previously subjoin a Word or two of _Advice_ (by way of _Precaution_) to
the Young _Andro-Boethogynist_: Which, in short, consists in this
_Point_, that as it is the too common _Practice_ here in _England_, for
an obstinate SET of _Women_ to keep their _Labouring PATIENTS_ so long
under their own Hands only, until the very last _Extremity_; so I would
not counsel him at that Time, when sent for, upon such a ticklish
Occasion, to go _Head-long_ to such a _Work_, nor to undertake the
DELIVERY of such a _Woman_, before He makes some requisite
_Observations_: And _that_ I mean no ways because of any Danger of the
_Preternatural BIRTH_ which she labours under, how difficult soever it
may be; but merely, on account of the _Woman_’s exhausted _Strength_ and
_Ability_, to undergo the respective _Operation_ in her weaken’d
_Condition_; which I would very much question in most Women, after
_One_, _Two_, or _Three Hours_ strong LABOUR, and that in SOME far
sooner, notwithstanding that _others_ have been known to stand it out,
and struggle a much _longer Time_.
HOWEVER, be this as it will, I commonly guess at the _Woman’s State of
Ability_, not only by her PULSE, if _strong_ or _weak_, _unequal_ or
_intermitting_; by her EYES, if _dejected_; by her SPEECH, if _faint_;
by touching the EXTREMITIES of her Body, if _frigid_: but also by some
other SYMPTOMS, which infallibly appear, if the _Woman_ be too far
spent, such as _Cold Sweats_, _Swoonings_, _Convulsions_, _Loss of
Sense_, &c. Whereupon I say in these _Cases_, it is more adviseable to
let alone or decline the _Office_, than to undertake such a precarious
uncertain Piece of _Work_; because if the _Woman_ happens to die under
his _Hand_, He may perhaps be (however unjustly) blam’d for the errant
_Midwife_’s Faults, or at least He will scarce avoid the CENSURE of the
_Ignorant_ and _Malevolous_.
YET this _Advice_ (however wholesome and prudent) is, I confess, what I
would but seldom have Recourse to, or follow myself, notwithstanding the
worst _Consequences_ of the _Case_; since as long as there is _Life_,
there is _Hope_ with me, by the Blessing of GOD: Which tho’ never so
_little_, I should think myself obliged in Conscience to do what both
ART and NATURE command, and rather in all _Conditions_ of LIFE to
attempt an uncertain CURE[170], than abandon the _Distressed_ to certain
DEATH, as some _Politicians_ in _Physical_ Affairs commonly do, who
prize their vain _Reputation_ above the LIFE of their Neighbour. But
_thus_, in short, (for my own Part) I would chuse to _act_, because I
have often seen, and known _NATURE_ to have perform’d, and recover’d a
weak spent parturient PATIENT, even beyond all human Probability.
NOT but that I would take the proper _Precautions_ along with me, before
putting my _Hand_ to the critical _Work_, upon any such desperate or
dangerous _Occasion_, by giving my ingenuous PROGNOSTICK to the nearest
_Friends_ and _By-standers_ of the extreme _Danger_ that both LIVES may
be in: Whereupon after thoroughly examining all _Circumstances_, with
respect to the CHILD, whether _One_ or _More_, _Dead_ or _Alive_, &c. I
would chearfully begin my _Endeavours_ to relieve the afflicted Woman,
encouraging and exhorting her in the first Place, for GOD’s-sake, as
well as _her own_, and the tender INFANT’s _Life_, to put herself
entirely into my HANDS, to undergo her LABOUR patiently, and contribute
what she can to the DELIVERY.
BUT to return from this pardonable _Digression_ to what is here
proposed; as I come first to speak of _Preternatural BIRTHS_ on the part
of the INFANT, I would observe that all ill _Postures_ of the CHILD, in
a WOMB well situated, are the only _Causes_ (meant in this place) of
_Preternatural BIRTHS_ on its _own Part_: Which _Postures_ being very
various and different, and each requiring a different peculiar
_Operation_; I shall _state_ them particularly (as above-mentioned) and
_that_ in their respective _Chapters_, after the manner following:
_viz._—
[Illustration]
CHAP. XIII.
