a Woman newly layd p. 247 Sect. 4. Of the bruises and rents of the outward parts of the Womb caused by Labors p. 252 Sect. 5. Of the After-pains p. 254 Sect. 6. Of the Lochia whence they come if good or bad their stopping and what ensues p. 255 Sect. 7. Of the Inflammation c. of the Womb. p. 258 Sect. 8. Of the Inflammation and Apostemation of the Breasts p. 259 Sect. 9. Of the curdling of the Milk in the Breasts p. 262 Sect. 10. Of Choping c. and loss of the Nipples p. 265 PART IV. Of the Diseases and Symptoms happening to little Children and of the choice of a Nurse SEct. 1. What manner of Woman a Nurse ought to be and whether the Mother be the best Nurse p. 269 Sect. 2. Of the Diseases and Symptoms which happen to Children and first of their Diseases in general p. 291 Sect. 3. Of Feavers Meazels and Small-Pox in little Children p. 293 Sect. 4. Of the milky scab Achores Scald-Head and Lice p. 295 Sect. 5. Of the watry swelling of the Head p. 298 Sect. 6. Of Fright in the Sleeps and Watchings p. 299 Sect. 7. Of the Falling-sickness and Convulsion p. 301 Sect. 8. Of pain in the Ears Moisture Vlcers and Worms p. 302 Sect. 9. Of the Thrush bladders of the Gums and Inflammation of the Tonsils p. 303 Sect. 10. Of the breeding of Teeth p. 304 Sect. 11. Of a Catarrh Cough and difficult breathing p. 305 Sect. 12. Of the Hiccup and Vomiting p. 307 Sect. 13. Of the pains and puffing of the Belly p. 309 Sect. 14. Of the Flux of the Belly p. 311 Sect. 15. Of Costiveness p. 312 Sect. 16. Of Worms p. 313 Sect. 17. Of the Rupture p. 314 Sect. 18. Of Bunching out and inflammation of the Navil p. 315 Sect. 19. Of the falling out of the Fundament p. 316 Sect. 20. Of difficulty and stopping of Vrine p. 317 Sect. 21. Of not holding Vrine p. 318 Sect. 22. Of Leanness and Bewitching p. 319 SECT I. Of the True generation of it Parts and Increase of the Infant in the Womb according to the daies and times till the time of the Birth WHen the Womb whose property it is naturally to receive seed for generation as a Loadstone attracts iron or Jeat straws or feathers hath received the seed and by its virtue hath shut it up for generation Presently from the first day until the sixth or seventh there grow and arise very many and very small fibres or hairs beginning with a hot motion by which vital heat the Liver with its chiefest organs are generated as this following Figure may the more illustrate The small Fibres In the one of which branches there is a collection of blood of which first the liver is generated From whence it easily appears the liver is a congealed and concrete blood and also it may be manifest how many and various veins it hath prepared and fitted for the attractive and expulsive virtue But in the other branch are generated those webs oâ— veins with the dilatation of other veins as oâ— the stomach spleen and intestines in the lower part of the belly And from hence immediately all veins are collected together as so many branches into one trunk in the upper web of the liver towards the hollow veinâ—… and this trunk by and by sends down brancheâ— to make the midriff and directs not a few branches to the lower parts even to the very thighs and then the heart with its arteries extended into seed from the navil iâ— generated by a vital virtue and is directeâ— towards the spine of the back as is demonstrated in this figure 3. But those do attract the hottest and more subtile blood of which the heart is generated incased in a membrane naturally fleshy and thick necessary upon the account of so â—ot a member But the hollow vein extendâ—ng it self and penetrating the inward conâ—avity of the right side in the heart c. deâ—ives thence blood for the nourishment of the â—eart From the same branch also of this his vein and in the same part another vein ariseth called by some the immoveable or quiet vein because according to the account of the pulsation of other veins it beats not at all but lies quiet ordained for this end that it should let go the purest blood to the Lungs being vested with a double tunicle like an Arterie from whence it is called the Arterial vein But in the left concavity of the heart there are two Arteries that is to say the Venal Arterie and the Great Arterie which carries a great pulse with it and diffuseth the vital Spirits by the blood of the heart into all the Arteries of the Body For as the hollow vein is the original of all veins by which the Body doth attract its whole nourishment of blood so from the Aorta or great Arterie all pulsatile veins are derived diffusing the vital Spirits through the whole Body For the heart is the fountain and original of vital heat without which no creature or member can thrive Under the abovesaid Arterie in the left concavity of the heart another vein ariseth called the Venal Arterie And although that be really a pulsatile vein and doth direct the vital Spirits yet according to the manner of all pulsatile veins that have blood it hath but one coat and therefore made for that end that it should derive the cold air from the Lungs to refresh the heart as also to attemper its over-much heat And veins issuing out from both the cavities of the heart are inserted into the Lungs of which they are formed for the vein that proceeds from the right cavity of the heart produceth the most subtile blood which by small fibres dispersed here and there is changed into the fleshy substance of the lungs But from the great vein of the Liver viz. the Vena Cava or hollow vein the whole brest is generated and so successively the Arms and Thighs Within the time aforesaid also is generated the highest and chiefest part of this noble structure the Brain in the third Region of this mass for the whole mass of seed is filled with the animal Spirits that contracts a great part of the genital moysture and concludes it in a certain cavity wherein the brain may be formed but as to the out-fide it is inveloped with a certain covering which being dried with heat is brought into a boney substance and becomes a scull as appears by this precedent figure But the brain is so formed that it may conceive retain and change the natures of all the vital Spirits from whence also proceed the beginnings of all Reason and of the Senses For as veins have their original from the Liver and as arteries have their rise from the heart so also nerves being of a softer and milder natural existence arise from the brain and are not hollow as the veins are but solid for they are the first and chiefest instruments of all the senses by
day or more there being blood enough in its body for that purpose but because the blood can be no longer enliven'd and renewed by circulation as it hath continual need which being obstructed always causeth the creatures sudden death sooner or later according as it is more or less obstructed I know it may be objected that though the circulation be so hindred and intercepted by the coming forth of the string it need not therefore cause such a sudden death to the Child because the blood may notwithstanding circulate in all the other parts of the body To which I answer that in respect to the Infant 't is either absolutely necessary that the blood for want of respiration should be elaborated or prepared in the thick part of the burthen call'd the placenta and therefore must be a free communication or for want of it that the Infant must immediately breathe at the mouth as well to be refreshed as to drive out the fuliginous or sooty Vapors by expiration which not being possible whilst in the Womb it must unavoidably be choaked and dye in a very short time if it wants both together Wherefore in this case the Woman must without any delay be deliver'd the which if nature doth not speedily perform the Child must be drawn forth by its feet Women that have great waters and along string to the burthen are very subject to this mischief for the waters coming forth in great abundance at the breaking of the skins or membranes do often at that instant draw the string which swims in the midst forth along with them and much the easier if the Infants head be not advanced very forward into the passage for to hinder the coming forth of it in this manner Assoon as 't is perceived you must immediately endeavor to put it back to prevent the cooling of it behind the Childs head least it be bruised as we have already noted whereby the blood may coagulate there keeping it in that place where it was thrust back until the head being fully come forth into the passage may hinder the coming down of it again which may be effected by holding it up with the fingers of one hand on that side it comes down untill the head be advanced as aforesaid or in case the hand be taken away to put a piece of fine soft rag between the side of the head and the Womb to stop up the way it came down by always leaving an end of the rag without the body to draw it forth by at pleasure But sometimes notwithstanding all these cautions and the putting of it back it will for all that come forth every pain and then without any more delays at all the Midwife must bring the Child forth by the Feet which she must make a diligent search and enquiry after although the Infant comes with the head foremost for there is but this only means left remaining to save the Childs life which it would certainly lose by the least delay in such a case Wherefore having placed the Woman conveniently let her gently put back the Head which offers provided it be not engaged too low amongst the bones of the passage and that it may be done without too great violence to the Woman for in that case it will be better to let the Child run the hazard of dying than to destroy the Mother for Tertullian as my learned Mr. Riolanus very well observes upon a like Subject saith That it is a necessary cruelty to kill the Child in such a case rather then to save it from the danger it is in of dying and so certainly cause the Mothers death and then let her slide up her hand being well anointed under the breast and belly to search for the Feet by which she must draw it forth according as hath been formerly discoursed the which being perform'd let her immediately take care of the Infant which is ever in this case very feeble SECT XXVII Wherein the Burthen either first offers it self or comes first quite forth DR Very well and excellently have you given us demonstrations of your skill and knowledge hitherto good Mrs. Eutrapelia now pray will you inform me how you act your part in a Labor wherein the burthen either first offers or else comes first quite forth Mid. That I shall Sir to the best of my Talent and therefore first of all Sir I must