because this _FEVER_ lasts only four or five Days at most, coming on
about the fourth, and ending about the ninth Day after the _BIRTH_, they
take all _Fevers_ in this time, for the _MILK-FEVER_; and consequently
thro’ this _Mistake_, neglecting, or not regarding duly the true
_Condition_, the PATIENT is very often endanger’d: Which _Mistake_, that
they may for the future diligently avoid, I shall subjoin here some
certain SIGNS of _Distinction_ in due Course. But previously——
THE _Causes_ of all _FEVERS_ incident to the _Child-Bed-Woman_, are
either the _Suppression_ of the LOCHIA in whole or in part; or the
vitious _Quality_ of the _Humours_ accumulated in _Gestation_, and
exasperated in the BIRTH; or a vitious irregular _DIET_ in the time of
_lying-in_; or the cold AIR, or any such _Accident_ by bad Management,
may readily convert the _MILK-FEVER_ into a putrid and dangerous _one_;
as a latent _CACOCHYMY_ may also easily dispose it to _Corruption_.
THE true _DIAGNOSTICKS_, in my Opinion, are as follow, _viz._ FIRST, the
_MILK-FEVER_ is known from hence, that it always begins about the
_Fourth Day_, when the _BREASTS_ begin to fill with _MILK_; and then the
_LOCHIA_ flowing regularly, the _Woman_ finds a certain _Gravity_ or
Weight in her _Back_ and _Shoulders_.
BUT, SECONDLY, when the _LOCHIA_ are _suppressed_, whether in whole, or
in part, ’tis then certain that the present _FEVER_ proceeds from
thence; the _BELLY_ thereby swells and is puffed up, as also it is
_pained_ when _touched_; and the _Humours_, at last, putrefying in the
_WOMB_, it ejects a certain _fœtid or corrupt Matter_.
WHEREAS, THIRDLY, if the _FEVER_ neither proceeds from the _MILK_, nor
from any Irregularity of the _LOCHIA_, why then it must necessarily
either proceed from the _vitious Quality_ and Preparation of the
_Humours_; or from a _Cacochymical Habit_ of Body; or from an _irregular
Way of Living_ in time of _GESTATION_.
THE most certain _PROGNOSTICKS_ are as follow, _viz._ FIRST, All _Acute
Diseases_ in _Child-bed Women_, whose _Strength_ is impaired by their
_LABOUR_, are much more dangerous than in any _Others_. SECONDLY, These
which proceed from the _Suppression_ of the _LOCHIA_ are most dangerous;
because the _Humours_ putrefying in the _WOMB_, occasion most severe
_SYMPTOMS_, yea and too commonly _DEATH_ itself, unless a lucky
_Diarrhæa_, or a timely _Ejection_ of the corrupted Matter, prevents the
_Misfortune_. THIRDLY, The self-same is the unfortunate _Consequence_,
when the _Distemper_ proceeds from the vitious _HUMOURS_; for _Nature_
then not being able to expurgate their abounding Superfluity by the
_LOCHIA_, the _PATIENT_ must needs be greatly endanger’d, if not
overwhelm’d.
THE most adviseable _Cure_, FIRST, as to the _MILK-FEVER_, is only to be
committed to _Nature_, the _Woman_ using always a proper _DIET_, and
carefully animadverting, that the _SWEAT_, in which it commonly
terminates, be no ways checked, impeded, or obstructed.
SECONDLY, As to the _Watchings_, _Deliria’s_, _Epilepsies_, &c. which
the _PATIENT_ is subject to in this Condition; as they proceed only from
_Vapours_ of the _BLOOD_ and _Humours_, ascending to the _Head_, when
the _LOCHIA_ do not flow regularly, or when the _Woman_ is _Feverish_:
So the _Cure_ of these distemper’d _Cases_ depends (at first) chiefly
upon retracting the _HUMOURS_ from the _Head_ to the inferiour Parts,
and correcting the _Course_ of the _LOCHIA_: Because, if these flow
orderly, and the vitious _Humours_, from which such depraved _Vapours_
as affect the _Head_, be removed and evacuated, all such _SYMPTOMS_
quickly cease and vanish of their own Accord.
