some that will not in three or four daies the Nurse must milk a little into his Mouth and upon his Lips that so he may by degrees taste it then let her put the Nipple dropping into its Mouth and squeeze her Breast with her Hand when he hath fastened that the Milk may come down the easier and that the Infant who hath yet but small strength may not take too much pains to draw and suck it doing thus dy degrees until he is well accustomed to suck If the Nurse hath much Milk she must not give the Child any thing else at least the first two Months Beasts do shew us that Milk alone is sufficient to nourish an Infant since that they do suckle five or six of their young ones and sometimes more without their taking any other food for a long time after As to the quantity of Milk a Child ought to suck it must be proportionable to his Age and Strength in the beginning he must not have too much nor too often that his Stomach not yet accustomed to concoct it may the better digest it afterwards let it daily by little and little be augmented until he may take his fill As to the time and hour it needs no limits for it may be at any time night or day when he hath a mind but let him have it rather little and often than too-much at a time that his little Stomach may the better concoct and digest it without Vomiting as it often doth when it cannot easily contain it After the Child hath suck'd Milk alone for two or three Months more or less according as one finds he needs stronger nourishment give him then Pap made of Flower and Milk though but little at first and not too thick lest his Stomach be soon overcharged by not being used to it or that it may be of easier digestion put the Meal in an earthen Pan into an Oven assoon as the bread is drawn stirring it often to dry it equally Pap made of this Flower besides that it is sooner concocted is much better than the ordinary which is heavier clammier and not so easy of digestion for being made with raw Flower 't is very difficult to boil it well without consuming the best part of the Milk leaving only the grossest part behind and losing by the long boiling both its goodness and taste When the Child hath taken Pap thus made which must be but once a day especially in the morning or twice at most the Nurse may give it a little suck to the end that being washed down into the Stomach the digestion may be the better and easier made There are many Women who give Pap to their Children assoon as they are born and Nurses who have little Milk ordinarily do so to hinder their crying as they will do when they are hungry but somtimes this only is enough to kill them because of the indigestion and obstruction it causeth which by reason of its gross and viscous consistence can hardly find passage through the Stomach and Guts which at the beginning are but weak and not sufficiently opened and dilated whereby there happens to the Children great oppressions and difficulty of Breathing Gripes Swellings pains of the Belly and often Death wherefore do not give it the Child 'till after the first or second Moneth at soonest and if you forbore it three or four whole Moneths he would thrive the better provided the Nurse wants no Milk When the Child hath sucked its fill let the Nurse lay it to rest and sleep not in the same Bed she lies in lest unawares she overlay it as I knew one that did and killed her Child whether wickedly to be freed from it or innocently she alone knoweth but to avoid this mischief let her lay it in a Cradle close by the Bed-side and put a Mantle over the head of the Cradle to prevent the falling of dust on its Face and that the Day-light Sun-shine Candle or Fire in the Chamber may not offend it Lay him to sleep upon his Back with his Head a little raised upon a Pillow and to make him sleep the sooner let the Nurse rock him gently with an equal motion without too-great shaking lest that hindering the digestion of the Milk in his Stomach provoke him to vomit it up just as persons do that are at Sea not because of the scent of the Salt-water but the shaking and tossing of the Ship wherein they are and as it happens to many Women only by riding in a Coach when they are not used to it But that you may not be forced thus to rock a Child every time you would have him sleep it is good not to use him to it at first but let his sleep come naturally of it self There needs no certain limited time for his rest for he may sleep at any time night or day when he hath a mind to it and ordinarily the better he is the more
at first it doth in some sort appear so to be if the Woman but a little before she was brought to Bed felt it to stir strongly if she did not flood much and if she had no very hard Labour but 't is very certain he is yet living although he do not cry nor move any part of his Body after he is born if laying the hand upon his Breast the motion of the Heart be felt or touching the Navel-string near the Belly there is yet perceived a small pulsation of the Arteries Then all sorts of means must be used to recover him out of this weakness Now the best help in this case is to lay him speedily in a warm Bed and Blanket and carry him to the fire and there let the Midwife sup some Wine and spout it into his Mouth repeating it often if there be occasion let her likewise lay Linnen dipt in warm Wine to the Breast and Belly let the Face be uncovered that he may draw breath the easier and to be yet more helpfull to him let the Midwife keep his Mouth a little open and cleanse the Nostrils with