note that the coming forth of the Navil-string before the Infant whereof we discoursed in our foregoing Section is oftentimes the cause of its death for the reason there alleadged but the coming forth of the burthen first is yet much more dangerous for that besides that the Children are then commonly Stil-born if they be not assisted in the very instant the Mother likewise is in great peril of her life also because of her great floodings which usually happen when it is loosened from the Womb before its due time by reason that it leaves all the orifices of the Vessels to which it did cleave open whence incessantly flows blood until the Child be born by reason that the Womb as long as any thing continues there doth every moment strongly endeavour to expell it by which means it continually voids and expresseth the blood of the Vessels which are alwaies open as we have already explained when the burthen is so separated as long as the Womb remains extended and cannot be closed until it hath voided all that it did contain and comes by the contraction of its Membranous substance to stop them by pressing them together wherefore if the Midwife ought to be vigilent and diligent to succour an Infant when the Navil-string comes first how much more ought she to be so when burthen comes forth first and wherein the least delay is ever the cause of the Infants sudden death if the Woman be not speedily delivered because the Infant cannot then remain long in the Womb without being choaked or stifled being it stands in need at that time of breathing at the mouth as we explain'd the foregoing discourse the blood being no longer enlivened by the preparation made in the burthen the use and function of which then ceasing from that very instant that it is separated from the Vessels of the Womb to which it was joined for which reason there immediately follows a great fludding which is so dangerous for the Mother that without speedy help she quickly looseth her life by this unlucky accident Now when the Burthen is not wholly come forth but lies in the passage some advise to put it back before the Child be fetch'd but I am not of their opinion for when it comes into the passage before the Infant it is at that time totally divided from the Womb at the bottom whereof it ought to be commonly situated and fastened until the Child be born but because as soon as it is wholly loosened as it always is when it comes first it becomes a body altogether unnatural therefore it is never to be
and no longer possessing the Womb and so fetch away the Child by the Feet For indeed although it be certain that the Child be quite dead in the Womb and other circumstances that will demonstrate that there is need of a Physitian or Surgeons Art yet he must not therefore presently use his crotchets because they are never to be used but when hands are not sufficient and that there is no other remedy to prevent the Womans danger or to bring away the Child any other way for very often though all hath been done that art directs some persons present that understand not these things will believe that the Child was kill'd with the crotches although it had been dead 3 days before and without other reasonings and better understanding of the matter for his recompence in saving the life of the Mother requite him with an accusation of which he is altogether innocent and in case the Mother should afterwards dye by misfortune lay her death also to his charge and instead of praise and thanks treat him like a Butcher or Hangman to which divers Midwifes are commonly very ready to contribute and are the first that make the poor Women that have need of the Men afraid of them Insomuch that they are afraid of being blamed by them for having themselves been the cause as some of them often are of the death of Infants and many ill accidents which often befall the poor Women for not causing them to be helped in due time and from the very instant that they perceive the difficulty of the labor to pass their understandings I speak this by way of caution on both sides Now therefore for the Physitian or Chirurgion to avoid these calumnies let him never use his crotchets but very rarely when there is no other way as also to endeavor his utmost as much as the case will permit to bring the Child whole into the World although it be dead and not by bits and peice-meals to give the ignorant not any pretence of blame I say as much as the case will permit that is with respect to the Woman under his hands for to save her he had better sometimes to bring forth the Child with Instruments then to kill her by tormenting her with excessive violence to bring it forth whole for in a word he must and ought to do in his conscience what his Art commands without taking heed to what may be spoken afterwards and every Physitian or Chirurgion that hath a well regulated conscience will always have a greater regard to his duty then his reputation in such a case in performing of which let him expect his reward from God SECT XXXII Of the extracting of a mola and false conception DR We have hitherto Mrs. Eutrapelia discoursed of births natural and unnatural there is somewhat more not like these but often with them and without them which Physitians call a Mola but you call it a false Conception I pray Mrs. therefore what is that Mola or false Conception Mid. A Mola Sir is a hard inform tumorfull of pores like so many ugly eyes scarce to be cut by a knife of a stony substance to touch and round appearing sometimes at the entrance of the Womb sometimes over the whole Womb and is thought by very Learned Doctors to be begotten by the woman her self without the help of a man though some affirm it cannot be without the seed of the man and therefore inanimate because not generated by two without the help of a man I say by the force of her own seed mixing it self with much menstruous blood reteined in the Womb which by immoderate heat is changeth into the shape of flesh and that altogether unnatural as is the stone in the bladder and in the fingers of gouty persons c. Dr. Well Mrs since 't is so tell me I pray wherein it differs from a true Conception Mid. It may Sir be like a true Conception in three respects yet differ in six As first 'T is true that a false conception stoppeth the monthly terms as doth the true Secondly The belly also doth swell and the breasts grow big Thirdly There is an alteration both in the color and appetite but yet they differ in these six following ways as First A false conception hath no ordinary nor periodical motion neither doth it stir from side to side except it be pressed Secondly In a false conception the belly is harder and the feet are much more swelled Thirdly The woman is more heavy and unweeldy and not so nimble as with a true conception Fourthly The breasts swell not so much as in a true conception Fifthly The whole body grows soft and consumes away in a false conception Sixthly a false conception may be moved in three months but the Child stirreth not till after three months or usually in the fourth month And again the birth of an Infant never exceeds the eleventh month whereas a false conception may continue for fourteen years or as long as they live Moreover there may be a Tympany caused by air included in the Womb. Or else there may be a Dropsie by reason of the many humors contained in the Womb both which may give a false supposition of being with Child but these also are easily distinguish'd from a false conception A Tympany may be moved from place to place but not the other A Tympany will sound if lightly strucken but not the other and a Dropsie caused by those many humors as aforesaid will shew some marks being depressed with the fingers whereas a Mola is hard and yieldeth not to the pulsation or depression of the fingers And lastly in both these most commonly the Thighs swell but in a false conception or Mola the Thighs wither and are lesser Dr. Thus far have you extreamly ingeniously Mrs. Eutrapelia exprest your self concerning a Mola and now you have done I pray you give me leave to lay you down my sentiments concerning both a Mola and a false conception and the safest and best way to draw them forth of the Womb with safety First of all then Mrs. you must know that there are several sorts of great bellies belonging to Women as hath been said before there are your natural big bellies which contain a living Child and those may be called true ones and others unnatural or against nature in which in lieu of a Child is engendred nothing but strange matters as wind mixed with waters which may be called dropsies of the Womb and false conceptions and Moles or Membranes full of blood and corrupted seed for which reason they are called false great bellies Now you must know that among the signs of a true great belly one is the stirring of the Child in the Womb but here you are to observe that it is very fit we should be always careful not to be deceived by what we feel to stir in the Womb inasmuch as the Infant of it self is endued with 2 sorts of motions in its Mothers
