They grow looser every day, until the appointed time for delivery; if, therefore, the body is in real need of purging, the woman may do it without danger in the fourth, fifth or sixth month, but neither before nor after that unless in the case of some violent illness, in which it is possible that both mother and child may perish. Apply plasters and ointments to the loins in order to strengthen the fruit in the womb. Take one drachm each of gum Arabic, galangale, bistort, hypocistid and storax, a drachm and a half each of fine bole, nutmeg, mastic, balaust, dragon's blood and myrtle berries, and a sufficient quantity of wax and turpentine and make into a plaster. Apply it to the loins in the winter, and remove it every twenty-four hours, lest the loins should become overheated by it. In the interim, anoint the private parts and loins with countess' balsam but if it be summer time and the loins hot, the following plaster will be more suitable. Take a pound of red roses, two drachms each of mastic and red Sanders, one drachm each of bole ammoniac and red coral, two drachms and a half each of pomegranate seed and prepared coriander seed, two scruples of barberries, one ounce each of oil of mastic and of quinces, and plantain-juice.

Anoint the loins also with sandalwood ointment, and once a week wash them with two parts of rose-water and one of white wine mixed together and warmed at the fire. This will assuage the heat of the loins, get rid of the oil of the plaster from the pores of the skin, and cause the fresh ointment or plaster to penetrate more easily, and to strengthen the womb. Some think that a load-stone laid upon the navel, keeps a woman from abortion. The same thing is also stated of the stone called aetites or eagle-stone, if it is hung round the neck. Samian stone has the same virtue.

* * * * *



CHAPTER XV

Directions for Women when they are taken in Labour, to ensure their safe Delivery, and Directions for Midwives.

Having thus given the necessary directions to pregnant women, how to manage their health during their pregnancy, I will now add what is necessary for them to do, in order that they may be safely delivered.

When the time of birth draws near, the woman must be sure to send for a skilful midwife, and that rather too soon than too late. She must have a pallet bed ready to place it near the fire, so that the midwife and those who are to help her, may be able to pass round it, and give assistance on either side, as may be required. A change of linen must be in readiness, and a small stool to rest her feet against, as she will have more power when her legs are bent, than when they are straight.

When everything is thus ready, and when the woman feels the pains coming on, if the weather be not cold, she should walk about the room, rest on the bed occasionally, waiting for the breaking of the waters, which is a fluid contained in one of the outward membranes, and which flows out thence, when the membrane is broken by the struggles of the child. There is no special time for this discharge, though it generally takes place about two hours before the birth. Movements will also cause the womb to open and dilate, and when lying long in bed will be uncomfortable. If she be very weak she may take some mild cordial to give her strength, if her pain will permit her; and if the labour be tedious, she may be revived with chicken or mutton broth, or she may take a poached egg; but she must be very careful not to eat to excess.

There are many postures in which women are delivered; some sitting in a chair, supported by others, or resting on the bed; some again upon their knees and resting on their arms; but the safest and most commodious way, is in the bed, and then the midwife ought to observe the following rules:—Let her lay the woman upon her back, with her head a little raised by means of a pillow, with similar supports for her loins and buttocks, which latter should also be raised, for if she lies low, she cannot be delivered so easily. Then let her keep her knees and thighs as far apart as she can, her legs bent inward towards each other, and her buttocks, the soles of her feet and her heels being placed upon a small rest, placed for the purpose, so that she may be able to strain the stronger. In case her back should be very weak, a swathing band should be placed under it, the band being doubled four times and about four inches broad. This must be held by two persons who must raise her up a little every time her pains come on, with steady hands and in even time, but if they be not exact in their movements, they had better leave her alone. At the same time two women must hold her shoulders so that she may strain out the foetus more easily; and to facilitate this let one stroke or press the upper part of her stomach gently and by degrees. The woman herself must not be nervous or downhearted, but courageous, and forcing herself by straining and holding her breath.

When delivery is near, the midwife must wait patiently until the child's head, or some limb, bursts the membranes, for if the midwife through ignorance, or through haste to go to some other woman, as some have done, tears the membrane with her nails, she endangers both the woman and the child; for by lying dry and lacking that slipperiness which should make it easy, it comes forth with severe pains.

When the head appears, the midwife must hold it gently between her hands, and draw the child, whenever the woman's pains are upon her, but at no other times; slipping her forefingers under its armpits by degrees, and not using a rough hand in drawing it out, lest the tender infant might become deformed by such means. As soon as the child is taken out, which is usually with its face downwards,—it should be laid upon its back, that it may receive external respiration more freely; then cut the navel string about three inches from the body, tying the end which adheres to it with a silk string, as closely as you can; then cover the child's head and stomach well, allowing nothing to touch its face.

When the child has been thus brought forth, if it be healthy lay it aside, and let the midwife attend to the patient by drawing out the afterbirth; and this she may do by wagging and stirring it up and down, and afterwards drawing it out gently. And if the work be difficult, let the woman hold salt in her hands, close them tightly and breathe hard into them, and by that she will know whether the membranes are broken or not. It may also be known by making her strain or vomit; by putting her fingers down her throat, or by straining or moving her lower parts, but let all be done immediately. If this should fail, let her take a draught of elder water, or the yolk of a new laid egg, and smell a piece of asafoetida, especially if she is troubled with a windy colic. If she happen to take cold, it is a great obstruction to the afterbirth; in such cases the midwife ought to chafe the woman's stomach gently, so as to break, not only the wind, but also to force the secundine to come down. But if these should prove ineffectual, the midwife must insert her hand into the orifice of the womb and draw it out gently.

Having thus discussed common births, or such as are generally easy, I shall now give directions in cases of extremity.

* * * * *



CHAPTER XVI

What ought to be done in cases of extremity, especially in women who, in labour, are attacked by a flux of blood, convulsions and fits of wind.

If the woman's labour be hard and difficult, greater care must be taken than at other times. And, first of all, the situation of the womb and her position in lying must be across the bed, and she must be held by strong persons to prevent her from slipping down or moving during the surgeon's operations. Her thighs must be put as far apart as possible, and held so, whilst her head must rest upon a bolster, and her loins be supported in the same manner. After her rump and buttocks have been raised, be careful to cover her stomach, belly and thighs with warm clothes, to keep them from the cold.

When the woman is in this position, let the operator put up his or her hand, if the neck of the womb be dilated, and remove the coagulated blood that obstructs the passage of the birth; and by degrees make way gently, let him remove the infant tenderly, having first anointed his hand with butter or some harmless salve. And if the waters have not come down, they may then be let out without difficulty. Then, if the infant should attempt to come out head foremost, or crosswise, he should turn it gently, to find the feet. Having done this, let him draw out one and fasten it with ribbon and then put it up again, and by degrees find the other, bringing them as close together and as even as possible, and between whiles let the woman breathe, and she should be urged to strain so as to help nature in the birth, that it may be brought forth. And to do this more easily, and that the hold may be surer, wrap a linen cloth round the child's thighs, taking care to bring it into the hand face downwards.

In case of flux of blood, if the neck of the womb be open, it must be considered whether the infant or the secundine, generally called the afterbirth, comes first, and as the latter happens to do so occasionally, it stops the mouth of the womb and hinders the birth, and endangers both the woman's and the child's life. In this case the afterbirth must be removed by a quick turn. They have deceived many people, who, feeling their softness, have supposed that the womb was not dilated, and by that means the woman and child, or at least the latter, have been lost. When the afterbirth has been removed, the child must be sought for and drawn out, as directed above; and if the woman or the child die in such a case, the midwife or the surgeon are blameless because they have used their best endeavours.

If it appears upon examination that the afterbirth comes first, let the woman be delivered as quickly as possible, because a great flow of blood will follow, for the veins are opened, and on this account two things have to be considered.