small linen tents also dipt in white Wine that so he may receive the smell of it let her chafe every part of his Body well with warm Clothes to bring back the Blood and Spirits which for being retired inwards through weakness put him in danger of being choaked in doing thus by little and little the Infant recovering his strength will insensibly come to stirr his Limbs one after another and so at first cry but weakly which afterwards as he breaths freer will augment and become stronger Besides these helps we have mentioned which certainly are the best and most certain for the weakness of a new-born Babe Midwives ordinarily make use of others which I do not approve of not only because they are useless but because some of them are very dangerous to the Child Some lay the After-burthen being very warm to the Belly and leave it there 'till it is cold I have elsewhere declared that the Burthen by reason of its heat may be something serviceable but notwithstanding because of its weight being so placed upon the Childs Belly which wanting a support is easily compressed it doth very much hinder his respiration which at that time is most necessary for him Others cast the Secondine into the Fire before it be parted and some put it in warm Wine believing that by this means the strength of the Wine conveighed through the Umbilical Vessels is able to give him new vigour But as this fleshy Mass and these Vessels are dead parts assoon as they are out of the Womb so there remains in them no spirits which can be communicated to the Infant And if this practice be continued it must rather be to satisfie custome than for any hope of benefit to be thereby received If these things do no good yet do they no great hurt but are only useless but this which follows is capable to suffocate a Child immediately that is when some do thrust back and make the Blood which is in the Umbilical Vessels to enter into the Body believing that it fortifies and recovers the Child out of its weakness but we have elsewhere declared that the Blood contained in these Vessels lose their spirits assoon as the Secondine is separated and come forth of the Womb nay it is there immediatly after half congealed Now if it be thus thrust back into a weak Childs Liver it remains there being no longer animated with any spirits and instead of giving him new strength it overcomes that little which remains and compleats the extinction of his languishing natural heat to avoid this be careful not to force back the Blood thus into the Infants Belly for besides in these weaknesses unless it should be otherwaies by the Mothers flooding before she was brought to Bed there is alwaies too much of it in the Infants body and instead of sending more to it there must be some drawn back from it towards the extremities that so its Ventricles being a little discharged may have afterwards a more free motion to send back the spirits to all parts which are deprived of them by these faintings Wherefore since the Child must receive nothing from the Vmbilical Vessels after its Birth let them be tyed assoon as may be and then ordered according as we have directed Very often the Children which are weak at their Birth are so by nature as when they come before their time and are so much the weaker by how much they want to compleat the end of the ninth Moneth and also when they are begotten by infirm and sick parents These are hard to remedy and there is nothing more to be done but to nourish and order them well according to our former directions but it will be rare for them to be long-lived and it is much if they do not dye by the least indisposition that befalls their natural weakness CHAP. XX. Of Contusions or Bruises of the Head and other parts of the Body of a new-born Babe THe Bodies of new-born Children are as we have said so tender and delicate that they are easily bruised and hurt and sometimes in a bad Labour their Members are dislocated either because it remained long in an unnatural Posture or because they were handled too rudely in the Operation the most usual and frequent bruise is for the most part on the top of their Head where sometimes at their Birth they have a Knob as big as half an Egg if not bigger as is usually seen in first Labours and which happens the sooner according as the Woman is advanced in Age because the inward orifice of the Womb called the Garland being more callous doth not dilate without much difficulty for which reason the Childs head pressing against it and the upper part of it which naturally presents first to the Passage being begirt with it as with a Garland is puft up and swelled because of the Blood and Humours which fall down and are retained in this part by the great compression which this inward orifice makes round about especially when the Throwes begin to be strong and the Child comes but slowly forward after the Waters which did a little defend it are broke away the Midwife also may do much ill in it if she toucheth it too-often or too-roughly with her Fingers when it lyes in the Birth but many times they are in this case wrongfully accused because for the most part the single compression this orifice makes in form of a Garland about the Childs Head is the cause of this kind of bruised Tumours This part swells after the same manner as we see all others which are either too-strongly prest bound or lased for by this means the Blood which cannot circulate being stopt in great abundance in one part obligeth it to swell and be blown up and by the repletion it makes renders it livid as if it were bruised Now this