Womb that is to say a total motion and a partial motion the total motion is when it removes the whole body and that is when it moves only but one part at a time as the Head Arms or Legs all the rest of its body lying unmoved now the Womb blown up in fits of the Mother yea and some moles have by accident a kind of total motion but never a partial one for that motion of a mole is rather a falling down then otherwise to wit a motion by which heavy things do use to fall downwards for a Woman who hath a mole of any considerable bigness whatsoever side she turns her self to her belly will fall the very self same way immediately even like unto an heavy bowl Then again you may remember that another sign of a great belly was the stopping of the courses and withal a little qualmishness which is not always true and women who daily use copulation are very often subject to be deceived hereby thinking that then they are with child whenas indeed false conception shall cause you almost the same accidents as true ones the which cannot easily be distinguished but by its consequences For this false great belly is often caused by wind which blows up and stretcheth out the womb like a bladder the which women often discharge with as much noise as if it came from the fundament and sometimes t is nothing but water which is gath'red there in such abundance as some women have been known to void a pail-ful without any child though they veryly believed they had been with child Now your moles always proceed from some false conceptions which continuing in the womb grow there by the blood that flows to them and by the accumulation of which they are by little and little encreased and if the womb chance to expell it before 2 months it may be called a false conception and some of them are only but as it were the seed involv'd in a membrane the others are alittle more solid and fleshy resembling in some sort the Gizard of a foul and are greater or less according to the time they remain in the womb and also according to the quantity of blood with which they are always soaked and women expell these false conceptions sooner or later according as they cleave to the womb the which makes them almost always to flood in great quantity at those times but for your moles they often continue in the womb after the ordinary time of labor some women having had them a whole year yea many years as happened to a certain Peuterors wife of whom the great Chirurgion Ambrose Parry makes makes mention in his book of generation who had a mole 17 years and at last dyed of it for if they keep it so long they go in danger of their lives for their long or short continuance is according as they are more or less adhering to the inward parts of the womb and are there entertained and nourished by the blood that flows thither And here I pray you note that it is of great importance to distinquish well betwixt a true and a false great belly for the faults committed by a mistake are always very considerable forasmuch as in a true great belly the child ought to continue in the womb till nature endeavors to expell it by a natural labor but contrarily the false great belly dictates to us to procure the expulsion of what it conteins as soon as may be wherefore we ought to be very careful And if there be any occasions wherein the Physitians and Chirurgions and Midwives ought to be more prudent and to make more reflections upon their prognostics for an affair of so great an importance as this is it is in this which concerns their judgments as to conceptions and womens being with child to the intent that they may avoid the great accidents and misfortunes which they may cause which are too precipitate in it without a certain knowledge Now the faults which are and may be committed at such a time through too much fear are in some sort excusable and to be pardoned but not those caused by rashness which are incomparably greater And now to return to my discourse of moles I take a mole to be nothing elce but a fleshy substance without bones or joynts or distinction of members without form or figure regulated and determined engendred against nature in the womb after copulation out of the corrupted seed both of the man and the woman notwithstanding there are some sometimes which have some lineamens of a rought form And here I take it to be very certain that a woman never engenders a mole without the use of copulation both seeds being required to it as well as for a true generation though it may be otherways imagined as you said by very learned Drs. for truely though there may be some women who though never having carnally had to do with any man yet do naturally cast forth some strange bodies after a flooding which in a appearance seems to be flesh yet notwithstanding if you shall take more diligent and special notice thereof you will find it to prove to be but some clods of blood coagulated either without consistance or fleshy texture or any ways membranous as are your moles and false conceptions and that stony hardness was caused through its long stay in the womb being there baked as in an hot oven Now as to the manner of the engendring of moles I take it to be ordinarily this that it is when either the mans or the womans seed or both together are weak or corrupted the womb not laboring for a true conception but by the help of the spirits with which the seed ought to be replenished but so much the easier as that small quantity found in it is extinguished and as it were choaked and drowned by an abundance of the gross and corrupted menstruous blood which sometimes flows thither soon after conception and gives not leisure to nature to perfect what she hath with great pains begun and so troubling its work bringing thither confusion and disorder there is made of the seeds and blood a mere Chaos called a Mole not usually engendred but in the Womb of a Woman and never or very rarely found in that of other animals by reason that they have no menstruous blood as a woman that divine creature hath A mole moreover you are to note hath no burthen nor navil-string fastned to it as a childs always hath for as much as the mole it self sticks close to the womb by which means it receives nourishment from its vessels it is also likewise usually clothed with a kind of skin in which is formed a piece of flesh confusedly interlaced with many Vessels it is of a bigness and consistence more or less according to the abundance of blood it receives and according to its disposition and also according to the temperature of the Womb and the time it remains there For the
most part there is but one yet sometimes there are more whereof some cleave very strongly to the Womb others very slightly if women miscarry of them before the 2d Month as I said before they are call'd false Conceptions and when they keep them longer and that this strange body begins to grow bigger then they are called Moles and here you must know that your false Conceptions are more Membranous and sometimes full of corrupted Seed but your Moles are altogether fleshy they cleave to the Womb almost always and are sustained by the blood with which it is always furnished just as plants are by the moisture of the Earth Sometimes there is a Child together with a Mole from which it is sometimes divided and sometimes cleaving to its body which puts it in great danger of being Monstrous or mishaken because of the Compression which this strange body causeth to the little Infant as yet being but very tender Thus having at large given you my Opinion concerning Moles and false Conceptions their causes signs and differences there remains now nothing more concerning this matter to be demonstrated but the manner how they ought to be drawn forth of the Womb. And now seeing that these things contained in the Womb are wholly unnatural their expulsion must be procured as soon as possible may be the which is very difficult to be performed when these strange Bodies cleave so fast to the Womb and especially the Mole therefore to avoid the abundance of accidents and inconveniences as near as may be that these unnatural things will produce they must be endeavoured to be expell'd as soon as may be and for the Mola you must before you come to the Manual Operation try if by any means you can to cause the Woman to expel it of her self to the which purpose you are to administer to her strong and sharp clysters to stir up throws for to open the Womb to give way to it moistning also and loosening the Womb with softening Oyntments Oyls and Grease not omitting bleeding in the foot if there be occasion Now the Mole will certainly be excluded by these means provided it be but of an indifferent bigness or that it cleave but very little or not at all to the Womb but if it shalâ— stick strongly to the bottom of the Womb or that it be very big the Womam wilâ— hardly be rid of it without the help of a Physitian Chyrurgions or Midwifes hand iâ— which case after that you have placed thâ— Woman conveniently as if you were to fetcâ— a dead Child then slide up your hand into the Womb and therewith draw forth the Mole but if it be so big that it cannot be brought forth whole then 't is wholly the man's work who for this purpose use your crotchet or knife but this is very rare because it is of a tender soft substance much more plyable then a Child's but if you find it be only joyned to the Womb and close fasten'd you must separate it gently with your fingers ends your Nails being paired by putting them by little and little between the Mole and the Womb beginning on that side where it doth not stick so fast to the Womb and so pursuing it until it be quite loosened being mighty careful if you find it grow to too fast of rending or bursting the proper substance of the Womb and proceeding as hereafter I shall speak of for the extraction of a Burthen staying behind in the Womb when the string is broken off For these same Moles never have any string fastened to them nor any burthen from whence they should receive their nourishment but they do of themselves immediately draw their nourishment from the Vessels of the Womb to which they are almost allways joined and sticking in some place and as for the substance of their flesh 't is also much more hard then that of the burthen and sometimes Schyrrhous which is the cause why it is difficult to be separated from the Womb. As to a false Conception although it be much less then a Mole yet it often puts a woman in hazard of her Life by reason of great fluddings which very often happens when the Womb would discharge it self of it and endeavours to expel it the which seldom cease till it be come away because it doth continually endeavour to exclude it whereby the blood is excited to flow away and in a manner squeesed out of the open Vessels Now the safest and best way and remedy for a Woman in this case is to fetch away the false Conception as soon as may be because the Womb can very hardly avoid it of its own nature without artificial help for it being very small the Womans impulse in bearing downwards cannot be so effectual when the Womb is but little distended by so small a body as when it contains a considerable bulk in it for then it is the more strongly compressed with the throws Many times 't is very difficult to fetch away these false Conceptions because the Womb doth not open and dilate it self ordinarily beyond the proportion of what it contains and that being but very little so is its opening which is the reason why the Midwife is sometimes so far from introducing her whole hand that she can scarce get in a few Fingers with which she will be obliged to finish the Operation as well as she may or can by proceeding in the following manner when she hath introduced them Having then very well anointed her hand she must slide up the neck of the Womb into the inward Orifice the which she will find sometimes to be but very little dilated and then very gently put in one of her Fingers the which she must presently turn and bend on every side until that she hath made way for a second and afterwards for a 3d or more if it may be done without violence but many times she hath enough to get in but 2 between which she must take hold of the false Conception as Crabs do with their claws when they fasten upon any thing and then she must gently draw it forth as also the clodded blood which she there shall find and then afterwards undoubtledly the fludding will cease if no part of the Conception be left behind but if the inward Orifice cannot be more dilated then to admit of one Finger and that the fludding is so violent as to endanger the Womans life then is matter and manner to be wholly committed to care and artful industry of the skilful Physitian or Chirurgeon Mid. Now Sir having discoursed so learnedly of these things let us in the next place if you please discourse of the Afterbith SECT XXXIV Of the Secundine or Afterburden and the best and safest way to draw it forth DR Come then Mrs. if you please tell me what the Secundine is Mid. The Secundine is that in which the Infant lyeth in the Womb and may be called a second house or covering made by the