THIRDLY, in the other above-mentioned _Cases_, the _PATIENT_ ought
always to be treated according to the various Circumstances of her
_Condition_; I mean, according to the attending _SYMPTOMS_, conformable
also to which the ingenious _Physician_ will always judiciously take his
prudent Measures: Since the _Cure_ does not always depend upon the _same
Method_; especially when a _symptomatick_, or concomitant _FEVER_, joins
the _first_, as it very often happens, by an _Inflammation_ of some
_particular Part_, proceeding from something of the vitious _HUMOURS_
enforcing itself upon the same very _Part_.
NOW, in short, tho’ such _Inflammations_ may affect any _Part_ of the
Body, yet (I think) the most common _Case_ is, that which affects the
_PLEURA_; and from hence (the _Pleurisy_ joining the _FEVER_) the
_Woman_ labours under both these complicated _Acute Diseases_ at once.
The _Cure_ of which difficult and dangerous _Condition_ belongs only to
the ablest _Physician_, to whom I should be justly censured, in
impertinently offering any _Instruction_ upon this Subject. Finally, in
a word, from what has been said in the _Chapter_ of the _Acute Diseases_
of Women with _CHILD_[181], we may more fully gather what is to be
prudently done to Women in _CHILD-BED_, afflicted with the like
_Distempers_.
[Illustration]
CHAP. VI.
_Of the various other Accidents incident to the CHILD-BED-WOMAN._
FIRST then, Because these _accidental_ Distempers are very many and
numerous, as well as various and different in _Kind_: SECONDLY, Because
_some_ of them have been already treated, or occasionally discoursed
upon at large: And, THIRDLY, because _others_ are only to be named in
this Place; I shall take leave to include and comprehend them all, for
_Brevity’s_ sake, in this present _Chapter_.
IN order to which, I may first observe, that most (if not All) of these
unfortunate _Accidents_, depend entirely upon the indiscreet _Conduct_
of the _MIDWIFE_ in time of _LABOUR_, or the _ill Management_ of the
_Woman_ after the _BIRTH_: Since by the prudent and judicious _Means_ of
the expert _MIDWIFE_, many _Accidents_ may be prevented, which otherways
must necessarily happen, especially in difficult or _preternatural
BIRTHS_; as also, on the other hand, by treating the _Woman_ orderly,
and guiding her carefully, many _Distempers_ may be totally averted,
which otherways will inevitably seize the _PATIENT_. As for Instance——
IT sometimes happens, that she is troubled with a _Prolapse_, or bearing
down of the _WOMB_, or _Vagina_, or _Both_; as also sometimes with a
_Falling out of the FUNDAMENT_: In all which unhappy _Conditions_ the
industrious _MIDWIFE_ will find her _Instructions_, not only with
respect to the _Cure_, but also with respect to the _Prevention_ (which
concerns her most) particularly set down and accounted for in _SECT._ V.
_Chap._ 10, and 11. as she will also, upon _Perusal_, find the _Method_
of preventing that deplorable _Accident_, of making a _Rupture_ in, or
renting the _Perinæum_, in _Chap._ 9.
BUT in _case_ of _Contusions_, or Smaller _Rents_ in the _VULVA_, or
_Vagina_, which sometimes cannot be well prevented, especially in the
_First BIRTHS_; _such_ are by no means to be neglected, lest they
degenerate into malignant _ULCERS_: Wherefore they ought to be _cured_,
as soon as possible, after the _Woman’s DELIVERY_; which _Cure_ is
easily performed, when taken in hand _betimes_, by proper
_Fomentations_, and convenient _CATAPLASMS_.
SOMETIMES again, the _WOMB_, the _Belly_, and the _Feet_ swell much
after the _BIRTH_; which _SYMPTOMS_ commonly proceed from some _Cold_,
or from _drinking too much_, or from either a _Suppression_ or
_Diminution_ of the _LOCHIA_, or from any _irregular way of Living_
during the time of _GESTATION_: By which means the vitious _HUMOURS_,
resolving themselves into _Flatulencies_, swell and puff up both the
_WOMB_ and the _ABDOMEN_; and these _Winds_ descending, have the same
Effect upon the _Legs_. But the _Cure_, however, of all such _SYMPTOMS_,
is readily accomplished by convenient _DIET_, proper _Fomentations_, and
discutient _Medicines_.