be a greater hinderance to the Childs sucking and that it turn not into an ill natured Ulcer CHAP. XXIV Of Gripes and Pains of the Belly of a young Child MAny Children are so griped that they cannot forbear crying night nor day for the great pains they feel in their Belly with which some are so vext and tormented that they dye of it 'T is very often the first and most common distemper which happens to little Infants after their Birth which in general and for the most part comes from the sudden change of their nourishment forasmuch as having alwaies received it by the Umbilical Vessels whiles they were in their Mothers Belly they come to change it of a sudden not only the manner of receiving it but the nature and quality of it assoon as they are born for instead of purified Blood only which was conveyed to them by means of the Umbilical Vein they are obliged for want of it to be nourished with their Mothers Breast-milk which they suck with their Mouth and from which are engendered many Excrements causing the Gripes as well because it is not so pure as the Blood with which it was fed in the Womb as because the Stomach and Intestines cannot yet make a good Digestion nor an easie Distribution being not accustomed to it The particular causes of these Gripes are either when the Moeconion amassed during all the time of Pregnancy is not evacuated soon after the Infants birth and that by its too-long stay in the Intestines it acquires a sharp and pricking Acrimony or that becoming hard the Infant cannot void it nor the new Excrements which proceed from the Milk which he hath taken at the first 't is also sometimes because the Child not being able to suck with ease he swallows in sucking the Milk with difficulty much air and wind which being retained in the Stomach and sliding into the Intestines doth painfully distend them This Wind sometimes is caused when a Child takes a greater quantity of Milk than he can digest or because of its ill quality as when the Woman gives her Breast-milk assoon as she is delivered without staying to have it purified Cold may also make it suffer the same But very often it is for giving him Pap too soon as also when it is not enough boiled because this nourishment which is gross and viscous cannot be easily digested by a new-born Babe whose Stomach is not yet accustomed to it and Worms that are engendred in the Intestines by their stirring and biting do also much torment them Besides all these things already mentioned the Midwife also may cause great pains in the Childs Belly by driving back into it the cold and clodded Blood out of the Navel-string before it be tyed For to remedy all these pains in the Belly which Women usually call all by one common name of Gripes respect must be had to their different causes as to that which is the general cause the too sudden change of the nourishment To avoid it one must forbear giving the Child suck until the next day lest the Milk being mixt with the Phlegm which is then in the Stomach corrupt and at first it must suck but little until it be accustomed to digest it If it be the Moeconion of the Intestines which by its long stay causeth these pains for to help to discharge them of it give them at the Mouth a little Oyl of sweet Almonds and Syrup of Roses as we have directed before and to provoke it further give it Beets-stalk covered over with Honey for a Suppository or a sugar'd Almond also dipt in common Honey or one may give it a small Clyster If a Child cannot suck with ease regard must be had to that which hinders it for if it be Tongue-tyed it must be cut as is above directed and if it be because the Nurse is hard milcht change her for one whose Milk is better purified and let her rather suckle it a little and often than more at once than the little Stomach can easily digest at a time And above all whiles the Child is griped give it no Pap because this food by its viscositie doth easily cause obstructions which afterwards engender Wind. If it be Wormes lay a cloath dipt in Oyle of Wormwood mixt with Ox-gall upon the Belly or a small Cataplasme mixt with Powders of Rue Wormwood Coloquint Aloes and the seed of Citrons incorporated with Ox-gal and flower of Lupines and to draw drive them more downwards if the little Infant can take any thing by the Mouth give it a small infusion of Rhubarb or half an Ounce of compound Syrup of Succory having before given it a small Clyster of sugar'd Milk for by this means the Wormes which shun the bitterness of the Medicines and seek after the sweetness of the Milk are easily brought away by Stool When these Gripes are caused by Wind as it often happens or by any sharp Humours in the Intestines anoint the Childs Belly all over with Oyl of Violets or with Oyl of sweet Almonds or else with Oyl of Walnuts Camomil and Melilot mixt together having first warm'd them in which also a Cloath may be dipt to lay upon it or a small Pancake may be made with an Egg or two fried in Oyl of Walnuts for to be applied to it and they may take a little Anodine or Carminative Clyster according as the cause of the Gripes is known above all ever keeping the Child very warm CHAP. XXV Of the Inflamation Ulceration or shooting forth or rupture of the Navel of a young Infant THe continual cries of little Children because of the Pains and Gripes which they feel at the beginning doth somtimes cause such an agitation of the Belly that the Navel-string falling off