of all the parts of its body which is very tender wherefore I cannot conceive any necessity to oblige them more to empty the Urine which is in a small quantity in the Bladder then the excrements which are in the Guts which is not then done in any manner but only after the Child is born Bartholinus and others would have the Infant however to empty its Urine through its Yard and that these waters proceed from thence but there is a greater probability it should be vented by transpiration for before it is yet fully shaped and quick there is notwithstanding found a proportionable quantity of these waters to the bigness of its body which makes it appear that it is then neither the Urine rendred by the Vrachus nor Yard as all the World imagine and that which proves it more plainly is the example of some Children born with their Yards imperforated who notwithstanding have these waters whilst in the Womb And here it must be observed that when there is more then one Child they are never in the same Membrane unless their bodies are joined together which is rare and monstrous but each have their Membranes and waters apart Now these waters thus collected within these Membranes have divers very considerable uses First They serve the Infant to move more easily as it were by swiming from one side to the other and that it may not hurt the Womb by its frequent motions in striking dry against it which would cause great pain and often excite to Abortion and they serve also very much to facilitate its passage in the birth making the way very slippery and by that means the orifice of the Womb being moistened is better widened and yielding when they break just when the Child is ready to follow or a little before for else remaining dry it is born with greater difficulty and the Mother also more tormented by it And now Mrs. Eutrap having thus sufficiently as I hope explained the Membranes of the fetus and the waters contained in them I think it may not be amiss to say something in order of inquiring after the parts by which it is nourished whilst in the Womb and and here Mrs. Eutrap since as was said in the beginning that it is only nourished by its Mothers blood and that I am of opinion that big-bellied Women have none that is fair or good provident nature hath formed the placenta to serve it for a Magazine that it may always have sufficient and be there again elaborated and perfected to render it more convenient for its nourishment for without doubt so gross a blood as the Mothers cannot possibly be converted into its substance if it were not first purified in the placenta which is afterwards sent to it by means of the umbelical veins and brought back as we shall shew hereafter by the Arteries which are the conduits of which the Navil-string is composed We say then that the placenta is nothing but a spungy and fleshy mass somewhat like the substance of the spleen woven and interlaced with an infinite number of Veins and Arteries which compose the greatest part of the body made to receive the Mothers blood appointed for the Infants nourishment This mass is so called because it resembles a cake also it may be call'd the delivery because being come forth after the Child is born the Woman is quite delivered of her burthen it is also call'd the after-burthen because it is as a 2d Labor of which the Woman is not discharged till after the Child be born some give it the name of liver of the Womb because they say it serves as a liver to prepare the blood appointed for the Infants nourishment and Laurentius calls it the sweet bread of the Womb and appoints it the same use as that of the lower belly to wit for a rest and support to the Vessels of the Navil which disperseth an infinite number of branches throughout all its substance Now this placenta is made of the menstruous blood of the Mother which flows into the Womb by the accumulation of which it is formed its shape is flat and round about the bigness of a Trencher and 2 fingers breadth thick about the middle where the umbilical Vessels are fastened but is thinner towards the edges It is covered with the Chorion and Amnios on the side next the Infant and on the other side 't is joined and fastned to the bottom on the inside of the Womb It is strongest fastned to the Womb with its circumference by the Chorion which cleaves so close to it by the interlacings of an infinity of Vessels which appear very large in its surface that it cannot be separated from it without tearing its substance Though there be 2 or 3 Children in the Womb begot in the same act they have usually but one common after-burthen which hath as many Navil-strings as Children which are notwithstanding separated from one another by their several Membranes in each being the Children and waters but if they be superfetations there will be as many burthens as Children and as superfetations happen but rarely so there are few Women that have their burthens separated when they are delivered of several Children We scarce find any Creature but a Woman that hath an Afterburthen like this described and dischargeth it as useless as soon as the Child is born for most other Animals cast forth nothing after their young except the waters only and some slimes with the skins which surround them and in lieu of this fleshy mass those which as a Woman have but one at a time have only some cotyledones or many spungy kernels joyn'd inwardly to the proper substance of their Womb which terminates all the branches of the umbelical Vessels of their Young which Kernels as I have often observed in cutting up Sheep when they were not with young are not bigger then hemp-seed but when they were with young they swell'd as big as one thumb one bigger and one lesser and then they resembled the Figure of a round mushrome on the outside not yet spread after it 's cut from its stalk and to each of these kernels are fastned the branches of the umbilical Vessels however those that have more then one at a time as Bitches Rabbits c. have no kernels instead of which each young hath in its celule a kind of particular placenta which the dam eats as soon as she voids it after she hath knawn off the umbilical Vessels that hold it But these thing being fitter for Physitians and Chyrurgions to be contemplated on I shall proceed no farther to discourse thereon and shall only desire you to note that those Vessels appointed for the nouriture of the fetus are bigger then they are in Men because of their hollowness and as soon as the Child is born dry up and that part of them which is without the belly falls off and is separated close to the Navil 5 or 6 days after for which
of the World and than which there can hardly happen a greater defamation to the Female Sex Insomuch as some like Rachel have cry'd out to their Husbands for Children or else their Lives will lye on 't rather than endure the reproach of Barrenness and some Women have preferr'd their maids to their Husbands so that their Child might be reputed theirs to take away the blemish of Barrenness But you shall find but few Women of their minds now a days so then we shall in the first place speak of the causes of this so odious and distateful a Disease and then of their removing for you know 't is an old saying and true take away the cause and the effect will consequently cease Now the chief method of finding out all causes which do or may bring damage to the faculties of the body is no other then the knowledge of the means whereby these faculties perform their Actions in the time of health and soundness of body And whereas to the producing of any natural Conception there is a necessity of distinction of both Sexes and a conjunction and carnal Copulation of the Man and Woman without which no Generation can be effected As for that story of a certain Maids conceiving with Child by standing in a Bath where some Mans seed had been cast the Womb drawing it to it as the Load-stone doth Iron or Jet straw it was either a miracle in Nature or she so gave out to save her bacon and so no ways belongs to our purpose and having before declared the manner in other Sect. Therefore we shall here lay down the manifest causes of Barrenness from either Sex so that neither may be unjustly blamed where they happen for since the Women have in this case a great interest and damage too if the fault be in the Man because they may often help their Husbands defect and in so doing pleasure themselves we shall not therefore omit to treat of the causes thereof which may happen to men and moreover there being a necessity that both Sexes be furnished with fit and proper Instruments for the work of Generation as the man with a Yard c. and a Woman with a Womb c. Then even reason will tell you that if there chance to be any defect or dissaffection in nature in any of the Members of either Sex belonging to this work of Generation the fruitfulness or Conception must necessarily be hindred impaired or quite and clear abolished To begin then first with what belongs to the Mans side one cause of Barrenness laid down by many Authors is the over-much length of the Yard by reason whereof the Seed is too much cooled in the passage before it can be injected home into the Womb. But though this be a somewhat probable and plausable reason yet I am of opinion that it is but weak and will not hold water with those of greater reason for all Souls are not endued with a like proportion of reason for the Seed passing through the pipe of the Yard is kept hot enough the generative Spirits at that time oft flocking to the Yard to assist it in so great a work and the like being performed on the Woman's part I cannot see how it can be any ways possible it should take cold in its journey but on the contrary