HENCE I might orderly descend to an _Indefinity_ of Particulars,
deriving from the following general _Heads_, which I Shall only name at
this time; _viz._ the various _Diseases_ of the _PUDENDUM_ and _Vagina_,
as well as of the _MATRIX_ itself, together with their _co-incident
SYMPTOMS_; as also the divers _Distempers_, and different _SYMPTOMS_ of
the _Woman’s BREASTS_. But _These Subjects_ being as different as
numerous (which I have already hinted) I must refer them to another
Opportunity; being resolved to keep the present Work, for the common
Good, within the _Purchase_ of all sorts of People as far as possible;
and until such time as something on _these Heads_ appears more judicious
or elaborate, either from _my own_, or some more _capable Hand_, I hope
_English Women_ can be at no great Loss for good _Instruction_, or ready
_Assistance_; especially not in this famous _City_ of LONDON, which is,
by the Divine Mercy, abundantly well-stock’d, and singularly well
provided, with some of the most excellent _Physicians_ of the Age, as
well as with some very ingenious _Practisers_ in the Art of _MIDWIFERY_.
AND, thus, in fine, having _piloted_ the good _Woman_ (as it were) thro’
the _three Gulphs_ of _GESTATION_; _BIRTH_, and _CHILD-BED_, and at last
brought her into safe _Harbour_; we may now (I hope) securely leave her
there, to _refit_ for the same prosperous _Voyage_ again; whilst we, in
the next Place, undertake to provide for the _Safety_ of her _CARGO_, or
direct the _Regimen_ and _Nursing_ of the _CHILD_. And FIRST—
[Illustration]
CHAP. VII.
_Of the Constriction of the NAVEL-STRING, and the Swaddling of the
Infant_.
IF after the _Torrents_ of Difficulties and _Oceans_ of Danger that the
MOTHER has painfully gone through, and narrowly evaded, the CHILD should
at last be lost; the _Comfort_ of her _Burden_ would be but small, and
the _Reward_ of her _Sufferings_ but very little: Wherefore special
_Care_ ought to be taken to prevent such melancholy _Events_; in order
to which, we are not only to remedy such _Indispositions_ as it (too
often) brings with it into the World, but also to defend it from the
many periculous _Contingencies_, to which the _Tenderness_ of its Body,
and the _Debility_ of its Age expose it.
THE first _Duty_ then, that the _INFANT_ requires of us after _BIRTH_,
whether born by the _Head_, or extracted by the _Feet_, is the _tying_
and _cutting_ of the _Umbilical Vein_, or _NAVEL-STRING_; which being a
thing generally well known, I shall have no Occasion to insist upon it,
especially since tho’ the common GOSSIPS may differ in the
_Performance_, yet they always agree in the _Fact_.
HOWEVER, that we may not pass this _essential Point_ by in Silence, in
case a notable Word may drop by the By, I would,——
I. OBSERVE, that, until the _STRING_ be cut, the CHILD is to be
carefully laid on _one Side_, not on its _Back_, for fear that the
_HUMOURS_, running to its _Mouth_ or _Nose_, may choke it, for want of
free Evacuation.
II. I would take notice, that, if need require, while the _MIDWIFE_ is
busy about the _Mother_, in extracting the _AFTER-BIRTH_, cleansing the
_WOMB_, &c. the most capable of the GOSSIPS should _tie_ and _cut_ the
_STRING_, especially if the _INFANT_ is weak or ill; otherways it may be
deferred until the _Woman_ be entirely _delivered_, and fairly _laid_.
Then,——
III. AS to the _Performance_ of this Matter, it may be _tied_ with a
good strong _Thread_, laid four or five-fold, according to its Strength;
and the KNOT tied close within _two Inches_ of the _CHILD’s_ Body: Tho’,
I say, that the KNOT is to be _tied_ close, yet it must not be so
strictly _tied_ as to cut asunder the _STRING_; which might easily
happen, especially to the _INFANTS_ of a tenderer Constitution. And the
Reason that I would have the _Constriction_ made _two Inches_ from the
Body, is this, That in case any _Blood_ should happen to drop out
afterwards (as it often happens) there may be _room_ enough to _tie_ it
again nearer the _NAVEL_.