First:—The manner in which the afterbirth advances, whether it be much or little. If the former, and the head of the child appears first, it may be guided and directed towards the neck of the womb, as in the case of natural birth, but if there appears any difficulty in the delivery, the best way is to look for the feet, and draw it out by them; but if the latter, the afterbirth may be put back with a gentle hand, and the child taken out first. But if the afterbirth has come so far forward that it cannot be put back, and the child follows it closely, then the afterbirth must be removed very carefully, and as quickly as may be, and laid aside without cutting the entrail that is fastened to it; for you may be guided to the infant by it, which must be drawn out by the feet, whether it be alive or dead, as quickly as possible; though this is not to be done except in cases of great necessity, for in other cases the afterbirth ought to come last.

In drawing out a dead child, these directions should be carefully followed by the surgeon, viz.—If the child be found to be dead, its head appearing first, the delivery will be more difficult; for it is an evident sign that the woman's strength is beginning to fail her, that, as the child is dead and has no natural power, it cannot be assisting in its own delivery in any way. Therefore the most certain and the safest way for the surgeon is, to put up his left hand, sliding it into the neck of the womb, and into the lower part of it towards the feet, as hollow in the palm as he can, and then between the head of the infant and the neck of the womb. Then, having a forceps in the right hand, slip it up above the left hand, between the head of the child and the flat of the hand, fixing it in the bars of the temple near the eye. As these cannot be got at easily in the occipital bone, be careful still to keep the hand in its place, and gently move the head with it, and so with the right hand and the forceps draw the child forward, and urge the woman to exert all her strength, and continue drawing whenever her pains come on. When the head is drawn out, he must immediately slip his hand under the child's armpits, and take it quite out, and give the woman a piece of toasted white bread, in a quarter of a pint of Hippocras wine.

If the former application fails let the woman take the following potion hot when she is in bed, and remain quiet until she begins to feel it operating.

Take seven blue figs, cut them into pieces and add five grains each of fenugreek, motherwort and rue seed, with six ounces each of water of pennyroyal and motherwort; reduce it to half the quantity by boiling and after straining add one drachm of troches of myrrh and three grains of saffron; sweeten the liquor with loaf sugar, and spice it with cinnamon.—After having rested on this, let her strain again as much as possible, and if she be not successful, make a fumigation of half a drachm each of castor, opopanax, sulphur and asafoetida, pounding them into a powder and wetting the juice of rue, so that the smoke or fumes may go only into the matrix and no further.

If this have not the desired effect, then the following plaster should be applied:—Take an ounce and a half of balganum, two drachms of colocynth, half an ounce each of the juice of motherwort and of rue, and seven ounces of virgin bees' wax: pound and melt them together, spreading them on a cere-cloth so that they may spread from the navel to the os pubis and extending to the flanks, at the same time making a pessary of wood, enclosing it in a silk bag, and dipping it in a decoction of one drachm each of sound birthwort, savin colocinthis, stavescare and black hellebore, with a small sprig or two of rue.

But if these things have not the desired effect, and the woman's danger increases, let the surgeon use his instruments to dilate and widen the womb, for which purpose the woman must be placed on a chair, so that she may turn her buttocks as far from its back as possible, at the same time drawing up her legs as close as she can and spreading her thighs open as wide as possible; or if she is very weak it may be better to lay her on the bed with her head downwards, her buttocks raised and both legs drawn up. Then the surgeon may dilate the womb with his speculum matrices and draw out the child and the afterbirth together, if it be possible, and when this is done, the womb must be well washed and anointed, and the woman put back to bed and comforted with spices and cordials. This course must be adopted in the case of dead children and moles, afterbirths and false births, which will not come out of themselves, at the proper time. If the aforementioned instrument will not widen the womb sufficiently, then other instruments, such as the drake's bill, or long pincers, ought to be used.

If any inflammation, swelling or congealed blood happens to be contracted in the womb under the film of these tumours, either before or after the birth, let the midwife lance it with a penknife or any suitable instrument, and squeeze out the matter, healing it with a pessary dipped in oil of red roses.

If the child happens at any time to be swollen through cold or violence, or has contracted a watery humour, if it is alive, such means must be used as are least injurious to the child or mother; but if it be dead, the humours must be let out by incisions, to facilitate the birth.

If, as often happens, the child is presented feet foremost, with the hands spreading out from the hips, the midwife must in such a case be provided with the necessary ointments to rub and anoint the child with, to help it coming forth, lest it should turn into the womb again, holding both the infant's arms close to the hips at the same time, that it may come out in this manner; but if it proves too big, the womb must be well anointed. The woman should also take a sneezing powder, to make her strain; the attendant may also stroke her stomach gently to make the birth descend, and to keep it from returning.

It happens occasionally, that the child presenting itself with the feet first, has its arms extended above its head; but the midwife must not receive it so, but put it back into the womb, unless the passage be extraordinarily wide, and then she must anoint both the child and the womb, and it is not safe to draw it out, which must, therefore, be done in this manner.—The woman must lie on her back with her head low and her buttocks raised; and then the midwife must compress the stomach and the womb with a gentle hand, and by that means put the child back, taking care to turn the child's face towards the mother's back, raising up its thighs and buttocks towards the navel, so that the birth may be more natural.

If the child happens to come out with one foot, with the arm extended along the side and the other foot turned backwards; then the woman must be immediately put to bed and laid in the above-described position; when the midwife must immediately put back the foot which appears so, and the woman must rock herself from side to side, until she finds that the child has turned, but she must not alter her position nor turn upon her face. After this she may expect her pains and must have great assistance and cordials so as to revive and support her spirits.

At other times it happens that the child lies across in the womb, and falls upon its side; in this case the woman must not be urged in her labour; therefore, the midwife when she finds it so, must use great diligence to reduce it to its right form, or at least to such a form in the womb as may make the delivery possible and most easy by moving the buttocks and guiding the head to the passage; and if she be successful in this, let the woman rock herself to and fro, and wait with patience till it alters its way of lying.

Sometimes the child hastens simply by expanding its legs and arms; in which, as in the former case, the woman must rock herself, but not with violence, until she finds those parts fall to their proper station; or it may be done by a gentle compression of the womb; but if neither of them avail, the midwife must close the legs of the infant with her hand, and if she can get there, do the like by the arms, and so draw it forth; but if it can be reduced of itself to the posture of a proper birth it is better.

If the infant comes forward, both knees forward, and the hands hanging down upon the thighs, then the midwife must put both knees upward, till the feet appear; taking hold of which with her left hand let her keep her right hand on the side of the child, and in that posture endeavour to bring it forth. But if she cannot do this, then also the woman must rock herself until the child is in a more convenient posture for delivery.

Sometimes it happens that the child presses forward with one arm extended on its thighs, and the other raised over its head, and the feet stretched out at length in the womb. In such case, the midwife must not attempt to receive the child in that posture, but must lay the woman on the bed in the manner aforesaid, making a soft and gentle compression on her belly, oblige the child to retire; which if it does not, then must the midwife thrust it back by the shoulder, and bring the arm that was stretched above the head to its right station; for there is most danger in these extremities; and, therefore, the midwife must anoint her hands and the womb of the woman with sweet butter, or a proper pomatum, and thrust her hand as near as she can to the arm of the infant, and bring it to the side. But if this cannot be done, let the woman be laid on the bed to rest a while; in which time, perhaps, the child may be reduced to a better posture; which the midwife finding, she must draw tenderly the arms close to the hips and so receive it.

If an infant come with its buttocks foremost, and almost double, then the midwife must anoint her hand and thrust it up, and gently heaving up the buttocks and back, strive to turn the head to the passage, but not too hastily, lest the infant's retiring should shape it worse: and therefore, if it cannot be turned with the hand, the woman must rock herself on the bed, taking such comfortable things as may support her spirits, till she perceives the child to turn.

If the child's neck be bowed, and it comes forward with its shoulders, as it sometimes doth, with the hands and feet stretched upwards, the midwife must gently move the shoulders, that she may direct the head to the passage; and the better to effect it, the woman must rock herself as aforesaid.

These and other like methods are to be observed in case a woman hath twins, or three children at a birth, which sometimes happens: for as the single birth hath but one natural and many unnatural forms, even so it may be in a double and treble birth.