too soon and before it be entirely closed and cicatrized there happens there an Inflammation and Ulceration at other times also for the same reason although it be outwardly healed not being so within it is dilated and thrust outward the bignesse of a small Egg and sometimes bigger which is usually called Exomphale or shooting forth of the Navel There are some who imagine when it is so inflamed and ulcerated that it was because the String was tied too-near the Belly which caused a great pain and inflamation to follow Others say that Nature having used to discharge the Urine by this part during the Childs being in the Mothers Belly doth at first still continue to send it this way and that it causeth this Accident by its acrimony for which there is no reason for 't is impossible the Urine should regorge from the Bladder to the Navel by the Urachus forasmuch as it is not hollow in an humane Foetus as we have elsewhere made appear And how near the Belly soever the Navel-string is tied and how hard provided some of the true skin which is sensible be not also tied with it it can cause no manner of pain to the Child because it is a dead and
inanimate part assoon as a Child is born and likewise insensible because there is no Nerve distributed into it But this Inflamation usually comes as I have mentioned because the Infant feeling the great pains and gripes in his Belly doth continually cry and thereby hinders the Navel from healing it may likewise be caused by a violent and frequent Cough because by these efforts the Blood is forced back into the remaining end of the Umbilical Vein which it alwaies keeps dilated and being corrupted by its stay there failes not to make an inflammation of the Navel and that which was tyed coming to fall off before it was perfectly healed there remains a very bad Ulcer upon which sometimes follows great loss of Blood and it may be Death The principal thing to be observed in the cure of this Malady is to appease the Cough and quiet the Childs crying respecting that which causeth it without which it would daily increase and if it were the Gripes it must be remedied as is directed in the foregoing Chapter as to the rest if the Navel be inflamed one must lay upon it Vnguentum refrigerans Galeni mixt with as much Populeon or a small Boulster dipt in Oyl of Roses with a little Vinegar Unguentum Rosatum Album mixt together is also good for it If the Navel continues ulcered after the String is fallen off Deficcative and Astringent Medicines must be applied to it such as is small Rags dipt in Lime water which is not too strong or Plantane water wherein a little Allom hath been dissolved If the Ulcer be small a Pledgit of dry Lint will be sufficient Many put to it only a little powder of a Post These things are better for this purpose than Plaisters which are never so drying because of the Oyles and Grease which enter into their composition But if notwithstanding one would use them he may take Desiccativum rubrum or Diapompholigos particularly observing to put a good linnen Compress on the top of these Remedies with a Swath to keep them fast until the Navel be ciccatrized and perfectly healed lest besides its Ulceration it be forced outwards and that its Vessels open by the violence of a great Cough or by the agitation which the Gripes cause in the Childs Belly As to the rupture of the Navel in young Children whether great or little the cure of it must not be otherwise undertaken than by Swathes and Compresses fitted for the purpose 'till they have acquired a more reasonable Age when if the Malady be not cured by the Swathes the Operation may be done if desired But if after the inflamation there growes an Imposthume which causeth the shooting forth of the Navel and that the tumor of it be very great then it ever kills the Children and if it be opened the matter indeed may be emptied but there is great danger that together with it the Guts come forth in the same place the first time the Child cries which may afterwards persuade those that understand not the Art that this accident happened through the Chirurgeons ignorance For this reason Ambrose Parè in his 94th Chapter of his Book of Generation adviseth you not to meddle with it but rather to let the Child die without doing any thing to it as he saith he did himself when he was sent for by a Taylor in the like case He recites in the same place a story of a Chirurgeon of his time called Mr. Peter de la Rock who was in very great danger of his life for having opened an Impostume of the Navel of a Child of Monsieur de Martigues which being done the Intestines came forth by the orifice and soon after the Child died which the servants of the house reported was thereby caused and therefore although without reason they would have killed him if the said Monsieur de Martigues had not hindered them but I believe the Chirurgeon had shunned the danger they put him in and that disgrace if he had before made a good Prognostick of what would follow and the danger wherein the Infant was for it may be resembling many of our time who undertake such things that they may be thought more able than others and being but simple fellows boast themselves capable to work miracles he had promised speedily to cure the Child of this Maladie which was incureable that under so fair hopes he might have a good summe in hand paid him In this we must follow Parey's advice with some distinction for if the Impostume be small and the Child strong one must not forbear having