IV. THE _STRING_ is not to be _cut off_ close to the KNOT, but also _two
or three Inches_ from it; so that, if it happens to swell with Wind (as
is very common) after being _tied_, it may be _loosed_ again, the _Wind_
discharged, and itself conveniently _retied_. But the far better and
preferable way is, to tie this VEIN in _two Places_, and cut it asunder
betwixt the _Ligatures_; being thereby secure from losing BLOOD. Some (I
know) will not have the VEIN to be _tied_ before the _CHILD_ cries or
makes _Water_; but, however, long _Delays_ in this _Case_ are no ways
convenient, nor without Danger.
V. THIS VEIN or STRING being _cut_, must be wrapped up in a _three_ or
_fourfold Rag_, to defend the _BABE_ from Cold or Pains of the _Belly_;
which otherways might ensue from the _naked_ VEIN’s lying upon its Body:
Which being done, this Part of the STRING is to be laid on the _upper
Part of the Belly_, with a small _Boulster_ on the Top of it; and then
swathed with a _Linnen Swath_ of about _four Inches broad_, to keep it
firm and steady.
VI. THE first time that the _CHILD_ is _unswathed_, a new KNOT ought to
be made or _tied_, and that to prevent all _Danger_ by Loss of _BLOOD_,
which may readily happen by the first KNOT’s relaxing, as the _STRING_
begins to wither away or contract.
THIS being so duly taken care of, it remains only in general, that the
Infant be presently _washed_, cleansed, and examined all over, and at
last orderly _swaddled_. All which if the _MIDWIFE_ does not perform
with her own Hands, she ought at least to see it carefully accomplished:
Upon which she may then say, she has faithfully discharged her _Duty_ to
both the _MOTHER_ and the _CHILD_.
VII. BUT more particularly, in the _seventh Place_, I must take notice,
that as soon as the _NAVEL-STRING_ is thus duly handled and provided
for, the _INFANT_ is to be tenderly cleansed of the adhering
_Excrements_, and washed all over in a little warm _Wine_, _Milk_, or
_Ale_; especially its _Head_, _Arm-Pits_, _Groins_, _Cods_, or
_Privities_, &c. are to be softly cleansed and gently bathed with a soft
_Spunge_ or _Rag_, dipt in the same _Liquors_: But if the _viscous
Matter_ sticks too fast or close to the tender Body, a little _Oil of
sweet Almonds_, or fresh _Butter_, may be added to either of the
foresaid _Liquors_. As also the _Ears_ and _Nostrils_ ought to be well
cleansed and unstopped with small Tents of _fine Rags_ wet therein; and
the _Eyes_ wiped with a soft dry _Cloth_; as the _Mouth_, _Tongue_, and
_Jaws_ may be cleans’d by the _Finger_.
VIII. THESE things being all very carefully and tenderly performed,
every Part of the Body ought to be diligently searched, in case of a
_Dislocation_, or any other _Accident_, happened by _Violence_ in the
_BIRTH_, or otherways; that present _Remedies_ may be used, according to
the Nature of the _Circumstances_: And especially the two _Conduits_ of
the _URINE_ and _ORDURE_ are to be examined; since it sometimes falls
out that _these_ are not perforated, and consequently that the
_Meconium_ cannot be voided, which inevitably proves fatal, unless
timely _Care_ be taken.
IX. AS to the _URINE_, all _Children_ discharge it as soon as born, at
least as soon as they feel the _Heat_ of the Fire; when if the
_Excrements_, properly called _MECONIUM_, tho’ improperly _COLLOSTRO_ by
the _Italians_, do not follow a little after; I mean within an _Hour or
two_; then a small _Suppository_ may be used, such as a _sugar’d Almond_
anointed with a little boiled _Honey_; or a Piece of _Venice-Soap_
anointed with fresh _Butter_; as also a little _Syrup_ of _Roses_ or
_Violets_, mixed with the Oil of _sweet Almonds_ by Expression, that is,
drawn without Fire, may be given in the _Mouth_, anointing the _Belly_
with the same _Oil_, or with fresh _Butter_; in like manner as a small
_Clyster_ (upon occasion) may be discreetly used and managed to purpose.