_Of Præternatural BIRTHS, by the FACE’s being turn’d upwards; or bent
forwards, and the CROWN backwards._
AMONG the many various _Preternatural Positions_ of the _INFANT_, I
cannot but reckon THIS _One_: FIRST when, tho’ the _CHILD_ offers itself
_Head foremost_, yet the FACE is turn’d upwards; and _that_ because the
_INFANT_ in such a _Posture_ can never be commodiously bent and adapted
to the _Form_ of the PELVIS.
IN this _Case_, the _MIDWIFE_ ought to take special Care, that the HEAD
_fall down directly_ and safely, without being _hurt_, whilst she
endeavours to bring it _forward_: For this Purpose, she is to enlarge
the _Passage_ as much as possible, dilating the _Privities_, and
depressing the OS COCCYGIS; which however must be done, without lifting
the HEAD with her _Hand_, for fear of bruising the FACE against the OS
PUBIS. By this Method the _BIRTH_ (how _Preternatural_ soever) may be
pretty well and easily perform’d.
BUT because the _CHILD_ can only be said to be _well turn’d_, when it
comes with its CHIN leaning upon its _Breast_, and its _Top_ or _Crown_
of the HEAD tending directly to the _Orifice_; I reckon THIS _another
Preternatural Position_, when the _INFANT_ presents itself with the
CROWN bent _backwards_, and consequently with the FACE _forwards_: By
reason that in this _Case_, the _Orifice_ itself and all the rest of the
_Passage_ must be much more dilated, than in the _natural Condition_;
and the HEAD (being thus bent _backwards_) requires more severe PAINS
and hard LABOUR, to make it slide through the _Passages_.
IN which _Case_, the _MIDWIFE_, having timely discover’d this
_Situation_ by the TOUCH, ought immediately (upon the flowing of the
_Waters_) to bend the HEAD gently _forwards_ to the BREAST, all the
while adverting to handle the FACE, especially the _Nose_ and _Eyes_,
very tenderly: And to this End, the _Woman_ may be laid down on her
_Back_, with her _Head_ low; by no means _labouring_ with the _PAINS_,
before the HEAD of the _CHILD_ is so conveniently turned: which may be
thus most properly perform’d; _viz._ By laying the Palm of the _Hand_ on
the _INFANT_’s _Breast_, near its _Throat_, pressing it entirely _back_
towards the _Fund_ of the WOMB; by which means the HEAD falls _forwards_
of its own Accord upon the _MIDWIFE_’s _Arm_, and _she_ with-drawing her
_Hand_, will find the HEAD _well turn’d_.
BUT supposing the HEAD to be very strictly bent or pressed _back_, then
the _MIDWIFE_ is to attract it gently _forwards_ by her _Thumb_, or
_Fore-Finger_ thrust into its MOUTH; or by the Points of all _Four_
thrust betwixt the WOMB and the _back Part_ of the HEAD. And thus, in
fine, the HEAD being _well Turned_, and dextrously brought into the
_Passage_; the _Woman_ is then to be placed commodiously for _BIRTH_,
and to labour her _Best_ as in other _Cases_.
HOWEVER to this _Case_, I must add, by way of _Remark_ for the
_MIDWIFE_’s farther Information and better Government, that, if the HEAD
is not brought into the _Passage_, as soon as the _Waters_ have flow’d,
it commonly happens, that the HANDS offer themselves _first_; which if
she do not instantly repel, the HEAD is turn’d up _forwards_ with the
FACE, near the _Chin_, upon the OS PUBIS; in which _Condition_, by
reason of the _Siccity_ and _Contraction_ of the WOMB, the only
Expedient is to _thrust back_ the ARMS, and so passing the _Hand_ under
the _CHILD_’S _Breast_, to take hold of, and extract it by the FEET.
[Illustration]
[Illustration]
CHAP. XIV.
_Of Præternatural BIRTHS, by the Hand, Elbow, Shoulder, Knees, or
Buttocks presenting first._
THE _CHILD_ also sometimes offers itself _preternaturally_ to the
_Orifice_, with its HAND, ELBOW, SHOULDER, KNEES, or BUTTOCKS _first_:
In which _Condition_, the HAND always gives an easier _BIRTH_ than the
ELBOW, the ELBOW than the SHOULDER, the SHOULDER than the KNEES, and the
KNEES than the BUTTOCKS: For the HAND being commonly placed near the
_Head_, it is no great Wonder, if it presents itself _before_, or
_along_ with it; as sometimes (after _Flooding_) the HAND may slide
together with the _Head_ obliquely to either _Side_, and thereby either
ELBOW or SHOULDER unfortunately fall into the _Passage_.