first made a good Prognostick to open it and when there is never so little hopes 't is better to practise what Art commands than to forsake the sick in a certain despair CHAP. XXVI Of the Smartings Redness and Inflammation of the Groin Buttocks and Thighs of the Infant IF the Nurse doth not keep the Child very cleanly not changeing the Beds or washing them each time or assoon as they are fouled with their Excrements their acrimony will not fail to cause redness and smartings in the Groins Thighs and Buttocks and afterwards because of the pain these parts will inflame which easily happens by reason of the tenderness and delicacy of their Skin from which the * The outward skin of the body Epidermis is at length separated and worn away if timely care be not taken The cure of these Indispositions is twofold that is first to keep the Child cleanly and secondly to take off the sharpness of its Urine As to the first the Nurse must cleanse the Child of his Excrements assoon as he hath voided them shifting it each time with a clean bed washed in the Buck as to the second thing to be observed of tempering the Childs Urine that cannot be executed but by the Nurses keeping a cooling Diet that so her Milk may have the same quality wherefore let her abstain from all things that may heat her Besides these two generals cooling and drying Remedies must be applyed to the inflamed parts Wherefore each time the Childs excrements are wip'd off let the parts be bathed with Plantane water mixt with a fourth part of Lime-water and if the pain be very great let it only be fomented with luke-warm Milk Many Women ordinarily use the powder of a Post to drie it or a little Mill-dust which they strew upon it Unguentum Album or Diapompholigos spread upon a small rag in form of a Plaister will not be amiss above all when the Nurse opens the Child let her be very careful to wrap the inflamed parts with fine white rags that those parts may not by rubbing together be more galled and pained CHAP. XXVII Of the Ulcers or Thrush of the Mouth of an Infant VEry frequently the Milk of a Nurse that is Red-haired given to Wine or very amorous may by its heat and acrimony cause small Ulcers in an Infants Mouth which are called Aphthae and vulgarly Cancers sometimes also
are much changed and cry every moment and cannot sleep or but very little at that time and one may feel and see small points of the Teeth through the Gums which appear thin and pale on the top and swelled and red on the sides and if it happens that the Teeth are a long time ere they are cut or that too many of them cut at a time there is great danger the Children will fall into those accidents mentioned by Hippocrates in the aforesaid Aphorisme and if it do not quickly cease they 'l die of it as many do In this case two things must be regarded the first to preserve the Child from the evil Accidents that may happen to it because of the great pain and the second to assist as much as may be the cutting of the Teeth when they can hardly cut the Gums themselves To prevent these Accidents to the Child the Nurse must keep a good Diet and use all things that may cool and temper her Milk that a Fever may not follow the pain of the Teeth and to hinder that the Humours may not fall too-abundantly upon the inflamed Gums keep the Childs Belly alwaies loose to empty them downward to which purpose give him gentle Clysters if he be bound but there is often no need of them because at that time they are usually troubled with a Loosness As to the second which helps the cutting of the Teeth that the Nurse must do from time to time who must pass her Finger upon the Childs Gums gently rubbing them that being thereby rarefied they may be the easier penetrated and cut by the Teeth which are ready to come forth to which also the Child may it self be helpful if they give it a little stick of Liquorice to champ or a little end of a small new wax-candle which is very good to soften the Gum. There is ordinarily made use of a Silver Coral furnished with small Bells to divert the Child from the pain it then feels Sometimes instead of Coral they put a Wolfs tooth in One must not however believe that these things have any peculiar property as many Women imagine but if they are helpful in this case it is because of their solidity evenness and smoothness for the Child rubbing the Gums with it to ease the itching which it feels there doth by degrees diminish the thickness of them and so they are at length insensibly cut by the Teeth which are under If these things do no good because the Gums are either too-hard or too-thick that the Child may not suffer so much nor by reason of the great pain fall into those accidents by us above-mentioned let the Gums be cut with a Lancet where the Teeth are ready Nurses use to do it with their Nails but 't is better to be done with * A thin Groat is as good or better than either a Lancet because 't is not so painful There are many Remedies which divers persons assert have a peculiar property to help the cutting of the Teeth as rubbing them with Bitches milk Hares or Pigs brains and hanging a Vipers tooth about the Neck of the Child and other such like trifles but since they are founded more on Superstition than any reason I will not trouble my self to enlarge upon what is so useless CHAP. XXIX Of the Loosness of an Infant ASsoon as little Infants are in the least indisposed they very ordinarily get a Loosness to which their natural Moistness very much contributes as is taught in