side it may be rationally imagin'd that the long Yard is most fit and commodious for Conception by sending Seed to the inmost and furthermost parts of the Womb and so most likely to be there retained its due time And now others on the contrary side will have the short Yard the cause of rendring Men unfruitful and these I think have more reason on their side because it cannot so well inject the Seed into the Womb as you heard before But indeed neither can this be a firm reason for unfruitfulness in Man since 't is confirmed by experience that such an one hath begot Children likewise But a greater reason of unfruitfulness in the man may be some vitiousness or defect in his Yard as if it be crooked or if any of its Ligaments be writhed or broken or bruised whereby the passages through which the seed should flow be corrupt stop'd or vitiated or some Disease or imperfection be either in the proper or Neighbor parts thereof Another cause of Barrenness by defect of the Yard is a too much weakness and tenderness thereof it being not strongly enough erected to inject the Seed into the Womb. Then another cause in Men may be some vice in the Stones as if they be oppressed with any Inflammation or swelling or wound or ulcer Also the Man may be Barren from his want of Seed or if it be nought as in the Running of the Reins or Venereal Disease Glutony or Drunkenness c. and then too frequent Carnal Copulation is a cause of Barrenness because it attracteth the Seedy moisture from the Stones before 't is sufficiently prepared and concocted as all other members of the body by institution of nature use to draw their accustomed juice to themselves so now if any one by daily Copulation draws out all the moisture of his Seed then do the Stones draw the moist humors from the upper Veins to themselves and so having but a little blood in them they are forced of necessity to cast it out raw and thus the stones being deprived of the moisture of their veins draw the same from the upper veins and the upper veins from all the parts of the body for their proper nutriment to the great damage of the body robbing the same of the vital Spirits It is therefore no wonder if those that use immoderate Copulation are very weak in their bodies seeing the whole body is thereby depriv'd of its best and purest blood and vital Spirits insomuch as those that have been too much addicted to that pleasure have killed themselves in the Act can it then be a wonder that such Seed is not fit for Generation And having now shewn the causes of Barrenness in Men we shall now discourse of those in Women Now the causes of Barrenness in Women proceed either from the Age or evil temper of the Womb and its vicious conformation and parts depending on it or the indisposition of the whole habit of the body The evil form of the womb renders Women barren according to the great Hippocrates the Prince of all Physitians as if the mouth or neck of the Womb be turned backwards towards the great Gut or a side out of its place contrary from the Privities if it appear too big or if it be fallen down before the Privities to which may be added when 't is so narrow that it cannot admit the Yard to enter and when 't is wholly or in part closed by some inward or outward skin which is very rare if at all or by a swelling collosity or cicatrice c. But then it is not sufficient that the Mans Yard enter the Neck which is the
with juice of Oranges or Lemons Verjuice or rose vinegar or eat after Meals a little Marmelade of Quinces and she must forbear fat meat and sauces for they soften the Skins of the Stomach which are weak and loose by vomitings and also sweet sauces But if for all this that it continues although the Woman be above half gone 't is a clear sign there are cleave corrupt humors to the inward sides of the Stomach which must be purged by stool to effect which give half a dram of Rhubard a dram or two at most of Sena infuss'd in posset-Ale to which streined add an ounce of Syrup of Succory which dissolves the humors and in voiding them comforts the parts or you may give her Cassia and Tamarinds always adding a little Rhubarb or syrup of Succory compound If once be not enough repeat it some few days respite between If it continues for all this you must rest here lest some worse thing happen for she is then in great danger of miscarrying and if the Hiccoup takes them from too much emptiness by vomiting and purging 't is very bad as Hippocrates Prince and oracle of Physick teacheth us As for great Cupping-glasses which some advice to be applied to the Stomach to keep it in its place I believe it 's a chip in Potage because the Stomach is loose and no way cleaving to this upper part of the Belly But since these vomitings cool and weaken it I should advise them to wear a piece of Scarlet or Flannel or Lamb-skin which would help digestion SECT IV. Of the pains of the Back Loins Reins and Hips ALL these Accidents are but the effects of the widening of the Womb and the compression it makes on the Neighboring parts by its weight These are greater the first time she is with Child for afterwards the Womb only receives the same dimensions it had before and the cords which hold it in its natural place as well round as large suffer a greater stress being much drawn and streightned by the bigness and weight of the Womb to wit the large ones those of the Back and Loins which answer to the Reins because these two strings are strongly fast'ned towards these parts and the round ones cause those of the Groins Share and Thighs where they end These are sometimes so much stretch'd by this weight and higness of the Womb that they are torn chiefly if the Woman chance to have a false step which causes very great pains and other worse accidents as it happened to a certain Woman being six months gone of her first Child who felt the like after she had stumbled and perceived at the same time something crack towards her Reins and Loins which was one of the large cords made a noise by the suddain jolt she receiv'd at the same instant she felt extream pains in her Reins and Loins and all one side of her belly which caused her immediately to vomit very often with much violence and the next day was taken with a great continued Feaver which lasted seven or eight days without being able to sleep or rest one hour all that time she vomited all she took with a strong and frequent Hiccoup and great pains which seem'd as if they would hasten her Labor which I was very apprehensive of as also of her death but by the help of God causing her immediately to be put to Bed where she rested 12 whole days she was thrice let blood in her Arm on several days and took a grain of Laudanum at twice in the yelk of an Egg a little to ease her violent pains by giving her rest taking also from time to time good strengthening Cordials so that all these Symptoms which at first seemed desperate ceased by little and little and she went out her full time and then was happily delivered of a Son which lived 15 months notwithstanding all those mischievours accidents befel her which were enough to have kil'd half a dozen others but God sometimes is pleased to work Miracles by nature assisted with remedies fit for the purpose as well as by his Grace And also the Womb causeth the pains of the Hips by its weight in bearing too much upon them And assure your selves there is nothing will ease all these pains better then to rest in Bed and bleed i' th Arm if there be any great extension or breaking of any cord of the Womb as was in this case and when the Womb bears too much upon the Hips if she cannot keep her Bed she must support her Belly with a broad swaith SECT V. Of the pains of the Breasts AS soon as a Woman conceives her monthly blood wanting ordinary evatuation and she daily breeding blood there is a necessity she consuming but little whilst first with Child that the Vessels being too full should discharge part as it doth upon the parts dispos'd to receive it such as the kernelly parts especially the Breasts which suck up a great quantity of it which swelling them causes this pain which she feels and happens also to those whose Terms are only stop'd To ease her we ought in the beginning to leave it to Nature the chief Physitian and she must only have a care she receive no blows thereon nor be streight laced but after the third or fourth month the blood being still sent to the Breasts in great store 't is much better to evacuate it by bleeding in the Arm then to turn it back upon some other part by repercussive or binding Medicines because it cannot flow to any part where it can do less hurt than these and to shun the accident oâ— which Hippocrates speaks in his 40th Aphorism of the 5th book If Blood be carried in too great abundance to the Breasts it shews thâ— Woman is in danger of being Frantick because of the transport which may be madâ— thence of the brain whcih is voided by moderate bleeding i' th Arm and a regular cooling dyet moderately nourishing SECT VI. Of involuntary voiding and stoping of Urine THE seat of the Bladder which is just upon the Womb is sufficient to instruct us why Women with Child are sometimes troubled with difficulty of Urine and why often they cannot hold their water which is caused 2 ways 1. because the Womb by its bigness and weight presses the bladder so that 't is hindred from its ordinary extension and so incapable of containing a reasonable quantity of Urine which is the cause the bigger she grows and the nearer her time the oftner she's compelled to make water 2. if the weighty burthen of the Womb doth very much press the bottom of the bladder it forceth the Woman to make water every moment but if the neck of it be pressed it is fil'd full with Urine being not able to expel it because the Sphincter Muscle in this compression cannot be opened to let it out which causes great pain Sometimes by its sharpness stirs up the bladder often by pricking it to discharge it self and