THIS is one great Reason, why I have before inculcated, that the
_MIDWIFE_ ought to be diligent and accurate in _Touching_ her Woman,
even before the MEMBRANE breaks, that she may thereby discover and
prevent this _Case_: Which is easily perform’d, either by _repelling_
the HANDS, or by pinching the _INFANT_ sensibly by the _Fingers_, and
then it soon retracts them; for thus, in short, by moving my own _Hand_
seasonably, the HEAD (of its own accord) slips of course down into the
_Passage_. But and if it happens otherways, ’tis no difficult Matter to
_turn_ and bring it down, by directing my _Fingers_ beyond the FACE to
the _CHILD_’s _Forehead_; which however must be done immediately after
FLOODING: Whereas, if _This_ be neglected until the _dry_ WOMB is
contracted, THEN, and in that _Condition_, the _FEET_ may be looked for,
which (in such a _Posture_) are soon found, with the _KNEES_ next the
_Belly_; and the _INFANT_ may be readily drawn out by them. But
WHEN it so happens, that the _CHILD_ comes with its _KNEES foremost_, it
commonly has its _LEGS_ folded towards the _BUTTOCKS_; by which means
many a _MIDWIFE_ has been deceiv’d, especially when _she_ feels but one
_KNEE_, mistaking it for the _HEAD_, because of its _Hardness_ and
_Roundness_.
IN this _preternatural Condition_, the _INFANT_ must be stopped and
hindered from advancing _farther_; wherefore having placed the _Woman_
aright, I would gently repel the _KNEES_, that I may the more
commodiously _unfold_ the complicated _LEGS_, one after another; which I
commonly do by directing _one_ or _more Fingers_ under the HAM,
gradually along behind the _LEG_, until I come to the FOOT; drawing
always a little _obliquely_, that I may come the easier to its
_Extremity_: And thus, in short, having disengaged the _One_, I
accordingly manage the _Other_ after the same manner; and by bringing
both _FEET_ at last together, I finish my _Work_, as if the _Child_ had
come _FEET_ foremost, of which in course.
MOREOVER again it also happens sometimes, that the _CHILD_ falls with
its _BUTTOCKS forwards_; in which _preternatural Condition_, the MIDWIFE
must industriously prevent it from coming _too low_ in the PASSAGE,
before it be duly corrected or rectify’d; since the INFANT cannot
possibly come, after this manner, into the World; unless it be very
_small_, and the _PASSAGE_, on the other hand, very _large_. Wherefore
in this _Case_, after the _Woman_ is decently laid upon her _Back_, with
her _Head_ declining, I would advise to thrust back the _BUTTOCKS_ as
well as possible; then passing up my _Hand_ along the _THIGHS_ to the
_Legs_, I would take hold of the _FEET_, and bring them gently, and one
by one, forth gradually; which being done, I would attract them by the
_HEELS_ towards the _Side_ as far as the Length of the _BUTTOCKS_; and
then at last taking good _Hold_ under the _HIPS_, I would easily and
softly with the greatest _Deliberation_, draw out the whole Body
successively.
[Illustration]
CHAP. XV.
_Of Preternatural BIRTHS, by the Breast, Belly, or Back, presenting
first; and the INFANT’s lying transverse._
SOMETIMES likewise the _CHILD_ offers its BREAST or BELLY _first_, along
with the _Navel-string_; which _Preternatural Figure_ is most dangerous
for the _BIRTH_, because of the _Body’s bending backwards_.
IN this difficult _Case_, the attentive _MIDWIFE_ places her _Woman_
conveniently, as soon as the _Waters_ have flow’d, and sliding her
_Hand_ into the WOMB, removes the _String_, and endeavours to bring the
_HEAD forwards_ into the _PASSAGE_; which she easily performs, as long
as the INFANT is suspended on high, and its _Back_ not too much _bent_,
by putting-in her _Hand_ gently up to the _hinder Part_ of the _CHILD_’S
_Head_, attracting it gradually _downwards_. But if in this _Condition_
the _BIRTH_ be fallen too _far down_, it is more adviseable _first_ to
attract the _FEET_ considerately.
