REMEDIES
FOR SEVERAL DISEASES
INCIDENTAL TO HUMAN BODIES
* * * * *
_For the Apoplexy._
Take man’s skull prepared, and powder of male peony, of each an ounce and a half, contrayerva, bastard dittany, angelica, zedvary, of each two drachms, mix and make a powder, add thereto two ounces of candied orange and lemon peel, beat all together to a powder, whereof you may take half a drachm or a drachm.
_A Powder for the Epilepsy or Falling Sickness._
Take of opopanax, crude antimony, castor, dragon’s blood, peony seeds, of each an equal quantity; make a subtle powder; the dose, half a drachm of black cherry water. Before you take it, the stomach must be prepared with some proper vomit, as that of Mynficht’s emetic tartar, from four grains to six; if for children, salts of vitrol, from a scruple to half a drachm.
_For a Headache of Long Standing._
Take the juice or powder in distilled water of hog lice and continue it.
_For Spitting of Blood._
Take conserve of comfrey and of hips, of each an ounce and a half; conserve of red roses, three ounces; dragon’s blood, a drachm; spices of hyacinths, two scruples; red coral, a drachm; mix and with syrup of poppies make a soft electuary. Take the quantity of a walnut, night and morning.
_For a Looseness._
Take Venice treacle and diascordium, of each half a drachm, in warm ale or water gruel, or what you like best, at night, going to bed.
_For the Bloody Flux._
First take a drachm of powder of rhubarb in a sufficient quantity of conserve of red roses, in the morning early; then at night, take of tornified or roasted rhubarb, half a drachm; diascordium, a drachm and a half; liquid laudanum cyclomated, a scruple: mix and make into a bolus.
_For an Inflammation of the Lungs._
Take of cherious water, ten ounces; water of red poppies, three ounces; syrup of poppies, an ounce; pearl prepared, a drachm; make julep, and take six spoonfuls every fourth hour.
_An Ointment for the Pleurisy._
Take oil of violets or sweet almonds, an ounce of each, with wax and a little saffron, make an ointment, warm it and bathe it upon the parts affected.
_An Ointment for the Itch._
Take sulphur vive in powder, half an ounce, oil of tartar per deliquim, a sufficient quantity, ointment of roses, four ounces; make a liniment, to which add a scruple of rhodium to aromatize, and rub the parts affected with it.
_For Running Scab._
Take two pounds of tar, incorporate it into a thick mass with well-sifted ashes; boil the mass in fountain-water, adding leaves of ground-ivy, white horehound, fumitory roots, sharp-pointed dock and of flocan pan, of each four handfuls; make a bath to be used with care of taking cold.
_For Worms in Children._
Take wormseed, half a drachm, flour of sulphur, a drachm; mix and make a powder. Give as much as will lie on a silver threepence, night and morning, in grocer’s treacle or honey, or to grown up people, you may add a sufficient quantity of aloe rosatum and so make them up into pills; three or four may be taken every morning.
_For Fevers in Children._
Take crab-eyes, a drachm, cream of tartar, half a drachm; white sugar-candy finely powdered, weight of both; mix all well together and give as much as will lie on a silver threepence, in a spoonful of barley-water or sack whey.
_A Quieting Night-Draught, when the Cough is Violent._
Take water of green wheat, six ounces, syrup diascordium, three ounces, take two or three spoonfuls going to bed every night or every other night.
_An Electuary for the Dropsy._
Take best rhubarb, one drachm, gum lac, prepared, two drachms, zyloaloes, cinnamon, long birthwort, half an ounce each, best English saffron, half a scruple; with syrup of chicory and rhubarb make an electuary. Take the quantity of a nutmeg or small walnut every morning fasting.
_For a Tympany Dropsy._
Take roots of chervil and candied eringo roots, half an ounce of each, roots of butcher-broom, two ounces, grass-roots, three ounces, shavings of ivory and hartshorn, two drachms and a half each; boil them in two or three pounds of spring water. Whilst the strained liquor is hot, pour it upon the leaves of watercresses and goose-grass bruised, of each a handful, adding a pint of Rhenish wine. Make a close infusion for two hours, then strain out the liquor again, and add to it three ounces of magirtral water and earth worms and an ounce and a half of the syrup of the five opening roots. Make an apozen, whereof take four ounces twice a day.
_For an Inward Bleeding._
Take leaves of plantain and stinging nettles, of each three handfuls, bruise them well and pour on them six ounces of plantain water, afterwards make a strong expression and drink the whole off. _Probatum est._
* * * * *
GENERAL OBSERVATIONS
_Worthy of Notice._
WHEN YOU FIND
A red man to be faithful, a tall man to be wise, a fat man to be swift of foot, a lean man to be a fool, a handsome man not to be proud, a poor man not to be envious, a knave to be no liar, an upright man not too bold and hearty to his own loss, one that drawls when he speaks not to be crafty and circumventing, one that winks on another with his eyes not to be false and deceitful, a sailor and hangman to be pitiful, a poor man to build churches, a quack doctor to have a good conscience, a bailiff not to be a merciless villain, an hostess not to over-reckon you, and an usurer to be charitable—-
THEN SAY,
_Ye have found a prodigy._
Men acting contrary to the common course of nature.
* * * * *
PART II
* * * * *
THE
EXPERIENCED MIDWIFE
* * * * *
INTRODUCTION.
I have given this Part the title of The Experienced Midwife, because it is chiefly designed for those who profess Midwifery, and contains whatever is necessary for them to know in the practice thereof; and also, because it is the result of many years’ experience, and that in the most difficult cases, and is, therefore, the more to be depended upon.
A midwife is the most necessary and honourable office, being indeed a helper of nature; which therefore makes it necessary for her to be well acquainted with all the operations of nature in the work of generation, and instruments with which she works. For she that knows not the operations of nature, nor with what tool she works, must needs be at a loss how to assist therein. And seeing the instruments of operation, both in men and women, are those things by which mankind is produced, it is very necessary that all midwives should be well acquainted with them, that they may better understand their business, and assist nature, as there shall be occasion.
The first thing then necessary as introductory to this treatise, is an anatomical description of the several parts of generation both in men and women; but as in the former part of this work I have treated at large upon these subjects, being desirous to avoid tautology, I shall not here repeat anything of what was then said, but refer the reader thereto, as a necessary introduction to what follows. And though I shall be necessitated to speak plainly so that I may be understood, yet I shall do it with that modesty that none shall have need to blush unless it be from something in themselves, rather than from what they shall find here; having the motto of the royal garter for my defence, which is:–“Honi soit qui mal y pense,”–“Evil be to him that evil thinks.”
* * * * *
A
GUIDE TO CHILDBEARING
WOMEN
* * * * *
BOOK I
CHAPTER I
SECTION I.–_Of the Womb._
In this chapter I am to treat of the womb, which the Latins call _matrix_. Its parts are two; the mouth of the womb and the bottom of it. The mouth is an orifice at the entrance into it, which may be dilated and shut together like a purse; for though in the act of copulation it is big enough to receive the glans of the yard, yet after conception, it is so close and shut, that it will not admit the point of a bodkin to enter; and yet again, at the time of a woman’s delivery, it is opened to such an extraordinary degree, that the child passeth through it into the world; at which time this orifice wholly disappears, and the womb seems to have but one great cavity from the bottom to the entrance of the neck. When a woman is not with child, it is a little oblong, and of substance very thick and close; but when she is with child it is shortened, and its thickness diminished proportionably to its distension; and therefore it is a mistake of anatomists who affirm, that its substance waxeth thicker a little before a woman’s labour; for any one’s reason will inform him, that the more distended it is, the thinner it must be; and the nearer a woman is to the time of her delivery the shorter her womb must be extended. As to the action by which this inward orifice of the womb is opened and shut, it is purely natural; for were it otherwise, there could not be so many bastards begotten as there are, nor would any married women have so many children. Were it in their own power they would hinder conception, though they would be willing enough to use copulation; for nature has attended that action with so pleasing and delightful sensations, that they are willing to indulge themselves in the use thereof notwithstanding the pains they afterwards endure, and the hazard of their lives that often follows it. And this comes to pass, not so much from an inordinate lust in woman, as that the great Director of Nature, for the increase and multiplication of mankind, and even all other species in the elementary world, hath placed such a magnetic virtue in the womb, that it draws the seed to it, as the loadstone draws iron.
The Author of Nature has placed the womb in the belly, that the heat might always be maintained by the warmth of the parts surrounding it; it is, therefore, seated in the middle of the hypogastrium (or lower parts of the belly between the bladder and the belly, or right gut) by which also it is defended from any hurt through the hardness of the bones, and it is placed in the lower part of the belly for the convenience of copulation, and of a birth being thrust out at full time.
It is of a figure almost round, inclining somewhat to an oblong, in part resembling a pear; for being broad at the bottom, it gradually terminates in the point of the orifice which is narrow.
The length, breadth and thickness of the womb differ according to the age and disposition of the body. For in virgins not ripe it is very small in all its dimensions, but in women whose terms flow in great quantities, and such as frequently use copulation, it is much larger, and if they have had children, it is larger in them than in such as have had none; but in women of a good stature and well shaped, it is (as I have said before), from the entry of the privy parts to the bottom of the womb usually about eight inches; but the length of the body of the womb alone, does not exceed three; the breadth thereof is near about the same, and of the thickness of the little finger, when the womb is not pregnant, but when the woman is with child, it becomes of a prodigious greatness, and the nearer she is to delivery, the more the womb is extended.
It is not without reason then, that nature (or the God of Nature) has made the womb of a membranous substance; for thereby it does the easier open to conceive, is gradually dilated by the growth of the foetus or young one, and is afterwards contracted or closed again, to thrust forth both it and the after-burden, and then to retire to its primitive seat. Hence also it is enabled to expel any noxious humours, which may sometimes happen to be contained within it.
Before I have done with the womb, which is the field of generation, and ought, therefore, to be the more particularly taken care of (for as the seeds of plants can produce no plants, nor sprig unless grown in ground proper to excite and awaken their vegetative virtue so likewise the seed of man, though potentially containing all the parts of the child, would never produce so admissible an effect, if it were not cast into that fruitful field of nature, the womb) I shall proceed to a more particular description of its parts, and the uses for which nature has designed them.