Wherefore, in all such cases the midwife must take care to receive the first which is nearest the passage; but not letting the other go, lest by retiring it should change the form; and when one is born, she must be speedy in bringing forth the other. And this birth, if it be in the natural way, is more easy, because the children are commonly less than those of single birth, and so require a less passage. But if this birth come unnaturally, it is far more dangerous than the other.

In the birth of twins, let the midwife be very careful that the secundine be naturally brought forth, lest the womb, being delivered of its burden, fall, and so the secundine continue longer there than is consistent with the woman's safety.

But if one of the twins happens to come with the head, and the other with the feet foremost, then let the midwife deliver the natural birth first; and if she cannot turn the other, draw it out in the posture in which it presses forward; but if that with its feet downward be foremost, she may deliver that first, turning the other aside. But in this case the midwife must carefully see that it be not a monstrous birth, instead of twins, a body with two heads, or two bodies joined together, which she may soon know if both the heads come foremost, by putting up her hand between them as high as she can; and then, if she finds they are twins she may gently put one of them aside to make way for the other, taking the first which is most advanced, leaving the other so that it do not change its position. And for the safety of the other child, as soon as it comes forth out of the womb, the midwife must tie the navel-string, as has before been directed, and also bind, with a large, long fillet, that part of the navel which is fastened to the secundine, the more readily to find it.

The second infant being born, let the midwife carefully examine whether there be not two secundines, for sometimes it falls out, that by the shortness of the ligaments it retires back to the prejudice of the woman. Wherefore, lest the womb should close, it is most expedient to hasten them forth with all convenient speed.

If two infants are joined together by the body, as sometimes it monstrously falls out, then, though the head should come foremost, yet it is proper, if possible, to turn them and draw them forth by the feet, observing, when they come to the hips, to draw them out as soon as may be. And here great care ought to be used in anointing and widening the passage. But these sort of births rarely happening, I need to say the less of them, and, therefore, shall show how women should be ordered after delivery.

* * * * *



CHAPTER XVII

How child-bearing Women ought to be ordered after Delivery.

If a woman has had very hard labour, it is necessary that she should be wrapped up in a sheep's skin, taken off before it is cold, applying the fleshy side to her veins and belly, or, for want of this, the skin of a hare or coney, flayed off as soon as killed, may be applied to the same parts, and in so doing, a dilation being made in the birth, and the melancholy blood being expelled in these parts, continue these for an hour or two.

Let the woman afterwards be swathed with fine linen cloth, about a quarter of a yard in breadth, chafing the belly before it is swathed, with oil of St. John's wort; after that raise up the matrix with a linen cloth, many times folded: then with a linen pillar or quilt, cover the flanks, and place the swathe somewhat above the haunches, winding it pretty stiff, applying at the same time a linen cloth to her nipples; do not immediately use the remedies to keep back the milk, by reason the body, at such a time, is out of frame; for there is neither vein nor artery which does not strongly beat; and remedies to drive back the milk, being of a dissolving nature, it is improper to apply them to the breasts during such disorder, lest by doing so, evil humours be contracted in the breast. Wherefore, twelve hours at least ought to be allowed for the circulation and settlement of the blood, and what was cast on the lungs by the vehement agitation during labour, to retire to its proper receptacles.

Some time after delivery, you may take a restrictive of the yolks of two eggs, and a quarter of a pint of white wine, oil of St. John's wort, oil of roses, plantain and roses water, of each an ounce, mix them together, fold a linen cloth and apply it to the breast, and the pains of those parts will be greatly eased.

She must by no means sleep directly after delivery; but about four hours after, she may take broth, caudle or such liquid victuals as are nourishing; and if she be disposed to sleep it may be very safely permitted. And this is as much, in the case of a natural birth, as ought immediately to be done.

But in case of an extremity or an unnatural birth, the following rules ought to be observed:—

In the first place, let the-woman keep a temperate diet, by no means overcharging herself after such an extraordinary evacuation, not being ruled by giving credit to unskilful nurses, who admonish them to feed heartily, the better to repair the loss of blood. For that blood is not for the most part pure, but such as has been retained in the vessels or membrane better voided, for the health of the woman, than kept, unless there happen an extraordinary flux of the blood. For if her nourishment be too much, which curding, very often turns to imposthumes.

Therefore, it is requisite, for the first five days especially, that she take moderately panado broth, poached eggs, jelly of chickens or calves' feet or fresh barley broth; every day increasing the quantity a little.

And if she intend to be a nurse to the child, she may take something more than ordinary, to increase the milk by degrees, which must be of no continuance, but drawn off by the child or otherwise. In this case likewise, observe to let her have coriander or fennel seeds boiled in barley broth; but by all means, for the time specified, let her abstain from meat. If no fever trouble her, she may drink now and then a small quantity of pure white wine or of claret, as also syrup of maidenhead or any other syrup that is of an astringent quality, taken in a little water well boiled.

After the fear of fever or contraction of humour in the breast is over, she may be nourished more plentifully with the broth of capons, pullets, pigeons, mutton, veal, etc., which must not be until after eight days from the time of delivery; at which time the womb, unless some accident binds, has purged itself. It will then likewise be expedient to give cold meats, but let it be sparingly, so that she may the better gather strength. And let her, during the time, rest quietly and free from disturbance, not sleeping in the day time, if she can avoid it.

Take of both mallows and pellitory of the wall a handful; camomile and melilot flowers, of each a handful; aniseed and fennel of each two ounces; boil them in a decoction of sheep's head and take of this three quarts, dissolving in it common honey, coarse sugar and fresh butter and administer it clysterwise; but if it does not penetrate well take an ounce of catholicon.

* * * * *



CHAPTER XVIII

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.

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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.

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PART II

* * * * *

THE

EXPERIENCED MIDWIFE

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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

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BOOK I

CHAPTER I

SECTION I.—Of the Womb.

In this chapter I am to treat of the womb, which the Latins call matrix. Its parts are two; the mouth of the womb and the bottom of it. The mouth is an orifice at the entrance into it, which may be dilated and shut together like a purse; for though in the act of copulation it is big enough to receive the glans of the yard, yet after conception, it is so close and shut, that it will not admit the point of a bodkin to enter; and yet again, at the time of a woman's delivery, it is opened to such an extraordinary degree, that the child passeth through it into the world; at which time this orifice wholly disappears, and the womb seems to have but one great cavity from the bottom to the entrance of the neck. When a woman is not with child, it is a little oblong, and of substance very thick and close; but when she is with child it is shortened, and its thickness diminished proportionably to its distension; and therefore it is a mistake of anatomists who affirm, that its substance waxeth thicker a little before a woman's labour; for any one's reason will inform him, that the more distended it is, the thinner it must be; and the nearer a woman is to the time of her delivery the shorter her womb must be extended. As to the action by which this inward orifice of the womb is opened and shut, it is purely natural; for were it otherwise, there could not be so many bastards begotten as there are, nor would any married women have so many children. Were it in their own power they would hinder conception, though they would be willing enough to use copulation; for nature has attended that action with so pleasing and delightful sensations, that they are willing to indulge themselves in the use thereof notwithstanding the pains they afterwards endure, and the hazard of their lives that often follows it. And this comes to pass, not so much from an inordinate lust in woman, as that the great Director of Nature, for the increase and multiplication of mankind, and even all other species in the elementary world, hath placed such a magnetic virtue in the womb, that it draws the seed to it, as the loadstone draws iron.

The Author of Nature has placed the womb in the belly, that the heat might always be maintained by the warmth of the parts surrounding it; it is, therefore, seated in the middle of the hypogastrium (or lower parts of the belly between the bladder and the belly, or right gut) by which also it is defended from any hurt through the hardness of the bones, and it is placed in the lower part of the belly for the convenience of copulation, and of a birth being thrust out at full time.

It is of a figure almost round, inclining somewhat to an oblong, in part resembling a pear; for being broad at the bottom, it gradually terminates in the point of the orifice which is narrow.