sometimes by its heat it makes an inflammation in the neck of the bladder which causes its stopping and if it be from a stone in the bladder 't is more in supportable and dangerous to a Woman with Child then one that is not because the Womb by its swelling causeth the stone perpetually to press against the bladder and the pains are violenter if it be greater or of an unequal or sharp shape 'T is of great moment to hinder these violent endeavors to make water and to remedy them if possible in all indispositions because by long continuance of forcing downwards to make water the Womb is loosened and bears down and is sometimes forced to discharge its self of its burthen before its time which we must endeavour to hinder having respect to its different causes as when it comes from the weight of the Womb pressing the bladder as for the most part now she may remedy it if with both her hands when she would make water she lift up the bottom of her belly or wear a large swath or keep her bed If it be sharpness of Urine that makes an inflammation i' th neck o th' bladder appease it by a cooling dyet forbearing strong drinks using emulsions made of the 4 cold seeds or whey with syrup of Violets use not purging because its heat augments the inflammation these are proper to cleanse the Urinary passages without either prejuding Mother or Child taken Morning and Evening If all this prevail not let her blood a little i' th Arm and bath the outward entry of the neck of the bladder with a decoction of Mallows Marsh-mallows Pellitory and Violets with a little Linfeed and inject some of the same into the bladder to which you may add Hony of Violets or luke warm Milk abstaining from all diuretics for fear they provoke Abortion And when all fails she must send for a Physitian or Chyrurgeon to make use of his Catheter And also if it arise from the stone in the neck of the bladder they may thrust it back with it but if small draw it forth for a great one cannot be drawn forth before she be delivered being better to leave her so then endanger her life or the Childs SECT VII Of a Cough and difficult breathing THey whose Infants lye low are more troubled with difficulty of Urine then they whose lye higher who are free from that and the like distemper but are more subject to a Cough and difficult breathing If a Cough be violent to vomiting 't is one of the chiefest things which cause Abortion because 't is an essay whereby the Lungs endeavour to cast forth of the Breast that which offends them by a compression of all its Muscles which pressing all the inclosed air inwards wherewith the Lungs are much stretched thrusts also downwards by the same means the midriff and consequently all the parts of the lower belly but particularly the Womb which continuing long and violent often causeth Abortion Sometimes it proceeds from sharp rheums which distil from the brain upon the Artery and Lungs and sometimes from such blood which flows towards the Breast upon stopping the Terms also from too cold air breathing which stirs up the parts to motion but being begun by these causes 't is often augmented by the compression the Womb makes upon the Midriff which cannot have its liberty in those that bear their Children high because by its great extension it bears up almost all the parts of the lower belly towards the Breast and chiefly the Stomach and Liver forcing them against the Midriff You must remedy this by keeping good dyet somewhat cooling if from sharp humors avoiding all Salt and Spice meats Oranges Lemons Vinegar c. but she may use juice of Liquorice Sugar-candy syrup of Violets or Mulberries which she may mix with a Ptysan made with Jujubs Sebestens French Barley and a little Liquorice and it may not be amiss to divert and draw down these humors by a gentle Clyster If these prevail not and there appears signs of fulness of blood bleed her in the Arm at what time soever of going with Child and though it be not usually practis'd when they are young with Child yet here it must for a continual Cough is much more dangerous then a moderate bleeding If it come of cold keep in a close Room with a napkin doubled about her Neck or a Lamb-Skin and going to bed take 3 or 4 spoonfuls of this syrup of burnt wine following which is very Pectoral and causeth good digestion Take half a pint of French wine 2 drams of Cinnamon bruised half a dozen cloves 4 ounces of white Sugar or Sugar-candy put them together in a Porrenger and boil them upon a Chaffing dish of Coals burn it and then boil it to the consistence of a Syrup You must not from whatever cause it proceeds that she must go loose in her cloaths and because sleep is proper to stay fluxions it may be procured by the Physitian using no strong stupefactives of opium which are dangerous if there be not very great necessity as in the patient mentioned in the Section of the pain of Back Loins Reins and Hips Some Women carry their first Child chiefly so high because the cords which support the Womb are not stretch'd that they think them to be in their Breasts which causes a difficult breathing as soon as they have eaten a little walked or gone up the stairs so that they fear they shall be choaked which comes from the Wombs being enlarged and pressing the Stomach and the Liver which forces the Midriff upward leaving it no room to be moved sometimes their Lungs are so full of blood driven thither from all parts that it hardly leaves passage for the air if so they will breath more easily as soon as a little blood is taken from the Arm but if it comes from a compression made by the womb against the Midriff the best remedy is to wear her clothes loose and eat little and often eating no windy meats as pease and avoiding all grief and fear because they drive the blood to the Heart and Lungs in too great quantity so that she having her Breast already stuffed and hardly breathing will be in danger of being choak'd for the abundance of blood filling the Ventricles of the Heart above measure and at once hinders its motion without which she cannot live SECT VIII Of the swelling and pains of the Thighs and Legs MAny think which is in part true that the Woman having more blood then the Infant needs to nourish it nature by virtue of the expulsive faculty of the upper parts which are always strongest drives the superfluity upon the lower as the Legs c. as most feeble and apt to receive it and so are caused their swelling and pain and sometimes red spots from the swelling of the Veins along the inside which extreamly hinders her going but the doctrine of the circulation of the blood invented by our
Country-man the immortal Dr. Harvey the English Hippocrates will teach us better how this comes then that we need have have recourse to this expulsive faculty but because 't is fitter for Physitians and Chyrurgeons that are learned in Anatomy then Midwifes being they may help them without such curious knowledge I shall omit it and if you would be satisfied see what the learned and expert French Chirurgeon Moricean hath written on this Subject 't is put into English by Dr. Chamberlain Now to remedy these let her only use a palliative cure in swathing the parts with a rowler 3 or 4 fingers broad beginning at the bottom and she should most keep her bed if she can and if there be signs of abundance of blood in other parts she may bleed without danger Some Womens Legs swell only from weakness and are so Flegmatick that when you press them with your finger the print remains because they want Natural heat sufficient to concoct all the nourishment sent to them and expel its superfluities which remaining makes them so Hydropical To resolve these swellings make a Lee made with the ashes of Vines or other wood ashes and Melilote Camomil and Lavender boild in it if that do not foment them with this Take Rosemary Bays Time Merjoram Sage and Lavender of each a handful Province Roses half a handful Pomgranat flowers and Alum each an ounce boil them in 3 pints of strong red wine to the wasting of a 3d part and use it But these swellings commonly cease when she brought to Bed because she purgeth the superfluity of her whole habit by her Lochia SECT IX Of the Hemorrhoids THese are swellings and painful Inflammations caused by a flux of humors upon the extremities of the Hemorrhoid veins and Arteries caused by a bundance of blood cast upon these parts because the body is not purged as before and sometimes by endeavors they have to go to stool when costive If they be small and without pain either inward or outward 't is easie to prevent their farther growth by remedies which hinder and turn the flux from those parts but the great ones are cured by first easing the pain so that if she have other signs of fulness in the rest of her body she may safely be once let blood i' th Arm and if great necessity twice if she be costive let her take a Clyster of Violets Mallows Marsh-mallows and hony of Violets with some fresh Butter or Oil of Almonds adding no sharp thing especially in inward Piles after let her keep a moderate and cooling dyet and rest in her Bed if she may till the flux be past in that while anointing them with strokings from the Cow and foment them with the decoction of her Clyster adding some Linseed your Oil of sweet Almonds Oil of Poppies and Oil of water Lillies well beaten together with the yelk of an Egg in a leaden morter are very good to ease pain and if that Inflammation be great anoint a little with Vnguentum refrigerens Galeni or anguentum album populeon equally mixed After all this if the swelling abates not apply Leeches or if soft or any kind of inundation use a Lancet but Leeches are properer for hard Piles because they pain not so much Women are not here eased by Piles as Men are because 't is contrary to nature for this evacuation ought always to be made by the Womb if not with Child but if she be it may in some measure if full of blood supply the natural if they bleed moderately and without pain she may be eased but if they flow too much there 's danger of both Mother and Child being weakned to avoid which make binding fomentations with the decoction of Pomgranate flowers and Vines and Province Roses made in Smiths water and a little Allum or this pultis made of Bole-Armenac Dragons-blood and sealed earth with the white of an Egg and to turn the blood by bleeding i' th Arm and Cupping-Glasses to the Reins c. as you may consult the Physitian SECT X. Of the several Fluxes happening to Women with Child SHE is Subject to three sorts of Fluxes the Flux of the Belly of the Terms and Fludings Of the Belly are three kinds the first Lienteria when the Stomach and Guts not digesting the nourishments received let it pass away raw 2. Diarrhea when they simply discharge the humours and excrements which they contain The 3d and worst is a Dysenteria when with the humors and excrements she voids blood with violent pains caus'd by an ulceration of the Guts Any of these if they continue long put her in great danger of Aborting if the first the Stomach letting the food pass before it be turned into juice whereof blood is made to nourish Mother and Child they must both be weakened if the 2d it will cause the same accident because of voiding the Spirits with the humors but most danger's i' th last because she hath then great pains and Gripes