The womb, then, is composed of various similar parts, that is of membranes, veins, arteries and nerves. Its membranes are two and they compose the principal parts of the body, the outermost of which ariseth from the peritoneum or caul, and is very thin, without it is smooth, but within equal, that it may the better cleave to the womb, as it is fleshier and thicker than anything else we meet with within the body, when the woman is not pregnant, and is interwoven with all sorts of fibres or small strings that it may the better suffer the extension of the child, and the water caused during pregnancy, and also that it may the easier close again after delivery.
The veins and arteries proceed both from the hypogastric and the spermatic vessels, of which I shall speak by and by; all these are inserted and terminated in the proper membranes of the womb. The arteries supply it with food and nourishment, which being brought together in too great a quantity, sweats through the substance of it, and distils as it were a dew at the bottom of the cavity; from thence proceed the terms in ripe virgins, and the blood which nourisheth the embryo in breeding women. The branches which issue from the spermatic vessels, are inserted on each side of the bottom of the womb, and are much less than those which proceed from the hypogastrics, those being greater and bedewing the whole substance of it. There are some other small vessels, which arising the one from the other are conducted to the internal orifice, and by these, those that are pregnant purge away the superfluity of the terms when they happen to have more than is used in the nourishment of the infant: by which means nature has taken so much care of the womb, that during pregnancy it shall not be obliged to open itself for passing away those excrementitious humours, which, should it be forced to do, might often endanger abortion.
As touching the nerves, they proceed from the brain, which furnishes all the inner parts of the lower belly in them, which is the true reason it hath so great a sympathy with the stomach, which is likewise very considerably furnished from the same part; so that the womb cannot be afflicted with any pain, but that the stomach is immediately sensible thereof, which is the cause of those loathings or frequent vomitings which happen to it.
But beside all these parts which compose the womb, it has yet four ligaments, whose office it is, to keep it firm in its place, and prevent its constant agitation, by the continual motion of the intestines which surround it, two of which are above and two below. Those above are called the broad ligaments, because of their broad and membranous figure, and are nothing else but the production of the peritoneum which growing out of the sides of the loins towards the veins come to be inserted in the sides of the bottom of the womb, to hinder the body from bearing too much on the neck, and so from suffering a precipitation as will sometimes happen when the ligaments are too much relaxed; and do also contain the testicles, and as well, safely conduct the different vessels, as the ejaculatories, to the womb. The lowermost are called round ligaments, taking their origin from the side of the womb near the horn, from whence they pass the groin, together with the production of the peritoneum, which accompanies them through the rings of the oblique and transverse muscles of the belly, by which they divide themselves into many little branches resembling the foot of a goose, of which some are inserted into the os pubis, the rest are lost and confounded with the membranes which women and children feel in their thighs. These two ligaments are long, round and nervous, and pretty big in their beginning near the matrix, hollow in their rise, and all along the os pubis, where they are a little smaller and become flat, the better to be inserted in the manner aforesaid. It is by their means the womb is hindered from rising too high. Now, although the womb is held in its natural situation by means of these four ligaments, it has liberty enough to extend itself when pregnant, because they are very loose, and so easily yield to its distension. But besides these ligaments, which keep the womb, as it were, in a poise, yet it is fastened for greater security by its neck, both to the bladder and rectum, between which it is situated. Whence it comes to pass, that if at any time the womb be inflamed, it communicates the inflammation to the neighbouring part.
Its use or proper action in the work of generation, is to receive and retain the seed, and deduce from it power and action by its heat, for the generation of the infant; and it is, therefore, absolutely necessary for the conservation of the species. It also seems by accident to receive and expel the impurities of the whole body, as when women have abundance of whites, and to purge away, from time to time, the superfluity of the blood, as when a woman is not with child.
SECT. II.–_Of the difference between the ancient and modern Physicians, touching the woman’s contributing seed for the Formation of the Child._
Our modern anatomists and physicians are of different sentiments from the ancients touching the woman’s contributing seed for the formation of the child, as well as the man; the ancients strongly affirming it, but our modern authors being generally of another judgment. I will not make myself a party to this controversy, but set down impartially, yet briefly, the arguments on each side, and leave the judicious reader to judge for himself.
Though it is apparent, say the ancients, that the seed of man is the principal efficient and beginning of action, motion and generation, yet the woman affords seed, and contributes to the procreation of the child, it is evident from hence, that the woman had seminal vessels, which had been given her in vain if she wanted seminal excretions; but since nature forms nothing in vain, it must be granted that they were formed for the use of the seed and procreation, and fixed in their proper places, to operate and contribute virtue and efficiency to the seed; and this, say they, is further proved from hence, that if women at years of maturity use not copulation to eject their seed, they often fall into strange diseases, as appears by young women and virgins, and also it appears that, women are never better pleased than when they are often satisfied this way, which argues, that the pleasure and delight, say they, is double in women to what it is in men, for as the delight of men in copulation consists chiefly in the emission of the seed, so women are delighted, both in the emission of their own and the reception of the man’s.
But against this, all our modern authors affirm that the ancients are very erroneous, inasmuch as the testicles in women do not afford seed, but are two eggs, like those of a fowl or other creatures; neither have they any such offices as in men, but are indeed an ovarium, or receptacle for eggs, wherein these eggs are nourished, by the sanguinary vessels dispersed through them; and from hence one or more, as they are fecundated by the man’s seed, are conveyed into the womb by the oviducts. And the truth of this, say they, is so plain, that if you boil them, the liquor shall have the same taste, colour and consistency with the taste of bird’s eggs. And if it be objected that they have no shells, the answer is easy; for the eggs of fowls while they are in the ovary, nay, after they have fallen into the uterus, have no shell: and though they have one when they are laid, yet it is no more than a fence which nature has provided for them against outward injuries, they being hatched without the body, but those of women being hatched within the body have no need of any other fence than the womb to secure them.
They also further say, that there are in the generation of the foetus, or young ones, two principles, _active_ and _passive_; the _active_ is the man’s seed elaborated in the testicles out of the arterial blood and animal spirits; the _passive_ principle is the ovum or egg, impregnated by the man’s seed; for to say that women have true seed, say they, is erroneous. But the manner of conception is this; the most spirituous part of the man’s seed, in the act of copulation, reaching up to the ovarium or testicles of the woman (which contains divers eggs, sometimes fewer) impregnates one of them; which, being conveyed by the oviducts to the bottom of the womb, presently begins to swell bigger and bigger, and drinks in the moisture that is so plentifully sent hither, after the same manner that the seed in the ground suck the fertile moisture thereof, to make them sprout.
But, notwithstanding what is here urged by modern anatomists, there are some late writers of the opinion of the ancients, viz., that women both have, and emit seed in the act of copulation; and even women themselves take it ill to be thought merely passive in the act wherein they make such vigorous exertions; and positively affirm, that they are sensible of the emission of their seed in that action, and that in it a great part of the delight which they take in that act, consists. I shall not, therefore, go about to take away any of their happiness from them, but leave them in possession of their imaginary felicity.
Having thus laid the foundation of this work, I will now proceed to speak of conception, and of those things which are necessary to be observed by women from the time of their conception, to the time of their delivery.
* * * * *
CHAPTER II
_Of Conception; what it is; how women are to order themselves after Conception._
SECTION I.–_What Conception is, and the qualifications requisite thereto._
Conception is nothing but an action of the womb, by which the prolific seed is received and retained, that an infant may be engendered and formed out of it. There are two sorts of conception: the one according to nature, which is followed by the generation of the infant in the womb; the other false and wholly against nature, in which the seed changes into water, and produces only false conceptions, moles, or other strange matter. Now, there are three things principally necessary in order to a true conception, so that generation may follow, viz., without diversity of sex there can be no conception; for, though some will have a woman to be an animal that can engender of herself, it is a great mistake; there can be no conception without a man discharge his seed into the womb. What they allege of pullets laying eggs without a cock’s treading them is nothing to the purpose, for those eggs should they be set under a hen, will never become chickens because they never received any prolific virtue from the male, which is absolutely necessary to this purpose, and is sufficient to convince us, that diversity of the sex is necessary even to those animals, as well as to the generation of man. But diversity of sex, though it be necessary to conception, yet it will not do alone; there must also be a congression of the different sexes; for diversity of sex would profit little if copulation did not follow. I confess I have heard of subtle women, who, to cover their sin and shame, have endeavoured to persuade some peasants that they were never touched by man to get them with child; and that one in particular pretended to conceive by going into a bath where a man had washed himself a little before and spent his seed in it, which was drawn and sucked into her womb, as she pretended. But such stories as these are only for such who know no better. Now that these different sexes should be obliged to come to the touch, which we call copulation or coition, besides the natural desire of begetting their like, which stirs up men and women to it, the parts appointed for generation are endowed by nature with a delightful and mutual itch, which begets in them a desire to the action; without which, it would not be very easy for a man, born for the contemplation of divine mysteries, to join himself, by the way of coition, to a woman, in regard to the uncleanness of the part and the action. And, on the other side, if the woman did but think of those pains and inconveniences to which they are subject by their great bellies, and those hazards of life itself, besides the unavoidable pains that attend their delivery, it is reasonable to believe they would be affrighted from it. But neither sex makes these reflections till after the action is over, considering nothing beforehand but the pleasure of the enjoyment, so that it is from this voluptuous itch that nature obliges both sexes to this congression. Upon which the third thing followeth of course, viz., the emission of seed into the womb in the act of copulation. For the woman having received this prolific seed into her womb, and retained it there, the womb thereupon becomes depressed, and embraces the seed so closely, that being closed the point of a needle cannot enter into it without violence. And now the woman may be said to have conceived, having reduced by her heat from power into action, the several faculties which are contained in the seed, making use of the spirits with which the seed abounds, and which are the instruments which begin to trace out the first lineaments of the parts, and which afterwards, by making use of the menstruous blood flowing to it, give it, in time, growth and final perfection. And thus much shall suffice to explain what conception is. I shall next proceed to show
SECT. II.–_How a Woman ought to order herself after Conception._
My design in this treatise being brevity, I shall bring forward a little of what the learned have said of the causes of twins, and whether there be any such things as superfoetations, or a second conception in a woman (which is yet common enough), and as to twins, I shall have occasion to speak of them when I come to show you how the midwife ought to proceed in the delivery of the women that are pregnant with them. But having already spoken of conception, I think it now necessary to show how such as have conceived ought to order themselves during their pregnancy, that they may avoid those inconveniences, which often endanger the life of the child and many times their own.