the 53th Aphorism of the Second Book Quicunque alvos humidas habent siquidem juvenes fuerint melius degunt his quae siccas habent c. They saith Hippocrates who have a loose Belly in their youth are in better health than those that are bound Besides that all Children are of a moist nature and usually during their sucking fed with Spoon-meats which easily and readily flow from the Stomach and the Guts For the most part the Loosnesses happen to them by reason of the great pain they have at the cutting their Teeth for all the Humours are so over-heated that they are then very thirsty which makes them endeavouring to extinguish it draw more Milk than their weak Stomachs can digest which corrupting there a Loosness certainly follows It may also happen by the vitiousness of the Nurses Milk which may be too hot as a new-laid Womans also is being ever impure especially the first five or six daies If the Loosness be not accompanied with a Fever or some other accident it is not dangerous because it is an indisposition convenient to a Childs nature and moist habit as also to the food wherewith it is nourished Hippocrates assures us as much in the four and thirtieth Aphorism of his second Book In morbis minus periclitantur quorum naturae aut aetati aut tempori morbus magis cognatus fuerit quam quibus in nullo horum cognatus fuerit They saies he are in less danger whose maladies are more familiar and convenient to their Nature and Temperament or their Age Custom of living or the Season than they whose Disease hath no respect to any of these things But however if it continues too-long it will not be amiss to remedy it lest the Child composed of a tender and soft substance easie upon this account if one may so say to be melted be not too-much enfeebled by it because of the great dissipation of spirits which the continual evacuation of humours flowing through the Belly effects For this purpose let it suck well purified Milk giving it but little at a time to the end it may the better digest it and to cleanse his Stomach and Guts of the ill humours which being contained in and cleaving to them will yet so much the more hinder the digestion give it a flight Infusion of Rhubarb or a little compound Syrup of Succory gentle Anodine Clysters may likewise be given made with Milk Yolks of Eggs and Honey of Violets and after purging let them be made with Plantane water One may then also mix the Yolk of an Egg in the Pap he eats rub the Belly with Oile of Quinces and lay upon his Stomack Compresses dipt in Red-wine wherein Provence-Roses are boiled ever having respect above all to the cause of the Loosness and the Accidents complicated with it and using Remedies convenient to their nature CHAP. XXX Of Vomitings in Children ONe need not wonder at the Vomiting of little Children because 't is an accident more ordinary and common to them than any other nor need one be very careful to stop it unless it be continual and a little excessive in which case 't is fit to remedy it to prevent the consequents of a worse Malady Vomiting usually happens to Children because they often draw more Milk than their little Stomach can easily contain or digest with which being over-charged they are obliged to cast it up it may also happen to them because 't is bad Milk The efforts of
diligent care reduced to their natural state now amongst other things endeavour to prevent the Childs squinting growing awry crooked or lame and to redress any of these whatsoever as much as possible To prevent its Squinting chuse a Nurse whose sight is stable and right lest by her ill example he gets an ill habit and as we have said elsewhere let the Cradle be ever so placed that being laid in it he may alwaies see the light directly before him either of day candle or fire lest by being on one side he come to turn continually his Eyes that way whereby he will be in great danger of growing asquint Paulus Aeginetus and Pareus also would have a squint-eyed Infant 's sight redressed by putting a Mask upon his Face with only two small holes right against the Eyes to see through which will cause him perceiving no light but through those holes to hold his Eyes ever that way by means whereof they will be established in a right scituation and by degrees quit the ill habit they had gotten of looking aside This counsel seems good in appearance but I believe it will be very inconvenient for a Child to follow it besides that the least removing of the Mask on which side soever the little holes not corresponding perfectly in a direct line to the middle of the Eyes the sight will be thereby more perverted To prevent a Childs growing crooked awry or lame the Nurse must swaddle its Body in a strait scituation equally extending the Arms and Legs and swathing the Child sometimes one way sometimes another lest swadling it alwaies one way the parts should take an ill habit When he is laid in the Cradle he must be streight on his back and not bending and above all when the Nurse holds him in her Arms let her carry him sometimes upon one and sometimes upon the other for holding the Childs Legs alwaies on the same fashion it would be a great hazard if they did not at length grow crooked and it is often the only reason that so many Children have crooked Legs especially about the Knees and this few Nurses take notice of which notwithstanding is of great consequence When these parts have an evil conformation in their Figure they must be helpt with Swathes and Boulsters conveniently placed to keep the