I say _considerately_, because it is not sufficient to penetrate with
the _Hand_ to the _FEET_; which however yet, in this _Posture_ is pretty
difficult: But also to know exactly in what manner they are to be _drawn
down_; since it is no indifferent Matter to understand how that is to be
rightly perform’d with Success. Wherefore I shall in this place take
upon me to set forth _two different Ways of Turning the INFANT_ in this
_Condition_; viz.
I. I would _either_ FIRST pass my _Right Hand_ to the _Left Thigh_ of
the _CHILD_, and taking hold of it near the _KNEE_, push it _upwards_
with my _Thumb_, drawing it at the same time _downwards_ with my
_Fingers_ placed behind: _Thus_ I would bring _down one KNEE_ to the
_Passage_, leaving the FOOT yet above, and then the _other KNEE_ in its
Turn; which being done, I would change my _Hand_, and put the _Left_ up
to the _INFANT_’s _Belly_ or _Breast_; where, as I _thrust back_ its
Body _upwards_, there is presently _Room_ enough: then I would take hold
again of _one_ or _both KNEES_, to move the _CHILD higher_, that so the
_FEET_ may be more conveniently brought into the _Passage_ one by one,
if not _Both_ at once: Or, upon the _LEGS_ being bent with the _Right
Hand_, and the _KNEES_ brought into the _Passage_ (as above) I would
take hold of them below the HAM, and bring them past the _Orifice_ of
the WOMB, till the _FEET_ are before the _Passage_; whereupon I would
then readily endeavour to extract the INFANT by the _FEET_. _Or_,
SECONDLY,
II. I would put my _Right Hand_ up along the _Belly_ to either THIGH, or
KNEE, having at the same time a thin _Bandage_ doubled and dipp’d in
_Oil_, upon my _Fingers’ Ends_, in order to be put about the KNEE, that
I may attract it gently thereby; which I would draw out again by the
_Right Hand_, whilst my _Left_ holds the Ends of the _Bandage_, that
they may not move out of their Place: Then I would take the Extremities
of the _Bandage_ in my _Right Hand_, attracting it softly thereby,
whilst I pass up my _Left_ into the WOMB, to thrust the _CHILD_’s _Belly
upwards_. By which ingenious and regular Means, I think, Dr. _Daventer_
first moved the _upper Part_ of the BODY _upwards_, and the FEET
_downwards_, because the KNEES are thereby brought nearer to the
_Orifice_. Now these, in short, are the only safe, and proper _Methods_
to be taken in this present _Case_, or nice Conjuncture; because, by all
_other_ inconsiderate and temerarious _Means_, the _INFANT_’s LOINS may
be _twisted_, its HIPS or KNEES _disjointed_, its FEET _lamed_, and
itself at last quite lost or destroy’d.
IN like manner it happens not very seldom, that the _INFANT_ comes with
its BACK _forwards_ into the _Passage_; and in this _Posture_ the
NAVEL-STRING falls commonly down _there_, so that besides _itself_,
nothing else is to be felt by the TOUCH: In this _Case_, the MIDWIFE is
to observe well the FLOODING; immediately upon which, _she_ is to seek
for the FEET, which are more easily come at than the _HEAD_, tho’ the
same is even also a very difficult TASK, by reason that the _CHILD_’s
_Back_ takes up the whole Space of _Room_; which, notwithstanding, must
be cautiously done, and the _INFANT_ discreetly extracted by _them_.
BUT again sometimes, the _BIRTH_ lies also _Transverse_, or a-cross the
WOMB; in which dangerous _Case_, I confess the _MIDWIFE_ cannot well
perceive, so as to distinguish Matters by the _Touch_, before
_Flooding_: Because the _INFANT_ (swimming in the _Waters_) is as yet
seated high, and then moving its HANDS and FEET variously, _she_
sometimes feels _one_, and sometimes _another Member_ at the _Orifice_;
or, one Moment she finds _Something_, and another _Nothing_ at all
there. However, in fine, _she_ may perceive the _Humours_ most commonly
compressed into an _acuminated_ or _oblong Form_.