The length, breadth and thickness of the womb differ according to the age and disposition of the body. For in virgins not ripe it is very small in all its dimensions, but in women whose terms flow in great quantities, and such as frequently use copulation, it is much larger, and if they have had children, it is larger in them than in such as have had none; but in women of a good stature and well shaped, it is (as I have said before), from the entry of the privy parts to the bottom of the womb usually about eight inches; but the length of the body of the womb alone, does not exceed three; the breadth thereof is near about the same, and of the thickness of the little finger, when the womb is not pregnant, but when the woman is with child, it becomes of a prodigious greatness, and the nearer she is to delivery, the more the womb is extended.

It is not without reason then, that nature (or the God of Nature) has made the womb of a membranous substance; for thereby it does the easier open to conceive, is gradually dilated by the growth of the foetus or young one, and is afterwards contracted or closed again, to thrust forth both it and the after-burden, and then to retire to its primitive seat. Hence also it is enabled to expel any noxious humours, which may sometimes happen to be contained within it.

Before I have done with the womb, which is the field of generation, and ought, therefore, to be the more particularly taken care of (for as the seeds of plants can produce no plants, nor sprig unless grown in ground proper to excite and awaken their vegetative virtue so likewise the seed of man, though potentially containing all the parts of the child, would never produce so admissible an effect, if it were not cast into that fruitful field of nature, the womb) I shall proceed to a more particular description of its parts, and the uses for which nature has designed them.

The womb, then, is composed of various similar parts, that is of membranes, veins, arteries and nerves. Its membranes are two and they compose the principal parts of the body, the outermost of which ariseth from the peritoneum or caul, and is very thin, without it is smooth, but within equal, that it may the better cleave to the womb, as it is fleshier and thicker than anything else we meet with within the body, when the woman is not pregnant, and is interwoven with all sorts of fibres or small strings that it may the better suffer the extension of the child, and the water caused during pregnancy, and also that it may the easier close again after delivery.

The veins and arteries proceed both from the hypogastric and the spermatic vessels, of which I shall speak by and by; all these are inserted and terminated in the proper membranes of the womb. The arteries supply it with food and nourishment, which being brought together in too great a quantity, sweats through the substance of it, and distils as it were a dew at the bottom of the cavity; from thence proceed the terms in ripe virgins, and the blood which nourisheth the embryo in breeding women. The branches which issue from the spermatic vessels, are inserted on each side of the bottom of the womb, and are much less than those which proceed from the hypogastrics, those being greater and bedewing the whole substance of it. There are some other small vessels, which arising the one from the other are conducted to the internal orifice, and by these, those that are pregnant purge away the superfluity of the terms when they happen to have more than is used in the nourishment of the infant: by which means nature has taken so much care of the womb, that during pregnancy it shall not be obliged to open itself for passing away those excrementitious humours, which, should it be forced to do, might often endanger abortion.

As touching the nerves, they proceed from the brain, which furnishes all the inner parts of the lower belly in them, which is the true reason it hath so great a sympathy with the stomach, which is likewise very considerably furnished from the same part; so that the womb cannot be afflicted with any pain, but that the stomach is immediately sensible thereof, which is the cause of those loathings or frequent vomitings which happen to it.

But beside all these parts which compose the womb, it has yet four ligaments, whose office it is, to keep it firm in its place, and prevent its constant agitation, by the continual motion of the intestines which surround it, two of which are above and two below. Those above are called the broad ligaments, because of their broad and membranous figure, and are nothing else but the production of the peritoneum which growing out of the sides of the loins towards the veins come to be inserted in the sides of the bottom of the womb, to hinder the body from bearing too much on the neck, and so from suffering a precipitation as will sometimes happen when the ligaments are too much relaxed; and do also contain the testicles, and as well, safely conduct the different vessels, as the ejaculatories, to the womb. The lowermost are called round ligaments, taking their origin from the side of the womb near the horn, from whence they pass the groin, together with the production of the peritoneum, which accompanies them through the rings of the oblique and transverse muscles of the belly, by which they divide themselves into many little branches resembling the foot of a goose, of which some are inserted into the os pubis, the rest are lost and confounded with the membranes which women and children feel in their thighs. These two ligaments are long, round and nervous, and pretty big in their beginning near the matrix, hollow in their rise, and all along the os pubis, where they are a little smaller and become flat, the better to be inserted in the manner aforesaid. It is by their means the womb is hindered from rising too high. Now, although the womb is held in its natural situation by means of these four ligaments, it has liberty enough to extend itself when pregnant, because they are very loose, and so easily yield to its distension. But besides these ligaments, which keep the womb, as it were, in a poise, yet it is fastened for greater security by its neck, both to the bladder and rectum, between which it is situated. Whence it comes to pass, that if at any time the womb be inflamed, it communicates the inflammation to the neighbouring part.

Its use or proper action in the work of generation, is to receive and retain the seed, and deduce from it power and action by its heat, for the generation of the infant; and it is, therefore, absolutely necessary for the conservation of the species. It also seems by accident to receive and expel the impurities of the whole body, as when women have abundance of whites, and to purge away, from time to time, the superfluity of the blood, as when a woman is not with child.



SECT. II.—Of the difference between the ancient and modern Physicians, touching the woman's contributing seed for the Formation of the Child.

Our modern anatomists and physicians are of different sentiments from the ancients touching the woman's contributing seed for the formation of the child, as well as the man; the ancients strongly affirming it, but our modern authors being generally of another judgment. I will not make myself a party to this controversy, but set down impartially, yet briefly, the arguments on each side, and leave the judicious reader to judge for himself.

Though it is apparent, say the ancients, that the seed of man is the principal efficient and beginning of action, motion and generation, yet the woman affords seed, and contributes to the procreation of the child, it is evident from hence, that the woman had seminal vessels, which had been given her in vain if she wanted seminal excretions; but since nature forms nothing in vain, it must be granted that they were formed for the use of the seed and procreation, and fixed in their proper places, to operate and contribute virtue and efficiency to the seed; and this, say they, is further proved from hence, that if women at years of maturity use not copulation to eject their seed, they often fall into strange diseases, as appears by young women and virgins, and also it appears that, women are never better pleased than when they are often satisfied this way, which argues, that the pleasure and delight, say they, is double in women to what it is in men, for as the delight of men in copulation consists chiefly in the emission of the seed, so women are delighted, both in the emission of their own and the reception of the man's.

But against this, all our modern authors affirm that the ancients are very erroneous, inasmuch as the testicles in women do not afford seed, but are two eggs, like those of a fowl or other creatures; neither have they any such offices as in men, but are indeed an ovarium, or receptacle for eggs, wherein these eggs are nourished, by the sanguinary vessels dispersed through them; and from hence one or more, as they are fecundated by the man's seed, are conveyed into the womb by the oviducts. And the truth of this, say they, is so plain, that if you boil them, the liquor shall have the same taste, colour and consistency with the taste of bird's eggs. And if it be objected that they have no shells, the answer is easy; for the eggs of fowls while they are in the ovary, nay, after they have fallen into the uterus, have no shell: and though they have one when they are laid, yet it is no more than a fence which nature has provided for them against outward injuries, they being hatched without the body, but those of women being hatched within the body have no need of any other fence than the womb to secure them.

They also further say, that there are in the generation of the foetus, or young ones, two principles, active and passive; the active is the man's seed elaborated in the testicles out of the arterial blood and animal spirits; the passive principle is the ovum or egg, impregnated by the man's seed; for to say that women have true seed, say they, is erroneous. But the manner of conception is this; the most spirituous part of the man's seed, in the act of copulation, reaching up to the ovarium or testicles of the woman (which contains divers eggs, sometimes fewer) impregnates one of them; which, being conveyed by the oviducts to the bottom of the womb, presently begins to swell bigger and bigger, and drinks in the moisture that is so plentifully sent hither, after the same manner that the seed in the ground suck the fertile moisture thereof, to make them sprout.

But, notwithstanding what is here urged by modern anatomists, there are some late writers of the opinion of the ancients, viz., that women both have, and emit seed in the act of copulation; and even women themselves take it ill to be thought merely passive in the act wherein they make such vigorous exertions; and positively affirm, that they are sensible of the emission of their seed in that action, and that in it a great part of the delight which they take in that act, consists. I shall not, therefore, go about to take away any of their happiness from them, but leave them in possession of their imaginary felicity.