X. THE _INFANT_ being in these respects _provided_ for, it is now to be
duly dressed and swaddled in its _Swathing-Cloathes_; and beginning with
the _HEAD_, a _Compress_ of a three or fourfold fine _Linnen Rag_, about
_four Inches broad_, is to be applied to the _MOULD_, for defending the
(yet open) _BRAIN_ from _Cold_, &c. which _Compress_ is to be carefully
covered with, and pinned to the ordinary _CAPS_ made on purpose. Next
then, some small soft _RAGS_ are to be laid behind the _Ears_, upon the
_Breast_, in the _Arm-Pits_, and the _Groins_; after which the _BABE_ is
to be wrapped softly up in _warm Blankets_, and discreetly _swathed_;
not too strait, especially not about the _Breast_ and _Stomach_, that it
may _breathe_ the freer, and the better retain the _MILK_ it sucks. The
_ARMS_ are to be stretched along the _Sides_, and the _LEGS_ equally
_streight_, with a little of the _Bed_ betwixt them; and the _HEAD_ is
always to be kept steady, as the whole _CHILD_ is to be preserved _thus_
warmly wrapped up, and judiciously appointed. But now because the
_INFANT_ is commonly committed to the _Nurse’s Care_, I shall, in the
next Place, enter upon the _Description_ of the proper _Person_ for that
purpose.
[Illustration]
CHAP. VIII.
_Of the NURSE and her Regimen, together with the requisite Qualities of
her MILK._
THO’ the _BABE_ may be brought up by the Hand only, without _Suckling_,
as many Instances of very thriving _Children_ testify; yet because the
most natural, common, and commendable way is to _suckle_ it, I come now
to touch upon the proper _NURSE_, her _Milk_, and _Diet_. Upon which I
first observe, that the prime and chief _Quality_ of a good _NURSE_ is,
that she be the _Mother_ of the _Fosterling INFANT_ herself; and that
because her _MILK_, being generated of the same _Blood_, of which the
_CHILD_ is formed, and has hitherto been nourished, is of a nearer
_Affinity_ with the Nature of her _BABE_, than the _MILK_ of any _other
strange Woman_ whatsoever; which can differ no less from the _Maternal
Milk_, than the own _Mother_, and the _other_ differ in _Constitution_
and _Temperament_ of Body, _Regimen_, and _Method of Living_, &c. All
which affect the _INFANT_ in no small Degree; for as the BLOOD is
generated of the _Chyle_, and the _Spirits_ of the BLOOD, so the _CHILD_
imbibes the very _Manners_ and _Disposition_, as well as the gross
_Humours_ and _Qualities_ of the _NURSE_ with her _Milk_.
AS a _Lamb_ sucking a _Goat_, changes not only its _Nature_, but even
its _Skin_ and _Wool_ into the GOAT-_Kind_; so it is also among the
_rational Creatures_: From hence we have justly the _old Proverb_,
touching an _ill-natured Person_, that some _Brute_ or other has been
his _NURSE_. And hence it is that _Romulus_ and _Remus_, the Sons of
MARS (without any Reality) are said to have been nursed by a WOLF[182];
_Pelias_, the Son of _Neptune_, by a MARE; _Telephus_, the Son of
_Hercules_, by a HIND, &c. Not that they ever actually sucked such
_Creatures_, only their _NURSES_ were of such _Tempers_ and _Natures_,
which they were thus supposed to have by the BREAST infused into them.
AND, in short, daily _Experience_, as well as many _Learned
Authorities_, may sufficiently convince us, that CHILDREN really _suck_
in the several _vitious Inclinations_ and _depraved Passions_ of their
_NURSES_; such as _Anger_, _Malice_, _Fear_, _Melancholy_, &c. Agreeable
to which Opinion, _Diodorus_ says[183], that _Nero_ the Emperor’s
_NURSE_ was very much addicted to _Drinking_; which Habit _Nero_ imbibed
from _her_, to such a Degree, that the People took notice of it, and
from thence instead of CLAUDIUS TIBERIUS NERO, call’d him _Caldius
Biberius Mero_. The same Author relates of _Caligula_, that his _NURSE_
used frequently to moisten her _Nipples_ with BLOOD, that he might take
the better hold of them; which (says the same _Diodorus_) was the
_Cause_ of his being so cruel and _Blood-thirsty_ all the Days of his
Life; that he not only committed frequent _Murders_ by his own Hand, but
even wished that all humane Race was but one NECK, that he might have
the pleasure to _cut it off_.