A woman, after conception, during the time of her being with child, ought to be looked upon as indisposed or sick, though in good health; for child bearing is a kind of nine months’ sickness, being all that time in expectation of many inconveniences which such a condition usually causes to those that are not well governed during that time; and therefore, ought to resemble a good pilot, who, when sailing on a rough sea and full of rocks, avoids and shuns the danger, if he steers with prudence, but if not, it is a thousand to one but he suffers shipwreck. In like manner, a woman with child is often in danger of miscarrying and losing her life, if she is not very careful to prevent those accidents to which she is subject all the time of her pregnancy. All which time her care must be double, first of herself, and secondly of the child she goes with for otherwise, a single error may produce a double mischief; for if she receives a prejudice, the child also suffers with her. Let a woman, therefore, after conception, observe a good diet, suitable to her temperament, custom, condition and quality; and if she can, let the air where she ordinarily dwells be clear and well tempered, and free from extremes, either of heat or cold; for being too hot, it dissipateth the spirits too much and causes many weaknesses; and by being too cold and foggy, it may bring down rheums and distillations on the lungs, and so cause her to cough, which, by its impetuous motion, forcing downwards, may make her miscarry. She ought alway to avoid all nauseous and ill smells; for sometimes the stench of a candle, not well put out, may cause her to come before time; and I have known the smell of charcoal to have the same effect. Let her also avoid smelling of rue, mint, pennyroyal, castor, brimstone, etc.
But, with respect to their diet, women with child have generally so great loathings and so many different longings, that it is very difficult to prescribe an exact diet for them. Only this I think advisable, that they may use those meats and drinks which are to them most desirable, though, perhaps, not in themselves so wholesome as some others, and, it may be not so pleasant; but this liberty must be made use of with this caution, that what they desire be not in itself unwholesome; and also that in everything they take care of excess. But, if a child-bearing woman finds herself not troubled with such longings as we have spoken of, let her take simple food, and in such quantity as may be sufficient for herself and the child, which her appetite may in a great measure regulate; for it is alike hurtful to her to fast too long as to eat too much; and therefore, rather let her eat a little and often; especially let her avoid eating too much at night, because the stomach being too much filled, compresseth the diaphragm, and thereby causeth difficulty of breathing. Let her meat be easy of digestion, such as the tenderest parts of beef, mutton, veal, fowls, pullets, capons, pigeons and partridges, either boiled or roasted, as she likes best, new laid eggs are also very good for her; and let her put into her broth those herbs that purify it, as sorrel, lettuce, succory and borage; for they will purge and purify the blood. Let her avoid whatever is hot seasoned, especially pies and baked meats, which being of hot digestion, overcharge the stomach. If she desire fish let it be fresh, and such as is taken out of rivers and running streams. Let her eat quinces and marmalade, to strengthen her child: for which purpose sweet almonds, honey, sweet apples, and full ripe grapes, are also good. Let her abstain from all salt, sour, bitter and salt things, and all things that tend to provoke the terms–such as garlic, onions, mustard, fennel, pepper and all spices except cinnamon, which in the last three months is good for her. If at first her diet be sparing, as she increases in bigness, let her diet be increased, for she ought to consider that she has a child as well as herself to nourish. Let her be moderate in her drinking; and if she drinks wine, let it be rather claret than white (for it will breed good blood, help the digestion, and comfort the stomach, which is weakly during pregnancy); but white wine being diuretic, or that which provokes urine, ought to be avoided. Let her be careful not to take too much exercise, and let her avoid dancing, riding in a coach, or whatever else puts the body into violent motion, especially in the first month. But to be more particular, I shall here set down rules proper for every month for the child-bearing woman to order herself, from the time she first conceived, to the time of her delivery.
_Rules for the First Two Months._
As soon as a woman knows, or has reason to believe, that she has conceived, she ought to abstain from all violent motions and exercise; whether she walks afoot, or rides on horseback or in a coach, it ought to be very gently. Let her also abstain from Venery (for which, after conception, she has usually no great inclination), lest there be a mole or superfoetation, which is the adding of one embryo to another. Let her beware not to lift her arms too high, nor carry great burdens, nor repose herself on hard and uneasy seats. Let her use moderately good, juicy meat and easy of digestion, and let her wines be neither too strong nor too sharp, but a little mingled with water; or if she be very abstemious, she may use water wherein cinnamon has been boiled. Let her avoid fastings, thirst, watchings, mourning, sadness, anger, and all other perturbations of the mind. Let no one present any strange or unwholesome thing to her, nor so much as name it, lest she should desire it and not be able to get it, and so either cause her to miscarry, or the child to have some deformity on that account. Let her belly be kept loose with prunes, raisins or manna in her broth, and let her use the following electuary, to strengthen the womb and the child–
“Take conserve of borage, buglos and roses, each two ounces; an ounce of balm; an ounce each of citron peel and shreds, candied mirobalans, an ounce each; extract of wood aloes a scruple; prepared pearl, half a drachm; red coral and ivory, of each a drachm; precious stones each a scruple; candied nutmegs, two drachms, and with syrup of apples and quinces make an electuary.”
_Let her observe the following rules._
“Take pearls prepared, a drachm; red coral and ivory prepared, each half a drachm, precious stones, each a scruple; yellow citron peel, mace, cinnamon, cloves, each half a drachm; saffron, a scruple; wood aloes, half a scruple; ambergris, six drachms; and with six ounces of sugar dissolved in rosewater make rolls.” Let her also apply strengtheners of nutmeg, mace and mastich made up in bags, to the navel, or a toast dipped in malmsey, or sprinkled with powdered mint. If she happens to desire clay, chalk, or coals (as many women with child do), give her beans boiled with sugar, and if she happens to long for anything that she cannot obtain, let her presently drink a large draught of pure cold water.
_Rules for the Third Month._
In this month and the next, be sure to keep from bleeding; for though it may be safe and proper at other times, yet it will not be so at the end of the fourth month; and yet if blood abound, or some incidental disease happens which requires evacuation, you may use a cupping glass, with scarification, and a little blood may be drawn from the shoulders and arms, especially if she has been accustomed to bleed. Let her also take care of lacing herself too straitly, but give herself more liberty than she used to do; for inclosing her belly in too strait a mould, she hinders the infant from taking its free growth, and often makes it come before its time.
_Rules for the Fourth Month._
In this month also you ought to keep the child-bearing woman from bleeding, unless in extraordinary cases, but when the month is passed, blood-letting and physic may be permitted, if it be gentle and mild, and perhaps it may be necessary to prevent abortion. In this month she may purge, in an acute disease, but purging may only be used from the beginning of this month to the end of the sixth; but let her take care that in purging she use no vehement medicine, nor any bitter, as aloes, which is disagreeable and hurtful to the child, and opens the mouth of the vessels; neither let her use coloquintida, scammony nor turbith; she may use cassia, manna, rhubarb, agaric and senna but dyacidodium purgans is best, with a little of the electuary of the juice of roses.
_Rules for the Fifth, Sixth and Seventh Months._
In these months, child-bearing women are troubled with coughs, colds, heart-beating, fainting, watching, pains in the loins and hips, and bleeding. The cough is from a sharp vapour that comes to the jaws and rough artery from the terms, or the thin part of that blood got less into the reins of the breast; this endangers abortion, and strength fails from watching: therefore, purge the humours that come to the breast, with rhubarb and agaric, and strengthen the head as in a catarrh, and give sweet lenitives as in a cough. Palpitation and faintness arises from vapours that go to it by the arteries, or from blood that abounds and cannot get out of the womb, but ascends and oppresses the heart; and in this case cordials should be used both inwardly and outwardly. Watching, is from sharp dry vapours that trouble the animal spirits, and in this case use frictions, and let the woman wash her feet at bed-time, and let her take syrup of poppies, dried roses, emulsions of sweet almonds, and white poppy seed. If she be troubled with pains in her loins and hips, as in those months she is subject to be, from the weight of her child as it grows big and heavy, and so stretches the ligaments of the womb and part adjacent, let her hold it up with swathing bands about her neck. About this time also the woman often happens to have a flux of blood, either at the nose, womb or haemorrhoids, from plenty of blood, or from the weakness of the child that takes it not in, or else from evil humour in the blood, that stirs up nature and sends it forth. And sometimes it happens that the vessels of the womb may be broken, either by some violent motion, fall, cough or trouble of the mind (for any of these will work that effect), and this is so dangerous, that in such a case the child cannot be well, but if it be from blood only, the danger is less, provided it flows by the veins of the neck of the womb, for then it prevents plethora and takes not away the nourishment of the child; but if it proceeds from the weakness of the child, that draws it not in, abortion of the child often follows, or hard travail, or else she goes beyond her time. But if it flows from the inward veins of the womb, there is more danger by the openness of the womb, if it come from evil blood; the danger is alike from cacochymy, which is like to fall upon both. If it arises from plethora, open a vein, but with great caution, and use astringents, of which the following will do well:–Take prepared pearls, a scruple; red coral, two scruples; mace, nutmeg, each a drachm; cinnamon, half a drachm; make a powder, or with white sugar make rolls. Or give this powder in broth:–“Take red coral, a drachm; half a drachm precious stones; red sander, half a drachm; bole, a drachm; scaled earth and tormental roots, each two scruples, with sugar of roses and Manus Christi; with pearl, five drachms; make a powder.” You may also strengthen the child at the navel, and if there be a cacochymy, alter the humours, and if you can do it safely, evacuate; you may likewise use amulets on her hands and about her neck. In a flux of haemorrhoids, wear off the pain, and let her drink hot wine with a toasted nutmeg. In these months the belly is also subject to be bound, but if it be without any apparent disease, the broth of a chicken or veal, sodden with oil, or with the decoction of mallows or marsh-mallows, mercury or linseed, put up in a clyster, will not be amiss, but in less quantity than is given in other cases:–viz. of the decoction, five ounces, of common oil, three ounces, of sugar, two ounces, and of cassia fistula, one ounce. But if she will not take a clyster, one or two yolks of new laid eggs, or a little peas-pottage warm, a little salt and sugar, and supped a little before meat, will be very convenient. But if her belly be distended and stretched with wind a little fennel seed and aniseed reduced to a powder and mixed with honey and sugar made after the manner of an electuary, will be very well Also, if thighs and feet swell let them be anointed with erphodrinum (which is a liquid medicine) made with vinegar and rose-water, mingled with salt.