i' th Guts from their Ulcer which excites them continually by constant prickings to discharge themselves of the sharp humors which causes a violent motion of the Womb being plaâ—ed upon the right gut and to the Child and by the compression the Muscles of the belly make on all sides as also those that are made by them of the Midriff which force themselves downwards in the endeavors she makes with pain so often to go to stool the Child is constrained to come before its time and the oft'ner by how much the prickings are greater for according to Hippocrates Aphorism 27 book 7. If a tenasm happen to one with Child it makes her Miscarry Now this tenasm is a great passion of the right Gut which forceth it to make those violent endeavours to discharge it self without being able to avoid any thing but Cholerick humors mixt with blood by which 't is perpetually pricked This Flux happens to her commonly from a weak digestion of the Stomach because of her bad dyet which her strange appetite causes her often to long for by the constant use whereof at last being weakened it suffers the food to pass without digestion or if it stay longer 't is turn'd into a corrupt juice which descending into the Guts iritates them by its sharpness to discharge themselves as soon as they can To proceed safely in the cure of these Fluxes their nature must be consider'd that the cause that maintains them may be remov'd If it be a Lienteria following Vomitings as is usual which have so weakn'd the Stomach and loosn'd its Skins that haveing no longer strength to vomit up the food it suffers it to pass downward without digestion then she must refrain all irregular appetites and eat food of good digestion and little at a time she may drink a little deep Claret wine in which Iron hath been quenched if she have not a strong Feaver for in a small one wine is to be prefer'd because her Feaver is but
symptomatick from the weakness of her Stomach and will vanish as soon as it is fortified which may be promoted if she take before and after meals some of that burnt wine spoke of before for the Cough or a little good Hippocras or right Canary or eat a little Marmalade of quinces before meals and wear a Lamb-skin upon the pit of her Stomach be sure to give no purge for this is only caused by weakness If it be a Diarrhea simply voiding such excrements as are in the Guts and some superfluous humors which nature hath sent to be expelled and it be gentle and continue not long she will feel no damage by it and so 't is good to leave it to nature without interrupting it in the beginning but if it continue above 4 or 5 days 't is a sign there are ill humors cleaven to the inside of the Guts and ought to be expell'd by some light purge after which it will certainly cease But if for all fit purges it changes into a Dysentery she is then in danger of miscarrying which must be prevented if possible therefore having purged the ill humor and hindering that no more be engendred by Chicken or Veal broths c. with cooling herbs pap with the yelk of an Egg well boild let her quench Iron or Steel in her drink which must be small beer or water with a little strong or wine if she be not Feaverish for then half a spoonful of syrup of Quinces or Pomgranates is better and she may eat a little Marmalade of Quince or other strengtheners if she was purg'd before and because there is always great gripes they must be appeas'd by Clysters made of the broth of a Calves or Sheeps head well boild with 2 ounces of oil of Violets or good Milk and the yelk of an Egg after the use of these as long as is judged necessary which she must keep as long as she can you must proceed to clensers made with Mallows and Marsh-mallows with hony of Roses and then binding ones in which must be neither oil nor hony beginning first with gentlest made of Rose-water with Lettice and Plantain water then to stronger of the roots and leaves of Plantain tapsus barbatus horse-tail province Roses rind of Pomgranates in Smiths water adding of sealed earth and Dragons blood of each 2 drams you may also foment the Fundament Of the monthly blood before and if it be from to much blood 't wil do her a kindness SECT XI Of Fluddings THe Courses come at accustomed times without pain distilling by little and little from the Wombs Neck during pregnancy and then wholly ceaseth but these come with pain from the Wombs bottom and almost on a sudden in great abundance and continue without intermission except some clods formed there seem sometimes to lessen the accident by stopping for a small time the place whence they flow but it soon returns with greater violence and after follows death to the Mother and Child if not prevented by delivering the Woman If the Fludding happen when young with Child it 's usually because of some false Conception or Mole of which the Womb endeavours to discharge it self by which it opens some of the Vessels in its bottom whence the blood ceases not to flow till it hath cast out the strange bodies it contain'd the subtiller the blood is the more it flows but when this happens to one truely Conceiv'd at whatever time it proceeds likewise from the opening of the Vessels of the Womb's fund caused by some blow slip c. and chiefly because the secundine separating in part if not wholly from the inside of the Wombs bottom to which it ought to stick to receive the Mothers blood for the Childs nouriture leaves open all the Orifices of the Vessels where it joyned and so follows a great flux of blood which never ceases till she be brought a Bed yet I do not intend it should be done as soon as perceiv'd for some small fluddings have been stop'd by lying quietly in Bed bleeding i' th Arm and the use of Remedies mention'd in the menstruous Flux and it may be but an ordinary monthly Flux and then 't is good leaving the Labor to nature provided she hath strength and accompanied with no other ill accident but when she falls into Convulsions and Faintings 't is absolutely necessary she be deliver'd whether she be at her count or no pains or throws or no for there is no other way to save both their Lives You must not always expect pains and throws to force and forward Labor in these dangerous accidents for though they come at the beginning they usually cease as soon as it comes to Faintings and Convulsions neither must it be put off till the Womb be opened enough for this Flux moistens and the weakness loosens it so that it may then be as easily widen'd as if there had been abundance of strong throws Wherefore let the Midwife introduce her Fingers anointed with Oil or Butter 2 or 3 at a time and all by degrees and at last her whole Hand and if she find the waters not broke break them and then whatever part of the Child presents though the head provided it be not i' th Birth let her search for the Feet and draw it forth by them observing the circumstances in delivery of a Child with the Feet first because there 's better hold so that if the Feet lye not ready seek for them which is easier done at that time then another because the Fluddings make the Womb slippery then fetch the after-burthen which in these cases cleaves but little being careful not to leave so much as a clod i' th Womb lest it continue the Fludding In this case many Women and Children have perished for want of this operation and many escaped death by being timely succor'd Guilemeau a Famous French Chirurgion mentions 6 or 7 Histories to confirm this and Moriceau by his experience avers it and in the case of his own Sister too long here to relate You are always here to give good strengthning broths gellies and a little good Wine and smell to rose Vinegar and to prevent the blood Fludding in great quantity open a vein i' th Arm or bind her Arm with fillets above her Elbow and lay cloaths upon her Reins wet in water and Vinegar but if this proceeds from the parting of the after-burden she must be delivered as soon as may be though she were but 3 or 4 months gone because all must be broughâ— away whether false Conception Mole or Child SECT XII Of the Weight of the Womb c. THis is often caused by the stretching of the large Cords of the Womb and this will cause an hinderance of Copulation and a numness in her Hips sleepiness in her Thighs and difficulty of Urine and going to stool chiefly towards her latter reckonings because it presseth down the Bladder and great Gut being seated between both But she may be easier
when 't is thick apply it indifferently warm taking away the closures and clods of blood renew this if need be after 5 or 6 hours then make a decoction of Barley Linseed and Chervil or Marsh-Mallows and Violet leaves adding an ounce of honey of Roses to a pint and foment the bearing place Lukewarm 3 or 4 times a day for the first 5 or 6 days some use only milk and others Barley water After 10 or 12 days fortifie the parts with a decoction of Province Roses Plantan leaves and roots and Smith's water The 2d day use loose swaths with a large square bolster over the Belly till the 8th day taking it off i' th mean time often to anoint her Belly if it be sore with Oil of sweet Almonds and St. John's wort mixt then begin to swaith her streighter If she will not be a Nurse apply remedies to the Breasts to drive back the Milk if she will Nurse them keep her warm with soft clothes and if you fear too much blood carrying to them anoint them with Oil of Roses and a little Vinegar beat together and lay on fine Linnen dipt in 't let her not suck the Child the same day she 's deliver'd but stay 6 or 7 days In driving back the Milk some remedies hinder flowing of humors to the Breasts others scatter and in part dissolve the Milk therein Of the first sort are the last ointment or unguentum populeon and unguentum album equally mixt spread upon Linnen and applied Of the 2d is a Pultis made of Linseed Fenugreek Beans and Vetches powder'd boiled with the decoction of Chervil or Sage with Honey and Saffron some apply Honey only others rub the Breasts with Honey and lay on a red Cabbage leaf a little dryed the stalks taken away having great care she take not cold and above all procure ample voiding of the clensings by keeping the belly open by Clysters provoking them then the Milk will soon vanish SECT II. Of Fludding after Child-birth OF that preceding Labor before this blood now flows more abundantly by how much 't is hotter or mov'd by a long and hard Labor and the Woman 's full of blood and besides what 's said note sometimes this blood continuing to flow and remaining i' th bottom o th' Womb becomes clotted which causeth a new Flud and continues by Fits and i' th intervals there comes away some