Having thus laid the foundation of this work, I will now proceed to speak of conception, and of those things which are necessary to be observed by women from the time of their conception, to the time of their delivery.

* * * * *



CHAPTER II

Of Conception; what it is; how women are to order themselves after Conception.

SECTION I.—What Conception is, and the qualifications requisite thereto.

Conception is nothing but an action of the womb, by which the prolific seed is received and retained, that an infant may be engendered and formed out of it. There are two sorts of conception: the one according to nature, which is followed by the generation of the infant in the womb; the other false and wholly against nature, in which the seed changes into water, and produces only false conceptions, moles, or other strange matter. Now, there are three things principally necessary in order to a true conception, so that generation may follow, viz., without diversity of sex there can be no conception; for, though some will have a woman to be an animal that can engender of herself, it is a great mistake; there can be no conception without a man discharge his seed into the womb. What they allege of pullets laying eggs without a cock's treading them is nothing to the purpose, for those eggs should they be set under a hen, will never become chickens because they never received any prolific virtue from the male, which is absolutely necessary to this purpose, and is sufficient to convince us, that diversity of the sex is necessary even to those animals, as well as to the generation of man. But diversity of sex, though it be necessary to conception, yet it will not do alone; there must also be a congression of the different sexes; for diversity of sex would profit little if copulation did not follow. I confess I have heard of subtle women, who, to cover their sin and shame, have endeavoured to persuade some peasants that they were never touched by man to get them with child; and that one in particular pretended to conceive by going into a bath where a man had washed himself a little before and spent his seed in it, which was drawn and sucked into her womb, as she pretended. But such stories as these are only for such who know no better. Now that these different sexes should be obliged to come to the touch, which we call copulation or coition, besides the natural desire of begetting their like, which stirs up men and women to it, the parts appointed for generation are endowed by nature with a delightful and mutual itch, which begets in them a desire to the action; without which, it would not be very easy for a man, born for the contemplation of divine mysteries, to join himself, by the way of coition, to a woman, in regard to the uncleanness of the part and the action. And, on the other side, if the woman did but think of those pains and inconveniences to which they are subject by their great bellies, and those hazards of life itself, besides the unavoidable pains that attend their delivery, it is reasonable to believe they would be affrighted from it. But neither sex makes these reflections till after the action is over, considering nothing beforehand but the pleasure of the enjoyment, so that it is from this voluptuous itch that nature obliges both sexes to this congression. Upon which the third thing followeth of course, viz., the emission of seed into the womb in the act of copulation. For the woman having received this prolific seed into her womb, and retained it there, the womb thereupon becomes depressed, and embraces the seed so closely, that being closed the point of a needle cannot enter into it without violence. And now the woman may be said to have conceived, having reduced by her heat from power into action, the several faculties which are contained in the seed, making use of the spirits with which the seed abounds, and which are the instruments which begin to trace out the first lineaments of the parts, and which afterwards, by making use of the menstruous blood flowing to it, give it, in time, growth and final perfection. And thus much shall suffice to explain what conception is. I shall next proceed to show



SECT. II.—How a Woman ought to order herself after Conception.

My design in this treatise being brevity, I shall bring forward a little of what the learned have said of the causes of twins, and whether there be any such things as superfoetations, or a second conception in a woman (which is yet common enough), and as to twins, I shall have occasion to speak of them when I come to show you how the midwife ought to proceed in the delivery of the women that are pregnant with them. But having already spoken of conception, I think it now necessary to show how such as have conceived ought to order themselves during their pregnancy, that they may avoid those inconveniences, which often endanger the life of the child and many times their own.

A woman, after conception, during the time of her being with child, ought to be looked upon as indisposed or sick, though in good health; for child bearing is a kind of nine months' sickness, being all that time in expectation of many inconveniences which such a condition usually causes to those that are not well governed during that time; and therefore, ought to resemble a good pilot, who, when sailing on a rough sea and full of rocks, avoids and shuns the danger, if he steers with prudence, but if not, it is a thousand to one but he suffers shipwreck. In like manner, a woman with child is often in danger of miscarrying and losing her life, if she is not very careful to prevent those accidents to which she is subject all the time of her pregnancy. All which time her care must be double, first of herself, and secondly of the child she goes with for otherwise, a single error may produce a double mischief; for if she receives a prejudice, the child also suffers with her. Let a woman, therefore, after conception, observe a good diet, suitable to her temperament, custom, condition and quality; and if she can, let the air where she ordinarily dwells be clear and well tempered, and free from extremes, either of heat or cold; for being too hot, it dissipateth the spirits too much and causes many weaknesses; and by being too cold and foggy, it may bring down rheums and distillations on the lungs, and so cause her to cough, which, by its impetuous motion, forcing downwards, may make her miscarry. She ought alway to avoid all nauseous and ill smells; for sometimes the stench of a candle, not well put out, may cause her to come before time; and I have known the smell of charcoal to have the same effect. Let her also avoid smelling of rue, mint, pennyroyal, castor, brimstone, etc.

But, with respect to their diet, women with child have generally so great loathings and so many different longings, that it is very difficult to prescribe an exact diet for them. Only this I think advisable, that they may use those meats and drinks which are to them most desirable, though, perhaps, not in themselves so wholesome as some others, and, it may be not so pleasant; but this liberty must be made use of with this caution, that what they desire be not in itself unwholesome; and also that in everything they take care of excess. But, if a child-bearing woman finds herself not troubled with such longings as we have spoken of, let her take simple food, and in such quantity as may be sufficient for herself and the child, which her appetite may in a great measure regulate; for it is alike hurtful to her to fast too long as to eat too much; and therefore, rather let her eat a little and often; especially let her avoid eating too much at night, because the stomach being too much filled, compresseth the diaphragm, and thereby causeth difficulty of breathing. Let her meat be easy of digestion, such as the tenderest parts of beef, mutton, veal, fowls, pullets, capons, pigeons and partridges, either boiled or roasted, as she likes best, new laid eggs are also very good for her; and let her put into her broth those herbs that purify it, as sorrel, lettuce, succory and borage; for they will purge and purify the blood. Let her avoid whatever is hot seasoned, especially pies and baked meats, which being of hot digestion, overcharge the stomach. If she desire fish let it be fresh, and such as is taken out of rivers and running streams. Let her eat quinces and marmalade, to strengthen her child: for which purpose sweet almonds, honey, sweet apples, and full ripe grapes, are also good. Let her abstain from all salt, sour, bitter and salt things, and all things that tend to provoke the terms—such as garlic, onions, mustard, fennel, pepper and all spices except cinnamon, which in the last three months is good for her. If at first her diet be sparing, as she increases in bigness, let her diet be increased, for she ought to consider that she has a child as well as herself to nourish. Let her be moderate in her drinking; and if she drinks wine, let it be rather claret than white (for it will breed good blood, help the digestion, and comfort the stomach, which is weakly during pregnancy); but white wine being diuretic, or that which provokes urine, ought to be avoided. Let her be careful not to take too much exercise, and let her avoid dancing, riding in a coach, or whatever else puts the body into violent motion, especially in the first month. But to be more particular, I shall here set down rules proper for every month for the child-bearing woman to order herself, from the time she first conceived, to the time of her delivery.



Rules for the First Two Months.