_Rules for the Eighth Month._
The eighth month is commonly called the most dangerous; therefore the greatest care and caution ought to be used, the diet better in quality, but no more, nor indeed, so much in quantity as before, but as she must abate her diet, she must increase her exercise; and because then women with child, by reason that sharp humours alter the belly, are accustomed to weaken their spirits and strength, they may well take before meat, an electuary of diarrhoden, or aromaticum rosatum or diamagarton; and sometimes they may lick a little honey. As they will loathe, nauseate their meat, they may take green ginger, candied with sugar, and the rinds of citron and oranges candied; and let them often use honey for strengthening the infant. When she is not very far from her labour, let her eat every day seven roasted figs before her meat, and sometimes let her lick a little honey. But let her beware of salt and powdered meat, for it is neither good for her nor the child.
_Rules for the Ninth Month._
In the ninth month let her have a care of lifting any great weight, but let her move a little more, to dilate the parts, and stir up natural heat. Let her take heed of stooping, and neither sit too much nor lie on her sides, neither ought she to bend herself much enfolded in the umbilical ligaments, by which means it often perisheth. Let her walk and stir often, and let her exercise be, rather to go upwards than downwards. Let her diet, now especially, be light and easy of digestion and damask prunes with sugar, or figs with raisins, before meat, as also the yolks of eggs, flesh and broth of chickens, birds, partridges and pheasants; astringent and roasted meats, with rice, hard eggs, millet and such like other things are proper. Baths of sweet water, with emollient herbs, ought to be used by her this month with some intermission, and after the baths let her belly be anointed with oil of sweet roses and of violets; but for her privy parts, it is better to anoint them with the fat of hens, geese or ducks, or with oil of lilies, and the decoction of linseed and fenugreek, boiled with oil of linseed and marshmallows, or with the following liniment:–
Take mallows and marshmallows, cut and shred, of each one ounce; of linseed, one ounce; let them be boiled from twenty ounces of water to ten; then let her take three ounces of the boiled broth, of oil of almonds and oil of flower-de-luce, of each one ounce; of deer’s suet, three ounces. Let her bathe with this, and anoint herself with it, warm.
If for fourteen days before the birth, she do every morning and evening bathe and moisten her belly with muscadine and lavender water, the child will be much strengthened thereby. And if every day she eat toasted bread, it will hinder anything from growing to the child. Her privy parts must be gently stroked down with this fomentation.
“Take three ounces of linseed, and one handful each of mallows and marshmallows sliced, then let them be put into a bag and immediately boiled.” Let the woman with child, every morning and evening, take the vapour of this decoction in a hollow stool, taking great heed that no wind or air come to her in-parts, and then let her wipe the part so anointed with a linen cloth, and she may anoint the belly and groins as at first.
When she has come so near to her time, as to be ten or fourteen days thereof, if she begins to feel any more than ordinary pain let her use every day the following:–“Take mallows and marshmallows, of each a handful; camomiles, hard mercury, maidenhair, of each a handful; of linseed, four ounces; let them be boiled in a sufficient quantity of water as to make a bath therewith.” But let her not sit too hot upon the seat, nor higher than a little above her navel; nor let her sit upon it longer than about half an hour, lest her strength languish and decay, for it is better to use it often than to stay too long in it.
And thus have I shown how a child-bearing woman ought to govern herself each month during her pregnancy. How she must order herself at her delivery, shall be shown in another chapter, after I have first shown the intended midwife how the child is first formed in the womb, and the manner of its decumbiture there.
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CHAPTER III
_Of the Parts proper to a Child in the womb; How it is formed there, and the manner of its Situation therein._
In the last chapter I treated of conception, showed what it was, how accomplished and its signs, and how she who has conceived ought to order herself during the time of her pregnancy. Now, before I come to speak of her delivery, it is necessary that the midwife be first made acquainted with the parts proper to a child in the womb, and also that she be shown how it is formed, and the manner of its situation and decumbiture there; which are so necessary to her, that without the knowledge thereof, no one can tell how to deliver a woman as she ought. This, therefore, shall be the work of this chapter. I shall begin with the first of these.
SECTION I.–_Of the Parts proper to a Child in the Womb._
In this section, I must first tell you what I mean by the parts proper to a child in the womb; and they are only those that either help or nourish it; and whilst it is lodged in that dark repository of nature, and that help to clothe and defend it there and are cast away, as of no more use, after it is born, and these are two, viz., the umbilicars, or navel vessels, and the secundinum. By the first it is nourished, and by the second clothed and defended from wrong. Of each of these I shall speak distinctly; and first,
_Of the Umbilicars, or Navel Vessels._
These are four in number, viz.:–one vein, two arteries, and the vessel which is called the urachos.
(1) The vein is that on which the infant is nourished, from the time of its conception till the time of its delivery; till being brought into the light of the world, it has the same way of concocting the food we have. This vein ariseth from the liver of the child, and is divided into two parts when it has passed the navel; and these two are divided and subdivided, the branches being upheld by the skin called _chorion_ (of which I speak by and by), and are joined to the veins of the mother’s womb, from whence they have their blood for the nourishment of the child.
(2) The arteries are two on each side which proceed from the back branches of the great artery of the mother, and the vital blood is carried by those to the child being ready concocted by the mother.
(3) A nervous or sinewy production is led from the bottom of the bladder of the infant to the navel, and this is called _urachos_, and its use is, to convey the urine of the infant from the bladder to the alantois. Anatomists do very much vary in their opinion concerning this, some denying any such thing to be in the delivery of the woman, and others on the contrary affirming it; but experience has testified there is such a thing, for Bartholomew Carbrolius, the ordinary doctor of anatomy to the College of Physicians at Montpellier in France, records the history of a maid, whose water being a long time stopped, at last issued out through the navel. And Johannes Fernelius speaks of the same thing that happened to a man of thirty years of age, who having a stoppage at the neck of the bladder, his urine issued out of his navel for many months together, and that without any prejudice at all to his health, which he ascribes to the ill lying of his navel, whereby the urachos was not well dried. And Volchier Coitas quotes such another instance in a maid of thirty-four at Nuremburg in Germany. These instances, though they happen but seldom, are sufficient to prove that there is such a thing as anurachos in men.
These four vessels before mentioned, viz., one vein, two arteries and the urachos, join near the navel, and are united by a skin which they have from the chorion and so become like a gut or rope, and are altogether void of sensibility, and this is that which women call the navel-string. The vessels are thus joined together, that so they may neither be broken, severed nor entangled; and when the infant is born are of no use save only to make up the ligament which stops the hole of the navel and for some other physical use, etc.
_Of the Secundine or After-birth._
Setting aside the name given to this by the Greeks and Latins, it is called in English by the name of secundine, after-birth or after-burden; which are held to be four in number.
(1) The _first_ is called placenta, because it resembles the form of a cake, and is knit both to the navel and chorion, and makes up the greatest part of the secundine or after-birth. The flesh of it is like that of the melt or spleen, soft, red and tending something to blackness, and hath many small veins and arteries in it: and certainly the chief use of it is, for containing the child in the womb.
(2) The _second_ is the chorion. This skin and that called the amnios, involve the child round, both above and underneath, and on both sides, which the alantois does not. This skin is that which is most commonly called the secundine, as it is thick and white garnished with many small veins and arteries, ending in the placenta before named, being very light and slippery. Its use is, not only to cover the child round about, but also to receive, and safely bind up the roots of the veins and arteries or navel vessels before described.
(3) The _third_ thing which makes up the secundine in the alantois, of which there is a great dispute amongst anatomists. Some say there is such a thing, and others that there is not. Those who will have it to be a membrane, say it is white, soft and exceedingly thin, and just under the placenta, where it is knit to the urachos, from which it receives the urine; and its office is to keep it separate from the sweat, that the saltness of it may not offend the tender skin of the child.
(4) The _fourth_, and last covering of the child is called amnios; and it is white, soft and transparent, being nourished by some very small veins and arteries. Its use is, not only to enwrap the child, but also to retain the sweat of the child.
Having thus described the parts proper to a child in the womb, I will next proceed to speak of the formation of the child therein, as soon as I have explained the hard terms of the section, that those for whose help it is designed, may understand what they read. A _vein_ is that which receives blood from the liver, and distributes in several branches to all parts of the body. _Nerve_ is the same with _sinew_, and is that by which the brain adds sense and motion to the body. _Placenta_, properly signifies _sugar_ cake; but in this section it is used to signify a spongy piece of flesh resembling a cake, full of veins and arteries, and is made to receive a mother’s blood appointed for the infant’s nourishment in the womb. The _chorion_ is an outward skin which compasseth the child in the womb. The _amnios_ is the inner skin which compasseth the child in the womb. The _alantois_ is the skin that holds the urine of the child during the time that it abides in the womb. The _urachos_ is the vessel that conveys the urine from the child in the womb to the _alantois_. I now proceed to
SECT. II.–_Of the Formation of the Child in the Womb._
To speak of the formation of the child in the womb, we must begin where nature begins, and, that is at the act of coition, in which the womb having received the generative seed (without which there can be no conception), the womb immediately shuts up itself so close that the point of a needle cannot enter the inward orifice; and this it does, partly to hinder the issuing out of the seed again, and partly to cherish it by an inward heat, the better to provoke it to action; which is one reason why women’s bellies are so lank at their first conception. The woman having thus conceived, the first thing which is operative in conception is the spirit whereof the seed is full, which, nature quickening by the heat of the womb, stirs up the action. The internal spirits, therefore, separate the parts that are less pure, which are thick, cold and clammy, from those that are more pure and noble. The less pure are cast to the outside, and with these seed is circled round and the membrane made, in which that seed that is most pure is wrapped round and kept close together, that it may be defended from cold and other accidents, and operate the better.
The first thing that is formed is the amnios; the next the chorion; and they enwrap the seed round like a curtain. Soon after this (for the seed thus shut up in the woman lies not idle), the navel vein is bred, which pierceth those skins, being yet very tender, and carries a drop of blood from the veins of the mother’s womb to the seed; from which drop the vena cava, or chief vein, proceeds, from which all the rest of the veins which nourish the body spring; and now the seed hath something to nourish it, whilst it performs the rest of nature’s work, and also blood administered to every part of it, to form flesh.
This vein being formed, the navel arteries are soon after formed; then the great artery, of which all the others are but branches; and then the heart, for the liver furnisheth the arteries with blood to form the heart, the arteries being made of seed, but the heart and the flesh, of blood. After this the brain is formed, and then the nerves to give sense and motion to the infant. Afterwards the bones and flesh are formed; and of the bones, first of all, the vertebrae or chine bones, and then the skull, etc. As to the time in which this curious part of nature’s workmanship is formed, having already in Chapter II of the former part of this work spoken at large upon this point, and also of the nourishment of the child in the womb, I shall here only refer the reader thereto, and proceed to show the manner in which the child lies in the womb.