IN short, _honest Parents_ perceiving their _Children_ to incline
variously, _one_ to _Thieving_, _another_ to _Drinking_; _one_ to
_Stupidity_, _another_ to _Barbarity_; are amazed at such _Degeneracies_
of Mankind, not knowing after whom the _Child_ can take those
Propensions. But abstracting from _this_, how many fine _Children_ do we
daily see thrown into _Fits_, _Rickets_, _Consumptions_, &c. merely by
_sucking_ their imprudent _NURSES_, when enraged, or otherways in a
Passion? If then the _Case_ stands thus, that every _Disorder_ of the
_NURSE_ is a real _Detriment_ to the _INFANT_, surely, upon this
Account, all _Parents_ ought to know HER well, to whom they entrust
these _Dear Pledges_ of their sacred and natural Desires.
MOREOVER yet, besides all these Things, the tender _Care_, as well as
the _Love_ and _Affection_ of the MOTHER to her own CHILD, by far
surpasses that of any _mercenary NURSE_ whatsoever. Wherefore the
MOTHER, tho’ perhaps not the best _NURSE_ in other respects, is always
preferable to a _STRANGER_: Which if People of _Probity_ and _Honour_
would more observe, I sincerely believe that there would not be so many
graceless, disobedient, and undutiful _CHILDREN_ of our Age. I do not
think what I have read of _Scipio Africanus_ to be any singular
_Instance_; namely, that He esteemed _Her_ more for his MOTHER, who
nursed him two Years after his _Birth_, than HER who brought him forth,
and then forsook him in the World. Agreeable to which, and most _à
propos_, was the Answer of the Philosopher, _Favorinus_[184], to the
MOTHER of a certain _Noble-woman_ in _CHILD-BED_, who was dissuading her
_Daughter_ to _nurse_ the _CHILD_ she had born; _viz._ _I entreat thee
Woman_ (says he) _suffer her to be the whole and entire Mother of her
own Son_. And verily, SHE only can be properly so called, who carefully
_nurses_ as well as _brings forth_ her own _CHILDREN_. Hence it is that
the _Earth_ is called the MOTHER of all Things, not so much because she
produces all Things, as because she _maintains_ and _nurses_ what she
produces.
ALL which, notwithstanding, there is sometimes a _Necessity_ (on account
of sundry Reasons) to provide another _NURSE_ for the _CHILD_; wherefore
I come now briefly to describe the most proper _Person_ for this
_TRUST_, and to set forth the _Qualities_ of the most convenient _MILK_,
for the wholesome Nourishment of the INFANT.
FIRST then, the _NURSE_ ought to be a Woman between the 20th and 35th
_Year of her Age_, perfectly graced with the _Blessings_ and _Ornaments_
of _Nature_; and a Person of _Probity_ and _Reputation_ in her _Rank_,
endued with _Love_, _Pity_, and _Tender-heartedness_: As she also ought
to be _sound_ and _healthy_, of a good _Habit_ and _Disposition_ of Body
and Mind, of a sanguine _Complexion_, and rosy _Colour_; of a _middle
Stature_, having black or brown _Hair_, a _lively Eye_, _sweet Breath_,
sound and white _Teeth_, with an agreeable chearful _Countenance_. In
short, she ought also to be a _well-mannered_, _modest_, and _sober
Person_, having middle-sized, well shaped, not flabby nor hanging down,
but solid fleshy BREASTS, with elegant, firm, and well perforated
_Nipples_.
SECONDLY, As to her _MILK_, it ought neither to be too _new_, nor too
_old_; but at any time from the _Puerperial Flux_, until the 6th or 8th
Month thereafter, it is not to be rejected; especially if it be of a
good _Consistence_, neither too _thick_ nor too _thin_, of a pure _white
Colour_, an agreeable pleasant _Smell_, and a perfect sweet _Taste_.