As soon as a woman knows, or has reason to believe, that she has conceived, she ought to abstain from all violent motions and exercise; whether she walks afoot, or rides on horseback or in a coach, it ought to be very gently. Let her also abstain from Venery (for which, after conception, she has usually no great inclination), lest there be a mole or superfoetation, which is the adding of one embryo to another. Let her beware not to lift her arms too high, nor carry great burdens, nor repose herself on hard and uneasy seats. Let her use moderately good, juicy meat and easy of digestion, and let her wines be neither too strong nor too sharp, but a little mingled with water; or if she be very abstemious, she may use water wherein cinnamon has been boiled. Let her avoid fastings, thirst, watchings, mourning, sadness, anger, and all other perturbations of the mind. Let no one present any strange or unwholesome thing to her, nor so much as name it, lest she should desire it and not be able to get it, and so either cause her to miscarry, or the child to have some deformity on that account. Let her belly be kept loose with prunes, raisins or manna in her broth, and let her use the following electuary, to strengthen the womb and the child—

"Take conserve of borage, buglos and roses, each two ounces; an ounce of balm; an ounce each of citron peel and shreds, candied mirobalans, an ounce each; extract of wood aloes a scruple; prepared pearl, half a drachm; red coral and ivory, of each a drachm; precious stones each a scruple; candied nutmegs, two drachms, and with syrup of apples and quinces make an electuary."



Let her observe the following rules.

"Take pearls prepared, a drachm; red coral and ivory prepared, each half a drachm, precious stones, each a scruple; yellow citron peel, mace, cinnamon, cloves, each half a drachm; saffron, a scruple; wood aloes, half a scruple; ambergris, six drachms; and with six ounces of sugar dissolved in rosewater make rolls." Let her also apply strengtheners of nutmeg, mace and mastich made up in bags, to the navel, or a toast dipped in malmsey, or sprinkled with powdered mint. If she happens to desire clay, chalk, or coals (as many women with child do), give her beans boiled with sugar, and if she happens to long for anything that she cannot obtain, let her presently drink a large draught of pure cold water.



Rules for the Third Month.

In this month and the next, be sure to keep from bleeding; for though it may be safe and proper at other times, yet it will not be so at the end of the fourth month; and yet if blood abound, or some incidental disease happens which requires evacuation, you may use a cupping glass, with scarification, and a little blood may be drawn from the shoulders and arms, especially if she has been accustomed to bleed. Let her also take care of lacing herself too straitly, but give herself more liberty than she used to do; for inclosing her belly in too strait a mould, she hinders the infant from taking its free growth, and often makes it come before its time.



Rules for the Fourth Month.

In this month also you ought to keep the child-bearing woman from bleeding, unless in extraordinary cases, but when the month is passed, blood-letting and physic may be permitted, if it be gentle and mild, and perhaps it may be necessary to prevent abortion. In this month she may purge, in an acute disease, but purging may only be used from the beginning of this month to the end of the sixth; but let her take care that in purging she use no vehement medicine, nor any bitter, as aloes, which is disagreeable and hurtful to the child, and opens the mouth of the vessels; neither let her use coloquintida, scammony nor turbith; she may use cassia, manna, rhubarb, agaric and senna but dyacidodium purgans is best, with a little of the electuary of the juice of roses.



Rules for the Fifth, Sixth and Seventh Months.

In these months, child-bearing women are troubled with coughs, colds, heart-beating, fainting, watching, pains in the loins and hips, and bleeding. The cough is from a sharp vapour that comes to the jaws and rough artery from the terms, or the thin part of that blood got less into the reins of the breast; this endangers abortion, and strength fails from watching: therefore, purge the humours that come to the breast, with rhubarb and agaric, and strengthen the head as in a catarrh, and give sweet lenitives as in a cough. Palpitation and faintness arises from vapours that go to it by the arteries, or from blood that abounds and cannot get out of the womb, but ascends and oppresses the heart; and in this case cordials should be used both inwardly and outwardly. Watching, is from sharp dry vapours that trouble the animal spirits, and in this case use frictions, and let the woman wash her feet at bed-time, and let her take syrup of poppies, dried roses, emulsions of sweet almonds, and white poppy seed. If she be troubled with pains in her loins and hips, as in those months she is subject to be, from the weight of her child as it grows big and heavy, and so stretches the ligaments of the womb and part adjacent, let her hold it up with swathing bands about her neck. About this time also the woman often happens to have a flux of blood, either at the nose, womb or haemorrhoids, from plenty of blood, or from the weakness of the child that takes it not in, or else from evil humour in the blood, that stirs up nature and sends it forth. And sometimes it happens that the vessels of the womb may be broken, either by some violent motion, fall, cough or trouble of the mind (for any of these will work that effect), and this is so dangerous, that in such a case the child cannot be well, but if it be from blood only, the danger is less, provided it flows by the veins of the neck of the womb, for then it prevents plethora and takes not away the nourishment of the child; but if it proceeds from the weakness of the child, that draws it not in, abortion of the child often follows, or hard travail, or else she goes beyond her time. But if it flows from the inward veins of the womb, there is more danger by the openness of the womb, if it come from evil blood; the danger is alike from cacochymy, which is like to fall upon both. If it arises from plethora, open a vein, but with great caution, and use astringents, of which the following will do well:—Take prepared pearls, a scruple; red coral, two scruples; mace, nutmeg, each a drachm; cinnamon, half a drachm; make a powder, or with white sugar make rolls. Or give this powder in broth:—"Take red coral, a drachm; half a drachm precious stones; red sander, half a drachm; bole, a drachm; scaled earth and tormental roots, each two scruples, with sugar of roses and Manus Christi; with pearl, five drachms; make a powder." You may also strengthen the child at the navel, and if there be a cacochymy, alter the humours, and if you can do it safely, evacuate; you may likewise use amulets on her hands and about her neck. In a flux of haemorrhoids, wear off the pain, and let her drink hot wine with a toasted nutmeg. In these months the belly is also subject to be bound, but if it be without any apparent disease, the broth of a chicken or veal, sodden with oil, or with the decoction of mallows or marsh-mallows, mercury or linseed, put up in a clyster, will not be amiss, but in less quantity than is given in other cases:—viz. of the decoction, five ounces, of common oil, three ounces, of sugar, two ounces, and of cassia fistula, one ounce. But if she will not take a clyster, one or two yolks of new laid eggs, or a little peas-pottage warm, a little salt and sugar, and supped a little before meat, will be very convenient. But if her belly be distended and stretched with wind a little fennel seed and aniseed reduced to a powder and mixed with honey and sugar made after the manner of an electuary, will be very well Also, if thighs and feet swell let them be anointed with erphodrinum (which is a liquid medicine) made with vinegar and rose-water, mingled with salt.



Rules for the Eighth Month.

The eighth month is commonly called the most dangerous; therefore the greatest care and caution ought to be used, the diet better in quality, but no more, nor indeed, so much in quantity as before, but as she must abate her diet, she must increase her exercise; and because then women with child, by reason that sharp humours alter the belly, are accustomed to weaken their spirits and strength, they may well take before meat, an electuary of diarrhoden, or aromaticum rosatum or diamagarton; and sometimes they may lick a little honey. As they will loathe, nauseate their meat, they may take green ginger, candied with sugar, and the rinds of citron and oranges candied; and let them often use honey for strengthening the infant. When she is not very far from her labour, let her eat every day seven roasted figs before her meat, and sometimes let her lick a little honey. But let her beware of salt and powdered meat, for it is neither good for her nor the child.



Rules for the Ninth Month.

In the ninth month let her have a care of lifting any great weight, but let her move a little more, to dilate the parts, and stir up natural heat. Let her take heed of stooping, and neither sit too much nor lie on her sides, neither ought she to bend herself much enfolded in the umbilical ligaments, by which means it often perisheth. Let her walk and stir often, and let her exercise be, rather to go upwards than downwards. Let her diet, now especially, be light and easy of digestion and damask prunes with sugar, or figs with raisins, before meat, as also the yolks of eggs, flesh and broth of chickens, birds, partridges and pheasants; astringent and roasted meats, with rice, hard eggs, millet and such like other things are proper. Baths of sweet water, with emollient herbs, ought to be used by her this month with some intermission, and after the baths let her belly be anointed with oil of sweet roses and of violets; but for her privy parts, it is better to anoint them with the fat of hens, geese or ducks, or with oil of lilies, and the decoction of linseed and fenugreek, boiled with oil of linseed and marshmallows, or with the following liniment:—

Take mallows and marshmallows, cut and shred, of each one ounce; of linseed, one ounce; let them be boiled from twenty ounces of water to ten; then let her take three ounces of the boiled broth, of oil of almonds and oil of flower-de-luce, of each one ounce; of deer's suet, three ounces. Let her bathe with this, and anoint herself with it, warm.