WHEREFORE in this difficult _Preternatural Condition_, the _MIDWIFE_
ought primarily and chiefly to consider and discover the _Posture_ of
the WOMB, whether it be _direct_ or _oblique_; since according to THAT
_she_ must proceed in assisting her _Woman_ with true Discretion. As for
_Example_, if _she_ finds it in a streight or _natural State_, and the
_Waters_ sufficiently exuberant, extended _length-ways_, &c. as
aforesaid, _She_ must, without _Loss of Time_, break the _MEMBRANE_, and
presently, removing all _Impediments_ of _HAND_, _FOOT_, or
_NAVEL-STRING_, judiciously direct the _HEAD_ into the _Passage_; which
may be very easily and safely done immediately upon the FLOODING.
Whereas if _this Method_ be delay’d, or not taken in _due Time_, and
consequently the _HANDS_ (as the readiest) present themselves to the
_Orifice first_: In this _Condition_, I would lay the _Woman_ discreetly
upon her _Back_, with the _upper Part_ of her Body _lowest_; after
which, I would move the _INFANT_’s _Hands_ back with my _own_; whereby
at the same time bringing its _FEET_ into the _Passage_, I would in the
next Place gently extract the whole Body with all possible _Conduct_ and
_Success_.
[Illustration]
CHAP. XVI.
_Of Preternatural BIRTHS, by the Feet presenting first._
IN like manner again, it often happens, that the _CHILD_ offers its
_FEET foremost_; which next to a _Natural BIRTH_ is the most easy and
safe _Position_, however I have been oblig’d to postpone it to the
_rest_, for Method’s sake: In this _Case_, the _MIDWIFE_, observing _one
FOOT_ presenting itself in the _Passage_ after _FLOODING_, ought to stop
and retain it _there_, that it may not slide through, until _she_ meets
with the _other_. In order to which Performance, _she_ must immediately
seek for _it_, with either _Hand_, according as she perceives the
_INFANT_’s great _Toe_ situated, since it is only to be sought for along
its _Side_; and being found, it is to be gently _drawn down_, and placed
near its _Fellow_ in the _Passage_.
BUT it falls out sometimes, that the _MIDWIFE_ comes too late, and finds
_one LEG_ so far through, that the BUTTOCKS are strictly confin’d: In
this _Condition_, I would advise to lay the _Woman_ conveniently upon
her _Back_, with her _Head_ low, that both the WOMB and the CHILD may
_retreat_ a little; then taking hold of the _right LEG_ with my _Right
Hand_, I would thrust the _INFANT back_, till the whole FOOT (or at
least the KNEE) is brought back into the _Orifice_ of the WOMB, in order
that I may have the more _Room_ for passing my _Hand_ along the _LEG_:
By which means I get hold of the _other_ FOOT; and bringing it also into
the _Passage_, I place it along with the _other_, that both may come
forth successfully together.
WHICH Thing, happening so when it will, that _both FEET_ are excluded,
whether done _spontaneously_ or by ART, they are never to be _repell’d_
or _thrust back_ again; but, on the contrary, the way is to be duly
cleared for their PASSAGE; _This_ being a very commodious _Situation_,
provided the CHILD be _well turned_, I mean, with _HEELS_ and _BUTTOCKS
upwards_, and _TOES_ and _BELLY downwards_: Whereas, if otherways, the
_CHIN_ may be easily hooked upon the _OSSA PUBIS_; which (if not so
happily _turned_ at first) I commonly prevent in the most adviseable
manner following; _viz._
UPON attracting the _INFANT_, I _turn_ it cautiously at the same time,
using _both Hands_ in the ensuing _Method_; namely, The _One_ I put up
under its _Body_ as far as possible, whilst with the _Other_ I hold both
_FEET_ together: Insomuch that by this Means I gradually _turn_, not
only the _FEET_ and the _LEGS_, but also the _whole Body_; bringing it
always _forwards_ in the Interim, till at last it lies with its _BELLY
downwards_, and is _out_ above half way: Upon this I then give my
_Woman_ the Motion, to begin her LABOUR and endeavour her _Best_;
because the _HEAD_ and _ARMS_ must necessarily pass through _All at
once_. For notwithstanding the contrary Opinion of most _Authors_, who
teach us to draw down the ARMS _one_ by _one_, and place them upon the
_Body_, I cannot but agree with _Daventer_, and positively advise in
_this_ and all such _other like Cases_, to leave the ARMS about the
_HEAD_, that they may be excluded along with it: Because, as he says,
tho’ the _Woman_ in so doing, is obliged to force her _INFANT forwards_
with all possible Endeavours, yet like a small transient CLOUD, it is
soon over.