SECT. III.–_Of the manner of the Child’s lying in the Womb._
This is a thing so essential for a midwife to know, that she can be no midwife who is ignorant of it; and yet even about this authors extremely differ; for there are not two in ten that agree what is the form that the child lies in the womb, or in what fashion it lies there; and yet this may arise in a great measure from the different times of the women’s pregnancy; for near the time of its deliverance out of those winding chambers of nature it oftentimes changes the form in which it lay before, for another.
I will now show the several situations of the child in the mother’s womb, according to the different times of pregnancy, by which those that are contrary to nature, and are the chief cause of ill labours, will be more easily conceived by the understanding midwife. It ought, therefore, in the first place to be observed, that the infant, as well male as female, is generally situated in the midst of the womb; for though sometimes, to appearance a woman’s belly seems higher on one side than the other, yet it is so with respect to the belly only, and not to her womb, in the midst of which it is always placed.
But, in the second place, a woman’s great belly makes different figures, according to the different times of pregnancy; for when she is young with child, the embryo is always found of a round figure, a little long, a little oblong, having the spine moderately turned inwards, and the thighs folded, and a little raised, to which the legs are so raised, that the heels touch the buttocks; the arms are bending, and the hands placed upon the knees, towards which part of the body, the head is turned downwards 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 mother’s great gut; and this turning of the infant in this manner, with its head downwards, towards the latter end of a woman’s reckoning, is so ordered by nature, that it may be thereby the better disposed of its passage into the world at the time of its mother’s labour, which is not then far off (and indeed some children turn not at all until the very time of birth); for in this posture all its joints are most easily extended in coming forth; for by this means its arms and legs cannot hinder its birth, because they cannot be bent against the inner orifice of the womb and the rest of the body, being very supple, passeth without any difficulty after the head, which is hard and big; being passed the head is inclined forward, so that the chin toucheth the breast, in which posture, it resembles one sitting to ease nature, and stooping down with the head to see what comes from him. The spine of the back is at that time placed towards the mother’s, the head uppermost, the face downwards; and proportionately to its growth, it extends its members by little and little, which were exactly folded in the first month. In this posture it usually keeps until the seventh or eighth month, and then by a natural propensity and disposition of the upper first. It is true there are divers children, that lie in the womb in another posture, and come to birth with their feet downwards, especially if there be twins; for then, by their different motions they do so disturb one another, that they seldom come both in the same posture at the time of labour, but one will come with the head, and another with the feet, or perhaps lie across; but sometimes neither of them will come right. But, however the child may be situated in the womb, or in whatever posture it presents itself at the time of birth, if it be not with its head forwards, as I have before described, it is always against nature, and the delivery will occasion the more pain and danger, and require greater care and skill from the midwife, than when the labour is more natural.
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CHAPTER IV
_A Guide for Women in Travail, showing what is to be done when they fall in Labour, in order to their Delivery._
The end of all that we have been treating of is, the bringing forth of a child into the world with safety both to the mother and the infant, as the whole time of a woman’s pregnancy may be termed a kind of labour; for, from the time of the conception to the time of her delivery, she labours under many difficulties, is subject to many distempers, and in continual danger, from one affection or other, till the time of birth comes; and when that comes, the greatest labour and travail come along with it, insomuch that then all the other labours are forgotten, and that only is called the time of her labours, and to deliver her safely is the principal business of the midwife; and to assist therein, shall be the chief design of this chapter. The time of the child’s being ready for its birth, when nature endeavours to cast it forth, is that which is properly the time of a woman’s labour; nature then labouring to be eased of its burden. And since many child-bearing women, (especially the first child) are often mistaken in their reckoning and so, when they draw near their time take every pain they meet with for their labour, which often proves prejudicial and troublesome to them, when it is not so, I will in the first section of this chapter, set down some signs, by which a woman may know when the true time of her labour is come.
SECTION I.–_The Signs of the true Time of a Woman’s Labour._
When women with child, especially of their first, perceive any extraordinary pains in the belly, they immediately send for their midwife, as taking it for their labour; and then if the midwife be not a skilful and experienced woman, to know the time of labour, but takes it for granted without further inquiry (for some such there are), and so goes about to put her into labour before nature is prepared for it, she may endanger the life of both mother and child, by breaking the amnios and chorion. These pains, which are often mistaken for labour, are removed by warm clothes laid to the belly, and the application of a clyster or two, by which those pains which precede a true labour, are rather furthered than hindered. There are also other pains incident to a woman in that condition from the flux of the belly, which are easily known by the frequent stools that follow them.
The signs, therefore, of labour, some few days before, are that the woman’s belly, which before lay high, sinks down, and hinders her from walking so easily as she used to do; also there flow from the womb slimy humours, which nature has appointed to moisten and smooth the passage that its inward orifice may be the more easily dilated when there is occasion; which beginning to open at this time, suffers that slime to flow away, which proceeds from the Glandules called _prostata_. These are signs preceding the labour; but when she is presently falling into labour, the signs are, great pains about the region of the reins and loins, which coming and retreating by intervals, are answered in the bottom of the belly by congruous throes, and sometimes the face is red and inflamed, the blood being much heated by the endeavours a woman makes to bring forth her child; and likewise, because during these strong throes her respiration is intercepted, which causes the blood to have recourse to her face; also her privy parts are swelled by the infant’s head lying in the birth, which, by often thrusting, causes those parts to descend outwards. She is much subject to vomiting, which is a good sign of good labour and speedy delivery, though by ignorant people thought otherwise; for good pains are thereby excited and redoubled; which vomiting is excited by the sympathy there is between the womb and the stomach. Also, when the birth is near, women are troubled with a trembling in the thighs and legs, not with cold, like the beginning of an ague fit, but with the heat of the whole body, though it must be granted, this does not happen always. Also, if the humours which then flow from the womb are discoloured with the blood, which the midwives call _shows_, it is an infallible mark of the birth being near. And if then the midwife puts up her fingers into the neck of the womb, she 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 down with each pain she hath; at which time one may perceive them sometimes to resist, and then again press forward the finger, being more or less hard and extended, according as the pains are stronger or weaker. These membranes, with the waters in them, when they are before the head of the child, midwives call _the gathering of the waters_, resemble to the touch of the fingers those eggs which have no shell, but are covered only with a simple membrane. After this, the pains still redoubling the membranes are broken by a strong impulsation of these waters, which flow away, and then the head of the infant is presently felt naked, and presents itself at the inward orifice of the womb. When these waters come thus away, then the midwife may be assured the birth is very near, this being the most certain sign that can be; for the _amnios alantois_, which contained these waters, being broken by the pressing forward of the birth, the child is no better able to subsist long in the womb afterwards than a naked man in a heap of snow. Now, these waters, if the child comes presently after them, facilitate the labour by making the passage slippery; and therefore, let no midwife (as some have foolishly done) endeavour to force away the water, for nature knows best when the true time of birth is, and therefore retains the waters till that time. But if by accident the water breaks away too long before the birth, then such things as will hasten it, may be safely administered, and what these are, I will show in another section.
SECT. II.–_How a Woman ought to be ordered when the time of her labour is come._
When it is known that the true time of her labour is come by the signs laid down in the foregoing, of which those most to be relied upon are pains and strong throes in the belly, forcing downwards towards the womb, and a dilation of the inward orifice, which may be perceived by touching it with the finger, and the gathering of the waters 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 itself (as we have said before), especially if it be the head of the child, by its roundness and hardness; I say, if these things concur and are evident, the midwife may be sure it is the time of the woman’s labour, and care must be taken to get all those things that are necessary to comfort her at that time. And the better to help her, be sure to see that she is not tightly laced; you must also give her one strong clyster or more, if there be occasion, provided it be done at the beginning, and before the child be too forward, for it will be difficult for her to receive them afterwards. The benefit accruing therefrom will be, that they excite the gut to discharge itself of its excrements, so that the rectum being emptied there may be the more space for the dilation of the passage; likewise to cause the pains to bear the more downward, through the endeavours she makes when she is at stool, and in the meantime, all other necessary things for her labour should be put in order, both for the mother and the child. To this end, some get a midwife’s; but a pallet bed, girded, is much the best way, placed near the fire, if the season so require, which pallet ought to be so placed, that there may be easy access to it on every side, that the woman may be the more easily assisted, as there is occasion.
If the woman abounds with blood, to bleed her a little more may not be improper, for thereby she will both breathe the better, and have her breasts more at liberty, and likewise more strength to bear down her pains; and this may be done without danger because the child being about ready to be born, has no more need of the mother’s blood for its nourishment; besides, this evacuation does many times prevent her having a fever after delivery. Also, before her delivery, if her strength will permit, let her walk up and down her chamber; and that she may have strength so to do, it will be necessary to give her good strengthening things, such as jelly, broth, new laid eggs, or some spoonfuls of burnt wine; and let her by all means hold out her pains, bearing them down as much as she can, at the time when they take her; and let the midwife from time to time touch the inward orifice with her finger, to know whether the waters are ready to break and whether the birth will follow soon after. Let her also anoint the woman’s privities with emollient oil, hog’s grease, and fresh butter, if she find they are hard to be dilated. Let the midwife, likewise, all the time be near the labouring woman, and diligently observe her gestures, complaints, and pains, for by this she may guess pretty well how far her labour advanceth, because when she changeth her ordinary groans into loud cries, it is a sign that the child is near the birth; for at the time her pains are greater and more frequent. Let the woman likewise, by intervals, rest herself upon the bed to regain her strength, but not too long, especially if she be little, short and thick, for such women have always worse labour if they lie long on their beds in their travail. It is better, therefore, that she walk about her chamber as long as she can, the woman supporting her under the arms, if it be necessary; for by this means, the weight of the child causes the inward orifices of the womb to dilate the sooner than in bed, and if her pains be stronger and more frequent, her labour will not be near so long. Let not the labouring woman be concerned at those qualms and vomitings which, perhaps, she may find come upon her, for they will be much for her advantage in the issue, however uneasy she may be for a time, as they further her pains and throes by provoking downward.