parts in a good posture whiles the Child is in swadling Clothes afterwards being grown a little bigger one may use little leather Boots somewhat stiff with which the Legs must be straitned and if the Foot be only awry Shoes underlaid of one side higher than the other will serve the turn When the Breast or Back-bone are in fault it must be helped if possible or at least hindered from growing worse and the fault may be hid by ordering the Childs clothes with Past-board Whale-bone and Tinne placed where the Chirurgeon shall think fit to reduce the mishapen part to a better Figure Having hitherto mentioned the most ordinary Diseases befalling little Infants 't is not necessary here to make a larger description of them for as for those that we have not treated of since they may indifferently happen to all sorts of ages they have nothing peculiar in respect of Children as to the knowledg or cure of them but only for the tenderness and delicacy of their Body There now remains only for to finish our undertaking that we give necessary directions in the choice of a good Nurse CHAP. XXXIV Of the requisites and necessary conditions in the choice of a good Nurse THe first and principal of all the qualities in a good Nurse is that she be the own Mother of the Child as well because of the mutual agreement of their tempers as that having much more love for it she will be much more careful than an hired Nurse who ordinarily loves her Nurse-child but with a feined and seeming love having no other end or foundation but the hope of her recompence she expects for her pains by a mercenary hire Wherefore the true Mother though not the best Nurse should ever be preferred before a Stranger But because there are several that either will not or cannot suckle their own Children whether it be to preserve their beauty as all persons of quality and most of the Citizens do or that their Husbands will not suffer them nor be troubled with such a noise or that being ill or indisposed they cannot there is then an obligation to provide another Nurse which should be chosen as convenient for the Child as may be Now even as we see Trees though of the same kind growing in the same place being afterwards transplanted into another soil produce fruits of a different taste by reason of the nourishment they draw thence Even so the health of Children and sometimes their manners depends on the nourishment they receive at the beginning for as to the health of the Body 't is well known it answers the Humours that all the parts are nourished and maintained with which Humours ever retain the nature of the food whereof they are engendred As for the Manners they ordinarily follow the Temperament which also proceeds from the quality of the Humours and the Humours from the Food By this consequence as the Nurse is so will the Child be by means of the nourishment which it draweth from her and in sucking her it will draw in both the vices of her Body and Mind This appears very easily in Animals that suck a strange Dam for they alwaies partake something of the creature they suck being accordingly either of a mild or fiercer nature or of a stronger or weaker Body which may be noted in the example of young Lions tamed by sucking a domestick Animal as a Cow Asse or Goat and on the contrary a Dog will become more furious or fierce if it sucks a Wolf The necessary conditions in a good Nurse are usually taken from her Age the time and manner of her Labour the good constitution of all the parts of her Body and particularly of her Breasts from the nature of her Milk and in fine from her good Manners As to her Age the most convenient is from twenty five to thirty five years of age because that during this space the Woman is most healthy strong and vigorous she is not fit before five and twenty because her Body not having yet acquired all its dimensions cannot be so robust nor after thirty five because not having Blood enough in so great abundance she cannot have Milk enough for the nourishment of the Child However some Women are indifferent good Nurses from twenty to fourty but very rarely before or after As to the time and manner of her Labour it must be at least a Month or six Weeks after it that so her Milk may be throughly purified because at that time her Body is usually cleansed of the Lochia which follows Labour and the Humours are no longer disturbed with it nor must it be above five or six Months that
he sleeps however if his sleep be very immoderate it may be a little broken to which purpose let his Nurse carry him in her Arms to the light singing with a soft and sweet voice shewing him some glistering thing to please his sight and dancing him a little to awake him out of his drowsiness for by too long Sleep the natural Heat doth so retire inwards that it is as it were buried there by means of which all the Body and chiefly the Brain is so cooled that the Infants Senses are thereby quite dull and their functions languishing and stupified When he is in the Cradle let it be so turned as it may be towards the Fire the Candle or the Chamber Window that having the light directly in its Face he may not be allured to look continually on one side for doing so often his sight will be so perverted that he will grow squint-eyed Wherefore for the better security throw some Covering over the head of the Bed as we have said to hinder him from seeing the light because by this means his sight being staied from rouling from side to side will be the better fortified Let us