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