When the waters of the child are ready and gathered (which may be perceived through the membranes presenting themselves to the orifice) to the bigness of the whole dilatation, the midwife ought to let them break of themselves, and not, like some hasty midwives, who being impatient of the woman’s long labour, break them, intending thereby to hasten their business, when instead thereof, they retard it; for by the too hasty breaking of these waters (which nature designed to make the child slip more easy), the passage remains dry by which means the pains and throes of the labouring woman are less efficacious to bring forth the infant than they would otherwise have been. It is, therefore, much the better way to let the waters break of themselves; after which the midwife may with ease feel the child by that part which first presents, and thereby discern whether it comes right, that is, with the head foremost, for that is the proper and most natural way of the birth. If the head comes right, she will find it big, round, hard and equal; but if it be any other part, she will find it rugged, unequal, soft and hard, according to the nature of the part it is. And this being the true time when a woman ought to be delivered, if nature be not wanting to perform its office, therefore, when the midwife finds the birth thus coming forward let her hasten to assist and deliver it, for it ordinarily happens soon after, if it be natural.
But if it happens, as it sometimes may, that the waters break away too long before the birth, in such a case, those things which hasten nature may safely be administered. For which purpose make use of pennyroyal, dittany, juniper berries, red coral, betony and feverfew, boiled in white wine, and give a drachm of it, or it would be much better to take the juice of it when it is in its prime, which is in May, and having clarified it, make it into a syrup with double its weight of sugar, and keep it all the year, to use when occasion calls for it; mugwort used in the same manner is also good in this case; also a drachm of cinnamon powder given inwardly profits much in this case; and so does tansey broiled and applied to the privities; or an oil of it, so, made and used, as you were taught before. The stone _aetites_ held to the privities, is of extraordinary virtue, and instantly draws away, both child and after-burden; but great care must be taken to remove it presently, or it will draw forth womb and all; for such is the magnetic virtue of this stone that both child and womb follow it as readily as iron doth the load-stone or the load-stone the north star.
There are many things that physicians affirm are good in this case; among which are an ass’s or horse’s hoof, hung near the privities; a piece of red coral hung near the said place. A load-stone helps very much, held in the woman’s left hand; or the skin cut off a snake, girt about the middle, next to the skin. These things are mentioned by Mizaldus, but setting those things aside, as not so certain, notwithstanding Mizaldus quotes them, the following prescriptions are very good to speedy deliverance to women in travail.
(1) A decoction of white wine made in savory, and drank.
(2) Take wild tansey, or silver weed, bruise it, and apply to the woman’s nostrils.
(3) Take date stones, and beat them to powder, and let her take half a drachm of them in white wine at a time.
(4) Take parsley and bruise it and press out the juice, and dip a linen cloth in it, and put it so dipped into the mouth of the womb; it will presently cause the child to come away, though it be dead, and it will bring away the after-burden. Also the juice of the parsley is a thing of so great virtue (especially stone parsley) that being drank by a woman with child, it cleanseth not only the womb, but also the child in the womb, of all gross humours.
(5) A scruple of castorum in powder, in any convenient liquor, is very good to be taken in such a case, and so also is two or three drops of castorum in any convenient liquor; or eight or nine drops of spirits of myrrh given in any convenient liquor, gives speedy deliverance.
(6) Give a woman in such a case another woman’s milk to drink; it will cause speedy delivery, and almost without pain.
(7) The juice of leeks, being drunk with warm water, highly operates to cause speedy delivery.
(8) Take peony seeds and beat them into a powder, and mix the powder with oil, with which oil anoint the privities of the woman and child; it will give her deliverance speedily, and with less pain than can be imagined.
(9) Take a swallow’s nest and dissolve it in water, strain it, and drink it warm, it gives delivery with great speed and much ease.
Note this also in general, that all that move the terms are good for making the delivery easy, such as myrrh, white amber in white wine, or lily water, two scruples or a drachm; or cassia lignea, dittany, each a drachm; cinnamon, half a drachm, saffron, a scruple; give a drachm, or take borax mineral, a drachm, and give it in sack; or take cassia lignea, a drachm; dittany, amber, of each a drachm; cinnamon, borax, of each a drachm and a half; saffron, a scruple, and give her half a drachm; or give her some drops of oil of hazel in convenient liquor; or two or three drops of oil of cinnamon in vervain water. Some prepare the secundine thus:–Take the navel-string and dry it in an oven, take two drachms of the powder, cinnamon a drachm, saffron half a scruple, with the juice of savin make trochisks; give two drachms; or wash the secundine in wine and bake it in a pot; then wash it in endive water and wine, take half a drachm of it; long pepper, galangal, of each half a drachm; plantain and endive seed, of each half a drachm; lavender seed, four scruples; make a powder, or take laudanum, two drachms; storax, calamite, benzoin, of each half a drachm; musk, ambergris each six grains, make a powder or trochisks for a fume. Or use pessaries to provoke the birth; take galbanum dissolved in vinegar, an ounce; myrrh, two drachms, with oil of oat make a pessary.
_An Ointment For the Navel._
Take oil of keir, two ounces, juice of savine an ounce, of leeks and mercury, each half an ounce; boil them to the consumption of the juice; add galbanum dissolved in vinegar, half an ounce, myrrh, two drachms, storax liquid a drachm, round bitwort, sowbread, cinnamon, saffron, a drachm, with wax make an ointment and apply it.
If the birth be retarded through the weakness of the mother, refresh her by applying wine and soap to the nose, confect. alkermas. diamarg.
These things may be applied to help nature in her delivery when the child comes to the birth the right way, and yet the birth be retarded; but if she finds the child comes the wrong way, and that she is not able to deliver the woman as she ought to be, by helping nature, and saving both mother and child (for it is not enough to lay a woman if it might be done any other way with more safety and ease, and less hazard to woman and child), then let her send speedily for the better and more able to help; and not as I once knew a midwife do, who, when a woman she was to deliver had hard labour, rather than a man-midwife should be sent for, undertook to deliver the woman herself (though told it was a man’s business), and in her attempting it, brought away the child, but left the head in the mother’s womb; and had not a man midwife been presently sent for, the mother had lost her life as well as the child; such persons may rather be termed butchers than midwives. But supposing the woman’s labour to be natural, I will next show what the midwife ought to do, in order of her delivery.
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CHAPTER V
_Of Natural Labour; What it is and what the Midwife is to do in such Labour._
SECTION I.–_What Natural Labour is._
There are four things which denominate a woman’s natural labour; the first is, that it be at the full time, for if a woman comes before her time, it cannot be termed natural labour, neither will it be so easy as though she had completed her nine months. The second thing is, that it be speedy, and without any ill accident; for when the time of her birth come, nature is not dilatory in the bringing it forth, without some ill accident intervene, which renders it unnatural.
The third is, that the child be alive; for all will grant, that the being delivered of a dead child is very unnatural. The fourth is, that the child come right, for if the position of the child in the womb be contrary to that which is natural, the event will prove it so, by making that which should be a time of life, the death both of the mother and the child.
Having thus told you what I mean by natural labour, I shall next show how the midwife is to proceed therein, in order to the woman’s delivery. When all the foregoing requisites concur, and after the waters be broken of themselves, let there rather a quilt be laid upon the pallet bedstead than a feather bed, having there-on linen and cloths in many folds, with such other things as are necessary, and that may be changed according to the exigency requiring it, so that the woman may not be incommoded with the blood, waters and other filth which are voided in labour. The bed ought to be ordered, that the woman being ready to be delivered, should lie on her back upon it, having her body in a convenient posture; this is, her head and breast a little raised, so that she may be between lying and sitting, for being so placed, she is best capable of breathing, and, likewise, will have more strength to bear her pains than if she lay otherwise, or sunk down in her bed. Being so placed, she must spread her thighs abroad, folding her legs a little towards her buttocks, somewhat raised by a little pillow underneath, to the end that her rumps should have more liberty to retire back; and let her feet be stayed against some firm thing; besides this, let her take firm hold of some of the good women attending her, with her hands, that she may the better stay herself during her pains. She being thus placed at her bed, having her midwife at hand, the better to assist as nature may require, let her take courage, and help her pains as best she can, bearing them down when they take her, which she must do by holding her breath, and forcing them as much as possible, in like manner as when she goes to stool, for by such straining, the diaphragm, or midriff, being strongly thrust downward, necessarily forces down the womb and the child in it. In the meantime, let the midwife endeavour to comfort her all she can, exhorting her to bear her labour courageously, telling her it will be quickly over, and that there is no fear but that she will have a speedy delivery. Let the midwife also, having no rings on her fingers, anoint them with oil of fresh butter, and therewith dilate gently the inward orifice of the womb putting her finger ends into the entry thereof, and then stretch them one from the other, when her pains take her; by this means endeavouring to help forward the child, and thrusting by little and little, the sides of the orifice towards the hinder part of the child’s head, anointing it with fresh butter if it be necessary.
When the head of the infant is a little advanced into the inward orifice, the midwife’s phrase is:–“It is crowned”; because it girds and surrounds it just as a crown; but when it is so far that the extremities begin to appear without the privy parts, then they say, “The infant is in the passage”; and at this time the woman feels herself as if it were scratched, or pricked with pins, and is ready to imagine that the midwife hurts her, when it is occasioned by the violent distension of those parts and the laceration which sometimes the bigness of the child’s head causeth there. When things are in this posture, let the midwife seat herself conveniently to receive the child, which will come quickly, and with her finger ends (which she must be sure to keep close pared) let her endeavour to thrust the crowning of the womb (of which I have spoken before), back over the head of the child, and as soon as it is advanced as far as the ears, or thereabouts, let her 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 entangled about the neck or any part, as sometimes it is, lest thereby the after-burden be pulled with violence, and perhaps the womb also, to which it is fastened, and so either cause her to flood or else break the strings, both which are of bad consequence to the woman, whose delivery may thereby be rendered the more difficult. It must also be carefully observed that the head be not drawn forth straight, but shaking it a little from one side to the other, that the shoulders may sooner and easier take their places immediately after it is past, without losing time, lest the head being past, the child be stopped there by the largeness of the shoulders, and so come in danger of being suffocated and strangled in the passage, as it sometimes happens, for the want of care therein. But as soon as the head is born, if there be need, she may slide her fingers under the armpits, and the rest of the body will follow without any difficulty.