wheyishness of the imprison'd blood which dissolves and makes some ignorant People think the Flux is stop'd tho it continue flowing within wherein it stops only by the clotted blood when which comes away it begins a fresh This is a more dangerous accident then any can happen to one newly lay'd which dispatches her so soon if in great quantity that there 's often scarce time to remedy it so that you are immediately to apply remedies both to stop and turn back from the places whence it flows to which end if it be a false Conception piece of the burthen or clotted blood use all diligence to fetch them away or cause them to be speedily expell'd but if it flows and nothing remain bleed her i' th Arm not so much to empty the fulness as to turn the course lay her body equally flat not raised and keep quiet without turning from side to side nor must the upper part of her Belly be swath'd or bolstered keep her Chamber a little cool and not too warm in Bed All forbid Clysters lest they say humors be cal'd down but the contrary hath been experimentally found that great fluddings have been stopt by pretty strong clensing ones But if for all this the Flud continues then to the last Remedy which is to lay her upon fresh Straw with a single cloth upon it and no Quilt applying cloths wet in Vinegar and water along her Loins and if in the Winter a little warm give every half hour a little strong broth with a few spoonfuls of Gelly and between whiles the yelk of a new laid Egg give her not too much food at a time drinking red Wine with a little water wherein Iron hath been quenched If all this prevail not she will be in danger of her life SECT III. Of the bearing down and falling out of the Womb and Fundament of a Woman newly layd ANd here I shall make 2 sorts of Bearing down and 2 sorts of falling forth which differ but in degree for the first is when the Womb only bears down and comes not forth the 2d when it comes out of the Body The first sort of bearing down is when the full body of the Womb falls into the Neck in such manner as putting up a Finger you may feel the Orifice very near the 2d when the Womb being yet lower one can clearly perceive this Orifice quite without The falling out is twofold too in one the Womb comes quite forth but is not turn'd inside out nor can its inside be seen only its orifice which appears at the end of a great fleshy Mass which makes the body of the Womb and this is cal'd a falling forth of the Womb the other is cal'd a perversion or turning inside out most dangerous for you may perceive all even and without any Orifice and thus it seems to be only a great piece of bloody flesh almost like a Mans Cod which hangs between her Thighs and that which is wonderful in this case is the Womb the infants house goes forth at the Gate which is the inner Orifice A loosening or breaking of the Cords causes the bearing down which comes from hard Labor who have many whites are subject to it and heavy Children Coughing Sneezings a fall going in a Coach or Horseback great lifts burdens lifting the Arms too high and putting them over their head looseness great pains and needings all which shake and thrust the Womb downwards when with Child and the cords being loosened or broken cannot keep it up so that a bearing down doth easily follow the Birth of a Child but the most ordinary cause is violent travel when a Child cometh wrong and cannot be born so or hath too big an head or the inner Orifice not enough opened for the Womb is violently forced down and yet the Child can't advance into the passage because the cords are so rent or loosen'd or when the Secondine sticking close to the bottom is pul'd away on a sudden or too violently and much sooner if putting up the hand as when the String 's broke one pulls the body of the Womb instead of the After-birth but your directions will prevent this She feels a great weight at the bottom of her Belly extream pain i' th Reins and Loins and a bloodish moisture passes through this Mass of Flesh hanging between her Legs A loosening may happen to all Women a falling out but seldom a perfect perversion never but upon or immediately after a delivery because the inner Orifice is then almost as wide as its bottom but not at other times when
closed there is no possibility of its turning inside out how to remedy it I have told you If she be young and disease new easily expect a cure for a loosening or falling out but if she old and of a long standing 't is so much the more incurable Here do two things 1. reduce the Womb to its place 2. strengthen it and keep it there for the first if it be quite out or turned first make her render Urine and give a Clyster if necessary to empty the Guts then lay her on her back her Hips raised a little higher than her Head foment all with a little wine and water luke-warm and with a soft rag put it up wagging it little and little from side to side and if this be too painful anoint it with Oil of sweet Almonds wiping off the Oil as much as may be after As to the keeping it in its place and strengthening it after let her keep in Bed on her back her Hips a little raised Legs something crossed Thighs joined but the best is to put a pessary up the neck of the Womb the Figures of which you may see some of the Figure of an Egg of the length and bigness of the Womb's neck but these are Subject to fall out and so are not so convenient as those made of a piece of Cork they are to be of a thick circular figure like a small wreath and peirc'd i' th middle with a pretty big hole they must be cover'd with white wax and pretty large pull them out with a Finger to clear them they may be made some round others somewhat square or trianguler the corners must be blunted or rounded While the Lochia flow use nothing else to strengthen and above all swath not her belly but only for a stay for many Midwifes by a strong compression force it more down use a Bed-pan and ly along if possible when she goes to stool keeping her hand all the while on the bottom of her Belly but haveing cleansed well then use astringent injections and respect must be had to the whole habit of body to dry up the humors by a course of Physick and she must keep her Bed for 5 or 6 weeks Sometimes by the great throws she endures in Labor the fundament falls out now if the Child be very forward i' th passage 't will be enough to hinder it if possible before it happens perswading her not to help her throws so much but if it be down she must stay till the Child be born for it will be difficult before without bruising the Gut then reduce it as the Womb giving no Clysters for straining will cause it SECT IV. Of the bruises and rents of the outward parts of the Womb caused by Labors THese happen from the bigness of the Child's head which makes her cry in her first-Labor that the Midwife scratches those parts when 't is the head makes a separation of the parts and bruises and somtimes rents them of which they are not insensible after Labors These must not be neglected least they turn to malignant Ulcers then as soon as she 's lay'd if there be only simple bruises apply the Pultis before directed to those parts to ease pain very warm for 5 or 6 hours then lay some few rags dipt in Oil of St. John's wort on each side and renewing them twice or thrice a day foment with Barley water and Honey of Roses and when she makes water defend them with fine rags If the bruises be great and inflam'd and an Impostume follows it must be open'd and cur'd by the Chyrurgeon as also when by an unlucky accident the Privity and Fundament is rent in one which when cur'd she will be oblig'd if she happen to be with Child to prevent the like to anoint the parts with soft'ning Oils and Ointments and forbear helping her throws too strongly at once but usually when these parts have been once rent 't is very difficult to prevent the like because the scar streightens the parts Lastly if by neglecting such a rent the Lips be cicatriz'd and the cure be desired 't is the Chyrurgeons business SECT V. Of the After-pains IF these come from wind i' th Bowels it runs from side to side and sometimes towards the Womb to prevent this some give of Oil of sweet Almonds and syrup of Maiden-hair each 2 ounces immediately after Child-birth and to those that loath Oil I prefer warm broth or caudle and give a Clyster and repeat it as need is if it cease not thus 't is maintained by some other cause If from some strange body i' th Womb see to cast it out If her clensings be suddenly stop'd give Clysters to draw down use hot foments to the bearing place bleed i' th Foot and if full i' th Arm first Rest alone will fortifie and unite the stretching or breaking o' th Womb's cords but never forget in all pains to mind the Lochia SECT VI. Of the Lochia whence they come if good or bad their stopping and what ensues THere flows waterish humors from the Womb as soon as the Child is born besides those before when the Skins break which are often bloody because mostly blood's mixt with them but immediately after the burden is loosen'd there flows pure blood but after the 1st day there comes waterish humors when the Vessels close then they become thickish by heat more or less as they come in greater or lesser quantity and the length of time they stay there and then they resemble troubled milk which makes People believe 't is Breast milk Now I believe the cause of their change of colour consistance and diminution of â—heir quantity to be no other then that in â—he suppuration of a great wound as soon â—s 't is made it bleeds fresh and much but â—fter it yeilds only bloodish humors then a white matter so you must imagine there is a kind of wound made by loosening the burden from the Womb and what comes from it is the Lochia so that they are not what hath stay'd in and about the Womb during all the time of Child-bearing for that 's the Secundine neither is their any certain rule for their quantity and continuance being according to the Season Country Age Temper more or less hot or moist the habit more or less full and Vessels remaining long or short time open but 't is finish'd commonly in 15 or 20 days but after a mischance the less the fetus is and the less time she is gone with Child the less are the Lochia If they be fresh but the 3 or 4 first days they are good else 't is a pure bloody flux which will be very dangerous if of no ill scent without sharpness so we know the Womb 's without inflammation or corruption and if they flow in so great quantity as to cause Faintings or Convulsions she 's in danger of death or very much weaken'd grows lean and pale Legs and Thighs swell and becomes Dropsical The