WHEREFORE I commonly make it my Business to prevent the _Woman_’s
_PAINS_, until I have brought the _CHILD_ this _Length_; when allowing
her a little Time to rest, I heartily encourage and positively promise
_Her_, that, she performing her _Part_ effectually, (by using all her
_Strength_, and behaving herself as if the _PAINS_ were most really
_pressing_ upon her, whether so or not) the _BIRTH_ will immediately
succeed: And upon this _Promise_, with the _PATIENT_’s mutual
Assistances concurring, I never yet fail’d; neither will any _Persons_
who faithfully and ingeniously follow this _Method_, in comfortably
helping the _Woman_ upon such an Occasion, by drawing the _CHILD_
cautiously _downwards_, with whatsoever judicious _Force_: I mean not
_downwards_, according to the _Woman_’s LENGTH, but _downwards_ towards
the _strait Gut_. And as I every Moment insinuate to the _MOTHER_, that
her _BABE_’s _Life_ depends entirely upon her vigorous confederate
LABOUR; so _she_ mutually concurring with me, in endeavouring to do our
_Best_, the AGRIPPA _INFANT_ is presently _brought forth_ to the great
Satisfaction of _Both_.
BY these _Means_ and _Methods_, we prevent the _Tragical Consequences_,
which Mr. _Portal_ and many _others_ confess they have often met with in
their _Practice_; viz. That the _HEAD_ has been sometimes pulled-off
from the _SHOULDERS_, or that the _CHILD_ has been frequently _stifled_,
by the WOMB’s contracting and shutting-up about the _NECK_: Which was
altogether owing to the injudicious _Method_ of their Practice, in
drawing down the ARMS awkwardly (as mentioned above) along the SIDES of
the _Body_.
[Illustration]
CHAP. XVII.
_Of Preternatural BIRTHS, by Two, or more INFANTS presenting themselves
ill-Turn’d._
THIS _Case_ also happens sometimes remarkably; upon which, if _Both_ or
_All_ are contain’d in _one_ and the _same SECUNDINE_, or when the
_MEMBRANES_ are broken, _then_ the right VERSION is very difficult; not
so much for want of _Room_, as because their _HANDS_ and _FEET_ are
commonly interwoven and twisted together: In which _preternatural
Condition_, when so complicated and entangled, they are to be unfolded
and cleared off _one another_ with the nicest Circumspection and
Judgment.
BUT besides, farther, they are otherways, only to be treated in this
difficult Point, as if there was but _one CHILD_; for _turning_ them
always _One_ by _One_ duly, I would bring all their FEET into the
_Passage_, and consequently handle them, as if they had offer’d
themselves so at _first_. The _first CHILD_ being born, I would give it
to the next capable _Person_ to tie and cut its STRING; whilst I
directly repass up my _Hand_, to seek for the _other_’s FEET, by which I
would also _draw it forth_, after breaking its proper _MEMBRANES_, in
Case the _second_ FLOODING is not yet over, and _that_ notwithstanding
the HEAD should present itself _First_.
BUT and if it happens, that _each CHILD_ has its own proper and
_distinct SECUNDINE_, and _That_ of the _INFANT_ already _brought forth_
chance to be loose and separated from the WOMB; In that _Case_, I would
presently fetch it away, and then extract the _other INFANT_, as long as
there is _any_ yet left behind, and _that_ also by the FEET, as
aforesaid: Whereas otherwise, the _BIRTHS_, together with the
_Constriction_ of their _UMBILICALS_, are to be previously accomplished.
IN fine, having _thus_ accounted for all the _Preternatural BIRTHS_
whatsoever, which may or can occur on the _Part_ of the _INFANT_, and
_that_ conformable to the most nice and polite _Rules_ of ART; It
remains now in the next place, that I acquit myself in a consonant
manner, with respect to _Those_ proceeding from the _Part_ of the WOMB.
Of which _First_ in general——
[Illustration]
[Illustration]
CHAP. XVIII.
_Of Preternatural BIRTHS, proceeding from Causes of the WOMB._