As soon as the midwife hath in this manner drawn forth the child, let her put it on one side, lest the blood and water which follows immediately, should do it any injury by running into its mouth and nose, as they would do, if it lay on its back; and so endanger the choking of it. The child being thus born, the next thing requisite is, to bring away the after-burden, but before that let the midwife be very careful to examine whether there be more children in the womb; for sometimes a woman may have twins that expected it not; which the midwife may easily know by the continuance of the pains after the child is born, and the bigness of the mother’s belly. But the midwife may be sure of it, if she puts her hand up to the entry of the womb, and finds there another watery gathering, and the child in it presenting to the passage, and if she find it so, she must have a care of going to fetch the after-birth, till the woman be delivered of all the children she is pregnant with. Wherefore the first string must be cut, being first tied with a thread three or four times double, and fasten the other end with string to the woman’s thighs, to prevent the inconvenience it may cause by hanging between the thighs; and then removing the child already born, she must take care to deliver her of the rest, observing all the circumstances as with the first; after which, it will be necessary to fetch away the after-birth, or births. But of that I shall treat in another section, and first show what is to be done to the new-born infant.
SECT. II.–_Of the Cutting of the Child’s Navel String._
Though this is accounted by many but as a trifle, yet great care is to be taken about it, and it shows none of the least art and skill of a midwife to do it as it should be; and that it may be so done, the midwife should observe: (1) The time. (2) The place. (3) The manner. (4) The event.
(1) The time is, as soon as ever the infant comes out of the womb, whether it brings part of the after-burden with it or not; for sometimes the child brings into the world a piece of the amnios upon its head, and is what mid wives call the _caul_, and ignorantly attribute some extraordinary virtue to the child so born; but this opinion is only the effect of their ignorance; for when a child is born with such a crown (as some call it) upon its brows, it generally betokens weakness and denotes a short life. But to proceed to the matter in hand. As soon as the child comes into the world, it should be considered whether it is weak or strong; and if it be weak, let the midwife gently put back part of the natural and vital blood into the body of the child by its navel; for that recruits a weak child (the vital and natural spirits being communicated by the mother to the child by its navel-string), but if the child be strong, the operation is needless. Only let me advise you, that many children that are born seemingly dead, may soon be brought to life again, if you squeeze six or seven drops of blood out of that part of the navel-string which is cut off, and give it to the child inwardly.
(2) As to the place in which it should be cut, that is, whether it should be cut long or short, it is that which authors can scarcely agree in, and which many midwives quarrel about; some prescribing it to be cut at four fingers’ breadth, which is, at best, but an uncertain rule, unless all fingers were of one size. It is a received opinion, that the parts adapted to the generation are contracted and dilated according to the cutting of the navel-string, and this is the reason why midwives are generally so kind to their own sex, that they leave a longer part of the navel-string of a male than female, because they would have the males well provided for the encounters of Venus; and the reason they give, why they cut that of the female shorter is, because they believe it makes them more acceptable to their husbands. Mizaldus was not altogether of the opinion of these midwives, and he, therefore, ordered the navel string to be cut long both in male and female children; for which he gives the following reason, that the instrument of generation follows the proportion of it; and therefore, if it be cut too short in a female, it will be a hindrance to her having children. I will not go about to contradict the opinions of Mizaldus; these, experience has made good:–That one is, that if the navel-string of a child, after it be cut, be suffered to touch the ground, the child will never hold its water, either sleeping or waking, but will be subjected to an involuntary making of water all its lifetime. The other is, that a piece of a child’s navel-string carried about one, so that it touch his skin, defends him that wears it from the falling sickness and convulsions.
(3) As to the manner it must be cut, let the midwife take a brown thread, four or five times double, of an ell long, or thereabouts, tied with a single knot at each of the ends, to prevent their entangling; and with this thread so accommodated (which the woman must have in readiness before the woman’s labour, as also a good pair of scissors, that no time may be lost) let her tie the string within an inch of the belly with a double knot, and turning about the end of the thread, let her tie two more on the other side of the string, reiterating it again, if it be necessary; then let her cut off the navel-string another inch below the ligatures, towards the after-birth, so that there only remains but two inches of the string, in the midst of which will be the knot we speak of, which must be so close knit, as not to suffer a drop of blood to squeeze out of the vessels, but care must be taken, not to knit it so strait, as to out it in two, and therefore the thread must be pretty thick and pretty strait cut, 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 tied, therefore great care must be taken that no blood squeeze through; for if there do, a new knot must be made with the rest of the string. You need not fear to bind the navel-string very hard because it is void of sense, and that part which you leave, falls off in a very few days, sometimes in six or seven, or sooner, but never tarries longer than eight or nine. When you have thus cut the navel-string, then take care the piece that falls off touch not the ground, for the reason I told you Mizaldus gave, which experience has justified.
(4) The last thing I mentioned, was the event or consequence, or what follows cutting the navel-string. As soon as it is cut, apply a little cotton or lint to the place to keep it warm, lest the cold enter into the body of the child, which it most certainly will do, if you have not bound it hard enough. If the lint or cotton you apply to it, be dipped in oil of roses, it will be the better, and then put another small rag three or four times double upon the belly; upon the top of all, put another small bolster, and then swathe it with a linen swathe, four fingers broad, to keep it steady, lest by moving too much, or from being continually stirred from side to side, it comes to fall off before the navel-string, which you left remaining, is fallen off.
It is the usual custom of midwives to put a piece of burnt rag to it, which we commonly call tinder; but I would rather advise them to put a little ammoniac to it, because of its drying qualities.
SECT. III.–_How to bring away the After-burden._
A woman cannot be said to be fairly delivered, though the child be born, till the after-burden be also taken from her; herein differing from most animals, who, when they have brought forth their young, cast forth nothing else but some water, and the membranes which contained them. But women have an after-labour, which sometimes proves more dangerous than the first; and how to bring it safely away without prejudice to her, shall be my business to show in this section.
As soon as the child is born, before the midwife either ties or cuts the navel-string, lest the womb should close, let her take the string and wind it once or twice about one or two fingers on her left hand joined together, the better to hold it, with which she may draw it moderately, and with the right hand, she may only take a single hold of it, above the left, near the privities, drawing likewise with that very gently, resting the while the forefinger of the same hand, extended and stretched forth along the string towards the entrance of the vagina, always observing, for the greater facility, to draw it from the side where the burden cleaves least; for in so doing, the rest will separate the better; and special care must be taken that it be not drawn forth with too much violence, lest by breaking the string near the burden, the midwife be obliged to put the whole hand into the womb to deliver the woman; and she need to be a very skilful person that undertakes it, lest the womb, to which the burden is sometimes very strongly fastened, be drawn away with it, as has sometimes happened. It is, therefore, best to use such remedies as may assist nature. And here take notice, that what brings away the birth, will also bring away the after-birth. And therefore, for effecting this work, I will lay down the following rules.
(1) Use the same means of bringing away the after-birth, that you made use of to bring away the birth; for the same care and circumspection are needful now that there were then.
(2) Considering that the labouring woman cannot but be much spent by what she has already undergone in bringing forth the infant, be therefore sure to give her something to comfort her. And in this case good jelly broths, also a little wine and toast in it, and other comforting things, will be necessary.
(3) A little hellebore in powder, to make her sneeze, is in this case very proper.
(4) Tansey, and the stone aetites, applied as before directed, are also of good use in this case.
(5) If you take the herb vervain, and either boil it in wine, or a syrup with the juice of it, which you may do by adding to it double its weight of sugar (having clarified the juice before you boil it), a spoonful of that given to the woman is very efficacious to bring away the secundine; and feverfew and mugwort have the same operation taken as the former.
(6) Alexanders[10] boiled in wine, and the wine drank, also sweet servile, sweet cicily, angelica roots, and musterwort, are excellent remedies in this case.
(7) Or, if this fail, the smoke of marigolds, received up a woman’s privities by a funnel, have been known to bring away the after-birth, even when the midwife let go her hold.
(8) Boil mugwort in water till it be very soft, then take it out, and apply it in the manner of a poultice to the navel of the labouring woman, and it instantly brings away the birth. But special care must be taken to remove it as soon as they come away, lest by its long tarrying it should draw away the womb also.
SECT. IV.–_Of Laborious and Difficult Labours and how the Midwife is to proceed therein._
There are three sorts of bad labours, all painful and difficult, but not all properly unnatural. It will be necessary, therefore, to distinguish these.
The _first_ of these labours is that when the mother and child suffer very much extreme pain and difficulty, even though the child come right; and this is distinguishably called the laborious labour.
The _second_ is that which is difficult and differs not much from the former, except that, besides those extraordinary pains, it is generally attended with some unhappy accident, which, by retarding the birth, causes the difficulty; but these difficulties being removed, it accelerates the birth, and hastens the delivery.
Some have asked, what is the reason that women bring forth their children with so much pain? I answer, the sense of feeling is distributed to the whole body by the nerves, and the mouth of the womb being so narrow, that it must of necessity be dilated at the time of the woman’s delivery, the dilating thereof stretches the nerves, and from thence comes the pain. And therefore the reason why some women have more pain in their labour than others, proceeds from their having the mouth of the matrix more full of nerves than others. The best way to remove those difficulties that occasion hard pains and labour, is to show first from whence they proceed. Now the difficulty of labour proceeds either from the mother, or child, or both.
From the mother, by reason of the indisposition of the body, or from some particular part only, and chiefly the womb, as when the woman is weak, and the mother is not active to expel the burden, or from weakness, or disease, or want of spirits; or it may be from strong passion of the mind with which she was once possessed; she may also be too young, and so may have the passage too narrow; or too old, and then, if it be her first child, because her pains are too dry and hard, and cannot be easily dilated, as happens also to them which are too lean; likewise those who are small, short or deformed, as crooked women who have not breath enough to help their pains, and to bear them down, persons that are crooked having sometimes the bones of the passage not well shaped. The colic also hinders labour, by preventing the true pains; and all great and active pains, as when the woman is taken with a great and violent fever, a great flooding, frequent convulsions, bloody flux, or any other great distemper. Also, excrements retained cause great difficulty, and so does a stone in the bladder: or when the bladder is full of urine, without being able to void it, or when the woman is troubled with great and painful piles. It may also be from the passages, when the membranes are thick, the orifice too narrow, and the neck of the womb not sufficiently open, the passages strained and pressed by tumours in the adjacent parts, or when the bones are too firm, and will not open, which very much endangers the mother and the child; or when the passages are not slippery, by reason of the waters having broken too soon, or membranes being too thin. The womb may also be out of order with regard to its bad situation or conformation, having its neck too narrow, hard and callous, which may easily be so naturally, or may come by accident, being many times caused by a tumour, an imposthume, ulcer or superfluous flesh.