now see how a Nurse must daily cleanse her Child from the Excrements As the young of all other Animals have their bodies free without the trouble of any coverings so they easily discharge themselves of their Excrements without being befouled and they no sooner empty their Belly but their Dam if they cannot do it themselves perceiving it casts it forth of their Nest or at lest rangeth it in some one part where it cannot hurt them but it is not the same with Infants who for being bound and swathed with Swathes and Blankets as we are forced to give them a strait Figure only suitable to mankind cannot render their Excrements but at the same time they must be befouled and in which because it cannot be perceived for their Clothes they often remain until the ill scent of it offends the Nurses nose or that she doubts it because of the Cryes and Tears of the Child which is incommoded by the Moistness and Acrimony of it to avoid which let the Child be opened and changed at least twice or thrice a day and also sometimes in the night if necessary to cleanse him from his Excrements and change the bed which ought to be well washed and not slightly as most part of hired Nurses do which causeth a great itching and galleth the Childs body because of a certain salt coming from the Excrements and not easie to be dissolved when the Blanket hath once imbued it but by putting it into a Bucking-tub The best time to shift the Child is immediatly after the Excrements are rendred without suffering him to lye longer in them than 'till he awakes if he were then asleep Now since he may render them at any hour indifferently no other time can be appointed to do it but when there is no need that is as often as it is necessary to keep him alwaies clean The Child must alwaies be opened before the fire and his Beds and Clouts well warmed and dried before he be put into them lest their coldness and moisture cause a Cholick and Gripes the Nurse likewise must be careful from time to time to put soft Rags behind the Ears and under the Arm-pits to dry up the moisture there found being very careful during the first four or five daies not to make the remaining part of the Navel-string fall off too soon and before the Vessels of it be perfectly closed Let her likewise see every time she opens him whether the Navel for want of being well tyed at first do not bleed or because the thread is loosened and after the end is quite fallen off let her still for some time swath the Navel ever laying a boulster on the top of it until it be well cicatriced and wholly depressed and as it were sunk inwards Besides this let her put upon the Mould of the head under the Biggen another Compress as well to keep the Brain warm as to defend it from outward Injuries which might easily hurt it because of the tenderness of that place not yet covered over with any bone let her also be very careful not to let the Child cry too-much especially at first lest the Navel be forced outwards and that there happen to him by its dilatation an Exomphale or a rupture in the Groine nor must she hearken to the sayings of some good people who affirm it necessary a Child should sometimes cry to discharge its Brain the two best waies to quiet him when he cryes is to give him suck and lay him clean and dry 't is likewise good to present to his sight things that rejoyce him and to remove what may affright or grieve him All these directions in this present Chapter concerning the Diet and Order of a new-born Babe must be understood for one in health for if he be any waies indisposed he must be treated according as the case requires This is what we intend to examine in all the remaining part of the Book CHAP. XIX Of the Indispositions of little Children and first of their weakness YOung Trees are scarce raised out of the Earth which is their Mother but often many of them soon after dye because their small bodies by reason of the tenderness of their substance easily receive alteration and cannot without great difficulty resist the smallest opposition until they become a little bigger and have taken stronger and deeper root So likewise we see daily above half of the young Children dye before they are two or three years old as well because of the tenderness of their Bodies as by reason of the feebleness of their Age they cannot otherwise express the incommodities they suffer within but by their cryes We have heretofore discovered how they ought to be governed in the beginning for the preservation of a good health we will now discourse of the indispositions to which they are subject principally from their birth 'till they are seven or eight Months old Let us first mention some they are born with and then wee 'l entertain you with those that usually happen to them afterwards The first Accident to be remedied is the weakness many Children bring into the world with them which often happens not because they are so by Nature but by the violence of a bad Labour or the length of it during which they suffer so much that sometimes after they are born they are so weak that it is hard to be discovered whether they are dead or alive not any part of their Body being perceived to stir which sometimes is so blew and livid especially the Face that one would think they were quite choaked And many times after they have been thus for whole hours they recover by little and little from their weakness as if they revived and were returned from Death to Life One may guess that the Child is not effectually dead although