If for fourteen days before the birth, she do every morning and evening bathe and moisten her belly with muscadine and lavender water, the child will be much strengthened thereby. And if every day she eat toasted bread, it will hinder anything from growing to the child. Her privy parts must be gently stroked down with this fomentation.

"Take three ounces of linseed, and one handful each of mallows and marshmallows sliced, then let them be put into a bag and immediately boiled." Let the woman with child, every morning and evening, take the vapour of this decoction in a hollow stool, taking great heed that no wind or air come to her in-parts, and then let her wipe the part so anointed with a linen cloth, and she may anoint the belly and groins as at first.

When she has come so near to her time, as to be ten or fourteen days thereof, if she begins to feel any more than ordinary pain let her use every day the following:—"Take mallows and marshmallows, of each a handful; camomiles, hard mercury, maidenhair, of each a handful; of linseed, four ounces; let them be boiled in a sufficient quantity of water as to make a bath therewith." But let her not sit too hot upon the seat, nor higher than a little above her navel; nor let her sit upon it longer than about half an hour, lest her strength languish and decay, for it is better to use it often than to stay too long in it.

And thus have I shown how a child-bearing woman ought to govern herself each month during her pregnancy. How she must order herself at her delivery, shall be shown in another chapter, after I have first shown the intended midwife how the child is first formed in the womb, and the manner of its decumbiture there.

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CHAPTER III

Of the Parts proper to a Child in the womb; How it is formed there, and the manner of its Situation therein.

In the last chapter I treated of conception, showed what it was, how accomplished and its signs, and how she who has conceived ought to order herself during the time of her pregnancy. Now, before I come to speak of her delivery, it is necessary that the midwife be first made acquainted with the parts proper to a child in the womb, and also that she be shown how it is formed, and the manner of its situation and decumbiture there; which are so necessary to her, that without the knowledge thereof, no one can tell how to deliver a woman as she ought. This, therefore, shall be the work of this chapter. I shall begin with the first of these.



SECTION I.—Of the Parts proper to a Child in the Womb.

In this section, I must first tell you what I mean by the parts proper to a child in the womb; and they are only those that either help or nourish it; and whilst it is lodged in that dark repository of nature, and that help to clothe and defend it there and are cast away, as of no more use, after it is born, and these are two, viz., the umbilicars, or navel vessels, and the secundinum. By the first it is nourished, and by the second clothed and defended from wrong. Of each of these I shall speak distinctly; and first,



Of the Umbilicars, or Navel Vessels.

These are four in number, viz.:—one vein, two arteries, and the vessel which is called the urachos.

(1) The vein is that on which the infant is nourished, from the time of its conception till the time of its delivery; till being brought into the light of the world, it has the same way of concocting the food we have. This vein ariseth from the liver of the child, and is divided into two parts when it has passed the navel; and these two are divided and subdivided, the branches being upheld by the skin called chorion (of which I speak by and by), and are joined to the veins of the mother's womb, from whence they have their blood for the nourishment of the child.

(2) The arteries are two on each side which proceed from the back branches of the great artery of the mother, and the vital blood is carried by those to the child being ready concocted by the mother.

(3) A nervous or sinewy production is led from the bottom of the bladder of the infant to the navel, and this is called urachos, and its use is, to convey the urine of the infant from the bladder to the alantois. Anatomists do very much vary in their opinion concerning this, some denying any such thing to be in the delivery of the woman, and others on the contrary affirming it; but experience has testified there is such a thing, for Bartholomew Carbrolius, the ordinary doctor of anatomy to the College of Physicians at Montpellier in France, records the history of a maid, whose water being a long time stopped, at last issued out through the navel. And Johannes Fernelius speaks of the same thing that happened to a man of thirty years of age, who having a stoppage at the neck of the bladder, his urine issued out of his navel for many months together, and that without any prejudice at all to his health, which he ascribes to the ill lying of his navel, whereby the urachos was not well dried. And Volchier Coitas quotes such another instance in a maid of thirty-four at Nuremburg in Germany. These instances, though they happen but seldom, are sufficient to prove that there is such a thing as anurachos in men.

These four vessels before mentioned, viz., one vein, two arteries and the urachos, join near the navel, and are united by a skin which they have from the chorion and so become like a gut or rope, and are altogether void of sensibility, and this is that which women call the navel-string. The vessels are thus joined together, that so they may neither be broken, severed nor entangled; and when the infant is born are of no use save only to make up the ligament which stops the hole of the navel and for some other physical use, etc.



Of the Secundine or After-birth.

Setting aside the name given to this by the Greeks and Latins, it is called in English by the name of secundine, after-birth or after-burden; which are held to be four in number.

(1) The first is called placenta, because it resembles the form of a cake, and is knit both to the navel and chorion, and makes up the greatest part of the secundine or after-birth. The flesh of it is like that of the melt or spleen, soft, red and tending something to blackness, and hath many small veins and arteries in it: and certainly the chief use of it is, for containing the child in the womb.

(2) The second is the chorion. This skin and that called the amnios, involve the child round, both above and underneath, and on both sides, which the alantois does not. This skin is that which is most commonly called the secundine, as it is thick and white garnished with many small veins and arteries, ending in the placenta before named, being very light and slippery. Its use is, not only to cover the child round about, but also to receive, and safely bind up the roots of the veins and arteries or navel vessels before described.

(3) The third thing which makes up the secundine in the alantois, of which there is a great dispute amongst anatomists. Some say there is such a thing, and others that there is not. Those who will have it to be a membrane, say it is white, soft and exceedingly thin, and just under the placenta, where it is knit to the urachos, from which it receives the urine; and its office is to keep it separate from the sweat, that the saltness of it may not offend the tender skin of the child.

(4) The fourth, and last covering of the child is called amnios; and it is white, soft and transparent, being nourished by some very small veins and arteries. Its use is, not only to enwrap the child, but also to retain the sweat of the child.

Having thus described the parts proper to a child in the womb, I will next proceed to speak of the formation of the child therein, as soon as I have explained the hard terms of the section, that those for whose help it is designed, may understand what they read. A vein is that which receives blood from the liver, and distributes in several branches to all parts of the body. Nerve is the same with sinew, and is that by which the brain adds sense and motion to the body. Placenta, properly signifies sugar cake; but in this section it is used to signify a spongy piece of flesh resembling a cake, full of veins and arteries, and is made to receive a mother's blood appointed for the infant's nourishment in the womb. The chorion is an outward skin which compasseth the child in the womb. The amnios is the inner skin which compasseth the child in the womb. The alantois is the skin that holds the urine of the child during the time that it abides in the womb. The urachos is the vessel that conveys the urine from the child in the womb to the alantois. I now proceed to



SECT. II.—Of the Formation of the Child in the Womb.

To speak of the formation of the child in the womb, we must begin where nature begins, and, that is at the act of coition, in which the womb having received the generative seed (without which there can be no conception), the womb immediately shuts up itself so close that the point of a needle cannot enter the inward orifice; and this it does, partly to hinder the issuing out of the seed again, and partly to cherish it by an inward heat, the better to provoke it to action; which is one reason why women's bellies are so lank at their first conception. The woman having thus conceived, the first thing which is operative in conception is the spirit whereof the seed is full, which, nature quickening by the heat of the womb, stirs up the action. The internal spirits, therefore, separate the parts that are less pure, which are thick, cold and clammy, from those that are more pure and noble. The less pure are cast to the outside, and with these seed is circled round and the membrane made, in which that seed that is most pure is wrapped round and kept close together, that it may be defended from cold and other accidents, and operate the better.

The first thing that is formed is the amnios; the next the chorion; and they enwrap the seed round like a curtain. Soon after this (for the seed thus shut up in the woman lies not idle), the navel vein is bred, which pierceth those skins, being yet very tender, and carries a drop of blood from the veins of the mother's womb to the seed; from which drop the vena cava, or chief vein, proceeds, from which all the rest of the veins which nourish the body spring; and now the seed hath something to nourish it, whilst it performs the rest of nature's work, and also blood administered to every part of it, to form flesh.