As to hard labour occasioned by the child, it is when the child happens to stick to a mole, or when it is so weak it cannot break the membranes; or if it be too big all over, or in the head only; or if the natural vessels are twisted about its neck; when the belly is hydropsical; or when it is monstrous, having two heads, or joined to another child, also, when the child is dead or so weak that it can contribute nothing to its birth; likewise when it comes wrong, or there are two or more. And to all these various difficulties there is oftentimes one more, and that is, the ignorance of the midwife, who for want of understanding in her business, hinders nature in her work instead of helping her.
Having thus looked into the cause of hard labour, I will now show the industrious midwife how she may minister some relief to the labouring woman under these difficult circumstances. But it will require judgment and understanding in the midwife, when she finds a woman in difficult labour, to know the particular obstruction, or cause thereof, that so a suitable remedy may be applied; as for instance, when it happens by the mother’s being too young and too narrow, she must be gently treated, and the passages anointed with oil, hog’s lard, or fresh butter, to relax and dilate them the easier, lest there should happen a rupture of any part when the child is born; for sometimes the peritoneum breaks, with the skin from the privities to the fundament.
But if the woman be in years with her first child, let her lower parts be anointed to mollify the inward orifice, which in such a case being more hard and callous, does not easily yield to the distention of labour, which is the true cause why such women are longer in labour, and also why their children, being forced against the inward orifice of the womb (which, as I have said, is a little callous) are born with great bumps and bruises on their heads.
Those women who are very small and mis-shaped, should not be put to bed, at least until the waters are broken, but rather kept upright and assisted to walk about the chamber, by being supported under the arms; for by that means, they will breathe more freely, and mend their pains better than on the bed, because there they lie all of a heap. As for those that are very lean, and have hard labour from that cause, let them moisten the parts with oil and ointments, 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 mother’s bones which form the passage. If the cause be weakness, she ought to be strengthened, the better to support her pains, to which end give her good jelly broths, and a little wine with a toast in it. If she fears her pains, let her be comforted, assuring her that she will not endure any more, but be delivered in a little time. But if her pains be slow and small, or none at all, they must be provoked by frequent and pretty strong clysters; let her walk about her chamber, so that the weight of the child may help them forward. If she flood or have strong convulsions she must then be helped by a speedy delivery; the operation I shall relate in this section of unnatural labours. If she be costive, let her use clysters, which may also help to dispel colic, at those times very injurious because attended with useless pains, and because such bear not downward, and so help not to forward the birth. If she find an obstruction or stoppage of the urine, by reason of the womb’s bearing too much on the bladder, let her lift up her belly a little with her hands, and try if by that she receives any benefit; if she finds she does not, it will be necessary to introduce a catheter into her bladder, and thereby draw forth her urine. If the difficulty be from the ill posture of the woman, let her be placed otherwise, in a posture more suitable and convenient for her; also if it proceeds from indispositions of the womb, as from its oblique situation, etc., it must be remedied, as well as it can be, by the placing her body accordingly; or, if it be a vicious conformation, having the neck too hard, too callous, too straight, it must be anointed with oil and ointments, as before directed. If the membranes be so strong that the waters do not break in due time, they may be broken with the fingers, if the midwife be first well assured that the child is come forward into the passage, and ready to follow presently after; or else, by the breaking of the waters too soon, the child may be in danger of remaining dry a long time; to supply which defect, you may moisten the parts with fomentations, decoctions, and emollient oils; which yet is not half so well as when nature does her work in her own time, with the ordinary slime and waters. The membranes sometimes do press forth with the waters, three or four fingers’ breadth out of the body before the child resembling a bladder full of water; but there is no great danger in breaking them, if they be not already broken; for when the case is so, the child is always in readiness to follow, being in the passage, but let the midwife be very careful not to pull it with her hand, lest the after-burden be thereby loosened before its time, for it adheres thereto very strongly. If the navel-string happen to come first, it must presently be put up again, and kept so, if possible, or otherwise, the woman must be immediately delivered. But if the after-burden should come first, it must not be put up again by any means; for the infant having no further occasion for it, it would be but an obstacle if it were put up; in this case, it must be cut off, having tied the navel-string, and afterwards draw forth the child with all speed that may be, lest it be suffocated.
SECT. V.–_Of Women labouring of a dead Child._
When the difficulty of labour arises from a dead child, it is a great danger to a mother and great care ought to be taken therein; but before anything be done, the midwife ought to be well assured that the child is dead indeed, which may be known by these signs.
(1) The breast suddenly slacks, or falls flat, or bags down. (2) A great coldness possesses the belly of the mother, especially about the navel. (3) Her urine is thick, with a filthy stinking settling at the bottom. (4) No motion of the child can be perceived; for the trial whereof, let the midwife put her hand into warm water, and lay it upon the belly, for that, if it is alive, will make it stir. (5) She is very subject to dreams of dead men, and affrighted therewith. (6) She has extraordinary longings to eat such things as are contrary to nature. (7) Her breath stinks, though not used so to do. (8) When she turns herself in her bed, the child sways that way like a lump of lead.
These things being carefully observed, the midwife may make a judgment whether the child be alive or dead, especially if the woman take the following prescription:–“Take half a pint of white wine and burn it, and add thereto half an ounce of cinnamon, but no other spices whatever, and when she has drunk it, if her travailing pains come upon her, the child is certainly dead; but if not, the child may possibly be either weak or sick, but not dead. This will bring her pains upon her if it be dead, and will refresh the child and give her ease if it be living; for cinnamon refresheth and strengtheneth the child.
Now, if upon trial it be found the child is dead, let the mother do all she can to forward the delivery, because a dead child can in no wise be helpful therein. It will be necessary, therefore, that she take some comfortable things to prevent her fainting, by reason of the putrid vapours arising from the dead child. And in order to her delivery let her take the following herbs boiled in white wine (or at least as many of them as you can get), viz., dittany, betony, pennyroyal, sage, feverfew, centaury, ivy leaves and berries. Let her also take sweet basil in powder, and half a drachm at a time in white wine; let her privities also be anointed with the juice of the garden tansey. Or take the tansey in the summer when it can most plentifully be had, and before it runs up to flower, and having bruised it well, boil it in oil until the juice of it be consumed. If you set it in the sun, after you have mixed it with oil, it will be more effectual. This, an industrious midwife, who would be prepared against all events, ought to have always by her. As to the manner of her delivery, the same methods must be used as are mentioned in the section of natural labour. And here again, I cannot but commend the stone aetites, held near the privities, whose magnetic virtue renders it exceedingly necessary on this occasion, for it draws the child any way with the same facility that the load-stone draws iron.
Let the midwife also make a strong decoction of hyssop with water, and let the woman drink it very hot, and it will in a little time bring away the dead child.
If, as soon as she is delivered of the dead child, you are in doubt that part of the afterbirth is left behind in the body (for in such cases as these many times it rots, and comes away piece-meal), let her continue drinking the same decoction until her body be cleansed.
A decoction made of herbs, muster-wort, used as you did the decoction of hyssop, works the effect. Let the midwife also take the roots of pollodum and stamp them well; warm them a little and bind them on the sides of her feet, and it will soon bring away the child either dead or alive.
The following medicines also are such as stir up the expulsive faculty, but in this case they must be stronger, because the motion of the child ceases.
Take savine, round birthwort, trochisks of myrrh, castor, cinnamon and saffron, each half a drachm; make a powder, give a drachm.
Or she may purge first, and then apply an emollient, anointing her about the womb with oil of lilies, sweet almonds, camomiles, hen and goose-grease. Also foment to get out the child, with a decoction of mercury, orris, wild cucumbers, saecus, broom flowers. Then anoint the privities and loins with ointment of sow-bread. Or, take coloquintida, agaric, birthwort, of each a drachm; make a powder, add ammoniacum dissolved in wine, ox-gall, each two drachms. Or make a fume with an ass’s hoof burnt, or gallianum, or castor, and let it be taken in with a funnel.
To take away pains and strengthen the parts, foment with the decoction of mugwort, mallows, rosemary, with wood myrtle, St. John’s wort, each half an ounce, spermaceti two drachms, deer’s suet, an ounce; with wax make an ointment. Or take wax six ounces, spermaceti an ounce; melt them, dip flux therein, and lay it all over her belly.
If none of these things will do, the last remedy is to try surgery, and then the midwife ought without delay to send for an expert and able man-midwife, to deliver her by manual operation, of which I shall treat more at large in the next chapter.
FOOTNOTES:
[10] Horse-parsley.
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CHAPTER VI
_Of Unnatural Labour._
In showing the duty of a midwife, when the child-bearing woman’s labour is unnatural, it will be requisite to show, in the first place, what I mean by unnatural labour, for that women do bring forth in pain and sorrow is natural and common to all. Therefore, that which I call unnatural is, when the child comes to the birth in a contrary posture to that which nature ordained, and in which the generality of the children come into the world.
The right and natural birth is when the child comes with its head first; and yet this is too short a definition of a natural birth; for if any part of the head but the crown comes first, so that the body follows not in a straight line, it is a wrong and difficult birth, even though the head comes first. Therefore, if the child comes with its feet first, or with the side across, it is quite contrary to nature, or to speak more plainly, that which I call unnatural.
Now, there are four general ways a child may come wrong. (1) When any of the foreparts of the body first present themselves. (2) When by an unhappy transposition, any of the hinder parts of the body first present themselves. (3) When either of the sides, or, (4) the feet present themselves first. To these, the different wrong postures that a child can present itself in, may be reduced.
SECTION I.–_How to deliver a Woman of a Dead Child by Manual Operation._
When manual operation is necessary, let the operator acquaint the woman of the absolute necessity there is for such an operation; and that, as the child has already lost its life, there is no other way left for the saving hers. Let him also inform her, for her encouragement, that he doubts not, with the divine blessing, to deliver her safely, and that the pains arising therefrom will not be so great as she fears. Then let him stir up the woman’s pains by giving her some sharp clyster, to excite her throes to bear down, and bring forth the child. And if this prevails not, let him proceed with the manual operation.
First, therefore, let her be placed across the bed that he may operate the easier; and let her lie on her back, with her hips 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. Being thus situated, she must fold her legs so as her heels be towards her buttocks, and her thighs spread, and so held by a couple of strong persons, there must be others also to support her under her arms, that