This vein being formed, the navel arteries are soon after formed; then the great artery, of which all the others are but branches; and then the heart, for the liver furnisheth the arteries with blood to form the heart, the arteries being made of seed, but the heart and the flesh, of blood. After this the brain is formed, and then the nerves to give sense and motion to the infant. Afterwards the bones and flesh are formed; and of the bones, first of all, the vertebrae or chine bones, and then the skull, etc. As to the time in which this curious part of nature's workmanship is formed, having already in Chapter II of the former part of this work spoken at large upon this point, and also of the nourishment of the child in the womb, I shall here only refer the reader thereto, and proceed to show the manner in which the child lies in the womb.



SECT. III.—Of the manner of the Child's lying in the Womb.

This is a thing so essential for a midwife to know, that she can be no midwife who is ignorant of it; and yet even about this authors extremely differ; for there are not two in ten that agree what is the form that the child lies in the womb, or in what fashion it lies there; and yet this may arise in a great measure from the different times of the women's pregnancy; for near the time of its deliverance out of those winding chambers of nature it oftentimes changes the form in which it lay before, for another.

I will now show the several situations of the child in the mother's womb, according to the different times of pregnancy, by which those that are contrary to nature, and are the chief cause of ill labours, will be more easily conceived by the understanding midwife. It ought, therefore, in the first place to be observed, that the infant, as well male as female, is generally situated in the midst of the womb; for though sometimes, to appearance a woman's belly seems higher on one side than the other, yet it is so with respect to the belly only, and not to her womb, in the midst of which it is always placed.

But, in the second place, a woman's great belly makes different figures, according to the different times of pregnancy; for when she is young with child, the embryo is always found of a round figure, a little long, a little oblong, having the spine moderately turned inwards, and the thighs folded, and a little raised, to which the legs are so raised, that the heels touch the buttocks; the arms are bending, and the hands placed upon the knees, towards which part of the body, the head is turned downwards towards the inward orifice of the womb, tumbling as it were over its head so that then the feet are uppermost, and the face towards the mother's great gut; and this turning of the infant in this manner, with its head downwards, towards the latter end of a woman's reckoning, is so ordered by nature, that it may be thereby the better disposed of its passage into the world at the time of its mother's labour, which is not then far off (and indeed some children turn not at all until the very time of birth); for in this posture all its joints are most easily extended in coming forth; for by this means its arms and legs cannot hinder its birth, because they cannot be bent against the inner orifice of the womb and the rest of the body, being very supple, passeth without any difficulty after the head, which is hard and big; being passed the head is inclined forward, so that the chin toucheth the breast, in which posture, it resembles one sitting to ease nature, and stooping down with the head to see what comes from him. The spine of the back is at that time placed towards the mother's, the head uppermost, the face downwards; and proportionately to its growth, it extends its members by little and little, which were exactly folded in the first month. In this posture it usually keeps until the seventh or eighth month, and then by a natural propensity and disposition of the upper first. It is true there are divers children, that lie in the womb in another posture, and come to birth with their feet downwards, especially if there be twins; for then, by their different motions they do so disturb one another, that they seldom come both in the same posture at the time of labour, but one will come with the head, and another with the feet, or perhaps lie across; but sometimes neither of them will come right. But, however the child may be situated in the womb, or in whatever posture it presents itself at the time of birth, if it be not with its head forwards, as I have before described, it is always against nature, and the delivery will occasion the more pain and danger, and require greater care and skill from the midwife, than when the labour is more natural.

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CHAPTER IV

A Guide for Women in Travail, showing what is to be done when they fall in Labour, in order to their Delivery.

The end of all that we have been treating of is, the bringing forth of a child into the world with safety both to the mother and the infant, as the whole time of a woman's pregnancy may be termed a kind of labour; for, from the time of the conception to the time of her delivery, she labours under many difficulties, is subject to many distempers, and in continual danger, from one affection or other, till the time of birth comes; and when that comes, the greatest labour and travail come along with it, insomuch that then all the other labours are forgotten, and that only is called the time of her labours, and to deliver her safely is the principal business of the midwife; and to assist therein, shall be the chief design of this chapter. The time of the child's being ready for its birth, when nature endeavours to cast it forth, is that which is properly the time of a woman's labour; nature then labouring to be eased of its burden. And since many child-bearing women, (especially the first child) are often mistaken in their reckoning and so, when they draw near their time take every pain they meet with for their labour, which often proves prejudicial and troublesome to them, when it is not so, I will in the first section of this chapter, set down some signs, by which a woman may know when the true time of her labour is come.



SECTION I.—The Signs of the true Time of a Woman's Labour.

When women with child, especially of their first, perceive any extraordinary pains in the belly, they immediately send for their midwife, as taking it for their labour; and then if the midwife be not a skilful and experienced woman, to know the time of labour, but takes it for granted without further inquiry (for some such there are), and so goes about to put her into labour before nature is prepared for it, she may endanger the life of both mother and child, by breaking the amnios and chorion. These pains, which are often mistaken for labour, are removed by warm clothes laid to the belly, and the application of a clyster or two, by which those pains which precede a true labour, are rather furthered than hindered. There are also other pains incident to a woman in that condition from the flux of the belly, which are easily known by the frequent stools that follow them.

The signs, therefore, of labour, some few days before, are that the woman's belly, which before lay high, sinks down, and hinders her from walking so easily as she used to do; also there flow from the womb slimy humours, which nature has appointed to moisten and smooth the passage that its inward orifice may be the more easily dilated when there is occasion; which beginning to open at this time, suffers that slime to flow away, which proceeds from the Glandules called prostata. These are signs preceding the labour; but when she is presently falling into labour, the signs are, great pains about the region of the reins and loins, which coming and retreating by intervals, are answered in the bottom of the belly by congruous throes, and sometimes the face is red and inflamed, the blood being much heated by the endeavours a woman makes to bring forth her child; and likewise, because during these strong throes her respiration is intercepted, which causes the blood to have recourse to her face; also her privy parts are swelled by the infant's head lying in the birth, which, by often thrusting, causes those parts to descend outwards. She is much subject to vomiting, which is a good sign of good labour and speedy delivery, though by ignorant people thought otherwise; for good pains are thereby excited and redoubled; which vomiting is excited by the sympathy there is between the womb and the stomach. Also, when the birth is near, women are troubled with a trembling in the thighs and legs, not with cold, like the beginning of an ague fit, but with the heat of the whole body, though it must be granted, this does not happen always. Also, if the humours which then flow from the womb are discoloured with the blood, which the midwives call shows, it is an infallible mark of the birth being near. And if then the midwife puts up her fingers into the neck of the womb, she will find the inner orifice dilated; at the opening of which the membranes of the infant, containing the waters, present themselves and are strongly forced down with each pain she hath; at which time one may perceive them sometimes to resist, and then again press forward the finger, being more or less hard and extended, according as the pains are stronger or weaker. These membranes, with the waters in them, when they are before the head of the child, midwives call the gathering of the waters, resemble to the touch of the fingers those eggs which have no shell, but are covered only with a simple membrane. After this, the pains still redoubling the membranes are broken by a strong impulsation of these waters, which flow away, and then the head of the infant is presently felt naked, and presents itself at the inward orifice of the womb. When these waters come thus away, then the midwife may be assured the birth is very near, this being the most certain sign that can be; for the amnios alantois, which contained these waters, being broken by the pressing forward of the birth, the child is no better able to subsist long in the womb afterwards than a naked man in a heap of snow. Now, these waters, if the child comes presently after them, facilitate the labour by making the passage slippery; and therefore, let no midwife (as some have foolishly done) endeavour to force away the water, for nature knows best when the true time of birth is, and therefore retains the waters till that time. But if by accident the water breaks away too long before the birth, then such things as will hasten it, may be safely administered, and what these are, I will show in another section.